Experiences of coercion during investigation and treatment

According to Swedish legislation (LVM) compulsory treatment shall be decided on if someone, due to ongoing abuse of alcohol, drugs or volatile solvents, is in need of care to overcome abuse and if a voluntary intervention is not possible. Very little research has been conducted in Sweden on this particular legislation with regard to the clients' experiences of entire process from assessment to aftercare. We interviewed 74 subjects who were being assessed prior to the court's decision on involuntary care (n=39), or with previous experience of assessment and involuntary care (n=35). The assessment group more often reported having the opportunity to express their opinions to the social worker during the assessment period (55% vs. 21%, p<.05) and they were more positive towards the final decision (60% vs. 24%, p<.05). In spite of the law, 18% were not contacted by the social services while in coercive treatment. The clients who did meet with a social worker, often described the conferences as more of a perfunctory nature with a lack of focus on the actual situation and aftercare planning. This study points at a need of studying the subjects' experiences of the whole continuum of the coercive process: from the investigation, to treatment and to aftercare. It also points at the need for new instruments to be developed covering all aspects of the coercive process and in particular the period of investigation prior to the decision on involuntary care.     

In the wake of a negligent release law suit

Several staff members at a state psychiatric hospital were found negligent in a jury trial for having released a psychiatric patient who subsequently killed a member of the plaintiff's family. This study explored the impact of the law suit on the hospital staff members as individuals and on the functioning of the institution. Self-report measures revealed that both named defendants and nondefendant staff experienced symptoms of emotional disturbance associated with the litigation. Self-report measures suggest that the law suit was not instructive in any meaningful way regarding improved procedures for subsequent release decision making. Archival data indicate that the staff did release significantly fewer patients during the trial and follow-up period than prior to the litigation. Results are discussed in the context of Wexler's concept of therapeutic jurisprudence.This study was supported by a grant from the Research Grants Committee of the University of Alabama. The results are the opinions of the authors and do not reflect the opinions of the Research Grants Committee or the University of Alabama. We are indebted to Saleem Shah for his suggestions regarding methodology and particularly the need to investigate positive and instructive aspects of law suits.     

Does involuntary outpatient commitment lead to more intensive treatment?

Studies of involuntary outpatient commitment (OPC) among persons with severe mental illness have concluded that OPC is only effective in improving treatment outcomes when it is sustained for 6 months or longer and is combined with frequent outpatient services. This article explores factors that influence the delivery of outpatient services to subjects in a randomized trial of OPC and finds 2 general patterns. Outpatient visits were more frequent among all subjects with apparent clinical need, regardless of study assignment, and among subjects whose OPC was sustained beyond an initial court order. These results suggest that, in practice, sustained OPC represents a consensual agreement between clinicians and the court to more intensively address the complex needs of persons with severe and persistent mental illness.     

Note takers who review are less vulnerable to the influence of stereotypes than note takers who do not review

Abstract

The current research investigated whether the opportunity to review reduced note takers' vulnerability to the influence of stereotypes when making decisions. Participants were presented with a trial in which a man or a woman had been charged with a stereotypically masculine crime. Results revealed that note takers who did not review were more likely to find a man guilty than a woman, and attributed a higher degree of offender relevant traits to a man than to a woman. Non-note takers and note takers who reviewed did not engage in stereotype-based processing. It was concluded that the provision of dedicated review periods reduced the extent to which note takers were influenced by stereotypes during decision making. Future research may consider investigating whether the benefit of dedicated review periods remains when jurors are presented with longer trials and when they are required to engage in deliberation.     

Emotional Experiences and Motivating Factors Associated with Fingerprint Analysis

Abstract: In this study, we investigated the emotional and motivational factors involved in fingerprint analysis in day‐to‐day routine case work and in significant and harrowing criminal investigations. Thematic analysis was performed on interviews with 13 experienced fingerprint examiners from a variety of law enforcement agencies. The data revealed factors relating to job satisfaction and the use of skill. Individual satisfaction related to catching criminals was observed; this was most notable in solving high profile, serious, or long‐running cases. There were positive emotional effects associated with matching fingerprints and apparent fear of making errors. Finally, we found evidence for a need of cognitive closure in fingerprint examiner decision‐making.     

“Knowledge and Death Penalty Opinion: The Marshall Hypotheses Revisited.”

This study tests the three hypotheses derived from the written opinion of Justice Thurgood Marshall in Furman v Georgia in 1972. Subjects completed questionnaires at the beginning and the end of the fall a semester. Experimental group subjects were enrolled in a death penalty class, while control group subjects were enrolled in another criminal justice class. The death penalty class was the experimental stimulus. Findings provided strong support for the first and third hypotheses, i.e., subjects were generally lacking in death penalty knowledge before the experimental stimulus, and death penalty proponents who scored “high” on a retribution index did not change their death penalty opinions despite exposure to death penalty knowledge. Marshall’s second hypothesis--that death penalty knowledge and death penalty support were inversely related--was not supported by the data. Two unexpected findings were that death penalty proponents who scored “low” on a retribution index also did not change their death penalty opinions after becoming more informed about the subject, and that death penalty knowledge did not alter subjects’ initial retributive positions. Suggestions for future research are provided.     

Equity,equality, and need: A study of the patterns and outcomes associated with their use in intimate relationships

This study examined the extent to which specific justice principles (equity, equality, and need) are associated with different orientations within complex relationships. This contrasts with previous research that has focused on the extent to which justice principle use varies across relationships representing distinctly different goals. Forty-eight men and 60 women were randomly assigned to conditions of equity, equality, or need. Each was asked to describe a recent incident from their own relationship illustrating the principle to which they were assigned. Incidents were coded into one of three domains representing the multiple orientations of intimate relationships. Subjects in the need condition were more likely to describe incidents related to issues of nurturance or personal development, whereas subjects in equity and equality were more likely to describe incidents related to the allocation of responsibilities. Subjects in the equality condition rated their principles as a more desirable basis for decision making in intimate relationships than subjects in either equity or need. Regardless of the relationship domain, subjects in the equality as compared to the equity condition also reported more positive feelings about the decision and themselves as well as more positive and less negative feelings toward their partner.     

Social Support Related to Women Who Have Remained with Their Partners After the Physical Violence has Ceased

Using a U.S. nationally representative sample (N?=?5,692; U.S. National Comorbidity Survey- Replication Part II [NCS-R]; Alegria et al. 2007), this research explored social support as a possible protective factor for abused women. Women who were physically abused by their partners, but not during the past year reported more positive social support from friends than women who continued to experience physical violence or women who had not experienced partner violence. Women who had experienced recent physical violence reported more negative social support than women who had not experienced partner violence. These findings suggest that positive social support might be a protective mechanism for women in abusive relationships.     

There's Nothing New in Dying Now: Will Welfare Attorney Decision Making at End of Life Make a Real Difference?

Advance care planning is a way to express value‐based preferences in order to guide future treatment decisions following loss of decision‐making capacity. It aims to ensure that one's critical values continue to influence healthcare decisions, particularly at end of life. The Mental Capacity Act 2005 permits adults with capacity to appoint welfare attorneys to act as their proxy decision‐makers following loss of capacity. A focus group study was used to explore the views and perceptions of lawyers and health professionals to attorney decision making at end of life. Whilst participants gave a guarded welcome to the introduction of healthcare and welfare attorneys, potential challenges were identified, based upon professional norms and expectations. A shared consensus was that the realization of the full potential of proxy decision making was likely to be a theoretical, rather than real, benefit. Opinions were divided on elemental tenets such as prospective autonomy, best interests, and the potential for conflict.     

Canada: study demonstrates positive effect of methadone treatment

A recent study on methadone maintenance treatment (MMT) in federal correctional institutions demonstrates that MMT has a positive impact on release outcome and on institutional behaviour. The study provides support for the need to expand access to MMT in prisons. Importantly, it concludes that the CSC may spend less money on offenders who are on MMT in the long term, saying that "the cost of the institutional MMT program may be offset by the cost savings of offenders successfully remaining in the community for a longer period of time than equivalent offenders not receiving MMT."     

The reduction of male abusiveness as a result of treatment: Reality or myth?

A 6-month outpatient treatment program for male abusers emphasized honesty, shame reduction, and group support for change. Ratings on the Abusive Behavior Inventory (ABI) obtained before and immediately after treatment demonstrated a significant decrease in physical and psychological abuse as rated by both the abusers and their female partners. This decrease in male abusiveness was maintained 6 months and two years after completion of treatment for those couples who cooperated in followup. No decrease in male abusiveness was observed during treatment, however, for those couples who did not cooperate in the followup. The authors suggest that the noncooperative female partners may have been afraid to rate their partners because of continued abuse. Therefore, the selective attrition of subjects who did not improve is a major problem in evaluating the apparent long-term success of treatment.     

Emotion Regulation in Police Officers Following Distress: Effects of Tenure and Critical Incidents

This study focuses on the functionality of emotion regulation of police officers who have or have not experienced a work-related critical incident. Traumatic events experienced by police officers may have long-lasting and significant consequences, including health concerns, emotional difficulties, impairment in social functioning, and they may have an impact on work performance. The hypotheses outline the expected results to include higher scores for officers who had been involved in one or more critical incidents in emotional well-being concerns and more difficulties with emotion regulation as compared to officers who had not experienced a critical incident. The research design employs written instruments including the General Health Questionnaire-30 to measure general emotional well-being, the Impact of Events Scale to measure the impact of a past traumatic event, and the Difficulties in Emotion Regulation Scale to measure current problems with emotion regulation. Participants consist of 76 full-time police officers assigned to patrol in two police agencies. The findings, analyzed through analysis of variance, did not include significant differences between those groups as expected; however, there were unexpected findings. These findings were that although newer officers were less likely to have experienced one or more work-related critical incidents, they measured higher in measures of emotion regulation difficulties and concerns regarding emotional well-being than did the more tenured officers. The social implications of this study include increased officer and agency awareness and increased use of effective intervention. Implications for future study include the need to further explore emotional challenges that may be experienced by new police officers.     

Commodifying life? A pilot study of opinions regarding financial incentives for organ donation

In recent years many policy proposals have been put forward to create financial incentives to encourage families to allow the harvesting of organs from their deceased relatives. While research has focused on whether these policies would actually increase the supply of organs, no research has focused on testing the ethical concerns about such policies. This article presents the findings of a pilot study conducted to determine whether people think that families should end life support of a family member in order to harvest organs if various incentive policies are in place. While the findings do not suggest a direct effect of these inducements, they do indicate that the amount of money received from organ donation is a consideration in making the decision whether to end life support. The implications of this finding for ethical debates and health policy are reviewed.     

The Impact of Acceptance and Commitment Therapy on Positive Parenting Strategies Among Parents Who Have Experienced Relationship Violence

Evidence supports the use of acceptance and commitment therapy (ACT) for well-being and behavior change among parents. This study examined the impact of a brief ACT intervention on positive parenting strategies, psychological flexibility, and distress among parents who have experienced relationship violence.As part of a larger study, 43 parents were recruited from a community outreach center and completed measures of parenting, ACT processes, and distress. Participants were pseudo-randomly assigned to either receive their treatment-as-usual (TAU) or ACT plus TAU. Twenty-five participants received four weekly sessions of ACT plus TAU, and 18 received TAU only. Positive parenting behaviors among parents in the ACT?+?TAU group improved immediately following treatment compared to the TAU group. Improvements were maintained six weeks following treatment. The hypothesis that psychological flexibility would mediate improvements was not supported.The present study provides initial, preliminary support for the secondary benefits of brief, broad ACT interventions for positive parenting behaviors among parents who have experienced relationship violence. Clinical implications for implementing ACT for parents who have experienced relationship violence and methodological limitations are discussed.     

Medical Treatment of Children with HIV Illness and the Need for Supportive Intervention: The Challenges for Medical Providers,Families, and the State

Human immuno‐deficiency virus (HIV) illness in children poses tremendous challenges to medical providers and families to work together to deliver optimal care. An alternative to filing “neglect” reports with the Department of Social Services is necessary to provide support and appropriate intervention to families and medical providers caring for HIV‐positive children. The creation of a neutral entity that could intervene and identify barriers to treatment and communication between the medical providers and the family would benefit all the parties involved. Knowledgeable mediators could help facilitate communication and identify appropriate support for the child and family. Intervention would not be delayed until it is demonstrated that a child has been “neglected” or is at substantial risk of harm. Assistance could be made available without a finding that a parent was guilty of wrongdoing. Involving parents as full partners in medical decision making and monitoring would benefit children living with HIV now and in the future. The creation of an alternative process will also prove valuable in assisting providers and families caring for other medically at‐risk children, e.g., children with asthma, diabetes, or mental illness.     

Involuntary outpatient commitment.

This article offers a novel approach to outpatient commitment (OPC). After distinguishing 4 varieties of OPC, the article shows how 3 are easy to justify, whereas "preventive outpatient commitment" (POC) requires more careful scrutiny. The article argues that, as a general matter, POC is not justified, except for on a "one free shot" basis. The hope is that patients will come to appreciate the benefits of treatment in the community and will become voluntarily compliant; after one free shot, they are in a much better position to decide. The consequences of noncompliance are also explored.     

CHILDREN'S AND PARENTS’ PERCEPTIONS ON CHILDREN'S PARTICIPATION IN DECISION MAKING AFTER PARENTAL SEPARATION AND DIVORCE*

This article outlines the views of children and parents involved in family law disputes, about the need for and appropriateness of children's participation in decisions regarding residence and contact arrangements. Ninety parents and 47 children (ranging in age from 6 to 18 years) who had been through parental separation, were interviewed. Both parents and children had a range of views about the general appropriateness and fairness of children being involved, but the great majority, particularly of parents, thought that children should have a say in these matters. Core findings of the study include the considerable influence that older children had over the arrangements either in the aftermath of the separation or in making further changes over time, and the higher stated need of children who had experienced violence, abuse, or high levels of conflict to be heard than those in less problematic and noncontested matters. Parents involved in contested proceedings supported the participation of children at a younger age than those who were not. There was a reasonable degree of agreement between parents and children about the need for children to be acknowledged and the value of their views being heard in the decision‐making process. Parents, however, expressed concern about the pressure and manipulation that children can face and exert in this process, whereas children were generally more concerned about the fairness of the outcomes, and maintaining their relationships with their parents and siblings.