How do group meetings make a community Therapeutic?

Summary Following an abrupt shift from a therapeutic community with emphasis on group meetings to a hierarchical medical model on a mental hospital floor, disturbed patients required extensive individual nursing care. This increased work load for the nursing staff resulted in admissions having to be limited to the rare cases who needed little or no nursing care. As patients were discharged, the vacancy rate went up to approximately 20% for a week and remained high for another two weeks. Nursing staff-patient relations deteriorated.Subsequently, it was possible to resume the emphasis on the groups of a therapeutic community and to observe the contrast. The experience showed how groups can effect and support a therapeutic community. It clarified some of the mechanisms by which groups positively affected disturbed patients. Some mechanisms by which the staff, community, and group meetings favorably influenced the nursing staff-patient relationship and intrastaff communications became clear also.     

Counseling Directory and Consumer's Guide: Implementing Professional Disclosure and Consumer Protection

The publication of a “counseling directory” and “consumer's guide” is a new approach that can be used to respond to the current professional issues of professional disclosure and consumer protection. In a recent project in Benton County, Oregon, a directory and guide were published and distributed. This article reviews and evaluates that project. The purposes, format, and content of both the directory and guide are summarized. It is hoped that this article will stimulate interest in this approach and that the information provided will be used for similar projects in other communities.     

The use of teachers as behavioral observers

The effect of using teachers as behavioral observers on both student and teacher behavior was examined with eight teachers and 32 elementary school children. The frequency of prompts (but not praise or criticism) to those students observed by the teacher increased significantly from nonobserver to teacher observed experimental phases. In addition, students observed by the teacher showed more change in appropriate behavior than students who were not observed. The significance of these findings for research and therapy is discussed.     

SELF-STIMULATION AND LEARNING IN AUTISTIC CHILDREN: PHYSICAL OR FUNCTIONAL INCOMPATIBILITY?1

This study investigated whether an observed inverse relationship between self-stimulation and learning in autistic children is due to a physical inability of the subject to use the same body part for self-stimulation and task responding, or whether self-stimulation “distracts” the subject from task responding. Four actively self-stimulating autistic children were taught two discrimination tasks; one required a response that physically interferred with their self-stimulation; the other did not. Results were: (a) all subjects responded similarly across both tasks; (b) the three subjects with higher mental age scores learned both tasks without external suppression of self-stimulation; and (c) none of the subjects showed an inverse relationship between self-stimulation and learning. The study demonstrated that elimination of self-stimulation is not a necessary prerequisite for the acquisition of a new behavior in all autistic children.     

Flooding therapy: Effectiveness,stimulus characteristics,and the value of brief in vivo exposure

Three analogue experiments examined flooding therapy. Experiment 1 showed that flooding was more effective than standardized desensitization in reducing snake phobia. Experiment 2 examined three different modes of presenting the feared stimuli in flooding: taped auditory presentation, pictorial presentation, and a combination of these two. An additional combination group were given a brief in vivo exposure to the feared object immediately after each of three treatment sessions. Both a behavioral test and subjective estimates of fear showed advantages for the combined group that had the in vivo exposure, although it appeared that auditory instructions to imagine interaction with the snake was the best method for presenting the feared stimuli. Experiment 3 compared the auditory imagined method with and without ‘aversive’ or ‘implosive’ scenes, and with either an immediate or a delayed in vivo exposure. The only procedure to produce marked effects was the one that omitted ‘aversive’ scenes and provided immediate post-treatment in vivo exposure.