Community reintegration for people with psychiatric disabilities: challenging systemic barriers to service provision and public policy through participatory action research

People with psychiatric disabilities represent a growing group within the population of nursing home residents in the USA. Despite a preference for living in community‐based settings, the availability of supportive services for community living is hindered by barriers at both the service provision and public policy levels. Therefore, understanding and responding to the community living and participation needs of people with psychiatric disabilities is a highly relevant area for action research. This paper discusses a participatory action research endeavor carried out in collaboration with key personnel at Centers for Independent Living who work to provide community reintegration services for individuals with psychiatric disabilities. The events of this 15 month partnership are extensively described, analyzed and discussed. Findings reflect the critical need for communication, dialogue and action to support people with psychiatric disabilities in the community.     

A group-based,acceptance & commitment therapy intervention for chronic pain

ABSTRACT

As the effects of the opioid epidemic continue, the availability of interventions that address the emotional and psychological needs of people who suffer from chronic pain are increasingly necessary. Acceptance and commitment therapy (ACT) is one of the more actively researched psychological approaches amongst the third wave of developing psychotherapies. In fact, ACT has been shown to improve chronic pain in several different populations. In order to widen access to treatment, the use of group-based, ACT interventions with individuals who suffer from chronic, non-cancer pain should be made available in more traditional, mental health settings. The purpose of the current article is to describe a group-based, ACT intervention for people who suffer from chronic, non-cancer pain. A 10-session group intervention is outlined, and recommendations intended to increase the intervention’s efficacy are provided.     

论锡伯族萨满神歌的心理医疗功能

在漫长历史中 ,锡伯族创造了与自身的生产方式和赖以生存的自然界相适应的萨满教 ,并不断发展丰富 ,萨满教成为锡伯族传统文化的深厚根基。萨满教延续千百年 ,其主要功能和价值之一是治疗疾病 ,保障氏族的生存繁衍。锡伯族萨满治疗患者是在歌、舞、乐三者浑然一体的场景中 ,即在“跳神”场景中进行的。歌、舞、乐三者是古老时代集体创作的产物。在萨满“跳神”过程中 ,他和助手及众人共同吟唱的神歌 ,对患者产生了心理医疗功能。     

Considering Improvisation: Play,Transitional Space,and Discovery

This article explores the concept of improvisation in the therapeutic setting as a complex construction when elaborated in the idiom of jazz music. A composite clinical case is offered that illustrates an impasse and how improvisational thinking offers a way forward. Improvisation has recently been conceptualized through the metaphor of theater improvisation, dance, and rhythm. The therapeutic hour is considered an improvisational dialogue with the main theme (melody) and counter melodies, and harmonic possibilities that underlie the rhythmic pulse of the hour. Improvisation requires a reflective/interpretive process that draws on patterns, structures, and experiences reformulated in the relational field of the participants. The client initiates the call and response pattern, from which improvisation emerges as a mutual process of discovery. A more relaxed, receptive, and reflective posture extends Winnicott’s 1971 notion of play to integrate classic understanding and relational interaction.     

Return to work: A comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed

Abstract

We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions were based on CBT; however, one was conducted by psychotherapists and involved extensive CBT, while the other was delivered by “labour experts” and consisted of a brief CBT-derived intervention combined with both individual-focused and workplace interventions. One hundred and twenty-two self-employed people who had applied for sickness benefit from an insurance company enrolled in a randomized controlled design. These individuals were assessed before the intervention and then at 4 months and 10 months after the onset of the intervention. The outcome was assessed based on duration of sick leave until partial and full return to work and on psychological complaints. Significant effects on partial and full return were found in favour of the combined intervention: partial return occurred 17 and 30 days earlier in this group than in the CBT group and the control group, respectively. For full return to work, the difference was approximately 200 days. A decrease in psychological complaints was present in each condition but we found no significant interaction effects. The results suggest that work resumption should be addressed earlier in individuals receiving CBT. This insight is of value for the (scarce) literature concerning interventions for individuals who are on sick leave owing to work-related psychological complaints.     

Variables related to psychiatric sick leave taken by Spanish secondary school teachers

Abstract

This study analyses the relationships of certain sociodemographic, organizational, and personality variables with psychiatric sick leave taken by Spanish secondary school teachers. The sample comprised 200 teachers (84 men and 116 women) divided into two groups. The first group was composed of 100 teachers who had suffered from psychiatric disorders requiring sick leave. The second was a matched control group composed of 100 teachers with no history of psychiatric disorders. Both groups shared the same organizational variables (same centre, town, number of students, etc). Logistic regression analysis was conducted to determine any relationships and the risk and protection factors for psychiatric sick leave. It is concluded that the most significant variables related to psychiatric sick leave included competitiveness and hostility, as defined by Type A Behaviour Pattern, emotional exhaustion as a factor of burnout, and job dissatisfaction.     

The accommodation and support needs of people with a mental illness: A process and framework for action

Abstract

This paper reports the results of a consumer-focused assessment of the accommodation and support needs of people with a mental illness living in a regional city. The study utilises a 'pathway to stability' approach to assess the phase-contingent accommodation and support needs of mental health consumers through interviews and focus groups with consumers, carers and service providers. The study identifies five broad phases of the life course impacted by mental illness—beginnings, long-term needs become clearer, instability as needs evolve, finding stability and ongoing. Five key issues—information, self-competence, comorbidity, coordination and flexibility were expanded upon in focus groups. Principles for planning future service delivery are identified. The implications of the findings and research methodology for social work practice and research are discussed.     

Incremental Change: The Pace of Progress in Health

Abstract

In a prospective study of acute diarrheal illness among college students, during one academic year, the incidence of Campylobacter enteritis was 5.57 per 1,000. Approximately 17% of all patients with acute diarrheal illness had Campylobacter enteritis. Campylobacter enteritis is briefly discussed. The value of the stool wet-mount examination is emphasized. It can serve as a guide to which stools to culture and often can lead to a presumptive diagnosis of Campylobacter enteritis. Student health center labs are urged to perform stool wet-mount exams and to provide cultures for isolating the Campylobacter organism.     

Characterization of psychiatrically hospitalized college students

Abstract

Objective: To characterize contemporary college students requiring psychiatric hospitalization. Participants and methods: Sociodemographic and diagnostic information was gathered retrospectively and analyzed from the electronic medical records (EMRs) of the consecutive inpatient hospitalizations of 905 college students admitted to a psychiatric inpatient unit. Results: Significantly more females compared to males experienced the following: more hospitalizations, more family and financial stressors, more depression, and less psychotic and bipolar disorder. The most frequent diagnosis was a depressive disorder, followed by bipolar disorder, psychotic disorder, and personality disorder, most frequently borderline personality disorder. Half of participants had comorbid diagnoses with substance abuse most common. More than two-thirds of students endorsed social or intimate relationship, academic, and family challenges as psychosocial stressors. In all, 15% of participants had repeat admissions. Conclusions: The present study provides demographic data from a sample of psychiatrically hospitalized college students. Findings can help improve screening and identification of decompensation in college students.