Putting Values into Practice: Public Policy and the Future of Mental Health Consumer-run Organizations

The purpose of the paper is to reflect on value dilemmas in mental health consumer-run organizations and to discuss implications for research, policy, and practice. We review the roots of consumer-run organizations in the self-help movement and the psychiatric survivor liberation movement, focusing on the distinctive values espoused by consumer-run organizations. We also discuss evidence-based and value-based approaches to mental health policy formulation and mental health reform, noting the particular importance of value-based approaches and the role that consumer-run organizations can play in mental health reform. Based on our experiences conducting a participatory action research study of four mental health consumer-run organizations, we identify and examine several value dilemmas, discuss the lessons that we learned about these value dilemmas, and note their implications for future directions in research, policy, and practice.     

Family sessions as part of child psychological assessment: goals, techniques, clinical utility, and therapeutic value

Including a family session in a child assessment can significantly advance the assessor's and parents' understanding of the child's problems and enhance the likelihood that parents will follow through on recommendations after the assessment. A family session allows the assessor to observe the child in the family context, test systemic hypotheses, better understand the meaning of individual test results, and try out possible interventions. A family session may also help parents see systemic aspects of their child's problems, help the child feel less blamed, foster positive experiences among family members, and offer the family a glimpse of family therapy. We describe methods and techniques for structuring family sessions and offer guidance on preparing for and conducting such sessions depending on one's case conceptualization. Detailed case examples illustrate each technique and demonstrate the immediate and subsequent impact of family sessions as well as their therapeutic value. We also address common clinical and pragmatic issues.     

Building and using a social network: nurture for low-income Chinese American adolescents' learning

Little research has examined how low-income Asian American children are supported to achieve well in school. The authors used the notion of social capital to study higher versus lower achieving Chinese adolescents from low-income backgrounds. They found that families of higher-achieving adolescents built and used more effectively three kinds of social networks in lieu of direct parental involvement: (a) designating a helper in and outside the home for the child, (b) identifying peer models for the child to emulate, and (c) involving extended kin to guide the child jointly. These forms of social capital reflect Chinese cultural values applied to the challenges of immigrant adaptation.     

The relationship between relative levels of motivation and intrapersonal, interpersonal, and academic functioning among older adolescents

Using cluster analysis to combine specific adaptive measures related to mastery motivation (intrinsic motivation, self-adequacy, and locus of control), a total of 654 high school students were placed into distinct adaptive motivation groups. Mean scores on a variety of self-reported and peer-reported measures of interpersonal, intrapersonal, and academic functioning were compared across the groups. Results found that youth in the “high adaptive” motivation group reported significantly higher global and family satisfaction, self-esteem, interpersonal relations, grade-point average and school belonging, and significantly lower depression, anxiety and social stress than youth in the other two motivation groups. Peer-reported prosocial and academic behaviors were significantly related to higher levels of adaptive motivation. Collectively, these findings suggest a number of psychological, social, and academic benefits that are associated with incremental levels of adaptive motivation. The implications of these findings for research and practice conclude the paper.     

Different Media for Organizational Communication: Perceptions of Quality and Satisfaction

We examined the satisfaction in and perceived quality of information about one’s job, business unit, and company, as well as perceived quality of urgent news (i.e., news about changes in business and generally considered legally sensitive material), communicated via different media. Results from 598 fulltime employees revealed that rich media (e.g., face-to-face) was most related to satisfaction in information about one’s job and business unit and in perceived quality of information from the supervisor; lean media (e.g., company newsletter) was most related to satisfaction in and quality of information from top management, while moderate media (e.g., e-mail) was only significantly related to perceived quality of urgent news. Trust in top management was positively related to satisfaction in and quality of information shared by management. Lean media most strongly related to quality of urgent news, over and above rich communication.The authors would like to thank Monica Moloney for her support on this project.     

Movement abnormalities predict conversion to Axis I psychosis among prodromal adolescents

Evidence suggests that movement abnormalities are a precursor of psychosis. The link between movement abnormalities and psychotic disorders is presumed to reflect common neural mechanisms that influence both motor functions and vulnerability to psychosis. The authors coded movement abnormalities from videotapes of 40 adolescents at risk for psychosis (designated prodromal on the Structured Interview for Prodromal Symptoms; T. J. Miller et al., 2002). Following initial assessment, participants were evaluated for diagnostic status at 4 times annually. Ten participants converted to an Axis I psychosis (e.g., schizophrenia) over the 4-year period. Comparisons of converted and nonconverted participants at baseline indicated that the groups did not differ on demographic characteristics or levels of prodromal symptomatology, but those who converted exhibited significantly more movement abnormalities. Movement abnormalities and prodromal symptoms were strongly associated and logistic regression analyses indicated that abnormalities in the face and upper body regions were most predictive of conversion. Findings suggest that individuals with elevated movement abnormalities may represent a subgroup of prodromal adolescents who are at the highest risk for conversion. The implications for neural mechanisms and for identifying candidates for preventive intervention are discussed.