The development and evaluation of a community mental health education program for seminarians

American Journal of Community Psychology -     

Effects of the community mental health centers program on the growth of mental health facilities in nonmetropolitan areas

Using a quasi-experimental design, changes in the numbers of mental health facilities between 1964 and 1974 were examined for a sample of 50 nonmetropolitan catchment areas that established a Community Mental Health Center (CMHC) before January 1973 and a sample that did not. Compared to non-CMHC areas, CMHC areas had a slightly greater number of general hospital psychiatric units in 1974. Nevertheless, the rate of increase in such units over the 10-year period was not significantly different between the two types of areas. Other findings supported the conclusion that the number of outpatient and day/night facilities continued to increase in areas not participating in the CMHC program, but that the program produced even greater numbers of such facilities in areas that did participate. This growth, though, occurred both through introducing additional facilities and supplanting existing ones.     

A family-based mental health program of recovery from state terror in Kosova

Family processes of communication, mutual support, and sustenance of cultural values can play vital roles in recovery from psychological and material damage in societies afflicted by terror. This is particularly the case when a campaign of terror has specifically targeted family life and its traditions, when the culture is one whose identity has been centered in its families, and when public mental health resources have been scarce. At the end of the 1999 war in Kosova, the Kosovar Family Professional Educational Collaborative (KFPEC) was initiated to counter mental health sequelae of war in Kosova. This initiative focused upon the recovery and strengthening of Kosovar families, rather than the psychiatric treatment of individuals for post-traumatic symptoms. Findings and outcomes from this project may usefully inform the design of other international public mental health initiatives.     

Dose response effects of cognitive-behavioral therapy in a school mental health program

ABSTRACT

School mental health (SMH) programs have been shown to be effective in providing evidence-based interventions to underserved youth. However, limitations of SMH programs are that they can entail holiday breaks, typically do not operate through summer, and often require pulling students from class to receive therapy. These limitations suggest that treatment must be expeditious and potent. Although researchers have investigated dose response to treatment, no studies were located that addressed dose response to treatment in SMH programs. The present study addressed this gap by evaluating the dose response to SMH treatment in a sample of 133 adolescents. Adolescents were assessed at baseline, post-treatment, and at multiple time points throughout treatment. An average treatment response of a 26.81-point decrease in Youth Outcome Questionnaire (YOQ-30) score was found across 14 sessions of cognitive-behavioral therapy (CBT). Further, adolescents exhibited reliable change in YOQ-30 score within an average of 2.91 sessions. Finally, it was found that baseline scores on the Depression and Hyperactivity subscales of the Behavior Assessment System for Children, 2nd Edition, along with YOQ-30 score, predicted treatment response. These findings advance our understanding of dose response to CBT in SMH settings, and create opportunities to better inform effective treatment strategies in similar contexts.     

A two-year follow-up study of a preventive mental health program for preschoolers

The long-term effects of a preschool intervention program for high-risk experimental children were assessed and compared to a high-risk placebo control group and low-risk normal controls. Seventy first-grade children were involved in this 2-year follow-up. The experimental treatment group was superior to that of the placebo control group at follow-up on the criteria measures of behavioral adjustment and achievement. The low-risk normal control group was significantly different from that of the placebo control groups, but generally not significantly different from that of the experimental groups, suggesting that the intervention had boosted the high-risk experimental treatment children to the point where their performance was comparable to that of children who had not experienced behavioral or learning difficulties.The study was supported by grants from the McGregor Fund and the Eloise and Richard Webber Foundation, and by the Detroit Public Schools, for which the authors express grateful appreciation. A version of this paper was presented at the Annual Meeting of the American Psychological Association, New York, September 1979.     

Treating infants and mothers in psychic distress: A mental health program for infancy

Our purpose is to outline a program of mental health for mothers and infants up to the age of 3. The theoretical background of the program refers to the psychoanalytical genetic point of view developed by French and American authors. The therapeutic objectives consist of promoting the infant's self-development and the mother's reflective self-capacity to improve the infant's resiliency. These objectives aim to have preventive purposes. The program has clinical, research and training activities and a multidisciplinary staff. The clinical population is referred by medical services, from families with a middle-low socioeconomic status. With the data collected during the assessment phase, we establish a diagnosis based on a psychodynamic analysis of the pathological process and the evaluation of the risk and protective factors. Our multidisciplinary approach combines individual therapeutic modalities focused on mothers, child or mother-child relationship, with family interventions in our Unit or in the community. An evaluation of our intervention based on Parent-Infant Relationship-Global Assessment Scale (PIR-GAS) is presented. © 1997 Michigan Association for Infant Mental Health     

A program for increasing early identification and prevention of mental health problems in infancy

Dealing with mental health in infancy as a specific clinical modality is relatively recent.¹ Preventive programs during infancy were mainly directed to promote cognitive development. Indeed, the review on prevention by Murphy and Frank² indicated that there are scarcely any programs directed specifically to improve mental health in infancy. This paper will describe a preventive program, conducted by the author, aimed specifically towards mental health aspects in infancy. It began in child guidance services in Jerusalem in 1977.     

Culturally competent outcome evaluation in systems of care for children's mental health

Conclusions The area of culturally competent outcome evaluation and cross-cultural mental health research in general needs to be greatly developed given the culturally diverse nation we live in and the different needs of culturally diverse children and their families. Such evaluation is crucial in supporting the need for and effectiveness of culturally competent programs and special programs with a focus on particular cultural populations. The imperatives for cost effectiveness and clinical effectiveness which have been promoted by the transition to managed systems of care may actually promote the development of higher levels of cultural competence in community-based systems of care. Culturally competent care may well be the most cost-effective and clinically effective care.     

The Woodlawn school mental health training program: A community-based university graduate course

The observance of traditional jurisdictional boundaries in the training of human service professionals has contributed heavily to the general failure of these professions to provide adequate and effective services. This article describes the rationale, design, and development of a community-based school mental health training program that seeks to establish constructive collaboration between those principals most influential in the mental health of young school children-educators, mental health professionals, parents, and the children themselves. A single curriculum for both professionals and parents and the diversity of professional disciplines involved are two of the unique aspects of this training program.     

The growth and development of an infant mental health program: An integrated perspective

This article details the development of the Infant Mental Health Clinical and Training Program at the University of Colorado School of Medicine from 1976 to the present. The article discusses the clinical sites where the program takes place, which include the Neonatal Intensive Care Unit, outpatient child psychiatry clinic, and day treatment programs. Trainees from several mental health disciplines participate in the program, including predoctoral psychology externs, interns from the Clinical Psychology Internship, residents from the Child Psychiatry Training Program, and postdoctoral research fellows in developmental psychopathology. Recently, the Infant Mental Health Program has also been able to offer its own training positions. The philosophical models of clinical service and training are outlined. The article concludes by looking at future directions and challenges for the Infant Mental Health Program. © 1997 Michigan Association for Infant Mental Health     

Developing a family-based depression prevention program in urban community mental health clinics: a qualitative investigation

Extensive research documents that children of depressed mothers are at a significantly higher risk for developing a variety of socioemotional difficulties than children of nondepressed mothers. Yet, little prevention research has been conducted for this population, and low-income, minority, and urban families are rarely included. To address this deficit, we are developing the Protecting Families Program (PFP), a family-based multicomponent depression prevention program for mothers in treatment at urban community mental health agencies and their school-aged children. To inform intervention development and begin relationship building with the agencies, patient and staff focus groups were conducted in the participating agencies. Eighteen mothers with depression participated, and eight major themes were identified: (1) depression symptoms, (2) generational legacy, (3) parenting difficulties, (4) child problems, (5) social support, (6) stressful life events, (7) therapy and other helpful activities, and (8) desired treatment. In the focus groups with 10 mental health providers, the five major themes identified were parenting difficulties, lack of social support, life stress, current mental health practices, and intervention development. The findings support the multicomponent design of PFP, which focuses on increasing knowledge of depression, enhancing social support, and improving parenting skills. The study helped clarify many of the challenges of conducting research in a community mental health system.     

In-depth continuing education for clergy in mental health: Ten years of a large scale program

This paper describes an interdenominational continuing education program for parish clergy in the mental health dimension of pastoral work. The program is in its eleventh year and has reached a significant proportion of the clergy, representing a wide range of religious, ethnic, and socio-economic groups, within a large urban community. The format utilizes case-oriented, small group discussion focused on the clergy's own pastoral work. It emphasizes preventive educational activities along with the development of basic counseling and mental health skills. Ongoing evaluation indicates that the program constitutes an effective, economical, and flexible tool for continuing education with clergy.Dr. Wasman is Assistant Professor of Psychology, Dr. Corradi is Assistant Professor of Psychiatry, and Dr. Clemens is Assistant Clinical Professor of Psychiatry in the Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, Ohio, 44106. This work has been supported in part by the National Institute of Mental Health Grant MH11929 and by grants from the Cleveland Foundation, The Grant Foundation, Inc., and The Cuyahoga County Board of Mental Health and Retardation. The authors wish to thank Dr. Milton Matz, the current Director of the Pastoral Psychology Service-Institute, Case Western Reserve University, for his advice and cooperation in preparing this article.