THE EFFICACY AND EFFECTIVENESS OF MARITAL AND FAMILY THERAPY: A PERSPECTIVE FROM META-ANALYSIS

This article reviews the major findings from a multiproject meta-analysis of the effects of marital and family therapy (MFT). Across 163 randomized trials, MFT demonstrates moderate, statistically significant, and often clinically significant effects. No orientation is yet demonstrably superior to any other, nor is MFT superior to individual therapy. Cost effectiveness information is scant in these 163 studies, but supportive. Randomized experiments yield very different answers from nonrandomized experimental studies of the effects of MFT, calling into question whether we should mix the two in reviews. We have also found several new differences in the ways that marital therapy (MT) and family therapy (FT) studies are conducted, making them harder to compare. Finally, important questions still exist about whether any psychotherapy, including MFT, yet has sufficient information about how well research generalizes to everyday clinical practice.     

Benefits of preventive dentistry in children: Cost factors and public policy

Dental caries in children is now recognized as a preventable disease. The use of fluoride and sealants has produced a major reduction in caries prevalence among school aged children in the United States and other countries. A portion of the child population who are educationally and socioeconomically disadvantaged are not fully receiving these benefits. Public policy, insurance and medicaid groups must be made aware of these preventative measures and strategies developed to implement them.     

Rural Income-Generating Programs and Fertility Limitation: Evidence from a Microdemographic Study in Nepal1

Abstract Participation in rural development programs that organize members into local cooperative groups can alter the decision-making environment facing couples to reflect some of the negative consequences of childbearing. This study uses data from Nepal, collected through a combination of ethnographic and survey methods, to test the effects of participation in such a development program on fertility behavior. Results demonstrate that program participants are much more likely to use contraceptives to limit their fertility than are non-participants. The study provides empirical support for theories linking this type of institutional change to fertility and indicates a policy option that can allow some negative consequences of childbearing to affect couples' fertility decisions.     

A simultaneous-equations model of the relationship between public sector bargaining legislation and unionization

This paper estimates a simultaneous-equations model with public sector bargaining laws and union membership treated as jointly-determined variables. The extent of public sector unionization has a significant positive influence on the passage of prolabor bargaining legislation and bargaining legislation has strong, independent effects on the extent of public sector unionization. We gratefully acknowledge the research support provided by Minbo Kim and Parisun Chantonahom.     

Dimensions of Participation in a Professional Social-Movement Organization

Differential participation after recruitment remains a black box in the social-movement and voluntary-association literatures. This paper identifies several dimensions of membership participation in a professional social-movement organization (SMO) with a national membership and analyzes the determinants of differential involvement in these forms. In general, members' ideological beliefs, social and organizational ties, perceptions about their SMO, and communication with SMO officials all predict participation across the various forms. Our findings extend previous work on differential participation in three ways. First, we statistically isolate cultural dimensions of postrecruitment participation and, in so doing, complement recent ethnographic research. Second, our findings suggest that the distinct dimensions of external and internal participation found by Knoke (1988) in a national sample of voluntary associations may not generalize to national SMOs studied individually. Third, our results indicate that models combining ideological and microstructural factors should explain the multiple forms of participation in SMOs lacking these distinct dimensions.     

The Role of Cancer Risk in the Regulation of Industrial Pollution

The extent of carcinogen regulation under existing U.S. environmental statutes is assessed by developing measures of the scope and stringency of regulation. While concern about cancer risk has played an important political role in obtaining support for pollution control programs, it has not provided the predominant rationale for most regulatory actions taken to date. Less than 20% of all standards established to limit concentrations of chemicals in various media address carcinogens. Restrictions on chemical use are more frequently based on concerns about noncancer human health or ecological effects. Of the chemicals in commercial use which have been identified as potential human carcinogens on the basis of rodent bioassays, only a small proportion are regulated. There is an inverse relationship between the scope of regulatory coverage and the stringency of regulatory requirements: the largest percentages of identified carcinogens are affected by the least stringent requirements, such as information disclosure. Standards based on de minimis cancer risk levels have been established for only 10% of identified carcinogens and are restricted to one medium: water. Complete bans on use have affected very few chemicals. The general role that carcinogenicity now plays in the regulatory process is not dramatically different from that of other adverse human health effects: if a substance is identified as a hazard, it may eventually be subject to economically achievable and technically feasible restrictions.