The Use of E‐mail in the Therapy Process

The therapeutic letter has a long history, with roots in psychoanalytic work and continuing application in family therapy. The advent of e‐mail has allowed another form for therapeutic written communication which, while incorporating the benefits of therapeutic letters, adds to these. It has also opened up some potential risks. This article incorporates a brief review of the literature covering therapeutic written communication and offers a case example where e‐mail was used as an adjunct in face‐to‐face therapy with a client who experienced attachment difficulties. This therapy was informed by systemic and psychoanalytic traditions. The authors explore a variety of technical matters including the timing and crafting of e‐mail responses, the integration of written communication with face‐to‐face therapy, impact on the therapeutic relationship and management of crisis. Ethical issues such as confidentiality and duty of care are also considered.     

Research project on advocacy and autism

This article presents the findings of a qualitative research project about the difficulties in accessing advocacy faced by adults labelled as having autism and Asperger's Syndrome in the Northwest of England. It is also an example of partnership working between three organisations. The article examines both the process of team-led (emancipatory) research and the project findings. Seven main themes emerged throughout the research: late diagnosis and lack of service support; bad experiences with systems of care; feelings of 'not belonging' (identity issues); barriers around communication and sensitivity towards individuals; lack of awareness and access to advocacy and rights; difficulties of 'fitting into' what is already available; and interest in developing knowledge around advocacy. Examination of the main themes pointed to a disturbing link between poor service response, episodes of crisis and mental ill health. The Carlisle People First Research Team is made up of 6 researchers who are labelled as having 'learning difficulties' who work in partnership with one other researcher.     

Neutralizing marginally deviant behavior: Bingo players and superstition

Bingo is one of the most popular and most accepted forms of gambling in the United States today. Yet, despite its popularity, many bingo players are not completely comfortable with the moral rightness of their actions. This participant observation and interview study spanning a 5 year period shows how bingo players use superstitious strategies, such as feelings, hunches and psi, attitudes, and luck to neutralize their marginally deviant behaviors.     

When You Can't Afford to Leave Home: Clinical Implications of Economic Realities

Young adults entering the job market are finding that, despite strong corporate profits, economic growth is not trickling down to worker earnings, and federal policies are moving from the notion of entitlement to one of blame (Uchitelle, 1996, Sec. 4, p. 1). Adolescence is becoming increasingly confusing, since for many Americans economic opportunity is more fantasy than reality. This article highlights the declining opportunity for young adults and points out the limitations of existing adult developmental theory, both of which call for altered treatment conceptualizations that include the clinician operating as an anthropologist and utilizing the concepts of relationship-differentiation and response/ability from Stone Center writings.     

Physician perceptions of medical malpractice and defensive medicine

Using judgments obtained in interviews with 33 Massachusetts physicians, the annual statewide volume of expenditures incurred for defensive medical reasons in 1982 was estimated to be $1.0 billion, 12% of all medical care expenditures. Estimates for the nation were $37 billion, 14% of expenditures. Nationally, 180,000 cesarean deliveries were thought to be performed for defensive motives. In their own institutions, respondents judged 43% of all skull x-rays following injury to be medically justified, 30% to be defensive medicine, 16% to be placebos, and 11% to be physician misjudgments. In considering the economic and noneconomic costs of medical malpractice procedures, the dollar costs of insurance were considered most serious, followed closely by defensive medicine, unfairness, and poorer relations with patients. Thirty-two percent of the responsibility for the negative aspects of malpractice processes was assigned to lawyers, 21% to physicians, 18% to legislatures and courts, 16% to patients, and 13% to insurance companies.     

Evaluating alternative approaches to strategic planning

The question which, unfortunately, often goes unanswered, is whether a company's process of corporate planning is optimal. Furthermore, even if they wished to answer such a question there is little in the literature which can provide them with a direct, and explicit evaluative model. This paper examines the development of planning and the many different contributors towards its theoretical underpinning. Whilst recognizing that planning is a field which is a ‘semantic's jungle’ the authors carefully pick their way through the mine-field of misunderstanding and misquotation and clearly establish a base-line for evaluation and indeed propose a detailed methodology. It is hoped that this paper will be a fore-runner of many which will assist the executive in his important evaluative role concerning alternative planning approaches.     

Codes of Ethics: What Are They Really and What Should They Be?

Codes of ethics are prevalent in major corporations around the world. They are seen as the first tangible commitment to being ethical. This paper examines codes of ethics and tries to establish what they are, how they are developed and their net utility. We then proffer the idea of codes as the first part of a five-stage process that leads to an overall corporate commitment to being ethical in one's business dealings.     

Variable precision rough set theory and data discretisation: an application to corporate failure prediction

Since the seminal work of Pawlak (International Journal of Information and Computer Science, 11 (1982) 341–356) rough set theory (RST) has evolved into a rule-based decision-making technique. To date, however, relatively little empirical research has been conducted on the efficacy of the rough set approach in the context of business and finance applications. This paper extends previous research by employing a development of RST, namely the variable precision rough sets (VPRS) model, in an experiment to predict between failed and non-failed UK companies. It also utilizes the FUSINTER discretisation method which neglates the influence of an ‘expert’ opinion. The results of the VPRS analysis are compared to those generated by the classical logit and multivariate discriminant analysis, together with more closely related non-parametric decision tree methods. It is concluded that VPRS is a promising addition to existing methods in that it is a practical tool, which generates explicit probabilistic rules from a given information system, with the rules offering the decision maker informative insights into classification problems.