Community care for the kibbutz chronic psychiatric patient

After over 15 years' experience with a very structured community care program for kibbutz chronic psychiatric patients, the author is convinced that these severely disturbed patients show improved psychosocial adjustment and a highly significant reduction in recidivism and rehospitalization as compared to their records before the institution of the community treatment program.1981, Fall     

Pastoral care of the discharged psychiatric patient

Pastoral Psychology -     

Outpatient groups for chronic psychiatric patients

Long-term support groups have been utilized at the University of Alberta Hospitals since 1977 in order to meet the needs of chronic psychiatric patients who are unwilling or unable to commit to insight-oriented therapy. These groups meet once weekly for one hour and are intended to be drop-in groups, which patients can use regularly or only while in crisis. It is hypothesized that the institution or style of therapy practiced at an institution, rather than the specific therapists, provides a source of stability and support to these patients. Our experience suggests these groups are beneficial and cost-efficient, but research is necesssary to evaluate them to determine components of therapeutic effectiveness.Linda McAuley, M.A., was a staff therapist at the Psychiatric Walk-in Clinic and is currently in private practice.An earlier version of this paper was presented at a meeting of the Canadian Group Psychotherapy Association in Banff, Alberta, October, 1987.     

Brief therapy in the Israeli kibbutz

Analysis of results of therapy in an unselected sample of 211 kibbutz patients seen over a three year period by the author in his capacity as kibbutz member and psychiatrist indicated that over 70% of the identified patients responded very satisfactorily to brief therapy. About one-third of the clients did not need more than a single comprehensive therapy session to achieve continuous improvement. In a minority of the cases more than 10 sessions were required. The results were significantly better in cases treated by brief therapy than in the sample treated by long-term therapy, where the pre-treatment severity was determined to be greater. The paper describes the unique aspects of brief therapy in the kibbutz setting, giving an outline of the author's model of intervention, using all components of the individual, family, and community ecosystem.     

The schizophrenic diathesis and the kibbutz

In this article, the National Institute of Mental Health (NIMH) "Israeli High Risk Study," which extended over two decades and compared the relative effects of kibbutz and city environments on the diathesis of schizophrenia, is critically examined. Comparison data on personality and cognitive functions of groups of 11- to 16-year-olds and adults are reviewed in the light of previously published material. The apparent shifts in level of adjustment of kibbutz and city subjects, as well as the allegedly greater incidence of pathology in the kibbutz index group, are questioned on methodological grounds.     

Gender and health on the kibbutz

Gender differences in health status and illness behavior have been explained in terms of sex roles and gender-related personality traits. It may be hypothesized that in a community that is committed to gender-negating ideology, where men and women alike participate in public life, and housework and child care largely collectivized, gender health differences will disappear. The kibbutz movement is committed to the ideology of the emancipation of women: women fully participate in the labor force and decision making. Nonetheless, women on the kibbutz are responsible for the housework and are concentrated in feminine occupations. The kibbutz, then, allows us to test the relationship between gender ideology and participation in public life vs. gender roles and tasks, and health. The health behavior, health status, and illness behavior of 230 members of two kibbutzim, one religious and one secular, were studied. Men and women report similar health status and illness behavior; parental status is not related to health; and marital status is related to psychological distress only. Similar patterns were observed for the secular kibbutz and the religious one despite the more traditional division of labor in the latter.Medical student, supported by the National Fund for Medical Education, 35 Kneeland Street, Boston, MA 02111.     

The earliest memory in individuals raised in either traditional and reformed kibbutz or outside the kibbutz

In two studies we compared the age of traditional kibbutz members' first memories with the first memories of people raised in Israeli cities (Study 1) and of people who were raised in reformed kibbutzim (Study 2). Building on the socio-cultural model of autobiographical memory, we predicted and found that children raised in the traditional kibbutz, not by their parents, but by a metapelet, had a significantly later onset of autobiographical memory than children raised in reformed kibbutzim or outside the kibbutz, who were under the primary care of their parents. We also examined gender differences in reporting the earliest memory. No gender differences were observed within each setting in the age of the earliest memory, but consistent with past research, memories reported by females were more elaborate than those reported by males.     

Pastoral care in psychiatric crisis

Pastoral Psychology -     

The psychiatric patient as a person

The dehumanization which is so much a part of a technological society is keenly felt by psychiatric patients. Pastors must treat them with care if they are to recover their personhood. The author suggests certain pastoral approaches intended to reflect the values of the inherent worth of persons and their moral responsibility and right to self-fulfillment. Included in the approach is the need to gather the facts, establish rapport, empathize, listen with love, interpret, and have a plan of action.Professor Barnette is Professor of Christian Ethics Emeritus at the Southern Baptist Theological Seminary. He presently serves as Clinical Professor, Department of Psychiatry, University of Louisville School of Medicine, Louisville, Kentucky 40201.     

Divorce in the kibbutz: Past and present

In the kibbutz today, there are no ideological or economic barriers to prevent a couple from deciding to divorce. Both husband and wife are assured continued economic security and equal opportunities for co-parenting, thus reducing fears of disruption in the daily contact with the children. In spite of these favorable circumstances, marital breakups in the kibbutz are less frequent than in the larger cities in Israel. In recent years, however, at a time when a stronger and more intensive family life has gained legitimacy within the kibbutz structure, there is a marked tendency toward a rise in the rate of divorce. In this article we analyze the possible causes of the variations in the frequency of divorce within the kibbutz framework.The authors express appreciation to Esther Mivtzari, a psychologist on the staff of the Kibbutz Child and Family Clinic and a member of the religious kibbutz Ein-Tzurim, for assistance in gathering data on divorce in the religious kibbitzum.     

Divorce in the kibbutz: Affective responses to separation

This article is part of a comprehensive research project in which the central characteristics of the process of divorce in the kibbutz were examined. It appears that the framework of the kibbutz, free as it is from socio-economic pressures and boundary factors not directly connected with the marital relationship as such, provides an excellent and perhaps unique opportunity to investigate the pure emotional effects of the marital breakup.