Problems of Developing a Group-Centered Mental Hospital

All relationships could be described in terms of the coordinations and conflicts between competing needs for attention and the mechanisms utilized to seek this goal. In this article, I introduce the initialism AGM (Attention-getting Mechanism) to refer to an interpersonal style or particular behavior or constellation of behaviors that one adopts and displays publicly that is unhealthy, repetitively counterproductive and ultimately harmful to self and/or others. Delineated from socially- and personally- productive modes of seeking attention, self-defeating AGMs categorize across varied spectra, from subtle and seemingly inhibited, to blatant, excessive, or frankly pathological. They arise in response to trauma and psychological disturbance and, as such, are the outcome of enduring deficits in getting appropriate and sufficient attention. I record the evolution of my thinking and doing, over the course of leading two group sessions, spaced several months apart, regarding dilemmas in getting attention. The first drew me to the topic, and, unexpectedly, stimulated personal associations and remembrances, which centered on a cumulative childhood trauma organized around the term, “AGM.” I approached the second session better equipped to understand the proceedings, and to connect my ideas to current diagnostic criteria, technical considerations, clinical research, and metapsychological theory.     

乡村水利的组织基础--以荆门农田水利调查为例

“水利是农业的命脉”。对于粮食产区特别是水稻产区来说 ,农田水利及农业用水是最为重要的生产性公共物品 (准公共物品 ) ,对于农民收入和农业收成 ,都具有决定性意义。农田水利作为公共物品 ,因为难以克服外部性 ,而容易出现严重的供给不足。且传统的以人民公社体制为基础的大型水利设施与目前建立在市场经济条件下的农户承包制经济模式存在着严重的不适应。农田水利和农业用水作为生产性公共物品 ,是乡村治理研究的基本内容之一。从乡村治理的角度来看 ,农民的合作能力 ,乡村关系状况及以此为依托的国家任务 ,构成了目前农田水利供给的主…     

Perspectives on Focus Group Participation and Remuneration

Recruiting participants from underserved and marginalized communities for behavioral research is an essential yet challenging task. We examined participants' motivation to participate in a focus group about health communication and their beliefs about appropriate remuneration for participation. Twelve focus groups were conducted with low-income African American and Latina adolescent girls and African American women. We utilized a grounded theory approach and thematic analysis to examine views about research participation and remuneration. This study can inform important considerations about the consent process, study recruitment, and remuneration.     

The Effects of Interpatient and Group Influences in a General Hospital

This article discusses the leader's use of metaphor in outpatient, psychodynamic group psychotherapy. Four clinical examples are provided that illustrate how the phase of group envelopment informs the leader's use of metaphor. Therapeutic features and uses of metaphor include (1) the development of ego skills that transform passivity into activity and foster the examination of unhealthy norms; (2) the modulation and rechanneling of potentially destructive affect and the intensification of affect that is denied, minimized, or avoided; (3) the creation of a verbal play space in which shared group language evolves; (4) and the provision of various levels of concreteness and abstraction as well as differing perspectives. Abuses of metaphorical interventions are discussed.     

Understanding How Participation in a Consumer-Run Organization Relates to Recovery

The goal of this study was to examine how different types of participation in a consumer-run organization (CRO) are related to recovery. More specifically, this study uses structural equation modeling to examine the relative impact of empowering and socially supportive participation experiences on progress towards recovery among 250 CRO members from 20 CROs. An empowering participation experience refers to involvement in leadership roles and contribution to organizational functioning. A socially supportive participation experience refers to social involvement in mutually supportive friendships with intimacy and sharing. Results indicate that both types of participation are associated with recovery, although a socially supportive participation experience maintains a stronger relationship with recovery than an empowering participation experience. Findings are consistent with the idea that CROs should encourage both types of participation. Drawing from over ten years of experience supporting CROs, the discussion section explores several strategies CROs can use to foster empowering and socially supportive participation experiences.     

组织公正管理——基于心理帐户的视角

组织公正管理对组织意义重大,心理契约的提出给我们动态的管理组织公正提供了指导,心理帐户的提出使我们对组织公正的评判过程有了进一步的了解.其中经济帐户主要与交易型心理契约关联,而情感帐户主要与关系型心理契约关联.并最终影响公平感.     

Changeover of a Mental Hospital Unit into a Therapeutic Community

This paper explores some clinical implications of combining individual and group psychotherapy for children functioning at different levels of ego development. More highly structured children are able to observe the continuity and discontinuity that inevitably exist between the two modalities. Bridging of the two therapeutic contexts—integrating split off object representations—enriches the transference and strengthens the therapeutic alliance. In working with ego impaired children the goal in combining treatment modalities is to provide a therapeutic structure capable of containing unintegrated affects and perceptions. The therapist's challenge is to provide the opportunity to regulate emotional distance while at the same time maintaining the experience of a nurturing relationship. While potential hazards exist, with proper precautions taken, combined treatment can provide significant opportunities to establish or strengthen a therapeutic alliance with children, particularly those most in need and yet most resistant to treatment.     

The Influence of Posttreatment Mutual Help Group Participation on the Friendship Networks of Substance Abuse Patients

The effect of 12-step mutual help groups (e.g., Narcotics Anonymous) on members' friendship networks has received little attention. This 1-year longitudinal study examined such effects in a sample of 2,337 male substance abuse inpatients, 57.7% of whom became significantly involved in 12-step activities (e.g., reading program literature, attending meetings) after treatment. An a priori model of the interplay of 12-step involvement and friendship networks was tested using structural equation modeling, and found to have excellent fit to the data. Twelve-step group involvement after treatment predicted better general friendship characteristics (e.g., number of close friends) and substance abuse-specific friendship characteristics (e.g., proportion of friends who abstain from drugs and alcohol) at follow-up. Results are discussed in terms of how mutual help group involvement benefits patients and how the self-help group evaluation paradigm should be broadened.     

The Group as a Training Device and Treatment Method in a Private Pyschiatric Hospital

Clinical and research evidence indicates that the recently bereaved represent a large at-risk population. Bereavement groups constitute a particularly efficient preventive intervention for this high-risk population and thus represent excellent preventive mental health practice. In this paper, we report specifically on the technical and thematic considerations of four bereavement groups that met weekly for eight weeks. Group members were recruited from a consecutive series of individuals who had lost a spouse to cancer and who were undergoing normal grief and mourning. We found that we were able to be most technically helpful to the groups by being aware of the issues and themes that preoccupy bereaved spouses and by facilitating the emergence and discussion of these themes in the group setting. Many members, for example, struggled with complex questions of growth, identity, and responsibility for the future, questions that have not often been identified in discussions on bereavement groups as being of particular therapeutic import.     

Mental Health Interventions in a General Hospital Following Terrorist Attacks

Abstract

Over three years of repeated terrorist attacks in Israel have shown that the victims suffering from acute stress syndromes constitute the bulk of the casualties. The large number of psychological victims presents an immediate problem of hospital surge capacity. The need for alleviating acute suffering and preventing chronic, disabling posttraumatic syndromes requires organizational and clinical skills. The article reviews deployment and intervention protocols for the treatment of victims and affected staff members in a general hospital setting.     

医院集团内社区卫生服务中心管理初探

探讨如何发挥三级医院的资源优势,创建一种新型的城市中心医院内社区卫生服务中心管理模式,通过这种模式充分整合城市卫生资源,在三级医院与社区卫生服务中心之间形成良好的互动,资源互补,短期内带动社区卫生服务健康持续发展,完善社区卫生服务功能.同时提出了当前社区卫生服务机构运行过程中亟待解决的一些政策问题.     

13所上海市医院伦理委员会组织与管理现状分析

通过对上海市13所医院伦理委员会的问卷调查,分析了医院伦理委员会的组织、日常管理、伦理审核与咨询及生命伦理培训.研究结果显示,上海市医院伦理委员会的总体功能定位较好,但管理相对薄弱、运行状况差异较大.建议上海市医院伦理委员会应加强医院生命伦理培训、完善运行管理,对于区属专科医院的伦理委员会应给予关注.