Individualized services and supports through the wraparound process: Philosophy and procedures

The wraparound process is emerging as an alternative to the traditional treatment planning processes inherent in categorical services for children and adolescents with emotional and behavioral disorders. We describe the current practices which have been developed in the field. Key elements of the value and philosophical base for the wraparound process are discussed. Proposed procedural steps are described to aid communities in the implementation of the wraparound process. Due to social and policy pressures, it is likely that wraparound process implementations will continue to develop.     

Interpolation and Amalgamation; Pushing the Limits. Part I

Continuing work initiated by Jónsson, Daigneault, Pigozzi and others; Maksimova proved that a normal modal logic (with a single unary modality) has the Craig interpolation property iff the corresponding class of algebras has the superamalgamation property (cf. [Mak 91], [Mak 79]). The aim of this paper is to extend the latter result to a large class of logics. We will prove that the characterization can be extended to all algebraizable logics containing Boolean fragment and having a certain kind of local deduction property. We also extend this characterization of the interpolation property to arbitrary logics under the condition that their algebraic counterparts are discriminator varieties. We also extend Maksimova's result to normal multi-modal logics with arbitrarily many, not necessarily unary modalities, and to not necessarily normal multi-modal logics with modalities of ranks smaller than 2, too.The problem of extending the above characterization result to no n-normal non-unary modal logics remains open.Related issues of universal algebra and of algebraic logic are discussed, too. In particular we investigate the possibility of extending the characterization of interpolability to arbitrary algebraizable logics.     

INCREASING APPROPRIATE SPEECH IN A CHRONIC SCHIZOPHRENIC

In a severely withdrawn schizophrenic, a combination of instructions, modeling, informational feedback, and noncontingent reinforcement was associated with a low rate of appropriate verbalizations. However, an increase in speech output was obtained using a combination of instructions, modeling, informational feedback, and contingent reinforcement. The design of this study thus permitted the conclusion that contingent reinforcement was crucial in bringing about the increase in appropriate verbalizations. The three verbal behaviors that increased in frequency were: (a) the number of socially appropriate words emitted, (b) declarative statements, and (c) appropriate replies to questions. The verbal behaviors of conversational questions and positive conversational feedback failed to be significantly affected by the experimental procedures. An attempt was also made to establish whether having the subject engage in the observable, information-gathering response of reading aloud would result in increased speech output during a subsequent conversation period. Having the subject read aloud failed to have any discernible positive effect on his speech output. A withdrawal design was used to evaluate the effectiveness of the experimental procedures. The importance of assessing changes in verbal output with a variety of verbal response measures, stereotyped verbal behaviors, and carryover effects are discussed.     

Behavior Problems in Young Children With or At Risk for Developmental Delay

We examined the prevalence of behavior problems and their relationship to child, parent, and family factors in 76 children with or at risk for developmental delay. Parents reported that 42% of the children had behavior problems. Child Behavior Checklist (CBC) scores revealed that 25% of the sample scored above the borderline cutoff. Although the total, externalizing, and internalizing mean CBC scores did not differ from the normative group (same-aged peers without developmental delay), each of the syndrome subscales was significantly higher in the study group. The Reiss Scales for Children's Dual Diagnosis revealed that, as compared to older children (4 years) with developmental delay, the study sample scored significantly lower on the total score and 8 of the 10 subscales. Increased CBC total scores were significantly related to dependency and management of the child, birth weight, gestational length, paternal illness, maternal depression, perceived personal burden of care, maternal escape-avoidance coping strategy, family disharmony, and financial stress. CBC total scores were significantly negatively correlated with being of a multiple birth, paternal education, maternal employment, two-parent family, family social support, and family income. Multiple regression analyses revealed that an empirically-derived combination of child, parent, and family variables accounted for 31% of the variance in CBC total scores. Our findings suggest that 2-year old children with or at-risk for developmental delay may already be showing signs of increased risk of behavior problems relative to peers without developmental delay. We identified several child, parent, and family variables that may help to pinpoint children at increased riskxs for psychopathology.     

Adapting Cognitive Processing Therapy for PTSD for People With Disabilities: A Case Study With a U.S. Veteran

Many veterans receiving treatment for PTSD in the VA health care system are also living with a disability and utilize assistive technologies for communication and/or mobility. While evidence-based treatments for PTSD have been disseminated in VA hospitals nationwide, clinicians may have concerns about implementing these treatments with people with disabilities or question how to adapt evidence-based protocols to facilitate successful outcomes. This clinical case study details the treatment of a 48-year-old male U.S. veteran with a diagnosis of military-related PTSD and significant functional and communicative complexities characteristic of locked-in syndrome. The study implemented an adapted protocol of Cognitive Processing Therapy (CPT), a first-line evidence-based psychotherapy for PTSD with unknown application to people with disabilities. CPT protocol structure, length, and delivery was adapted to accommodate the veteran’s assistive devices and functional abilities. The veteran experienced a clinically significant reduction in PTSD symptoms over the course of treatment, suggesting successful application of the adapted protocol. In addition to symptom reduction, the veteran reported advances in his ability to tolerate emotional distress while engaged in goal-directed behavior and improved interpersonal functioning. Results suggest that CPT can be adapted and effective in instances where the presence of disability and multiple assistive technologies impact standard treatment implementation. This information is valuable in its potential ability to make evidence-based psychotherapies more accessible and disability-sensitive. Clinical recommendations for using and adapting CPT for people with disabilities are provided.     

Help‐Seeking Behaviors of African Americans After a Loss

We investigated attitudes toward seeking professional psychological help, ethnic identity, and complicated grief symptoms among 86 African Americans after they experienced the death of a loved one. There were no significant correlations among ethnic identity, help‐seeking attitude, and complicated grief symptoms. Multiple regression analyses indicated that gender and education level predicted help‐seeking attitude, F(2, 84) = 4.64, p < .05, and that gender, education level, and religious affiliation predicted complicated grief symptoms, F(3, 79) = 3.73, p < .05. We explore the results, implications, and areas for future research. Investigamos las actitudes hacia la búsqueda de ayuda psicológica profesional, la identidad étnica y los síntomas de duelo complicado en 86 personas afroamericanas tras experimentar la muerte de un ser querido. No se hallaron correlaciones significativas entre la identidad étnica, la actitud de búsqueda de ayuda y los síntomas de duelo complicado. Los análisis de regresión múltiple indicaron que el sexo y el nivel de educación pronosticaron la actitud de búsqueda de ayuda, F(2, 84) = 4.64, p < .05, y que el sexo, el nivel de educación y la afiliación religiosa pronosticaron los síntomas de duelo complicado, F(3, 79) = 3.73, p < .05. Exploramos los resultados, implicaciones y áreas para investigaciones futuras.     

Postpartum Depression Among Women With Disabilities: A Multicultural Counseling Perspective

Postpartum depression is an important mental health problem for women, and women with disabilities are at greater risk than are women without disabilities. This article explores the disability‐specific contextual, environmental, social, and systemic causes of postpartum depression from an ecological perspective. I aim to help counselors develop a nonpathologizing, multicultural counseling–rooted approach and to prepare counselors to work effectively with this unique population. Implications of multicultural counseling tenets and advocacy are also examined for best practices. La depresión posparto es un problema de salud mental importante para las mujeres, y el riesgo es mayor para las mujeres con discapacidades que para las mujeres sin discapacidades. Este artículo explora las causas contextuales, sociales, del entorno y sistémicas de la depresión posparto relacionadas con la discapacidad desde una perspectiva ecológica. Mi objetivo es ayudar a los consejeros a desarrollar un enfoque no patológico basado en la consejería multicultural y preparar a los consejeros para trabajar de forma efectiva con esta población singular. También se examinan las implicaciones de los principios de la consejería multicultural y la defensoría para las prácticas recomendadas.     

Archetypes of the pandemic

This paper attempts to read the psychological and emotional impact of the COVID-19 pandemic through the archetypal images contained in patients’ dreams. In these dreams, symbols related to the power of nature and to extreme danger are paired with feelings of detachment that seem to point to a traumatic dissociation, due to the archetypal experience that erupts in familiar surroundings. Through the humanization of the ineffable experience, dissociation, which in the beginning of the pandemic showed in high levels of anxiety, panic attacks and depersonalization, can be transformed into the overview needed for the search for meaning. The container for this process of transformation is the analyst, the real, virtual or imagined one, and his or her ability to relate and feel.     

What,After All,Is the Work of Culture?

This paper offers an overview of Joseph Margolis’s philosophy of culture, highlighting how Margolis’s radical historicism is not inconsistent with our realistic intuitions regrading facts and objectivity. While Margolis identifies interpretation as the work of culture, the paper suggests that a much more basic sense of human labor needs to be thematized more fully than Margolis does in any defensible account of culture. Margolis of course appreciates work in this sense, but he does not consistently make it integral to his conception of culture. Even so, what he so forcefully defends is, as one commentator has put it, “beautiful. It’s also erudite, elegant, and insightful (and frightfully, dialectically intricate).”