Adolescent Satisfaction with School-Based Mental Health Services

Examining adolescents' satisfaction with mental health services is an important program evaluation activity. Their perceptions of whether services were beneficial and resulted in improved functioning are indices of treatment quality. Assessment of adolescent satisfaction with school-based mental health programs has been limited. In our study, adolescents receiving services from a School Mental Health Program (SMHP) completed satisfaction surveys. Participants were predominantly minority youth residing in an urban area. Results indicated that students were highly satisfied with their mental health services. Students valued the therapeutic relationship, catharsis associated with therapy, and skills they learned during therapy. Several factors influenced satisfaction ratings including clinician training and availability.     

Sensitivity to Levels of Importance in the Logical Memory Subtest

The performance of Alzheimer's disease (AD) and neuropsychiatric patients was examined using the Logical Memory (LM) subtest of the WMS-R, utilizing a levels of importance methodology described by Haut et al. (1990). Although patient groups were matched for dementia severity, we found the expected differences between groups in terms of absolute level of performance. There was considerable variability, however, in the AD patients' performance. AD patients' recall and sensitivity to levels of importance depended on the story (Anna or Robert), and when the passages were recalled (immediate or delayed recalls). Results suggested that AD patients were able to utilize semantic information in their immediate recall, though this was dependent on individual story characteristics. AD patient's delayed recall was essentially absent. Thus, no conclusions could be drawn with respect to the level of importance factor. NP patient's recall performance was similar to patterns observed in other clinical samples for both immediate and delayed memory.     

Book Reviews

Aronson, Ronald After Marxism
Chambliss, William J. and Zatz, Marjorie S. (Eds) Making Law: The State, the Law, and Structural Contradictions
Kirschner, Don S. Cold War Exile: The Unclosed Case of Maurice Halperin
Earle, Robert L. and Wirth, John D. (Eds) Identities in North America: The Search for Community
Dunn, Susan The Deaths of Louis XVI; Regicide and the French Political Imagination
Brothers, Barbara Jo Peace, War and Mental Health
Singer, Margaret Thaler with Lalich, Janja Cults in Out Midst
Smith, Craig Allen and Smith, Kathy B. The White House Speaks: Presidential Leadership as Persuasion
Renshon, Stanley A. High Hopes: The Clinton Presidency and the Politics of Ambition     

Insurance Coverage and Mental Health Service Use by Adolescents with Serious Emotional Disturbance

This paper examines the relationships between insurance coverage, need, and mental health services in a community-based sample of 1,015 youths who were 9, 11, and 13 years old at the beginning of the study. They were followed over a two-year period. A strong measure of need based on a standardized diagnostic interview was available and repeated over three annual waves. Data on service use was collected quarterly across two years. Major findings included: (a) high need (serious emotional disturbance [SED]) was strongly related to use of any mental health services; (b) services use was much more likely to occur with public (Medicaid) insurance coverage than either private or no insurance; (c) considerable unmet need was observed even for youths with SED; (d) school-based mental health services potentially substituted for professional mental health services; and (e) there was little unnecessary use of mental health services in the low need group. The major policy implication of these findings is that the regulation of insurance benefits should be based on level of need, rather than on arbitrary limits which are likely to either reduce the probability of or appropriate amount of care for youths who most need mental health services.     

An Examination of Race Differences in Patients' Psychological Adjustment to Cancer

Although African Americans are at increased risk of cancer morbidity and mortality, very little is known about their psychological adjustment. African American males may be at especially high psychological risk, considering their disproportionately higher cancer mortality. Subjects were 42 African American and 56 White adults similar in age, cancer stage, marital status, and socioeconomic status. Analyses revealed no significant race or gender effects on global indices of psychological adjustment, depression, or anxiety. However, African Americans were more likely than Whites (a) to use avoidant coping strategies in dealing with the exigencies of their illness, (b) to report more cancer-related disruption in family relations, and (c) to identify fewer individuals in their social support network. No significant race differences were found on a measure of health care satisfaction. These findings highlight the need to provide a more comprehensive examination of individual, family, and socioecological variables and their relationship to psychological adaptation among minorities with cancer.     

Overt and covert antisocial behavior: Child and family characteristics among psychiatric inpatient children

The present study examined child and family characteristics associated with overt and covert antisocial child behaviors. Child psychiatric inpatients (N=258, ages 6–13) were identified as high in overt and/or covert antisocial behaviors (e.g., aggression and stealing, respectively) based on a structured parent interview measuring antisocial behavior. Children were classified into four groups derived from the factorial combination of level of overt (high vs. low) and covert (high vs. low) antisocial behaviors. Analyses were made of the children's reactions to hostile and anger-provoking situations, deviant and prosocial child behaviors at home and at school, and family structure and organization. Children higher in overt antisocial behaviors were more negative, resentful, and irritable in their reactions to hostile situations and more aggressive at school. They came from families with significantly greater conflict and less independence among family members. Children higher in covert antisocial behavior participated in fewer social activities and were higher in anxiety; their families showed significantly lower family cohesion and organization and less of an emphasis on moral-religious values. The results suggest reliable differences in child and family functioning as a function of patterns of overt and covert antisocial behavior.     

EVALUATION OF A SOCIAL INTERACTION COACHING PROGRAM IN AN INTEGRATED DAY-CARE SETTING

We used a multiple baseline design across teachers (with a reversal phase for 1 teacher) to evaluate the direct and indirect effects of a structured coaching procedure on the teaching behaviors of 3 day-care teachers. Structured coaching preceding daily caregiver routines resulted in (a) substantial increases in adult delivery of behavioral support of social interaction during group activities with 2- and 4-year-old children and (b) marked collateral increases in positive interactions of socially withdrawn children. Long-term maintenance effects were demonstrated by both the teachers and target children, and social validity measures indicated that the teachers rated coaching very positively on several dimensions. The results are discussed in relation to in-service training of day-care staff, the concept of coaching as a setting event, and the dissemination of teaching technology related to social interaction of young children.     

Changes in behavioral problems and prosocial functioning in child treatment

Decreasing emotional and behavioral problems and increasing prosocial functioning are two ares of interest in child treatment. The present study examined the extent to which changes in deviant behavior were associated with changes in prosocial functioning. Three separate samples of children (N = 393, ages 6–13) referred to inpatient or outpatient services were evaluated by parents and teachers on three separate assessment occasions spanning 1–2 years. The major findings indicated that behavioral problems and prosocial functioning and changes in behavioral problems and prosocial functioning over time showed low to moderate negative correlations for parent and teacher evaluations. These relations were consistent across separate time periods, samples of children, and parent and teacher ratings. The magnitude of the correlations between behavioral problems and prosocial functioning indicated that these domains are related but represent relatively independent spheres of child functioning. The importance of assessing both domains of functioning in evaluating children and treatment outcome is discussed.     

VIDEO-BASED TRAINING OF RESPITE CARE PROVIDERS: AN INTERACTIONAL ANALYSIS OF PRESENTATION FORMAT

We conducted two studies to evaluate a video-based instructional package for training respite care providers and the role of presentation format (viewing the videotapes alone, with a partner, and with structured group training) as a contextual variable. In Study 1, the results of a within-subjects Latin square design nested within a multiple baseline showed that performance during simulated (role-played) respite care situations improved in five of the six skill areas for the 12 trainees following presentation of the videotape, with no differences between presentation formats. Correct responding generalized to respite care situations involving a developmentally disabled child, and in most cases, acquired skills were maintained for up to 6 months. In Study 2, we conducted a clinical replication of Study 1 under conditions more closely approximating those in which the training program would be implemented by respite care agencies. Results of the between-groups analysis were consistent with the findings of Study 1.     

Effects of day care and maternal teaching on child educability

Two groups of matched mother-child pairs, a day care sample (N = 38) and a home reared sample (N = 38) participated in a study testing mothers for degree of decentred teaching and children for degree of decentred educability. The children were seven years old. Mother and child were tested in separate settings, thus preventing interdependency among scores. The study used a matched-pair design with control of five background variables; age of the child, mother's educational level, mother's occupational status, family SES level, and type of family. The results showed strong positive effects of both day care experience and maternal teaching on child educability. Day care experience improved the educability of children independent of the mother's teaching strategy and gender of the child.