Crisis for community mental health: The use of groups in the struggle for survival

The task of community mental health is to provide quality services to clients despite funding cutbacks. This paper describes the recent evolution in conceptualization and service delivery in one center. The outcomes are a philosophy that is customer oriented, and treatment that draws upon brief techniques, in group and long term contexts.     

The Experience of Caregiving Among Mothers of Adults Suffering from Psychotic Disorders: Factors Associated with Their Psychological Distress

To identify correlates of psychological distress among multiple indicators, 99 women with adult children suffering from a psychotic disorder were interviewed. The women, who were recruited through hospitals and self-help groups, represented different socioeconomic levels. A face-to-face standardized interview was conducted, mainly in the participants' homes. Multiple hierarchical regression analysis showed that dimensions of burden and social support were strongly associated with distress reported by the participants. The negative interactions that participants had with their main confidant or spouse constituted a more powerful correlate than their perception of the quality of this relationship. Furthermore, a perception of their own health as poorer is a strong correlate of their distress. Since no control group was studied simultaneously, these results suggest, but do not prove, the presence of differences between mothers of adults with psychotic disorders and other mothers.     

CONTROL OF ARITHMETIC ERRORS USING INFORMATIONAL FEEDBACK AND GRAPHING1

The effect of informational feedback and graphing on reducing the number of arithmetic worksheet errors was investigated. The present study replicated and extended earlier findings with other populations (Journal of Applied Behavior Analysis, 1974, 7 , 547–555; 1970, 3 , 1–4; 1970, 3 , 235–240) to a first-grade classroom. Ten first-grade pupils (four males and six females) served in an ABAB design. During the feedback-only phase, subjects were provided informational feedback, in the form of a written number, on the number of errors made on individual arithmetic worksheets. The feedback-only phase lasted seven days and was followed by the feedback-plus-graphing phase, during which subjects graphed the number (of errors written at the top of the individual worksheet) daily on individual graphs on their desks. The feedback-plus-graphing phase lasted 10 days and was followed by a reversal to feedback only for 10 days. The final phase was a replication of the feedback-plus-graphing phase. All subjects showed a change in number of worksheet errors, in the predicted direction, during the feedback-plus-graphing phases. An overall mean difference of ?2.66 was found to be statistically significant (P < 0.01), using a Wilcoxson Matched-Pairs Sign Test. The results were interpreted as being empirical support for earlier findings in other populations. In addition, the present findings represented a successful extension of feedback and graphing interventions to the management of academic behaviors in a first-grade classroom.     

A classroom program teaching disadvantaged youths to write biographic information

Little attention has been given to how formal classroom instruction can be adapted to teach youths everyday skills such as the correct writing of biographic information frequently requested in transactions like applying for a job or a social security number and cashing a check. In this study, six youths in a special education classroom were taught to complete job application forms with the date, their name, signature, address, telephone number, date of birth, and a reference's name, address, and occupation. Each youth was trained on one item of biographic information at a time, after which he was tested on four application forms, including one on which he had not been trained. The tests show that after an item had been taught, it was correctly used in completing application forms on which the youths had been trained and forms on which they had never been trained. The study demonstrates the feasibility of teaching community-living, vocation-related skills to special-education youths in a classroom setting.     

MODIFYING LETTER AND NUMBER REVERSALS IN ELEMENTARY SCHOOL CHILDREN1

Children from regular and special-education classes were exposed to tutoring procedures designed to modify letter and number reversals. In Experiment I, two students showed reversals during letter-naming (e.g., saying p for q) and two-digit number (e.g., writing 31 for 13) exercises. In Experiment II, one subject made two-digit reversals, while the other child reversed single-digit numbers (e.g., 9 written with circle on right side of stem). The subject in Experiment III emitted letter reversals under naming, dictation, and copying exercises. The child in Experiment IV showed written letter reversals on both sides of the “body midline” under dictation procedures. Basic treatment procedures during all experiments involved modelling of correct and incorrect symbol formation, and differential experimenter feedback following student responses. During Experiments I and II, subjects were praised for each correct response, and informed when a reversal occurred. Experiment III included a Modelling Only Phase before these feedback procedures. Besides praise, treatment conditions in Experiment IV consisted of additional feedback following correct responses (e.g., charting correct responses), and temporal delays imposed between dictated letters and student responses. Except for occasional letter-naming reversals of one subject (Experiment I), and letter dictation errors of another (Experiment IV), reversals were eliminated when all experiments terminated. The Modelling Only Phase in Experiment III also reduced reversals to a low level. These findings suggest that a variety of reversal problems may be effectively assessed and remediated via simple modelling and reinforcement procedures. In addition, postcheck observations indicated that the effects were enduring. The present procedures should be easily implemented by school personnel.     

REDUCING TIME LIMITS: A MEANS TO INCREASE BEHAVIOR OF RETARDATES1

A common assumption in special education is that temporal limits for a task should be expanded so that ample time is provided for completing the work. This study describes the opposite strategy of restricting temporal limits to augment academic performance. Three educable retarded children received token reinforcement contingent on the number of correct math problems answered during daily sessions. A reversal design was used to assess the effects of an abrupt reduction in time limits (20-5-20 min) and a graduated sequence of reductions (20-15-10-5-20 min). The graduated sequence resulted in rate increases of correct responding ranging from 125% to 266% and these gains endured when temporal limits were again expanded. In contrast, the abrupt shift produced interfering emotional behaviors and rate decreases in academic performance of 25% to 80%. The findings indicate that systematically restricting temporal limits for an academic task can further enhance the performance of slow learners already maintained by a token system.     

Modifying food purchases in supermarkets with modeling, feedback, and goal-setting procedures

We compared several procedures designed to modify consumer food purchases with the objectives of reducing fat and increasing carbohydrate content, and reducing dollar expenditures on food. Participants were 126 volunteer community households which, after a 7-week baseline period, were randomly assigned to video-modeling, video-modeling-feedback, video-lecture, video-lecture-feedback, participant-modeling, video-modeling-discussion, and control conditions. The main dependent measure was a weekly record of food purchases, convertible to percentages of nutrients and dollar expenditures. Results indicated that modeling-feedback and participant-modeling procedures were most effective (e.g., 6% reduction of total fat consumption, 19% dollar savings). Strategies to refine and automate modeling and feedback in supermarkets that may benefit consumers, corporations, and government are discussed.     

SELF-RECORDING OF ATTENTION VERSUS PRODUCTIVITY

We investigated the relative effects of self-recording of attentive behavior and self-recording of academic productivity with 5 upper elementary-aged special education students in their special education classroom. Following baseline, both self-recording treatments were introduced according to a multielement design. After the multielement phase, we assessed the pupils' performance under a choice condition, faded the overt aspects of the treatment program according to a withdrawal design, and probed maintenance over 5 weeks. Results revealed that both treatments produced clear improvements in arithmetic productivity and attention to task, neither treatment was clearly and consistently superior to the other, pupils preferred the self-recording of attention treatment, the effects were maintained for all pupils, achievement test scores improved, and pupils generally recorded accurately.     

Contingency contracting with disadvantaged youths: Improving classroom performance

This study evaluated the effects of a student-teacher contracting procedure on adolescent students' academic productivity. Participants were 13 youths enrolled in a vocational training program for disadvantaged youth and their classroom teacher. During the baseline conditions students were paid contingent on attendance alone, the system operating in the program prior to this research. During contracting conditions students were paid contingent on contract fulfillment of academic productivity goals set by mutual agreement between the student and teacher. Contracting and contingent pay procedures were developed with, and implemented by, the classroom teacher. A reversal experimental design showed that student's productivity more than doubled during contracting conditions as compared with their productivity during baseline.