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Dogukan Ulupinar Carlos Zalaquett So Rin Kim Jonna M. Kulikowich 《Journal of counseling and development : JCD》2021,99(1):37-46
Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed. 相似文献
74.
Elizabeth M. Z. Farmer H. Ryan Wagner Barbara J. Burns Jesse T. Richards 《Journal of child and family studies》2003,12(1):11-25
We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group homes or residential treatment). Two-thirds of youth remained in TFC throughout the follow-up year. Of those who left, nearly half returned home, and slightly fewer were discharged to group homes. By the end of the 12-month follow-up period, rates of group home use were similar to those seen in the pre-TFC period. Movement out of TFC during the year was associated with being older at placement and with increased problem behavior (particularly externalizing behaviors). TFC serves as a step-down placement for a substantial number of youth. However, this is not the only way it is used, and models based on short-term transitioning or reunification with families may not be widely implemented or relevant in practice. Additional research is needed to understand current functions of TFC in residential trajectories and to maximize its utility in systems of care. 相似文献
75.
Neuronal changes in normal human aging and Alzheimer's disease 总被引:8,自引:0,他引:8
This article discusses age-related changes in brain weight, total number of cortical neurons, cortical dendrites, spine, and synapse density. The conclusion is that the present outlook is less grim than it was 30 years ago. Age-related reduction appears to be specific to brain region and cortical layer rather than a general feature. In addition, we describe a different pattern of changes that occur in Alzheimer's disease patients. This review concludes that the association cortices in particular are affected in aging and Alzheimer's disease and that the primary visual and somatosensory cortices are relatively spared. 相似文献
76.
"以病人为中心"医疗服务模式的理念与发展 总被引:25,自引:1,他引:24
纵观20世纪医疗服务的发展历程,医疗服务的发展经历了“以疾病为中心”的传统医疗服务模式到“以病人为中心”的新的医疗服务模式的转变;目前,以“以病人为中心”的医疗服务模式已经成为我国现代医院改革与发展的主题。因此,在阐述医疗服务模式变革与发展的基础上,系统论述了“以病人为中心”的医疗服务模式的内涵与特点,新的理念、新的认识,也带来了新的希望,新的医疗服务模式将不断地改善与提高人们的健康状况与生活质量。 相似文献
77.
Noddings N 《Theoretical medicine and bioethics》2002,23(6):441-454
Care theory offers a way to overcome a weaknessof liberalism – its reluctance to intervene inthe private lives of adults. In caring for thehomeless, we must sometimes use a limited formof coercion, but our intervention is alwaysinteractive, and the process of finding asolution is one of negotiation between theneeds expressed by the homeless and the needswe infer for them. 相似文献
78.
Thomas?W.?MillerEmail author Robert?F.?Kraus Chelsea?A.?York 《Journal of Contemporary Psychotherapy》2005,35(4):347-357
Health-focused psychotherapy offers a contemporary model used in assessment, treatment planning and evaluation in addressing
patients with both medical and psychiatric diagnoses. Clinicians in the health and mental health disciplines must know and
understand the importance of standards of care and models of intervention and evaluation in clinical practice for this type
of patient. Examined is the use of a specific model providing a tailored orientation to patient education, along with the
development and use of a clinical algorithm and care pathway for clinical practice. Provided is a case study for applying
the development and use of a clinical algorithm and care pathway for a dual diagnosed patient receiving health-focused psychotherapy. 相似文献
79.
Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions. 相似文献
80.
The common factors debate in psychology and, more recently, marriage and family therapy is slow to erupt in pastoral care
and counselling. This article introduces the common factors debate into pastoral science by proposing the Stewardship Models
of Pastoral Ministry and Supervision. The model integrates common factors research and pastoral practice using Ricoeur’s “economy
of the gift” ethic. The model’s focus is pastoral care, counselling and supervision in congregations, a unique community context
in search of an adequate pastoral praxis. 相似文献