Evaluation of a Congressionally Mandated Wraparound Demonstration

In order to determine whether expenditures for mental health could be reduced and quality improved, Congress mandated that the Department of Defense conduct a demonstration project utilizing a wraparound mental health service system for child and adolescent military dependents. A longitudinal quasiexperimental design was used to evaluate the cost-effectiveness of the demonstration. The results showed that children in the Wraparound Group received more wraparound services than those in the treatment as usual (TAU) Comparison Group. These services included case management, in-home treatment, and other nontraditional services. The Demonstration also provided better continuity of care. Multiple methods were used to investigate the impact of wraparound. Both groups showed some improvement on some measures but there were no differences between the groups in functioning, symptoms, life satisfaction, positive functioning, or sentinel events. Regardless of which statistical model was used to estimate costs, the Demonstration was also more expensive. The higher level of expenditures for the Wraparound group was a result of some expensive traditional care and the addition of nontraditional services. Several possible explanations of these results are provided.     

A qualitative analysis of young people's experiences of receiving a novel,client‐led,psychological therapy in school

Mental health problems often arise in adolescence. Schools have been recognised as a potential hub for support; however, delivering targeted interventions in schools can be difficult due to impracticalities. Subsequently, students have little or no say in the support process. Given the importance of control in well‐being, the current study explored how adolescents experienced Method of Levels, a therapy that allowed them to choose if and when to attend therapy. Interviews with 14 adolescents were conducted and then analysed using thematic analysis. Three main themes were identified; therapy style, therapy experience and exploring problems. An additional overarching theme was generated, regarding choice and control. Findings indicate that adolescents value having choice and control. This made the therapy style accessible, enhanced the therapeutic experience and ultimately facilitated the process of exploring problems.     

Using Wordle in Addictions Education

The authors of this article present a creative teaching strategy which illustrates how Wordle can be used in the addiction courses in counselor education programs. Wordle creates a representation of text where the more frequently the word is used, the larger the word appears in the form of a “word-cloud.” This method of graphically using words can illustrate meaning, perception, and change.     

A case of thalamic aphasia with postmortem verification

This study discusses a case of aphasia after dominant thalamic lesion, a hemorrhagic infarction. Unlike other such cases, both repeated standardized assessment and postmortem verification were available. The patient was assessed at 3 weeks and again at 9 weeks postonset. The aphasia demonstrated the syndrome common to dominant thalamic hemorrhage: fluent but paraphasic output sometimes deteriorating to jargon, comprehension less impaired than this type of output usually indicates, and the least impairment in repetition. As sometimes reported in previous cases, semantic paraphasias were more common than phonemic paraphasias. The lesion was located in the dorsal aspect of the lateral nucleus, but it extended into the pulvinar, including the anterior superior lateral aspect which has been implicated in language by previous studies. Thus, data from this case are consistent with an involvement of the dominant pulvinar in language and suggest that this role involves the semantic aspects of language.