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The problems and needs of rural substance abusers vary from those of abusers in urban areas. Accordingly, the means of treatment must acknowledge and address these differences. Despite this call for specialized care, no theoretically grounded therapy has yet been made available to rural patients.
Behavioral Therapy for Rural Substance Abusers, developed and piloted over three years by University of Kentucky faculty and staff and substance abuse counselors in rural eastern Kentucky, provides a model for effective treatment for this segment of the population. A two-phase outpatient treatment, this approach combines group and individual sessions in an environment that is both comfortable and useful for the client.
The success of this method lies in its regional approach to therapy. Rather than using role-playing techniques to examine old behaviors, therapy is designed around storytelling activities. Rural patients respond more positively to such time-honored traditions and thus become active participants in their own treatment.
This manual offers a clear and well-constructed guide through the strategies of Structured Behavioral Outpatient Rural Therapy (SBORT). Supplemented with illustrations, sample exercises, and case studies, Behavioral Therapy for Rural Substance Abusers is a vital tool in meeting the treatment needs of an otherwise ignored rural population.
Behind Every Choice Is a Story is a poignant blend of personal stories, commentary, and memoir that chronicles the life-changing reproductive choices that women, men, and teens make every day. The book also traces Gloria Feldt's personal journey from the dusty oil fields of West Texas to becoming a Head Start teacher and activist in the civil rights and women's movement, culminating in her current standing as one of the most influential voices in the reproductive freedom movement. The book was inspired by the 1928 Motherhood in Bondage , a collection of letters written by women to Margaret Sanger, the founder of Planned Parenthood. Publishing these letters from women in desperate circumstances helped to equate the concept of birth control with higher values of wanted children, healthy mothers, loving couples, self realization, and female emancipation. Behind Every Choice Is a Story addresses many of those same issues and values and advances a new agenda for the twenty-first century. Behind Every Choice Is a Story sounds a clarion call by highlighting the importance of storytelling as a cultural force in encouraging change. Feldt recognizes and values women's stories for their personal, social, and political importance. The book uniquely positions current issues of reproductive freedom in the context of everyday experiences and provides a refreshing new framework to understand the current political and social landscape. Although the primary audience for this book is women who support reproductive freedom, a wide audience including men and teens will find their experiences among the compelling stories. It will also appeal to those who are intrigued by the unique perspective the book gives to the real-life impact of reproductive choices. "Behind Every Choice Is a Story will change how America talks about reproductive rights. Gloria's book inspires us to heed the clarion call, tell out stories, and raise our voices together."--Kathleen Turner
Psychopathy and Moral Incapacity
Mental Health Policy in the United States since 1950
The past half-century has been marked by major changes in the treatment of mental illness: important advances in understanding mental illnesses, increases in spending on mental health care and support of people with mental illnesses, and the availability of new medications that are easier for the patient to tolerate. Although these changes have made things better for those who have mental illness, they are not quite enough. In Better But Not Well, Richard G. Frank and Sherry A. Glied examine the well-being of people with mental illness in the United States over the past fifty years, addressing issues such as economics, treatment, standards of living, rights, and stigma. Marshaling a range of new empirical evidence, they first argue that people with mental illness—severe and persistent disorders as well as less serious mental health conditions—are faring better today than in the past. Improvements have come about for unheralded and unexpected reasons. Rather than being a result of more effective mental health treatments, progress has come from the growth of private health insurance and of mainstream social programs—such as Medicaid, Supplemental Security Income, housing vouchers, and food stamps—and the development of new treatments that are easier for patients to tolerate and for physicians to manage. The authors remind us that, despite the progress that has been made, this disadvantaged group remains worse off than most others in society. The "mainstreaming" of persons with mental illness has left a policy void, where governmental institutions responsible for meeting the needs of mental health patients lack resources and programmatic authority. To fill this void, Frank and Glied suggest that institutional resources be applied systematically and routinely to examine and address how federal and state programs affect the well-being of people with mental illness.
Political Group Dynamics and Foreign Policy-making
Strategic issues and crises in foreign policy are usually managed by relatively small groups of elite policymakers and their closest advisors. Since the pioneering work of Irving Janis in the early 1970s, we have known that the interplay between the members of these groups can have a profound and, indeed, at times a pernicious influence on the content and quality of foreign policy decisions. Janis argued that "groupthink," a term he used to describe a tendency for extreme concurrence-seeking in decision-making groups, was a major cause of a number of U.S. foreign policy fiascoes. And yet not all small groups suffer from groupthink; in fact many high-level bodies are handicapped by an inability to achieve consensus at all. Beyond Groupthink builds upon and extends Janis's legacy. The contributors develop a richer understanding of group dynamics by drawing on alternate views of small-group dynamics. The relevant literature is reviewed and the different perspectives are explored in detailed case studies. The contributors link the group process to the broader organizational and political context of the policy process and stress the need to develop a multi-level understanding of the collegial policy-making process, combining the insights drawn from micro-level theories with those derived from study of broader political phenomena. The contributors include Alexander George, Sally Riggs Fuller, Paul D. Hoyt, Ramon J. Aldag, Max V. Metselaar, Bertjan Verbeek, J. Thomas Preston, Jean A. Garrison, and Yaacov Y. I. Vertzberger. This book should appeal to political scienctists and international relations specialists, as well as researchers in social psychology, public administration, and management interested in group decision-making processes. Paul 't Hart is Associate Professor, Department of Public Administration, Leiden University and Scientific Director of of the Leiden-Rotterdam Crisis Research Center. Eric Stern is Professor of Political Science at Stockholm University. Bengt Sundelius is Professor of Political Science at Stockholm University.
Breastfeeding Constraints and Realities
Current public health promotion of breastfeeding relies heavily on health messaging and individual behavior change. Women are told that “breast is best” but too little serious attention is given to addressing the many social, economic, and political factors that combine to limit women’s real choice to breastfeed beyond a few days or weeks. The result: women’s, infants’, and public health interests are undermined. Beyond Health, Beyond Choice examines how feminist perspectives can inform public health support for breastfeeding.
Written by authors from diverse disciplines, perspectives, and countries, this collection of essays is arranged thematically and considers breastfeeding in relation to public health and health care; work and family; embodiment (specifically breastfeeding in public); economic and ethnic factors; guilt; violence; and commercialization. By examining women’s experiences and bringing feminist insights to bear on a public issue, the editors attempt to reframe the discussion to better inform public health approaches and political action. Doing so can help us recognize the value of breastfeeding for the public’s health and the important productive and reproductive contributions women make to the world.
Life, Death, and Social Policy
Health care spending in the United States today is approaching 20 percent of GDP, yet levels of U.S. population health have been declining for decades relative to other wealthy and even some developing nations. How is it possible that the United States, which spends more than any other nation on health care and insurance, now has a population markedly less healthy than those of many other nations? Sociologist and public health expert James S. House analyzes this paradoxical crisis, offering surprising new explanations for how and why the United States has fallen into this trap. In Beyond Obamacare, House shows that health care reforms, including the Affordable Care Act, cannot resolve this crisis because they do not focus on the underlying causes for the nation’s poor health outcomes, which are largely social, economic, environmental, psychological, and behavioral.
House demonstrates that the problems of our broken health care and insurance system are interconnected with our large and growing social disparities in education, income, and other conditions of life and work, and calls for a complete reorientation of how we think about health. He concludes that we need to move away from our misguided and almost exclusive focus on biomedical determinants of health, and to place more emphasis on addressing social, economic, and other inequalities.
House’s review of the evidence suggests that the landmark Affordable Care Act of 2010, and even universal access to health care, are likely to yield only marginal improvements in population health or in reducing health care expenditures. In order to rein in spending and improve population health, we need to refocus health policy from the supply side—which makes more and presumably better health care available to more citizens—to the demand side—which would improve population health though means other than health care and insurance, thereby reducing need and spending for health care. House shows how policies that provide expanded educational opportunities, more and better jobs and income, reduced racial-ethnic discrimination and segregation, and improved neighborhood quality enhance population health and quality of life as well as help curb health spending. He recommends redirecting funds from inefficient supply-side health care measures toward broader social initiatives focused on education, income support, civil rights, housing and neighborhoods, and other reforms, which can be paid for from savings in expenditures for health care and insurance.
A provocative reconceptualization of health in America, Beyond Obamacare looks past partisan debates to show how cost-efficient and effective health policies begin with more comprehensive social policy reforms.
Cultural History and Developmental Psychology
In 1900, Ellen Key wrote the international bestseller The Century of the Child. In this enormously influential book, she proposed that the world's children should be the central work of society during the twentieth century. Although she never thought that her "century of the child" would become a reality, in fact it had much more resonance than she could have imagined.
The idea of the child as a product of a protective and coddling society has given rise to major theories and arguments since Key's time. For the past half century, the study of the child has been dominated by two towering figures, the psychologist Jean Piaget and the historian Philippe Ariès. Interest in the subject has been driven in large measure by Ariès's argument that adults failed even to have a concept of childhood before the thirteenth century, and that from the thirteenth century to the seventeenth there was an increasing "childishness" in the representations of children and an increasing separation between the adult world and that of the child. Piaget proposed that children's logic and modes of thinking are entirely different from those of adults. In the twentieth century this distance between the spheres of children and adults made possible the distinctive study of child development and also specific legislation to protect children from exploitation, abuse, and neglect. Recent students of childhood have challenged the ideas those titans promoted; they ask whether the distancing process has gone too far and has begun to reverse itself.
In a series of essays, Beyond the Century of the Child considers the history of childhood from the Middle Ages to modern times, from America and Europe to China and Japan, bringing together leading psychologists and historians to question whether we unnecessarily infantilized children and unwittingly created a detrimental wall between the worlds of children and adults. Together these scholars address the question whether, a hundred years after Ellen Key wrote her international sensation, the century of the child has in fact come to an end.