Barriers to successful treatment completion in child sexual abuse survivors

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.     

The Impact of Funding Modalities on the Performance of Indigenous Organisations

Governments’ choice of funding modality can produce powerful incentives for organisations to perform in preferred ways, but it can also divert limited resources, narrow accountability, and undermine capability. Through literature review and interviews, the research explored the international literature on public finance management in developing country contexts, and compared this to case studies of Indigenous organisations. The situation in Australia was found to differ in three ways: (1) performance indicators are imposed, rather than negotiated; (2) few existing public funding modalities reward performance or provide incentives; and (3) funding arrangements do not generally require receiving organisations to be accountable to their constituents. Stability and durability of funding modalities, and clarity in functions and jurisdictional boundaries, were also found to positively influence performance. Further research is required to design new performance frameworks that build around the organisation, rather than the grant, with indicators of governance capability and downward accountability to constituents.     

Toward a Demographic Understanding of Incarceration Disparities: Race,Ethnicity, and Age Structure

Objectives

Non-Hispanic blacks and Hispanics in the United States are more likely to be incarcerated than non-Hispanic whites. The risk of incarceration also varies with age, and there are striking differences in age distributions across racial/ethnic groups. Guided by these trends, the present study examines the extent to which differences in age structure account for incarceration disparities across racial and ethnic groups.

Methods

We apply two techniques commonly employed in the field of demography, age-standardization and decomposition, to data provided by the Bureau of Justice Statistics and the 2010 decennial census to assess the contribution of age structure to racial and ethnic disparities in incarceration.

Findings

The non-Hispanic black and Hispanic incarceration rates in 2010 would have been 13–20 % lower if these groups had age structures identical to that of the non-Hispanic white population. Moreover, age structure accounts for 20 % of the Hispanic/white disparity and 8 % of the black/white disparity.

Conclusion

The comparison of crude incarceration rates across racial/ethnic groups may not be ideal because these groups boast strikingly different age structures. Since the risk of imprisonment is tied to age, criminologists should consider adjusting for age structure when comparing rates of incarceration across groups.

     

Examining the Effects of Health in Explaining Fear of Crime: A Multi-Dimensional and Multi-Level Analysis

We examine the understudied link between mental/physical health problems and their relationship with perceived unsafety via higher levels of vulnerability. We examine this relationship by linking data at the individual-level, the neighborhood-level, and the county-level using the Portraits of American Life Survey (PALS). Using this data we examine the effect of individual and neighborhood conditions on perceived safety while controlling for county-level crime rates. Findings indicate that higher numbers of physical impairment and mental health issues are independently related to higher levels of perceived unsafety. Both mental and physical health problems are associated with higher levels of fear. These higher levels of vulnerability then directly contribute to higher levels of feeling of unsafety. Unlike past research, we find a mental health link to fear of crime that cannot be explained by physical impairments.     

Preparing children for cross-examination: do the practice questions matter?

Research has shown that a brief intervention involving practice and feedback can help children maintain accuracy when challenged with cross-examination-style questions. To date, however, researchers have prepared children using the same cross-examination challenges that they would encounter during the subsequent cross-examination interview. It is unknown whether the intervention will still be effective when children later face novel cross-examination-style questions. Six- to 11-year-old children (n?=?132) took part in a staged memory event, and were then interviewed with analogues of direct-examination (1–2 days later) and cross-examination (6–8 weeks later). One week prior to the cross-examination interview, some children participated in a preparation session, where they were given practice answering cross-examination-style questions about an unrelated topic, and feedback on their responses. For half of these children, the cross-examination-style challenges they encountered during the preparation session were the same as the challenges they subsequently faced during cross-examination; for the others, there was no overlap. Relative to a control group that did not receive the intervention, the preparation session resulted in better performance during cross-examination, regardless of the degree of overlap. These findings are encouraging given that we can never predict the questions that cross-examining lawyers will ask children.     

The Double Delegitimatisation of Julia Gillard: Gender,the Media,and Australian Political Culture

This article explores Australian media coverage of Julia Gillard's leadership. It employs a comparative discourse analysis of the gendered nature of media reporting on her sexism and misogyny speech and eventual demise. The article places these gendered framings within two contexts: that of the more general gendered expectations of the double bind facing all women leaders; and the more specific challenge to Australia's women leaders, posed by exclusivist national identity narratives. These narratives — of mateship, the ANZAC myth, and various apparently ideal‐type masculinities — serve to further disassociate Australian women from positions of national leadership. Together, we argue that the twin constraints of gender expectations and exclusivist national identity narratives amounted to a double delegitimisation of Julia Gillard's leadership, on the basis of her being a woman leader, generally, and an Australian woman leader, specifically.     

Truth,Effort, and the Legal Battle

In lawsuits, relative success depends upon two main factors:the true degree of fault, and the efforts invested on eachside. A proposed Litigation Success Function displays thisdependence while satisfying other essential properties. Undertwo different protocols, Nash-Cournot and Stackelberg,solutions are obtained for the litigation efforts,proportionate success, and values of the lawsuit on each side.Outcomes are evaluated in terms of two normative criteria; (i)achieving `justice' (interpreted as equality between Defendantfault and relative Plaintiff success) and (ii) minimizingaggregate litigation cost. Achievement of these aims isdetermined by the decisiveness of litigation effort relativeto true fault.     

Making a difference? Public perceptions of coalition,single-party,and minority governments

It is often argued that coalition governments are less likely to ‘make a difference’ than single-party governments. Because they are composed of multiple actors who need to agree to policy innovations, and because there are fewer personnel changes between successive coalition governments, coalitions are associated with fewer policy differences. From this it follows that public perceptions that governments should ‘make a difference’ will be weaker under coalition than single-party governments. The same logic applies to minority governments, which require support to pass legislation from opposition parties, and hence are less likely to deliver on their commitments. Using data from the Comparative Study of Electoral Systems, this paper tests these hypotheses. The expected effects, albeit small ones, are found for coalition governments, but only in old democracies.