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.     

Systems of Care: New Partnerships for Community Psychology

For almost two decades, the federal government has supported the development of integrated models of mental health service delivery for children and families, known as systems of care (SOCs), that strive to be child-centered, family-focused, community-based, and culturally competent. These efforts align well with the values and principles (e.g., empowerment, collaboration, strengths emphasis, focus on macro-level social/system change) central to community psychology (CP; Kloos et al. in Community psychology, Cengage Learning, Belmont, 2012). Despite the convergence of many core values, CPs have historically been underrepresented in key roles in SOC initiatives. However, this has changed in recent years, with increasing examples of community psychology skills and principles applied to the development, implementation, and evaluation of SOCs. Because successful and sustainable implementation of SOCs requires community and system-level change, and SOCs are increasingly being urged to adopt a stronger "public health" orientation (Miles et al. in A public health approach to children's mental health: a conceptual framework, Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children's Mental Health, Washington, DC, 2010), there is great potential for CPs to play important roles in SOCs. This paper discusses opportunities and roles for CPs in SOCs in applied research and evaluation, community practice, and training.     

A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity

The Child and Adolescent Level of Care System/Child and Adolescent Service Intensity Instrument (CALOCUS/ CASII) is designed to help determine the intensity of services needed for a child served in a mental health system of care. The instrument contains eight dimensions that are rated following a comprehensive clinical evaluation. The dimensions are risk of harm, functionality, co-morbidity (psychiatric, substance abuse, development disability and medical), environmental stressors, environmental supports, the child's resiliency, and the child and family's willingness to engage in treatment. An algorithm connects the ratings to a level of care recommendation. The instrument specifies six levels of care defined flexibly enough to consider whatever services are available. The results of psychometric testing using raters with a broad range of clinical experience and training from four different systems of care around the country are presented. The testing demonstrates excellent reliability when rating vignettes. Using children and adolescents in live system of care clinical settings, the CALOCUS/CASII demonstrates reasonable validity when compared with the Child Global Assessment Scale, and the Child and Adolescent Functional Assessment Scale.     

ACQUISITION OF ADJECTIVES AND ADVERBS IN SENTENCES WRITTEN BY HEARING IMPAIRED AND APHASIC CHILDREN

The effect of an instructional package, which included modeling, reinforcement, and remedial feedback on the rate, accuracy, and topography of sentences composed by four hearing impaired and aphasic children, was examined. In a specially designed classroom, students wrote sentences describing a stimulus picture on acetate sheets placed on the stage of an overhead projector which was built into each student's desk. This arrangement provided the teacher and other students immediate and continuous visual access to each student's sentences. In a multiple baseline design across behaviors, model sentences were projected and token reinforcment and remedial feedback were made contingent upon writing correct sentences containing prenominal adjectives only, then adverbs only, then prenomial adjectives plus adverbs. During baseline all students displayed poor written language skills and seldom wrote sentences containing modifiers. When the instructional package was implemented, all students demonstrated significant increases in response rate, accuracy, and percentage of correct sentences including prenominal adjectives and adverbs.     

Change in vocational choice as a function of initial career choice,interests, abilities,and sex

This study examines changes in expressed vocational choices made over an 18-mo period by a sample of students who were each enrolled in one of 62 2-yr institutions. Four mutually exclusive categories of vocational choice change were constructed. Ability, interest, and family background measures were used as independent variables. Results indicated (a) that changers were very similar to nonchangers in terms of the independent variables examined, (b) that there were substantial differences in the choice changes made by males and females, and (c) that vocational choice change patterns varied widely among groups of individuals whose original vocational choices places them in different major vocational categories.     

Inhibition and Attention Deficit Hyperactivity Disorder

This paper updates the author's earlier hypothesis that Attention Deficit Hyperactivity Disorder (ADHD) reflects underactivity in Gray's Behavioral Inhibition System. Five areas of research are reviewed: (1) studies using the stop-signal task, (2) studies of errors of commission, (3) a study of inhibition indexed by eye movements, (4) a neuroimaging study of the corpus callosum, and (5) a study on the prediction of response to methylphenidate. Data from the many different dependent variables in these studies are interpreted as supporting disinhibition as a core deficit in ADHD.     

Connectionism and the Philosophical Foundations of Cognitive Science

This is an overview of recent philosophical discussion about connectionism and the foundations of cognitive science. Connectionist modeling in cognitive science is described. Three broad conceptions of the mind are characterized, and their comparative strengths and weaknesses are discussed: (1) the classical computation conception in cognitive science; (2) a popular foundational interpretation of connectionism that John Tienson and I call "non-sentential computationalism"; and (3) an alternative interpretation of connectionism we call "dynamical cognition." Also discussed are two recent philosophical attempts to enlist connectionism in defense of eliminativism about folk psychology.     

A Poetics of Psychological Explanation

Intentional, 'commonsense,' or 'folk' psychology is, as Jerry Fodor has remarked, ubiquitous. Explanations of what we say and do in terms of our reasons for acting are the stock in trade of intentional psychology. But there is a question whether explanations in terms of reasons are properly explanatory. Donald Davidson and Daniel Dennett, to name two, have defended intentional psychology and its reason-explanations. Still, many philosophers – including Fodor, Davidson and Dennett – fail to pay due attention to the narrative basis of such agent-centered accounts of action. In this paper, I argue that psychological explanation is an agent-centered, narrative-based interpretive practice. To make my case, I present a poetics of psychological explanation: seven elements which collectively describe what makes psychological explanations work. Narrative form allows us to represent the temporal arc of agents' actions – as well as the temporal arc of their reasoning about their actions, both prospective and retrospective. It allows us to negotiate between the canonical and the exceptional in human experience, and thus to account for actions that strike us as puzzling or unusual – whether the puzzle originates in our suboptimal understanding or the agent's suboptimal reasoning. And it allows us to juxtapose different perspectives on any action. Such juxtapositioning gives us a mechanism for coming to see how an action that strikes us as misguided might have been construed by the agent as reasonable given her understanding of her circumstances. After establishing the seven elements of the poetics, I address the objection that narrative-based accounts of intentional action are not properly explanatory.     

On the Poverty of Scientism, or: The Ineluctable Roughness of Rationality

If there is one rationality there must be a plurality of them. This conclusion follows, I argue, partly from the extreme and ineradicable vagueness of the fundamental concepts that every would-be rational explanation must presuppose. Logicistic/scientistic assaults on this vagueness are doomed to fail partly because they are unable to acknowledge the imaginative dimension of rational thought. Being limited to the play of "outward appearances," scientific investigations are also dependent on "inward imaginings" on their speculative side. The upshot is that schools of philosophy should be characterized by the kind of imaginary they adopt rather than by their logics. In which case, every attempt to get and tell something right about the world is bound to incorporate mythopoeic elements in its explanations.     

A Systems Perspective on the Introduction of Narrative Practice in Human Services Organizations in the Era of Managed Care

General System Theory is used to examine the structure and activity of human services organizations for conditions which support the introduction of selected narrative ideas in a systemic approach to mental health services. The inquiry includes examination of the influence of larger systems (such as managed care companies and regulatory bodies) on such introduction.