Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

The effects of polydrug use with and without cocaine on mother-infant interaction at 3 and 6 months

The face-to-face interactions of 43 polydrug-with-cocaine-using mothers and their infants at 3 and 6 months were compared to 17 non-cocaine-but other-drug-using mothers and 21 mothers who used no drugs during their pregnancy. Coders blind to mothers' drug use status scored 3 min of face-to-face interactions for 16 measures of maternal and infant interactive behaviors. A principal component of 7 behaviors formed a measure of maternal attentiveness; a principal component of 5 behaviors formed a measure of mother-infant dyadic organization; and a principal component of 4 behaviors formed a measure of infant readiness to interact. A measure of maternal interruption was computed as the mean standard score of 3 additional interruptive behaviors. At 3 and 6 months, polydrug-with-cocaine-using mothers were less attentive to interactions, and polydrug-with-cocaine-using mothers and their infants engaged in fewer dyadic interactions than either non-cocaine or non-drug-using mothers. Compared to 3 months, polydrug-with-cocaine-using mothers at 6 months were less attentive to interactions and more frequently interrupted interactions by looking away, redirecting the infant, or withdrawing, whereas non-cocaine-using and non-drug- using mothers showed no change or an improvement in attentiveness to interactions and a decrease in interruptions. No differences emerged in the interactive behaviors of the infants of polydrug- with-cocaine-using, non-cocaine-using, or non-drug-using mothers. Cocaine use represents a significant risk for diminished parental attentiveness and responsiveness to infants and for diminished interactiveness in infants.     

What harm can it do?: A discussion of the potential for harm inherent in psychodynamic work

Abstract

This paper examines some of the ethical issues raised by the nature of psychodynamic work. It suggests that both the aims and the process of psychodynamic therapy raise ethical issues which we cannot responsibly ignore, but that if the work is to be effective it cannot be made wholly safe. That, however, does not absolve us from the requirement for taking care, and for thinking about what we are doing and what we are risking.     

‘I don't want to be the mother of a paedophile’: the perspectives of mothers whose adolescent sons with learning disabilities sexually offend

The subject of sexual abuse is a major focus of professional and public concern. Sexual abuse of (and by) people with learning disabilities evokes even greater disquieting emotions, and makes severe demands on the social services, and the criminal justice system. The aims of the project were: 1) to determine whether group psychotherapy produced effective outcomes for adolescent boys with learning disabilities who exhibit sexually abusive behaviour, 2) to explore the perspectives of parents and other care-givers, and 3) to document the nature and extent of service support to families. This paper focuses solely on the mothers' perspectives. This was a three-year project with six boys (under 16) receiving group psychotherapy, using both quantitative and qualitative methods. Clinical measures were used to track changes throughout the course of psychotherapy. Semi-structured interviews (taped and transcribed) were held (separately) with the boys, their parents, paid care-givers and the therapists. The mothers tried hard to make sense of, and come to terms with, what was happening to their sons and to themselves, they struggled to reconcile their own confused and often conflicting emotions, and to maintain their own sense of identity. They felt almost totally unsupported by the services, both in the past and present, and could see little hope for the future. There is an urgent need for development of effective and sympathetic services for the parents of boys with learning disabilities who have been abused, and who are now showing abusive behaviour.     

Addressing Family Violence Within Juvenile Courts

Summary

Whether as overt or underlying issues, family violence is prevalent within juvenile court caseloads, yet often is not identified within intake and disposition. Focusing on juvenile victimization of parents, and to a lesser extent teen dating partners, this article discusses model programs emerging in juvenile courts specifically addressing these issues. A comparative analysis of the drug court trend is explored in the context of its applicability for specialized family violence applications in the Juvenile Court. An overview of the King County (Washington) Juvenile Court's Step-Up Program and the Santa Clara County (California) Juvenile Court's Family Violence program is offered, followed by the process by which the Travis County (Texas) Juvenile Court has implemented a program similar to these models. Effective interventions with violent families must be informed by the domestic violence community's treatment expertise, building on the paradigm of youth resilience.     

Workplace Violence and Worker Injury in Elderly Care Settings

Abstract

Many incidents of injury, assault, and abuse occur in health care settings. To better examine the situational context of the workplace, this paper examines whether workers providing care to elderly persons experience injuries that are consistent with the “for-profit” and “interpersonal conflict” explanations of elder abuse or neglect. Using data from the Bureau of Labor Statistics, results indicate that nursing home workers and home health care workers have higher rates of workplace injuries resulting from assaults and overexertion than do other workers. The data suggest that there are unique structural and situational factors present in the nursing home, which create a work setting vulnerable to conflict, violence, and elder abuse.     

Forging Community Links to Address Abuse in Lesbian Relationships

Abstract

This study is a comprehensive review of lesbian domestic abuse in the psychological, sociological, legal, and social work literature. Planning intervention and prevention strategies is discussed in light of what is known and what remains to be known. A strong argument is made to turn attention away from the elusive tasks of documenting prevalence and incidence characteristics, and forge the community links needed to develop effective intervention and prevention strategies.     

Victims of Abuse by Priests: Some Preliminary Observations

This paper describes the results of psychological assessments of 25 adult males who were victims of sexual abuse by Catholic priests as children or early adolescents. Preliminary data suggest that premorbid personality patterns in these victims put them at greater risk for abuse and also exacerbated the effects of their victimization. These observations are considered in the context of prevalent explanatory models of the traumagenic effects of child sexual abuse.