When Strategic Approaches get Stuck: Maps out of the Mire

Using a biopsychosocial model, a three dimensional map provides guidelines for changing from strategic therapy when progress in this approach falters. The method is pragmatic and atheoretical, and brings together ideas from various schools which empirically have been found useful. Practical and inclusive guidelines are offered for family (and individual) therapy which address two important issues: reinforcement of change when progress is occurring, and a shift from an interactional to another dimension when stuck points are reached. The multi-dimensional approach is clear, can be used by individuals or teams, lends itself to teaching and is of particular value for entrenched and complex problems. Four case histories are presented to highlight the approach.     

Employment and the Risk of Domestic Abuse Among Low‐Income Women

This paper uses data from 2 randomized evaluations of welfare‐to‐work programs—the Minnesota Family Investment Program and the National Evaluation of Welfare‐to‐Work Strategies—to estimate the effect of employment on domestic abuse among low‐income single mothers. Unique to our analysis is the application of a 2‐stage least squares method, in which random assignment enables us to control for omitted characteristics that might otherwise confound the association between employment and domestic abuse. We find that increased maternal employment decreases subsequent reports of domestic abuse in both studies. In the Minnesota Family Investment Program—a program with an enhanced income disregard that allowed welfare mothers to keep a portion of their welfare income as earnings rose—an increase in household incomes appears to have contributed to reductions in reports of domestic abuse.     

Developmental Outcomes for Children of Young Mothers

This study tested the association between mother’s early age at first birth and various life outcomes for her children in later adolescence and early adulthood. Data were analyzed from the Rochester Youth Development Study, an ongoing panel study of adolescents enrolled in seventh or eighth grade in Rochester Public Schools in 1988 (N =729). Boys born to mothers who began childbearing before age 19 had elevated risks of drug use, gang membership, unemployment, and early parenthood. Girls born to young mothers only had elevated risks of early parenthood. Of the mediators tested, low maternal education had the largest mediating effects. The findings suggest that the risks associated with being born to a young mother are substantial but perhaps disproportionately so for boys.     

Multinomial and conditional logit discrete-choice models in demography

Although discrete-choice statistical techniques have been used with increasing regularity in demographic analyses, McFadden's conditional logit model is less well known and seldom used. Conditional logit models are appropriate when the choice among alternatives is modeled as a function of the characteristics of the alternatives, rather than (or in addition to) the characteristics of the individual making the choice. We argue that this feature of conditional logit makes it more appropriate for estimating behavioral models. In this article, the conditional logit model is presented and compared with the more familiar multinomial logit model. The difference between the two techniques is illustrated with an analysis of the choice of marital and welfare status by divorced or separated women.     

Foster Parents and Long-Term Placements: Key Findings from a Northern Ireland Study

SUMMARY: This article draws on the findings of a recent Northern Ireland Study on planned long-term foster care placements which it sets in both an all Ireland and a UK context. The article focuses on the aspirations and experiences of what the study found to be a very traditional group of foster parents. The article also identifies and discusses the implications of this type of foster carer for the development of the service.     

Severe self-neglect: an epidemiological and historical perspective

Older adults with severe self-neglect have multiple deficits in various social, functional and physical domains, and often live insqualor. These individuals often present with poor personal hygiene, domestic squalor and hoarding which results in a threat to their own health as well as personal and public safety. Severe self-neglect occurs along a continuum with older adults often having cognitive and affective disorders compared with younger individuals presenting with psychiatric illnesses. In cases of severe self-neglect with hoarding, evidence has shown this behavior occurs in diverse social strata and not among the wealthy and professionals alone as believed earlier. Due to the multiple conditions associated with severe self-neglect, this population will require an interdisciplinary, multidimensional approach to reduce morbidity and mortality rates including nursing home placement. Research on this group has been limited and is rarely described in the medical and nursing literature. Future research is needed to provide practitioners with effective screening instruments and interventions on cases of severe self-neglect.     

The importance of cross‐disciplinary scientific engagement in the development of quantitative procedures for aggregate safety assessments

Recent guidance on safety monitoring during drug development, issued by regulatory authorities in the United States and European Union, indicate a shift in focus towards aggregate safety monitoring and scientific evaluation of integrated safety data. The call for program‐level reviews of accumulating safety data, including from ongoing studies, provides an opportunity to leverage the scientific expertise and medical judgment of safety management teams with (a) a multidisciplinary approach, (b) quantitative frameworks to measure level of evidence, and (c) assessments that are product‐specific and driven by medical judgment. A multidisciplinary team, regularly reviewing aggregate safety data throughout the development program, is vital not only for early signal detection but also for generating a better understanding of the accumulating data and context needed for decreasing false alarms.     

Compulsory income management: Combatting or compounding the underlying causes of homelessness?

Compulsory Income Management (CIM) is a form of conditional welfare that involves the mandatory quarantining of a portion of welfare recipients’ social security payments. Quarantined funds are accessible via a government-issued debit card, with restrictions surrounding where and on what funds can be spent. Official justifications of CIM have framed these policies as attempts to combat substance abuse and gambling problems, and to thus secure better outcomes for welfare recipients and their families. Central to this narrative has been the argument that welfare quarantining will ensure more money is spent on ‘essentials’, including accommodation. No existing studies, however, have specifically interrogated the impacts of CIM on housing security. This article responds to this gap in the literature by reviewing existing research concerning CIM's impacts and locating this research within broader debates regarding the causes of homelessness and the efficacy of individualised policy interventions. In doing so, it highlights CIM's potential to exacerbate housing insecurity not only through technical issues such as rental transfer failures, but also by contributing to underlying stressors such as economic disadvantage; relationship difficulties, poor health and addiction; and social stigma. The article concludes that – far from addressing the structural causes of homelessness – CIM has enflamed them.