Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA)

This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA) — a self-report instrument for use with 8– to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use).     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

One size doesn't fit all: Full inclusion and individual differences

Recent studies have documented the increasing trend among school districts toward adopting full inclusion as the predominant model for serving students who qualify for special education services. Although these data may suggest that a paradigm shift has already taken place and that a consensus of opinion has been achieved, several organizations representing students with specific disabilities continue to support a continuum of placement options. This paper challenges a one size fits all approach to special education, and highlights the importance of considering the individual characteristics of students. The relevance of research on full inclusion, as well as methodological issues that limit generalizability of findings related to student outcomes, are discussed. The radical perspective of full inclusion is rejected in favor of an approach that emphasizes the complexities of placement decisions.     

Family-centered intensive case management: A step toward understanding individualized care

New York State's initial attempt at individualizing services occurred within the context of an experiment. We randomly assigned children 5–12 years old who were referred for out-of-home placement in treatment foster care to either treatment foster care, Family-Based Treatment (n=15), or to Family-Centered Intensive Case Management (FCICM) (n=27). FCICM used teams of case managers and parent advocates to provide in-home services. Flexible service dollars, respite care, and behavior management skills training were available to assist teams in individualizing care. Preliminary outcomes indicate that children in FCICM are doing as well or better than children assigned to FBT in their functioning and symptom reduction. Parents of children in FCICM have made gains, although not at a statistically significant level, in behavior management skills and family strengths that allow them to provide care for their children at home.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

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.     

The Performance Diagnostic Checklist-Human Services: A brief review

The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to identify the variables contributing to poor employee performance in human service settings, such as clinics, schools, and residential facilities. Upon completion of the tool, an intervention indicated by PDC-HS results is used to improve employee performance. To date, the PDC-HS has been used in a number of studies. This review describes the existing research on the PDC-HS and provides suggestions for future research.     

The typology of parricide and the role of mental illness: Data-driven approach

Parricide is a rare type of homicide in which mental illness is often an important factor. The aims of this study were (a) to describe the characteristics of parricide offenders with a focus on mental illness and clinical care and (b) to examine Heide's widely used typology of parricide through a data-driven approach. We analyzed all homicides in England and Wales between 1997 and 2014. Parricide offenders in our sample were most often male, unmarried, and unemployed, with a third of offenders diagnosed with schizophrenia; 28% had been in contact with mental health services before the offense. The latent class analysis resulted in three types of parricide offenders: middle-aged with affective disorder, previously abused, and seriously mentally Ill, which confirmed, to an extent, Heide's typology. Health and social care services should actively engage with carers of people with mental illness and support to those caring for older relatives and victims of abuse.     

心理健康服务的文化胜任力：理论取向与实践策略

心理健康服务的文化胜任力随着欧美对多元文化群体的重视而逐渐发展起来。该领域存在两种不同的理论取向及相应的实践策略。内容取向关注静态的、结构化的文化胜任力; 过程取向则关注动态的、非结构化的文化胜任力。两种取向的异同体现了文化胜任力的研究和实践中对文化特异性和普遍性因素的平衡。在此基础上, 本文最后讨论了如何参考国外经验, 立足中国现实问题和加强社会心理服务体系建设的大背景, 来发展中国的文化胜任力。