BC court orders government to pay for treatment

On 9 October 2002, the British Columbia Court of Appeal upheld a ruling of a BC court that the BC government must not discriminate against a disabled and disadvantaged group when choosing what medical treatments it will fund. The Court of Appeal ordered the BC government to pay for a particular form of treatment. The case is significant in the context of HIV/AIDS because it could lend support to arguments that a government must make appropriate accommodation for the health-care needs of other disabled and marginalized groups--for example, safe injection supervision for the treatment of addiction.     

Les innovations techniques en santé: le processus décisionnel et les limites de la réglementation

Sommaire: Dans nos sociétés, les décisions relatives aux nouveaux équipements techniques en santé sont en général prises au sein d'instances relevant plus ou moins directement du pouvoir gouvernemental (ministères, organismes régionaux, hôpi-taux, etc.). Plusieurs intervenants agissent dans ce milieu public où, comme acteurs du processus décisionnel, ils ont à résoudre diverses incertitudes et è tenir compte d'enjeux politiques, professionnels ou organisationnels. L'influence de ces incertitudes et de ces enjeux sur les décisions dépend aussi beaucoup de la phase (décou-verte, implantation ou diffusion, par exemple) dans laquelle se trouvent les innovations à un moment donné. Cet article tente donc de démontrer la complexité du processus décisionnel dans la mise en place des nouvelles technologies médicales de haute intensité. II met I'emphase sur le rôle et les limites de la réglementation. Abstract: In our society, decisions concerning new technical equipment for health care are in general made by bodies that are more or less directly under government control (ministries, regional bodies, hospitals, etc.). As actors in the decision-making process, these entities are required to clear up many uncertainties and take into account the political, professional or organizational issues. The influence of these uncertainties and issues on decision-making also depends on the stage (for example, discovery, introduction or dissemination) that an innovation has reached at any given moment. This article attempts to illustrate the complexity of the decision-making process as regards the implementation of new advanced medical technologies, and emphasizes the role and the limitations of regulation.     

CUSTODY EVALUATIONS

The procedures used to conduct custody evaluations and the purpose of such reports are currently under review by mental health and legal professionals. This article describes (a) the limitations inherent in clinical assessment and (b) characteristics of the adjudication process which necessarily limit the evaluator's thoroughness and the potential usefulness of evaluations. Given the primitive methods available for assessing families and predicting outcomes, the inability and unwillingness of the courts to process large amounts of clinical data, the conflicting motives surrounding evaluations, and the biases inherent in custody recommendations, the author argues for limited, well-defined, and objectively supported assessment procedures and evaluation criteria.     

Family Functioning and School Success in At-Risk, Inner-City Adolescents

The relation between family functioning and school success was examined in 211 at risk, African American, inner city adolescents attending middle school (grades 6–8). Interviews with adolescents and caregivers yielded data on family cohesion, parental monitoring, and school engagement; school records provided data on grade point average. Results showed that both family cohesion and parental monitoring predicted school engagement, but neither family characteristic predicted GPA. Important gender differences also emerged. For boys only, the relation between family cohesion and school engagement was stronger when parental monitoring was high. For girls only, the effects of cohesion and monitoring on school engagement were additive: girls with both high family cohesion and high parental monitoring were most likely to be engaged in school. These findings extend the research base on family protective factors for antisocial behavior in young adolescents. Implications for future examination of family process characteristics in high-risk adolescents are discussed. This work is based on the dissertation research of the first author submitted to the Department of Psychology at Fordham University. Research Associate, Hudson Valley Cerebral Palsy, Patterson, NY. Professional Training: PhD, Developmental Psychology, Fordham University. Major interests include etiology and treatment research on developmental disabilities and psychological health problems in children and adolescents. Senior Research Associate, The National Center on Addiction and Substance Abuse (CASA) at Columbia University, New York, NY. Professional Training: PhD, Clinical Psychology, Temple University. Major interests include development of family-based interventions for adolescent drug use and delinquency, adherence and process research on family intervention models. Research Associate, National Clinical Assessment Authority, London, England. Professional Training: PhD, Developmental Psychology, Fordham University. Major interests include mental health services research and program evaluation. Professor and Director, Center for Treatment Research on Adolescent Drug Abuse, University of Miami School of Medicine, Miami, FL. Professional Training: EdD, Counseling Psychology and Family Therapy, Northern Illinois University. Major interests include developing, testing, and disseminating family-based treatment for adolescent substance abuse and related behvioral problems.     

Predictors of Attrition in a Treatment Program for Battering Men

This study examines factors associated with the high attrition rate in treatment programs for men who batter. In accord with past research, we expected demographic variables of age, race, employment status, relationship status, and socioeconomic status to predict attrition. We also hypothesized that attitudinal and personality variables, as well as contextual/program variables, might account for attrition more parsimoniously. Specifically, we hypothesized that attrition would be predicted by frequency and severity of violence, denial of a problem with violence, rigidity of thinking, low levels of self-disclosure, and higher anxiety and constriction in social situations. In addition, we predicted attrition would relate to dependency, maladaptive personality styles, and expectations regarding group counseling (e.g., whether treatment is perceived as aversive). Finally, we proposed that attrition would relate to whether batterer participation in treatment was self-motivated or the result of external pressures. Participants were 61 men enrolled in a batterer treatment program in a mid-sized city. Analyses of variance and discriminant analyses indicated that program attrition was unrelated to demographic, attitudinal, or personality variables. Only the contextual/program variables of mileage traveled to attend and external monitoring of attendance significantly differentiated treatment rejecters, drop-outs, and treatment continuers. Findings are discussed with regard to intrinsic and extrinsic motivational factors. Future directions for exploration are discussed.