Continued growth and increased legitimacy are anticipated for the American self-help group (SHG) phenomenon. Currently estimated at six and a quarter million participants annually, self-help groups will assume a central role in the nation's mental health delivery system over the next two decades. The first part of this article illuminates the self-help group phenomenon itself. Its scope, characteristics, supporting social climate, and associated research issues are reviewed. The second part is a futuristic examination of its interface with the newly industrializing world of health care. Massive increases in mental health services are predicted, especially via the SHG format. Theory development, research sophistication, changing SHG formats, a place in public policy, and acceptance into graduate curricula are also expected, as are collaborative relationships with a variety of professional disciplines. Psychologists are urged to enhance the relevance of the profession by taking an early leadership role in these developments.
Discusses 6 response modes for therapeutic communication which are independent of orientation or professional status. The modes are part of a system to be used both in therapy process research and in paraprofessional training. Communication behaviors are divided into the following categories: (a) the question; (b) advisement, including suggestion, demonstration instruction, and command; (c) silence, including length between utterances; (d) interpretation, an explicit explanation not accompanied by a recommendation; (e) reflection, the relatively nonarousing representation of expressed thougths and feelings; and (f) disclosure. An average interrater correlation of 0.80 was obtained across the verbal categories. Potential applications of the framework in job training, competence assessment of nonprofessional mental health workers, comparative psychotherapy, and specification of treatment conditions are discussed. (91 ref)
Safety in healthcare organizations is often an ownerless process with responsibility falling under a myriad of departments that individually are coordinating initiatives to improve aspects of safety. In contrast, other high-hazard industries seek to institutionalize safety management as a key characteristic of organizational culture. Healthcare seeks to model its approach to patient safety on other high-hazard industry models, but without an understanding of the impact of creating a uniform approach to safety management, healthcare organizations will not implement a similar organization-wide safety culture.
18 mos. after psychotherapy, a variety of tests were readministered to 69 available Ss constituting a biased subgroup from 93 tested previously at the beginning and at the termination of therapy. While the group as a whole showed no reliable movement after therapy, individuals made reliable and correlated changes. Only the Ss' direct report of such change was found to be predictable from several earlier measures. Less favorable movement was found on some measures for the 16 Ss who had additional therapy. While status at termination of therapy appears to be an adequate index of group effects associated with therapy, individuals show systematic trends in the subsequent 18 mos.
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