Direct observation of quality of care in residential settings

Direct-observation procedures were used to objectively and efficiently assess several classes of service provided for individuals residing at two state facilities for the developmentally disabled. Time samples were taken of the condition of the clients' physical environment and of the clients themselves. The ongoing behavior of both clients and staff also was recorded. Each residence was observed at least three times during both regular work hours and evening/weekend hours. Results showed that both facilities scored high in the categories regarding the physical condition of the living areas, as well as the categories concerning the condition of the clients. Greater variability was seen in the data on client and staff behavior. More generally, the results indicate that time-sampling procedures can be used efficiently to collect data on multiple aspects of service delivery for large numbers of individuals.     

Short-term psychodynamic intervention in an urban health clinic: A case report

This paper describes the application of short-term dynamic therapeutic techniques to treat both symptom disturbance and character pathology in an urban mental health clinic. Short-Term dynamic psychotherapy focuses extensively on the subjectivity and inner life of the patient with emphasis on repressed anger, sadness and desire. Methods to overcome patient ambivalence and resistance to psychotherapy are presented. The clinical psychodynamics associated with early life trauma are illustrated with a case of an African-American patient.Acknowledgments for support & critical feedback are expressed to Christine Baker, Ph.D., John Swanson, ACSW, Duncan Walton, Ph.D., and Isabelle Beveridge (Graphics).     

EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.     

Variations on incremental interpretation

The strict competence hypothesis has sparked a small dialogue among several researchers attempting to understand its ramifications for human sentence processing and incremental interpretation in particular. In this paper, we review the dialogue, reconstructing the arguments in an attempt to make them more uniform and crisp, and provide our own analyses of certain of the issues that arise. We argue that strict competence, because it requires a synchronous computation mechanism, may actually lead to more complex, rather than simpler, models of incremental interpretation. Asynchronous computation, which is arguably both psychologically more plausible and conceptually more basic, allows for incremental interpretation to fall out naturally, without additional machinery for interpreting partial constituents. We show that this is true regardless of whether the presumed interpretation mechanism is top-down or bottom-up, contra previous conclusions in the literature, and propose a particular implementation of some of these ideas using a novel representation based on tree-adjoining grammars.The research in this paper was supported in part by grant IRI-9157996 from the National Science Foundation to the first author. The authors would like to thank Fernando Pereira, Edward Stabler, and Mark Steedman for discussions on the topic of this paper and for their comments on previous drafts.     

Good Practice in Transcultural Counselling: An Asian Perspective

In Britain today, counsellors and therapists often work with people from a diverse range of ethnic groups whose cultures are substantially different from their own. There is increasing concern that people from black and ethnic communities have limited access to appropriate services—despite service planners' and providers' statements that mental health services are being restructured to become more sensitive, relevant and meaningful to these communities. This paper is an attempt to redress the balance with an emphasis on the therapeutic needs of South Asian communities. It aims to challenge assumptions and beliefs held by therapists and counsellors, question therapeutic practice based within a white, middle-class ideology, raise awareness of an 'Asian' perspective in therapy, and provide some guidelines for good practice in transcultural counselling.     

The influence of perceptual and motor factors on bimanual coordination in a polyrhythmic tapping task

Summary In this study the role of perceptual and motor factors on the motor organization (integrated versus parallel) adopted by musically skilled and unskilled subjects in a polyrhythmic tapping task was investigated. Subjects tapped a 3:2 polyrhythm to match the timing of two isochronous tone trains, one tone train for each hand. Perceptual factors were examined by the manipulation of the frequency difference between the tone trains to produce either an integrated or a streamed percept. Motor factors were examined by comparison of performance on two versions of the 3:2 polyrhythm. In one (simultaneous) version, each cycle of the polyrhythm began with a simultaneous left- and right-hand tap. In the other (shifted) version a 100-ms interval was introduced between the initial left and right taps in each cycle. Examination of the pattern of variances and covariances among intertap intervals suggested that most of the subjects in this study adopted an integrated motor organization that involved interleaving the timing of the two hands. Further analysis revealed that a serial chained model described the pattern of covariances best for the simultaneous pattern, whereas a hierarchical organization described the pattern of covariances for the shifted pattern best. The finding that performance was more accurate with integrated tones than with streamed tones provides some support for a perceptual-motor facilitation hypothesis.     

Contributors to the Appraisal of Major Life Changes: Gender, Perceived Controllability, Sensation Seeking, Strain, and Social Support

This study investigated relationships between the appraisal of life events and gender, locus of control, social support, strain, and sensation seeking. In group sessions, undergraduate males and females completed self-report measures assessing life events appraisals and self-report measures for the above individual differences. Analyses supported the notion that a range of these variables, previously shown to serve as moderators of life stress, are significantly related to the appraisals of life events. Moreover, in addition to the gender differences obtained for the perception of life events, gender was found to influence several associations between the individual differences and life events appraisal.     

AIDS prevention for intravenous drug users in the community: Street-based education and risk behavior

Conducted a study of behavior change associated with a street-based AIDS education project targeted to intravenous (IV) drug users in San Francisco. Two cross-sections were sampled from drug detoxification clinics and street locations in 1986 (n = 438) and 1987 (n = 623). Significant increases were reported in the percentage of IV drug users who used bleach to decontaminate syringes, who did not share needles in past year, and in condom use. A significant reduction in an index of the number of needle-sharing partners was reported. Respondents ranked treatment program as most important source of AIDS information prior to implementation of the program, and ranked outreach workers as most important after implementation. Findings suggest that this community-based outreach program had at least some impact on knowledge about AIDS and may have led to reductions in behaviors known to transmit HIV.