EFFICACY OF FAMILY THERAPY FOR DRUG ABUSE: PROMISING BUT NOT DEFINITIVE

Drug abuse is an enormous public health problem with consequences not only for individuals using drugs but also for families, communities, and society. Moreover, research evidence and clinical experience agree that drug abuse is one of the more difficult problems to treat. Despite considerable research on the connection between family factors and drug use, and the existence of family therapy models for drug abuse, comparatively few controlled efficacy studies have been conducted. This article presents a critical review of controlled treatment outcome research in the area of family therapy for drug abuse in both adults and adolescents. A number of studies from different clinical research groups demonstrate that different versions of family intevention can engage and retain drug users and their families in treatment, significantly reduce drug use and other related problem behaviors, and enhace particular domains of prosocial functioning. Moreover, a smaller number of comparative efficacy studies have shown family therapy to be more effective than nonfamily therapies. Family therapy of adolescent drug abuse is more developed at present than family therapy of adult drug abuse. Although the results of the reviewed studies are promising, a blanket confirmation of family therapy's efficacy for drug abuse cannot be made at this time because of the relatively small number of studies and the noted methodological limitations of the studies published to date. Nonetheless, substantial progress in this clinical research area has occurred, and if research and funding support continue or can expand, significant breakthroughs in the treamtment of drug abuse with family-based treatments are possible.     

INTERVENTION PLANNING FOR THE FAMILY OF THE AUTISTIC CHILD: A MULTILEVEL ASSESSMENT OF THE FAMILY SYSTEM*

The clinician working with the family of an autistic child may need to assess the family at several levels. The first level requires an assessment of the behavioral deficits and excesses of the child. The next level examines the family in terms of their behavioral skills and the impediments that occur when they implement behavior change programs. The third level involves assessing the family unit to identify obstacles to change. While many well-functioning families may be stressed by the crises that arise in raising an autistic child, other families are predisposed to dysfunction regardless of the presence of the child.     

Transfer pricing—A survey using discriminant analysis

There is a considerable literature on transfer pricing. One strand of this literature is empirical and is concerned with the extent to which companies use the various transfer pricing methods. The other strand is strongly normative being directed to devising transfer pricing methods and defining the circumstances under which it is appropriate to use them. This study attempts to address both these questions by using discriminant analysis methods to predict which approach a company will use to determine transfer prices given its weightings of certain ‘determinants’ which theory suggests should be relevant to the decision. Domestic and international transfer pricing are considered separately. Discriminant analysis is shown to be quite successful in predicting the transfer pricing systems adopted by the UK companies surveyed.     

The Perceived Threat of Nuclear War, Salience, and Open Questions

The most serious problem facing the United States, accordingto many scientific and political leaders, is the threat of nuclearwar. Yet the standard survey question on the most importantproblem facing the country has often shown little public concurrencewith this assumption. Our article uses experimentation in nationalsamples to test whether this difference can be traced to limitationsin either the form or the wording of the standard question.The results indicate that there are some important systematicdifferences between open and closed versions of the question,and also differences that result from reference to the nationas distinct from the world, but neither type of difference accountsfor the infrequent mention of nuclear war on the standard question.Instead, other evidence indicates that most Americans believethat nuclear war is not going to happen at all, or that if itdoes happen it will be too far in the distant future to be ofpressing concern to them personally.     

George Herbert Mead and Karl Marx: Exploring Consciousness and Community*

Current discussions within symbolic interaction point to a concern with (a) returning to Mead's original insights, (b) extending Meadian thought beyond the micro realm, and (c) linking Mead's ideas to constructive social action. These concerns complement an effort within contemporary Marxist literature to provide a systematic social psychology for understanding new forms of domination in capitalist society. In exploring the philosophical foundations of Mead and Marx, the authors identify fundamental similarities in their approaches to the relation between consciousness and community. The authors criticize the current attempts to synthesize Marx and Freud and call for a more thoroughly sociological approach. A Meadian reading of Marx, unlike the Marx-Freud synthesis, is consistent with sociological assumptions and points to the practical possibility of transformative social change through the interpersonal act.     

Attitudes Toward Managing Hazardous Waste: What Should Be Cleaned Up and Who Should Pay for It?

Hazardous waste policy in the United States uses a liability-based approach, including strict, retroactive, and joint and several liability. To assess attitudes toward these basic principles of liability, and toward priorities for clean-up of wastes, a questionnaire was mailed to legislators, judges, executives of oil and chemical companies, environmentalists, and economists. The questionnaire consisted of abstract, simplified cases, which contrasted basic principles rather than dealing with real-world scenarios. Subjects were asked how they would allocate clean-up costs between companies and government as a function of such factors as adherence to standards, adoption of best available technology (BAT), and influence of penalties on future behavior. Most subjects felt that, if the company followed government standards or used the best available technology (BAT), it should pay for only a portion of the clean-up cost, with the government paying the rest. In general, responses did not support the principles underlying current law–strict, retroactive, and joint-and-several liability. Most subjects were more interested in polluters paying for damages than in deterrence or future benefit–even to the extent that they would have "harmless" waste sites cleaned up. A bias was found toward complete clean-up of some sites, or "zero risk." Different groups of subjects gave similar answers, although more committed environmentalists were more willing to make companies pay and to clean up waste regardless of the cost.     

A case of mistaken identity? Debating the dilemmas of street-level bureaucracy with Musil et al.

Lipsky's Street-level Bureaucracy (Russell Sage Foundation, New York, 1980 Lipsky, M. 1980. Street-level Bureaucracy: The Dilemmas of Individuals in Public Service, New York: Russell Sage Foundation.  [Google Scholar]) has exerted a strong influence on the study of public service organisations. There has been a growing interest in using this perspective to understand the organisational context of social work and Musil et al.'s article in the EJSW (2004, ‘Do social workers avoid the dilemmas of work with clients?’, European Journal of Social Work, vol. 7, no. 3, pp. 305–319) reflects this interest. Musil et al. argue that it is possible to identify two forms of practitioner response to the constraints of street-level bureaucracies: adapting working practices in ways that disadvantage service users or challenging working conditions in order to achieve more professionally acceptable practice. Their contribution to the debate is helpful, particularly with regard to their identification of responses by practitioners that seek to advance the interests of service users. However, we view their approach as constrained by lack of consideration of the construction of social work roles within particular street-level bureaucracies. We suggest that Lipsky's work should be approached as a tentative analytic framework, rather than as a fixed model and we argue that a productive approach to research on social workers as street-level bureaucrats is conjunctural analysis. Such analysis examines the contexts, circumstances and statuses of practitioners and how these factors shape the specific forms of street-level practice that operate in particular organisational settings. We illustrate this in our discussion of the factors that are likely to have had a bearing on the two practice settings used as case studies by Musil et al.     

A Note on the Poisson Likelihood Ratio Test Statistic for Kulldorff's Scan Methods

Methods based on scan statistics are widely used in health-related applications to detect clusters of disease. The most common methods are based on the Bernoulli and Poisson models. Kulldorff (1997 Kulldorff , M. ( 1997 ). A spatial scan statistic . Communications in Statistics—Theory and Methods 26 : 1481 – 1496 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) derived the likelihood ratio test statistic for his scan method for both of these models. His scan statistic is widely used with freely available software, SaTScan^? (see Kulldorff, 2005 Kulldorff , M. ( 2005 ). SaTScan: software for the spatial, temporal, and space-time scan statistics , version 5.1 [computer program]. Information Management Services 2005; Available: http://www.satscan.org/. Accessed July 2007 . [Google Scholar]). We provide an alternative derivation of the likelihood ratio test statistic in the Poisson case. Our derivation is simpler and more general in the sense that it applies when the incidences are not aggregated into subregional counts.