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The present research examined the ability of a group of objective and subjective social indicators to discriminate between respondents who were community mental health center clients and those who were community residents with no history of contact with mental health professionals. Previous research had suggested that objective social indicators were inadequate both for assessing well-being and for assessing mental health needs. Thus, the purpose of this project was to provide initial data on the relative efficacy of objective and subjective social indicators in discriminating those who needed mental health services from those who did not. In addition, the goal was to determine the ability of a combined group subjective and objective indicators to discriminate between those who needed mental health services and those who did not. Teams of trained undergraduates administered questionnaires containing questions regarding demographic variables, recent stressful life events, social supports, daily activities, and quality of life (domain satisfaction). Community mental health center clients appearing for the first time in East Tucson, Arizona were designated as those in need of mental health services (clinic). East Tucson community residents reporting no history of contact with mental health professionals were designated as those who were not in need of mental health services (community). Results indicate that discriminant function analysis using only demographic variables was able to correctly classify 85.7 percent of these respondents as belonging to either the community or clinic group. Using quality of life variables, 85.2 percent of these respondents were correctly classified. By combining one demographic variable, one recent stressful life event, and three quality of life items, a discriminant function analysis correctly classified 93.1 percent of these respondents as either clinic or community. Results of discriminant function analyses with a cross-validation sample support these results. The overall results are viewed as preliminary but suggestive of the potential utility of combining objective and subjective indicators for predicting mental health needs. The results are discussed in terms of their implications for preventive approaches to mental health in light of the limitations of defining need on the basis of utilization of services.

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The American Psychiatric Association criteria for differential psychiatric diagnoses (DSM III-R) do not exhaust the list of socially problematic behaviors displayed by the mentally ill. The extent to which such behaviors influence a person's "career" as a deinstitutionalized patient is the major topic of this study. Fiscal crises and changing public commitments have reduced support to those with severe mental illness who are deinstitutionalized, increasing the importance of understanding how degrees of competence at activities of daily living and the extent of socially problematic behaviors affect their participation in the community. The concept Interactive Competence was developed on the basis of the writer's clinical experience and a review of the literature on community adjustment of persons with severe mental illness. The concept characterizes the social functioning of persons diagnosed as mentally ill, and includes demonstration of self-care (ADL) skills and self-management skills (trouble in relationships). Secondary analysis was performed on data from a 1984 probability sample of clients in Community Support Programs for seriously mentally ill adults. Factor analysis reduced items in the original instrument, The Uniform Client Data Instrument, to scales measuring Interactive Competence. Only persons with the diagnosis of Schizophrenia or Affective Disorders were studied (n=824 of 1053), excluding diagnoses which were diverse in nature and infrequent in occurrence. Bivariate correlation and regression techniques were used to test the major hypotheses: 1) Schizophrenics demonstrate less Interactive Competence than those with the diagnosis of Affective Disorder; 2) the greater the chronicity (length of time in the social role as a patient from point of first diagnosis) the less Interactive Competence; 3) lower level of Interactive Competence is associated with a lower level of mental health service utilization. Monitoring Interactive Competence self-care (ADL) skills and selfmanagement skills (trouble in relationships) provides new insights about the service utilization of the severely mentally ill and their families. Schizophrenics had less the Interactive Competence than those with Affective Disorders; those with lower scores on Interactive Competence used more services; family involvement influenced clients' use of crisis assistance services and urgent care services. / 2031-01-01

In the ESL classroom, there are often cultural differences between learners and teachers. Sometimes these differences can lead to misunderstandings or even conflict. One area where differences between cultures can be seen is language learning strategies and styles. This study explores the possibility that awareness of differences, explicit teaching, and negotiation may help to resolve differences. This study looks at differences between Russian-speaking adult ESL learners and American ESL teachers, with respect to strategy use and preferences. Three aspects are investigated. The first is to see whether there are statistically significant differences ~tween these groups of learners and teachers. The second is to try to form a loose profile of the learners as a cultural group. The third is to see whether or not there is evidence to suggest the validity of explicit teaching of strategies in the ESL classroom. The Strategy Inventory for Language Learners (SIIL), developed by Rebecca Oxford, is one way to assess differences ~tween learners and teachers. A survey including the SIIL and a questionnaire was given to ninety-four subjects. Forty-seven are Russian-speaking adult ESL learners and forty-seven are American-English-speaking ESL teachers or potential ESL teachers taken from a TESOL program. The results of the survey show that, in this case, there are statistically significant differences in preferences for and use of several sets of strategies. A preliminary cultural profile is derived from the SILL results and from anecdotal evidence gathered from the questionnaire. There is some evidence that the explicit teaching of language learning strategies and their use may help resolve some of the classroom conflicts between the two groups studied.

This study focused on the quantitative and qualitative aspects of suicidal behaviour of 90 people who had come to the attention of the Accident and Emergency Department of Westmead Hospital, Sydney, N.S.W., after an attempt to harm themselves. The risk factors identified in the study were combined with the circumstances and motive of attempt. Participants were regrouped according to whether the problems the respondent described were chronic (longstanding) or acute (pivotal). The participants were further classified according to the persistence of thoughts of self-harm ( impulsive or non-impulsive/deliberate) and the presence or absence of these feelings at the time of the interview (the resolution of the attempt) and the types of problems/situations and triggering events the person described as wanting to escape. By developing strategies and treatments for the problems as they were identified in this study and by raising the awareness that there is help available for these different issues, we may be able to reduce the pain which results in an attempt to self harm. / Doctor of Philosophy (PhD)

Thesis (Ph. D.)--University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file viewed on (March 2, 2007) Vita. Includes bibliographical references.

Given the high prevalence of client unilateral termination from psychotherapeutic services, elucidating client reasons for ending therapy is an important activity for researchers. Three studies were designed to shed light on reasons for both premature and appropriate termination from the perspective of adult clients and therapists: 1) In Study 1, I examined data from the Canadian Community Health Survey, Cycle 1.2, to establish base rates of client reasons for psychotherapy termination in Canada, along with their demographic and clinical correlates, 2) In Study 2, I used training clinic data to examine client and therapist perspectives of reasons for termination, working alliance, and barriers to treatment participation in mutual versus unilateral terminators, and 3) In Study 3, I collected data from Canadian clinical psychologists to examine their perspectives of client reasons for early versus later termination, and their use of engagement strategies to reduce client-initiated unilateral termination. In Study 1, 43.1 percent of respondents reported terminating therapy for reasons other than feeling better or completing treatment. In general, individuals with low income and diagnosable mental disorders had significantly increased odds of premature termination. Study 2 revealed that when clients made unilateral decisions to end therapy, therapists were only partially aware of either the extent of clients’ perceptions of their success in therapy or with their dissatisfaction with therapy. Although working alliance and barriers to treatment participation were rated as lower in the context of unilateral termination by both clients and therapists than in the context of mutual decisions to terminate therapy, all clients, in general, rated the early alliance and barriers to treatment as higher than did their therapists. In Study 3 psychologists assigned differential importance to reasons for termination depending on whether termination was before versus after the third session. Theoretical orientation (CBT versus other) did not influence views of reasons for termination, but influenced use of some engagement strategies. Results are discussed in terms of research and clinical implications.

Given the high prevalence of client unilateral termination from psychotherapeutic services, elucidating client reasons for ending therapy is an important activity for researchers. Three studies were designed to shed light on reasons for both premature and appropriate termination from the perspective of adult clients and therapists: 1) In Study 1, I examined data from the Canadian Community Health Survey, Cycle 1.2, to establish base rates of client reasons for psychotherapy termination in Canada, along with their demographic and clinical correlates, 2) In Study 2, I used training clinic data to examine client and therapist perspectives of reasons for termination, working alliance, and barriers to treatment participation in mutual versus unilateral terminators, and 3) In Study 3, I collected data from Canadian clinical psychologists to examine their perspectives of client reasons for early versus later termination, and their use of engagement strategies to reduce client-initiated unilateral termination. In Study 1, 43.1 percent of respondents reported terminating therapy for reasons other than feeling better or completing treatment. In general, individuals with low income and diagnosable mental disorders had significantly increased odds of premature termination. Study 2 revealed that when clients made unilateral decisions to end therapy, therapists were only partially aware of either the extent of clients’ perceptions of their success in therapy or with their dissatisfaction with therapy. Although working alliance and barriers to treatment participation were rated as lower in the context of unilateral termination by both clients and therapists than in the context of mutual decisions to terminate therapy, all clients, in general, rated the early alliance and barriers to treatment as higher than did their therapists. In Study 3 psychologists assigned differential importance to reasons for termination depending on whether termination was before versus after the third session. Theoretical orientation (CBT versus other) did not influence views of reasons for termination, but influenced use of some engagement strategies. Results are discussed in terms of research and clinical implications.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2001. / Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains viii, 170 p. Includes abstract. Includes bibliographical references (p. 108-157).