Adoption of evidence-based practices among substance abuse treatment providers

This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area.     

Casino Gambling Among Older Adults in North Dakota: A Policy Analysis

This article examined social issues surrounding casino gambling among older adults both nationally and in the state of North Dakota. An exploratory review of gambling trends among older adults and an examination of policies to protect older gamblers revealed that older adults are targeted by the gaming industry as a lucrative market (Singh et al. J Retail Leisure Property 2007, 6(1):61–68). The authors used the national literature to frame their qualitative study, which explored gambling issues among older adults in North Dakota from the perspective of six counselors trained in gambling addiction who provide treatment services in the state. Findings indicated that relatively few policies existed at the state and national levels to protect older, more vulnerable adults who gamble. Further, the six casinos in North Dakota were viewed as very effective in marketing their casino gaming opportunities to older citizens by the gambling treatment providers interviewed. Additionally, barriers to gambling addiction treatment involved lack of available services and distance to receive services in this rural state. Based on the findings of this study, social policy changes which could lead to increased protection for older adult gamblers in the state were included.     

Older Parent–Child Relationships in Six Developed Nations: Comparisons at the Intersection of Affection and Conflict

Intergenerational solidarity and ambivalence paradigms suggest that emotional relationships between generations consist of both positive and negative sentiments. We applied latent class analysis to measures of affection and conflict in 2,698 older parent–child relationships in 6 developed nations: England, Germany, Israel, Norway, Spain, and the United States (Southern California). The best fitting model consisted of 4 latent classes distributed differently across nations but with a cross‐nationally invariant measurement structure. After controlling for demographics, health, coresidence, contact, and support, the following classes were overrepresented in corresponding nations: amicable (England), detached (Germany and Spain), disharmonious (United States), ambivalent (Israel). We discuss policy and cultural differences across societies that may explain why the prevalence of particular emotional types varied by nation.     

An assessment of self-echoic behavior in young children

In the behavioral literature, self-echoic behavior has been hypothesized to play an important role in, for example, emergent conditional discriminations (e.g., Lowenkron, 1991), emergent verbal operants (Horne & Lowe, 1996), and problem solving (Skinner, 1957). Although early behavioral intervention programs for children with autism emphasize the establishment of accurate echoic repertoires, the type of stimulus control that defines a self-echoic response is typically not addressed. We report the development of a self-echoic assessment procedure that was administered to children with and without autism spectrum disorders. Preliminary results indicated that a discrepancy between echoic and self-echoic repertoires was more likely to be present among participants with autism than among typically developing participants. Future research should evaluate the extent to which interventions to establish self-echoic responding might produce other collateral benefits.     

Interview With Michael Kerr

The following article was written by Dr Michael Kerr in response to questions put to him by Barbara Fraser; Linda Mackay and Lu Pease when he visited Australia two years ago. These three family therapists took it upon themselves to prepare this interview in recognition of Dr Kerr's unique vantage point on Bowen Theory and family therapy. Michael Kerr was trained by Murray Bowen in the 1970s and subsequently went on to work as faculty at the Georgetown Family centre. He succeeded Bowen as director of the centre where he has devoted his professional life to the understanding, application and extension of theory. He is the co‐author with Dr Bowen of Family Evaluation: An Approach Based on Bowen Theory (Kerr & Bowen, 1988), which remains the most esteemed text on this theory. He is also the editor of Family Systems: A Journal of Natural Systems Thinking in Psychiatry and The Sciences. Bowen's Family Systems Theory grew out of years of research from the 1950s‐1970s, which included observations of inpatient families with a schizophrenic member and using data from Bowen's own interactions with his family of origin (Bowen, 1978). The theory continues to be influential in family therapy with its most well‐known contributions being the process of triangling, the intergenerational transmission of family patterns and the concept of differentiation of self. (Brown, 1999). The following discussion from Dr Kerr brings a fresh perspective on the current applications and developments of this systems theory     

Expression and ambivalence over expression of negative emotion: cross-sectional associations with psychosocial factors and health-related quality of life in postmenopausal women

Inhibition of emotional expression has been associated with the incidence and progression of breast cancer and other chronic illnesses. The important health-related factor, however, may be ambivalence about the expression of emotions rather than repression itself. This cross-sectional analysis of baseline data from 159,557 participants in the Women's Health Initiative examined the influence of expression of negative emotion and ambivalence about expression of emotion on psychosocial factors and health-related quality of life measured by the Medical Outcomes Study Short-form 36 (SF-36). Overall, observed correlations were modest but in the expected direction; that is, greater ambivalence about negative emotional expression was associated with worse general health and poorer psychosocial risk profile. Ambivalence about expressing negative emotion was more highly correlated with psychosocial factors and health-related quality of life than emotional expression. In general, our analysis supports prior studies suggesting that ambivalence may be more important to consider in studies of health-related outcomes than expression.     

St Christopher's and the future

The founding vision of St Christopher's Hospice was based on a recognition that permeating mainstream health care services would be essential and an emphasis on an adaptable philosophy rather than a building. Today, demographic and disease related changes mean that need and demand for end-of-life care will inevitably outstrip professional and financial resource. Hospices must engage with the development of cost-effective models of service delivery and rational planning. Only partnership working with the National Health Service, care homes, and others will ensure that appropriate care is available to everyone wherever the bed in which they die, regardless of diagnosis. Only collaboration and active engagement will ensure that future strategy in end-of-life care retains the original insight that its focus rightly includes not only patients but also the social context that will be affected by their death. Cost and patient choice dictate an emphasis on care at home. Health-promoting, public education and family-focused strategies will be essential. At a pivotal moment for the delivery of health care generally, hospices can play a vital part by marrying the role of "insistent conscience" of the health care service with continued cost-effective clinical innovation.     

How Condom Discontinuation Occurs: Interviews With Emerging Adult Women

We have almost no data on how and when couples stop using condoms. This qualitative study investigated the process of condom discontinuation. From November 2013 to April 2014, a total of 25 women living in a college town in the Midwest, ages 18 to 25, participated in semistructured interviews centered around three domains: partner interactions, contraceptive use, and sexually transmitted infection (STI) prevention. Analysis followed a critical qualitative research orientation. Participants described actively seeking the best options to prevent pregnancy, perceiving condom discontinuation in favor of hormonal methods as a smart decision, and reported wanting to discontinue using condoms due to physical discomfort. Oftentimes, nonverbal communication around contextual instances of condom unavailability paved the way for discontinuation. Participants indicated the decision to stop using condoms was neither deliberate nor planned. Condom discontinuation rarely occurred at one point in time; instead, it was preceded by a period of occasional use. Even after participants described themselves as not using condoms, sporadic condom use was normal (typically related to fertility cycles). This study provides a more detailed understanding of how and why emerging adults negotiate condom discontinuation, thereby enhancing our ability to design effective condom continuation messages. Attention should be paid to helping emerging adults think more concretely about condom discontinuation.     

Parent,carer, person: future plans and the identities of parent carers for people with disabilities

Parent carers are often central in future planning for their children with disability; however, little is known about the implications of planning for parents’ futures and aspirations. In understanding these, parents’ own identities are important, but how these identities intersect with their planning is not well understood. This study explored how parents were positioned in discussions about planning. Interviews with parents and planning service staff highlighted three positions among parents – carer, parent, and person – representing multiple, intersecting identities. These impacted on and were impacted by planning in particular ways. Understanding these processes may assist programmes to support parents more effectively.