Brief and lengthy Rorschach records have been identified as common problems in protocol administration. Clinicians have debated how to prevent overly short and long records, but they have been reluctant to alter standardized administration for fear of introducing bias. The present study examines a nonintrusive method for constraining responses by prompting for an extra response when only one is offered per card and by removing the card after four responses are given. Among patients who typically produce brief records, consisting of a residential sample of civil and forensic patients with a range of disordered thinking, the alternative administration method demonstrated improved Comprehensive System validity in assessing thought disorder and eliminated the need to readminister the test due to fewer than 14 responses. The findings have clinical implications for protocol administration with thought-disordered populations that typically produce brief records.
The consequences of Hurricane Katrina have far-reaching implications for the mental health system in the Gulf Coast region, with some of the most vulnerable survivors being children and adolescents. School-based services have been proposed as an ideal way to provide care; however, significant challenges remain in providing trauma-informed services in schools postdisaster. The authors discuss the consultation and training activities of the Los Angeles Unified School District Trauma Services Adaptation Center for Schools and Communities following Hurricane Katrina. Issues related to the dissemination of evidence-based treatment in schools following a disaster are discussed, as are the particular needs of providers and school staff and the importance of community collaboration in identifying ways to adapt implementation strategies for specific communities.
The goal of the current article is to describe the implementation and outcomes of an innovative statewide dissemination approach of the evidence-based trauma intervention (CBITS). In the context of a 2-year statewide learning collaborative effort, 73 CBITS groups led by 20 clinicians from 5 different school-based mental health provider organizations served a total of 350 racially and ethnically diverse (66.9% Hispanic, 26.2% Black/African American, 43.7% White, and 30.1% Other), majority female (61%) children, averaging 12.2 years (SD = 2.4, range 8-19). Of the 350 children who began CBITS, 316 (90.3%) successfully completed treatment. Children demonstrated significant reductions in child posttraumatic stress disorder (PTSD) symptoms (42% reduction, d = .879) and problem severity (25% reduction, d = .396), and increases in child functioning, t(287) = -3.75, p< .001 (5% increase, d = .223). Findings point to the need, feasibility, and positive impact of implementing and scaling up school-based interventions for students suffering from posttraumatic stress. (PsycINFO Database Record
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