A Review of Trauma Specific Treatments (TSTs) for Post-Traumatic Stress Disorder (PTSD)

Clinical Social Work Journal - Trauma is a significant public health concern that has widespread and adverse effects on people. There is a high prevalence of trauma and PTSD in general populations,...     

‘We Can All Just Get on a Bus and Go’: Rethinking Independent Mobility in the Context of the Universal Provision of Free Bus Travel to Young Londoners

This paper uses qualitative data from interviews with 118 young Londoners (age 12–18) to examine how the universal provision of free bus travel has affected young people’s independent mobility. Drawing on Sen’s capabilities approach, we argue that free bus travel enhanced young Londoners’ capabilities to shape their daily mobility, both directly by increasing financial access and indirectly by facilitating the acquisition of the necessary skills, travelling companions and confidence. These capabilities in turn extended both opportunity freedoms (e.g. facilitating non-‘necessary’ recreational and social trips) and process freedoms (e.g. feeling more independent by decreasing reliance on parents). Moreover, the universal nature of the entitlement rendered buses a socially inclusive way for groups to travel and spend time together, thereby enhancing group-level capabilities. We believe this attention to individual and group capabilities for self-determination provides the basis for a broader and more child-centred view of independent mobility than the typical research focus upon travelling without an adult and acquiring parental permissions.     

Medical Negligence and Resource Allocation in the NHS

The recent growth in medical malpractice claims and in awards for damages has created concern both amongst doctors and health administrators. Steps which have been taken by the Review Body on Doctors’and Dentists’Remuneration and policy now advocated by the BMA suggest a movement away from the current system of negligence and towards a stricter no-fault system of liability. Under the current system, medical negligence occurs when doctors have not met the standards of treatment expected by reference to current professional standards. Under a no-fault system patients would be entitled to compensation for losses which arise from treatment, irrespective of whether negligence had occurred; although the implication is that the amounts of compensation would necessarily be limited. While there are reasons to believe that financial difficulties for doctors and pressures on NHS budgets may be ameliorated by a no-fault system, there are other criteria against which the current system of negligence should be judged. This article attempts to provide a framework within which a negligence system may be assessed. In particular, attention is drawn to the educative role of a negligence system and to the provision of information which may improve decisions on resource allocation. A critique of the current system of medical negligence in the UK suggests that a package of reforms to improve the system would be better than further movements towards non-market solutions.     

The social and demographic impact of the Southeast Asian Crisis of 1997–99

When an unexpected financial crisis overtook Southeast Asia in 1997 planners and policymakers feared that the economic difficulties would unwind two decades of remarkable economic and social development. Newspaper headlines spoke of massive increases in poverty, unemployment and malnutrition, and it was speculated that family planning programs would collapse and fertility would rise dramatically. Infant and child mortality and maternal mortality were also expected to increase. This paper briefly reviews the onset of the financial crisis as a background for assessing whether speculations about die demographic and social effects tallied with reality. It is found that these effects were neither as dramatic nor as easy to monitor as some of the public debate implied. The general lesson is that the most serious social and demographic problems were not so much the products of crisis as embedded in chronic weaknesses that had become entrenched in times of economic growth. The crisis exposed these weaknesses.     

Implementing a Multidimensional Poverty Measure Using Mixed Methods and a Participatory Framework

Recently, there have been advances in the development of multidimensional poverty measures. Work is needed however on how to implement such measures. This paper deals with the process of selecting dimensions and setting weights in multidimensional poverty measurement using qualitative and quantitative methods in a participatory framework. We estimate the multidimensional poverty measures developed by Alkire and Foster for a particular group: persons with psychiatric diagnoses in the United States. To select relevant dimensions and their relative ordering, two discussion groups are convened: one consisting of persons with lived-experience expertise and the other consisting of people with mental health service provision or research expertise. Several methods are used to convert dimension rankings into weights. The selection and ordering of dimensions differed between the two discussion groups, as did the resulting poverty measures. For instance, the poverty headcount using the dimensions and weights of the ‘lived experience’ group ranged from 20.61 to 26.96% as compared to a range of 18.62–33.19% using those of the ‘provider/researcher’ group. One of the main results of this study is that the Alkire Foster method is sensitive to the selection of dimensions and the methods used to derive rankings and weights. It points toward the limitation of relying exclusively on small scale qualitative methods for the selection and ranking of dimensions. In addition, the participatory framework used in this study was found to be essential in interpreting results, in particular with respect to the limitations of the data set in measuring relevant dimensions.