Fixing forensic patients: Psychiatric recommendations for treatment in pretrial settings

This article is concerned with psychiatric recommendations for treatment at the Metropolitan Toronto Forensic Service (METFORS), a clinical assessment agency providing both 1-day and 30-day evaluations of criminal defendants in Toronto, Canada. Analysis of both psychiatric reports and quantitative research instruments demonstrated the saliency of treatment as a central forensic issue at METFORS. Among a sample of 592 defendants, 134 were considered in need of outpatient care. Persons recommended for hospitalization were most likely to exhibit histories of mental health rather than criminal justice contacts; to be arrested for nonviolent offenses; to manifest psychotic behavior while at METFORS; to be found unfit for bail, incompetent to stand trial, in need of further assessment and dangerous to self; and to experience higher rates of hospitalization, but lower levels of criminalization during the two years following their initial forensic assessment. Psychiatric reports at METFORS tended to merge recommendations for treatment and assessment; to suggest prison or probation as means for securing clinical treatment; and to provide little written support for judgments about the need for intervention. Along with competency and dangerousness, treatment is a key issue in forensic practice, and warrants further attention in the psycholegal literature.     

Treatment recommendations for mentally disordered offenders: More than roulette?

Clinical judgments on the treatability and prognosis of mentally disordered offeenders (MDO) may strongly influence legal dispositions and the availability of treatment resources. This study examined 1,238 discharge summaries for MDOs referred for court assessments. Psychiatrists evidenced marked variability in how often they recommended treatment and how frequently they judged patients to have a poor prognosis. Two logit analyses suggested that diagnosis and consultation by other clinicians were associated with (a) treatment recommendations (i.e., Axis I diagnosis and social work consultations) and (b) prognosis (i.e., Axis II diagnosis and psychology consultations).     

Personal Versus Vocational Focus in Career Counseling: A Retrospective Outcome Study

In this archival study the authors sought to determine the relationship, if any, between counseling outcomes and the topical focus in career counseling. Twenty-two counselors saw 46 adult clients at a community-based clinic for an average of eight sessions. Counseling outcome and topical focus (the extent to which the actual content of counseling sessions reflected relatively more vocationally or personally focused topics) were assessed from follow-up questionnaires to former career clients and from trained raters' evaluations of the counselors' written progress notes. Results showed that, from the counselors' perspective, outcomes were better when the focus of the sessions was relatively more vocational than personal and when relatively more interviews were held. Client satisfaction, on the other hand, was predictable only from the counselor's level of experience. Satisfaction with occupational status was not associated with any of the client, counselor, or treatment factors. Discussion focuses on the contribution of the results to career counseling practice and on the feasibility and validity of retrospective, archival research.     

Menopause: Salient Issues for Counselors

Counselors are in ideal positions to help change attitudes toward viewing menopause as a time of positive change, rather than a time of psychological distress. Following definitions and a review of historical, sociological, psychological, and attitudinal factors that account for negative responses associated with menopause, recommendations for counselor interventions are proposed.     

A Gender Role Workshop Focused on Sexism,Gender Role Conflict,and the Gender Role Journey

A 6-day gender role workshop for adult men and women, using the phases of the gender role journey, is presented. The workshop's curriculum and process are described, including its assumptions, norms, and media. Movie clips, music, music videos, and academic content were used to promote participants' learning in both the cognitive and affective domains. Systematic follow-up evaluations of participants ( N =84) in three separate workshops are reported using Likert scaled questions. These evaluations assessed participants' personal learning, emotional reactions, and the workshop's overall impact over l-month and 1-and 2-year follow-up periods. Results indicate that participants were affected personally and professionally over the various time periods.     

Norm-of-reaction: definition and misinterpretation of animal research

The development of a phenotype is due to an interaction of the genotype with the environment. Two terms have been used to describe the outcome of this interaction, the norm-of-reaction and the reaction range. The first represents the theoretically limitless distribution of the phenotypes that may be expressed by a given genotype. The reaction range implies an upper and lower limit for phenotype expression possible from a given genotype. A critical distinction between the reaction range and the norm-of-reaction is that the norm-of-reaction is a statement of the conceivable interactions found but does not imply any predictability other than that within the conditions previously tested experimentally, that is, the tails of a normal distribution are infinitely variable, whereas the concept of reaction range implies a limitation inherent in the genotype, that is, a finite range. Empirical support for the reaction-range concept is questionable. Animal studies cited in support of the reaction range have been inappropriately and incorrectly interpreted.     

Mass media treatment of violence in sports and its effects

There appears to be a strong relationship between mass media portrayals of violence and real-life violence itself. This article reviews the available literature on the effects of media treatment of sports violence; analyzes the theoretical explanations for this treatment; and makes proposals on how the problems of both sports violence and its media coverage may be remedied, with a particular focus on amateur hockey in Canada.     

Predicting diagnosis performance with measures of cognitive style

This study examines the relationship between performance on a context-independent fault diagnosis task and two dimensions of cognitive style: field dependence/independence (D-I) and focusing/scanning (F-S). The effects on diagnosis performance of training and the ability of both dimensions of style jointly to predict fault-finding ability were considered. The results showed that field independents and focusers were superior fault diagnosticians. Training, in the form of verbal feedback messages, was uniformly effective for the D-I dimension although field independents maintained a superior level of performance, over field dependents. In general, for the F-S dimension, training had little effect on either the focusers or scanners. A combination of scores on the F-S and D-I dimensions significantly enhanced the proportion of the variance in testing efficiency that could be accounted for during fault-finding. Finally it is argued that the F-S and D-I dimensions should be recognized as measures of ability, not style. Future research should be directed at identifying between subject differences on fault diagnosis tasks with reference to theories of information processing.     

Age analysis of cognitive-behavioral group therapy for chronic pain outpatients

This study explored the effectiveness, in terms of age of the client, of a 10-week cognitive-behavioral group therapy (stress inoculation training) for chronic pain. A total of 69 outpatients between the ages of 27 and 80 (M = 52.74 years, SD = 14.40) with diverse types of chronic pain were assigned randomly to immediate or wait-list-delayed therapy. Self-report measures of pain, activities, coping, and the use of medications and other physical pain control techniques were obtained at baseline, during therapy, and at 1- and 6-month follow-up. Treatment decreased the degree to which pain interfered with activity, increased ability to cope with pain, and decreased use of some medications and other physical treatments. It had little effect on perceived pain intensity. Gains were maintained through 6-month follow-up. Age was unrelated to outcome. Stress inoculation training appears to be an effective method of ameliorating the interference of chronic pain with the daily activities of life for adults of all ages.