This study explored an intensive 3-week training program and use of psychiatric service dogs for military-related posttraumatic stress disorder (PTSD) and associated symptoms. The sample included 2 separate cohorts of military veterans (n = 7 and n = 5) with prior diagnoses of PTSD. Participants completed self-report measures assessing PTSD, depression, perception of social support, anger, and overall quality of life 1 month prior to the training (baseline), at arrival to the training site, and 6-month follow-up. Results indicated that, for this sample, there was a statistically significant decrease in PTSD and depression symptoms from pre- to posttreatment, as well as 6-month follow-up. For most participants decreases were both clinically significant and reliable changes. Further, participants reported significant reductions in anger and improvement in perceived social support and quality of life. Limitations of the study include a lack of control group, a limitation of most naturalistic studies, as well as small sample size. Despite this, the findings indicate that utilizing psychiatric service dogs, coupled with an intensive trauma resilience training program for veterans with ongoing symptoms, is feasible as a complementary treatment for PTSD that could yield beneficial results in terms of symptom amelioration and improvement to overall quality of life. (PsycINFO Database Record

This article introduces the therapeutic contracting program as a comprehensive treatment system for persons with serious mental illness. Therapeutic contracting offers a promising framework for integrating medical, psychological, and social therapies in a manner that fosters clients' active involvement in treatment. This article outlines a multistage therapy program that mobilizes clients' adaptational resources through experimental interventions, structured goal-setting exercises, and skills-building experiences. Data illustrate the effectiveness of therapeutic contracting for (a) securing clients' treatment compliance, (b) promoting positive clinical outcomes, (c) reducing overall treatment costs. The therapeutic contracting model is discussed as a potential vehicle for expanding the professional role of psychologists in psychiatric settings, particularly in areas of clinical and administrative decision making.

Psychologists increasingly have the opportunity to work with persons with serious and chronic mental illnesses. Managed care encourages services that rely less on hospital treatment and more on a combination of brief and intensive outpatient therapy and long-term, low-cost maintenance and support. Diagnostic practices needed to be effective in such an environment include categorical and functional assessment. Psychological treatments that have been demonstrated effective include cognitive-behavioral social skills training, pragmatic supportive therapy, personal therapy, the multimodal functional model, therapeutic contracting, case management, and multiple family therapy. These innovative assessment and treatment techniques are described along with some experimental treatments of cognitive dysfunction.In the past, many psychologists believed that they had little to offer individuals suffering from serious mental disorders, such as schizophrenia and chronic major depression, and considered those cases to be more suitable for psychiatric treatment that was based on pharmacology and hospital care. Psychology training generally includes little exposure to course work and practical training with seriously mentally ill individuals (Millet & Schwebel, 1994), and there are relatively few role models in the profession to encourage students to pursue this area of spe-JEFFREY R. BEDELL received his PhD in clinical psychology from the University of South Florida in 1975. He is currently an associate professor of psychiatry (psychology) at Mount Sinai School of Medicine and is the director of Community Options, .a clinical research program at Elmhurst Hospital Center developing and evaluating clinical and costeffective community treatments for persons with serious mental illness. RICHARD H. HUNTER received his PhD from Southern Illinois University at Carbondale in 1982. He is chief psychologist for the Bureau of Clinical Services, Illinois Department of Mental Health and Developmental Disabilities, and is clinical associate professor in the Department of Psychiatry at Southern Illinois University's School of Medicine. He is working on programs and intervention strategies for treatment-resistant patients and interventions for people with a dual diagnosis of mental retardation and mental illness. PATRICK W, CORRIGAN, PsyD, is an associate professor of psychiatry at the University of Chicago, where he directs the Center for Psychiatric Rehabilitation, a clinical, research, and training program for persons with serious mental illness and their families. He is also the principal investigator and director of the Illinois Staff Training Institute for Psychiatric Rehabilitation, related to the implementation and maintenance of effective rehabilitation programs in real world settings.

Outcomes in psychiatric care are improved by expanding treatment options and reducing dependence on management and control interventions.

Improving clinical outcomes, treating aggression, and reducing the use of restraints and seclusion are major concerns to providers of psychiatric services. Devising precise treatments directed by causal hypotheses that address the functional properties of maladaptive behaviors are essential for reducing aggression, increasing understanding of causal factors, and enhancing individual control and adaptive choices. This article describes the Multimodal Functional Model (MFM), a sophisticated case formulation and treatment model that moves beyond the "diagnose and treat" paradigm and provides interventions that address causal factors, reduce aggression, and prevents the use of restraints and seclusion in psychiatric settings.