The present research examined self-reported counseling activities and referral practices of Canadian clergy in Vancouver and surrounding areas in British Columbia. It was found that the clergy spend an average of about seven hours per week in counseling, dealing primarily with marriage and family or emotional problems. The median number of clients seen in the past six months was found to be 28. Almost 80% of the clergy reported referring at least one client to a mental health setting during the past year (median number of referrals = 2.6). The clergy's major community contacts were found to be social workers and physicians, although referrals were made to mental health centers, psychologists or psychiatrists. Communication between the clergy and the community tended to flow in one direction, from the pastor to the community. Years of education, positive attitudes towards community mental health, and recent workshop attendance were found to correlate positively and significantly with measures of the clergy's involvement in mental health. Denominational affiliation and theological fundamentalism were found to be poor predictors of the clergy's counseling and referral activities. Results are discussed in terms of their significance for the role of the clergy in community mental health.
Research is reviewed which suggests that hyperventilation syndrome is an underdiagnosed disorder for the presentation of many patients experiencing apparent anxiety states. In a test of this hypothesis, 21 normal individuals (9 female) underwent a 2 min period of intentional hyperventilation following a 10 min baseline phase. Hyperventilation was accompanied by increased subjective anxiety and tachycardia, and indications of peripheral vasoconstriction. Following hyperventilation, Ss experienced increased levels of state anxiety and perceived autonomic arousal, as indexed by self-report instruments. These results support the hypothesis that undiagnosed hyperventilatory phenomena may be etiologically implicated in states of pathologic anxiety.
The existence of lengthy wait lists, a not uncommon condition found in many public community mental health services, prompted a small team that was performing the intake function for its clinic to launch a pilot project of Brief Therapy. Amidst a traditionally oriented service and in the face of understandable skepticism, this team constructed a coherent plan of action founded upon the solution focused model of brief therapy. Not only did the results more than validate the team's initial expectations, they so impressed their management team with their data, that even in times of marked fiscal restraint, the Brief Therapy Program was expanded.
College students (40 male and 40 female) were administered Rotter's Internal-External Locus of Control (I-E) Scale and the Irrational Beliefs Test. A significant correlation of .41 was found indicating a moderately strong relationship between externality and extent of irrational thinking. Five of 10 irrational belief scales, Demand for approval, Frustration reactive, Anxious overconcern, Dependency, and Helplessness, were also significantly positively correlated with extetnality ( rs ranging from .22 to .40). The results were interpreted as reinforcing an association between externality and maladjustment.
The assessment of a client's need to be admitted to acute psychiatric care during an emergency room (ER) visit can be quite difficult. This article outlines ways in which an effective evaluation of a client's strengths and abilities can be integrated into the assessment of clients presenting in the ER. Assessing client strengths integrates well with traditional forms of mental health assessment that focus more exclusively on the exploration of risks and challenges faced by the client. However, the investigation of a client's strengths requires training and skill in a strength-based model, such as Solution-Focused Therapy (SFT). The Crisis and Response Team at the Red Deer Regional Hospital, Alberta, Canada, has found that the skillful use of SFT during crisis assessment enables mental health professionals to provide a more balanced and client-centered picture of the client. This more balanced assessment can better determine a client's level of risk and level of resources. A balanced assessment also improves decisions about admission and provides a more helpful experience for clients. This article explores how SFT in conjunction with the medical model in psychiatric crises supports decision making, leads to goal-oriented strategies by therapists, empowers clients, and facilitates positive conversations. It also describes the commitment to ongoing learning required to establish and reinforce the skills required to provide a balanced assessment.
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