PROFESSIONAL ATTITUDES,AWARENESS AND USE OF SELF-HELP GROUPS

The aim of this project was to contribute information on an important aspect of the self-help movement: the nature of its relationship with professional mental and physical health practitioners. Focusing on the professions of psychology, social work, psychiatry, medicine and nursing, the goal was to ascertain the degree to which these professionals were aware of selected self-help groups in Toronto, the extent to which they used them and their attitudes toward these self-help groups. Data obtained from 308 professionals indicated that they have some degree of familiarity with self-help groups in the community, are prepared to inform their clients about groups which may be helpful to them, are prepared to make referrals to such groups and hold favorable attitudes toward such groups.     

THE ROLE OF A SELF-HELP CLEARINGHOUSE

As the number of self-help groups continues to proliferate, the formation of an umbrella body is suggested. A Self-Help Clearinghouse would serve as such an umbrella through the establishment of an information, referral and research service for mutual aid groups in an area. It would also be available to offer technical assistance to existing groups and assistance in the formation of new self-help groups. As a prevention service, it can be integrated into a comprehensive community mental health service system or operated under other auspices. In either case, it is a barometer of community stressors and offers great promise in strengthening social supports, coping skills, and competence provided by self-help groups.     

MUTUAL-HELP GROUPS:

Members of 18 self-help groups in Canada were surveyed as to the benefits of participation in mutual help groups and the roles for professionals in such groups. Three distinctions are made among mutual help groups: (1) those dealing with loss-transition (L-T), (2) those with members one step removed (OSR) from the problem, and (3) groups for stress, coping and support (SC&S). Members in OSR groups feel they benefit significantly more from participation than SC&S group members, while many L-T members feel they could get along well without the group if they had to. Members of SC&S groups tend to favor indirect involvement of professionals and see professional help and mutual help as complementary, more than do members of L-T and OSR groups. The traditional health care system is found to ignore the needs of L-T and OSR group members; mutual help thus provides a critical source of support and education for these people.     

Chapter 9: Partnerships Between Health Professionals and Self-Help Groups

SUMMARY

The study aimed to identify the meanings and mechanisms of partnership between health professionals and self-help group members. The three project stages involved in-depth individual interviews of professionals (n = 47) and of members (n = 49) using a semistructured interview guide; separate group interviews of professionals and members to rank themes which emerged in Phase I, and a joint professional/member workshop. A Partnership Framework was developed. The predominant partnership characteristics identified by professionals were egalitarian, flexible, decreased professional control, understanding and shared goals; and by members were trusting, reciprocal, shared goals, flexible and understanding. The five critical obstacles to partnerships, from professionals' standpoint were communication, attitudes, role ambiguity, the format health care system and ideological conflicts, and from self-help groups' perspectives were knowledge, the system, skills deficiency, attitudes and ideological conflicts. The foremost mechanisms for achieving partnership according to health professionals involved education, clearinghouses, and role and goal clarification; to self-help group members, they entailed trust building, communication building, and education. [Note: italics denote consensus by professionals and members.]     

Chapter 14: Self-Help Group Participation Among People with Severe Mental Illness

SUMMARY

An experimental design was attempted to test the effectiveness of self-help group participation among people with severe and long-standing mental illnesses. A sample of 90 individuals was randomized to either experimental or control groups with experimentals invited to join self-help groups and given outreach to encourage participation. Control subjects were not invited to join self-help groups. Results showed low rates of 17% participation in the self-help groups for both experimental and control subjects. The small number of experimental subjects participating and the presence of cross-overs from the control group yielded a sample too small for statistical analyses and the experiment was ended. Post hoc analyses comparing subjects who participated in self-help (15), non-participating subjects (75) and a comparison group of existing self-help group members (90) showed participants to have more severe psychiatric symptoms than either non-participants or members. Participating subjects were more likely to be female, though the self-help groups had more male members. Results indicate the need for multi-site studies in self-help group research.     

The Family Therapist in the Courts

SUMMARY

This article describes the Parent Education and Custody Effectiveness Program (P.E.A.C.E.), a series of interdisciplinary educational seminars for persons going through the divorce process; reports on the results of three P.E.A.C.E. Program pilot studies that occurred in New York State; and describes the crucial role of mental health professionals in this program.     

PARENTS UNITED OF OREGON:

A natural history is reported for an agency-supported self-help group for sexually abusive families. Four developmental stages of the group are identified as a) development of the idea, b) operationalization of the group, C) promotion of community recognition, and d) achievement of organizational goals and group consolidation. Experiences drawn from the natural history are discussed in terms of the guidelines tbey suggest for the development of other agency-supported self-help groups.     

SELF-HELP PARTICIPATION AND QUALITY OF LIFE:

This report explores mental health outcomes reported by the self-help group leaders and administrators of Recovery, Inc.: The Association of Nervous and Former Mental Patients. Following Campbell (1976), both global and domain-specific quality of life indicators are used as measures of mental health. The contributions of the leader's income, health history, and Recovery career variables are also examined and the general findings are compared to a normative population. The data indicates that Recovery participation is associated with positive mental status reports, particularly in global self-ratings. Residual areas requiring supplementary human service intervention are specified.     

Quality Assurance of Self-Help Sites on the Internet

Abstract

One of the most common uses of the Internet is to access health and mental health information. While thousands of Websites have been developed to provide consumers with health and mental health information, little has been done regarding assuring the quality of the material provided. This article presents the quality assurance assessment findings of 80 Websites that provide consumers information on common DSM-IV psychiatric disorders. The results of this assessment found a number of concerns: (1) a lack of evidence of qualified authors; (2) a lack of any formal review, or existence of a review board; (3) a lack of timely updating of the Website material; (4) potential conflicts of interest with advertisements; (5) average readability indexes at the 11.2 grade reading level; and (6) a paucity of Websites that use any evidence of behavior change theories. The authors recommend a standards be established to assure quality of the self-help information provided on the Internet. Furthermore, the authors encourage future Web based self-help efforts to apply the embedded power of the Internet to offer interactive, theory-driven educational interventions to not only improve knowledge, but also behavior.     

Prevalence and Predictors of Service Utilization Among Racially and Ethnically Diverse Adolescents in Foster Care Diagnosed With Mental Health and Substance Abuse Disorders

This study examined the prevalence of mental health and substance abuse disorders and service utilization among a racially and ethnically diverse group of foster youth. Self-report data on symptoms and service receipt were used to identify whether groups of adolescents defined by their race and ethnicity were equally likely to receive services given the presence of a mental health or substance use disorder. Study findings showed that Caucasians are more likely to receive mental health services than African Americans. Race was not a significant predictor of accessing substance abuse services. Hispanic ethnicity was not a predictor of receipt of mental health or substance abuse treatment services. Implications for future research, practice, and policy are discussed.     

Chapter 13: Workshop on “Good Practice” in the Collaboration Between Professionals and Mutual Aid Groups

SUMMARY

The workshop's purpose was to initiate a dialogue concerning “good practice” issues in research and collaboration with mutual aid groups with the long range goal of developing ethical guidelines for professionals and for mutual aid organizations. Participants represented mutual aid groups, professionals and self-help clearinghouses. Three of the topic areas addressed during the workshop were analysed from the perspectives of the professionals: respecting the autonomy, integrity and unique culture of each group, ensuring that guidelines for confidentiality are adhered to, and respecting experiential knowledge. From the perspectives of mutual aid organizations, preserving autonomy and self-determination, incorporating new information and maintaining confidentiality were also discussed.     

EPILEPSY SELF-HELP GROUPS:

Two sequential cases of professional-self-help/mutual aid collaboration are described. The first was a federally funded demonstration project to develop epilepsy self-help groups in 15 cities. It involved a "mixed strategy" of national and local collaboration, where decision-making, and problem solving was vested in persons with epilepsy. The second related case was the "action learning workshop" that combined research with extension work. Knowledge about self-help group development and persons with epilepsy was advanced at the same time that a national network and alliance of epilepsy self-help groups was developed.     

Socioeconomic Status and Behavior Problems

Abstract

Violence in the schools is a fundamental concern for students, educators and communities as they collectively address issues that make schools safer. A longitudinal analysis of disciplinary referrals was conducted with a large countywide school district to measure differences across socioeconomic status and school level. These variables proved to be critical in identifying and targeting schools that may need to be the focus of prevention and intervention efforts. Other suggestions related to the effects of school violence on academic instruction and methods for the targeting of services are discussed along with implications for educators and mental health professionals in school based settings.     

Mental Health Treatment Experiences and Expectations in Foster Care: A Qualitative Investigation

This study explores perspectives on mental health treatment experiences and expectations for youth in foster care and their foster parents. In-depth interviews were conducted and identified for major themes: (1) the dual stigma of foster care and mental health care; (2) the lack of engagement in mental health therapy; (3) trust issues with the therapist and other individuals; and (4) the desire to integrate mental health services with primary care services. These results have implications for mental health service delivery and suggest opportunities to improve mental health treatment through an integrated care approach.     

Child Welfare and the Courts

ABSTRACT

This exploratory study focuses on the relationships between professionals working in the juvenile dependency system, including judicial officers, attorneys, social workers, and court-appointed special advocates. It includes an examination of the quality of professional relationships, factors contributing to tensions, the consequences of difficult relationships, and strategies for improving relationships. It utilizes interviews and focus groups with professionals and focus groups with clients involved in the juvenile dependency system. The major findings address: (a) the nature and quality of professional relationships, (b) the structural and operational factors contributing to tension in those relationships, (c) client perceptions of professional relationships, and (d) respondent recommendations for improving professional relationships. This study is a contribution to the small but growing literature on the complexity of the interface between public child welfare services and the court system.     

Rapid assessment of existing HIV prevention programming in a community mental health center

In preparation for implementation of a comprehensive HIV prevention program in a Community Mental Health Center for persons with mental illness who are also abusing substances, a rapid assessment procedure (RAP) of existing prevention services that may have developed in the setting over time was undertaken at baseline. In addition to an ecological assessment of the availability of HIV-related information that was available on-site, in-depth interviews and focus groups were conducted with Center administrators, direct-care staff, and mental health consumers. Results indicated that responses regarding available services differed depending upon type of respondent, with administration reporting greater availability of preventive programs and educational materials than did direct-care staff or mental health consumers themselves. But overall, formalized training on HIV prevention by case managers is extremely rare. Case managers felt that other providers, such as doctors or nurses, were more appropriate to deliver an HIV prevention intervention.     

警察协助分类的再探讨

警察协助在内容上分为执法协助和一般职务协助。在此初步探讨的基础上进一步深化,从主体视角观察,分为内部协助义务和对外职务协助。从性质视角观察,根据裁量性强弱,分为羁束协助和裁量协助;根据时间性紧迫,可以区分为日常协助和紧急协助。警察协助未来的发展方向应当是主体间的协助义务动态化,协助义务的性质不断明确化。     

School Mental Health's Response to Terrorism and Disaster

Abstract

The events of September 11,2001, have underscored the mental health needs of youth and families, and amplified the advantages of proactively bringing a range of mental health services to them, where they are, in natural settings such as schools. Further, there is increasing momentum for the enhancement of coordinated and comprehensive school-based approaches that seek to effectively respond to significant crises such as terrorist attacks and disaster. This article explores key themes related to school mental health's response to terrorism and disaster. Following review of background literature on child and adult reactions to trauma, we discuss the development of crisis response teams, and present a range of strategies for schools to respond to crises and disaster. The experiences of one elementary school in responding to the events of September 11 are presented, followed by review of critical challenges facing schools and school mental health programs in improving their ability to respond to significant crises.     

Examining the Role of School Resource Officers on School Safety and Crisis Response Teams

School resource officers (SROs) are being increasingly employed in schools to respond to incidents of school violence and to help address safety concerns among students and staff. While previous research on school safety and crisis teams has examined the role of school mental health professionals’ and administrators, fewer studies have evaluated the role of the SRO. The current study examined differences between SROs, school administrators, and school mental health professionals (i.e., school psychologists, school counselors, social workers) regarding experiences with crisis events, as well as perceived effectiveness of crisis prevention and response strategies. The most common crisis events across professionals included student assaults, drug offenses, and mandated child abuse and neglect reporting. While SROs and school mental health professionals had similar ratings of school safety strategies, school administrators had less effective appraisals of crisis response plans and crisis postvention activities. Implications for practice and future directions for research are reviewed.