Mental Health Professionals and Assisted Death: Perceived Ethical Obligations and Proposed Guidelines for Practice

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics (Murphy, DeBernardo, &; Shoemaker, 1998) were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed.     

The Practice of Integrity for Mental Health Professionals

Summary

The focus of this article revolves around accuracy and honesty in the mental health field. Integrity, both professional and personal, is the foundation of all mental health professionals' functioning. Honesty, fairness, and respect for others are necessary ingredients to professional behavior. Mental health professionals avoid misleading other individuals with regard to professional training and other areas of expertise. In professional roles, they clarify as early as feasible the nature of the expectations and activities in which they are engaged.     

The Interprofessional Collaborative Practice: Clergypersons and Mental Health Professionals

The purpose of this study is to examine the relationships among variables identified in research literature as obstacles and benefits to interprofessional collaboration-- academic education, interprofessional education, teamwork and communication skills, and trust---as it relates to the participation of clergypersons in interprofessional collaborative practice. The sample consisted of ordained Christian clergypersons in Florida who voluntarily completed a survey questionnaire. Standard and stepwise multiple regression was applied to analyze the data. The model accounts for 25% of the variation of interprofessional collaborative practice. Results also revealed that the education variables explained significantly 20% of the variance of interprofessional collaborative practice.     

精神卫生工作者面临的困境及其对策

目前国内的精神卫生工作者不能满足社会的需要,认为精神卫生工作开展难度大、职业发展前景不乐观、工作的特殊性和职业满意度低等社会心理因素是导致目前这种状况的主要原因,提出规范精神卫生服务行业,政府增加投入、普及精神卫生知识和工作人员自我调节等措施干预目前这种困境.     

Exploring the Relationship Between Gay Affirmative Practice and Empathy Among Mental Health Professionals

During the last several decades, psychologists have placed emphasis on multicultural competence as an essential aspect of training and practice. However, despite this emphasis, empirical data on the effects of multicultural training and practice are generally limited to variables such as race and ethnicity, with very little research on sexual minorities. However, a framework for understanding competent practice with sexual minorities does exist in the form of the concept of gay affirmative practice (GAP), which has been successfully operationalized by Crisp ( 2006b ). Using the GAP measure and scores of empathy, the authors examined students and practitioners in the helping profession to explore the relationship between empathy and level of gay affirmative work. Findings indicated that levels of empathy predicted overall levels of GAP. The authors discuss the clinical implications of these findings and explore how the findings fit within the literature surrounding empathic understanding. Durante las últimas décadas, los psicólogos han puesto un énfasis especial en la competencia multicultural como un aspecto esencial en la formación y la práctica. Sin embargo, a pesar de este énfasis, los datos empíricos sobre los efectos de la formación multicultural y su práctica están generalmente limitados a variables como raza y etnicidad, con escasas investigaciones realizadas sobre minorías sexuales. Aun así, existe un marco teórico para comprender la práctica competente con minorías sexuales denominado terapia afirmativa gay (GAP, por sus siglas en inglés), que fue operacionalizado con éxito por Crisp ( 2006b ). Usando las medidas GAP y puntuaciones de empatía, los autores examinaron a estudiantes y profesionales del campo de la consejería para explorar la relación entre empatía y el nivel de trabajo afirmativo con la comunidad gay. Los resultados indicaron que los niveles de empatía pronosticaron niveles totales de GAP. Los autores discuten las implicaciones clínicas de estos resultados y exploran cómo estos encajan con la literatura sobre comprensión empática.     

The Hmong in the United States: An Overview for Mental Health Professionals

Since Laos fell to the communist Pathet Lao, many Hmong people have relocated to the United States. Because of the vast cultural differences, the Hmong have had a notoriously difficult time adjusting to life in the United States. In view of the many problems faced by Hmong Americans, it is likely that many of them will seek or be referred to non-Hmong professionals for various counseling services. This article provides an overview of Hmong culture and a history of their migration to the United States. Specific adjustment and mental health problems are noted and suggestions are provided for designing appropriate counseling interventions for Hmong Americans.     

The Ethics of Supervision and Consultation: Practical Guidance for Mental Health Professionals

Studies of academic dishonesty typically rely on potentially inaccurate self-reports or on actual behavior during less realistic tasks. Eliminating the drawbacks of such approaches, we assessed cheating during completion of actual coursework via electronic records of online behavior. Thirty-six college students completed unproctored, online quizzes. The majority of students responding to a follow-up questionnaire reported that they never considered consulting online sources during the quizzes. Computer logs reveal that although some students accessed relevant online information during the quizzes, many did not: 6 instances over 72 quiz attempts are attributable to 3 or 4 individuals. Although online environments may offer more opportunities for academic dishonesty, electronic records of online activity provide a valuable and objective means of detecting such dishonesty.     

Exploring Well-Being among Mental Health Professionals in India

An exploratory mixed methods study was designed to understand the construction and experience of happiness and well-being among Mental Health Professionals (MHPs) in India. Through non-probabilistic sampling techniques, 17 MHPs were selected from three government hospitals in a city in North India. Qualitative interview data were triangulated with scores from the Mental Health Continuum-Long Form (MHC-LF). Analysis showed that despite happiness being a desirable and pleasurable state, participants rarely devoted time thinking about it. Happiness was a multidimensional phenomenon which affected personal, interpersonal, social and environmental realms. Happiness was synonymous with contentment and satisfaction and was understood as the opposite of unhappiness. Although recognised as a universal phenomenon, happiness had a subjective and individual-specific understanding, experience and manifestation. Data from the MHC-LF provided scores on overall well-being, and emotional, psychological and social well-being, and indicated that 14 participants had flourishing mental health, and three were moderately mentally healthy. The personal and professional lives of the MHPs were closely intertwined and impacted well-being in multiple ways. Certain temperamental qualities, personal insight from the field, supportive interpersonal relations and management of time, work, thought, behaviour and affect were protective factors of well-being. Additional responsibilities at work, negativities in client narratives, stigma and myths associated with the profession, biases from other professionals, lack of opportunities for personal development and growth, insufficient infrastructural and human resources were threats to well-being. The findings of the study have implications for policy, education and training, and practice for mental health practitioners.     

Ethics in the Teaching of Mental Health Professionals

Summary

It is the position of the authors that mental health professionals-in-training must be well versed in the ethical/legal matters of clinical practice. Indeed, most graduate programs in the field of mental health require formal training in Ethics. The California School of Professional Psychology (Alliant International University) San Diego campus has developed a model that requires (a) an ethics course integrated with the student's on-campus supervision in the Fall and Spring semesters at the practicum level, focusing on the American Psychological Association's Ethics Code (2002) and California's Licensing Laws; and (b) an advanced ethics course (in the fourth year of training) that focuses on the integration of ethical and legal issues in clinical practice and providing a knowledge base of sound ethical judgment. Syllabi for these two courses are included.     

How Clients Are Harmed by Sexual Contact with Mental Health Professionals: The Syndrome and Its Prevalence

Research concerning the prevalence, varieties, contributing factors, and harmful consequences of sexual intimacies with clients (occurring either prior to or subsequent to termination) is reviewed. The sequelae of therapist-client sex may form a distinct syndrome, with similarities to Rape Response Syndrome, Battered Spouse Syndrome, reaction to incest, response to child abuse, and Post-Traumatic Stress Disorder. Aspects of Therapist-Patient Sex Syndrome include: (a) ambivalence, (b) a sense of guilt, (c) feelings of emptiness and isolation, (d) sexual confusion, (e) impaired ability to trust, (f) identity, boundary, and role confusion, (g) emotional lability (frequently involving severe depression and acute anxiety), (k) suppressed rage, (i) increased suicidal risk, and (j) cognitive dysfunction (especially in the areas of attention and concentration, frequently involving flashbacks, nightmares, intrusive thoughts, and unbidden images).     

Pet Bereavement Support Groups: A Guide for Mental Health Professionals

Companion animals are becoming increasingly important in society. Pets have been recognized for their vast contributions to human lives, including emotional support, social support, health benefits, and connection. However, society does not recognize the significant loss associated with losing a pet, which can contribute to bereaved pet owners feeling isolation and shame as they cope with the loss of their beloved companion. Mental health professionals must be aware of this disenfranchised grief and creatively expand their services to provide support and advocacy for bereaved pet owners. This article includes a framework for clinicians to establish a pet loss support group in their community.     

Psychology Without Psy Professionals: Exploring an Unemployed Centre Families Project as a Mental Health Resource

The activities and technologies of the psychology (Psy) disciplines, in the process of privileging professional understandings of distress, could be seen to be potentially facilitating corrosion in the capacity of the lay public to understand and ameliorate their distress. This paper draws on the experiences of people who use an Unemployed Centre Families Project in the South of England to provide an example of community mental health work that does not draw on the dominant discourses, institutions or practitioners of the Psy sciences. Through interviews with centre users, staff and volunteers, a picture emerges of a community space that provides a variety of services, projects and opportunities that have a very considerable positive impact on the mental well‐being of the centre users. This picture highlights non‐medical intersubjective processes that offer possibilities for recoveries from mental distress but that are often neglected and subordinated in the professional worlds of Psy and psychiatry. Such centres facilitate social networks and practical help, and transitions in identity can be beneficial for those experiencing mental distress. In so doing, they make prominent some of the key limitations of biomedical approaches to recovery. Copyright © 2015 John Wiley & Sons, Ltd.     

Gender Differences in Mental Health: The Mediating Role of Perceived Personal Discrimination

Why is women's mental health inferior to that of men? This study hypothesized that women's mental health is not as good as men's because women perceive more personal discrimination. It was confirmed that women obtained higher scores than did men on a subjective scale of psychological distress. Additionally, women perceived greater personal and group discrimination than did men. Perceived personal discrimination proved to be the more robust predictor of psychological distress. This was evident when results of a mediation analysis revealed that gender differences in subjective distress were mediated by the measure of perceived personal discrimination, but not by the measure of group discrimination.     

The Kawa Model: Therapists' Experiences in Mental Health Practice

This pilot study sought to gather information related to the experience of occupational therapists, using the Kawa Model of practice in a mental health setting. Two therapists utilized the model with one client, each over a six-week period. Through qualitative inquiry, the participants (therapists) revealed that, although initially apprehensive about using a new model, they found that the Kawa Model increased client/therapist interaction and energy levels and challenged them to push the boundaries of therapeutic practice. This research suggests that exploration of new models of practice may be beneficial in terms of facilitating successful partnerships and outcomes with clients in mental health settings.     

Regulating Research for the Decisionally Impaired: Implications for Mental Health Professionals

Mental health professionals, in fulfilling their different roles, often become involved with research protocols involving decisionally impaired current or prospective human subjects, many of whom are elderly. The opening section of this paper briefly describes the present regulatory environment regarding human subjects research, followed by an overview of the Institutional Review Board (IRB) process. There then ensues an enumeration of some of the general criticisms of the current regulatory scheme that have been enunciated recently. Particular concerns concerning decisionally impaired persons as research subjects are then addressed, referring when applicable to the recommendations made by the National Bioethics Advisory Commission (NBAC) in its 1998 report on this subject and the implications of those recommendations for mental health professionals.     

Training Mental Health Professionals to Assess and Manage Suicidal Behavior: Can Provider Confidence and Practice Behaviors be Altered?

Remarkably little systematic research has studied the effects of clinical suicidology training on changing practitioner attitudes and behaviors. In the current study we investigated whether training in an empirically‐based assessment and treatment approach to suicidal patients administered through a continuing education workshop could meaningfully impact professional practices, clinic policy, clinician confidence, and beliefs posttraining and 6 months later. At the 6 month follow‐up we found that 44% of practitioners reported increased confidence in assessing suicide risk, 54% reported increased confidence in managing suicidal patients, 83% reported changing suicide care practices, and 66% reported changing clinic policy. These results suggest that a brief and carefully developed workshop training experience can potentially change provider perceptions and behaviors with a possible impact on clinical care therein.     

Education and Training of Children's Mental Health Professionals: The Existing and Potential Role of Schools of Public Health

Since the early 1980s, increasing attention has been devoted in the literature to the conceptualization, development, and implementation of integrated and comprehensive mental health systems of care for children and adolescents. In establishing this new children's mental health paradigm of community-based systems of care, there are presently very few well-trained professionals and leaders focused on collaborative (including interagency) initiatives in the delivery of children's mental health services. Nevertheless, the field of public health offers an interdisciplinary setting for the education and training of individuals in children's mental health services. This national survey of all 27 accredited schools of public health in the United States and Puerto Rico examined the existing capacity for and potential to expand educational and training opportunities in the organization, financing, and delivery of children's mental health services.