The mental health professions are reluctant to admit, and quick to minimize or deny, therapist sexual abuse. Constructive action will be facilitated by understanding the ingredients of this “conspiracy of silence”: the belief that it only happened in the '60s and '70s, a we-they attitude to abusers, professional protectionism, denial of sexual attraction to clients, trivialisation, idealization of therapist-client sexual contact, victim-blaming, and the myriad fears and other feelings that hinder client disclosure.

In this article we examine a series of letters written by members of the DSM-IV Revisions Task Force and by Paula Caplan, who co-authored the proposal for Delusional Dominating Personality Disorder (DDPD), and had been asked to serve on the Self-Defeating Personality Disorder (SDPD) and Late Luteal Phase Dysphoric Disorder (LLPDD) subcommittees. Through this process we identify the gatekeeping techniques used by the DSM Task Force to determine who is, and who is not, normal. In doing so, we unmask the process that guarantees the continuation of a diagnostic manual based on sexist biases.

The majority of the women in this study had been physically or sexually assaulted; overwhelmingly, this happened in their own homes, at the hands of a close relative, usually a father or step-father, and prior to becoming homeless. Even for the minority of women who were assaulted after becoming homeless, the assailant usually was not a stranger and the location not a public place. Although repeated incidents of assault were the rule rather than the exception, very few of the women who had been assaulted by their father or step-father while living at home, were later assaulted by a husband, common-law partner, or boyfriend. These findings support other research which discredit the myth that abused women set themselves up for further abuse. The findings also seem to indicate that dealing with the problem of family violence should be part of any policy dealing with women's homelessness.

The aims of this research were twofold: to investigate the relationship between family adversity (based on a composite index) and the number of teacher-rated behaviourally disordered children in kindergarten and to examine the relationship between family adversity and the stability of behavioural disorders from kindergarten to grade one. The sample was comprised of 3,026 children who were rated by their kindergarten and grade one teachers on three behavioural dimensions (aggressiveness-disruptiveness—13 items; anxiety-withdrawal—6 items; prosociality—10 items) using the Preschool Behavior Questionnaire (Behar & Stringfield, 1974) and the Pro-social Behavior Questionnaire (Weir & Duveen, 1981). The Family Adversity Index (FAI) was based on information provided by mothers pertaining to family structure, parents' occupation, parents' education level, and parents' age at the birth of the child. According to teacher ratings, children who obtained a score of 1.5 standard deviations above the mean of their same-gender classmates on the aggressiveness-disruptiveness and anxiety-withdrawal scales or 1.5 standard deviations below the mean of their same-gender classmates on the prosociality scale were classified as extremes on each of these dimensions. These were termed the “extreme cases.” Results showed that the number of extreme cases on the aggressiveness-disruptiveness scale in kindergarten was significantly related to FAI for both genders. Moreover, the number of extreme aggressive-disruptive cases who remained extreme after making the transition to grade one (i.e., stable cases) was also significantly related to FAI. For both genders, twice more stable aggressive-disruptive cases had a high FAI (i.e., top third) compared to transient extreme cases (i.e., extreme in kindergarten only). Discussion underlines the link between family adversity and incidence and persistence of behavioural problems during the early school years. It also stresses the need to consider family adversity to screen stable extreme aggressive-disruptive cases in kindergarten for early intervention purposes.

La naissance d'un enfant atteint d'une déficience peut provoquer une crise psychologique chez les parents. La présente étude analyse le processus d'adaptation des parents au cours de quatre mois qui suivent la naissance. Elle propose également un programme d'intervention précoce qui s'appuic sur une appréciation périodique des capacités d'adaptation des parents sur le plan individuel, conjugal, parental, et interpersonnel. Une grille d'évaluation de l'adaptation des parents vient compléter l'analyse.

The objective of this paper is to raise questions about appropriateness of the concept of continuity of care for guiding the development of helping strategies for people with mental health problems in the era of non-institutionalization. Research on continuity of care is reviewed to show the strong legacy of institutional thinking. A leading problem addressed in this literature is that of client drop-out from programs designed to ensure continuity. The research results clearly suggest that this “problem” lies with the agency of clients: the fact that, in the natural milieu, they make decisions according to their own definitions of the situation and in a social context of their own. This perspective, however, seemingly cannot be incorporated into the continuity of care paradigm, which remains firmly grounded in the world of service providers. We argue, therefore, that the era of the non-institutionalization calls for a recasting of the meaning of “continuity” for people with mental health problems, a reorientation of the type of research conducted in this domaine, and ultimately, a reformulation of the nature and role of support services in the community.

Perceived social support measures and descriptions of social support networks for three groups of former patients living in community settings are presented. Findings suggest that former patients living independently are at a serious disadvantage. Results are discussed in terms of identifying the circumstances which need to be created to allow former patients to attain a reasonably supported existence through independent living rather than relying on non-normalizing placements such as group homes or living with families of origin.

Supported housing (as distinct from supportive housing) emphasizes the values of consumer choice; independence; participation; permanence; normalcy; and flexible, ongoing supports. As a model, it has only recently become popular in the literature and therefore little is known of its effectiveness in serving people with long-term psychiatric backgrounds. In 1989, Homeward Projects, a community mental health agency located in Metropolitan Toronto, established a supported housing project. Homeward included an evaluative component in its program from the outset. In order to give equal weight to the tenants' opinions, both quantitative and qualitative methodologies were employed. In the quantitative component, residential milieu, social support, and service delivery were examined. The qualitative component involved an ethnographic study which allowed the tenants to voice their experiences of living in such a setting. Results provided a rich understanding of the model. Overall, the tenants eventually came to describe their house as a home.