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.     

Sleep in the dove Zenaida asiatica

Electrographic and behavioral observations were made in five adult birds of the genus Zenaida asiatica. Five different vigilance states were quantitated: (1) Active waking (Aw) was characterized by constant behavioral activity; the nuchal electromyogram was tonically active with bursts associated to movements. The electroencephalographic pattern was low voltage and high frequency. (2) Quiet waking (Qw) was characterized by diminished behavioral activity and the EEG pattern was similar to that of Aw. (3) Drowsiness (D) was characterized by behavioral calm. Frequency of cerebral activity diminished progressively, but there were short periods of desynchronization corresponding to brief awakenings. (4) Slow wave sleep (SWS); during this period there was behavioral rest and EEG pattern of continuous slow waves and the nuchal EMG was tonically reduced. Spindles of sleep were not observed. (5) Paradoxical sleep (SP), behaviorally characterized by phasic manifestations consisting of noddings originated by rapid falling down of head and bursts of rapid eye movements. EEG activity was like that of waking state. EMG activity was maintained at the same level as during SWS but sometimes it decreased lightly. Total atonie was not observed. Sleep percentages were higher when recordings were done during the nocturnal period.     

Predicting Persistence of Nonsuicidal Self‐Injury in Suicidal Adolescents

Prospective predictors of persistent nonsuicidal self‐injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy‐one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow‐up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI were more likely to persist in NSSI. Depression over follow‐up, but not at baseline, also predicted persistence. These results suggest that helping high‐risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI should be a high priority treatment target.     

Chaplains' Engagement with Suicidality among Their Service Users: Findings from the VA/DoD Integrated Mental Health Strategy

Chaplains play an important role in supporting the mental health of current and former military personnel; in this study, the engagement of Department of Veterans Affairs (VA), Army, Navy, and Air Force chaplains with suicidality among their service users were examined. An online survey was used to collect data from 440 VA and 1,723 Department of Defense (DoD) chaplains as part of the VA/DoD Integrated Mental Health Strategy. Differences were noted for demographics, work setting characteristics, encountering suicidality, and self‐perceived preparation for dealing with suicidality. Compared to DoD chaplains, VA chaplains encounter more at‐risk service users, yet feel less prepared for dealing with suicidality.