Dilemmas for clinicians in use of Community Treatment Orders

Clinicians who treat patients using Community Treatment Orders (CTOs) face many potential dilemmas in their relations with involuntary outpatients and the exercise of their powers. We compare the dilemmas identified in the literature with those reported by responsible clinicians in New Zealand (NZ). These clinicians experienced a number of well-known dilemmas, such as determining the right moment for a person's discharge from a CTO, but they seemed less troubled by some other difficulties than might be expected, usually because they considered involuntary outpatient treatment the best option for the patient or the best way to manage the risks involved. Further dilemmas were identified by the NZ clinicians that have not been widely discussed, concerning the proper scope of clinical authority over patients under CTOs and the decision to revoke involuntary outpatient status. In conclusion, some suggestions are made as to how clinicians might best manage the dilemmas involved.     

Brain function and writing with the unaccustomed left hand

Twenty right-handed subjects were asked to handprint a passage containing all the letters of the alphabet once with each hand. The purpose was to describe the changes a document examiner can expect to find in handprinting done with the unaccustomed left hand and to offer a hypothesis as to why these changes occur. It was found that many of the writers displayed persistent differences between their right- and left-hand writings. It is suggested that these differences were due to both a lack of manual dexterity when writing with the unaccustomed left hand and to the fact that different neurophysiological processes are involved.     

Normal responses to sexually anatomically detailed dolls

The behaviors and verbalizations of normal, preschool age boys and girls during interactions with sexually anatomically detailed (SAD) dolls were examined. A structured, nonsuggestive interview with each child was videotaped, and five behaviors and five verbalizations were coded for each of five phases of the interview. A two-way ANOVA (gender × phase) showed that during those phases when the dolls were undressed, both boys and girls showed more sexual exploratory play, aggressive behavior which was nonsexual, and active avoidance. Across all phases, nonsexual aggression accounted for 31% of the boys' and 22% of the girls' total responses. Behavioral and verbal sexual exploratory play represented 42% of the boys' responses and 50% of the girls' responses. In contrast, sexually aggressive behavior accounted for only 1% and 2% of the boys' and girls' responses, respectively. Girls interacted with the dolls more than did boys. Additionally, girls demonstrated more affection to the dolls than did the boys, and boys displayed more anxiety with the dolls than did girls. Investigators should be cautious as to inferences about preschoolers' interactions with SAD dolls, especially interactions of a sexual or aggressive nature which do not clearly depict fondling or intercourse.     

Leadership and the Transformation of a Major Institution: Charles Rossotti and the Internal Revenue Service

Charles Rossotti took the helm at the Internal Revenue Service in 1997 amid complaints of abuse of both IRS workers and taxpayers. Did he succeed at improving the agency’s image without sacrificing its principal mission to enforce the tax code fairly and effectively? This retrospective on Rossotti’s five‐year tenure suggests that he, his leadership team, and teams of IRS employees managed effective changes that substantially improved services to taxpayers and the administration of a beleaguered revenue‐collection system. His leadership offers valuable lessons and insights for administrators in all settings. Are there invaluable lessons that public administrators might learn from Rossotti’s management strategy?