Beginning with the HMO Act of 1973, managed care, a system for controlling health care costs, rapidly expanded and gained influence as the main vehicle for health care delivery in the United States. Implementation of managed care principles in the mental health arena has generated much debate, particularly with respect to issues of quality of care. The authors briefly trace the development of managed care and evaluate its impact on the practice of psychology. The extant literature is reviewed with specific attention to issues of quality of care, confidentiality of patient information, and shifting practice patterns of clinicians. Finally, the future of professional psychology within the context of managed care is examined, and the implications of newly created mental health roles for practitioners, training programs, and organized psychology are discussed.
Clinical approaches in treating and preventing suicidal behaviors in patients with borderline personality disorder (BPD) have received limited attention. To stimulate further work in this area, we present a behavioral activation treatment for depression (BATD; Lejuez, Hopko, & Hopko, 2002) that has shown promising results in treating clinically depressed patients and a theoretical conceptualization for why BATD may prove particularly useful in reducing the frequency of suicide-related behaviors and other symptoms characteristic of patients with BPD. We also present theoretical consistencies between BATD and the well-established intervention of dialectical behavior therapy (DBT; Linehan, 1993), which may allow for their practical integration, and conclude with a case study that illustrates the assimilation of these strategies in the treatment of a patient with BPD.
The Great Recession of late 2007 through 2009 had profound negative economic impacts on the U.S. states, with 49 states experiencing revenue decreases in their 2009 budgets representing more than $67.2 billion USD. Also during this period, states enacted a record number of laws related to immigrants residing in their states. We make use of data from the National Conference of State Legislatures (NCSL) to examine punitive immigration policy enactment from 2005 to 2012 and conduct a state comparative study using cross-sectional time-series analysis to examine the potential ways in which the economic recession and changing demographics in the states have impacted punitive state immigration policy making. We hypothesize that although anti-immigrant anxieties are driven in part by economic insecurity, they are also impacted by the presence of a large or growing proportion of racialized immigrants. We find that increases in state Hispanic populations and state economic stressors associated with the recession have both led to a greater number of enacted punitive state immigration policies. In addition, we find that changes in the non-Hispanic white populations in the states are also impacting the expression of anti-immigrant attitudes in state policy during this period.
This article uses the concepts of intersectionality and linked fate to understand the relationship between group identification and political behavior among lesbian, gay, bisexual, transgender, and queer (LGBTQ) and non-LGBTQ Latinx individuals. Drawing on the 2016 Collaborative Multiracial Post-Election Survey (CMPS), we find that LGBTQ Latinx respondents report feelings of linked fate to both the Latinx and LGBTQ community, and that LGBTQ Latinx respondents exhibit more political participation than their non-LGBTQ Latinx counterparts. We then find that Latinx and LGBTQ linked fate are significant predictors of participation for non-LGBTQ respondents, and LGBTQ linked fate to predict LGBTQ Latinx participation. Finally, we provide evidence that suggests that feeling linked fate toward more than one marginalized group does not necessarily translate into participation in a greater number of political activities, demonstrating the complexity of group identification for predicting political participation. This study contributes to the theorizing of linked fate and political participation by deploying an intersectional lens that challenges assumptions of Latinx and LGBTQ intragroup political coherence and illuminates the complex effects that different kinds of linked fate have on political participation.
Do social media platforms help or hinder democracy? Internet enthusiasts posit that social media could have a democratizing effect by lowering the costs of promotion, while skeptics argue that these platforms replicate or even exacerbate preexisting inequalities. We inform this debate by combining campaign finance and electoral outcome data from the Federal Election Commission with Twitter metrics of candidates who ran in the 2016 U.S. congressional elections. We find that poorer candidates, who spent less than their competitor, performed better if they had indirect influence on Twitter—getting their tweets shared by users whose own tweets are widely shared. The effect of indirect influence on election outcomes was more pronounced in races with larger financial inequities between candidates or fewer total expenses across candidates. Moreover, poorer candidates with indirect influence saw smaller vote gaps than their party’s candidate in the same district (in House races) or state (in Senate races) in 2014.
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