Volume 30

Theory and Society -     

Defining child abuse in Hong Kong

Definitions of child abuse are culturally driven. Hong Kong, with a predominantly Chinese population, has managed to eradicate much of the societal abuse that children suffer elsewhere in Asia. Professional and government attention has now shifted to child abuse and neglect within the family. The paper, based on interviews with key professionals. analysis of policy documents and practice records examines traditional Chinese parent-child relationships. the status of parental authority and corporal punishment and changes in contemporary Hong Kong family life. It goes on to outline the development of responses to child abuse in Hong Kong, some of the dilemmas that professionals face in defining abuse and areas for future research.     

Cognitive-behavioral-expressive interventions with aggressive and resistant youths.

Research into the nature of aggressive behavior in youths has demonstrated that these youths are often the victims of abuse, exhibit aggressive behavior in early childhood, and remain aggressive into young adulthood. The treatment approach described in this article is a modification of Monahan's [1981] model of the prediction of violent behavior and the anger-management approach of Novaco [1985], and integrates the developmental models of Piaget [1963] and Erikson [1959]. The program is a combination of cognitive, behavioral, and expressive therapies and is targeted to the reduction of dysfunctional cognitive, affective, behavioral, and problem-solving patterns of aggressive youths. As referrals of such aggressive clients are often involuntary, interventions with unwilling and resistant clients are also presented.     

Old and thin

Viewing an elderly patient's refusal of food from the perspective of the jain tradition of sallekhana (voluntary starvation) permits the author to reconcile her need to "do something" with her belief in the principle of patient autonomy.     

Is the American health care delivery system ready for change?

In October 1992, the American College of Physician Executives sponsored a study tour to Berlin, Germany, and Amsterdam, Holland. Meetings were held with government officials, third-party payers, and providers, and on-site visits were made at hospitals, clinics, and academic centers. The purpose was to study the health care delivery system in those countries and to share some insights with the countries' hosts on the U.S. system. In a series of reports that began in the July issue of the journal, 5 of the 10 study tour participants describe their impressions of the tour and of the health care systems in the countries that were visited. In this final report, the implications of the German and Dutch systems for reform of the U.S. health care system are discussed.