Cuban health psychology: A priority is the primary health care system

Cuban health psychology has experienced a great expansion during the last 25 years, both in the number of psychologists and in range of activities in the field. Today, psychologists are integrated at all levels of the national health system, an achievement which is particularly interesting in that Cuba is a developing country. In a position isolated from trends in international psychology, Cuba has developed a role for psychologists within the field of health which is adapted to its situation as a poor and socialistic country. Priority is given to preventive and community-based psychology within primary health care facilities. Psychologists in primary health care serve a composite client-group, with high priority given to pregnant women and to children. The work of these psychologists covers a wide range of health problems—-physical as well as mental—and focuses upon individuals as bio-psycho-social units. Their responsibilities include health promotion, disease prevention, consultation and treatment, rehabilitation, research and education. This report is based on a 2½ month long field study in Cuba, where Cuban health psychology, particularly as it relates to primary health care, was explored.     

心理预防概念的更新及其对实践的指导意义

继Caplan的“公共卫生预防模型”之后,Gordon提出另一个综合性预防模型;美国国家科学院医学研究所绘制了“心理健康干预光谱”; 美国国家研究所和国家科学院医学院则进一步将“心理健康促进”正式纳入心理预防概念。“心理健康促进”是针对消极被动的传统预防而提出的积极主动的预防。心理预防概念的发展与更新,特别是将“心理健康促进”纳入心理预防体系,要求树立预防的全局观念,提高预防的针对性,将消极心理预防与积极心理健康促进结合起来。     

Mental health consultation in infant day care: A new frontier of prevention

This paper deals with the mental health aspects of infant day care emphasizing that mental health input into the design, implementation and ongoing supervision/evaluation of the majority of day care programs is minimal at the present time. The author proposes the following three criteria by which the adequacy of mental health input in a day care program could be judged: 1) ongoing mental health consultation to the caregiver staff on a weekly basis and by the same clinician(s), 2) assignment of primary caregivers to the infants, 3) periodic naturalistic observations of the infants to be recorded and discussed by the caregivers. The author postulates that consultation to the caregiver staff of infant day care programs represents the opportunity to establish a new frontier of prevention. Therefore, the mental health profession should consider it a goal that every infant day care setting would have a mental health clinician as a consultant. The methods, preventive functions and manpower aspects of such consultation work is discussed.     

The Prevention of Suicidal Behaviors: An Overview

The authors discuss the development of the concept of prevention as it has evolved from the public health and mental health fields. Concepts of epidemiology, treatment, and community mental health are defined in terms of their contributions to the evolution of prevention thinking. Four models of prevention are presented and critiqued: the public health model, the operational model, the antecedent conditions model, and the injury control model. Essential ingredients for implementing effective preventive interventions are presented, as well as examples of practical preventive interventions.     

The Role of the Occupational Therapist as a Community Consultant

Concern for health development has been in the forefront of occupational therapy practice and training for many years. However, consultation in this area to community agencies and grass roots programs is a relatively new endeavor for occupational therapists. This article describes community consultation in a demonstration project emphasizing the concept of preventive mental health. Steps in establishing the consultation role are discussed using the theoretical constructs of systems consultation. Discussion of the educational objectives for field training in community mental health, community experience during the field training, and the supervisory and communication networks essential to such a program are presented as a model in developing the role of the occupational therapist as a community consultant.     

2010~2020中国内地小学生心理健康问题检出率的元分析

我国小学生心理健康问题的检出率莫衷一是, 为整合调查结果并分析其原因, 对2010~2020年来检索到的相关研究进行了元分析。结果显示：(1)小学生心理健康问题的检出率由高到低依次是睡眠问题(25.2%, 95% CI = [0.16, 0.37])、抑郁(14.6%, 95% CI = [0.12, 0.18])、焦虑(12.3%, 95% CI = [0.06, 0.23])、攻击行为(4.1%, 95% CI = [0.02, 0.10])、退缩(3.8%, 95% CI = [0.02, 0.06])、违纪行为(3.7%, 95% CI = [0.02, 0.07])、躯体化(3.6%, 95% CI = [0.02, 0.07])。(2)测量工具、检出标准、检出时间是导致小学生心理健康问题检出率不一致的关键因素。总体而言, 我国小学生除了睡眠问题、抑郁和焦虑检出率偏高外, 整体心理健康状况尚可。未来应开发适合中国小学生的心理健康状况测评工具及检出标准, 为心理健康问题的预防和精准干预提供支持。     

Group-based problem-solving therapy in self-poisoning females: A pilot study

Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed.     

中小学教师心理健康维度的初步构建

本研究通过开放式问卷调查和深度访谈,构建出教师心理健康的八个维度,编制了初测问卷,对初测问卷的结果进行探索性因素分析,形成了六个维度6、1个项目的正式问卷,对正式问卷进行验证性因素分析。结果得到中小学教师心理健康的六个维度是:挫折应对问题、职业倦怠、人格障碍、躯体症状、社会适应问题和人生态度问题。对问卷进行描述性统计分析,发现中小学教师在这六个维度上存在一定的心理健康问题。     

An “issue-focused” model for mental health consultation with groups of teachers

This paper presents and evaluates a model for group mental health consultation with teachers in which sessions are organized around mental health issues rather than cases. The rationale and advantages of the model are explicated and compared with other models of group consultation and group work with teachers. The model incorporates a heavy emphasis on educational preventive measures and is designed to simultaneously satisfy a wide range of consultee needs and to reduce anxiety and defensiveness. Consultant's preparations for the group sessions are highlighted so as to maximize their contribution to the participants' level of involvement, knowledge, skills, confidence, and objectivity. The different roles of the consultant during the session and the variety of techniques employed are described as they relate to group processes and consultation needs. Specific guidelines for the organization of consultation groups and training of group consultants are offered. Evaluation data based on feedback from participants in ten groups are included.     

Primary Prevention Mental Health Programs: The Future is Exciting

Current outcome research on primary prevention mental health programs is encouraging and the future is exciting. Data continue to accumulate regarding the efficacy of preventive intervention. Exemplary programs can prevent multiple problems across different outcome domains suggesting the need for collaboration among preventionists across disciplines and research areas. The commentators on our review (Durlak and Wells, 1997) offered many useful suggestions to improve the next generation of research. Most recommendations fall broadly under the rubric of increasing the precision of theory, design, and program evaluation. If current recommendations for improving future research are followed, the next reviewers of primary prevention mental health programs for children and adolescents will have a more complete and useful database for analysis.     

Collaborative Consultant: A New Role for Counselors Serving At-Risk Youths

School and community counselors have important roles in developing and implementing mental health programs for youths and families. Counselors who are working with the more complex issues of at-risk youths can enhance implementation of prevention programs by altering their roles to function within a collaborative consultation model. This model represents a new paradigm in that counselors interdependently and collaboratively partner with people previously considered their “consultees.” Such collaboration can result in more comprehensive and integrated programs, and it can prevent fragmentation and duplication of efforts. Collaborative consultation is described and contrasted with more traditional consultation models, and a 5-stage implementation process is presented. Personal and systemic factors that support the collaborative process are examined.     

The role of primary prevention in mental health services: A review and critique

Community psychology in the West has had a growing impact on mental health service provision. One facet of this development has been the advocacy of an increased focus on the primary prevention of mental illness. This paper reviews both theoretical and practical work in this area in order to assess the current role and relevance of primary preventive interventions. There is a discussion of primary prevention's historical and theoretical contexts, of its conceptualisations and definitions, of criticisms of its relevance and efficacy, and of examples of its practice. It is argued that primary prevention is inappropriately marginalised in current service provision and that there is a need to engage in the long-term planning and evaluation of primary preventive interventions in order to facilitate their fuller incorporation into national and local policies on mental health.     

Roles for the Black pastor in preventive medicine

In recent years, a new role for Black pastors has emerged. As agents of health-related social and behavioral change, Black ministers have taken active roles in preventive medicine at the tertiary, secondary, and primary levels of prevention, succeeding despite resistance by some physicians. The literature detailing these new health-related pastoral roles is reviewed, with special reference to the place of the Black Church in health care and to the place of the Black pastor in the Black experience. It is concluded that Black ministers are ideal people to take part in planning, promoting, and delivering preventive health care in the Black community.The author wishes to acknowledge Dr. John W. Hatch of the University of North Carolina School of Public Health, who supervised the preparation of an annotated bibliography upon which this paper is based.     

The Values of Counseling: A Disparity Between a Philosophy of Prevention in Counseling and Counselor Practice and Training

The results of a study examining the disparity between counseling's philosophy of primary prevention and actual education and practice are presented. Results indicate that only the belief that society does not demand preventive mental health services provided a meaningful explanation for the disparity. Two paradoxical implications for the field of counseling are offered and discussed within the perspective of virtue ethics.     

A Public Health Framework for Preventing Mental Disorders in the Context of Pandemics

The COVID-19 pandemic has universally threatened the building blocks of mental health, well-being, and quality of life, namely, expectations of safety, connectedness, hope, and individual and societal efficacy. Consequently, unprecedently large numbers of individuals are significantly stressed and many are at risk for relapse of mental health problems, exacerbations of existing mental and behavioral health problems, and new onset clinical problems. Because of the scope of the problem, a population-based public health perspective is needed, which in the context of disasters has well-established theories and prevention approaches. Public health approaches to disasters and pandemics focus on preventing subclinical problems from becoming clinical disorders, in comparison to clinical care approaches that focus on treating established disorders. Fortunately, specialty care clinicians who typically think about assessing and treating established disorders have the training and clinical competencies to deliver prevention-focused interventions. This paper is designed to help specialty care clinicians who use cognitive-behavioral strategies to understand the biopsychosocial impacts and resource deficits associated with COVID-19-related stressors and the public health perspective to address them. We also provide ways clinicians can help people who are suffering from significant stress and resource deficits bounce back and regain functioning. We describe psychological first aid, stress management, repeated ecological assessment, writing about stressors, problem-solving, and behavioral activation approaches to assist individuals at risk for enduring stress-linked problems.     

A practical approach to school psychology

Exclusive use of the clinical model in school psychology is impractical. This is discussed in terms of incidence of adjustment problems, psychologist-student ratios, and undesirable side effects that have resulted from sole use of the clinical model. Reasons for implementing developmental and preventive mental health programs in the schools are discussed, and examples of such programs are presented. Some alternatives to the usual ways of handling the remediation of currently existing adjustment problems are suggested.     

Prevalence of mental health problems in Australian university health services

General practice patients report greater mental health problems than the general population, and students attending one university health service have reported greater prevalence rates at the end of the academic year. This study assessed the overall prevalence rate of mental health problems in university students using a cross‐sectional survey design of 1,168 students from three large, predominantly urban, Australian university health services. Approximately half of the students attending university health services reported elevated levels of psychological distress. The majority of severely distressed students had not sought any professional assistance for mental health problems. While there is scope for general practitioners to take a lead role in the identification of mental health problems in tertiary students, adequate treatment pathways need to be available. Implications for the role of universities in prevention work are discussed.     

Social Problem-Solving Abilities and Health Behaviors Among Persons with Recent-Onset Spinal Cord Injury

Although many persons with spinal cord injuries (SCI) are at risk for preventable complications, very little research has examined the health behaviors of these individuals. In this study, we examined self-reported health behaviors of persons with recent-onset SCI. We also studied the association between health behaviors and social problem-solving abilities. The results indicated that positive problem-solving characteristics were associated with more adaptive wellness and accident prevention behaviors. A negative orientation toward problem solving and avoidant and impulsive/careless styles was associated with increased traffic and substance risk taking. Implications are discussed in terms of health education, research, and prevention programs.     

Cognitive modeling of consultation processes: A means for improving consultees'' problem definition skills

This study investigated whether consultees' understanding and use of problem definition skills could be enhanced by increasing their awareness of these processes during consultation interactions. Subjects assigned to a consultation with cognitive modeling group viewed videotaped consultation interactions in which consultants' verbalizations during the problem definition stage of consultation frequently included overt references to the problem-solving processes being used by these consultants. Subjects in a consultation without cognitive modeling group viewed similar interactions except that the consultants' statements did not include overt references to problem-solving processes. A control group viewed irrelevant interactions between consultants and consultees. Data analyses indicated that the subjects exposed to consultations that included cognitive modeling components wrote better problem definitions and were better able to describe the process for defining children's problems than subjects in either the consultation without cognitive modeling or control groups. The subjects in the consultation without cognitive modeling group generally did better than those in the control group.     

Mental models in word problem-solving: A comparison between American and Korean sixth-grade students

Mental model analysis was conducted in word problem solving using American (n = 42) and Korean (n = 44) sixth-graders. Two levels of mental models–the problem model and the mathematical model–constructed in the process of word problem solving were investigated. Categories for correct and incorrect models were developed to be used in think-aloud protocol analysis. The majority of students who constructed correct problem models classified the problems rapidly according to solution procedures as they read the problems, or restated the problems focusing on the specific words relating them to other statements in the problems. However, significant differences were found between American and Korean sixth-graders' in some categories of problem and mathematical models. While many Korean sixth-graders' problem-solving process steps were proceduralized, this was not the case for American sixth-graders, even for those who had a readily accessible knowledge base of basic mathematical facts.