Concerning the present study, if in the test result of psychotic patients there is some distortion of reality concepts, as is generally expected, then their scores on any personality scale should vary considerably from norms established on the same test by "normal" subjects.

Drug default is the failure of a patient to comply fully with medication regimens and is major unsolved problem confronting health care providers oday. Drug default is also known as medication noncompliance. Very few studies have been reported comparing the effects of counseling and the unit dose packaging upon compliance. Further, no studies have been reported on the effects of counseling and unit dose packaging upon compliance in ambulatory psychiatric patients. The present investigation was undertaken to (i) evaluate the effectiveness of the Medication Reminder Record, a type of patient calender sheet, with counseling as a means of improving compliance with medication regimens in an ambulatory psychiatric patient population; and (ii) contrast the effects of the Daily Medication Package with counseling and Medication Reminder Records for ambulatory psychiatric patients.

While much research has examined factors thought to affect patient compliance with therapeutic regimen, relatively little is known about the relationship between psychiatric patients' attitudes toward treatment regimen and their adherence to the treatment regimen. Compliance rates for psychiatric patients remain the lowest of the medical patient population, probably due to psychological and social characteristics of psychiatric patients. Because of a trend in the United States toward self-medication for an increasingly ambulatory psychiatric patient population, the ability to predict patient compliance with medication regimen has become more important than ever before. Before potential noncompliers can be identified and patient compliance predicted through the use of attitudes, an examination of the nature of these attitudes is needed. Scientific literature and theory suggest that attitude is one of several variables which corresponds to behavior. Specific attitudes are thought to develop as a result of 2 real or vicarious experience with the attitude referent. In addition, research has shown that attitudes toward specific objects correlate highly with beliefs, behavioral intentions, and behavior. Therefore, it is hypothesized that psychiatric patients with prior medicine-taking experience will have developed different patterns of attitudes toward pharmacological treatment than will medicine-naive patients. The hypothesis implies that knowing these attitudes will permit prediction of compliance of experienced and naive patients with therapeutic regimen. As the first step of investigating using attitudes to predict compliance, a 20-item Likert-type rating scale, the Psychiatric Medicine Attitude Scale (PMAS), was developed. An alternate forms reliability coefficient of .93 was obtained. Mean score for Form A for the psychiatric medicineexperienced subjects was 2.85, for the medicine-naive subjects, 3.40. Form B scores were 3.17 for the experienced subjects and 3.51 for the naive subjects. These scores show that on both Forms A and B, individuals without prior experience with psychiatric medicine tended tb express more negative attitudes toward the referent object than did the subjects who had previous medicine experience. The next steps, outside the range of this project, will be to develop norms and to ascertain if compliance behaviors will be a function of PMAS scores.

Psychiatric inpatients, consisting of 32 males and 33 females between the ages of 15 and 58 completed Rotter's (1966) Internal-External Locus of Control (I-E) Scale. The scale was administered individually to the patients at both admission and discharge, at the Crisis Stabilization Unit (CSU) in Orlando, Florida. Analysis of variance was used to determine whether there were significant differences due to commitment status (voluntary and involuntary), diagnosis (thought and affective and other disorders), and change scores (admission versus discharge). The hypothesis that involuntary patients would produce significantly higher scores was not confirmed. Further, no significant difference was found due to diagnosis. A second hypothesis that patients would score more internally at the time of discharge versus initial admission also was not confirmed. Therefore, there were no differences in I-E scores before or after treatments regardless of diagnosis or commitment status. There is no evidence to conclude that in terms of treatment, involuntary commitment is detrimental to the patients.

M.A. (Psychology) / The aim of this dissertation is to investigate the services and methods provided by the various medical and psychological professions within an inpatient psychiatric hospital setting. While working at a psychiatric hospital, the researcher was struck by the high readmittance rate of patients. This tended to create a general feeling of disappointment, frustration and impotence amongst the professions. The importance of such an investigation was therefore required, in order to help facilitate and improve current methods. A thorough investigation of the literature with regard to the current treatment methods at psychiatric hospitals, both on an international and national level, were undertaken. An in-depth case study was described and analysed to indicate the recurrent procedures, methods and treatment modalities that were being instituted within the hospital setting. The aim of this thesis was also to propose an alternative method to the current procedures, using an in-depth case study to indicate the use thereof.

D.Cur. (Psychiatric Nursing Science) / Please refer to full text to view abstract

<p>Aggressive and violent behaviour in inpatient mental health facilities is found worldwide and is a frequent and serious clinical and nursing care problem. Despite the importance of international research findings and recommendations, it appears that patients perceptions of the possible contributing factors toward aggressive and violent behaviour in mental health facilities is an area of enquiry that has not been widely explored in South Africa in general, or in the Western Cape, in particular. It is against this background that this study endeavoured to investigate the external and situational contributing to patients aggressive and violent behaviour in mental health facilities in Cape Town, as seen from patients perspectives.</p>

This study involved a survey of 164 undergraduate students and sought to determine whether relationships exist between 1) religiosity and preferences for a counselor's use of religious interventions in counseling, and 2) gender and preferences for a counselor's use of religious intelentions in counseling. It was hypothesized that high religiosity in students would be related to a strong preferences for a counselor's use of religious interventions. It was also hypothesized that females would show stronger preferences for religious interventions in counseling. Results supported both hypotheses, indicating that a significant relationship exists between religiosity and preferences for religious interventions, and between gender and preferences for religious interventions. These results have important implications for counselors working with religious clients. / Department of Secondary, Higher, and Foundations of Education

Child-centered play therapists are taught unique relationship building approaches and therapeutic methods to utilize when working with children. The purpose of this study was to determine if adult clients counseled by child-centered play therapists would demonstrate greater positive therapeutic outcomes than adult clients who were counseled by non-educated child-centered play therapists. This study also attempted to determine if the play therapists' clients would show greater, significant improvement in any particular areas of client distress (i.e., depression/anxiety, relationship issues), more so than the clients of the non-play therapists. Archival data from an assessment, The Adult Self-Report Inventory (ASR), was gathered to measure reported pre and post-test client symptomology. This study utilized a 2X2 repeated measure ANOVA design to analyze the impact of counselors who were educated in child-centered play therapy who saw adult clients, versus their non-play therapy counterparts who saw adult clients. Before treatment pre-test and after treatment post-test administration was collected for use in the analysis. The population consisted of 60 adult clients seeking counseling services at a major university in the southwest. All clients were seen by Master's practicum students for ten sessions. The clients were divided into two groups - 30 were seen by play therapists, 30 were seen by non-play therapists. Five scales on the ASR were measured using a 2x2 split-plot design and Eta squared. There were three independent variables: group, measurement occasion, and the interaction between group and measurement. The results of this study did not reveal any statistical significance. However, clinical significance was demonstrated as the play therapists' clients did report greater reductions in symptomology on all five scales, some more than others.

The purpose of the present study was to assess patient improvement in a specific freestanding partial hospital. Improvement was assessed in two specific areas: 1) symptom reduction as measured by the Symptom Check List-90-Revised (SCL-90-R) and 2) social adjustment as measured by the Social Adjustment Scale Self-Report (SAS-SR) at admission, discharge and three month follow-up. In addition, improvement was assessed from two perspectives: 1) patient evaluation and 2) therapist evaluation. Results indicated that there was statistically significant improvement from admission to discharge on the SCL-90-R and the SAS-SR. This improvement was maintained from discharge to three month follow-up. Findings also revealed statistically significant improvement when analyzed from both the patient perspective and the therapist perspective.