Showing papers on "Psychological intervention published in 1978"

Psychosocial Aspects of Mastectomy: II. The Man's Perspective

Abstract: The authors administered a questionnaire to 41 women who had had mastectomies to investigate aspects of the procedure itself, pre- and postmastectomy adjustment, effects on sexual relationships, and the influence of age. Although most women reported good overall adjustment, there were strong indications of psychological suffering (suicidal ideation, increased use of alcohol and tranquilizers, etc.). Psychological intervention may be called for in many cases, and age, support systems, and premorbid functioning may be indicators of the amount and type of intervention needed. Counseling is particularly important before surgery, since this was viewed as the period of maximum stress by most women. Further research with larger, more random samples and postsurgical control groups is indicated to determine more precisely the factors related to adjustment to mastectomy.

Long-term effects of control and predictability-enhancing interventions: findings and ethical issues

Abstract: The long-term effects of participating in a field experiment on the effects of control and predictability-enhancing interventions are reported. Retirement home residents who had initially benefited from being exposed to a specific positive predictable or controllable event were assessed at three different intervals after the study was terminated. Health and psychological status data collected 24, 30, and 42 months after the study was terminated indicated no positive long-term effects attributable to the interventions. In fact, groups that had initially benefited from the interventions exhibited precipitous declines once the study was terminated, whereas groups that had not benefited remained stable over time. The theoretical and ethical implications of these data are discussed.

Stress disorders among Vietnam veterans : theory, research, and treatment

Abstract: The United States military involvement in Viet Nam began in earnest during the bold and exuberant presidency of John Kennedy and ended with the disorderly evacuation of the American Embassy in Saigon in April 1975. The slide from the exhilaration of Camelot to the cynicism of Watergate was unexpected and unsettling. Even now it remains difficult to write with moderation about this epoch and its major casualties-the Viet Nam veterans. The editor introduces this book by setting out six goals: I) to define the construct of Viet Nam-related combat stress disorders, 2) to alert mental health professionals to the theoretical and clinical importance of these disorders, 3) to persuade the reader that the residue ofcombat stress transcends time and situation, 4) to remind the reader that little is known about long-term results of catastrophic combat experience, 5) to provide treatment guidelines, and 6) to expand the knowledge base of combat-related stress disorders. These are ambitious tasks to accomplish in one volume, they are made even more elusive by the editor’s attempt to be evenhanded. Twenty-four authors contribute to this book. The reader will recognize the names and views of well-known antiwar activists as well as those of some career military mental health professionals. Two representative points of view seem in conflict. The first hypothesis is that the military experience in Viet Nam was unique and traumatic because ofthe inherent nature and savagery of the conflict, the elusive character of the enemy, the impact of individually tailored one-year duty rotations, and the ambivalent homecoming accorded combatants. The prediction made in this view is that initial opinions about the successful adjustment of veterans will not stand the test of time and that many veterans will seek help months and years later for delayed catastrophic stress disorders (post-Viet Nam syndromes). The second hypothesis is that attempts to attribute the problems of veterans to their unique experience in Viet Nam does not withstand scrutiny and does not lead to unique symptomatology. It is suggested in this view that those who have had the most difficulty during military duty and as veterans are those who already had the greatest number and kinds of preexisting handicaps in personal skills. The text is divided into three major sections involving theoretical formulations, some representative research reports, and suggestions for treatment of this special veteran population. The first and third divisions include papers based on literature reviews and clinical experiences with an emphasis on psychosocial perspectives. The section on research reports presents the results of descriptive follow-up studies with appropriate statistical analyses. Sixty-one pages in this section are used to reproduce the various research instrument questionnaires; this will not likely prove useful to most readers. Sober reflection suggests that, for many, the war in Viet Nam is still not over and the need for mental health services targeted for Viet Nam veterans continues and may increase. This book provides a service to those who work with veterans by examining pertinent treatment issues and offering relevant suggestions for therapeutic interventions that may be useful in making the mental health professional better informed and more empathic.

Sharing the crisis of rape: counseling the mates and families of victims.

Abstract: The involvement of mates and family members in counseling interventions designed to help victims of rape in their post-traumatic reconstitutive efforts is critical. Suggestions are offered for assisting those close to the woman in their attempts to explore and articulate feelings and concerns about the crisis.

The emergence of the bowery as a psychiatric dumping ground

Abstract: The drastic reduction of State Hospital population in New York over the past decade has led to a demographic relocation of the mentally ill, rather than any real decline in the rate or severity of mental disorders. Unable to function on their own in society and without adequate supportive facilities available, many discharged patients live in the streets and eventually end up on the Bowery, where they are cared for at The Men's Shelter. Studies have shown that over 50% of the current Bowery population has a history of mental illness and that alcoholism is often a secondary, rather than primary diagnosis. The most frequently encountered diagnostic syndromes are mentioned and commented upon. Possible alternative treatment interventions are suggested.

Ethical issues in the treatment of children.

Abstract: It is consistent with contemporary community standards and accepted professional ethics for psychologists to provide treatment for children who exhibit maladaptive behavior, including gender dysphoria. We do not believe it possible to obtain proper consent from the child which truly satisfies the legal criteria of being informed and competent. Although some critics allege that it is inappropriate for parents or professional to impose their standards on children, there seems no more appropriate reference group to make the social value judgment than the parent in consultation with professionals who are, in turn, sensitive to the broader social codes and moral expectations of the community. To distinguish psychological treatment from other forms of intervention for children (such as school attendance, dental care, and medical treatment) would imply that psychological intervention should follow different ethical standards, a conclusion we reject. All professions have the same ethical obligation to guarantee to children a foundation for happy and productive lives, whether it be through appropriate educational, psychological, medical, or dental intervention.

The parish clergy as a mental health resource.

Abstract: This paper presents observations on the assets and liabilities of the parish clergy as a mental health resource within the community. These observations are drawn from a ten-year program of continuing education for cleargy in mental health, which focuses on daily pastoral experience. The parish setting is similar in many respects to the service area of a community mental health center. The clergy's assets often include availability, experience, tradition, and the special significance of the religious leader. Inadequate training in mental health skills and the complex demands of parish life are among the problems confronting the clergy in this area. On the whole, the pastoral role offers a unique and highly useful opportunity for positive psychological intervention.

A Tripartite Model of Mental Health and Therapeutic Outcomes with Special Reference to Negative Effects in Psychotherapy.

Abstract: Since a judgment of "worse" is always made in relation to a standard, which presupposes a definition of "better," it is clear that the problem of what constitutes a negative effect is inextricably interwoven with a definition of mental health. Any form of psychotherapy or behavior modification is designed to move the patient toward a particular ideal or norm; the techniques used in a given form of therapy are instruments for accomplishing that purpose. Only by considering multiple perspectives will it be possible to derive a comprehensive definition of mental health and meaningful evaluations of psychotherapy outcomes. Consider the following: If, following psychotherapy, a patient manifests increased self-assertion coupled with abrasiveness, is this a good or a poor therapy outcome? If, as a result of therapy, a patient obtains a divorce, is this to be regarded as a desirable or an undesirable change? A patient may turn from homosexuality to heterosexuality or he may become more accepting of either; an ambitious, striving person may abandon pre-

Medico-psychological interventions in male asthmatic children: an evaluation of physiological change.

Abstract: The purpose of this study was systematically to evaluate the effectiveness of several modes of psychological intervention used with male asthmatic children being treated in the Allergy Outpatient Clinic. Therapeutic effectiveness was measured by large airway changes in respiratory function, and the number of recurrent asthmatic attacks. The psychotherapeutic modes used were Relaxation Training, Assertive Training, and combined Relaxation plus Assertive Training. All patients were administered medication by the responsible physician. The group psychotherapy experiences were controlled by using patients who received medication alone and by patients who received medication and met in a leaderless group. The effectiveness of the therapeutic interventions was determined by comparisons between pretreatment measures and measurements taken during and after the eight-week treatment program. Both Relaxation Training by itself and combined Relaxation plus Assertive Training increased respiratory functioning and reduced the number of attacks. Assertive Training alone failed to improve respiratory function and had a tendency to increase the frequency of asthmatic attacks. It was concluded that the most effective management in male asthmatic children was achieved by the combination of medical and psychological treatments.

Mental health interventions in divorce proceedings

Abstract: The protracted process involved in family disruption provides the opportunity for different types of mental health intervention. In addition to the traditional diagnostic and evaluative services typically requested by the legal system, preventive and therapeutic programs can be developed. Implementation of a program by the UCLA Section on Legal Psychiatry is described.

Measuring the interventions used in the short-term interpersonal psychotherary of depression

Abstract: This paper describes a method for measuring the interventions employed by psychotherapists in the short-term interpersonal treatment of depressive disorders. The psychotherapy techniques are described, and the methodology for measuring these techniques is presented. These are illustrated with the findings of the collaborative Boston-New Haven project.

The Coronary-Prone Behavior Pattern: A Behavioral Approach to Intervention

Abstract: The basic objective of intervention is the achievement of change in behaviors (or emotional states) where psychological interventions are involved. This implies that ongoing methods have not effected changes in the patient. For the Type A patient, this appears to be a correct assumption in that many Type A persons seem unable to alter their life-styles, even following a severe heart attack. Although these persons are intellectually aware of the importance of changing their life-style, many report that habits are too strongly ingrained. A behavioral analysis of this problem generally poses two questions: (1) what maintains the behavior in question, and (2) what alternative new behaviors are desirable and how might these be achieved?

Bridging the gap between clinical medicine and public health: an experimental course for medical students.

Abstract: An experimental course for third-year medical students, held at Columbia University, was aimed at enlisting larger numbers of future clinicians in the identification of public health problems and the development of nonclinical interventions, such as environmental and health education strategies. The course sought to develop a new perspective for the analysis of clinical observations. Students chose clinical problems, identified factors influencing incidence or prevalence, or both, and devised intervention strategies while working in a district of the New York City Department of Health. Students found that they could carry out their responsibilities only by going beyond the limitations of care for individual patients and clinical medicine. Students' perceptions and behaviour were measured during periods of their clinical training. Those who had taken the experimental course perceived public health problems and suggested and took corrective actions much more frequently than students in control groups.

Prediction of Elopement of Mentally Ill Offenders Using the MMPI.

Abstract: Authors’ Note: Requests for reprints should be sent to Gerald Cooke, Ph. D., Psychology Service, Norristown State Hospital, Norristown, PA 19401. Differences on the MMPI for elopers and non-elopers from a mentally ill offender population were analyzed and a sign approach was developed. Using four signs with unitary weights, correct prediction of elopement was made for 67% and 62% of two samples of elopers and incorrectly predicted elopement for 23% of controls. If a prediction of elopement is made, it is correct 85% of the time. Implications of MMPI differences for the psychological status of elopers are described. The utility of such prediction and cautions in terms of the patient’s right to a least restrictive alternative are discussed.

A Comparative Study of the Psychiatric Nurses' Attitudes Towards Mental Patients

Abstract: THE aim of the present study is to analyse the effect of professional training on the psychiatric nurse's tolerance of mental disorders. We have used as samples two clearly-differentiated population groups : university students (N=328) and psychiatric nurses (N=50). The testing instruments were a semantic differential test and questionnaires on the subjects of aetiological factors, prognosis of mental disorders and social distance. We have found that while in an aetiological context the attitudes of both nurses and the students towards mental disorders are practi cally the same, attitudes towards prognosis and treatment seem greatly changed in those who possess psychiatric training and experience. Psychiatric nurses are not free from prejudice in respect of mental disorders.

Conflicting concepts of mental health in a multi-cultural society.

Abstract: The paper challenges the claim that psychotherapy or any other form of treatment based solely on western concepts of mental health is applicable to patients whose basic concepts of life are non-wester

Community Mental Health Centers: Politics and Therapy

Abstract: This paper traces the development of theory and public awareness of mental health from 1900 to 1960, with particular stress on the rise of social psychiatric models and the impact of events in and around World War Two. The federal legislative history of the Community Mental Health Center (CMHC) program through 1976 is then outlined with regard to particular social problems (e.g., alcoholism) and to domestic politics as they influenced the program's regulations and mandates. A brief critique of the CMHC program from both viewpoints follows, with emphasis on poor administration, lack of community control, and poor evaluation and accountability. This is the basis of an argument for a more egalitarian, explicitly political viewpoint and methodology as a start toward solving problems that chronically afflict the mental health system.

A systematic approach to brief psychological intervention in the primary care setting.

Abstract: A systematic approach to psychological intervention that can be used by the primary care physician is presented. The approach specifies the sequence the physician takes when providing therapy: (1) identify the context of the patient's complaint(s), (2) assess the patient's current status, (3) develop a therapeutic plan, and (4) implement a therapy approach. These steps are based on four current status categories-functional, ambiguous, crisis, and dysfunctional-that describe the patient's life situation. Each category serves as a gateway for planning and for carrying out therapy. Four types of psychological intervention-short-term therapy, structured assessment, crisis intervention, and referral-are described and methods for implementing each activity are given. The advantages of the schema and a brief critique are presented.