Reimbursement for professional psychological services

A brief history of the professionalization of psychology precedes a section of how psychological services became reimbursable. Specific focus is placed on reimbursement for psychological services, especially the distinction between medical and psychiatric diagnoses as well as procedures or services. Specific guidelines for appropriate reimbursement are provided. Future directions for reimbursement for mental health and related services are considered.     

Primary Prevention Mental Health Programs: The Future is Exciting

Current outcome research on primary prevention mental health programs is encouraging and the future is exciting. Data continue to accumulate regarding the efficacy of preventive intervention. Exemplary programs can prevent multiple problems across different outcome domains suggesting the need for collaboration among preventionists across disciplines and research areas. The commentators on our review (Durlak and Wells, 1997) offered many useful suggestions to improve the next generation of research. Most recommendations fall broadly under the rubric of increasing the precision of theory, design, and program evaluation. If current recommendations for improving future research are followed, the next reviewers of primary prevention mental health programs for children and adolescents will have a more complete and useful database for analysis.     

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.     

Psychological Distress and Help Seeking in Rural America

The implications of exposure to acute and chronic stressors, and seeking mental health care, for increased psychological distress are examined. Research on economic stress, psychological distress, and rural agrarian values each point to increasing variability within rural areas. Using data from a panel study of 1,487 adults, a model predicting changes in depressive symptoms was specified and tested. Results show effects by size of place for men but not for women. Men living in rural villages of under 2,500 or in small towns of 2,500 to 9,999 people had significantly greater increases in depressive symptoms than men living in the country or in larger towns or cities. Size of place was also related to level of stigma toward mental health care. Persons living in the most rural environments were more likely to hold stigmatized attitudes toward mental health care and these views were strongly predictive of willingness to seek care. The combination of increased risk and less willingness to seek assistance places men living in small towns and villages in particular jeopardy for continuing problems involving depressed mood.     

Development and analysis of a community-based resource recovery program

Five studies were conducted over a 10-month period to determine the effectiveness of specific procedures in encouraging recycling among residential neighborhoods. Results indicated that: (a) initial levels of participation in neighborhoods were frequently related to housing values; (b) weekly recycling pick-ups that coincided with garbage collection days resulted in higher levels of participation than pick-ups that occurred at other times; (c) notifying homes about the recycling program through distributed door-to-door brochures was more effective than soliciting participation through newspaper ads; (d) distributing containers to help residents separate recyclable from nonrecyclable material proved to be an effective procedure, especially when combined with frequent prompting (prompting alone did not have much effect); and (e) procedures that facilitated the greatest levels of participation were not always cost-effective. The subsequent combination of these procedures into a package program resulted in high levels of neighborhood participation that were cost-effective and maintained over a 6-month period.     

Turning the table on advice programs for parents: Using placemats to enhance family interaction at restaurants

There are many opportunities in a family's daily routine to enrich the interactions among its members. One such opportunity arises at family restaurants. Surveys of restaurant personnel and customers suggested the possibility of enriching family interactions by redesigning indigenous materials such as table placemats. Accordingly, we developed Table-Talk placemats that provided conversational topics and illustrated games in which the entire family could participate. After some testing of these placemats in a preschool, a field experiment was conducted with families dining in restaurants. Table-Talk placements occasioned more social and educational dialogue among family members than either traditional-placemat or no-material conditions. Social validation ratings provided by mental health counselors and the parents suggested that Table-Talk placemats occasioned healthy and enjoyable interactions among family members.     

Rewarding safety belt usage at an industrial setting: Tests of treatment generality and response maintenance

An incentive program to motivate seat belt use was implemented at a large munitions plant. Seat belt usage was assessed daily at an entrance/exit gate of the industrial complex when employees arrived for work in the morning and departed in the afternoon. During treatment incentive fliers, which prompted seat belt usage and gave belt wearers opportunities to win prizes, were distributed only in the afternoon. Seat belt wearing increased from baseline means of 20.4% and 17.3% during the morning and afternoon, respectively, to averages of 55.5% during afternoon departures and 31.1% during morning arrivals. During follow-up, mean belt use dropped almost to baseline levels. Categorizing vehicles according to driver sex and license plate number enabled a study of belt wearing practices of individuals, and revealed that the incentive program influenced some drivers to wear their seat belts during morning arrival when incentives were not distributed (i.e., treatment generalization) and during a follow-up period after the incentives were withdrawn (i.e., response maintenance).     

Behavioral community psychology: training a community board to problem solve

This study demonstrated the effect of training nine lower socio-economic adults participating as policy board members in a federally funded rural community project to make behaviorally defined statements to increase problem-solving behaviors in board meetings. A multiple-baseline design across subjects and skills was used to analyze the behavioral categories of: (1) stating the problem; (2) finding solutions to the problem, and (3) implementing the action to the solution. Problem-solving responses during board meetings increased for subjects following training and remained higher than baseline during follow-up.     

Training public-speaking behavior: an experimental analysis and social validation

The effect of an instructional package on public-speaking behaviors was analyzed in two experiments. The instructional package was designed to teach public-speaking trainees to look at the audience, make gestures, and perform a number of speaking behaviors. The results of Experiment I, with a university student serving as the trainee, showed that the percentage of each category of public-speaking target behavior increased only after the instructional package was introduced for that category. The results of Experiment 2, with three low-income paraprofessional staff members of a neighborhood service center serving as trainees, showed that the percentage of target behaviors increased after the instructional package was introduced for the respective trainee. Audience ratings of public-speaking performance were correlated with direct observations of target responses. All trainees showed marked improvements in audience ratings from pretraining to posttraining. This study demonstrated an effective procedure for training public-speaking behaviors.