Sesen Negash

Critical Failures in a Regional Network of Residential Treatment Facilities

The present descriptive case study reports on the state of treatment services and environmental settings in adolescent residential treatment facilities (RTFs) conducted as part of the Residential Treatment Center Evaluation Project. The project frequently uncovered poor quality of care exposing youth to deleterious conditions. Observations related to harsh treatment practices, psychiatric practice and medication management, educational and aftercare planning, and general treatment planning were closely examined. The analysis indicated that accreditation and licensing are insufficient to assure the quality of the service process in RTFs. Future research should address the relationship between treatment quality and treatment outcome. Efforts should also be made to develop strategies for organizational change to support high-quality services in RTFs.

Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting

Internet pornography is a multi-billion-dollar industry that has grown increasingly accessible. Delay discounting involves devaluing larger, later rewards in favor of smaller, more immediate rewards. The constant novelty and primacy of sexual stimuli as particularly strong natural rewards make Internet pornography a unique activator of the brains reward system, thereby having implications for decision-making processes. Based on theoretical studies of evolutionary psychology and neuroeconomics, two studies tested the hypothesis that consuming Internet pornography would relate to higher rates of delay discounting. Study 1 used a longitudinal design. Participants completed a pornography use questionnaire and a delay discounting task at Time 1 and then again four weeks later. Participants reporting higher initial pornography use demonstrated a higher delay discounting rate at Time 2, controlling for initial delay discounting. Study 2 tested for causality with an experimental design. Participants were randomly assigned to abstain from either their favorite food or pornography for three weeks. Participants who abstained from pornography use demonstrated lower delay discounting than participants who abstained from their favorite food. The finding suggests that Internet pornography is a sexual reward that contributes to delay discounting differently than other natural rewards. Theoretical and clinical implications of these studies are highlighted.

Altered Book Making as a Form of Art Therapy: A Narrative Approach

Altered book making is a form of art in which people alter an existing book using a variety of materials. In narrative therapy the primary objective is to help clients find stories in their lives that allow them to gain flexibility and insight in their ability to resolve challenges. We show how altered book making can help clients explore their lives for alternative narratives. Clients who engage in the art form are to use the pages in the book to represent narratives in their lives. The exercise of reauthoring a book that already exists symbolizes the parallel possibilities that clients have to reauthor their own lives. The altered book making process also helps therapists facilitate narrative conversations that are otherwise static. Using dominant stories, externalization, and unique outcomes, the therapist may help clients penetrate stories that generate new meaning and alternative stories that clients may then use to resolve their dilemmas.

Improving the Quality of Services in Residential Treatment Facilities: A Strength-based Consultative Review Process

This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were observed in the areas of treatment planning and care, educational planning and services, and aftercare planning. Psychiatric practice improved and aversive and negative disciplinary practices were minimized. Improvement in service quality was achieved through a strength-based, consistent, and periodic consultative review process. Policy recommendations are discussed.

Service Process and Quality in Therapeutic Foster Care: An Exploratory Study of One County System

ABSTRACT This study assesses the quality of services in the therapeutic foster care programs used by one county in the Midwest. Using a consultative quality assurance review methodology, evaluators examined 67 randomly sampled cases across seven agencies to assess the service quality issues experienced by children. Following interviews with staff, foster parents, and children, and a review of case records, reviewers observed failures in service and in adherence to national program model standards and state regulations. The research indicates the need for consistent monitoring of child-placing agencies and the need for additional research linking service quality with foster care outcomes.

Predictors of extradyadic sex among young adults in heterosexual dating relationships: a multivariate approach

ABSTRACT A multivariate contextual analysis examined predictors of sexual extradyadic involvement (EDI) among young adults in heterosexual dating relationships. College students (n = 647) were surveyed to determine how a number of cultural precursors (i.e. gender, race, religiosity), relationship precursors (i.e. relationship satisfaction, relationship duration), alcohol related precursors (i.e. alcohol consumption, binge drinking,), and psychosocial precursors (i.e. attachment, symptoms of depression) predicted extradyadic sexual relationship within a two month period. Findings from a hierarchical regression analysis suggest that relationship satisfaction and attachment were the only reliable predictors of sexual EDI.

Intimacy in the Midst of Caregiving: Examining Relationship and Sexual Satisfaction of Parents Raising Children with Special Needs

The present study examined relationship and sexual satisfaction of parents of children with special needs. The impact of role differentiation, coping styles, and sexual desire on relationship and sexual satisfaction were measured, as well as the link between relationship and sexual satisfaction of parents (N = 62). Results from the study indicate that several dimensions were significantly correlated with both sexual (e.g., reframing coping strategies and sexual desire) and relationship (e.g., emotional reactivity, reframing coping strategies) satisfaction. Evidence from this study suggests that therapists should be attentive and sensitive to particular issues to help parents of children with special needs improve their relationship and sexual satisfaction.

Embracing Our Eroticism: A Foucauldian Discourse Analysis of Women’s Eroticism

ABSTRACT Women’s sexuality has been examined through political, religious, scientific, and social lenses. Despite advances, discourses driving sexual expression embody double standards, pathologizing, and silencing. Women’s own experiences are largely ignored in existing literatures. Foucauldian discourse analysis (FDA) is a qualitative methodology rooted in Foucault’s examinations of power and discourse construction. In this FDA, 111 women answered questions about their erotic definitions, experiences, and barriers to expression. Discourses emerging from the data included my own definitions, free but caged, voices of influence, and caution. These discourses are situated within social and institutional contexts, and therapeutic considerations discussed.

Relationship Dissolution and Psychologically Aggressive Dating Relationships: Preliminary Findings From a College-Based Relationship Education Course.

This study evaluated the impact of a relationship education program, delivered as part of a college course, among students (N = 152) who reported experiencing psychological aggression in their exclusive dating relationship. Preliminary results showed that compared to those in the control group, participants receiving relationship education were significantly more likely to end their romantic relationship, even after controlling for relationship satisfaction. Furthermore, when relationship termination occurred, those in the intervention group were significantly more likely to attribute the breakup to their participation in the class as compared to those in the control group. The tentative findings are an important preliminary step in assessing the benefits of relationship education in reducing the risk of psychological aggression among college students.