The theoretical underpinnings of Washington County Children's Services Division (CSD) Immediate Conflict-Resolution Family Treatment Program include the systems theory of family therapy with a focus on communication and roles. One of the many approaches to helping families in crisis, it incorporates theories regarding assessment of and intervention in families in crisis. Finally, while it draws upon several different approaches to family therapy, the Washington County program is most closely related to Multiple Impact Therapy (MIT). Thus, a review of relevant literature must address portions of the above enumerated theories that illuminate the thinking behind the Immediate Conflict- Resolution Family Treatment Program. While each of the four components of the literature review (systems theory, family crisis theory, assessment of families in crisis, and Multiple Impact Therapy) represents a topic area of breadth and complexity, the aspects of each topic area which seem most relevant to Washington County's MIT project have been reviewed.

It is estimated that approximately one in five patients will terminate therapy early, before participating in full treatment and obtaining maximum therapeutic benefits. Millions of people are forcibly displaced as refugees each year, and therefore at increased risk for poverty, discrimination, and complex mental health needs, yet no research has yet examined rates or predictors of psychotherapy attrition among refugees. The current study draws upon a sample of refugee clients seeking treatment at a community clinic (N = 196), and a comparison group of 165 non-refugee clients at the same clinic. Logistic regression was employed to (1) compare rates of attrition between refugees and a sample of non-refugees matched for income level, sex, and age, (2) identify socioeconomic predictors of attrition in refugees, and (3) identify psychological predictors of attrition in refugees only. Exploratory analyses also examined the interactive effects of formal education and psychological symptoms among refugees only. Results indicated comparable rates of early termination regardless of refugee status, although refugees were more likely than the comparison group to experience an extended gap in early treatment. Twenty-eight percent of refugees and 35% of non-refugees stopped therapy within ten weeks; 45% of refugees and 45% of non-refugees stopped therapy within ten sessions; 14% of refugees and two percent of non-refugees experienced an extended treatment gap within ten weeks/sessions. Fifty-four percent of refugees and 47% of non-refugees experienced at least one of these early treatment disruptions. Within refugee patients’ psychotherapy, and using empirically derived symptom-based scales (somatic, cognitive, avoidance, and posttraumatic stress), age, education, and the interaction between somatic symptoms and education significantly predicted attrition. Each increasing year of age was associated with a 3.4% decrease in risk for attrition. Each education level increase (e.g., primary school to secondary school) was associated with a 24.9-30.3% decrease in attrition risk. Although somatic symptoms alone did not significantly predict attrition, the interaction was significant such that for each increase in education level, a one-point somatic score increase conferred an additional 28.8% decrease in attrition risk. More educated clients with high somatic symptoms were most likely to stay in treatment, as were less educated clients with low somatic symptoms. Findings suggest new culturally relevant considerations for enhancing treatment retention in refugees.

The year 2012 was a year of great controversy surrounding autism in France. Thus it is an ideal time for an investigation of the treatment of and attitudes about autism in France, specifically in comparison with the United States. This investigation encompass several specific categories, and the Freudian psychoanalytic method against the behavior modification method, the French education system and the identification of autism, "Maternal Madness" - the connection between sexism and autism, the philosophy of humanity and the history of medical experimentation and psychiatry in France. This paper questions how is it that all these categories influence the opinions and and treatment of autism in France and what importance these attitudes have in French society.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2008. / Typescript. Includes bibliographical references (leaves 43-45).

Thesis (Ph. D.)--Duquesne University, 2004. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 117-118).

No description available.

Beck Depression Inventory

The pattern of frequent discharges and readmissions which characterizes most psychiatric hospitalization in this country today was described, and it was argued that the costs of this “revolving door” outweigh such benefits as might be derived from it. An alternative stepwise progression model of aftercare was proposed. This model identified community tenure as the most appropriate goal for initial aftercare efforts. Attempts to identify correlates of the establishment of community tenure by mental hospital releasees were reviewed. It was found that the ex-patient's ability to remain in the community is not highly correlated with the extent to which he manifests deviant behavior. This finding was interpreted as an indication that environmental factors may play significant part in ex-patients’ avoidance of rehospitalization. Data were presented which indicated that a clear majority of mental hospital releasees take up residency immediately with family members. It was hypothesized, then, that measurable family variables are correlated with the ability of the ex-patient to achieve community tenure. An attempt was made to examine this hypothesis in the light of relevant research. Studies of the issue which contained substantive empirical support were categorized into four topic areas: family tolerance of the ex-patient's symptomatic behavior, kin role which the family affords to the ex-patient, familial expectations of the ex-patient's performance, and family attitudes and personality characteristics. After reviewing the studies of authors who attempted to assess the degree of correlation between the capacity of the ex-patient’s family to tolerate symptomatic behavior on the part of the ex-patient and the ex-patient’s ability to avoid rehospitalization, it was concluded that the linear correlation between the two variables which would be predicted logically may not exist. A review of studies of the relationship between the kin role which the ex-patient's family affords to him and the ex-patient's ability to achieve community tenure yielded a tentative conclusion that returning to the social biological role of “child” (son or daughter) as opposed to the kin role of spouse was positively correlated with remaining in the community. After examining studies which attempted to explore the relationship between familial expectations of instrumental performance on the part of the ex-patient and the ability of the ex-patient to avoid rehospitalization, it was concluded that little support was provided for the hypothesis that the two variables are related. A survey of attempts to identify family attitude and personality characteristic correlates of ex-patient achievement of community tenure resulted in arrival at the conclusion that such efforts, as a whole, have met with little success, although significant correlations between two general family attitudes toward mental illness and ex-patient avoidance of rehospitalization were found. Considering the findings which were reviewed as a whole, it was concluded that little support was provided for the hypothesis that measurable family variables are correlated with the ability of the ex-patient to achieve community tenure. The rather limited aftercare practice applications which could be drawn from the few correlations that have been discovered were described, and implications of the over-all finding for future research were discussed.

Recent gains in understanding the effects of childhood maltreatment on the development of the brain and nervous system, combined with the revelation that nearly all psychiatric neuroimaging studies have had an unrecognized confound in childhood maltreatment, imply the possibility that psychotherapy treatment effectiveness studies have been similarly confounded by childhood maltreatment. This study examines whether treatment-seeking adults exposed to childhood maltreatment respond differently to psychotherapy than do individuals who report no history of childhood maltreatment. Response to therapy is conceptualized in this study as reduction in symptom measures pre- and post- treatment, as well as client dropout. It is hypothesized that people with a history of childhood maltreatment experience psychotherapy differently, may experience differences in symptom reduction and be more likely to drop out of treatment, than people with no history of childhood maltreatment. The current study examines psychotherapy effectiveness in symptom reduction and dropout rates of clients who experienced childhood maltreatment as compared to those with no history of childhood maltreatment.

Exercise has been shown to improve mood, anxiety, stress, and promote neuroplasticity (Conn, 2010; Donaghy, 2007; Josefsson, Lindwall, & Archer, 2014; Silveria et al., 2013; Stathopoulou et al., 2006). However, limited research on the topic suggests that many psychologists and mental health providers are not incorporating exercise into psychological treatment, and many lack the confidence to do so (Burton, Pakenham, & Brown, 2010; Weir, 2011). The purpose of this study was to evaluate current exercise prescription trends among practicing psychologists and trainees, including identifying their current beliefs, attitudes, training, and the perceived barriers hindering psychotherapists from recommending and prescribing exercise. Psychologists and trainees (N = 146), completed the Exercise in Mental Illness Questionnaire – Health Practitioner Version (EMIQ-HP). Results revealed: a) 40.4% (n = 59) of psychotherapists prescribed exercise only occasionally and recommended clients exercise “most days of the week,” at moderate intensity; b) older psychotherapists’ (t[163] = -2.15, p = .038) and trainees further along in training (t[163] = 2.26, p = .029)were both more likely to prescribe exercise (F[9, 36] = 9.27, p = .011, R2= .42); c) exercise habits of respondents were not significant predictors of exercise prescription; d) a small number of respondents (22.6%; n = 33) reported previous formal training in exercise prescription; and formal training (β = .39, p < .001) was positively correlated with exercise prescription [F(1, 144) = 26.99, p < .001, R2= .16]; and e) therapist barriers (β = -.39, p < .001; e.g., “Prescribing exercise to people with a mental illness is not part of my job…I do not know how to prescribe exercise to people with a mental illness…I don’t believe exercise will help people with a mental illness,” etc.) were inversely related with exercise prescription, F[2, 145] = 27.03, p < .001; R2= .27. In conclusion, psychotherapists’ age, year in graduate school (for trainees; n = 55), and formal training in exercise prescription were significant predictors of exercise prescription, while higher perceived therapist barriers to exercise prescription hinder prescription practices. Study findings, limitations, and future research directions are discussed.