Those Who Hesitate are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part II

In the first article of this three-part series, an overview of systematic problems related to behavioral health (BH) treatment and disability was discussed. In this second article of the series, I discuss a number of factors that contribute to the lack of standardization regarding the work of all professionals in the area, including those in the BH field, which serve to introduce imprecision into the BH treatment and disability determination processes. From how professionals are trained and continuing to those who are providing clinical treatment, it is essential to understand how the lack of standardization impacts the treatment itself as well as treatment outcomes. This lack of standardization contributes to poorly identified mental health (MH) conditions, no identification of psychosocial issues, and an overreliance on subjective information, including professional clinical opinion, which leads to poorly defensible professional decision-making as well as poorer outcomes in treatment. In this litigious age, it is not sufficient to employ clinical opinion alone as the basis for treatment decisions. The more sophisticated professional recognizes the importance that one's assessment and treatment decisions may later be questioned in court or in a disability determination hearing. The importance of standardization and utilizing the current scientific standards has become imperative in today's professional evaluation and treatment in the area.     

NGOs and advocacy: How well are the poor represented?

There is a widespread perception that Southern non-governmental organizations (NGOs) best represent the authentic voices of the Southern poor. This article challenges this perception, arguing that poor people in general, and children and women in particular, continue to be disenfranchised, while NGOs-both Northern and Southern-offer a poor imitation of their voices. It argues that what is needed, given the current global economic paradigm, is an authentic 'joint venture' between NGOs in the North and the South and the authentic voices of poor people themselves, that would bring the poor into the mainstream; and a new approach to capacity-building that would seek to empower them better to advocate for themselves. It concludes that, to achieve this, economic advocacy should perhaps take greater precedence over political advocacy.     

Good Governance and Bermuda’s Public Access to Information Act

Abstract

This paper examines the context surrounding, and debates concerning, freedom of information-type legislation in the British Overseas Territory of Bermuda. It situates the law within a wider push by the British Government for good governance in the British Overseas Territories. It explores the expectation for more ‘open and transparent’ government held by international government organisations, the British Government, and the Bermudian electorate. It analyses the resultant political debates, which are framed by traditions of governance that encouraged secrecy and legacies of distrust between political parties formed soon after universal suffrage was introduced in the 1960s. It investigates the implementation of the Act in response to global, metropolitan and local pressures.     

The personality assessment inventory as a selection device for law enforcement personnel

The Personality Assessment Inventory (PAI) is a recent development in psychological assessment which has attracted attention because of the breadth of its coverage and the fact that it includes a four-point scale of item agreement. Matrix, Incorporated, is a psychological assessment center that specializes in the assessment of law enforcement personnel. Matrix has collected performance variables on 800 police officers who had taken the PAI prior to being hired. Correlational analysis was performed and there was a significant effect in the data. Discussion focuses upon the criteria in relation to the PAI variables, particularly with regard to aggression, antisocial characteristics and the validity scales. The data clearly demonstrate that the PAI has good potential for the selection of law enforcement officers. Emily DeCoster-Martin was an undergraduate psychology major at The University of Evansville at the time this paper was written     

Incorporating a Healthy Living Curriculum within Family Behavior Therapy: A Clinical Case Example in a Woman with a History of Domestic Violence,Child Neglect,Drug Abuse,and Obesity

Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe the process of adapting an evidence-supported treatment to assist in managing significant co-existing health-related problems in a mother who was referred due to child neglect and drug abuse. At the conclusion of therapy, the participant reported improvements in perceived family relationships, illicit drug use, child maltreatment potential, whereas other health-related outcomes were mixed. Most improvements were maintained at 4-month follow-up. Issues relevant to implementing evidence-based treatments within community contexts are discussed, including methods of increasing the likelihood of valid outcome assessment, managing treatment integrity, and adjusting standardized treatments to accommodate co-occurring problems.     

A Brief History of Personality Assessment in Police Psychology: 1916–2008

Since the 1960s, the application of psychological services and research to law enforcement settings (known as “police psychology”) evolved from being practically nonexistent to almost universal in a relatively short period of time (Scrivner 2006). Currently, psychologists provide a variety of services to law enforcement agencies, including performing evaluations for pre-employment selection, “fitness-for-duty” evaluations (FFDE), and counseling/treatment for psychologically troubled officers and first responders. The extensive use of personality assessment instruments in police psychology is not surprising given the fact psychologists have traditionally concerned themselves with issues of psychological measurement and test construction. In the contemporary practice of police psychology, assessment using personality measures is essential, being utilized in all of the abovementioned evaluations, in addition to other occasional applications (Weiss et al. 2008). This article provides a brief history of personality assessment in police and public safety psychology as it developed from 1916 to 2008.     

A Person-centered Approach to Risk and Need Classification in Drug Court

A sample of 265 New York City drug court participants completed the Level of Service Inventory—Revised (LSI-R) and Texas Christian University Drug Screen II (TCUDS). Three participant clusters were identified through a person-centered analysis of their LSI-R and TCUDS responses: low risk (LR), criminogenic risk (CR), and complex behavioral health needs (CBHN). Although CBHN scored higher than CR and LR on the LSI-R and TCUDS, they were no more likely to be re-arrested at 24 months and no higher in their rate of positive drug tests. The CR cluster predicted re-arrest beyond the LSI-R and rate of positive drug tests beyond the LSI-R and TCUDS. CBHN participants placed in a residential (vs. non-residential) setting were disproportionately likely to be re-arrested. Results point to a sub-population of drug court participants not captured in variable-centered summary risk scores, who might require intensive case management or referral to suitable treatment.