L I T E R A T U R E ABSTRACTS
Family Diagnosis: Research Methods and Their Reliability for Studies of the Medical Social Unit, the Family. Robert J. Haggerty, American Journal o/Public Health, 1965, 55, 1521-
children, even in rural areas. Other aspects of the project are discussed and evaluated.
1533. This investigation was concerned with the development and testing of an instrument to study family functions (called family diagnosis). While standard social data were obtained with fair reliability, there was a large and variable degree of variation on all other types of social and attitude data. The variability shown within the framework of this model indicates further need to define reliability in each study of medical-social data.
1965, 13, 10-13. A brief report is given on the treatment of mental patients in a general hospital which does not segregate patients with mental illness from patients with physical illness. No special wards or special nursing staff appeared necessary to the successful management of acute disturbed mental patients in this general hospital. This experience is cited as supporting the contention that mental illness should be dealt with in precisely the same organizational framework as physical illness.
A Record Keeping System For A Psychiatric Consultation Service. Duaue Denney. The Journal of Nervous and Mental Disease, 1965, 141, 474-477. A technique is described for recording data obtained from patients referred to a psychiatric consultation service in a general hospital, The basic item in the system is a needle-sort card on which personal, social and medical data are coded and recorded and a copy of the psychiatric consultant's note is written. Advantages and disadvantages of the system are discussed. L o n g Term and Fatal Illness and the F a m ily. Norman B. Gordon and Bernard Kutner. Journal o/Health and Human Behavior, 1965, 6, 190-196. An outline of a problem area defined as the impact of serious or fatal childhood illness on the family has been presented. Many facts are known about the psychosocial impact of such fundamental disruptions in the normal family life cycle, but full understanding of the problems and the available means for aiding afflicted individuals to cope with the consequences are imperfect. Emotional pain, social stigmata, cognitional disruption and economic consequences attending such events are matters often left almost entirely to the individuals concerned. The entire set of circumstances suggests the need for a line of both practical and theoretical research to examine aspects of the problem such as family decision making and stress, physician-family relationships in serious illness as well as the long term impact of serious health events on child rearing practices and family well being. It is hoped that behavioral scientists will pay increased attention to this fruitful research area.
The Child Development Traveling Clinic Project in Southern California. A Report of the First Three Years (1959-1962). Richard Koch, Sylvia Schild, Nancy Ragsdale, and Karol Fishler. American Journal o/Public Health, 1965, 55, 1534-1544. A report is presented on the results of a three year demonstration project in which traveling clinics were used for the diagnosis, treatment, and counseling of retarded children and their families. It was possible to mobilize community resources to provide services for very young
Psychiatric Treatment in a General Hospital. J. E. Boulding. Canada's Mental Health,
Crisis Theory and Treatment Strategy: Some Socioeuhural and Psychodynamic Considerations. Gerald F. Jacobson. The Journal of Nervous and Mental Disease, 1965, 141, 209218. The general activities of a walk-in psychiatric center in Los Angeles, California, the Benjamin Rush Center, include early access and brief treatment. A majority of patients are in some stage of life crisis, and this fact provides the connection with the central treatment modality employed, crisis therapy. A significant number of so-called lower-elass patients have been treated in this setting. This paper deals with the potential usefulness of crisis therapy in the treatment of the economically underprivileged patient.
Uses of Data in Planning Community Psychiatric Services. Gwen Andrew. American Journal o/Public Health, 1965, 55, 1925-1935.The author proposes the unification of various systems to provide a common statistical base for different kinds of services, and then shows how a number of problems can be dealt with. She states the need for systems which will: (a) Characterize the populations with which we are dealing in terms relevant to program planning decisions. (b) Measure the movement of that population through a total care system in much more encompassing terms. (c) Make possible methods of census control for the variety of community agencies. (d) Lend themselves to useful techniques for allocation of resources, especially staff, within agencies and among agencies. (e) Make use of the tremendous increases in capacity available to us through modern instrumentation, namely, multivariate analysis using computers.
Problems in Treating the Lower-Class Psychotic. David A. Carlson, Jules V. Coleman, Paul Errara, and Robert W. Harrison. Archives o~ General Psychiatry, 1965, 13, 269-274.--Some of the problems encountered in outpatient psychiatric treatment of severely disturbed lower-class patients are described. Interaction of patients discharged from a state hospital with the staff of a universitycommunity psychiatric clinic are examined in an
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THE COMMUNITY MENTAL HEALTH JOURNAL
attempt to understand the apparent reluctance of patients and psychiatrists to work together. The aim of the project was to bring about coordination of care for patients and their families. Their special needs and ways of relating were described. The major problem in providing care to these patients revolved around the difficulties the residents had in reconciling an indicated directive treatment approach with the values implicit in expressive psychotherapy. The Well Baby Clinic: Its Prospects for Building Ego Strength. Samuel J. Braun. American Journal of Public Health, 1965, 55, 18891898. Some of the historical developments of the well baby clinic were reviewed. Studies regarding the clients suggested that many hoped for help in child rearing practices. The trend away from using the clinic as a referral source was emphasized. Anticipatory guidance and crisis intervention were viewed as being aimed toward increasing both the child's and parent's ability to cope with stress and not to uncover pathology. Techniques of intervention were reviewed. The conclusion is made that we still stand on the same threshold which held such promise 30 years ago. All too frequently, the public health nurse has had to carry the sole responsibility for well baby care and counseling, with the exception of the "three minute" hour contributed by the physician. Now is the time that the valiant single handed efforts of the public health nurse should receive the wholehearted support of the physician in carrying out the aims and purposes of the well baby clinic program. An Inventory of the Clinic Patient Load in a C o m m u n i t y Mental Health Program. Sheldon Gaylin, Anne Stauffer, and Auhrey Mallach. American Journal o] Public Health, 1965, SS, 19091923. An inventory of the entire patient load in all community mental health clinics in Westchester County was taken and the data analyzed. New data were obtained in many areas, while other data helped in the understanding of information provided by the analysis of patient termination reports submitted by the clinics. Information was obtained on age and sex of patients, source of referral, previous treatment, diagnosis, time on the rolls, and the type and content of service provided. In addition, information not previously available was obtained on waiting time for various types of service by various categories of patients, on presenting complaint at application, and on rates of clinic use by localities and by income groups. A new concept was developed in relating clinic use rates to eligible population rather than to total population. There was an indication that there was comparatively less use of the clinics by the lowest income groups in the county than by the higher income groups eligible for service. O n the Treatment o f the Poor. Joe Yamamoto and Marcia Kraft Goin. The American Journal o] Psychiatry, 1965, 122, 267-271. The poor patient with his special needs requires special psychiatric treatment. In the past, clinics have not con-
sidered this fact and have rejected them too often as unsuitable or unmotivated. The authors have learned some treatment techniques in listening to their patients and in considering the contributions of others. Thus they have developed techniques for a flexible, active, brief, supportive and realityoriented treatment approach. These techniques include changes in administrative procedures such as appointment scheduling and in efforts to create a warm, friendly social context in which to offer help. They have modified group therapy and have focused on not only insight but education, social interaction and group support. Minimal supportive therapy, with drugs as indicated, serves a portion of their patient population. With all these changes, the responses of their patients have been much more often enthusiastic than those of their professional colleagues. It is hoped that with experience they will also see the efficacy of treatment specifically planned for these poor patients. Do New Towns Breed Mental Illness? Edward H. Hare. Canada's Mental Health, 1965, 13, 5-9. Comparison of prevalence of mental disorder by house to house canvass between a new estate and an older district of the same city (Croydon) showed no significant differences. Results of this and several other studies are cited to refute earlier findings of "New Town Blues" in England. Adolescent Patients Served in Outpatient Psychiatric Clinics. Beatrice M. Rosen, Anita K. Bahn, Robert Shcll0w, and Eli M. Bower. American Journal o] Public Health, 1965, 55, 1563-1577.Adolescents are the largest users of psychiatric outpatient clinics in the United States. This paper presents findings obtained in a detailed study of the use of these facilities by members of this age group (10-19), carried out by NIMH with the cooperation of state mental health authorities. Data for terminated patients were reported on diagnosis, sources of referral, type and amount of service, and disposition. Interpretation of these data in terms of psychological development of the adolescent and implications for program development, particularly among schools and public nursing personnel, are discussed. Social Class and Mental Illness in Children: Choice of Treatment, Saul I. Harrison, John F. McDermott, Paul T. Wilson, and Jules Schrager. Archives o/General Psychiatry, 1965, 13, 411-417. .... Statistical analysis of the recommendation offered the parents of children evaluated at the Children's Psychiatric Hospital of the University of Michigan Medical Center reveals that these recommendations are correlated with the occupational status of the supporting parent. The child of a professional or executive parent had twice as great a chance of being offered one of the intensive and intimate psychotherapies than a child whose father was a blue-collar worker. The possibility that mental health professionals discriminate among children because of their class, as is done among adults, is distressing, but apparently true. Some practical implications of this finding are discussed.
Family Diagnosis: Research Methods and Their Reliability for Studies of the Medical Social Unit, the Family. Robert J. Haggerty, American Journal o/Public Health, 1965, 55, 1521-
children, even in rural areas. Other aspects of the project are discussed and evaluated.
1533. This investigation was concerned with the development and testing of an instrument to study family functions (called family diagnosis). While standard social data were obtained with fair reliability, there was a large and variable degree of variation on all other types of social and attitude data. The variability shown within the framework of this model indicates further need to define reliability in each study of medical-social data.
1965, 13, 10-13. A brief report is given on the treatment of mental patients in a general hospital which does not segregate patients with mental illness from patients with physical illness. No special wards or special nursing staff appeared necessary to the successful management of acute disturbed mental patients in this general hospital. This experience is cited as supporting the contention that mental illness should be dealt with in precisely the same organizational framework as physical illness.
A Record Keeping System For A Psychiatric Consultation Service. Duaue Denney. The Journal of Nervous and Mental Disease, 1965, 141, 474-477. A technique is described for recording data obtained from patients referred to a psychiatric consultation service in a general hospital, The basic item in the system is a needle-sort card on which personal, social and medical data are coded and recorded and a copy of the psychiatric consultant's note is written. Advantages and disadvantages of the system are discussed. L o n g Term and Fatal Illness and the F a m ily. Norman B. Gordon and Bernard Kutner. Journal o/Health and Human Behavior, 1965, 6, 190-196. An outline of a problem area defined as the impact of serious or fatal childhood illness on the family has been presented. Many facts are known about the psychosocial impact of such fundamental disruptions in the normal family life cycle, but full understanding of the problems and the available means for aiding afflicted individuals to cope with the consequences are imperfect. Emotional pain, social stigmata, cognitional disruption and economic consequences attending such events are matters often left almost entirely to the individuals concerned. The entire set of circumstances suggests the need for a line of both practical and theoretical research to examine aspects of the problem such as family decision making and stress, physician-family relationships in serious illness as well as the long term impact of serious health events on child rearing practices and family well being. It is hoped that behavioral scientists will pay increased attention to this fruitful research area.
The Child Development Traveling Clinic Project in Southern California. A Report of the First Three Years (1959-1962). Richard Koch, Sylvia Schild, Nancy Ragsdale, and Karol Fishler. American Journal o/Public Health, 1965, 55, 1534-1544. A report is presented on the results of a three year demonstration project in which traveling clinics were used for the diagnosis, treatment, and counseling of retarded children and their families. It was possible to mobilize community resources to provide services for very young
Psychiatric Treatment in a General Hospital. J. E. Boulding. Canada's Mental Health,
Crisis Theory and Treatment Strategy: Some Socioeuhural and Psychodynamic Considerations. Gerald F. Jacobson. The Journal of Nervous and Mental Disease, 1965, 141, 209218. The general activities of a walk-in psychiatric center in Los Angeles, California, the Benjamin Rush Center, include early access and brief treatment. A majority of patients are in some stage of life crisis, and this fact provides the connection with the central treatment modality employed, crisis therapy. A significant number of so-called lower-elass patients have been treated in this setting. This paper deals with the potential usefulness of crisis therapy in the treatment of the economically underprivileged patient.
Uses of Data in Planning Community Psychiatric Services. Gwen Andrew. American Journal o/Public Health, 1965, 55, 1925-1935.The author proposes the unification of various systems to provide a common statistical base for different kinds of services, and then shows how a number of problems can be dealt with. She states the need for systems which will: (a) Characterize the populations with which we are dealing in terms relevant to program planning decisions. (b) Measure the movement of that population through a total care system in much more encompassing terms. (c) Make possible methods of census control for the variety of community agencies. (d) Lend themselves to useful techniques for allocation of resources, especially staff, within agencies and among agencies. (e) Make use of the tremendous increases in capacity available to us through modern instrumentation, namely, multivariate analysis using computers.
Problems in Treating the Lower-Class Psychotic. David A. Carlson, Jules V. Coleman, Paul Errara, and Robert W. Harrison. Archives o~ General Psychiatry, 1965, 13, 269-274.--Some of the problems encountered in outpatient psychiatric treatment of severely disturbed lower-class patients are described. Interaction of patients discharged from a state hospital with the staff of a universitycommunity psychiatric clinic are examined in an
181
182
THE COMMUNITY MENTAL HEALTH JOURNAL
attempt to understand the apparent reluctance of patients and psychiatrists to work together. The aim of the project was to bring about coordination of care for patients and their families. Their special needs and ways of relating were described. The major problem in providing care to these patients revolved around the difficulties the residents had in reconciling an indicated directive treatment approach with the values implicit in expressive psychotherapy. The Well Baby Clinic: Its Prospects for Building Ego Strength. Samuel J. Braun. American Journal of Public Health, 1965, 55, 18891898. Some of the historical developments of the well baby clinic were reviewed. Studies regarding the clients suggested that many hoped for help in child rearing practices. The trend away from using the clinic as a referral source was emphasized. Anticipatory guidance and crisis intervention were viewed as being aimed toward increasing both the child's and parent's ability to cope with stress and not to uncover pathology. Techniques of intervention were reviewed. The conclusion is made that we still stand on the same threshold which held such promise 30 years ago. All too frequently, the public health nurse has had to carry the sole responsibility for well baby care and counseling, with the exception of the "three minute" hour contributed by the physician. Now is the time that the valiant single handed efforts of the public health nurse should receive the wholehearted support of the physician in carrying out the aims and purposes of the well baby clinic program. An Inventory of the Clinic Patient Load in a C o m m u n i t y Mental Health Program. Sheldon Gaylin, Anne Stauffer, and Auhrey Mallach. American Journal o] Public Health, 1965, SS, 19091923. An inventory of the entire patient load in all community mental health clinics in Westchester County was taken and the data analyzed. New data were obtained in many areas, while other data helped in the understanding of information provided by the analysis of patient termination reports submitted by the clinics. Information was obtained on age and sex of patients, source of referral, previous treatment, diagnosis, time on the rolls, and the type and content of service provided. In addition, information not previously available was obtained on waiting time for various types of service by various categories of patients, on presenting complaint at application, and on rates of clinic use by localities and by income groups. A new concept was developed in relating clinic use rates to eligible population rather than to total population. There was an indication that there was comparatively less use of the clinics by the lowest income groups in the county than by the higher income groups eligible for service. O n the Treatment o f the Poor. Joe Yamamoto and Marcia Kraft Goin. The American Journal o] Psychiatry, 1965, 122, 267-271. The poor patient with his special needs requires special psychiatric treatment. In the past, clinics have not con-
sidered this fact and have rejected them too often as unsuitable or unmotivated. The authors have learned some treatment techniques in listening to their patients and in considering the contributions of others. Thus they have developed techniques for a flexible, active, brief, supportive and realityoriented treatment approach. These techniques include changes in administrative procedures such as appointment scheduling and in efforts to create a warm, friendly social context in which to offer help. They have modified group therapy and have focused on not only insight but education, social interaction and group support. Minimal supportive therapy, with drugs as indicated, serves a portion of their patient population. With all these changes, the responses of their patients have been much more often enthusiastic than those of their professional colleagues. It is hoped that with experience they will also see the efficacy of treatment specifically planned for these poor patients. Do New Towns Breed Mental Illness? Edward H. Hare. Canada's Mental Health, 1965, 13, 5-9. Comparison of prevalence of mental disorder by house to house canvass between a new estate and an older district of the same city (Croydon) showed no significant differences. Results of this and several other studies are cited to refute earlier findings of "New Town Blues" in England. Adolescent Patients Served in Outpatient Psychiatric Clinics. Beatrice M. Rosen, Anita K. Bahn, Robert Shcll0w, and Eli M. Bower. American Journal o] Public Health, 1965, 55, 1563-1577.Adolescents are the largest users of psychiatric outpatient clinics in the United States. This paper presents findings obtained in a detailed study of the use of these facilities by members of this age group (10-19), carried out by NIMH with the cooperation of state mental health authorities. Data for terminated patients were reported on diagnosis, sources of referral, type and amount of service, and disposition. Interpretation of these data in terms of psychological development of the adolescent and implications for program development, particularly among schools and public nursing personnel, are discussed. Social Class and Mental Illness in Children: Choice of Treatment, Saul I. Harrison, John F. McDermott, Paul T. Wilson, and Jules Schrager. Archives o/General Psychiatry, 1965, 13, 411-417. .... Statistical analysis of the recommendation offered the parents of children evaluated at the Children's Psychiatric Hospital of the University of Michigan Medical Center reveals that these recommendations are correlated with the occupational status of the supporting parent. The child of a professional or executive parent had twice as great a chance of being offered one of the intensive and intimate psychotherapies than a child whose father was a blue-collar worker. The possibility that mental health professionals discriminate among children because of their class, as is done among adults, is distressing, but apparently true. Some practical implications of this finding are discussed.
