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Mental Masquerades
Published in Marc D. Feldman, Gregory P. Yates, Dying to be Ill, 2018
Marc D. Feldman, Gregory P. Yates
I worked for a few months seeing children and adults at a community mental health center. On an almost daily basis, I encountered parents who brought in their 3- or 4-year-old children. As would be expected, the children would usually dart about the office and play enthusiastically with the toys I had scattered on the floor for them. All too often, what quickly emerged was “malingering by proxy,” in which the parents were after state disability benefits for the children rather than any primary emotional gratification. The parent would point to the child and say, “See? He can’t sit still! He’s hyperactive! He has ADHD!” They almost always had a state form ready for me to complete; I was expected immediately to attest to the “disability.” When I interpreted the child’s behavior as entirely normal exploration in a new environment, they would complain to the center’s director, who caved in time after time, claiming I had too many “dissatisfied” clients and needed to do better. I was profoundly relieved to exit that job, though I suspect the problem continues under a new psychiatrist. Often, many members of the same family were receiving disability monies as well.
Children of Minority Groups and Substance Abuse
Published in Pedro J. Lecca, Thomas D. Watts, Preschoolers and Substance Abuse, 2014
Pedro J. Lecca, Thomas D. Watts
Representation on boards of directors or advisory boards of diverse client groups is another important strategy to encourage usage by minority clients. Whether the setting is a community mental health center required to incorporate the views and needs of the communities it serves, a private hospital, or a social service agency, involvement in the policy-making of programs serves at least two purposes. By identifying and electing representatives of respected and powerful social and cultural groups within communities, community members are assured a voice in the policy decisions of the service agency. At the same time, minority board members take the message of service opportunities from the agency to their communities. Community members respect their leaders' involvement and are more likely to use the services on their recommendation. Hiring minority consultants and working with informal social networks such as churches and social clubs are two additional methods to disseminate service information and involve community members in service delivery.
The Effect of Three Group Formats on Group Interaction Patterns
Published in Diane Gibson, Group Process and Structure in Psychosocial Occupational Therapy, 2014
The treatment setting was a partial hospital program in a community mental health center. The subjects attended the program two days each week and were likely to be in a combination of several of the eight groups studied. Four of the eight groups occurred on each of the days these patients attended, and all eight groups were observed each week. A series of five observation sequences was conducted over a period of five weeks, with all groups occurring in each observation sequence. Group observations were conducted by recording the interaction patterns in segments of each group on a sociogram. Within each group, two 5-minute segments were observed, beginning at 15 minutes and 25 minutes past the beginning of the hour-long groups. These segments were assumed to be representative of interaction patterns throughout the entire session. Each interaction was categorized according to a modified form of the Bales Interaction Process Analysis Method, indicating the type of interaction (Bales, 1950a, 1950b). The use of sociograms (Bradford, Stock, & Horwitz, 1978; Hearn, 1978; Howe & Schwartzberg, 1986) and the Bales System of categorizing interactions (Benjamin, 1978; Golembiewski, 1962; Howe & Schwartzberg, 1986; Sampson & Marthas, 1977) have been described as useful ways of observing and analyzing a group’s communication structure. The recordings were tabulated to show amount of interaction, type of interaction, and participants in interaction for each segment observed.
Convergent and Discriminant Validity of Self-Report and Performance-Based Assessment of Object Relations
Published in Journal of Personality Assessment, 2020
Rachel A. Pad, Steven K. Huprich, John Porcerelli
Details of participant recruitment and procedures are reported in detail elsewhere (Huprich, Paggeot, & Samuel 2015). Psychiatric outpatients (n = 161) were recruited from four locations: a hospital-based outpatient behavioral health treatment facility, two offices of a community mental health center, and a university-based psychology clinic. Clinical participants could not be actively psychotic or have a primary diagnosis of schizophrenia, schizophreniform, major depression with psychosis, bipolar disorder with psychotic features, or psychotic disorder not otherwise specified as determined in their medical records. For their participation, clinical participants received $75 cash. A nonclinical, undergraduate student sample (n = 171) was recruited from psychology courses at a Midwestern university. To be included in the study, students had to be at least 18 years of age. Students participants received extra credit for their participation. Undergraduate and clinical participants provided written consent after being informed about the general purpose of the study.
Acute Crisis Care for Patients with Mental Health Crises: Initial Assessment of an Innovative Prehospital Alternative Destination Program in North Carolina
Published in Prehospital Emergency Care, 2018
Jamie O. Creed, Julianne M. Cyr, Hillary Owino, Shannen E. Box, Mia Ives-Rublee, Brian B. Sheitman, Beat D. Steiner, Jefferson G. Williams, Michael W. Bachman, Jose G. Cabanas, J. Brent Myers, Seth W. Glickman
Limited literature exists describing demographics of patients who are transported to alternative destinations in lieu of the ED; however, to better provide and assess patient care, the demographics of these patients should be studied and compared to the larger community. WakeBrook's patient population differs from the general Wake County population in numerous ways. The patient population at WakeBrook is comprised of more males, more African Americans, and fewer Hispanics or Latinos than Wake County's general population. (10) Patients evaluated by APPs and transported to WakeBrook are slightly older than the median age of Wake County residents. (11) In addition, more than one-third of WakeBrook patients were uninsured and nearly half presented with a comorbidity. Not only were more uninsured patients transported to WakeBrook compared to Wake County, (12) the State of NC, and US populations, (13) but mental health patients are at far greater risk for numerous comorbidities, (14) including some prevalent comorbidities identified in this sample. The increased prevalence of minority demographics in addition to the increased prevalence of uninsured and comorbid patients confirms WakeBrook provides healthcare to a challenging patient population. Treating significantly more minority and uninsured subgroups, this community mental health center is providing services to groups known to have poorer access to health care and worse patient outcomes (15, 13).
An Effectiveness Trial of PCIT for Children with and without Autism Spectrum Disorder in a Private Practice Setting
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2022
Robin C. Han, Suzi Naguib, Christopher K. Owen, Lindsay R. Druskin, Kelsey R. Keen, Rachel Piper, Samantha N. Holbert, Sophia D. Shank, Erinn J. Victory, Cheryl B. McNeil
A number of case studies have examined PCIT for children with ASD in non-academic settings. In an urban community mental health center, Budd et al. (2011) found improvements in child disruptive behavior and parenting stress in a 5-year-old boy with high-functioning ASD and disruptive behavior disorder-not otherwise specified after completion of PCIT. However, it is worth noting that the community mental health center was situated in a university campus, and treatment was still conducted by a team consisting of clinical psychology doctoral students and a doctoral-level psychologist. Improvements in child problem behavior and positive parenting skills were observed in three children with ASD and their parents after PCIT in an outpatient clinic (Agazzi et al., 2017). Again, treatment was conducted by a licensed psychologist with a team of doctoral students providing support around coding and fidelity checks. In a center specializing in ASD and other developmental disorders, a significantly modified version of PCIT (e.g., shortened time-out, time-out teaching phase, a holding chair procedure) was used to treat a minimally verbal 5-year-old boy with ASD (Lesack et al., 2014). Parent-reported behavior problems dropped from a clinically significant to subclinical level, and the use of positive parenting skills increased following the completion of treatment. Sessions were conducted by two licensed psychologists supervised by a certified PCIT trainer. Although these case studies were conducted in non-academic settings, they were limited in that they did not employ more robust methodological designs to examine treatment effectiveness.