Consumer perspectives of New Zealand community treatment programmes for sexually abusive youth

Abstract

The aim of this process evaluation was to identify consumer perspectives of strengths and weaknesses of programme delivery at three New Zealand community treatment programmes for sexually abusive youth. Qualitative methods were employed, with data being obtained from in-depth interviews with 24 sexually abusive youth and 23 caregivers across three sites. Results indicated that clients value good pre-entry information to reduce barriers to participation; engagement in treatment is facilitated by the quality of the client–therapist relationship, family involvement, culturally appropriate communication and creative and physical activities; and post-treatment support is important. Findings highlight the importance of engaging adolescents and their families actively during the intake period, the treatment phase and post-treatment transition. They also support the use of flexible and integrated approaches to treatment that attend to the cultural context for ethnic minorities. This suggests that programmes should aim to provide wraparound services that promote engagement during the referral phase and offer transitional programmes and aftercare follow-up. Recognition should also be given to issues of cultural difference by ensuring that cultural services for ethnic minorities are integrated into all levels of programme delivery.     

MENTORS AND CRIMINAL ACHIEVEMENT*

Much of the research focusing on conventional occupations concludes that mentored individuals are more successful in their careers than those who are not mentored. Early research in criminology made a similar claim. Yet contemporary criminology has all but ignored mentors. We investigate this oversight, drawing on Sutherland's insights on tutelage and criminal maturation and incorporating ideas on human and social capital. We argue that mentors play a key role in their protégés' criminal achievements and examine this hypothesis with data from a recent survey of incarcerated adult male offenders in the Canadian province of Quebec. In this sample, a substantial proportion of respondents reported the presence of an influential individual in their lives who introduced them to a criminal milieu and whom they explicitly regarded as a mentor. After studying the attributes of offenders and their mentors, we develop a causal framework that positions criminal mentor presence within a pathway that leads to greater benefits and lower costs from crime.     

The Impact of Child‐Parent Psychotherapy on Child Dependency Court Outcomes

Although parental compliance with court orders in child welfare cases is key to achieving physical parent‐child reunification and successful case closure, little research has examined how parent‐child relationship‐focused rehabilitative services uniquely influence case outcomes. This project fills this gap by investigating links between court ordering of and parental participation in Child‐Parent Psychotherapy (CPP) with court outcomes. Data were obtained from court records of 448 court‐involved parents. Hierarchical regressions revealed that greater participation in CPP led to reunification and successful case closure but not faster case closure. Courtroom professionals should consider parent‐child relationship‐based therapies as tools for achieving child welfare goals.     

Family Drug Treatment Courts As Comprehensive Service Models: Cost Considerations

Literature on family drug treatment courts (FDTCs) suggests that parental participation in these courts is associated with improved substance abuse treatment and child welfare system outcomes. Despite these beneficial outcomes, FDTCs serve only 7‐10% of eligible child welfare involved families. As part of a FDTC evaluation, this FDTC site sought to provide stakeholders with information about costs and benefits. Considering the program costs alongside the cost avoidance from reduced time in foster care, this analysis determined that FDTC participation resulted in a net savings per child of $9,710. The cost component of the evaluation proved valuable, challenging, and informative.     

The Child's Attorney and the Alienated Child: Approaches to Resolving the Ethical Dilemma of Diminished Capacity

Increasingly lawyers for children follow a model of “client centered” (as opposed to “best interests”) representation in child custody disputes in which the child client defines the objectives of the representation. The client‐centered model, while appropriate in most cases to give voice to the child's preferences in a process that deeply impacts him or her, can create an ethical dilemma for the child's lawyer in cases where a child is truly alienated from the other parent by the actions of the alienating parent. Alienated children strongly and unreasonably express a preference for objectives of representation that might further damage the alienated parent's relationship with the child. The alienated child's objectives may be the result of a campaign of denigration and “brainwashing” by the alienating parent. This Note suggests that when a child is truly alienated from a parent, as diagnosed by a mental health expert, the child may have “diminished capacity” and therefore, the client‐directed model of representation is not adequate. This Note proposes that the Child's Attorney must determine whether the child is of diminished capacity under the Model Rules of Professional Conduct and, if so, must treat the client accordingly under Rule 1.14. Specifically, the attorney may, if all other remedial measures are inadequate, override the child's wishes and advocate a position that the child would take, but for the brainwashing of the child used to alienate him or her from a parent.     

Advocacy for battered women: A national survey

The literature defining advocacy for battered women is almost nonexistent and there is no systematic research on its parameters. This article reports the results of a national survey of 379 advocacy services in the United States. Findings on organizational context, definitions of advocacy, client issues and concerns, advocate activities, and advocate interactions with other social systems are presented. Possible explanations of an apparent emphasis on individual over system change are discussed.     

Healing Families: Outcomes from a Family Drug Treatment Court

Family drug treatment courts (FDTC) have been acknowledged as a promising intervention for substance‐abusing parents involved in the child welfare system. Over the past decade, the number of FDTC programs has grown substantially, yet questions remain regarding the efficacy of these courts. This study examines the ability of the Snohomish County (WA) FDTC to address the three main goals of the Adoption and Safe Families Act. Utilizing propensity score matching, this study found that participants were more likely to have their children returned, experienced stronger treatment completion rates, and had less use of foster care. Implications for replication and further analysis are discussed.     

Parent and Metabolite Opioid Drug Concentrations in Unintentional Deaths Involving Opioid and Benzodiazepine Combinations,,

Effects of benzodiazepines on postmortem opioid parent and parent/metabolite blood concentration ratios were determined for fentanyl‐, hydrocodone‐, methadone‐, or oxycodone‐related accidental deaths. These opioids are partially metabolized by the CYP3A4 enzyme system, which is also affected by diazepam and alprazolam. Opioid/metabolite combinations examined were as follows: fentanyl/norfentanyl, hydrocodone/dihydrocodeine, methadone/EDDP, and oxycodone/oxymorphone. Parent opioid concentrations were analyzed for 877 deaths. Parent/metabolite concentration ratios were analyzed for 349 deaths, excluding cases with co‐intoxicants present known to interfere with opioid elimination. Alprazolam in combination with diazepam significantly decreased median hydrocodone concentrations by 48% (p = 0.01) compared to hydrocodone alone. The methadone parent/metabolite concentration ratio was reduced by 35% in the presence of diazepam compared to methadone alone (p = 0.03). Benzodiazepines did not statistically significantly affect fentanyl or oxycodone concentrations. Possible factors affecting opioid concentrations and possible toxicity development, including any differential effects on specific opioids, should continue to be explored.     

CONTRIBUTIONS OF FAMILIES AND PEERS TO DELINQUENCY*

A model is presented that explains the contribution of parents and peers to adolescent delinquent behavior. It is hypothesized that during adolescence a failure in Parent Monitoring and deficits in Social Skills increase the likelihood that a youngster associates with Deviant Peers. Poor Parent Monitoring Deviant Peers, and low levels of Academic Skills are hypothesized to contribute directly to an adolescent's engagement in delinquent behavior, The present model was tested on a sample of 136 seventh and tenth grade male adolescents by using the structural modeling approach in the LISREL IV analysis program (Jöreskog & Sörbom, 1978). The major revision of the model was that the correlation between Academic Skills and Parent Monitoring was set to zero. A chi square goodness-of-fit test for the revised model showed adequate agreement between the hypothesized model and the observed covariance structure of the data. It was suggested that a number of requirements be completed before accepting the above model: (1) replication of this model on a new set of data, (2) longitudinal analyses showing the hypothesized relations through time, and (3) experimental testing by manipulation of one or more independent variables, as is possible in clinical intervention studies.     

LEGAL PROFESSIONALS AS TEACHERS OF FOSTER YOUTH: CHANGING EXPECTATIONS AND DEMANDING THE BEST

The foster care system sets low expectations for foster youth, and ultimately the system produces poor results in terms of outcomes. In its unique role, the legal system and its actors have the responsibility and opportunity to change expectations, mentor, and provide a frame work for successful reform using the skills inherent in the practice and study of the law. Importantly, foster youth must be supported and expected to achieve high educational outcomes through goals that are developed in partnership with service providers and professionals like attorneys.     

Affective determinants of treatment engagement in violent offenders

Affective factors are likely to play a major role in determining the extent to which offenders are able to engage with, and benefit from, treatment. In this article, it is argued that the relationship between affect and treatment engagement may be understood in three ways: the access the client has to emotional states, the ability to express such states, and the willingness of the client to do this in the therapeutic session. It is suggested that affective determinants of treatment readiness can be understood with reference to models of emotional regulation and that attention to these affective factors in the early stages of treatment is likely to promote engagement, reduce attrition, and consequently improve treatment outcomes for violent offenders.     

Evolution of the psycho-legal studies program

This article describes Saleem Shah's role as a mentor and consultant to the author. The author focuses on his influence in the development of the author's research program, examining issues in the police arrest of mentally ill offenders and the need for mental health services for jail detainees.     

Exploring Lawyer–Client Interaction

Personal injury victims involved in compensation processes have a worse recovery than those not involved in compensation processes. One predictor for worse recovery is lawyer engagement. As some people argue that this negative relation between lawyer engagement and recovery may be explained by lawyers’ attitude and communications to clients, it seems important to investigate lawyer–client interaction. Although procedural justice and therapeutic jurisprudence had previously discussed aspects relevant for lawyer–client interaction, the client’s perspective has been rather ignored and only few empirical studies have been conducted. In this qualitative study, 21 traffic accident victims were interviewed about their experiences with their lawyer. Five desirable characteristics for lawyers were identified: communication, empathy, decisiveness, independence, and expertise. Communication and empathy corresponded with aspects already discussed in literature, whereas decisiveness, independence and expertise had been addressed only marginally. Further qualitative and quantitative research is necessary to establish preferable lawyer characteristics and to investigate what would improve the well-being of personal injury victims during the claims settlement process.     

Co‐Parent Court: A Problem‐Solving,Community‐Based Model for Serving Low‐Income Unmarried Co‐Parents

The Hennepin County Co‐Parent Court Project was a 3‐year demonstration project for unmarried co‐parents. The goal of the project was to remove barriers to co‐parenting in low‐income, unmarried parents. The Co‐Parent Court Project encompassed a number of services, including educational workshops, individual case management, parenting plans, legal mediation, and, if needed, supports and treatment for domestic violence. There are published articles that highlight the participant outcomes of the Co‐Parent Project. This article, however, focuses on the background for why this project was developed, components of this project, and lessons learned from implementation.     

FAMILY BRIDGES: USING INSIGHTS FROM SOCIAL SCIENCE TO RECONNECT PARENTS AND ALIENATED CHILDREN*

This article describes an innovative educational and experiential program, Family Bridges: A Workshop for Troubled and Alienated Parent‐Child Relationships^TM, that draws on social science research to help severely and unreasonably alienated children and adolescents adjust to court orders that place them with a parent they claim to hate or fear. The article examines the benefits and drawbacks of available options for helping alienated children and controversies and ethical issues regarding coercion of children by parents and courts. The program's goals, principles, structure, procedures, syllabus, limitations, and preliminary outcomes are presented. At the workshop's conclusion, 22 of 23 children, all of whom had failed experiences with counseling prior to enrollment, restored a positive relationship with the rejected parent. At follow‐up, 18 of the 22 children maintained their gains; those who relapsed had premature contact with the alienating parent.     

BRINGING PEACE TO THE LATINO COMMUNITY

This study addresses the need for a parent education program for divorcing and separating parents in the Latino community. It is intended to identify special needs and issues that may affect the implementation of such a program and proposes a framework as to how such issues might be addressed and met. This study is based on the implementation of the PEACE (Parent Education and Custody Effectiveness) program, an existing parent education program in New York State. This study will explore how the program may need to be adapted or modified to serve adequately and effectively the Latino community.     

Trauma‐Informed Interventions in Parent–Child Contact Cases

Parent–child contact problems may arise in the context of high conflict separation/divorce dynamics between parents. In cases where there are parent–child contact problems and children resist or refuse contact with one of their parents, there may also be incidents of child maltreatment, intimate partner violence, or compromised parenting that can be experienced by a parent or child as traumatic. The circumstances around separation and/or post‐divorce often result in intense stress for families. In this paper we distinguish between the stressful circumstances that may arise as a result of high interparental conflict and pulls for alignment from a parent, and the real or perceived trauma as a factor which contributes to resistance or refusal of a child to have contact with a parent. Interventions to address both trauma responses and the resist‐refuse dynamics are differentiated and discussed. After screening and assessment, the intent is to treat trauma responses with short‐term, evidence‐based therapy, either before or concurrent with co‐parent and family intervention.     

Texas Christian University (TCU) Short Forms for Assessing Client Needs and Functioning in Addiction Treatment

The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (1-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for treatment (MOTForm), psychological functioning (PSYForm), social relations and functioning (SOCForm), and therapeutic participation and engagement (ENGForm). These instruments facilitate optically-scanned data entry, computerized scoring, and rapid graphical feedback for clinical decisions. The present study (based on 5,022 inmates from eight residential prison treatment programs) examines evidence on scale reliabilities and measurement structures of these tools. Results confirmed their integrity and usefulness as indicators of individual and group-level therapeutic dynamics.     

Australian mental health tribunals--'Space' for rights, protection, treatment and governance?

This paper draws on a multi-year Australian collaborative study of mental health review tribunals ('MHTs') in three jurisdictions (Victoria, New South Wales and the Australian Capital Territory) undertaken in conjunction with the NSW Law and Justice Foundation, using qualitative and quantitative methods to examine the role of MHTs in advancing goals such as fairness, legality and access to treatment. Study findings regarding stakeholder and client concerns - about access to quality treatment and associated support services, review of treatment adequacy and drug regimes, and their 'participation' or dignity of engagement in review processes - are presented as variants of the need for adequate hearing 'space': temporal, jurisdictional, cognate/relational, physical and symbolic, and 'connective'. Building on earlier arguments for MHTs to engage not only legal, but also clinical and social domains, and for adopting some processes more characteristic of case-conferencing, this paper examines the implications of tribunal 'flexibility' and a wider overall 'governance' jurisdiction in mental health.