Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

Enhancing the Behavioral and Mental Health Services Within School-Based Contexts

ABSTRACT

Recent health care reform provides many new opportunities to expand mental health and behavioral support to students in schools and school–community partnerships. Through newly available funding sources, as well as expanded legislative initiatives, school psychologists can advocate for and become leaders in delivering universal programming, tiered mental health supports, and formalized collaborative efforts with community agencies. The authors highlight the application of tiered levels of services, with current practice samples, designed to address students' mental and behavioral health. Implications for practice are discussed.     

Behavioral Genetics and the Forensic Mental Health Provider: An Overview

The area of behavioral genetics has sufficiently entered the area of forensic mental health work that providers should have some working knowledge of the strengths and limitations of these exciting technical advances. Using MAOA as an example, this essay reviews some of the recurring themes in forensic behavioral genetics and suggests additional ways in which the technology might be used in legal matters. Copyright © 2015 John Wiley & Sons, Ltd.     

聋生心理健康与成就动机、行为方式的相互影响

以苏州市聋生这一特殊群体为研究对象,运用问卷调查和半结构式访谈的方法,探讨其心理健康状况及影响因素。结果发现,聋生的心理健康程度不及正常学生,表现在总分以及躯体症状、焦虑担忧、抑郁三个分量表上的得分均高于正常学生。学业压力、应对方式、内部成就动机和外部成就动机是影响聋生心理健康的重要因素,聋生所感受到的社会支持程度要高于正常学生,聋生的成就动机也高于正常学生,而面对压力,他们的行为应对方式却较多退缩性的。造成这种矛盾的原因是家庭和学校教育中对聋生自强、自立、自理能力培养不到位,助长了聋生因残疾而产生的惰性和依赖性行为,对聋生的心理健康产生了消极影响。社会应提倡更多的正常人学习手语,让聋生有更好的社会交往环境     

The Role of Functions of Aggression in Associations Between Behavioral Inhibition and Activation and Mental Health Outcomes

While the behavioral acitivation system (BAS) has been most consistently linked to externalizing behaviors, the behavioral inhibition system (BIS) has been more closely related to internalizing outcomes. Proactive and reactive aggression have demonstrated a similar pattern of association, with proactive aggression more closely linked to externalizing behavior and reactive aggression more consistently linked to internalizing symptoms. Despite theoretical links, few studies have examined associations between these constructs. Accordingly, the current study examined associations between the BAS and BIS and proactive and reactive aggression, and the role of proactive and reactive aggression in the link between the BAS and BIS and mental health outcomes. The BAS was associated with both proactive and reactive aggression, while the BIS was uniquely related to reactive aggression. Both proactive and reactive aggression appear to be playing a role in associations between the BAS and indicated mental health outcomes. Implications and future directions are discussed.     

Overcoming Barriers to Collaboration Between Basic Behavioral Scientists and Public Health Scientists in Research on Mental Disorders

The behavioral and public health sciences both have a long and rich history supporting basic, translational, and applied research aimed at improving human lives and reducing human suffering. Through the complementary expertise of these disciplines, investigators have contributed to significant, worldwide improvements in mental and physical health. Further gains can be achieved through collaborative research among scientists in these 2 fields. Unfortunately, there are a number of barriers to such collaboration originating in different intellectual traditions, research methods, and the structure and values of academia. We identify these barriers and potential strategies for overcoming them. Several areas for future collaborative research appear promising, especially comorbid mental and physical disorders, adherence to interventions, stigma, and emotional processes. Theory-guided preventive interventions may represent especially fertile areas of collaborative effort.     

Latina Mothers' Perceptions of Mental Health and Mental Health Promotion

Latina mothers' perceptions of mental health and factors that promote/restore mental health were explored in this qualitative study. Participants discussed the importance of community, safety, and financial stability in addition to conventional factors that are related to mental health. Implications for working with urban Latinas and their families are discussed. En este estudio cualitativo se exploraron las percepciones de las madres Latinas sobre Salud Mental y los factores que la fomentan/restablecen. Las participantes discutieron acerca de la importancia de la comunidad, la seguridad y la estabilidad financiera además de otros factores convencionales relacionados con la salud mental. Se discuten las implicaciones para el trabajo con Latinas residentes en núcleos urbanos y sus familias.     

A Feasibility Study of Behavioral Activation for Major Depressive Disorder in a Community Mental Health Setting

Behavioral activation (BA) is a well-supported treatment approach, but little research has been conducted on the effectiveness of this treatment within publicly funded community mental health settings. We examined the feasibility of conducting a randomized trial examining the effectiveness of nine sessions of BA as a treatment for major depressive disorder (MDD) in a community mental health clinic (CMHC) setting. Following adaptation of a BA manual and training of BA therapists, 80 patients seeking treatment at a CMHC were randomized, with a 3:1 randomization rate of BA to nine sessions of treatment as usual (TAU). Feasibility assessments indicated that only one eligible patient refused randomization and, of patients who attended at least one session, the median number of sessions was six for the BA group and eight for the TAU group. Of three postbaseline monthly assessments, 71.3% (171/240) were successfully obtained. On average, patients in the BA condition completed homework assignments 83.9% of the time. Treatment fidelity ratings indicated that substantially more BA techniques were delivered in the BA group compared to the TAU group (d = 2.11). Measures of BA mechanisms improved significantly over time and these changes were significantly associated with change in depressive symptoms. These results indicate that it is feasible to conduct a randomized study of BA for MDD in a CMHC setting. In addition, the study reconfirmed the potential importance of theory-relevant BA mechanism variables. Following these findings, further investigation into the effectiveness of BA in this setting is needed.     

Inequalities in Mental Health: the Inner City Mental Health Project

This paper draws on the evidence of a 3-year evaluation study of an inner city mental health project. Innovative service developments aimed at Afro-Caribbean and Asian communities are described, as are the reactions of providers of mainstream mental health services to these initiatives. The structural position of special projects aimed at Black communities is explored in relation to mainstream mental health services, as are the difficulties which may be encountered by service users and project staff when the project is integrated into mainstream mental health services.     

Women and Mental Health

No abstract available for this article.     

Abortion and Mental Health

Abstract

Unwanted pregnancy and abortion are common life events, and therapists are likely to work with clients who experience them. Legal abortion currently entails little physical or mental health risk; most women currently cope effectively with these life events without need of clinical intervention. But current abortion politics include efforts to make abortion a more threatening, stressful, and stigmatized experience and to create a “postabortion syndrome.” Using a stress and coping framework, we examine how antiabortion activists spread myths and misinformation aimed at women's appraisal processes, and discuss approaches therapists can use to enhance women's strategies for coping with abortion. We also discuss specific issues and useful techniques for counseling about abortion concerns, including cultural sensitivity and strategies for promoting positive sexual health.