Group work in general practice

In this article, consideration is given to a problem often experienced in relation to courses offering psychodynamic understanding to front-line workers with troubled clients – the complexity for the student in taking the learning ‘home’ in a productive manner and the potential isolation of the student in, or alienation from, their workplace. A model of course delivery is described in which an active three-way partnership between student, course and workplace is fostered which enhances the students' learning, enables the workplace to benefit more fully from the course and enhances the effectiveness of the course in improving service to the ultimate client – the service user.     

Preschool Teacher Support Through Class-Wide Intervention

Abstract

Preparing professionals for class-wide consultation has a significant role in achieving goals associated with recent legislation and reform initiatives. Class-wide interventions are used to target achievement and social learning, are under a teacher's control and responsibility, and build on basic classroom interactions, routines, and resources. However, teachers may require considerable contextual appraisal and support from consultants. The purpose of this paper is to describe a teacher- support program evolving from Head Start consultations by school psychology students. Implications for training and practice are discussed.     

Families in Crisis

Abstract

Families are in crisis. With an increasing array of problems affecting children in the home, from child abuse to familial alcoholism, schools are facing a vast array of behavioral and emotional concerns affecting childhood behavior. Unfortunately, many negative behaviors are learned at home. Violent and aggressive behaviors, for example, as well as drug and alcohol abuse, are often demonstrated by parents. From a community perspective, schools are in a pivotal position from which to intervene. Yet, many school-based mental health professionals, including school psychologists, school counselors, and school social workers, lack the knowledge to provide direct interventions. This article examines contemporary problems facing families, considers the home-school linkage, and explores interventions for schools and school-based mental health professionals.     

A Needs Assessment of Transgendered People of Color Living in Washington,DC

SUMMARY

A needs assessment (N = 248) conducted in Washington, DC, revealed that trans-gendered people of color are at high risk for HIV/AIDS, substance abuse, suicide and violence/crime victimization. Overall HIV prevalence was 25%, with 32% in natal males (MTFs, i.e., male-to-females). Four predictors for HIV positive status were identified through logistic regression-male sex at birth, a history of substance abuse, sexual assault, and unemployment. Substance abuse was found in nearly half the sample (48%) but only half of those (51%) had sought treatment for it. Thirty-eight percent reported experiencing suicidal ideation, with 63% of those attributing it to their gender issues. Of those with suicidal ideation, nearly half (49%, or 16% of the entire sample), went on to make attempt(s) to kill themselves. Forty-three percent had been victims of violence or crime, including 13% who had been sexually assaulted.

Knowledge of the Standards of Care of the Harry Benjamin International Gender Dysphoria Association was quite low (9%) and associated with white race, any higher education beyond high school, and access to sex reassignment surgery (SRS). Access to SRS, defined as obtaining vaginoplasties for natal males and chest surgeries for natal females, was just 4%. White race (versus all other races, p < .001) and female at birth (versus male, p < .01) were significantly associated with access to SRS.

Use of hormones at some point during their lives was reported by 51% of participants. Thirty-five percent were currently taking hormones, with 72% acquiring their hormones from friends or on the street. Among natal males, 25% had injected silicone.

Nineteen percent did not have their own living space, and employment, housing and job training were the most commonly-reported immediate needs of the sample. The results of this needs assessment provide evidence of an urgent need for increased medical and social services specific to transgendered people of color living in the District of Columbia.     

Health and Social Services for Male-to-Female Transgender Persons of Color in San Francisco

SUMMARY

This article presents findings from an investigation of health needs, service utilization, and perceived barriers to services among male-to-female (MtF) transgender persons of color in San Francisco. Focus groups (n = 48) and survey interviews (n = 332) were conducted with convenience samples recruited from the community. Participants reported a range of health and social services needed during the previous year, with African-Americans and Latinas showing particularly strong service needs. Rates of utilizing services were high for basic health care but lower for social services, substance abuse treatment, psychological counseling, and gender transition-related medical services. No significant ethnic group differences in health service utilization were found. Qualitative findings evinced the call for transgender-specific programs and advanced provider training on transgender issues such as hormone use, gender transition, HIV/ AIDS care and prevention, substance abuse, and mental health problems.     

Ethical Considerations of Multiple Roles in Forensic Services

Attorneys increasingly rely on the services of mental health practitioners. Although some practitioners lack training, the promise of professional rewards lead some to accept opportunities with resulting ethical quandaries. Due to significant differences between the objectives of traditional mental health services and expert testimony, problems occur when clinicians venture into forensic services. Attorneys and judges, unfamiliar with mental health specialties, may seek to press a mental health practitioner into multiple roles. Although not all multiple roles are ethically inappropriate, caution demands careful parsing of particular roles: (a) academic/behavioral science expert; (b) fact witness as a treating therapist; (c) expert witness based on a clinically oriented assessment; (d) pretrial and/or trial consultant; and (e) professional critic of other experts. Possible ethical issues and risks associated with accepting multiple roles are identified and strategies for avoiding or minimizing harm or exploitation are discussed.     

Pregnant and Parenting Battered Women Speak Out about their Relationships and Challenges

Domestic violence is one of the leading health risks to women in the United States. Abuse during pregnancy increases the negative health consequences for mothers and their unborn children. This article presents survey and open-ended interview data from participants in an innovative program for pregnant and parenting battered women and examines the health status of mothers and newborns, their experience and perception of both physical and nonphysical abuse, and their challenges to prenatal care.     

Sharing Knowledge and Shared Care

Summary

This concluding article presents the main themes that emerged from this volume within a multidimensional, multidisciplinary integrative framework conceptualizing the consequences of the trauma of terrorism and informing optimal prevention and intervention methods. It reviews short- and long-term findings of the effects of terrorism on adults, children, families, communities, and societies and makes numerous research recommendations. Viewing terrorism as psychological warfare against the community, it advances community-based, culturally congruent interventions, with a public mental health approach, in an ongoing, integrated network of services promoting community and individual resilience, specialized training, international collaboration, and continued dialogue concerning the role of the media.     

European developments

The British National Health Service is 50 years old. The provision of many services has changed considerably through this time in ways that reflect shifts in organization and philosophy. The provision of psychotherapy has been particularly sensitive to these changes in ways that have made it more widely available but also shaped its content. As the pace of change continues to accelerate, some implications of the most recent shifts in philosophy for clinical practice are considered.     

The Influence of Person Traits on Lawyer Selection Among British Adults

The present study examined selection criteria for lawyers among British adults, which begins to overturn a dearth of studies examining this issue among legal professions. A total of 122 participants were asked to rate eight lawyers dichotomized along lawyer origin (Britain versus South Asia), gender (women versus men), and age (younger versus older). A mixed-design analysis of variance showed that there was a main effect of lawyer origin, with British lawyers preferred over the South Asian counterparts. There were also a number of significant interactions between lawyer variables, as well as participant gender and age. The effect sizes of these interactions were generally smaller (η_p ² = .07?.24) than the main effect lawyer origin (η_p ² = .54). Limitations and practical implications are discussed in conclusion.