This article offers a brief review of the history of supervision, defines reflective supervision, and reports the results of a Delphi study designed to identify critical components of reflective supervision. Academicians and master clinicians skilled in providing reflective supervision participated in a three-phase survey to elicit beliefs about best practice when engaging in reflective supervision. The process yielded consensus descriptions of optimal characteristics and behaviors of supervisors and supervisees when entering into supervisory relationships that encourage reflective practice. These results, although preliminary, suggest that it is possible to identify elements that are integral to effective reflective supervision. These initial findings may be used for future study of the reflective supervisory process.

This study details ethnic disparities that exist between American Indian/Alaska Native (AI/AN) youth and White, African American, and Hispanic/Latino youth based on secondary data analysis of Youth Risk Behavior Surveillance Survey from surveys conducted in 2003, 2005, and 2007. Items were selected for secondary analysis based on their relevance to one of five categories including (a) Violence or delinquent behaviors, (b) substance use, (c) sexual behaviors, (d) experience of victimization, and (f) suicide-related behaviors. The analyses suggest that pervasive levels of disproportionality exist between AI/AN youth and youth of other race/ethnicities on an array of risk items. These differences are most profound between the AI/AN and White youth populations, but also exist in numerous areas between the AI/AN and both African American and Hispanic/Latino youth. The findings highlight elevated levels of victimization, drug use, and suicidal behaviors among AI/AN youth. These data must be filtered through the realities of growing up in Indian Country, and must include positive factors not identified in the Youth Risk Behavior Surveillance Survey. Future research should focus not only on disparities, but on culturally appropriate interventions that have been successfully used to address the unique trauma experienced by youth living in AI/AN communities.

Using data from a random sample of 313 severely mentally ill individuals, we assessed the relation between race and schizophrenic diagnoses among those hospitalized at four Chicago metropolitan state mental hospitals. After we controlled for psychiatric diagnosis with an independent SADS diagnosis and other relevant variables, the logistic regression analysis reveals that being Black is predictive of a diagnosis of schizophrenia. These results suggest that significant problems may exist with regard to the treatment and diagnosis of minority groups within the mental health system and the need for culturally appropriate services for minorities, especially within large urban areas.Recently, an association between race and hospitalization in state-operated mental institutions across the United States has emerged. Data collected by the National Institute of Mental Health (NIMH;1980; Manderscheid & Barrett, 1987) suggest startling disparities in the types of diagnosis attributed to racial groups, indicating that the diagnosis of schizophrenia has increased among Blacks in comparison with Whites in state-operated facilities. Concurrently, literature that has accumulated over the last 20 years suggests that racial bias occurs within the institutions that treat the severely mentally ill.Given this context, we examined the issue of race and diagnosis in an urban mental health system. We asked, more specifically, to what extent being Black is predictive of a diagnosis of schizophrenia, independently of other clinical and social variables thought to influence clinical decision making. Institutional Racism Within the Mental Health SystemOver the last 20 years, a significant debate has focused on discriminatory practices within the mental health system. THOMAS PAVKOV, MA, is a doctoral candidate in the Human Development and Social Policy Program at Northwestern University. He is currently completing dissertation research focusing on welfare recipiency among the severely mentally ill. DAN A. LEWIS received his PhD from the University of California at Santa Cruz in 1980. He is currently the chair of the Human Development and Social Policy Program at Northwestern, as well as Associate Director of the

This study explored the role of family characteristics in the coping process of a family after having experienced Hurricane Katrina to gain an understanding of the relationship between family resiliency, hope, family hardiness, and spirituality for survivors of this natural disaster. It was hypothesized that families who demonstrate higher levels of hope, family hardiness, and spirituality would be more likely to effectively cope after the storm. Further, great resource loss was hypothesized to diminish a family's ability to cope. Four hundred fifty-two participants completed the survey. Results indicate a relationship between hope, family hardiness and spirituality, and the criterion variable, family coping. The importance of these findings in terms of exploring family resiliency following a natural disaster is discussed.

This study tested the relationship between family dynamics and self-injury. A total of 189 participants responded to a web-based survey collecting information related to previous self-injury behaviors and family dynamics. Participants were over 18 years old who had used self-injury (intentionally harming themselves physically to relieve painful emotions without suicidal intent), but who had not used self-injury for over a year. Results indicated that healthy family dynamics were negatively correlated and associated with higher scores of self-injury behaviors. This study offers some evidence that family dynamics influence self-injury behaviors. The implications for family therapy are discussed.

No abstract

No abstract

The present descriptive case study reports on the state of treatment services and environmental settings in adolescent residential treatment facilities (RTFs) conducted as part of the Residential Treatment Center Evaluation Project. The project frequently uncovered poor quality of care exposing youth to deleterious conditions. Observations related to harsh treatment practices, psychiatric practice and medication management, educational and aftercare planning, and general treatment planning were closely examined. The analysis indicated that accreditation and licensing are insufficient to assure the quality of the service process in RTFs. Future research should address the relationship between treatment quality and treatment outcome. Efforts should also be made to develop strategies for organizational change to support high-quality services in RTFs.