Medicaid: A potential source of revenue for special education

Currently, over 4.3 million children are receiving special services within the nation's schools because of physical, developmental, and educational disabilities. It is estimated that twice this number would benefit from special education services. Public Law 94–142, the Education for the Handicapped Act, offered the first real opportunity for many children with disabilities to receive special health and educational services. Public schools have become a primary setting for provision of services to these children, however, many states have encountered difficulty in procuring funding. One federally mandated source of revenue is the Medicaid program. In the fall of 1991, all state Medicaid and special education programs were asked to provide information concerning current or planned use of Medicaid funds for special education services. Responses were received from 36 states. Only 19 states reported using Medicaid funding in any capacity, and of these, only four required schools to bill Medicaid for services rendered. The majority of these programs are in the pilot stages of development. Special education services covered by Medicaid vary widely, as do reimbursement mechanisms. All 19 states allow Medicaid coverage for speech, physical, and occupational therapy. Only about half of those states provide allowances for diagnostic evaluation and assessment, while coverage for psychological services is provided by three-fourths of those states, and EPSDT screens by half of the states. Only two programs had been evaluated formally at the state and/or federal level. Medicaid remains a largely untapped source of revenue that could be used to help fund services for disabled children.     

Jealousy Workshop: A Conceptual Base and Format

Jealousy is a problematic aspect of relationships that has received a minimal amount of attention in the research and professional intervention strategies. A discussion of a six-session workshop on the theme of jealousy includes theoretical issues, conceptual framework of the program, overview of procedures for each session, and a summary of participant feedback.     

A preliminary study of an online pain management programme for patients with ankylosing spondylitis

This study was a preliminary attempt to develop and examine an online pain management programme incorporating mindfulness‐informed exercises (i.e. breathing and body scanning exercises) and CBT elements for ankylosing spondylitis patients. Thirty patients diagnosed with ankylosing spondylitis participated in a five‐week online pain management programme, which was delivered primarily through a website. The materials covered by the website included breathing and body scanning exercises, mindful walking exercise, positive thinking and management of dysfunctional thinking. Each participant received instructions and reminders from a counselling psychologist through electronic communications each week. They completed the Brief Pain Inventory, Ryff's Psychological Well‐being Scale, Pain Self‐Efficacy Questionnaire, Pain Catastrophizing Scale and Cognitive and Affective Mindfulness Scale‐Revised before and after the treatment programme. In addition, four face‐to‐face focus groups were conducted to yield supplementary qualitative findings. The overall results indicate that this online pain management programme can improve sleep quality and reduce pain interference and catastrophic responses to pain in ankylosing spondylitis patients, albeit being not very effective for mitigating the intensity of pain. Moreover, male and female patients can benefit equally from the online programme. Findings from the focus groups revealed some challenges faced by local patients when practising mindfulness‐informed exercises. Some solutions to those challenges were put forward in accordance with patients’ feedback.     

Outcome evaluation in brief mother-infant psychotherapies: Report on 75 cases

The effects of brief mother–infant psychotherapies (maximum of 10 sessions) were examined in cases of functional and behavioral disturbances in children less than 30 months old. Seventy-five mother-infant dyads were assessed prior to treatment, at 1 week, and 6 months after therapy ended. The outcome measures were changes in the infant's symptoms, the behavioral interactions between mother and infant, and maternal representations. The effect of two forms of intervention—Psychodynamic Therapy and Interaction Guidance Therapy—were compared. Results indicated a significant symptom reduction; dyadic interactions became more harmonious (mothers became less intrusive and infants more cooperative). Maternal self-esteem grew significantly and negative affects decreased. Improvements lasted as least several months, with some positive improvement detected at the 6-month follow-up. No major difference in outcome was found between the effects of the two forms of intervention. Within the limitations of research in a clinical context, this study suggests that brief mother–infant psychotherapies are a cost-effective method of early intervention.     

Effects of Social Conditions on the Expression of Sex-role Stereotypes

In this study, 129 female and 83 male undergraduates were asked to make judgments about identical male and female law school applicants. Evaluations of the candidate employed two types of measures: (a) direct measures set up to assess judgments based upon objective criteria such as GPA and aptitude test scores, and (b) indirect measures designed to provide more opportunity for subjective factors and subtle ways for stereotyping to operate. It was hypothesized that increased social awareness of sex discrimination would reduce more blatant types of stereotyping expressed in the direct measures and force stereotyping into more subtle forms, measurable through the construction of the indirect indices. The results revealed no differences between male and female candidates on the direct measures. However, stereotyping appeared on indirect measures associated with personality characteristics and employment alternatives. The investigators concluded that prejudicial attitudes toward women continue to exist and are expressed in more subtle or „hidden” forms. Suggestions for developing means for measuring these attitudes as well as practical considerations for reducing discrimination in employment settings were presented.     

Intrusive images and intrusive thoughts as different phenomena: Two experimental studies

According to the dual representation theory of PTSD, intrusive trauma images and intrusive verbal thoughts are produced by separate memory systems. In a previous article it was shown that after watching an aversive film, participants in non-movement conditions reported more intrusive images than participants in a free-to-move control condition (Hagenaars, Van Minnen, Holmes, Brewin, & Hoogduin, 2008). The present study investigates whether the experimental conditions of the Hagenaars et al. study had a different effect on intrusive thoughts than on intrusive images. Experiment 2 further investigated the image–thoughts distinction by manipulating stimulus valence (trauma film versus neutral film) and assessing the subsequent development of intrusive images and thoughts. In addition, both experiments studied the impact of peri-traumatic emotions on subsequent intrusive images and thoughts frequency across conditions. Results showed that experimental manipulations (non-movement and trauma film) caused higher levels of intrusive images relative to control conditions (free movement and neutral film) but they did not affect intrusive thoughts. Peri-traumatic anxiety and horror were associated with subsequent higher levels of intrusive images, but not intrusive thoughts. Correlations were inconclusive for anger and sadness. The results suggest intrusive images and thoughts can be manipulated independently and as such can be considered different phenomena.     

The Return of the Dissociated: Discussion

Psychoanalysis and politics intersect variously. Some psychoanalytic writings have critiqued society, whereas others have applied socially critical insights about class and race to illuminate transference—countertransference enactments and other clinical matters. The hegemonic politics of psychoanalysis, less intentional but equally influential, define maturity and mental health by idealizing of some psychological and behavioral traits and some clinical stances (especially authoritarianism), and by demonizing of certain categories of persons (notably nonheterosexuals and people of color), certain types of practice (e.g., social work), and certain sorts of ideas (e.g., that clinical and theoretical practices are political practices, too). One way to redress these problems is to reclaim the marginal—homosexuality and queerness, affect's presence in politics, and the political in the psychical (in which instance, the concept of multiple self-states may be useful). Any such effort requires recognizing and articulating one's own subject-position, that is, one's own class, race, gender, or sexual location.     

The Mystery of Hysteria and the Crossroads of Power: Commentary on Paper by Sam Gerson

“Hysteria and Humiliation,” it is argued, performs a small miracle, weaving inner and outer perspectives on a seemingly mysterious condition into a clinically useful formulation. Its bold new thinking is shown to clear up many conceptual problems about the state of mind and sufferings that a diagnosis of “hysteria” usually designates. This paper, it is suggested, also puts paid to the classical denigration of women implicit in the very category of hysteria itself, thus advancing the psychoanalysis of power.