Anatomy of a campus crisis center

This article describes the organization and implementation of a crisis calling center for college students at Southern Colorado State College. The “Help Anonymous” telephone service was established in November of 1968 to make counseling help readily available to students in distress. Volunteers staffed the service after they had completed special training supervised by professional personnel. Calls received as of May 28, 1969, totalled 380. Problem areas mentioned most frequently by callers included dating, family, college classes, loneliness, and lack of information. Help Anonymous thus far has evolved three functions: a listening service, an information service, and a referral service. In addition, the program has revealed unusual potential for a variety of future applications within the college community.     

A student-operated crisis center

In this article we describe an attempt to meet a university community's needs for emergency mental health services through the establishment of a student-operated telephone emergency service. The service provides an interesting model for use of nonprofessionals in mental health services, in which the professional functions primarily as a trainer and consultant rather than offering direct services. We describe the structure of the center and then discuss further innovations and projects.     

Pastoral care in a trauma center

The pastoral staff of the Mercy Hospital of Pittsburgh, Pennsylvania, is a vital participant in the advanced trauma-care team. The staff of professionally certified chaplains take an active role in ministering to the unique temporal, psychological, and spiritual needs of both patients and patients' families. These professionals serve as hosts, counselors, confidants, and friends to people who have been suddenly thrown into chaos. The pastoral staff at a trauma center also ministers to the emotional and spiritual needs of the various medical and nursing staffs.     

Starting a therapy group in a suicide prevention and crisis center.

This report outlines the experience of one center in establishing a group therapy program, discussing the "readiness" of the center, reservations of the governing board, qualifications and number of group leaders, composition of the group, time-place-duration of meetings, "open" versus "closed" structure, vagaries of obtaining participants, integration with the 24-hour telephone crisis service, problems of confidentiality, and dealing with the suicide of a group member.     

Lunar phases and crisis center telephone calls

The lunar hypothesis, that is, the notion that lunar phases can directly affect human behavior, was tested by time-series analysis of 4,575 crisis center telephone calls (all calls recorded for a 6-month interval). As expected, the lunar hypothesis was not supported. The 28-day lunar cycle accounted for less than 1% of the variance of the frequency of crisis center calls. Also, as hypothesized from an attribution theory framework, crisis center workers reported significantly greater belief in lunar effects than a non-crisis-center-worker comparison group.     

Pastoral care in psychiatric crisis

Pastoral Psychology -     

Sex-typed play of toddlers in a day care center

By the age of 3, boys prefer gross motor and vehicle play and girls prefer doll and housekeeping play. The present study was an attempt to define the age at which these sex differences first appear by observing the play behavior of one- and two-year-olds in a day care center. We observed use of stereotyped toys in children 15 to 35 months old during free play. Boys played more with the masculine toys than with either of the other types, whereas girls showed almost equal use of all three types. Choice of sex-typed toys was more prevalent among older boys, while older girls showed less play with feminine toys than younger girls.     

Illness as a crisis of meaning: Psycho-spiritual agendas in health care

The term psychosocial has come to refer to a host of issues in health care. Its wide, indiscriminate usage in referring to almost any non-biophysical aspect of illness obscures or distorts the experience of illness as a crisis of meaning. The term psycho-spiritual agenda is introduced to emphasize the problems of meaning associated with illness, and to avoid the potential reductionism, pathological skew, and interventionist bias of conventional psychosocial analyses of the illness experience.     

Measuring the quality of residential care

Administrative personnel require objective, reliable and valid information in order to monitor the effects of allocating resources to different components of the service that they are providing. The initial problem is to define and measure the dependent variable—the ‘quality of care’ —against which the effects of changing various independent variables can be evaluated. The paper describes an attempt to use the operant conditioning model as a basis for constructing such a measure of the quality of care provided in residential settings for severely mentally handicapped people. The rationale for adopting this model is described, against a background of other studies in which the same problem has been addressed. The hypothesis, the tasks generated, and the methodological problems encountered, are outlined and discussed.

A subsequent paper will present the results obtained when using the method to measure the quality of care, so defined, in two residential units for severely mentally handicapped children.     

Mothers,fathers, and the crisis of newborn intensive care

At hospital discharge of their infant from a newborn intensive care unit, 50 mothers and fathers were interviewed and completed questionnaires. There were significant within-couple correlations for appraisals of the harm that ensued from this crisis, perceptions of personal control over the infant's recovery, and expectations about the infant's future health and development. Mothers perceived more personal control, mobilized more social support, and used more escapist coping strategies than did fathers. Mothers and fathers exhibited different patterns of relations between their own coping strategies and emotional well-being. But, neither the coping strategies used by one's spouse nor differences between spouses in the use of individual coping strategies correlated with emotional well-being. Analysis of parents' perceived differences between their own and their partner's coping strategies suggested the possibility of mutually helpful, complementary strategies of coping with this problem.     

Evaluating the quality of training delivered by direct-care staff in a state mental retardation center

This study evaluated a center-wide training system in a state-operated mental retardation center. Staff performance was assessed under varying conditions with collateral measures collected on resident behavior. The quality of training delivered by direct-care staff was measured following the completion of an inservice training program and when individual feedback and praise were available or a group contingency where feedback, praise, and money were available. Inservice training was not found to be sufficient to maintain staff training skills. Providing feedback and praise had mixed results in maintaining staff behavior. A group contingency using feedback, praise, and money was found to be immediately effective in improving and maintaining staff behavior. Collateral measures on student behavior were also provided that indicated that consistent, quality training by staff resulted in increased student skill acquisition. These results are discussed within the framework of conducting research in applied settings.     

Caregiver behavior in center and family day care

In an effort to examine relationships between variations within day care settings and adult caregiving behaviors the social experiences of 40 toddlers and their caregivers in family and center care were systematically observed. Caregivers were interviewed and conditions of caregiving recorded. Caregivers in both settings with fewer children in their care, who worked shorter hours, with less housework responsibilities engaged in more facilitative social stimulation, expressed more positive affect, were more responsive, and less restrictive and negative. Family day care caregivers who worked in spaces specifically designed to be safe and appropriate for children were less restrictive of toddler activity. Adult-child ratio and caregiver training appeared to be the best indicators of quality care in center day care, while a safe and appropriate caregiving environment and small groups appeared as quality indicators in family day care.     

Direct assessment of quality of care in a geriatric nursing home

Direct observation was used to examine multiple aspects of care provided in a proprietary nursing home. The samples were taken at random intervals, 7 days per week for 5 weeks, across several categories of environmental and resident conditions as well as staff and resident activity. Results showed a high degee of compliance with predefined standards (based on current federal regulations) for environmental and resident conditions. Overall distributions of resident and staff activity showed results similar to those found in previous studies, with residents spending most of their time engaged in nonsocial activity and staff spending the majority of their time engaged in nonresident work. When data were analyzed across areas of the facility, times of day, and weekdays versus weekends, some differences were noted. Weekend versus weekday comparisons showed higher resident:staff ratios on weekends and more resident inactivity, but no significant differences in environmental or resident conditions. In addition, more frequent resident care, resident interaction, and resident activity were observed in Medicare units than in non-Medicare units. Results are discussed in terms of federal requirements for monitoring the quality of care in nursing homes and the potential use of time sampling expressly for this purpose.     

Prevention and public health. Psychology's response to the nation's health care crisis

Psychology as a scientific and applied discipline has a unique responsibility to participate in the pursuit of strategies that reduce the nation's health care needs. As a social and behavioral science, psychology can contribute to unraveling the processes underlying conditions of health and disorder. As an applied discipline, psychology can work to design effective interventions to promote human health and to avoid disease and dysfunction. Insofar as these endeavors are unsuccessful, psychology can help reduce significant contributors to the nation's morbidity and mortality. Achieving such success, however, challenges psychologists to collaborate effectively, to combine science with practice and policy, and to address complex philosophical and ethical issues concerned with individual freedom and public responsibility.     

Reducing obstacles to the provision of quality diabetic care

Abstract

High quality diabetic care is seen as influenced by the organisation of care, health care workers' involvement in diabetes-specific areas, co-operation among staff members, the availability of resources, and the competence of medical staff (including both physicians and nurses). In a prospective study we have tested a programme for improvements of the quality of diabetes services which combined organisational development and continuing medical education (CME) measures. The study involved 34 primary health care centres over an 18 month period and was based on the responses to questionnaires answered by 123 general practitioners and 247 registered nurses at the 34 PHCCs.

The combined programme had a considerable influence on inter-group co-operation, staff members' perceptions of resources available, and nurses' involvement in diabetic care (54 versus 30% seeing diabetic patients for regular check-ups).

The results show that, in order to diminish obstacles to high quality care, organisation of care as well as care workers' theoretical knowledge has to be focused.