Treatment for Hoarding Behaviors: A Review of the Evidence

This article reviews the empirical literature on treating clients with hoarding behaviors, including psychosocial treatments, mainly cognitive behavioral, and pharmacotherapy. Standard treatments used for obsessive compulsive disorder (OCD) such as medication and/or behavior therapy have been associated with poor treatment response for those with hoarding. Recent prospective pharmacotherapy research suggests that serotonergic medication may be helpful to OCD patients with or without hoarding. A multi-component cognitive behavioral treatment (CBT) designed specifically for hoarding has shown promising results especially in trials of individual therapy with periodic home visits. Social work researchers have played a prominent role in the development and testing of this CBT intervention and development of instruments to assess hoarding treatment outcomes. This CBT intervention has demonstrated modest success when delivered individually in an open trial and a waitlist-controlled trial, and in quasi-experimental studies of group treatment modalities, including in-person and web-based groups as well as bibliotherapy-based support groups. Overall, evidence supports the use of specialized CBT methods to improve hoarding symptoms. Future testing may include controlled trials with more diverse samples.     

Delivering LGBT-sensitive substance use treatment to sexual minority women

Abstract

Epidemiologic studies have consistently found elevated rates of alcohol and other substance use among sexual minority women (SMW), and despite calls for “lesbian, gay, bisexual, and transgender (LGBT)-specific” services and culturally tailored interventions, few such services exist. This study involved qualitative interviews with directors from substance use treatment programs (N?=?10) about how they addressed the needs of SMW. Strategies implemented primarily focused on creating a safe and welcoming environment for sexual minority clients. Findings highlight challenges involved in meeting the treatment needs of SMW and provide guidance to researchers and service providers on how to improve the quality of care for them.     

Several Common Bonds: Addressing the Needs of Gay and Bisexual Men in LGBT-Specific Recovery Housing

ABSTRACT

Recovery housing is a promising way to augment the substance use continuum of care, but we know little about the experiences of members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community who live in them or about residences specifically for them. Within the LGBTQ community, gay, bisexual, and other men who have sex with men (MSM) often experience co-occurring syndemic conditions (e.g., trauma, depression, HIV) that present unique recovery challenges. Using qualitative data gathered from residents living in a recovery residence specifically for gay and bisexual men and from community key informants, we examine the experiences of men living in the home and factors that facilitate operating it. Findings highlight the need for residences that can address syndemic burden among gay and bisexual men in recovery and identify programmatic and community-level factors critical to operating residences for this population.     

Compliance issues raised by the United States' ratification and implementation of the education articles of the Convention on the Rights of the Child

This article evaluates compliance issues the United States could face in ratifying the education provisions of the United Nations Convention on the Rights of the Child (CRC). The authors compare states parties' obligations under the education provisions of the CRC--as construed by the CRC committee--with federal and state education protections and programs in the United States. The authors conclude that the United States currently complies with most of the provisions and faces minimal risk in ratifying the remaining provisions.     

Racial differences in DSM diagnosis using a semi-structured instrument: the importance of clinical judgment in the diagnosis of African Americans

Schizophrenia is diagnosed more frequently among African Americans while mood disorders are identified more often among whites. Such findings have raised serious questions about the accuracy of clinical judgment. This article analyzes data on 665 African American and white psychiatric inpatients using a semi-structured diagnostic instrument. The paper explores the relationship of patient race to schizophrenia, schizoaffective disorder, major depression, and bipolar disorder. The paper also explores the extent to which patient race is related to the manner in which clinicians link individual symptoms to diagnoses. Results indicate some significant race differences in diagnosis remain even when a semi-structured instrument and DSM criteria are used, whites, were more likely than African Americans to receive a diagnosis of bipolar disorder and less likely to be diagnosed with schizophrenia. There were no race differences in major depression. Some patterns of symptom attribution differed by race. The results are consistent with previous sociological research showing that patient race is related to diagnosis even when standardized diagnostic criteria are used. These findings underscore the importance of clinical judgment within the context of cross-race and cross-ethnic diagnosis. Clinical training programs must reduce ethnocentric bias by teaching the appropriate use of the socio-cultural information necessary to employ DSM-IV's Cultural Formulation.     

Demographic and Motivation Differences Among Online Sex Offenders by Type of Offense: An Exploration of Routine Activities Theories

This article presents an analysis of the relationship between online sexual offenders’ demographic background and characteristics indicative of motivation and offense type. Specifically, we investigate whether these characteristics can distinguish different online sexual offender groups from one another as well as inform routine activity theorists on what potentially motivates perpetrators. Using multinomial logistic regression, this study found that online sexual offenders’ demographic backgrounds and characteristics indicative of motivation do vary by offense types. Two important implications of this study are that the term “online sexual offender” encompasses different types of offenders, including some who do not align with mainstream media’s characterization of “predators,” and that the potential offender within routine activity theory can be the focus of empirical investigation rather than taken as a given in research.     

A multi-scalar critical analysis of return migration policies in Mexico

Services and resources for migrants returning to Mexico are necessary to ease their transition and “re-integration” into home communities. Policies that do not have a holistic approach can result in serious implications for the social, political, cultural, and health of returnees, receiving families, and communities. This research critically analyses return migration policies in Mexico drawing from the intersectionality-based policy analysis framework and a multi-scalar approach to critically study return migration policies in Mexico. We analysed 20 return migration policies using the principles of the intersectionality-based policy analysis framework. In 2021, we interviewed those impacted by return migration policies in Veracruz, Mexico to gain deeper insights into return migration policies. Women who stayed behind, return migrants, community leaders, and health-care providers were interviewed via phone or face-to-face in Spanish. Information was transcribed verbatim and analysed with the aid of computer-assisted data analysis software and quotes were translated into English. They shed light on two major inequities in policies: (1) the lack of acknowledgement of diversity or return migrants and (2) the exclusion of receiving families and communities from the “re-integration” process of return migrants. Based on the multi-scalar critical policy analysis, return migration policies in Mexico would benefit from a more comprehensive and inclusive approach where the needs of return migrants and community members are protected based on their diversity.