Homelessness Is Traumatic: Abuse,Victimization, and Trauma Histories of Homeless Men

Homelessness is traumatic, and trauma-informed care is an emerging best practice. Using structured interviews with day shelter clients (N = 152), this study examined trauma among homeless men. The PTSD Checklist (PCL–C) was used to assess for posttraumatic stress disorder (PTSD). Participants’ pattern of PCL–C responses suggested that 23% to 30% screened positive for PTSD. Those with positive PTSD screens had been homeless longer and were more likely to have met time criteria for chronic homelessness. They were significantly more likely to be veterans and to report violent attacks, abuse histories, and mental health problems. Importantly, only 69% of those with positive PTSD screens acknowledged current mental health problems. These individuals were much less likely to report mental health counseling in the prior year.     

A Model of Professional Development for Practicing Genetic Counselors: Adaptation of Communication Skills Training in Oncology

Ongoing professional development for practicing genetic counselors is critical in maintaining best practice. Communication skills training (CST) workshops for doctors in oncology, utilizing trained actors in role plays, have been implemented for many years to improve patient-centred communication. This model was adapted to provide professional development in counseling skills for practicing genetic counselors, already highly trained in counseling skills. Detailed evidence based scenarios were developed. Evaluation of participants’ experience and perceived outcomes on practice included surveys immediately post workshops (2002, 2004, 2005, 2008 (×2); n = 88/97), 2–5 years later (2007; n = 21/38) and a focus group (2007; n = 7). All rated workshops as effective training. Aspects highly valued included facilitator feedback, actors rather than role-playing with peers and being able to stop and try doing things differently. Perceived outcomes included the opportunity to reflect on practice; bring focus to communication; motivation and confidence. The high level of satisfaction is a strong endorsement for ongoing communication skills training in this format as part of professional development.     

System-Level Change in Cultural and Linguistic Competence (CLC): How Changes in CLC are Related to Service Experience Outcomes in Systems of Care

As US demographic trends shift toward more diversity, it becomes increasingly necessary to address differential needs of diverse groups of youth in mental health service systems. Cultural and linguistic competence (CLC) is essential to providing the most appropriate mental health services to youth and their families. The successful implementation of CLC often begins at the system level. Though various factors may affect change and system-level factors set the tone for broad acceptance of CLC within systems, there is limited empirical evidence linking culturally competent practices to outcomes. The purpose of the present study was to examine system-level CLC changes over time within systems of care and their associations with service experiences among youth and their families. Participants were 4,512 youth and their families enrolled in the national evaluation of the Children’s Mental Health Initiative (CMHI). Results suggest that implementation of CLC at the system level improves over time in funded systems of care. Further, variation exists in specific system-level components of CLC. In addition, the changes in CLC at the system level are related to family/caregiver participation in treatment. Implications for supporting positive changes in CLC among systems of care communities, and specific strategies for community psychologists, are discussed.     

Implementation and Development of Federally-Funded Systems of Care Over Time

This study describes development in federally funded systems of care. Data for this study were collected using the System of Care Assessment that rated grantees' enactment of system of care principles in the infrastructure and service delivery domains. Data were collected by trained raters who conducted several site visits over the funding period. This study described system development over time across 61 sites and tested whether gains were statistically significant. Latent profile analysis was used to explore whether sites could be meaningfully grouped based on their baseline service delivery domain scores. Differences across groups were tested in terms of community, system, and client characteristics. Differential growth across groups was also examined. Overall, systems of care developed over time in both the infrastructure and service delivery domains. Although infrastructure scores were generally lower than service delivery scores, greater gains were seen for the infrastructure domain. Three groups of sites were identified that could be distinguished in terms of degree of development overall, and for specific system of care principles. The groups of sites differed in terms of community factors, system features, and client characteristics. In addition, repeated measures analyses found differential growth in system development over time across groups.     

Pediatric–Psychology Partnership for Abuse Prevention

Intimate partner violence (IPV) is a significant, albeit underreported and underidentified, public health problem that requires the informed and coordinated efforts of the health care system for appropriate recognition and intervention. In addition, health disparities are seen in the incidence, prevalence, and burden of IPV among specific population groups in the United States. Pediatric–Psychology Partnership for Abuse Prevention is a graduate psychology education training project focused on developing an integrated primary health-care based workforce that is culturally sensitive and competent in the identification and remediation of IPV. In addition, this project aimed to increase the number of health service psychologists from diverse backgrounds who are culturally competent and aware of health disparities. The training included clinical psychology trainees and pediatric residents working together in an ambulatory pediatric health care setting. Project methods, outcomes, and implications for predoctoral clinical psychology training programs are described.     

Effects of exposure of mice to hindlimb unloading on leukocyte subsets and sympathetic nervous system activity

The hindlimb unloading (HU) rodent model was developed to simulate some of the aspects of spaceflight conditions. Our previous studies showed that exposure to HU for 48 h (h) followed by bacterial challenge, reduces the ability of mice to resist infection. The purpose of this study was to investigate the physiological changes in mice during the 48 h of exposure to HU to understand the mechanisms involved in the increased susceptibility to infection observed in mice subjected to these conditions. Female Swiss Webster mice were hindlimb-unloaded during 48 h. Blood samples, spleen and peritoneal cells were removed before and after 18 or 48 h of HU-exposure. Leukocyte subset analysis was performed in spleen and peritoneal cells by flow cytometry, and catecholamine levels were measured in plasma and whole spleen by a catecholamine enzyme immunoassay. Catecholamine levels measured in plasma and spleen were significantly greater in mice exposed to HU compared to control. This increase coincided with significant reductions in spleen size in the HU group. Flow cytometric analyses showed a significant reduction of splenic CD19 + B-cells and NK1.1+ cells in mice exposed to HU with a concomitant increase in T-cells. These results suggest that exposure to HU increases the activity of the sympathetic nervous system (SNS) and induces lymphocyte sub-population changes that may contribute to the deregulation of immunity seen in mice exposed to HU and, more importantly may predispose the otherwise healthy host to the subsequent reduced ability to resist infections.     

A portable pupilometer system for measuring pupillary size and light reflex

A new pupilometry assessment system was evaluated as an instrument for potential use in basic research and clinical studies of addictive drug use in humans. The system is portable and can be used as a peripheral device with a variety of IBM-compatible personal computers. The pupilometer electronically measures the pupil diameter with infrared sensors and has the ability to stimulate the pupil with a programmable pulse of light and to record the resultant papillary response. The present report compares the static pupil-diameter measurements obtained with this infrared pupilometer and those obtained photographically in a bench-top and in a clinical setting. The infrared pupilometer was also used to record the light reflex of the pupil in research subjects after administration of various morphine-related drugs. The results indicate that static pupil-diameter measurements made with the infrared pupilometer compare favorably with the photographic measurement. The ability of the infrared pupilometer to record the light reflex may provide an additional means of quantitatively measuring drug action.     

Perceived Marital Changes Following Marriage Guidance Training

Training to become a marriage guidance counsellor in Scotland involves a relatively demanding 18 months' programme of both didactic and experiential learning. Changes in the counsellors' marital relationships following training were evaluated using the Marital Adjustment Test and two ad hoc questionnaires. Of the 49 counsellors who (a) began training between 1976 and 1980, (b) completed the training and (c) were still counselling in February 1983, 33 participated, as did 30 of their partners. In general, the counsellors and their partners reported increased marital satisfaction following the training period, though five counsellors and two partners reported a decrease. The findings from the ad hoc questionnaires were also encouraging.