Health-Related Quality of Life and Perceived Need for Mental Health Services in Adolescent Solid Organ Transplant Recipients

The purpose of the current investigation was to assess interest in mental health services among parents of adolescent solid organ transplant recipients and the relationship between parent perceived need for mental health services and patient health-related quality of life (HRQOL). Sixty-three parents rated interest in receiving 10 mental health services, and patient HRQOL ratings were gathered from adolescent transplant recipients and their parents. Ninety-four percent of parents expressed some level of interest in at least one of the proposed services, with over 40 % indicating maximum interest. Parents’ perceived need for mental health services was inversely related to adolescent and parent reports of HRQOL on the behavior, mental health, family cohesion, and parental impact-emotional domains. Results suggest that parents of adolescent solid organ transplant recipients are interested in receiving mental health services for their families. Assessment of need for mental health services and HRQOL may inform the medical team of families requiring intervention.     

Stakeholders’ Perspectives on Community-Based Participatory Research to Enhance Mental Health Services

Historically, consumers of mental health services have not been given meaningful roles in research and change efforts related to the services they use. This is quickly changing as scholars and a growing number of funding bodies now call for greater consumer involvement in mental health services research and improvement. Amidst these calls, community‐based participatory research (CBPR) has emerged as an approach which holds unique promise for capitalizing on consumer involvement in mental health services research and change. Yet, there have been few discussions of the value added by this approach above and beyond that of traditional means of inquiry and enhancement in adult mental health services. The purpose of this paper is to add to this discussion an understanding of potential multilevel and multifaceted benefits associated with consumer‐involved CBPR. This is accomplished through presenting the first‐person accounts of four stakeholder groups who were part of a consumer‐involved CBPR project purposed to improve the services of a local community mental health center. We present these accounts with the hope that by illustrating the unique outcomes associated with CBPR, there will be invigorated interest in CBPR as a vehicle for consumer involvement in adult mental health services research and enhancement.     

Public and private responsibility for mental health services

Relative to public services, private sector corporate mental health care has significantly increased since the late 1960s. The many tensions encountered in assigning public and private responsibility for mental health service give rise to significant value-laden questions for psychologists. These questions go to the heart of community mental health, deinstitutionalization, mental health policy development and evaluation, and many other areas in which psychologists are playing major roles. The public-private issue should be understood historically, from the twin vantage points of developments in general medicine and in mental health. Among the many public interest and public policy matters psychologists and others concerned with mental health should address are the emergence of corporate chains; the nature, cost, and quality of private sector services; the compatibility of profit motivation and the motivation to provide care; and patient selection issues (e.g., cream-skimming). Public and private cooperation and planning are certainly in order if the public interest is to be served in addressing the nation's mental health problems.     

Extending Models of Prosocial Behavior to Explain University Alumni Contributions1

Survey data merged with contribution records from a development office database provided a basis for understanding alumni support for a university. The survey randomly sampled alumni of a state university school of management who had graduated between 1980 and 1988. Subjects filled out mail questionnaires measuring social psychological constructs from the literature on prosocial behavior. The determinants of obligation to donate included perceived efficacy, perceived need, reciprocity, and individual attachment to the university. Obligation and other constructs explained the number of donations recorded in the development office database over 6 years. The model also predicted intentions to support the university by working for an alumni association or attending reunions. This model of alumni donation leads to recommendations for designing university fund-raising communications.     

Integrating Behavior into Health Research and Health Care: One Psychologist's Journey

The author narrates a history of the development of her interest in integrating behavior into heath research and health care. Using diabetes as an exemplar, she describes some of the challenges of integrating behavior into health research and health care: (1) becoming a member of interdisciplinary research and health care teams; (2) acquiring funding for behavioral research with medical populations; (3) communicating scientific findings; and (4) acquiring reimbursement for psychological services rendered. Specific examples of how the author and other psychologists can address these challenges are provided.     

医院的社会责任：伦理学视角

讨论了评价医院管理行动的伦理框架,严峻的卫生形势,医院的社会责任,其中着重讨论参与全面建设小康社会;向社会提供公平的卫生保健服务;重建医患信托关系以及调整与企业关系防止利益冲突。     

Medical Genetics and Genetic Counseling in Chile

In the South American Republic of Chile genetic counseling is not currently recognized as an independent clinical discipline, and in general is provided by physicians with training in clinical genetics. At present only one genetic counselor and 28 clinical geneticists practice in this country of over 16 million inhabitants. Pediatric dysmorphology constitutes the primary area of practice in clinical genetics. Although the country has a universal health care system and an adequate level of health care, genetic conditions are not considered a health care priority and there is a lack of clinical and laboratory resources designated for clinical genetics services. Multiple educational, cultural and financial barriers exist to the growth and development of genetic counseling services in Chile. However, during the last 10 years increased awareness of the importance of identifying individuals at risk for inherited cancer syndromes led to growing interest in the practice of cancer genetics.     

Religious Orientation in Three Central European Environments: Quest,Intrinsic, and Extrinsic Dimensions

Research in religion and health has spurred new interest in measuring religiousness. Measurement efforts have focused on subjective facets of religiousness such as spirituality and beliefs, and less attention has been paid to congregate aspects, beyond the single item measuring attendance at services. We evaluate some new measures for religious experiences occurring during congregational worship services. Respondents (N = 576) were religiously diverse community-dwelling adults interviewed prior to cardiac surgery. Exploratory factor analysis of the new items with a pool of standard items yielded a readily interpretable solution, involving seven correlated but distinct factors and one index variable, with high levels of internal consistency. We describe religious affiliation and demographic differences in these measures. Attendance at religious services provides multifaceted physical, emotional, social, and spiritual experiences that may promote physical health through multiple pathways.     

Boundaryless LMX: Examining LMX's Impact on External Career Outcomes and Alumni Goodwill

Research has convincingly shown that leader–member exchange (LMX) is associated with a range of beneficial outcomes for employees within organizations. As employees increasingly pursue boundaryless careers that straddle multiple organizations, it is important to ask: Do advantages from LMX extend beyond the current organization and persist even after employees have left it? We propose that employees in higher quality LMX relationships with their managers benefit from stronger professional development, which can pay off in the form of better career outcomes on the external job market. Further, after leaving, whether or not ex‐employees (i.e., alumni) harbor goodwill toward their former organizations is likely to depend on their LMX quality prior to leaving. Alumni goodwill matters because organizations can potentially reap important strategic benefits from their alumni. Using time separated data including alumni interviews conducted by third‐party consultants, we find that, among employees who quit, pre‐turnover LMX is positively related to higher salaries and greater responsibility in their next jobs and is also positively related to alumni goodwill. Moreover, the strength of the LMX–alumni goodwill relationship depends on whether managers made robust retention efforts after employees communicated their decisions to quit.     

Dubious and bogus credentials in mental health practice

Within an ethics framework, this article explores mental health practitioners' use of credentials that lack acceptable accreditation or authority. Increased competition among mental health care providers has elevated the importance of credentials for marketing professional services. Practitioners worried about economic survival, along with certain personality characteristics (e.g., sheer ego), are tempted to rely on credentials that lack proof of quality, thereby potentially jeopardizing professionalism. Specific assertions and recommendations are set forth in the interest of safeguarding consumers and promoting professionalism.     

Conscience and conscientious actions in the context of MCOs

Managed care organizations can produce conflicts of obligation and conflicts of interest that may lead to problems of conscience for health care professionals. This paper provides a basis for understanding the notions of conscience and conscientious objection and offers a framework for clinicians to stake out positions grounded in personal conscience as a way for them to respond to unacceptable pressures from managers to limit services.     

The Experience of Foster Care and Long-Term Attachment

Abstract

There are almost half a million children currently in foster care in the United States. The purpose of this paper is to study the linkage between foster care alumni and long-term attachment. In this qualitative study, six foster care alumni were interviewed. Nine themes emerged: trauma, stolen childhood, relationship style, trust issues, anxieties, current parenting concerns, broken system, coping strategies, and implications for counseling. The results of this study indicate that there are attachment implications for foster care alumni and that the experience of being in foster care was generally perceived as negative.     

Expanding Mental Health Services to Older High-Utilizing HMO Patients: A Pilot Study

Background: Expanded mental health benefits were offered to older HMO patients who were high medical utilizers. Outcomes of interest were use of services, subjective well-being, and psychopathology. Methods: Sixty-nine (25 male, 44 female) patients age 55 or above seeking frequent outpatient medical care completed the SF-36 health survey and the revised Symptom Check List (SCL-90-R). Patients were assigned to usual care, health education, or expanded mental health benefit conditions. Results: Patients showed high initial levels of psychopathology and distress. Over the 6 months of the study, patients in the expanded benefits group made a mean of 11.5 visits to mental health professionals versus a mean of 3.4 visits by usual care patients. Patients in the expanded benefits group showed significant improvement in SF-36 General Health and Mental Health well-being scores. Patients in the health education group showed no improvement. Patients in the usual care group showed improvements in Vitality scores. Psychopathology summary scores showed improvement for both usual care and enhanced benefit groups. Conclusions: Mental health treatment may improve well-being and reduce psychopathology in older high-utilizing patients. Creativity will be needed in expanding access to mental health services for this population.     

An Underserved Population and Untapped Resource: A Preliminary Study of Collegiate Sorority Response to Dating Violence

ABSTRACT

To what extent do national collegiate sororities have formal programs and policies addressing dating violence? Given that undergraduate women are at high risk for violence by a male partner, sororities represent an opportunity to reach large numbers of undergraduates as well as women in the community who are active in alumni chapters. Based on a telephone survey and review of organizational Web sites, study results suggest that collegiate sororities are an underserved population with regard to prevention, education, and outreach services and an untapped resource with regard to opportunities for community service. Suggestions for building collaboration between sororities and service providers to raise awareness, support victims, create safety planning, and develop resources are addressed.     

Bartering

Summary

This article examines issues related to bartering arrangements in the context of providing professional mental health services. The risks associated with significant conflict of interest in the professional-client relationship and the potential for exploitation of the client are analyzed by examining the interplay of personal, business, and clinical interests in bartering relationships. Professional practice guidelines are suggested.     

医疗活动中的利他主义与医务人员的价值取向

医学的目的是增进人的健康,当今医疗技术主义和医疗市场在诱惑医学超越固有疆界。医疗行业必须坚持正确的价值取向,社会公众利益最大化是医疗卫生服务的基本目标。市场经济条件下的医疗卫生服务具有无私利他的道德责任和追求利益的需求,医疗市场中的利他行为包括无私利他与为己利他,为病人最大利益着想是医护专业最根本的道德规范与责任。     

Interagency Collaboration

Abstract

Child welfare, education, health, juvenile justice, and mental health systems have simultaneously initiated movements to reform services to troubled children during the past ten years. Recently, these agencies have shown increased interest in bringing their change efforts together for a more unified system of care. This paper describes essential components of systems of care and interagency collaboration. A case illustration describes a setting in which special service providers in schools, particularly special education administrators and school psychologists, played major roles in the conceptualization and implementation interagency collaboration for a system of care.     

Examining Factors Associated with Primary Care and Continuity of Care Among Adults with Severe Mental Illness

A number of studies have consistently reported that there is a greater prevalence of mental illness among the most socioeconomically disadvantaged. At the same time, there is evidence that services are not optimally accessed by the most socioeconomically disadvantaged; the most in need of care are also the most likely to have unmet healthcare needs. Of people with mental illnesses, those with severe mental illnesses (SMI) are the most at risk of poverty and the least likely to have optimal care. In the past, specialized community mental health services have been identified as the primary provider for people with SMI. However, there is growing interest in using the primary care setting as the main source of mental health care where both medical treatment and psychotherapy can be accessed. In this paper, we examine factors related to primary care use (and in turn, pharmacologic and psychotherapies) for people who are socioeconomically disadvantaged and who have a SMI.     

What Do the Spiritual and Religious Traditions Offer the Practicing Psychologist?

There has been a remarkable amount of interest in the relationship among spirituality, religion, psychology, and health of late. Contemporary interest in spirituality and religion is hot among not only the general population but among professionals in the mental and physical health disciplines. While most people believe in God and consider themselves to be spiritual, religious, or both, most mental health professionals have little if any training in this area. Psychologists can use spiritual and religious principles and tools to better serve their clients even if they do not share the same religious interests. The purpose of this article is to offer thirteen spiritual and religious tools common among all of the major religious traditions that can be used by contemporary professional psychologists in clinical practice to enhance the already high quality professional services that they provide. Examples of spiritually and religiously integrated treatment along with several ethical precautions are noted as well. This article is based on book project by Plante currently in press.