Health financing, service utilization, and national policy: A conversation with Stan Jones.

Interviews Stan Jones, Vice President for Government Relations for Blue Cross/Blue Shield, about his perspective on major health care issues. Topics discussed include access to health care, the role of government in health care services, and factors affecting rising health care utilization and increasing costs. The moral and economic issues related to competition as a means of cost containment are considered. Also discussed is the importance of consumer demand in securing new health insurance benefits, such as coverage for mental health services. Marketplace and diagnostic/treatment issues that make insurance coverage for mental health services problematical are explored. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human welfare and national policy: A conversation with Stuart Eizenstat.

Problems encountered in designing a national health policy include special interest groups and cost. The major inhibitor to broader mental health coverage is a concern about where the costs stop and what will be the overall impact on Medicare costs; this derives from the difficulty in establishing a cure for some illnesses and the open-ended time frame for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging, research on aging, and national policy: A conversation with Robert Butler.

Reports on an interview with R. N. Butler (August 10, 1982), who was the first director of the National Institute on Aging (NIA), from 1976 to 1982. Butler speaks about the federal role on aging research in the "post-Butler" era (following his resignation from NIA), stressing the importance of behavioral science. He suggests that the National Institute of Health may support more behavioral research than the Alcohol, Drug Abuse, and Mental Health Administration. Butler also expresses views on the 1981 White House Conference on Aging and the 1982 United Nations World Assembly on Aging; the national social, economic, and health policies related to a 4-generational society; nursing home training sites where health care providers can get first-hand experience with the aged; and the role of Medicaid and Medicare in meeting health care cost of the elderly. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care, Medicare, and health policy for older people: A conversation with Arthur Flemming.

Fleming, former secretary of the Department of Health, Education, and Welfare and former US Commissioner on Aging, addresses (a) national health policy and how it might be more supportive of mental and general health needs of older people; (b) the need for changes to the Medicare program, such as enabling psychologists to provide mental health services to the elderly; (c) the need for a national health insurance other than Medicare; and (d) the importance of the Age Discrimination in Employment Act. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A conversation with a physician and a cancer patient. Interview by Judith D Burke

The influence of Ca2+ on the growth, antibiotic production and differentiation of Streptomyces albogriseolus 444 was studied. Consumption of the calcium ions by the strain was followed up. It was shown that Ca2+ changed the dynamics of the biomass accumulation and had no significant effect on the antibiotic production. Calcium present in the medium was assimilated more intensively during the first 24 hours of the strain growth. The own antibiotic nigericin exogenously added to the medium increased the calcium assimilation. In the presence of Ca2+ the nigericin stimulation of the strain differentiation was higher.     

Therapeutic effort, treatment outcome, and national health policy.

Contends that psychotherapy is seen as repairing or preventing emotional, social, and behavioral dysfunction. The therapeutic effort in the delivery of psychotherapy can be construed as containing 3 components: (1) the dosage of each element in the therapeutic effort; (2) the extent to which each therapeutic intervention restricts the patient's life; and (3) the cumulative costs, in terms of human and material resources invested, of the clinical episode. Dosage measures provide a means of assessing the differences in outcome that might result when 2 or more interventions are provided with the same dosage, or when the same intervention is provided at different dosage levels. Restrictiveness measures provide a means for assessing the differences in outcome that might result when 2 or more interventions seek to control the therapeutic environment in different ways. Cost measures can combine the issues raised in both dosage and restrictiveness studies to provide measures of their combined influences. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teacher preferences for service delivery: A look at attribution research.

Reviews the literature on teacher attributions and discusses the relevance of causal attributions to teacher preferences for service delivery (i.e., referral for psychoeducational assessment, consultation). Literature is reviewed in the context of B. Weiner's (see record 1979-28688-001) proposed dimensions of causality. In addition, practical implications for this literature are discussed, and future research endeavors exploring the relationship between causal attributions and preferences for service delivery are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health manpower policy: A perspective from the National Institute of Mental Health.

Provides a brief history of the US National Institute of Mental Health (NIMH) and its role in mental health manpower development. It is concluded that the mental health clinical training programs of NIMH have been essential to the academic mental health community and to the growth of the professions. Presently in psychology and social work, the shortage of funds to support students is the primary concern. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public policy and public service: Our professional duty.

Psychology is a steadily maturing profession, and we psychologists are finally beginning to accept our societal responsibility to be involved in the public policy and political process. Although psychologists have shown increased involvement in the recent past, there are still many areas in which psychologists could become markedly more involved—especially in the area of programs that affect the quality of life of our nation's elderly, disabled, and poor citizens. As our profession seeks to become more active in the overall health care arena, we will, of necessity, begin to define the parameters of "quality of care" for other professions. In doing so, we must closely explore the "outer limits" of our own practice. We must ensure that all state and federal legislative (and administrative) policies do not impose arbitrary limitations on the scope of practice. To accomplish this objective, we must seek to influence our subset of our nation's health policy priorities and policies that we have traditionally shunned—the subset that affects "the public good." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

AIDS-related service and research, evolving federal policy, and psychological practice.

The HIV epidemic has provided multiple examples of the interrelationship of behavior to disease and multiple examples where the caregiver or policy maker has attended to the behavior as well as the virus. It is argued that those who are aware of the behavioral nature of disease, and of HIV infection and AIDS in particular, need to document what they know and share it widely with others. The behavioral sciences have much to offer in this arena. The Republican "Contract with America," the evolving scope of practice in psychology, and the importance of psychology thinking as a health care profession are also discussed. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research, program development, and the education of Native Hawaiians: A conversation with Myron Thompson.

Presents an interview with M. Thompson, a trustee of the Kamehameha Schools/Bishop Estate and chair of the committee that conducted the Native Hawaiian Educational Assessment Projects, focusing on the funding, goals, and achievements of both programs. Topics discussed include the importance of sensitivity to cultural background, the employment of psychologists in the Kamehameha schools, needs assessment of Hawaiian children, and the relevance of research in Hawaii for other cultures (e.g., Blacks). (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Paraprofessionals, partners, peers, paraphernalia, and print: Expanding mental health service delivery.

Presents a model that defines 5 types of nonprofessional therapeutic agents–paraprofessionals, partners, peers, paraphernalia, and print—and proposes their use at 3 levels of intervention—prevention, treatment, and maintenance. Selected research using these nonprofessional agents is described, and additional therapeutic applications are suggested. Implications of the model for treatment effectiveness, the role of mental health professionals, and cost-effective service delivery are also explored. (5? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The founder of common factors: A conversation with Saul Rosenzweig.

In preparation for a commentary on Saul Rosenzweig's classic 1936 paper, "Some Implicit Common Methods in Diverse Forms of Psychotherapy," an amazing discovery was made: Saul Rosenzweig is not only alive but also still contributing to science and society at age 93. This article sets the stage for a conversation with the incredibly prolific Dr. Rosenzweig by tracing the impact of his seminal contribution on early common factors theorists. This review reveals Rosenzweig's unrecognized but profound influence on leading figures of not only common factors but also of psychotherapy itself. A conversation with Rosenzweig, the founder of common factors, is presented. This noted scholar and wise elder of psychology reflects on the evolution of his thinking from common factors to idiodynamics, and on topics ranging from his passion for literature to his 1965 Buick Skylark, from the history of psychotherapy to falling in love with ideas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rethinking psychology and the schools: Implications of recent national policy.

Social reforms affecting society often are played out in America's schools. Within the past 3 years, the federal government and many states have passed massive social reforms, all of which affect schools, children, and families. This article explores 2 converging reform movements: education and health care reform. Education reform, which is addressed nationally in the Goals 2000: Educate America Act of 1994, the Improving America's Schools Act of 1994, the School-to-Work Opportunities Act of 1994, and the pending reauthorization of the Individuals With Disabilities Education Act (1994), is producing dramatic transformations at federal, state, and local levels. Although comprehensive national health care legislation has failed to gain passage, many states and national groups are promoting schools as health service delivery sites. Thus, social reform movements in education and health care are converging within the single social institution that touches the lives of every American citizen—the schools. This article explores the challenges and opportunities for psychology in addressing social reforms associated with the schools. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A national survey of U.S. statutes on juvenile transfer: implications for policy and practice

The opening and closing of a single ion channel can be described as the aggregation into two sets of states, open and shut, of an underlying Markov process with a finite number of states. In this paper we consider an inhomogeneous process due to changing physical conditions, in particular a pulse of activity in which the transition rates during the pulse differ from those obtaining both before and after the pulse. Outside the pulse the chain contains an absorbing shut subset, so that no activity is observed before the pulse and almost surely, at most a finite number of openings are generated by the pulse. We consider, in particular, the probability distribution of first latency (the time to first opening) and the distribution of the total activation time. We take into account the phenomenon of time-interval omission, when short open or shut times fail to be observed.     

Health psychology and public policy: The political process.

During the past 20 years, psychologists have successfully modified federal statutes, resulting in recognition of the profession's clinical and research expertise. Despite these successes, professional psychology's training institutions have largely failed to address basic issues in health policy and the implications of national health policy for psychology. The importance of public health programs under Title VII of the Public Health Act and the significance of full inclusion of psychology in all federal health programs, including Titles XVIII (Medicare) and XIX (Medicaid), are poorly understood by most health psychologists. Federal health policy decisions, including management of excessive federal health spending, will dictate the growth and opportunities for health psychologists. Understanding federal health spending and recent federal initiatives such as Resource Based Relative Value Scale, Diagnostic Related Groups, and practice guidelines will be of benefit to health psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Appropriateness in health care delivery: definitions, measurement and policy implications

A major focus of the current health care debate is the notion that a substantial proportion of the health care delivered in Canada is inappropriate. There are two types of appropriateness: appropriateness of a service and appropriateness of the setting in which care is provided (i.e., inpatient v. outpatient or home care). Measuring both types objectively requires the comparison of observed patterns of care with explicit criteria for appropriate care. The few studies of appropriateness conducted in Canada have shown that inappropriate services are provided and inappropriate settings are used. Reducing inappropriate health care delivery could involve active strategies for the implementation of guidelines and better cooperation and coordination within the health care system. However, lower rates of health care delivery or even inappropriate health care will not necessarily translate into higher quality care or lower costs overall.     

Acute stress management with public safety personnel: Opportunities for clinical training and pro bono community service.

Public safety personnel are exposed to high levels of chronic stress, and at times they experience intense emotional reactions to critical incidents that can severely impair their ability to provide emergency services to the public. Critical incident stress management (CISM) involves directly intervening in these cases, using a team composed of both mental health professionals and peer support personnel. Involvement with a CISM team offers psychologists an opportunity to intervene in a substantial community health problem. Because services are provided free of charge, psychologists can offer pro bono work to their communities, which is consistent with their ethical obligations to the public. CISM teams also present an excellent in vivo setting for training psychology interns about psychological trauma, and the teams offer the interns a chance to become involved in community-based interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care policy, psychotherapy research, and the future of psychotherapy.

In a quest for accountability in the delivery of health services, health care policymakers in both government and private sectors are creating clinical practice guidelines, many of which heavily emphasize medical and pharmacological approaches. Yet, there are now sufficient data to support the efficacy of psychotherapeutic procedures for a wide variety of specific disorders, and it seems now is the appropriate time to communicate these findings to health care policymakers and the public at large. At the same time, data must be developed on the delivery of these interventions by frontline clinicians in the settings where they practice. The emergence of practice research networks may accomplish this latter goal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health and social costs of unemployment: Research and policy considerations.

Reviews recent studies of the social and private costs of unemployment. Although the experience of joblessness differs according to circumstances, prolonged unemployment is commonly a serious threat to health and the broad quality of life. These costs are borne not only by individual workers, but also by their families and communities. Research on unemployment has examined (1) associations between unemployment rate and indicators of strain such as psychiatric admissions and infant mortality, (2) ecologic studies of economic change, and (3) associations between unemployment and the demand for mental health services. The implications of this research for economic and social policy are discussed and contrasted with policy development premised on a benign view of unemployment. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)