Attitudes of Disabled Individuals Enrolled in a Workstation Center and a Community College Program

This study measured the attitudes of disabled individuals toward the staff who gave them rehabilitation services. The attitudes of two groups of clients at a rehabilitation hospital were evaluated: (a) clients from a vocational rehabilitation workshop and (b) clients from a community college satellite program. Testing was performed at three-week intervals. It was found that clients in the community college program perceived their staff as having more concern than the workshop group. No relationship was found between attitudes and the length of time in the respective program. Clients who entered programs appeared to have attitudes that did not change to any great extent while they were in the rehabilitation programs.     

Are personality disorders associated with social welfare burden in the United States?

This study examined the association between personality disorders and use of major social welfare services in a nationally representative sample of U.S. adults (N = 43,093). Social welfare services received and diagnoses of personality, substance use, mood, and anxiety disorders were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV-version. Analyses quantified the association between personality disorders and forms of public assistance while controlling for numerous confounds. Logistic regression analyses revealed dependent personality disorder, paranoid personality disorder, antisocial personality disorder, and avoidant personality disorder were significantly associated with increased odds of receiving public assistance. In contrast, persons diagnosed with histrionic, schizoid, and obsessive-personality disorder were not significantly more likely to receive any public welfare service. Development of effective prevention and treatment of personality disorders would likely lead to reductions in overall social welfare burden.     

Adherence to HAART: perspectives from clients in treatment support programs

The development of highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and mortality for HIV-infected individuals. Because the long-term efficacy of HAART is dependent on near perfect adherence, many providers offer services to support adherence, including education, regimen review, counseling, and reminder tools. Little is known regarding the utilization or efficacy of these services. In this paper, we report on data collected during 32 open-ended interviews conducted with individuals receiving services through the New York State Treatment Adherence Demonstration Project. Participants in the project reported deriving benefits from a broad range of project activities. Educational efforts helped clients to recognize HIV as a manageable, rather than terminal, illness. Information and tools focused on specific regimens provided clients with concrete knowledge and skills. Effective communication with medical providers and pharmacists was facilitated by adherence staff who proactively advocated for client needs. Program-based social support was particularly valuable for many participants, helping them to retain needed motivation and strength. Educational, practical, and supportive services were all considered valuable to clients participating in adherence support programs. A mix of services may best meet the range of needs found among persons taking HAART.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

A project to strengthen linkages between genetic centers and child welfare services

Genetic centers are reaching out to underserved populations. One of the most vulnerable underserved populations is children receiving child welfare services. Delivering genetic services to this group is particularly problematic because of multiple barriers. The first step in overcoming barriers is developing linkages between the genetic and adoption service systems with the goal of increasing referrals of child welfare clients to genetic services. This paper presents a model of fostering linkages that was developed under the auspices of the Mid-Atlantic Regional Human Genetics Network with support from the Maternal and Child Health Bureau, Genetic Services Branch. Although the project was regional and funded, the model can be applied at the local level.     

Does psychopathology predict counseling duration?

Many university counseling centers have adopted case management policies in an effort to conserve limited resources. Fearing that students with more severe problems will consume too many clinical resources, many counseling centers have decided to refer such students to external agencies or providers for mental health services. However, this fear might be unwarranted because empirical research has not shown a substantial relationship between psychopathology and counseling duration. This investigation examined whether a new treatment-planning inventory, the Butcher Treatment Planning Inventory, might be useful for better understanding the relationships between various problem areas and counseling duration. Participants were new clients (students and staff members) at a university counseling center in the southeastern USA. Professional staff members and graduate students in counselor education, clinical psychology, and clinical social work provided counseling services to the participants. Lower scores on several scales predicted counseling duration. In other words, clients with lower scores on these scales (representing less psychopathology) attended more counseling sessions than clients with greater psychopathology. Therapists' background also predicted counseling duration; clients who worked with either a professional staff member or graduate student in counselor education attended more sessions than clients who worked with a graduate student in clinical psychology. The results of this study, combined with previous research, suggest that measures of psychopathology are not very useful for identifying which clients will complete long-term counseling. Until better information becomes available, actuarial tables remain the most efficient means for predicting counseling duration.     

The frequency and effect on outcome of different types of interpretation in psychodynamic and cognitive-behavioral group psychotherapy

The therapeutic effects of interpretations by both therapists and other clients were recorded by observers in three cognitive-behavioral and three psychodynamic groups over a period of thirty one-and-one-half-hour group therapy sessions. There was no significant difference in the overall frequency of interpretations made in the two different therapy modalities; however, there was the expected difference in the types of interpretations made. Cognitive-behavior therapists and group members tended to interpret patterns of behavior or impact on others more frequently than did psychodynamic therapists and group members; while psychodynamic therapists and group members made more historical cause interpretations. However, contrary to expectations, both therapy modalities made more interpretations of patterns of present behavior than any other type. When these interpretations were converted into problem statements that were sent to outside raters after the termination of the groups, the outside raters judged that clients improved most when interpretations of a pattern of behavior were made; next most when interpretations of impact on others were made; and did not improve when interpretations of motive were employed in either modality.     

Contrasting jail diversion and in-jail services for mental illness and substance abuse: do they serve the same clients?

Baseline data from a study of jail diversion services and in-jail behavioral health services were used to examine the differences in clients served by these two models of responding to people with co-occurring mental health and substance abuse problems in the criminal justice system. Clients of the diversion service had more acute psychiatric symptoms and were more likely to have a diagnosis of psychosis NOS. Clients of the in-jail service were more likely to have been on probation or parole in the past and to have received substance abuse treatment. Different service models may attract and serve different populations of clients. Diversion services may cast a wider net that includes clients who may not have otherwise been involved in forensic services.     

Therapeutic Multiple Family Groups

The therapeutic effects of interpretations by both therapists and other clients were recorded by observers in three cognitive–behavioral and three psychodynamic groups over a period of thirty one-and-one-half-hour group therapy sessions. There was no significant difference in the overall frequency of interpretations made in the two different therapy modalities; however, there was the expected difference in the types of interpretations made. Cognitive–behavior therapists and group members tended to interpret patterns of behavior or impact on others more frequently than did psychodynamic therapists and group members; while psychodynamic therapists and group members made more historical cause interpretations. However, contrary to expectations, both therapy modalities made more interpretations of patterns of present behavior than any other type. When these interpretations were converted into problem statements that were sent to outside raters after the termination of the groups, the outside raters judged that clients improved most when interpretations of a pattern of behavior were made; next most when interpretations of impact on others were made; and did not improve when interpretations of motive were employed in either modality.     

Revisiting relationships between sex-related variables and continuation in counseling

This study examined the relationships between three sex-related variables (client sex, therapist sex, and dyad matching on sex) and continuation in counseling. 245 college students who were clients at three university counseling centers participated. Consistent with previous studies, women comprised 68.2% of the clients seeking services at these counseling centers. Clients' sex was significantly related to counseling duration, explaining 2.2% of the common variance. Female clients, on the average, attended 1.8 more sessions than male clients. However, neither the therapists' sex nor dyad matching on sex was significantly related to the duration of counseling. None of the sex-related variables correlated with premature termination of counseling. The results have implications for providing counseling and outreach services to male students. Despite relatively equivalent rates in the incidence of mental health problems, female students continue to comprise the majority of clients. Therefore, university counseling centers need to communicate their services better to male students in need of mental health services.     

Adolescent pregnancy: effects of family support, education, and religion on the decision to carry or terminate among Puerto Rican teenagers

Why do some pregnant teenagers decide to carry to term while others terminate their pregnancy? This study examined the influence of family relationships and support, religion, and education on the decision to carry or to abort. A nonrandom sample of 43 pregnant Puerto Rican teenagers (21 who carried and 22 who aborted) were interviewed in 1982 using a 34-item interview schedule. It was found that girls in the carry group were more significantly influenced and supported by family and friends than were those in the abort group. Fathers were the least influential persons in both carry and abort groups, while mothers were the most influential in the carry group, and sisters in the abort group. Brothers, boyfriends, and best friends were more influential for carry girls than for abort girls. Contrary to expectations, girls in the abort group reported a greater degree of religiosity than did those in the carry group. Further, girls who received strong support from family and friends reported a higher degree of satisfaction with their decision than did those who received less support. Finally, girls in the abort group were more likely to continue their education than were those in the carry group. Overall, the findings of this study have immediate implications for research and counseling services. Practitioners should focus on the girls in conjunction with their families in order to achieve better results in both treatment and preventive services.     

Poverty and Mental Health: Underclaiming of Welfare Benefits

The study undertaken by a local MIND welfare benefits service found that 51% of people attending a local mental health resource centre were not receiving the welfare benefits to which they were entitled. Being in receipt of correct benefit entitlement was found to be unaffected by: whether a person had a long history of using mental health services; whether they had a care manager; or whether they had previously been given benefits advice. Women were less likely to be receiving their correct benefit entitlement than men. It is argued that the only way to guarantee that people receive their full benefit entitlement is to ensure that highly trained and experienced welfare benefits advisers are readily accessible to all people who use mental health services.     

Pregnant adolescents attending prenatal parent education classes: self-concept, anxiety and depression levels

Past research has indicated that pregnant adolescents who attend parent education programs (PEP) are more likely to have better outcomes after delivery than those who leave school. This study compared pregnant adolescents who attended a PEP (PA), those who did not attend a PEP (PC), and nonpregnant adolescents (NP) for differences in personality characteristics--self-concept, anxiety, and depression--which might account for postdelivery outcomes. On pre- and posttests administered four to six weeks apart, the PA did not indicate any changes over time and the groups did not differ significantly in self-concept and state and trait anxiety levels. Although the PA group showed a significantly higher level of depression on the pretest than did the NP group, they did not differ significantly at posttesting. According to demographic variables, the number of persons in household was significantly higher for the NP group than for the PA and PC groups. These results, not always consistent with past research on teenagers' personality characteristics, suggest: that the groups did not differ in terms of these personality characteristics, and that for these subjects (88% black), the tendency toward higher depression and anxiety levels in adolescence may not be significantly different from that experienced during pregnancy. The drawbacks of research in this area and for this project are discussed.     

Anti-equality: Social comparison in young children

Young children dislike getting less than others, which might suggest a general preference for equal outcomes. However, young children are typically not averse to others receiving less than themselves. These results are consistent with two alternatives: young children might not have any preferences about others receiving less than themselves, or they might have preferences for others receiving less than themselves. We test these alternatives with 5- to 10-year-old children. We replicate previous findings that children will take a cost to avoid being at a relative disadvantage, but also find that 5- and 6-year-olds will spitefully take a cost to ensure that another’s welfare falls below their own. This result suggests that the development of fairness includes overcoming an initial social comparison preference for others to get less relative to oneself.     

Faith‐Based Social Services: Saving the Body or the Soul? A Research Note

Faith‐based organizations might be ideal social service providers, claiming to transform clients’ lives with holistic support while meeting immediate needs. While organizations have such goals, their success is impacted by constituencies with differing goals for the organization. Clients with goals not commensurate with an organization's may compromise its ability to attain its goals. Three questions are examined here: What are the goals of faith‐based service providers? When asked what they think about the services, do clients share the organizational goals? Are organizations likely to meet either set of goals? Homeless persons patronizing faith‐based soup kitchens were interviewed; service activities of organizations were observed. Clients’ goals focused on survival in their current situation. Organizations’ goals ranged from meeting clients’ immediate needs to transforming clients through spiritual restoration. Congregations studied met clients’ immediate needs. However, clients’ accommodational goals were potentially problematic for organizations with spiritual goals.     

THE CHALLENGE OF WELFARE DEPENDENCY TO REHABILITATION1

The relationship of welfare status and socioeconomic status (SES) to employment outcomes following prevocational programs for mentally retarded young adults was investigated. About three-fourths of the clients who were neither on welfare nor from the lower SES were successful, about half of the clients who were either on welfare or from the lower SES were rehabilitated, and only about one-fourth of the clients who were both on welfare and from the lower SES were rehabilitated. The findings suggest the need for continual improvement in strategies for overcoming the vocational deficiencies of highly “dependent” clients.     

Implicit Theories of Personality: Further Evidence of Extreme Response Style

Five groups of 19 subjects made ratings on 11 personality trait scales of overlapping subsets of 59 artificial stimulus persons who were described by one to five personality trait adjectives. The data were analyzed per group of subjects (blockwise) and per type of stimulus person (questionnaire-wise) by means of three-mode principal component analyses. This yielded highly similar structures for the scales, and in the blockwise analyses, for the stimulus persons. This similarity was substantiated by external three-mode analyses, which showed that all stimulus persons can be mapped into one overall configuration. In all analyses it was found that differences between subjects consisted of differences in extremity of judgment, which suggests the operation of response style.     

CORE-OM mental health norms of students attending university counselling services benchmarked against an age-matched primary care sample

Whilst concern has been expressed at the increasing severity of the mental health of students, there has been very little research on this growing population outside of small, single institution studies. The aims of this paper are to provide CORE Outcome Measure (CORE-OM) norms for the psychological health of students across multiple sites receiving university counselling, and benchmark these against an age-matched sample of people receiving treatment in NHS primary care settings. Results indicate that students using university counselling services show severity levels only marginally lower than young people presenting in primary care, with the differences being at a functional/relationship rather than a symptomatic level and with levels of risk to self being similar. This suggests that university counselling services deliver a service to people who closely resemble NHS primary care clients in terms of severity and risk to self.     

Psycho-social Counselling in Predictive Genetic Testing for Cancer: The Association Between Number of Supportive Sessions and Client Characteristics as Assessed by Psycho-social Workers

Given the increased demand on genetic services, it is important to identify clients who may require relatively more extensive psychosocial support. This paper describes which client characteristics, as assessed in the first psycho-social counselling session, were associated with requiring relatively more psycho-social support (≥3 sessions) in the process of predictive testing for cancer. The study population consisted of 244 counselees for hereditary cancer. Data were derived from an electronic data-base, used by psycho-social workers for the systematic registration of relevant details of each counselling session. Data were analysed for two respective groups: (A) patients who had a known mutation in the family and (B) patients with an as yet unknown mutation in the family. Results show that two or more psychosocial sessions were given if the information derived from the first session indicated the client to have childhood experiences with cancer (in group A), to experience the family role and/or the psychological impact as burdensome (in both groups) or to experience the social impact as burdensome (in group B). We conclude that the first assessment by a psychosocial worker already provides valuable information on the psychological support needs of patients. These findings provide insight into possible problem areas for clients dealing with predictive genetic testing.