The effectiveness of relapse prevention with offenders: a meta-analysis

Although relapse prevention models have been applied within offender treatment, there has been little controlled outcome research evaluating their effectiveness. This meta-analysis of 40 tests of relapse prevention treatment revealed moderate mean reductions in recidivism (0.15), and certain elements of the relapse prevention model (i.e., training significant others in the program model and identifying the offense chain) yielded stronger effects than others (i.e., provision of booster/aftercare sessions and developing coping skills). Further analyses revealed that the clinically relevant and psychologically informed principles of risk, need, and general responsivity yielded the strongest reductions in recidivism. The implications for future research and treatment are discussed.     

Schizophrenia as a cause of death

Schizophrenia is a chronic disorder that is associated with increased mortality. Although traumatic deaths account for most of this increase, there is also an increased rate of natural deaths in this population. Altered autonomic physiology in this group might contribute to death. To determine if there are schizophrenics in whom, after a complete autopsy, no recognizable cause of death other than schizophrenia is established, the records of the Office of Chief Medical Examiner of the City of New York were reviewed for deaths associated with schizophrenia and a natural manner of death. Six such decedents were identified, and their histories and autopsy results are described. We believe that schizophrenia per se is a potentially lethal disorder. Autonomic irregularities and their interactions with psychotropic drugs deserve further attention.     

Making the Health Insurance Flexibility and Accountability (HIFA) waiver work through collaborative governance

This paper argues that collaborative governance should be an essential component in any HIFA waiver proposal, due to the fact that the health care system is moving away from a federal and hierarchical program design and implementation towards a more local, collaborative approach. As several current collaborative projects demonstrate, collaboration may overcome barriers to health expansion program success, such as stakeholder buy-in, notice, and state access to private health coverage information. Furthermore, collaboration within the context of the HIFA waiver process may maximize the strengths of current collaborations, such as providing: (a) access to greater and more stable funding sources; (b) access to a facilitator that can collect and distribute data; and (c) an avenue for accountability. Multiple challenges in ensuring collaborative governance are reviewed. Ms. Zabawa argues that these challenges are not insurmountable if states adopt a truly collaborative approach to designing and implementing programs under the HIFA waiver; there may be hope in expanding and improving health coverage, since collaboration is the most appropriate mechanism to address the complexity of health system reform.     

Explaining a paradox of mediation

Negotiation Journal -