Showing papers on "Psychological intervention published in 1975"

Cardiovascular control mechanisms in the conscious state.

Abstract: CLINICIANS and clinical physiologists would prefer to base an understanding of the function and regulation of the cardiovascular system on observations carried out in man. However, both ethical considerations and limitations in instrumentation mandate the study of laboratory animals, in which appropriate controls and interventions can be introduced. Whereas extremely important hemodynamic information has been obtained from studies of man, most of the knowledge of cardiovascular physiology and pharmacology is based on findings obtained in animal experiments, which have been conducted most frequently on animals in the anesthetized state, often with an open chest. The conclusions derived from these experiments . . .

Sociocultural and social-psychological factors affecting personal responses to psychological disorder.

Abstract: SOCIOLOGISTS and social psychologists have given considerable attention in recent decades to the processes leading to the identification of mental disorders in the community and to factors affecting help-seeking. Such work was given impetus almost twenty years ago with the publication of Social Class and Mental Illness (Hollingshead and Redlich, 1958) and its analysis of social class differences in thresholds for identifying mental disorder and pathways into care. At approximately the same time Clausen and Yarrow (1955), then at the National Institute of Mental Health, in a study of the

Mental health care in the community: an evaluative study.

Abstract: A study was designed to assess the therapeutic value of attaching a social worker to a metropolitan group practice in the management of chronic neurotic illness. The psychiatric and social status of a group of patients before treatment and after one year was compared with the status of a control group treated more conventionally over the same period. The results indicate that the experimental service conferred some benefit on the patient population.

Mental health problems associated with the only child.

Abstract: This study was undertaken to provide an evaluation of the mental health problems associated with the only child and a basis for further studies of singletons. Data were obtained from the recores of the Mental Health Clinic, London Psychiatric Hospital, of 115 only children and 115 non-only children between 5 and 15 years of age. The results showed that the only child did not differ significantly from his non-only peer in intelligence, school progress, referral reasons and the majority of mental health disturbances, but a significant difference was found in his increased submissiveness, greater number of repeat visits to clinic, and in the overprotective attitude of his parents. Aggressive behaviour was more frequently observed in the control group, which also had a significantly higher proportion of rejecting mothers. Suggestions for further research in this area are made.

Acute renal insufficiency complicating major cardiovascular surgery.

Abstract: Thirty-one patients underwent hemodialysis for renal failure as a complication of major cardiovascular surgery at the University of Minnesota (1968-1973). Only eight patients (26%) survived. A review of the literature shows that since the beginning of hemodialysis the mortality of those patients has not improved. Infection was the overwhelming cause of death. The infections were difficult to diagnosis because they were frequently associated with abdominal abscesses that were almost uniformly overlooked. Several possible ways of improving these patients survival are: 1) the use of early operative interventions of second look type; 2) improved hygenic measures in the care of these patients; 3) more selective antibiotic treatment based on frequent reculturing; and 4) daily short dialysis in association with hyperalimentation.

Differential Effects of Multiple Interventions in an Organization

Abstract: An organization development effort spanning several years in one organization is reexamined in order to assess the differential effects of interventions. The findings illustrate how organizational change efforts can have different effects upon different groups within an organization. Significant differences among hierarchical levels of the organization are found in satisfaction with several aspects of the work environment, the most important finding being the relatively low levels of satisfaction among supervisory and technical workers. Supporting clinical data identify the lack of an integrated change program, the failure to adequately structure supervisors into change activities, and problems in the management of participation as possible sources of the differential effects. Recommendations for the design of interventions are made, and the conclusion is reached that there is a need for the application of more systemic models of change combined with more comprehensive measurement of the effects of interv...

Relationship of psychopathology to death in asthmatic adolescents.

Abstract: With the help of three illustrative cases, all of whom died during an acute asthmatic attack, it is proposed that patients with severe psychopathology who also have asthma are particularly susceptible to the more serious complications of asthma. This is related to the circular reactions to anxiety and the patient's incapacity to cope with it. Often these patients are either unusually sensitive to the pharmacological agents used in the medical regime, or they overmedicate themselves. At the same time the reactions of the family and medical staff tend to increase anxiety in these patients. This finally leads to psychological decompensation, making medical treatment extremely difficult. Some therapeutic interventions in dealing with this problem have been suggested. These include the development of an asthma team which can provide supportive psychotherapy to high risk patients.

Social and Ecological Factors in the Etiology, Outcome, Treatment and Prevention of Mental Disorders

Abstract: Terms such as social and environmental are used as labels for a confusing variety of contents, which has unavoidably led to a lack of precision in the usage of these valuable words. This is particularly troublesome in psychiatry where the borderlines between social and individual are anyhow far from sharp. Mental disorders are reactions of the total personality to the total life situation, and cases in which a simple formulation is possible are rare.

Some perspectives on the role of biostatistics and epidemiology in the prevention and control of mental disorders.

Abstract: The paper reviews progress made in the past 30 years in the development of statistical and epidemiological methods in the mental health field. Applications have included determinations of need for psychiatric care and supporting personnel; interpretation of morbidity indices, and cross-national comparisons of diagnoses of mental disorders. Much remains to be done. Progress would include better measurement of incidence, duration, and prevalence of mental disorders; more precise estimates of service needs; more effective programs to prevent or reduce disability. Particularly needed are field-research units under long-term funding with the task of assessing effectiveness of mental health programs at the catchment-area level.

Impact of therapist interventions on early sessions of group therapy.

Abstract: A methodology for studying the effect of therapist style on the process of group therapy was developed and applied to two early sessions in two different therapy groups. In general, the results supported the hypothesis that individually directed, confrontative interventions would lead to emotionally focused and immediate client responding. The results failed to confirm the hypothesis that relatively interpretive interventions would be the most productive. In fact, simple facilitations tended to produce higher mean focusing than all other types of interventions. Perhaps in very early sessions the most productive interventions are those designed simply to encourage patients to talk and interact. The decisive technique of a group therapist may be interpretation, which helps patients to comprehend the significance of personally relevant, emotionally charged interactions. However, in the fledgling group, the therapist may be most helpful by simply facilitating members' speaking up and interacting. Indeed, clarifications and interpretations may turn out to be the group therapist's most productive interventions, but perhaps not until after group cohesiveness is developed in early sessions.

Evaluation of the clinical services of a regional mental health center

Abstract: A large midwest community-oriented regional mental health center reports a detailed methodology for evaluating the outcome effectiveness of clinical care for seriously disturbed mental patients. A controlled study of a 10% systematic sample of all public patients from a 10-county area compares the results obtained by traditional state hospitals with those of a new regional mental health center. The cohorts were followed for 3 full years. Outcomes were assessed in terms of social competence and economic cost to the patients and society. Although increased funds and staffing clearly improved the level of humanitarian care in all public institutions, no objective evidence was found that the community-oriented approach was superior in decreasing disability due to serious mental disorder. The study corroborated impressions that a relatively small proportion of persons entering mental hospitals tend to become chronically disabled and require large quantities of care-giving services. It is concluded that a period of consolidation and replanning is necessary in community psychiatry. It is suggested that early identification of potentially chronic patients, intensive social training, and specialized community living arrangements focused on this group might provide a break-through in rehabilitation of the mentally ill.

Control of violence in a mental health setting.

Abstract: MR. PENNINGROTH. M.A., states that his exposure to violence in a mental health setting began in the maximum security wards of a huge mental hospital, where suppression of such behavior was often brutally effective but seldom therapeutic. He moved to Hawaii. where he was a psychiatric social worker in the Hawaii State Hospital, Kaneohe. Later, under contract to the government of Guam, he helped develop a mental health program, which became the Guam Community Mental Health Center. As administrator, he developed the prototype of the inservice program described in this article. He is currently alcohol program coordinator of the Department of Mental Health Services, Kern County. Calif. suggestions in the literature. and by what I have found to be therapeutically successful in my own experience. I developed an inservice training program for the staff of an inpatient mental health unit. It was presented in two consecutive sessions of two

Administration in mental health: issues, problems, and prospects.

Abstract: The mental health field has grown larger and more complex in recent years, but this has not been equalled by increased administrative sophistication. Two problems, neither one irremediable, have contributed to this state of affairs. First, mental health organizations have generally been administered by mental health professionals with little administrative knowledge or training. And second, we have often failed to recognize the very special circumstances faced by administrators in the mental health field. These special circumstances are legion. For one thing, mental health services depend on public funding and must often deal with a high degree of government regulation. For another, the typical staff in a mental health organization is multidisciplinary, professional, and highly autonomous-a bit like a Navy with more admirals than ships. Then too, the transaction between therapist and patient is much more private and intimate in mental health than in most other fields; we are often dealing with a highly dependent patient population; our product is intangible and the success achieved is hard to judge; the boundaries of the field are very hard to define; and the enduring public stigma associated with use of mental health services, combined with the problem of confidentiality, complicates the administrative task. Finally, on top of all this, it is absolutely essential that the mental health administrator understand the need to create and maintain an organizational climate of efficacy and hope. Taken individually, many of these conditions have obvious counterparts in other fields; but taken as a group, they separate mental health from all the other human services, even ones that are closely related. To be effective, therefore, academic programs in mental health administration must reflect these conditions by developing specialized curricula and training procedures.

Physical interventions to alter behavior in a punitive environment: some moral reflections on new technology.

Abstract: There is, I suppose, a wide variety of techniques of social control that can be gathered together under the heading of physical intervention techniques. The term is chosen so as to be as inclusive as possible and yet to suggest an analogy to the medical notion of physical intervention for therapeutic purposes, since the role of medical research and medical administration in the development and the use of these techniques is a prominent feature of many of them. In order to be as specific as possible at the outset, I use the term &dquo;physical intervention techniques&dquo; to mean one or more of the following four sorts or sets of techniques:

Missing Links in the Human Services Nonsystem

Abstract: Four separate human services programs and their West Philadelphia service consumers were studied by the 1971 Health Network Project: a hospital receiving ward, a community mental health satellite center, a public assistance district office, and a public child welfare agency. The basic hypotheses were that 1) the four consumer groups present common health, economic, and social problems, and 2) each agency confines its services to its own specialized range of problems and provides minimal linkages to other service facilities, including those available within its own subdivisions. Data were obtained by interview and record review from over 600 patients and clients. Each agency was found to respond to presenting problems with specific interventions. However, failure to detect, treat, or refer concurrent problems was pronounced. Despite the great prevalence of physical and mental illness, compounded by economic marginality, each agency made minimal use of internal support services and external referrals. The human services nonsystem is discussed conceptually in light of specialization and fragmentation. Proposals for shifting the nonsystem toward a responsive service network include the introduction of comprehensive screening devices and of service generalists for case management.

The importance of administration in mental health

Abstract: The supply of qualified administrators has not kept pace with the needs of mental health programs. These programs are larger and more complex than ever before, with problems that are very difficult to resolve. The author identifies these problems and suggests that many of them are unique to the mental health field.

Recent Efforts in Planned Interventions for Affective Education.

Abstract: ABSTRACT The major purpose of this p er was to report on severaliinnovations in the promotion of affec ve skill development in the *chool setting. Three studies Were Carrie out in urban, parochi4i schools and were analyzed together. A ru'ial school study' was discussed separately. The major strategies instrumental in each of the four studies included: (1) feedback through test analysis, teacher attention, parental support;.(2) social contact exercise, teacher attention, videofeedback; (3) existential group work, teacher attention; and (4) social contaclexercise, process learning. Three analyses (analysis of variance, aptitude x treatment interaction, gain scores) were used to interpret the results of the four studies. A lower disruptive score Or fewer negative teacher' ratings were considered desirable directiOns of change in student behavior. Generally, for boys and girls, the comparisons of absolute'gains showed that Group I afid.III strategies were about equally effective, but that Group II strategies lowered the selected scale scores; Suggestions for further researOh are discussed. (Author/PC)

Mental health mystification and social control.

Abstract: The field of mental health suffers from an abundance of technical jargon. The major social issues that touch upon mental health are debated in these technical terms, but persons most affected by the issues are left out of the debate. Hence, professionals have come to serve as an exclusionary buffer between human anguish and social policy.