The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

Couple therapy reduces relational and individual distress and may affect utilization of other health services, particularly among higher service utilizers. Although average decreases in service utilization are predicted among recipients of couple therapy, low utilizers of services may appropriately increase use. The relationship between couple therapy and service utilization was examined among a sample of 179 U.S. military veterans who received treatment in Veterans Affairs (VA) specialty couple therapy clinics. Consistent with hypotheses, overall mental and physical health visits decreased from the 12 months preceding couple therapy to the 12 months following treatment. Moderator analyses showed that decreases were greatest among individuals who were rated by their therapist as having completed a full course of couple therapy, suggesting that change was attributable to intervention. Pretreatment service utilization also moderated observed change—higher utilizers’ use of services decreased substantially, whereas lower utilizers’ slightly increased. Cost analyses revealed that the estimated per person mean cost in our sample decreased by $930.33 in the year following compared to the year prior to couple therapy, as per 2008 VA cost data. As service utilization data were only available for one partner and only for 1 year posttherapy, the true magnitude of this effect may be underestimated. Our findings are relevant to policy makers as they demonstrate that couple therapy reduces average service utilization and associated costs and addresses calls for analyses of cost effectiveness of systemic interventions.     

The supermom trap: Do involved dads erode moms' self‐competence?

Increasingly, husbands have been expected to share equally in the task of childrearing, especially when their wives are employed. This study examined reactions to these changes in a sample of 78 dual-earner couples with 8-month-old infants. When wives felt that their husbands were skillful caregivers, greater husbands' contribution to caregiving was associated with lower self-competence among wives. In contrast, wives' caregiving behavior was unrelated to their husbands' self-competence. None of these effects emerged for the self-liking component of self-esteem. Thus, despite increasingly egalitarian sex roles, employed mothers (but not their husbands) seem to be trapped between their desire for help with childrearing and the threat to their personal competence posed by failure to meet socially constructed ideals of motherhood.     

On a Belief-Relative Moral Right to Civil Disobedience

Res Publica - Acts of civil disobedience are undertaken in defense of a variety of causes ranging from banning GMO crops and prohibiting abortion to fighting inequality and saving the environment....     

Power,participation and partnerships: reflections on the co-creation of knowledge

Narrative writing was used to critically reflect on the reasons for the success and failure of two research partnerships: one between the authors and a community group, the other between the authors and academic colleagues. The reflections relate to a vignette constructed on the experiences of the authors and somewhat fictionalised, but brought together to highlight the contrasts, whereby one research partnership was successful in producing outcomes while the other was not. An analysis of these reflections was informed by Wenger’s Communities of Practice framework. This helped draw out issues around power and participation as fundamental for successful research partnerships, particularly multidisciplinary partnerships, intent on the co-creation of knowledge. Such issues related to recognising partnerships and the underlying assumptions when these partnerships cross boundaries include transparent communication, power and decision-making processes, critical self-awareness, and negotiated meaning and identity.