An alcohol treatment program for college students: Community model of inclusion in the university setting.

Students struggling with alcohol problems continue to be part of the college experience. A community model of inclusion consisting of the components of embeddedness, interdependence, intradependence, and evolution (CMEIIE) was used to conceptualize an alcohol treatment program that encourages campus agencies to share resources, training, and ideas. The use of CMEIIE allows universities flexibility to design their own community model of intervention that takes into account (a) current policies, programming, and services; (b) relationships between offices; (c) extensiveness of mental health services; (d) resources of local community agencies; and (e) continual evaluation of the effectiveness of their intervention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceptance of moderate drinking by alcoholism treatment services in Canada

OBJECTIVE: The present study was conducted to provide a nationwide survey of acceptance of nonabstinence goals and related alcoholism treatment practices by Canadian alcoholism treatment services. METHOD: A random sample of 335 Canadian alcoholism treatment service agencies were mailed a 4-page questionnaire designed to assess acceptance of moderate drinking as a drinking goal and related alcoholism treatment practices. RESULTS: Acceptance varied by type of service, with considerably more acceptance by outpatient programs (62%) and mixed inpatient/outpatient programs (43%) than inpatient/detoxification/ correctional facilities (27%) and halfway houses (16%). Two-thirds of the respondents who reported moderate drinking as unacceptable in their own agencies categorically rejected moderation for all alcoholism clients. CONCLUSIONS: Individuals seeking services in Canadian alcoholism treatment agencies are more likely to have a choice of drinking goals if they present to an outpatient program than a residential institution, and Canadian agencies appear more accepting of moderation goals than American programs, but less accepting than British and Norwegian service agencies.     

Patterns in the institutional encounters of problem drinkers in a community human services network

It is useful to view the social handling of alcohol problems in US communities from the perspective of a whole network of human service systems that share in the burden of identifying and responding to problem drinkers. This analysis examines the management of alcohol problems in different community service systems by mapping patterns in the institutional encounters of problem drinkers across alcohol treatment, drug treatment, mental health treatment, social welfare and criminal justice systems in a single US community. Findings highlight the prominence of large bureaucratic systems for social welfare and criminal justice as sources of referrals for smaller service systems offering treatment for alcohol problems. However, large proportions of problem-drinking service recipients in the community remain exclusive clients of the welfare and criminal justice systems, making no contact with therapeutically orientated service settings. Compared with problem drinkers who obtain treatment services, problem drinkers on the case-loads of criminal justice and welfare agencies tend to be younger, of higher socio-economic status, are more likely to be male, and tend to drink less heavily and to experience fewer symptoms of alcohol dependence. Given the distinctive characteristics of problem drinkers found exclusively in criminal justice and welfare settings, it may be advisable for communities to introduce early intervention programs in these systems that target services to this particular subgroup of problem drinkers.     

Mental health services for homeless mentally ill persons: Federal initiatives and current service trends.

Recent research suggests that approximately one third of the population of homeless single adults suffer from severe mental illnesses. Despite multiple health, mental health, and social welfare needs, this population is often unable to obtain necessary housing and community-based services. For this reason, since 1982, the National Institute of Mental Health (NIMH) has undertaken a number of federal initiatives to encourage research and assist states and localities in improving services focused on this vulnerable subgroup of the homeless population. This article describes the target population, NIMH research findings, and current mental health programs—with particular emphasis on two mental health programs established under the Stewart B. McKinney Homeless Assistance Act. Proposed future directions for federal research and evaluation efforts in this area are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The multiple partnership: Scientist, university, agency, and government.

In the US, a significant portion of scientific effort is carried out in universities and financed by government and private agencies. While partnerships among these bureaucratic and social systems are strung together institutionally, the connecting links are provided by individuals in these institutions whose ideas, proposals, and advocacies shape the programs that ultimately are established. These human and political realities, while contributing to the richness and diversity of US science, may also have negative implications for the progress of science, particularly in the face of limited resources. Despite this, science is likely to be enhanced overall by multiple sources of influence and multiple partnerships. The key element will be the careful selection of effective advocates linking foundations, universities, agencies, and government. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Economic regulation of ambulance services in California

OBJECTIVE: This study was intended to identify economic regulatory programs used by California counties (including ambulance franchising and rate setting), to inventory their foci and application, and to identify differences around the state. By studying the variety of programs used in one state, this study establishes a framework for evaluation of state and local regulatory programs elsewhere. METHODS: This study surveyed all California local EMS agencies (LEMSAs); these are California's equivalent of regional EMS organizations. The survey achieved a 100% response rate, and all data involve population parameters obviating the need for inferential statistics. RESULTS: Seventy-three percent of California counties use economic regulations. Large-population counties and those that operate their own LEMSAs are more likely to use economic regulations than are small counties and those that participate in multicounty EMS agencies. Despite a preference for competition in the authorizing statute, most franchises were granted without competition to existing providers. The majority of franchises in the state were granted to public services. Most ambulance rate setting occurs outside of a competitive process. CONCLUSIONS: Economic regulations that were intended to provide a structured marketplace are often being used to protect existing providers, particularly public services, from competition. The growing interest by fire departments in entering the market for emergency ambulance service, along with the existing bias toward them in granting of franchises, does not bode well for use of the competitive process. The growth of managed care may change or eliminate the need for economic regulations but, if they are to continue, more state oversight should be considered.     

Twelve-step and cognitive-behavioral treatment for substance abuse: A comparison of treatment effectiveness.

The comparative effectiveness of 12-step and cognitive-behavioral (C-B) models of substance abuse treatment was examined among 3,018 patients from 15 programs at the US Department of Veterans Affairs Medical Centers. Across program types, participants showed significant improvements in functioning from treatment admission to a 1-year follow-up. Although 12-step patients were somewhat more likely to be abstinent at the 1-year follow-up, 12-step, C-B, and combined 12-Step–C-B treatment programs were equally effective in reducing substance use and improving most other areas of functioning. The finding of equal effectiveness was consistency over several treatment subgroups: Patients attending the "purest" 12-step and C-B treatment programs, and patients who had received the "full dose" of treatment. Also, patients with only substance abuse diagnoses, those with concomitant psychiatric diagnoses, and patients who were mandated to treatment showed similar improvement at the 1-year follow-up, regardless of type of treatment received. These data provide important new evidence supporting the effectiveness of 12-step treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outline of the therapeutic process in social skills training with socially dysfunctional patients.

This article outlines the therapeutic process in social skills training with 22 socially dysfunctional outpatients who met Diagnostic and Statistical Manual of Mental Disorders criteria for avoidant personality disorder. The performance of prosocial target behaviors was measured and associated subjective anxiety was assessed during baseline, treatment, and follow-up periods. For every target, improvement was evaluated for the target as a whole as well as for baseline, treatment, and follow-up periods separately. A relation between subjective anxiety and frequency of performance was established across targets for treatment and follow-up periods. Interrelations between targets for performance and anxiety were calculated separately. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of a rehabilitation psychology program for persons with schizophrenia: Changes in the treatment environment.

Reports the changes that occurred over a 4-yr period at a therapeutic community for persons with schizophrenia when a rehabilitation psychology program was added to the traditional inpatient treatment and eventually replaced it. Data collected (from patients and staff members over the 4 yrs) using the Community Oriented Programs Environment Scale revealed several significant and desirable changes in the quality of the perceived treatment environment, including increases in practical orientation and autonomy. Specific interventions that accounted for improvement in the rehabilitation potential of the treatment environment are described. Conceptual differences between the traditional inpatient psychiatric model and the rehabilitation psychology model are outlined. Value differences between these 2 models are presented as an explanation for the failure of rehabilitation services offered adjunctively with traditional psychiatric services. The treatment environment changed only when rehabilitation became a central part of the treatment philosophy. The fundamental differences between these 2 treatment approaches are related to reports of improved outcome from programs using psychosocial models. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Number and roles of psychologists in the federal-state Vocational Rehabilitation service system.

Data obtained from 70 vocational rehabilitation agencies reveal that the most frequent service psychologists rendered was routine assessment of clients; psychologists were described also as performing a wide variety of training, research, administrative, and treatment services. Data are interpreted as showing a need for additional rehabilitation psychology training programs if contributions of this specialty are to be implemented and future needs of personnel are to be met. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment and outcome for empirical subtypes of alcoholic patients.

387 alcoholic patients from 5 heterogeneous residential treatment programs were empirically grouped into 4 high- and 4 low-social-competence clusters. Within each social competence category, clusters were differentiated by social-psychological resources (high, medium, and low) and family press to drink. The typology was related to background, intake, and outcome variables. A significant association between types and treatment programs was obtained, but an intensive search for patient–program interaction effects yielded no significant results. There was also no evidence that patient types sought or were assigned differential therapeutic regimens in the 5 programs. Results are discussed in terms of the utility of typologies and the matching and mismatching of patients and programs. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rural hospital health promotion: programs, methods, resource limitations

Most hospitals provide health promotion programs for community residents. There is little information concerning the specific types of services offered by rural hospitals. A questionnaire was sent to every acute care hospital in Iowa (N = 124), including 99 rural hospitals and 25 urban hospitals. Surveys were returned from 95 rural hospitals (96%) and 20 urban hospitals (80%). Results indicated that 98.9% of rural hospitals offered health promotion services to community residents. These services provided on average 7.5 programs on a regular basis, while using only 1.2 full-time equivalent (FTE) employees. Urban hospitals provided 9.5 regular programs with 2.4 FTE. The most common types of rural promotion programs were blood pressure screening, cholesterol screening, safety and protection programs, diet/nutrition programs, prenatal/maternal health, and breast cancer screening. Over 40% of rural respondents stated that other less common programs, including substance abuse prevention and mental health promotion, were needed but could not be offered because of resource limitations; these types of services were offered more commonly in urban hospitals. Rural hospital health promotion programs are attempting to meet a wide variety of programming needs with limited resources, and attention may be well directed towards finding how best to provide various programs with limited resources to maximize their impact on community health.     

Head Start and preschool education: Toward continued improvement.

The first 5 years of life influence school readiness and achievement; high-quality preschool experiences can enhance development (C. T. Ramey & Ramey, 1998, 1999). Ripple, Giliam, Chanana, and Zigler (1999) provide valuable data about states' efforts on behalf of preschoolers. Their data reveal that too many states still have no programs, although some have launched promising, innovative, and universal preschool programs with accompanying research. A continued role for Head Start is thus justified, but only if Head Start invests seriously and consistently in high-quality programs. Present fragmentation of services, as well as support for weak programs, must be ended. Effective technical assistance to programs and the promotion of active collaboration with other community agencies, including schools, is critical to success for states and Head Start alike. Forging a new, powerful national coalition that has adequate resources, strong political clout, needed expertise, and a commitment to children's development and school readiness is necessary. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Estimating a population in need of alcoholism services: a new approach

A new approach for estimating a population at risk of alcoholism and problem drinking is discussed. Its advantages include specification of planning-relevant social-demographic characteristics of a population at risk and the identification of a population base in terms of which alcoholism programs, services, and resources can be comparatively evaluated.     

Eighteen-month follow-up data on a treatment program for homeless substance abusing mothers

In response to the dearth of data on substance abuse treatment among homeless mothers, this study breaks new ground in presenting 18-month follow-up data on 149 homeless mothers with young children enlisted in a substance abuse treatment program. The effects of residential compared to nonresidential services were evaluated over the follow-up period. Although dropout rates were high, predictors of dropout were identified, and the residential had a lower dropout rate compared to the nonresidential comparison group. Members of both residential and nonresidential groups evidenced improvement in alcohol and drug problems and in housing stability, regardless of the amount of time they spent in the program. This project demonstrated that homeless mothers can be more successfully engaged in substance abuse programs with provisions of residential placement in addition to participation in a therapeutic community. Future interventions can take advantage of this knowledge in designing more effective programs.     

Psychology positions in comprehensive community mental health centers and community clinics.

Analyzed data from 655 questionnaires completed by community mental health centers and community clinics in the US in 1968. 71% of the agencies offered services to adults and children. 15% served primarily adults, while 14% served primarily children. The major sources of financial support, in descending order, were state, county, and federal governments. 69% of agencies had private consultation privileges associated with positions, and a small percentage of agencies also paid professional membership dues. The median maximum salary for the chief psychologist was $16,750. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eleven components of effective drug abuse prevention curricula

A review of school-based drug abuse prevention programs was conducted for 1989-1994. In addition to a comprehensive literature review, interviews were conducted with a panel of 15 leading experts in prevention research. Key elements of promising prevention curricula were identified. Effective prevention programs were found to be based on a sound theoretical or research foundation. They included developmentally appropriate information about drugs, social resistance skills training, and normative education. Broader based personal and social skills training appeared to enhance program effects. Effective programs used interactive teaching techniques and teacher training, and provided adequate coverage and sufficient follow-up. Cultural sensitivity to the target population was found to be critical to program success. Additional program components were expected to enhance curriculum effectiveness. Finally, experts agreed that adequate evaluation of prevention curricula was critical. Unfortunately, despite information about the types of curricula that are effective, the most promising prevention curricula are not widely disseminated. Reasons for under-utilization are explored, and recommendations made for correcting the situation.