“Nothing About Me, Without Me”: Participatory Action Research with Self-Help/Mutual Aid Organizations for Psychiatric Consumer/Survivors

Participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors is reviewed. We begin by tracing the origins of and defining both participatory action research and self-help/mutual aid. In so doing, the degree of correspondence between the assumptions/values of participatory action research and those of self-help/mutual aid for psychiatric consumer/survivors is examined. We argue that participatory action research and self-help/mutual aid share four values in common: (a) empowerment, (b) supportive relationships, (c) social change, and (d) learning as an ongoing process. Next, selected examples of participatory action research with psychiatric consumer/survivor-controlled self-help/mutual aid organizations which illustrate these shared values are provided. We conclude with recommendations of how the key values can be promoted in both the methodological and substantive aspects of future participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors.     

Parent Satisfaction with Case Managed Systems of Care for Children and Youth with Severe Emotional Disturbance

Case management has emerged as an integral component of current efforts to reform the delivery of mental health services to children and youth with Severe Emotional Disturbance (SED). We examined parental satisfaction with one program's case management system for SED children. In order to validly address parental satisfaction, the program first turned to a group of its parents to develop a satisfaction measure, the Family Satisfaction Survey (FSS). Of the 51 parents who returned an FSS, 74% of the parents were generally satisfied while 26% indicated that they were dissatisfied with their families' case management services. Multivariate regression analyses were employed to examine the role played by client, service, and outcome variables in predicting parental satisfaction. After controlling for child diagnoses, severity of impairment, and levels of psychosocial stress, parent satisfaction with case management services was best predicted by the frequency of monthly contact and fewer days is a psychiatric hospital proportional to length of service. Our results suggest that parent satisfaction is based not only on what case managers do but on how this service impacts SED children's ability to remain at home and in their communities.     

The Client Cultural Competence Inventory: An Instrument for Assessing Cultural Competence in Behavioral Managed Care Organizations

The rapid growth in Behavioral Managed Care Organizations has led to increasing concern about the future availability of culturally competent mental health services for ethnic minorities. Prior efforts to assess cultural competence of mental health services have focused exclusively on agency providers and individual mental health professionals rather than on clients' perceptions of care. We introduce the Client Cultural Competence Inventory, which has several advantages over other cultural competence measures including its (a) lower susceptibility to social desirability bias, (b) ability to assess attitudes concerning a broader range of therapists, providers and plans, and (c) focus on clients rather than the psychiatric community as the central force in determining cultural competence. Preliminary psychometric analyses of the inventory are presented from data gathered in a group of parents with children who are severely emotionally disturbed.     

Family-Based Intervention with High-Risk Infants and Their Families

A model of family-based intervention for high-risk infants hospitalized in the neonatal intensive care unit and their families is presented. The theoretical underpinnings, principles, and nature of the intervention are described. The adaptation of the model from a clinical–research demonstration project to a clinical consultation service is highlighted, with particular emphasis on the practical application of the model. Domains of the intervention include infant behavior, family organization and functioning, caregiving environment, and home discharge/community resources. Three case illustrations are provided to demonstrate the breadth of the intervention and how it can be individualized based upon the presentation of the infant and family.     

中学生心理健康量表编制研究

本文阐述了正常人心理健康的内涵,提出以认知正常、情感协调、意志健全、个性完整和适应良好等五个心理健康维度来衡量中学生的心理健康水平。采用自陈量表编制原理和问卷调查分析法,编制了具有较高效度和信度的中学生心理健康量表,并随机抽取有代表性的中学生样本（ｎ＝１２４８）,制定了上海常模。对开展中学生心理健康与素质教育具有理论和实践上的指导意义。     

高中生心理健康水平及其影响因素的研究

采用ＳＣＬ－９０量表评定了５００名高中生的心理健康状况,运用因素分析的方法探讨了影响高中生心理健康的主要因素。结果表明：有１０．８％的高中生存在着各种明显的心理健康问题;高中生的心理健康问题主要表现为强迫、敌对、偏执、人际关系敏感和忧郁等症状;影响高中生心理健康的主要因素为学校教育、家庭环境、社会文化及学生自身等方面的生活事件;高中生不同的心理健康问题有其不同的影响因素。     

Practice variability in prenatal genetic counseling

This study demonstrated that the content of prenatal genetic counseling sessions varied from counselor to counselor and from center to center. The study was designed to examine which specific issues were included by genetic counselors in prenatal genetic counseling sessions, and to determine which factors led genetic counselors to include or exclude this information from such sessions. Data were collected by randomly surveying 200 full, master degree members of the National Society of Genetic Counselors (NSGC). Respondents provided information by deciding which of 45 specific issues they would include in a standard prenatal genetic counseling session, and which one factor from a bank of 11 factors most accurately described the reason for this decision. The results indicated that the issues included/excluded from sessions varied widely among genetic counselors. The results also indicated that Patient Education/Informed Decision Making (34.5%) played the largest role in decision making overall, with Standard at Center/Departmental Policy (17.6%), Personal Experience/Preference (12.4%), and Applicability (10.9%) serving as the next three most important reasons for including or excluding issues from prenatal genetic counseling sessions.     

Infant food refusal and parental social support

The purpose of this study was to examine the relations between various aspects of social support and maternal and infant outcome variables in a group of families having infants showing food refusal compared to a control group. In the case of early food refusal, the results indicated that access to emotional support and satisfaction with support were related to maternal psychosomatic health. The relationships were interpreted as showing that social support has moderating effects on negative outcomes of food refusal.     

ALTERING SHOPPERS' SUPERMARKET PURCHASES TO FIT NUTRITIONAL GUIDELINES: AN INTERACTIVE INFORMATION SYSTEM

This study reports the results of one effort to help supermarket shoppers alter food purchases to make purchases (and meals) that are lower in fat and higher in fiber. A prototype interactive information system using instructional video programs, feedback on purchases with specific goals for change, weekly programs, and the ability to track user interactions and intended purchases was evaluated. The major dependent measure was users' actual food purchases as derived from participants' highly detailed supermarket receipts. After a 5- to 7-week baseline phase, participants were randomly assigned to an experimental or control condition for the 7- to 8-week intervention phase. A follow-up phase began 5 to 8 weeks after participants completed the intervention and discontinued use of the system. The results indicated that experimental participants, when compared to control participants, decreased high fat purchases and increased high fiber purchases during intervention, with evidence for some maintenance of effect in follow-up. Plans for increasing the use and impact of the system are discussed.