FAMILY THERAPY TREATMENT OUTCOMES FOR ALCOHOLISM

We conducted a meta-analysis of 21 studies of family-involved therapy for alcoholism, evaluating them for design adequacy, clinical significance, and effect size. The review is divided into studies of family involvement in three phases of treatement: (a) initiation of treatment, (b) primary treatment/rehabilitation, and and (c)aftercare. We conclude that family therapy is effective in motivating alcoholics to enter treatment. Once the drinker enters treatment, family-involved treatment is marginally more effective that individual alcoholism treatment. The data suggest that three factors may mediate the effect of treatment: gender, investment in the relationship, and perceived support from the spouse for abstinence. Modest benefits have been obtained in family-involved relapse prevention programs. The most recent studies are starting to address tese issues by developing treatment models specifically for women alcoholics and identifying factors that could be used to match appropriate treatments to alcoholics and their families. These efforts are just beginning, however, and we make a number of recommendations to support implementation of these and other efforts.     

A COMPARISON OF FAMILY ADAPTATIONS TO HAVING A CHILD WITH CYSTIC FIBROSIS

The effect of Cystic Fibrosis (CF) on the structure and social climate of the family was examined with self-report scales and independent observations of family functioning. Families in which the child with CF was not the firstborn were found to be functioning more healthily than those in which the child was the firstborn. This was found on 7 of 10 family environment scales, a family hierarchy test, and on all three of the family system scales used by the independent observers (power, cohesion and closeness). Significant correlations between specific family variables and problem behaviors and social competencies were also found.     

Long-term care insurance in Japan

Among all the industrialized countries, Japan has the fastest rate of population aging and the highest life expectancy at birth. It is projected that the proportion of elderly people will reach 35.7% in 2050. In this demographic environment, Japan launched a social insurance program for long-term care for the elderly in 2000. What were the forces that led Japan to establish a long-term care program for elderly people? What are the provisions for financing, benefits, and service delivery? What aspects of policymaking in developing such a program are unique to Japan?.     

Anniversary reactions: Trauma revisited

This article is intended to acquaint the reader with a phenomena known in the psychoanalytic literature as anniversary reactions. Conceptualized as ensuing from incomplete forms of mourning, these reactions may be evident in various forms including somatic symptoms and diseases, depression, psychosis, suicide, and homicide on the anniversary date of a significant past traumatic event. This article identifies various manifestations of anniversary reactions and familiarizes the reader with some of the elements thought to constitute them: trauma, incomplete mourning, identification and an unconscious sense of time. A clinical vignette is presented and discussed.     

Gender,added-worker effects,and the 2007–2009 recession: Looking within the household

The U.S. recession of 2007–2009 saw unemployment rates for men rise by significantly more than those for women, resulting in the downturn’s characterization as a ‘mancession’. This paper uses data from the Census Bureau’s American Community Survey to reexamine gender-related dimensions of the 2007–2009 recession. Unlike most previous work, we analyze data that connects men’s and women’s employment status to that of their spouses. A difference-in-difference framework is used to characterize how labor-market outcomes for one spouse varied according to outcomes for the other. Results show that that employment rates of women whose husbands were non-employed rose significantly in the recession, while those for people in other situations held steady or fell—consistent with the view that women took on additional bread-winning responsibilities to make up for lost income. However, probabilities of non-participation did not rise by more for men with working wives than they did for other men, casting doubt on ideas that men in this situation made weaker efforts to return to work because they could count on their wives’ paychecks to support the household.