Predicting psychiatric symptoms in rural community mental health clients

Using the Brief Symptom Inventory administered to 88 rural clients on Visit 1 and to 56 clients, 3 mo. later after Visit 3 with an evaluation of service, regression analyses suggested a 4-variable model, with fewer symptoms on Visit 1, higher income, lower anxiety, and younger age accounted for 70% of the total variance. Cross-validation is needed.     

Measurement of state and trait anxiety in elderly mental health clients

Anxiety in elderly persons is frequently discussed but rarely measured. Difficulties in measuring state and trait anxiety with mental health clients aged 55 and older using the Spielberger State-Trait Anxiety Inventory (STAI) led the authors to validate the use of the simpler, children's form of their scale. Four types of validity data were found: (1) the childrens' form was highly correlated with the adult form, (2) both scales were significantly correlated with objective ratings of anxiety made by staff, (3) the STAI measures were not correlated with behavioral ratings other than anxiety (discriminant validity), (4) the residential clients were significantly higher in A-trait than the day clients. The nonresidential clients were not more anxious than college students. Discussion emphasizes the necessity of distinguishing between and measuring both state and trait anxiety in order to understand anxiety in the elderly.     

Preconceptional family health evaluation: A regional education program for family planning clients and health professionals

The Preconceptional Family Health Evaluation Program was a regional project developed and funded for 2 years by the New England Regional Genetics Group (NERGG) to educate family planning health professionals about genetics, and to offer family planning clients preconceptional identification of genetic and environmental exposure risks. To meet these goals, genetic education was provided on a regional basis to 45 family planning professionals. A self-administered family health risk questionnaire adaptable to individual family planning settings was developed. Five hundred and twenty-nine family planning clients voluntarily completed the questionnaire. Cigarette smoking (35%) and alcohol use (57%) were two major categories of risks identified. The Preconceptional Family Health Evaluation Program was well received by all participants and provided an effective means for regional education of family planning health professionals. As a result of the program, state program planners, clinical genetics services, and family planning health professionals developed a strong relationship that will serve future educational and genetic risk screening efforts.     

Custody evaluations: a survey of mental health professionals

Mental health professionals who conduct custody evaluations (N=165, 61% return rate) were surveyed about their practices and attitudes. These experts were primarily licensed psychologists, most with degrees in clinical and counseling. Few had specific training in child custody or forensic evaluation, and although they averaged 8·1 evaluations over the last year, most devoted a modest portion of their practice to custody work. They generally regarded custody evaluations as valuable to the courts, but were critical of the adversarial approach to determining custody. Procedures and priorities have changed little over the past decade, with most experts relying heavily on interviews and observation. Cautions are given regarding overstepping ethical guidelines and using procedures that presently lack established validity. © 1998 John Wiley & Sons, Ltd.     

The salience of sex role instructions to mental health professionals

This experiment was concerned with the question of how gender might affect clinical judgment. Mental health professionals (MHP) were asked to rate a protocol (varied for gender) describing a depressed pseudopatient who displayed stereotypically masculine behaviors. The major hypothesis was that, when subjects were aware that the experimental purpose was to measure how patient gender affected clinical ratings, they would suppress bias. If awareness were not present, then bias would be apparent in the ratings. The results failed to support this hypothesis. However, serendipitous results had meaningful relevance for the methodology of gender research. Data from subjects, given a credibility check to determine whether they had guessed the intent of the research, showed that aware subjects were more likely to make incorrect guesses about the study when they rated a male pseudopatient, whereas unaware subjects were more likely to make correct guesses when they rated a female pseudopatient. The interpretation of the data indicated that MHPs differed in their vigilance concerning women's issues. As a result, there may exist a woman's role within the context of psychological experimentation.Thanks to Drs. Tom Morgan, Ed Fischer, and John Turner for their help and support in statistical analyses.     

Relationship between job burnout and personal wellness in mental health professionals

This study aimed to determine the nature of the relationship between job burnout and personal wellness among mental health professionals. The authors performed intercorrelations and multivariate multiple regression analyses to identify the relationship between subscales of job burnout and personal wellness. Results showed that all subscales of job burnout, except for the Negative Work Environment subscale, significantly predicted a large amount of the variance in the collective personal wellness subscales. Implications for mental health professionals’ clinical practice, training, and supervision and limitations and prospects for future studies are discussed.     

Patterns of conversation between clergy and their parishioners and referral to other professionals

Clergy deal with mental and physical health care issues as well as spiritual concerns within their congregations. Collaboration with psychotherapists and physicians could be argued to be "best practice" by clergy, but little is known about how clergy collaborate, particularly in non-hospital settings. This study describes reported practice patterns of referral by clergy in the context of their conversations with parishioners. Clergy report that parishioners regularly express psychosocial and medical concerns to them, and clergy also initiate these conversations. Clergy refer to medical providers and psychotherapist 23% of the time, and these referrals are found to be helpful, even though the professionals rarely connect with each other. Physicians and psychotherapists report they refer to clergy 10% and 24% of the time, respectively, and often find these referrals helpful. Further research is needed to understand the barriers and bridges to collaboration between professionals in different domains of care.     

Adolescents and adults: ratings and expected ratings of themselves and each other

This study compares perceptions of adolescents and adults on twenty personality characteristics. Ratings based on tables originally constructed by Hess and Goldblatt (1957) were applied to 35 adolescents randomly selected from the population of a Southern California high school. These subjects then took complementary forms home for their parents to fill out, 45 of which were returned. The results were compared with those obtained by Hess and Goldblatt, and were further analyzed for possible differences by age, sex, ethnicity, and family size. The differences between parent and adolescent views were much less extreme than the differences found by Hess and Goldblatt. Their conclusion that conflict is based upon divergent "expected reputations" was marginally supported. Multivariate analysis of variance revealed no significant differences on any of the variables examined: age, sex, ethnicity or family size.     

The importance of cooperation among child health professionals and agencies in an inner city infant mental health service

The clientele of our Infant Mental Health Service mainly consists of unwed teenage mothers and babies beset by medical, social, and psychological complications. Efforts to help these families usually extend beyond the caregiver-infant dyad and may include working with grandmothers, pediatricians, and high-risk neonatology nurses, as well as outside social agencies and foster homes. Thus, cooperation among various disciplines, departments, and agencies'is indispensible in infant mental health practice. Problems and successes in building and maintaining such cooperation, its impact on clinical practice, staff work, administrative functioning, and therapeutic strategies are discussed. Clinical examples illustrate the nature of the cooperation.