Community Mental Health Journal Volume 2, Number I, Spring, 1966
CURRENT ISSUES IN M E N T A L H E A L T H PLANNING
ELIZABETH REICHERT SMITH, P~.D.*
Resolution of some of the issues identified by communities in planning comprehensive community mental health services is critical to movement from the planning stage to program development and operation. These issues relate both to the relationship of the local mental health system and to other major community systems: e.g., the general health system, the anti-poverty program and multijurisdictional political systems, and to the interrelationships of certain component parts within the mental health system itself, (including the private practice sector of psychiatry and other areas of medicine) delimited mental health services offered by voluntary agencies, the state mental hospital system, nonpsychiatric agencies, and the "gatekeepers." Specific reference is made to solutions proposed for the District of Columbia.
represents a unique adaptation of the national mental health program to the local scene. In the process, a number of issues which are crucial to effective local adaption of the national mental health program have been highlighted. These are crucial to both mental health professionals and community citizenry. The issues discussed here are those which, while being of common concern, have special relevance to planning efforts in the District of Columbia. Some of these have not yet attained satisfactory resolution. The critical issues involved seem to fall into at least two major groups: those which involve relationships among the several essential parts of a comprehensive and community-oriented mental health system; and those which involve the relationship between this total system itself and other
All across the country, states are putting finishing touches on plans for comprehensive mental health services. These plans were stimulated by two-year federal grants which terminated June, 1965. For some states, this planning has been considered a one-time affair. In other jurisdictions, mental health planning staffs have achieved an integral position in their state organizations. They have been charged with continuing responsibility for identifying developing mental health needs and for detailing proposals for meeting these in ways which take cognizance of community attitudes and resources. In essence, the planning has involved each state and its local communities in the development of a proposal for comprehensive mental health services which, in recognizing local needs, attitudes, and potentials,
*Dr. Smith, a nurse, was Senior Mental Heahh Planner, Division of Planning, Research, and Statistics, Washington, D.C., Department of Public Health. She is presently Chief, Office of Community Mental Health Program Development, D. C. Department of Public Health. 73
74
THE COMMUNITY MENTAL HEALTH JOURNAL
community-wide social and political systems. This dichotomy, while useful in considering some of the particular issues, is frequently obliterated at the local community level. ESSENTIAL LIAISONS Current planning for community mental health programs, especially with its focus on primary and secondary prevention, necessitates the elaboration of a system which is far more comprehensive in its components than was previously the case in programs focusing primarily on direct psychiatric treatment services. President Kennedy himself challenged psychiatry to reintegrate itself in a meaningful way within the totality of modern medicine. This is actually but one of a number of essential liaisons with which existing traditional psychiatric services must establish highly coordinated relationships if a unified system of comprehensive mental health services is to be the outcome of mental health planning.
The Relationship with the Private Practice Sector o] Medicine Physicians constitute a major resource in any community for developing, supporting, and exercising leadership in the utilization of a planned system of mental health services. Without such involvement and support, no plan could mature into successful operation. Involvement and support of psychiatric and nonpsychiatric physicians requires that they be assured a role which they view as appropriate and meaningful. Their usual diagnostic, therapeutic, supervisory, and referral functions must be related relevantly to the total mental health effort. Access of those patients ordinarily treated by private practitioners to the services of mental health centers will require clarity of policy and procedures which support a continuing relationship between the private practioner and his patient. In the District of Columbia a policy has been established that patients, on their first contact with the center through the diagnostic and referral service, will be questioned as to previous psychiatric care,
including any from private psychiatrists. Those who have been under private care will generally be referred back to their own physician. Patients who have not been under private care previously, but for whom this is deemed appropriate, will be referred for private care if possible. Patients under care of private psychiatrists will be considered for care in the mental health center on referral from the psychiatrist. Although such patients become the responsibility of the center, private physicians are encouraged to continue to see their patients while they are in intensive, day or night care treatment programs. When such patients have been reviewed by the diagnostic and referral service and assigned to treatment in one of the components of the center, the private physician will be so notified. A discussion will be held between the private physician and the senior physician on the service to which the patient has been assigned in order to establish the role which the private physician will play in the treatment program of the patient. Whenever appropriate, the private psychiatrist may continue the treatment of his patient in the center. When such patients are ready for discharge from the center, a decision as to the indicated follow-up care should be made jointly by the private physician and the responsible center psychiatrist. In support of this policy, all patients who are financially able will be expected to bear the full cost of care and treatment in a mental health center. It is hoped that with clear interpretation and proper implementation of these policies, local physicians will participate actively in the mental health center program and will constitute a major referral source.
Integration o] Psychiatric Services Much of what has been said about the essential involvement of private physicians in the mental health system applies also to voluntary agencies offering psychiatric services. The mechanisms of contract and cosponsorship have been used in the District of Columbia to assure responsible roles to voluntary services: the D. C. Department of Public Health contracts with voluntar)
ELIZABETH REICI-IERT SMITH
general hospitals for in- and outpatient psychiatric services; the D. C. Department of Vocational Rehabilitation contracts for services of private physicians; and the D. C. Department of Public Welfare contracts for psychiatric residential care for selected children and adolescents. In a recent development the D. C. Department of Public Health and Georgetown University Department of Psychiatry have collaborated in the establishment of an adolescent psychiatric clinic. The greatest difficulty occurs in those situations in which a publicly operated mental health center seeks to assure a meaningful role in the total mental health program to a voluntary agency whose function is essentially identical to a service of the mental health center itself. In our experience, family agencies clearly fall into this category; the determination to assign a client to the social work staff of the center or to refer him to a family agency is often difficult to make in practice.
The integration o] the State Mental Hospital In planning a total program, a plan of participation must be defined for the state mental hospital which fosters continued quality staffing and educational and training potentials. This is only possible if the state hospital continues to admit a wide variety of patients for care and treatment. This condition appears most readily achievable through the establishment of a mental health center program within the state hospital itself. Fortunately for many states, growth and shifts of population have placed some mental hospitals, originally intention. ally isolated from the community, in locations convenient for community use. Some states have reorganized the state hospital into sections aligned with specific geographical subdivisions of the territory served by the hospital; where the distance is not too great between a mental health center and a state hospital division, each of which serves the same population, the unification of the two staffs may enhance the stail~ng and training potential of each and promote continuity of patient care.
75
The Essential Participation o] a Wide Variety o] Nonpsychiatric Agencies and Workers The reorientation of emphasis from direct treatment services and rehabilitation to primary and secondary prevention necessitates co-equal participation, not only of nonpsychiatric health workers, but also of educators, clergymen, welfare workers, union counselors, child care workers, police, courts, correctional, probation, parole workers, and many others, with psychiatric professionals if long range goals are to be pursued. Basically, the goals of the mental health program can only be achieved to the extent that these workers have a major impact on human capacity for dealing effectively with stress. Most mental health plans have spelled out in some detail how these "gatekeepers" might be helped to do a better job. However, little thought has been given to the essential identity of mutually shared goals and of the necessary contribution of each area of activity. Consultation to them is invaluable; what of their consultation to mental health professionals? In recognizing the interaction of the individual and his personal social environment, daily decisions are made as to when and how to strengthen the individual's ability to cope with his environment; when and how to manipulate the environment so that the individual is competent and comfortable in dealing with it. A variety of nonpsychiatric workers understand the various worlds of people far better than do professionals and have skills to apply to them which are highly developed. RELATIONSHIP OF SYSTEMS
A second area of critical concern in developing and implementing comprehensive community mental health programs involves the relationship of the local mental health system to other major systems. Illustrative of these issues are:
The Mental Health System and the General System o] Health Services A comprehensive program of mental health services must be structured to fit
76
THE COMMUNITYMENTALHEALTH JOURNAL
into the overall pattern of health services in the particular community. The local organizational structure of public health and medical care; the extent to which public agencies develop, operate, or contract for medical services for all or specified segments of the community population; the extent and adequacy of health facilities; the economic, educational, and professional base for health services; and the community's attitudes and interests in health and modes of utilization of health services, all constitute dimensions of a broad pattern of health services within which the mental health program must be logically developed. In the District of Columbia, the Public Health and Mental Health authority are unified in the Director of the D. C. Department of Public Health. In addition, extensive inpatient and outpatient programs of medical care involving the municipal hospital, the hospital for tuberculosis and chronic disease care, an elaborate network of specialized clinics and of public health nursing services, are sponsored by the D. C. Department of Public Health. This arrangement facilitates the development of a comprehensive mental health center program under public health auspices. These relationships have been further promoted through the development of the mental health center as one major component of a community health center which will offer, in addition to mental health services, services to the mentally retarded and a broad range of traditional public health services, e.g., maternal and child health services, venereal disease control, tuberculosis control, public health nursing, etc. In addition, the historic involvement of the three local medical schools, and other educational agencies preparing health personnel, in most components of the total public health program, provides the model for similar relationships in developing segments of the total mental health plan.
The Relationship to Other Community Programs The development of other community programs focusing on the population served by the mental health program gives
rise to the need for meaningful integration of the several programs. In the District of Columbia, a major anti-poverty approach involves the establishment of neighborhood development centers and youth opportunity centers. In some instances, these have been developed within the context of ongoing community organizations such as settlement houses; in other instances, they have developed as separate anti-poverty activities. Similarly, the District of Columbia mental health plan proposes extensive decentralization--not only of preventive services but also of appropriate diagnostic, treatment, and rehabilitation services--into settlement houses, church basements, and rented space. Timing, administrative lines, and committed space affect the possibility of co-locating these activities for their mutual nurture as well as the convenience of their clients.
Metropolitan-wide Planning A third issue of context arises in those metropolitan communities which encompass two or more political jurisdictions, especially when the jurisdictions involved are states. Funds for mental health planing were allocated by state; use of mental health center construction money involves the development and approval of state mental health construction plans, a procedure essentially similar to that for using Hill-Burton monies. This is a knotty problem, which, in the case of the Washington metropolitan area, has not been fully resolved. The Washington metropolitan area indudes the District of Columbia which constitutes its central-core, two counties of Maryland, and two counties and two independent cities of Virginia. One-third of the population resides in the District of Columbia, two-thirds in the suburban area. Like other central areas of large cities, the District's functions include providing places of employment, low income housing, specialized wholesale and retail activities, and, most importantly, serves as a medical center for the total metropolitan area. As such, considerable demands are made on all District of Columbia medical resources,
ELIZABETH REICHERT SMITH
especially physicians in private practice, voluntary hospitals, and other voluntary health and welfare agencies. This is, of course, taken for granted. However, difficulties arise when planning for local community mental health services. The establishment of priorities for the development of new centers, if based principally on absolute need and lack of existing facilities, may result in a very low priority to those portions of Maryland and Virginia which constitute suburban Washington. Yet the program emphasis on community based resources is undermined by increasing the geographical bases of the District of Columbia mental health centers to encompass the entire metropolitan area. CONCLUSION These issues have been crucial in mental health planning and will continue to exercise considerable impact as preliminary planning moves into program development and operation. How each of these issues are resolved will define in many aspects orga-
77
nizational, administrative, and basic program structure of the local mental health system. It is axiomatic that, to the extent that the comprehensive mental health plan projects change from the system traditionally operative in the local community, change of responsibility, relationship, method, and prerogative of the many categories of workers in the mental health system will necessarily follow. Since the manner in which resolution is achieved may be as varied as the many local communities, it is difficult to anticipate the precise impact on the roles of the involved professionals. Such change is almost always difficult especially, when it is achieved through much experimentation and when its precise outcome cannot be foreseen. This will require creativity, flexibility, and patience and will, at the same time, offer the opportunity of a professional lifetime---to play a leadership role in demonstrating new concepts in the prevention, treatment, and care of mental illness, as local communities move from planning to the reality.
New Books for Spring THE ABNORMAL PERSONALITY THROUGH LITERATURE by Alan A. Stone, M.D., Director of Resident Education, McLean Hospital, Mass., and Sue S. Stone. Mental disorders and symptoms selected from literature----each type of disorder presented in this unusual collection is illustrated in a vivid and creative manner. January 1966, 423pp., paperbound, $4.50
PSYCHOPATHOLOGY OF CHILDHOOD by Jane W. Kessler, Director, Mental Development Center, Western Reserve University. This new book discusses child behavior problems at all degrees of seriousness, and combines research findings and clinical observations for each. It is problem-centered rather than profession-centered. January 1966, 544pp., $8.25
AN INTRODUCTION TO PERSONALITY.. A Research Approach by Donn Byrne, University of Texas. Concentrating on current aspects of research which deal with personaliW as a science rather than as a branch of speculative philosophy, this new basic text provides an understanding of the way in which the scientific method is utilized in studying human behavior. April 1966, 560pp., $7.75
PERSONALITY RESEARCH: A Book of Readings edited by Donn Byrne, University of Texas, and Marshall L. Hamilton, San lose State College. Here is a representative picture of current research, theoretical formulations, and issues typical of the field of personality. Ideal when used in conjunction with the above title. April 1966, 432pp., paperbound, $5.50 (PRICES SHOWN ARE FOR STUDENT USE)
For approval copies, write: Box 903
PRENTICE-HALL, Englewood Cliffs, New Jersey 07632
CURRENT ISSUES IN M E N T A L H E A L T H PLANNING
ELIZABETH REICHERT SMITH, P~.D.*
Resolution of some of the issues identified by communities in planning comprehensive community mental health services is critical to movement from the planning stage to program development and operation. These issues relate both to the relationship of the local mental health system and to other major community systems: e.g., the general health system, the anti-poverty program and multijurisdictional political systems, and to the interrelationships of certain component parts within the mental health system itself, (including the private practice sector of psychiatry and other areas of medicine) delimited mental health services offered by voluntary agencies, the state mental hospital system, nonpsychiatric agencies, and the "gatekeepers." Specific reference is made to solutions proposed for the District of Columbia.
represents a unique adaptation of the national mental health program to the local scene. In the process, a number of issues which are crucial to effective local adaption of the national mental health program have been highlighted. These are crucial to both mental health professionals and community citizenry. The issues discussed here are those which, while being of common concern, have special relevance to planning efforts in the District of Columbia. Some of these have not yet attained satisfactory resolution. The critical issues involved seem to fall into at least two major groups: those which involve relationships among the several essential parts of a comprehensive and community-oriented mental health system; and those which involve the relationship between this total system itself and other
All across the country, states are putting finishing touches on plans for comprehensive mental health services. These plans were stimulated by two-year federal grants which terminated June, 1965. For some states, this planning has been considered a one-time affair. In other jurisdictions, mental health planning staffs have achieved an integral position in their state organizations. They have been charged with continuing responsibility for identifying developing mental health needs and for detailing proposals for meeting these in ways which take cognizance of community attitudes and resources. In essence, the planning has involved each state and its local communities in the development of a proposal for comprehensive mental health services which, in recognizing local needs, attitudes, and potentials,
*Dr. Smith, a nurse, was Senior Mental Heahh Planner, Division of Planning, Research, and Statistics, Washington, D.C., Department of Public Health. She is presently Chief, Office of Community Mental Health Program Development, D. C. Department of Public Health. 73
74
THE COMMUNITY MENTAL HEALTH JOURNAL
community-wide social and political systems. This dichotomy, while useful in considering some of the particular issues, is frequently obliterated at the local community level. ESSENTIAL LIAISONS Current planning for community mental health programs, especially with its focus on primary and secondary prevention, necessitates the elaboration of a system which is far more comprehensive in its components than was previously the case in programs focusing primarily on direct psychiatric treatment services. President Kennedy himself challenged psychiatry to reintegrate itself in a meaningful way within the totality of modern medicine. This is actually but one of a number of essential liaisons with which existing traditional psychiatric services must establish highly coordinated relationships if a unified system of comprehensive mental health services is to be the outcome of mental health planning.
The Relationship with the Private Practice Sector o] Medicine Physicians constitute a major resource in any community for developing, supporting, and exercising leadership in the utilization of a planned system of mental health services. Without such involvement and support, no plan could mature into successful operation. Involvement and support of psychiatric and nonpsychiatric physicians requires that they be assured a role which they view as appropriate and meaningful. Their usual diagnostic, therapeutic, supervisory, and referral functions must be related relevantly to the total mental health effort. Access of those patients ordinarily treated by private practitioners to the services of mental health centers will require clarity of policy and procedures which support a continuing relationship between the private practioner and his patient. In the District of Columbia a policy has been established that patients, on their first contact with the center through the diagnostic and referral service, will be questioned as to previous psychiatric care,
including any from private psychiatrists. Those who have been under private care will generally be referred back to their own physician. Patients who have not been under private care previously, but for whom this is deemed appropriate, will be referred for private care if possible. Patients under care of private psychiatrists will be considered for care in the mental health center on referral from the psychiatrist. Although such patients become the responsibility of the center, private physicians are encouraged to continue to see their patients while they are in intensive, day or night care treatment programs. When such patients have been reviewed by the diagnostic and referral service and assigned to treatment in one of the components of the center, the private physician will be so notified. A discussion will be held between the private physician and the senior physician on the service to which the patient has been assigned in order to establish the role which the private physician will play in the treatment program of the patient. Whenever appropriate, the private psychiatrist may continue the treatment of his patient in the center. When such patients are ready for discharge from the center, a decision as to the indicated follow-up care should be made jointly by the private physician and the responsible center psychiatrist. In support of this policy, all patients who are financially able will be expected to bear the full cost of care and treatment in a mental health center. It is hoped that with clear interpretation and proper implementation of these policies, local physicians will participate actively in the mental health center program and will constitute a major referral source.
Integration o] Psychiatric Services Much of what has been said about the essential involvement of private physicians in the mental health system applies also to voluntary agencies offering psychiatric services. The mechanisms of contract and cosponsorship have been used in the District of Columbia to assure responsible roles to voluntary services: the D. C. Department of Public Health contracts with voluntar)
ELIZABETH REICI-IERT SMITH
general hospitals for in- and outpatient psychiatric services; the D. C. Department of Vocational Rehabilitation contracts for services of private physicians; and the D. C. Department of Public Welfare contracts for psychiatric residential care for selected children and adolescents. In a recent development the D. C. Department of Public Health and Georgetown University Department of Psychiatry have collaborated in the establishment of an adolescent psychiatric clinic. The greatest difficulty occurs in those situations in which a publicly operated mental health center seeks to assure a meaningful role in the total mental health program to a voluntary agency whose function is essentially identical to a service of the mental health center itself. In our experience, family agencies clearly fall into this category; the determination to assign a client to the social work staff of the center or to refer him to a family agency is often difficult to make in practice.
The integration o] the State Mental Hospital In planning a total program, a plan of participation must be defined for the state mental hospital which fosters continued quality staffing and educational and training potentials. This is only possible if the state hospital continues to admit a wide variety of patients for care and treatment. This condition appears most readily achievable through the establishment of a mental health center program within the state hospital itself. Fortunately for many states, growth and shifts of population have placed some mental hospitals, originally intention. ally isolated from the community, in locations convenient for community use. Some states have reorganized the state hospital into sections aligned with specific geographical subdivisions of the territory served by the hospital; where the distance is not too great between a mental health center and a state hospital division, each of which serves the same population, the unification of the two staffs may enhance the stail~ng and training potential of each and promote continuity of patient care.
75
The Essential Participation o] a Wide Variety o] Nonpsychiatric Agencies and Workers The reorientation of emphasis from direct treatment services and rehabilitation to primary and secondary prevention necessitates co-equal participation, not only of nonpsychiatric health workers, but also of educators, clergymen, welfare workers, union counselors, child care workers, police, courts, correctional, probation, parole workers, and many others, with psychiatric professionals if long range goals are to be pursued. Basically, the goals of the mental health program can only be achieved to the extent that these workers have a major impact on human capacity for dealing effectively with stress. Most mental health plans have spelled out in some detail how these "gatekeepers" might be helped to do a better job. However, little thought has been given to the essential identity of mutually shared goals and of the necessary contribution of each area of activity. Consultation to them is invaluable; what of their consultation to mental health professionals? In recognizing the interaction of the individual and his personal social environment, daily decisions are made as to when and how to strengthen the individual's ability to cope with his environment; when and how to manipulate the environment so that the individual is competent and comfortable in dealing with it. A variety of nonpsychiatric workers understand the various worlds of people far better than do professionals and have skills to apply to them which are highly developed. RELATIONSHIP OF SYSTEMS
A second area of critical concern in developing and implementing comprehensive community mental health programs involves the relationship of the local mental health system to other major systems. Illustrative of these issues are:
The Mental Health System and the General System o] Health Services A comprehensive program of mental health services must be structured to fit
76
THE COMMUNITYMENTALHEALTH JOURNAL
into the overall pattern of health services in the particular community. The local organizational structure of public health and medical care; the extent to which public agencies develop, operate, or contract for medical services for all or specified segments of the community population; the extent and adequacy of health facilities; the economic, educational, and professional base for health services; and the community's attitudes and interests in health and modes of utilization of health services, all constitute dimensions of a broad pattern of health services within which the mental health program must be logically developed. In the District of Columbia, the Public Health and Mental Health authority are unified in the Director of the D. C. Department of Public Health. In addition, extensive inpatient and outpatient programs of medical care involving the municipal hospital, the hospital for tuberculosis and chronic disease care, an elaborate network of specialized clinics and of public health nursing services, are sponsored by the D. C. Department of Public Health. This arrangement facilitates the development of a comprehensive mental health center program under public health auspices. These relationships have been further promoted through the development of the mental health center as one major component of a community health center which will offer, in addition to mental health services, services to the mentally retarded and a broad range of traditional public health services, e.g., maternal and child health services, venereal disease control, tuberculosis control, public health nursing, etc. In addition, the historic involvement of the three local medical schools, and other educational agencies preparing health personnel, in most components of the total public health program, provides the model for similar relationships in developing segments of the total mental health plan.
The Relationship to Other Community Programs The development of other community programs focusing on the population served by the mental health program gives
rise to the need for meaningful integration of the several programs. In the District of Columbia, a major anti-poverty approach involves the establishment of neighborhood development centers and youth opportunity centers. In some instances, these have been developed within the context of ongoing community organizations such as settlement houses; in other instances, they have developed as separate anti-poverty activities. Similarly, the District of Columbia mental health plan proposes extensive decentralization--not only of preventive services but also of appropriate diagnostic, treatment, and rehabilitation services--into settlement houses, church basements, and rented space. Timing, administrative lines, and committed space affect the possibility of co-locating these activities for their mutual nurture as well as the convenience of their clients.
Metropolitan-wide Planning A third issue of context arises in those metropolitan communities which encompass two or more political jurisdictions, especially when the jurisdictions involved are states. Funds for mental health planing were allocated by state; use of mental health center construction money involves the development and approval of state mental health construction plans, a procedure essentially similar to that for using Hill-Burton monies. This is a knotty problem, which, in the case of the Washington metropolitan area, has not been fully resolved. The Washington metropolitan area indudes the District of Columbia which constitutes its central-core, two counties of Maryland, and two counties and two independent cities of Virginia. One-third of the population resides in the District of Columbia, two-thirds in the suburban area. Like other central areas of large cities, the District's functions include providing places of employment, low income housing, specialized wholesale and retail activities, and, most importantly, serves as a medical center for the total metropolitan area. As such, considerable demands are made on all District of Columbia medical resources,
ELIZABETH REICHERT SMITH
especially physicians in private practice, voluntary hospitals, and other voluntary health and welfare agencies. This is, of course, taken for granted. However, difficulties arise when planning for local community mental health services. The establishment of priorities for the development of new centers, if based principally on absolute need and lack of existing facilities, may result in a very low priority to those portions of Maryland and Virginia which constitute suburban Washington. Yet the program emphasis on community based resources is undermined by increasing the geographical bases of the District of Columbia mental health centers to encompass the entire metropolitan area. CONCLUSION These issues have been crucial in mental health planning and will continue to exercise considerable impact as preliminary planning moves into program development and operation. How each of these issues are resolved will define in many aspects orga-
77
nizational, administrative, and basic program structure of the local mental health system. It is axiomatic that, to the extent that the comprehensive mental health plan projects change from the system traditionally operative in the local community, change of responsibility, relationship, method, and prerogative of the many categories of workers in the mental health system will necessarily follow. Since the manner in which resolution is achieved may be as varied as the many local communities, it is difficult to anticipate the precise impact on the roles of the involved professionals. Such change is almost always difficult especially, when it is achieved through much experimentation and when its precise outcome cannot be foreseen. This will require creativity, flexibility, and patience and will, at the same time, offer the opportunity of a professional lifetime---to play a leadership role in demonstrating new concepts in the prevention, treatment, and care of mental illness, as local communities move from planning to the reality.
New Books for Spring THE ABNORMAL PERSONALITY THROUGH LITERATURE by Alan A. Stone, M.D., Director of Resident Education, McLean Hospital, Mass., and Sue S. Stone. Mental disorders and symptoms selected from literature----each type of disorder presented in this unusual collection is illustrated in a vivid and creative manner. January 1966, 423pp., paperbound, $4.50
PSYCHOPATHOLOGY OF CHILDHOOD by Jane W. Kessler, Director, Mental Development Center, Western Reserve University. This new book discusses child behavior problems at all degrees of seriousness, and combines research findings and clinical observations for each. It is problem-centered rather than profession-centered. January 1966, 544pp., $8.25
AN INTRODUCTION TO PERSONALITY.. A Research Approach by Donn Byrne, University of Texas. Concentrating on current aspects of research which deal with personaliW as a science rather than as a branch of speculative philosophy, this new basic text provides an understanding of the way in which the scientific method is utilized in studying human behavior. April 1966, 560pp., $7.75
PERSONALITY RESEARCH: A Book of Readings edited by Donn Byrne, University of Texas, and Marshall L. Hamilton, San lose State College. Here is a representative picture of current research, theoretical formulations, and issues typical of the field of personality. Ideal when used in conjunction with the above title. April 1966, 432pp., paperbound, $5.50 (PRICES SHOWN ARE FOR STUDENT USE)
For approval copies, write: Box 903
PRENTICE-HALL, Englewood Cliffs, New Jersey 07632
