Comparison of causal effect estimators under exposure misclassification

Over the past decades, various principles for causal effect estimation have been proposed, all differing in terms of how they adjust for measured confounders: either via traditional regression adjustment, by adjusting for the expected exposure given those confounders (e.g., the propensity score), or by inversely weighting each subject's data by the likelihood of the observed exposure, given those confounders. When the exposure is measured with error, this raises the question whether these different estimation strategies might be differently affected and whether one of them is to be preferred for that reason. In this article, we investigate this by comparing inverse probability of treatment weighted (IPTW) estimators and doubly robust estimators for the exposure effect in linear marginal structural mean models (MSM) with G-estimators, propensity score (PS) adjusted estimators and ordinary least squares (OLS) estimators for the exposure effect in linear regression models. We find analytically that these estimators are equally affected when exposure misclassification is independent of the confounders, but not otherwise. Simulation studies reveal similar results for time-varying exposures and when the model of interest includes a logistic link.     

Narratives of Low-Income Mothers in Addiction Recovery Centers: Motherhood and the Treatment Experience

ABSTRACT

This study examines the narratives shared by low-income women in addiction recovery centers about the meaning they attach to being a parent in recovery and how they view current program models that include children in daily treatment. Their stories reflect the centrality of the mothering role to women in recovery and offer insights that can guide treatment and program planning with families.     

Standards of Care for the Treatment of Adult Sex Offenders

Summary

A proposed version of these standards was first produced and published in the Journal of Offender Rehabilitation through input from professional meetings (Coleman and Dwyer, 1990). Since that time, The Standards of Care were reviewed and revised by a group of professionals and unanimously endorsed by voice vote by the participants in the Third International Congress on the Treatment of Sex Offenders held in Minneapolis, Minnesota, September 20–22, 1994. These Standards were again published in the Journal of Offender Rehabilitation (Coleman, Dwyer, Abel, Berner, Breiling, Hindman, Honey-Knopp, Langevin, and Pfäfflin, 1996). Those Standards have been subsequently reviewed by the current authors at the Fifth International Conference on the Treatment of Sex Offenders held in Caracas, Venezuela, March 22–27, 1998 and minor modifications and changes were incorporated into this version. The authors invite feedback from readers. Further revisions are anticipated and will be reviewed by current committee members and at future International Conferences on the Treatment of Sexual Offenders.     

Religiosity as a Predictor of Successful Post-Treatment Abstinence for African-American Clients

ABSTRACT

The purpose of this study was to examine the role of religiosity as a predictor of post-treatment abstinence. A sample of 96 African-American clients receiving community-based outpatient alcoholism treatment were interviewed at treatment entry and three months later. Achieving complete abstinence was predicted from client gender and 17 other predictors, including 6 substance-related factors, 7 psychosocial and health variables, and 4 religiosity/spirituality measures. Bivariate analyses showed that abstainers drank less prior to treatment, had more prior formal treatment and AA involvement, practiced their religion more regularly, and scored higher on measures of both spirituality and extrinsic religiosity. In addition, women were more likely to achieve abstinence. Forward entry binary logistic regression revealed that, controlling for client gender and pre-treatment consumption, only regular practice of one's religion/faith significantly predicted abstinence. Recommendations include (1) the need for research to evaluate if the current findings can be generalized across race/ethnicity and religious affiliation and (2) directing more attention to clients' religiosity in alcoholism treatment.     

Theoretical Factors Influencing Adolescent Sexual Behavior: Evidence from a Rural Sample Living in Poverty

ABSTRACT

This study of 414 adolescents who resided in rural Arkansas families receiving AFDC was designed to investigate what theoretical factors predicted frequency of sexual intercourse in the past year prior to the study and number of lifetime sexual partners among males and females. Multivariate analyses indicated that elements of bonding were important to the sexual behavior of females, but not males. On the other hand, feelings of frustration influenced male sexual behavior only. The number of sex partners was increased by associations with sexually active peers for both genders while only females made excuses. The only factor which was associated with both sexual behaviors among both genders was having sex to have a baby to love or to draw a partner closer. The family social work implications of these findings were discussed.     

Victim's Response Cycle: A Model for Understanding the Incestuous Victim-Offender Relationship

ABSTRACT

The victim-response cycle is a theoretical and clinical model that can be utilized to assist victims in their healing from the trauma of sexual abuse. This model focuses on the specific aspects of the relationship that victims have with their offenders, particularly in incest cases, which contribute to the degree of trauma that victims experience. This relationship can also become the model for other relationships as the victim matures, and the victim-response cycle can be used to assist these adult survivors in understanding their difficulties with adult intimate relationships. This model addresses aspects of attachment and learned coping responses to assist clinicians in treating symptomatic behavior. While severe trauma is rarely treatable with a short-term approach, this model can assist in providing clients and clinicians with tools for symptomatic relief, which may be achievable in a short-term setting. This model has not been examined empirically, but it has been utilized in several outpatient practices in the Midwest with positive clinical results. A case example demonstrating the use of this model is also presented.     

Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA

ABSTRACT

This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence that the therapeutic benefits of EMDR for adult female survivors of CSA can be maintained over an 18-month period. Furthermore, there is some support for the suggestion that EMDR did so more efficiently and provided a greater sense of trauma resolution than did routine individual therapy.     

Current Practices in Residential Treatment for Adolescent Sex Offenders: A Survey

SUMMARY

A list of all treatment facilities for adolescent sex offenders that described themselves as inpatient or residential was requested from the Safer Society Foundation in Brandon, Vermont. A total of 203 such facilities were identified in this manner. Each was sent a questionnaire regarding their policies and practices. Of the 50 questionnaires that were returned, 49 were usable. Items on the questionnaire dealt with major phases of operating a residential program, including number of beds, average daily census, number of males and females in treatment, testing and assessment procedures, most frequent diagnoses, average IQ of patients, abuse history, therapeutic approaches used, number and types of individual/group treatment sessions per week, qualifications of therapists, average length of treatment, and follow-up research on treatment.     

What Is Valued in Gay and Lesbian Specific Alcohol and Other Drug Treatment?

Little is known about what gay and lesbian clients value about culturally specific alcohol and other drug treatment programs. This study involves a sample of clinical staff and former clients (N = 40) of four culturally specific alcohol and other drug treatment programs to clarify what is addressed and deemed valuable for the specific needs of gay and lesbian clients. Through the lens of the recovery capital conceptual framework, this qualitative research emphasizes resiliency and the supports necessary for long-term recovery. Results indicate three major themes that make this type of treatment valuable: (1) a separate treatment unit or facility, (2) a safe and supportive therapeutic milieu, and (3) specific tailored treatment approaches. Findings are discussed to include implications for ways to improve services for this all too often understudied population of potentially vulnerable individuals who can benefit from culturally sensitive care.     

When Adoption Is Not an Option: Counseling Implications Related to Surrogacy

Through the author's personal story, this article details a case in which traditional conception and adoption were not options available for starting a family. It gives the author's rational for choosing surrogacy and describes his experience with surrogacy. This article provides an overview of the surrogacy process and concludes with implications counselors may consider and apply to their clinical practice.