Although the idealistic vision of sexual reformers was impeded in Europe, the development of couples and family therapy continued in the United States. Social workers emphasized the need to expand interventions to include the family. Educators implemented home economics courses in high schools nationwide. Workshops addressing family and marital issues were offered through churches and universities. Finally, new psychoanalytic theories (such as object relations theory) opened the door for psychological interventions beyond just one individual.
Community coalitions (also discussed in Chapter 12) involving official health agencies, academic health centers, places of worship, and other community-based organizations have emerged as an essential part of any community-wide effort to improve health in many parts of the world including the United States (Green and Kreuter 1991). Levine and co-workers have described an ongoing community-based partnership in East Baltimore, Maryland, a community of 150,000 whose residents are predominantly African-American (Levine et al. 1994). The partnership involves a coalition of churches which have organized into an umbrella organization known as Clergy United for Renewal of East Baltimore (CURE), the Johns Hopkins Academic Health Center (the schools of medicine, nursing, and public health, and the Johns Hopkins Hospital), the Baltimore City Health Department and school system, and Health Care for the Homeless.