Ethnic variations in the initial phase of mental health treatment: a study of Sami and non-Sami clients and therapists in northern Norway

Several studies indicate that mental health and mental health service vary with ethnicity. Ethnically linked social differences affect these results. We examined the multiethnic population in northern Norway where social inequalities between the Sami and the non-Sami population are not prominent. Clients (N=347) and therapists (N=32) in outpatient treatments reported demographics, ethnicity and the therapeutic alliance. Clients also reported pretreatment psychosocial status, service utilization and the type of help requested. Therapist recorded clinical and diagnostic assessments and treatment plans. The Sami and non-Sami client groups were similar in demographics and pretreatment psychosocial characteristics. However, the therapists prescribed more sessions and more socially focused interventions when clients were Sami. Verbal therapy was more often used by the non-Sami therapists. Alliance ratings were positively correlated only between Sami therapists and their clients, and Sami therapists rated the largest initial clinical improvement. Clinics located in the high Sami density areas offered their clients more therapy sessions, than in clinics in the high non-Sami density areas. Ethnic similarity between client and therapist were associated with more frequent use of medication and less frequent use of verbal therapy.     

Hypochondriasis Among Patients with Multiple Somatoform Symptoms—Psychopathology and Outcome of a Cognitive-Behavioral Therapy

As hypochondriasis often occurs with somatization, patients with somatization disorder plus hypochondriasis were compared to patients with somatization syndrome alone regarding psychopathology, patterns of physical symptoms and outcome of a cognitive-behavioral inpatient treatment. A sample of patients with DSM-IV hypochondriasis and multiple somatoform symptoms(N = 27) and a matched sample of patients with multiple somatoform symptoms but without hypochondriasis (N = 27) were assessed. All subjects obtained a cognitive-behavioral treatment for somatization and hypochondriasis. Assessment took place at admission and at one-year follow-up. Only a few differences between the groups were found: Hypochondriacs suffered more often from abdominal pain, and they reported a higher intolerance of bodily complaints. At follow-up, all outcome variables improved significantly. High effect sizes were found for the reduction of symptoms and the mean number of visits to the doctor. The specific effect on health care use highlights the socioeconomic relevance of these results.     

Outcomes for Children and Adolescents After Residential Treatment: A Review of Research from 1993 to 2003

The focus of this research review is to determine what factors increase the likelihood that positive individual and systemic changes occur for children and adolescents following discharge from residential treatment. Residential treatment outcome studies from 1993 to 2003 that fulfilled predetermined criteria were located through 4 on-line databases using key word combinations. The research selected was: (a) 7 studies that measured outcome immediately upon completion of treatment and discharge, and (b) 11 studies where outcome progress was assessed at one or more follow-up dates after discharge. Results showed that children and adolescents with severe emotional and behaviour disorders can benefit and sustain positive outcomes from residential treatment that is multi-modal, holistic and ecological in its approach. Similar to the clinical child psychotherapy research, conclusions must be tempered due to the limited number of studies and methodological weaknesses. Future considerations highlight how research results can more realistically reflect intervention effectiveness when elements of the ecological and systemic landscape of care are addressed.     

Parenting Competency Across Pregnancy and Postpartum Among Urban Minority Women

Taking a life-course perspective, we explored the sense of parenting efficacy during the pregnancy-postpartum transition among a group under-represented in much of adult developmental research, minority women. Our intent was to describe the women's report of parenting competency in a major life transition occurring within the context of an impoverished urban environment. We also explored associations with depression, social support, and life events. One hundred and eighty-two African-American and Hispanic mothers at community health centers in low-income urban areas completed measures early in the third trimester and again at 3 months postpartum. Across time, the levels of reported parental efficacy and satisfaction increased while depressive symptoms decreased. Negative life events and levels of depressive symptomatology differentially influenced women's experience of parenting satisfaction and efficacy feelings before and after their babies were born.     

Mental Health and Other Service Use by Youth in Therapeutic Foster Care and Group Homes

Little is known about what additional services youth receive while they reside in out-of-home treatment settings. However, such information may be crucial for explaining effectiveness and variation in outcomes for youth in such settings. Our research examines patterns of multi-sector service use for youth in two settings—Therapeutic Foster Care and group homes. Data come from in-person interviews with Treatment Foster Parents and Group Home Staff for a NC state-wide sample of youth with psychiatric disorders and aggressive behavior. Findings indicated high rates of service use by youth in both settings. Analyses indicated significant differences in service types used by youth in each setting, yet similar volume of service use between settings. Clinical and demographic factors did not significantly influence types of services received. Differences in service patterns between the two groups indicated that youth in TFC were more likely to receive community-based, individualized services while youth in group homes were more likely to receive more restrictive services.     

Convergence of Sibling Risk Among Children of Parents with Serious Mental Disorders

We examined child psychiatric diagnoses, behavioral problems, overall symptom impairment, global psychological functioning, intellectual ability, and adaptive behavior in 83 sibling pairs whose mothers were diagnosed with a serious mental disorder. Sibling pairs were assessed for the extent to which they converged on the presence or absence of risk on each adverse outcome and then examined under conditions of high vs. low/moderate family stress. Consistent with the study hypotheses, we found that on each outcome assessed there was evidence for sibling convergence of risk. In addition, family stress was found to significantly moderate sibling risk convergence. The results are discussed in terms of their implications for understanding sibling convergence of risk in these families and for clinical and preventive intervention.     

Biofeedback treatment of paradoxical vocal fold motion and respiratory distress in an adolescent girl

In this investigation, we evaluated the effectiveness of surface electromyography (EMG) biofeedback to treat paradoxical vocal fold motion in a 16-year-old girl. EMG biofeedback training occurred once per week over the course of 10 weeks. In a changing criterion design, muscle tension showed systematic changes that corresponded with changes in the criterion. Overall, baseline muscle tension levels were reduced over 60%, with corresponding reductions in episodes of respiratory distress and chest pain. Subjective reports by the patient and the patient's mother indicated improvements in school attendance and overall adaptive functioning.     

Risk and Resiliency Factors Influencing Suicidality Among Urban African American and Latino Youth

For decades, suicide rates among minority African American and Latino young people have been stable and, when compared with Whites, relatively low. This is no longer the case, underscoring the need for documenting and understanding the problem of suicidality in this population. We report on the prevalence and predictors of suicidality among 879 urban adolescents in the Reach for Health study. All youth resided in economically disadvantaged neighborhoods; 69% were African American, 16% Latino, and 15% reported mixed or other ethnicity. In the past year, 15% had seriously considered suicide; 13% had made a suicide plan, 11% had attempted suicide at least once, and 4% reported multiple attempts. Risk factors significantly related to suicidal ideation are being female, having basic needs unmet, engaging in same-gender sex, and depression. Resiliency factors include family closeness and, marginally, religiosity. Risk factors related to reports of suicide attempts are being female, being Hispanic, and depression; family closeness is strong resiliency factor. Family composition, ethnic identity, coping style, peer support, and school attachment are not significant correlates of suicidal ideation or attempts.     

School Entry After a Community-Wide Trauma: Challenges and Lessons Learned from September 11th, 2001

The purpose of this paper is to describe the implementation of a school-based trauma-specific mental health program in New York City following the terrorist attacks on September 11, 2001. This program aimed to serve children most at risk for developing mental health problems as a result of physical proximity (e.g., evacuation from schools surrounding the World Trade Center) to the trauma. As we present the components of the program, we will review the literature that guided our decision making. The ongoing struggle between searching for answers from established science and immediate needs in a crisis is highlighted. Lastly, a discussion of the lessons learned and recommended next steps is presented.     

大学生心理健康教育教学模式的构建与实践研究

采用自然教学实验法,探索提高大学生心理健康水平的有效途径与教学模式。结果表明（1）开设心理健康教育课程并辅以心理咨询是眼下提高大学生心理健康水平的有效措施之一;（2）不同系科心理健康教育的效果不同,心理健康教育课程应根据学生的个别差异有针对性地进行;（3）大学生心理健康教育课程的教学模式为“面上集中释疑,线上互相解疑,点上个别辅导”。