Gay Affirmative Cognitive Behavioral Therapy for Sexual Minority Youth: A Clinical Adaptation

Sexual minority youth (SMY) are at high risk for negative mental health outcomes such as depression, anxiety, substance abuse, and suicidality. However, there has been a disconnect between clinical social work practice and research with SMY, resulting in a lack of rigorous research that demonstrates the use of effective interventions. While cognitive behavioral therapy (CBT) has long been established as a best practice option for the general adolescent population suffering from mental health problems, knowledge about the use of CBT with SMY lags far behind. Thus, the purpose of this article is to present a clearly defined adaptation of CBT for SMY that integrates gay affirmative practices for youth (e.g., coming out, stigma and discrimination, the role of social support and community). Specifically, the authors: (a) discuss the impact of minority stress on SMY; (b) highlight the specific components of CBT that represent a good fit for SMY and also address the criticisms of using such an approach; (c) consider the importance of using gay affirmative practices with SMY; and (d) offer recommendations for incorporating gay affirmative practices into traditional CBT models to better meet the needs of SMY.     

Expert and Public Perception of Risk from Biotechnology

Risk perceptions of a series of biotechnology applications were examined in a public (nonexpert) sample and an expert sample. Compared with the experts, the public perceived all biotechnology applications as more risky. Both groups perceived food-related applications to be riskier than medical applications. Compared with the public, experts perceived both food and medical applications as less harmful and more useful. Experts also judged the risks posed from medical biotechnology applications as more familiar and acknowledged by people and science. Lay estimates of the risk of food applications were predicted by potential harm, potential benefits, science knowledge, and familiarity; experts' estimates were predicted only by harm and benefits. Lay estimates of the risk of medical applications were predicted by potential harm; experts' estimates were predicted by potential benefits, number and type of people exposed, and science knowledge. We discuss the implications of the results for risk communication about and management of different types of biotechnologies.     

Safe credit to the poor: The role of anti‐usury policies

Usury regulations focus both on explicit recommendations, such as disclosure statements in lending acts or interest rate caps, and on incentives for the formal banking sector to reach the poor. Considerable attention is also devoted to adequate sanctions for the practice of usury. We propose a theoretical model to investigate where to direct reforms to curb usury. Our primary policy implication is the convenience of polarizing the allocation of public resources in either legal safeguards for formal lenders or sanction enforcement against usurers. Furthermore, we demonstrate that in developing countries such policy interventions may backfire when borrowers' higher wealth implies increasing inequality in its distribution. Therefore, countries undertaking reforms against predatory lending should be aware of their growth path during transition.     

Study of the association between gait variability and physical activity

Background

Gait variability can be considered an indirect measure of gait stability, in particular regarding temporal or spatial variability assessment. Physical activity, such as walking, is advised for the elderly and can be improved by gait stability. The aim of this study was to investigate the associations between gait stability and physical activity in women of different age ranges.

Methods

Forty-two healthy women of different age ranges (18-40 yrs. and 65-75 yrs.) were recruited in the study. To assess physical activity, the subjects wore a multi-sensor activity monitor for a whole week, inferring the time spent in moderate to vigorous physical activity (MVPA). MVPA were analysed in bouts of at least 10 subsequent minutes (MVPA_bouts) and in overall minutes (MVPA_tot). A kinematic analysis was performed with an optoelectronic system to calculate gait variability - expressed as standard deviation (SD) and coefficient of variability (CV) of step width, stride length, stance and swing time (during treadmill walking at different speeds).

Results

Elderly women, with high walking speed (5 km/h), and moderate step width variability (CV = 8–27%), met the recommended levels of physical activity (MVPA_tot and MVPA_bouts). Furthermore, gait variability, adjusted for age and number of falls, was significantly and negatively associated with MVPA_tot only at 3.5 km/h, and with MVPA_bouts only at 4 km/h.

Conclusions

In a population of healthy elderly women, gait variability was significantly and negatively associated with the level of physical activity. Healthy elderly women, with moderate gait variability (step width variability), and high preferred walking speed, seem to be able to meet the recommended levels of physical activity.

     

Meeting in the mist: Key considerations in a collaborative research partnership with people with mental health issues

Objectives: This study explored the experiences of an established collaborative research group, which were collected as data to gain research skills. Currently ideas about user involvement and knowledge transfer have not been considered together, indicating possible gaps in knowledge. Participants: Eight members of the group took part, including five people using local mental health services, an assistant and an occupational therapist from local services, and an academic. Methods: Experiences of collaborative working were explored in phases. Structured individual reflections were recorded and shared for initial analysis. A group discussion prepared for constant comparative analysis, which synthesized the emerging themes. Results: Participants had gained and shared skills, understanding and knowledge. "Meeting in the mist" was a metaphor to explain the journeys experienced by participants, within a collaborative cycle. This cycle was central to a visual model, "Creating space", which suggested the importance of allowing sufficient time and space to work for a shared vision of the future. A final theme was the "warp factor", which drew on relativity theory to highlight the sense of innovation. Conclusions: Collaborative work can be based on knowledge transfer and ideas about user involvement, generating tangible benefits for all involved, including engaging in productive occupations.     

The seasonality of conception

Individual data on menstrual cycles of noncontracepting women living in Western countries were used in order to verify whether the biological seasonality of conception persists after sexual behavior is controlled for. Episodes of intercourse were recorded daily, and the time of ovulation was detected by a marker We find that the seasonality of conception changes with woman's age and frequency of episodes of sexual intercourse. In particular; for women aged 27-31 having only one act of intercourse during the six most fertile days of the menstrual cycle, the seasonality of fecundability is stronger In this age group in the Northern Hemisphere, if seasonality of acts of sexual intercourse is controlled, the monthly distribution of probability of conception is bimodal, with two maxima (September and January) and two minima (December and March). When unobserved characteristics of the couples are considered, this seasonal pattern of conception persists.     

Working systemically following abuse: exploring safe uncertainty

This paper explores systemic practice and ‘safe uncertainty’ in work with parents who do not accept responsibility following child abuse. The prevailing view has been that little positive work can be carried out with families where responsibility is denied. Our work is offered to add to the small yet growing number of publications which challenge the dominant discourse relating to child protection work. A case study is illustrated within which the issue of assessment versus therapy emerges. The Legal Department of the Local Authority Social Services requested an assessment from child and family psychiatry. Concern developed regarding the point at which assessment ended and therapy began. The authors offer a systemic model in exploring the importance of a safe multi‐disciplinary framework within which uncertainty can be tolerated and therapy/change work can be affected. A framework within which parents can be supported in developing skills to meet the needs of children is presented. These issues are central to the professional and legal systems relating to child protection in the UK. Copyright © 1999 John Wiley & Sons, Ltd.