Integrating fieldwork into employment counseling for methadone‐treatment patients

An innovative employment counseling model, Customized Employment Supports, was developed for methadone‐treatment patients, a population with historically low employment rates. The effectiveness of a key component of the model, “vocational fieldwork,” the delivery of services in the community rather than only within the clinic, was assessed through a quasi‐experimental study of the first 55 patients receiving the model in 2 clinics. Employment outcomes after 6 months were compared between patients who received vocational fieldwork (n = 18) and those who did not (n = 37). Logistic regression analysis demonstrated that patients receiving vocational fieldwork had significantly better outcomes for competitive work, informal work, and any paid work.     

For There is Work to be Done: Poetry and Commentary

Poetry illuminates the work of health care professionals well beyond procedure guidelines, clinic schedules or best practice policy. Poems and commentary from the perspective of a nurse, an emergency medical technician and two physicians are accompanied by an exploration of the meaning of work and the role of medical humanities.     

The validity and reliability of the Violence Risk Scale-Sexual Offender version: assessing sex offender risk and evaluating therapeutic change

The Violence Risk Scale-Sexual Offender version (VRS-SO) is a rating scale designed to assess risk and predict sexual recidivism, to measure and link treatment changes to sexual recidivism, and to inform the delivery of sexual offender treatment. The VRS-SO comprises 7 static and 17 dynamic items empirically or conceptually linked to sexual recidivism. Dynamic items with higher ratings identify treatment targets linked to sexual offending. A modified stages of change model assesses the offender's treatment readiness and change. File-based VRS-SO ratings were completed on 321 sex offenders followed up an average of 10 years post-release. VRS-SO scores predicted sexual and nonsexual violent recidivism post-release and demonstrated acceptable interrater reliability and concurrent validity. A factor analysis of the dynamic items generated 3 factors labeled Sexual Deviance, Criminality, and Treatment Responsivity, all of which predicted sexual recidivism and were differentially associated with different sex offender types. The dynamic items together made incremental contributions to sexual recidivism prediction after static risk was controlled for. Positive changes in the dynamic items, measured at pre- and posttreatment, were significantly related to reductions in sexual recidivism after risk and follow-up time were controlled for, suggesting that dynamic items are indeed dynamic or changeable in nature.     

The Effect of Disruptions During Counseling on Recall of Genetic Risk Information: The Case of Cystic Fibrosis

Genetic counseling is a communication process with two main functions: information provision and supportive counseling. The information transmission function may be compromised by disruptions that occur during counseling. At least two mediators are possible: (a) disruptions may interfere with memory by creating distractions and divided attention during encoding or (b) disruptions may degrade the flow of interaction which requires that participants engage in conversation repair rather than the task at hand. This study examined both alternatives in a group of parents (N=20 families, 40 individual parents) whose infant had received a newborn screening for cystic fibrosis (CF). Upon arrival at the hospital, each parent completed a questionnaire designed to assess his or her knowledge of CF. Their interaction with the genetic counselor was videotaped and coded for the presence of disruptions. Six weeks after the counseling, parents again completed the knowledge measure. The data showed a direct negative effect for disruptions during counseling on memory for CF-related risk information six weeks later. Disruptions also produced the anticipated effect on conversation, but counter to expectations, interruptions of conversation flow was positively associated with knowledge at time 2.     

Defining ‘Modern’ Malay womanhood and the coexistent messages of the veil

The gender constructions and performances of Malay women are often perceived by outside researchers as ‘shrouded under a veil’ of increasing Islamic conservatism. Urban Malay women, however, argue that women actively engage in the construction and performance of gender identities. Based on research conducted in Kuala Lumpur, Malaysia, during 2001 and 2003, this article argues that women advantageously alter, transform and utilise the constructs placed upon them by Islam, by ethnic identification and by conceptions of ‘modernity’. Often one image of ‘womanhood’ is presented and in public - an image that is socially accepted, honoured and respected - while less publicly alternative forms of ‘womanhood’ articulate individual goals and aims. Using an agent-oriented perspective, this article further includes an analysis of women's individual renegotiations of larger cultural constructs and the ways in which the tudong, or headscarf, has become a symbol by which individual women express their understanding of social position and personal freedoms in an industrialised Islamic context.     

Re-thinking the relationship between theory and practice: Practitioners as map-readers, map-makers—or jazz players?

Theory is a major element in professional knowledge. Doubts about its value reported by practitioners raise questions at a critical juncture in the careers field about the relevance of prevailing theories and how they are approached. The topic of the relationship between theory and practice is a sensitive one in the debate on competencies and an illuminating one in that on post-modernism. As recent studies demonstrate, problems in integrating theory and practice arise in training and may persist, but experienced practitioners achieve 'fusion' between them and become 'practical theorists'. Practice is improvisatory, and is refined by frameworks provided by theory, critical thinking and 'reflective practice'. However, theories are often tardy or irrelevant, and practitioners also need to be able to carry out their own research, including action research. This has implications for initial and in-service training, supervision and policy, and for the relationships between researchers, theorists and practitioners.     

Mental health status among Puerto Ricans,Mexican Americans,and Non-Hispanic whites

Compared mental health characteristics of island Puerto Ricans to three groups from the Los Angeles Epidemiologic Catchment Area Study: Mexican American immigrants, U.S.-born Mexican Americans, and Non-Hispanic whites. The Diagnostic Interview Schedule was used to obtain both diagnostic and symptom scale information about affective disorders, alcohol abuse/dependence, somatization, phobic disorder, and psychotic disorder. Mexican American immigrants had the fewest mental health problems of all groups. Puerto Ricans had more somatization disorder, but less affective and alcohol disorders than U.S-born Mexican Americans or non-Hispanic whites. Results are considered in the light of selection factors, relative disadvantage of groups and methodological problems. This research was supported by grants MH36230 and MH45763 from the National Institute of Mental Health, and made use of data from the Los Angeles site of the Epidemiologic Catchment Area Program, which is a series of five epidemiologic research studies performed by independent research teams in collaboration with staff of the Division of Biometry and Epidemiology of the National Institute of Mental Health. The NIMH principal collaborators were D. Regier, B. Locke, W. Eaton and J. Burke. The NIMH project officers were C. Taube and W. Huber. The principal investigators and coinvestigators from the five sites were Yale University: J. Myers, M. Weissman, G. Tischler; Johns Hopkins University: M. Kramer, E. Gruenberg, S. Shapiro; Washington University: L. Robins, J. Helzer; Duke University: D. Blazer, L. George; University of California at Los Angeles: M. Karno, R. Hough, J. Escobar, A. Burnam, D. Timbers.     

The death and transfiguration of career-and of career guidance?

The predominant understanding of career in the industrial era has focused on progression within hierarchical work organisations. With the move into a post-industrial era, the possibility of such careers is rapidly receding. The concept of career, however, has always been broader than this, and other aspects of it are now claiming increased attention. They focus more upon individual experiences in terms of development in learning and work throughout life. The role of career guidance in relation to such experiences is potentially of much greater social significance. A number of implications for career guidance provision and practice are discussed.     

Career in context

Mainstream career theories have been criticised for their scanty conceptualisation of the environment that influences individuals' careers. There are few foundations upon which to build an appropriate conceptualisation of the dramatically changing environment of career today. The implications of Pepper's contextualist world hypothesis are discussed. Compared with orthodox approaches, the world as seen from this perspective is as different as the Internet is from a library; its understanding of the environment, and indeed career, is also significantly different. The contextualist perspective upon career research, theory and practice is outlined and the possibility of its adoption in the mainstream of the career field is explored