Barriers to Integrated Treatment of Substance Abuse and Trauma Among Women

Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.     

对我国新型农村合作医疗筹资问题的几点探讨

建立和完善新型农村合作医疗制度应不断探索和创新多元化的新型农村合作医疗筹资渠道,以稳定合作医疗的资金来源;根据不同地区、不同农民的实际收入水平和医疗消费需求状况,探索多层次的新型农村合作医疗筹资和补偿标准;根据我国农民个人及地方政府的投资心理、消费心理,建立自上而下的筹资顺序;结合我国农村实际,不断探索多种简便的、快捷的、农民愿意接受的筹资方式;将农民自愿筹资原则与适度强制筹资原则结合起来,以确保新型农村合作医疗制度的较高覆盖率。     

80岁以上脑卒中偏瘫患者康复治疗临床观察

目的探讨康复治疗对80岁以上脑卒中偏瘫患者的效果。方法对2008年7月至2009年6月本院老年康复科住院80岁以上脑卒中偏瘫患者66例进行分析总结，设定为治疗组33例，并与病区内未进行康复治疗的该类患者33例（对照组）比较，同时-9随机抽取的病区内低于80岁的中老年人脑卒中偏瘫患者康复治疗30例（年轻治疗组）比较。结果治疗组与对照组比较，治疗组肢体功能好转度Brunstrom分级优于对照组，P〈0．001。Barthel指数改善优于对照组，P〈0．001。高龄治疗组与年轻治疗组比较，肢体功能好转度与Barthel指数改善程度无明显差别，P〉0．05。结论康复治疗对80岁以上脑卒中偏瘫患者生活质量有明显提高作用，对高年脑卒中偏瘫患者也应该积极进行康复治疗。     

如何追求文学的精神高度——毕淑敏小说创作论

毕淑敏是一个不断开辟新的人生体验和文学描写的有追求的作家。她的创作给文坛带来新的界面，也提出新的命题。这突出体现在四个方面：作家气质：“白衣天使”与“天才病友”的路径选择；面对疾病：隐喻与治疗的相互矛盾；审视心灵：揭示痛苦与展现隐私的暧昧立场；伦理难题：医学一社会学一文学的彼此纠缠。对毕淑敏创作的深度分析，也同时揭示出当代文学如何追求精神高度的困难所在。     

Care without coercion – mental health rights,personal recovery and trauma‐informed care

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.     

Systemic Barriers to the Employment of Social Workers in Alcohol and Other Drug Treatment Agencies

Abstract

Literature suggests a low number of social workers employed in the field of alcohol and other drug (AOD) treatment. This study shows that social workers with undergraduate degrees (BSWs) have higher rates of employment in AOD than bachelor's degree holders from other disciplines. Master's level social workers (MSWs), however, have a much lower involvement than their counterparts with counseling degrees. Six factors are inferred to partially explain MSWs' low involvement in the field: (1) low education requirements; (2) low pay; (3) absence of “social worker” positions; (4) competition among different disciplines; (5) lack of MSW interns; and (6) state certification requirement. Suggestions to increase the employment of social workers in the AOD field are offered.     

Fostering secure attachment in low- and middle-income countries: Suggestions for evidence-based interventions

Children struggling with the effects of trauma in low- and middle-income countries (LMIC) face a substantial mental health resource gap that limits their opportunities for positive psychosocial development. Multidisciplinary interventions working to close this gap may benefit from incorporating an empirically supported treatment (EST) into their approach that targets a universal mechanism implicated in resilience, like attachment. ESTs should be selected based on their level of empirical support and cultural adaptability, and then modified on the basis of qualitative evaluations conducted with the local population and stakeholders. This paper will provide an overview of attachment as a mechanism of resilience, a critical analysis of existing attachment-based ESTs, and recommendations for overcoming EST implementation barriers in LMIC.     

A Postmodern Critique of Societal Discourses of Male Violence in Interpersonal Family Relationships: A Balancing Act for Social Work

In recent years, treatments of family violence have tended to be built around conventional discourses suggesting that men are major initiators in instances of interpersonal violence. Utilizing a postmodernist analysis, we assess societal discourses that continue to give life to this narrow conceptualization of interpersonal violence. We also examine literature suggesting that both men and women resort to violence to resolve relationship difficulties and suggest that a more holistic and inclusive approach to understanding interpersonal violence is critical for social workers committed to social justice and a balanced understanding of the contextual nature of human problems.     

Factors That May Influence Parent Treatment Decision Making for Young Children with Autism Spectrum Disorder

ABSTRACT

The number of interventions available for children with autism spectrum disorder (ASD) has expanded greatly in recent years, although relatively little is known about the factors that influence family caregivers as they make treatment decisions for their children. This study involved a statewide survey of parents of young children with ASD to examine the relative weights of the factors that influenced their treatment decisions. Results suggested that caregivers rely on their own intuition for much decision making, although selected professionals are also influential. Implications for professionals working with children with ASD and their families are discussed.