Mental Health and Adverse Childhood Experiences

The theoretical basis of occupational therapy interventions was investigated in two mental health facilities in the Midwestern United States. Using retrospective cohort and grounded theory designs, 121 medical records were reviewed and five occupational therapy practitioners were interviewed. Theoretical reasoning was not explicitly documented, but according to analysis, the behavioral/cognitive-behavioral model, client-centered models, and the model of human occupation were the most frequently used theories to guide interventions. Lack of documentation of theory use has significant implications for the value accorded to occupational therapy skills in health care. A larger study is recommended to increase external generalizability of the findings.     

Developing Roles and Skills in Community-Living Adults With Severe and Persistent Mental Illness

People with severe and persistent mental illness often experience a disruption in the development of social roles, and the skills within these roles. Role Development, a set of guidelines for practice, is an intervention to develop roles and skills. The purpose of this study was to continue to examine the efficacy of this intervention. Ten people attending two community mental health programs participated in evaluation and treatment based on Role Development. Quantitative pretest and posttest measures were used. Qualitative components were incorporated to get a sense of the experience involved in developing roles and skills. Quantitative results indicated statistical significance (p < .05) in the development of roles and skills. Qualitative data revealed multiple trends experienced by the participants. This study contributes to the evidenced-based knowledge regarding development of roles and skills for persons living with severe and persistent mental illness.     

The areas of change questionnaire: A cross-cultural comparison of israeli and american distressed and nondistressed couples

Abstract

This study examines Israeli couples' presenting complaints about their relationship, their perceptions of one another's complaints and perceptual accuracy between actual and perceived complaints, using the Areas of Change Questionnaire (ACQ). Samples were obtained of both distressed and nondistressed couples. Each sample met stringent criteria for categorization as distressed and nondistressed. Normative data for both samples are examined and areas of similarities and differences are discussed. The instrument is found to discriminate distressed and nondistressed Israeli couples. Results are compared with a previous study of American distressed and nondistressed couples. The American finding that women desire more change in marriage is not replicated in the Israeli sample, nor the American finding that distress and stage in the life cycle are related. However, there is an indication in both samples that men, compared to women, perceive more requests for change. Men in both cultures also feel more change is asked of them than they themselves ask in return.     

Countertransference and containment in a patient with a psychotic mother

The importance of countertransference reactions in the treatment of a borderline patient with a psychotic suicidal mother is discussed. In such a case containment can be seriously disrupted by the violence of the patient's projections into the therapist. Where a psychotic internal object has been brought for treatment it is particularly important that the therapist be able to identify not only with the sane and mad parts of the patient but with the destructiveness and cruelty of the patient and her primary object. The difficulties of tolerating these relentless projections of madness and despair are increased by the multiple and confusing aims of the patient's excessive use of projective identification. The invasive and hostile aspects of this are often heavily disguised beneath idealization of the self and object as well as of madness itself. For the patient, attempts to interpret the idealization are moreover felt as an assault on the lost loved object, and the therapy then unconsciously becomes a persecutory experience for the patient. The therapist can thus be drawn into feeling the full force of the anger and hatred towards the real disappointing object and the sense of hopelessness about the reparative task. Although such feelings need to be tolerated, eventually some distance from the often-unpleasant fluctuations in the countertransference must develop if a useful degree of containment is to be achieved.     

Effects of a Peer Engagement Program on Socially Withdrawn Children with a History of Maltreatment

Children with a history of child maltreatment often have limited social interactions with other children and adults. This study examined the effects of a Peer Engagement Program, consisting of peer mentoring and social skills training with positive reinforcement, in three children with low levels of oral and social interaction. A multiple baseline, single-subject research design was used to test whether introduction of the intervention was associated with increased, directly observed oral interaction and engagement in social activities with peers and adults. The Child Behavior Checklist (CBCL) and the Social Skills Rating Scale (SSRS) were administered before and after intervention. All children showed increased levels of oral and social interaction and improved scores on the SSRS and the CBCL.     

Parenting Wisely: Parent Training via CD-ROM with an Australian Sample

The effectiveness of a parenting program was examined with an Australian sample regarding improved parent knowledge, parental sense of competence, and child behavior. One hundred and sixteen parents and their children were randomly assigned to three conditions: a two-session group based intervention, a two-session self-administered individual intervention, or to a waitlist control group. Across both treatment modalities results reveal a significant increase in parental satisfaction, efficacy, and a reduction in child problem behavior. Improvements were maintained at 3-months follow-up. Results indicate the individual self-administered format enhanced treatment gains relative to the group format.