Search

As health care is reconfigured by HMOs and managed care organizations, family therapists often have to decide whether or not to cooperate with the new power structures and their ways of doing things. The chief concern of many therapists is the ethical bind created when the managed care organization demands breaches of confidentiality or makes decisions about the course of treatment that may not, in the therapist's opinion, be in the best interest of the family. Associations of independent, nonmanaged care psychotherapists are springing up in response to these dilemmas. This paper describes the philosophical evolution and organizational development of one such association.

Abstract: This paper describes a multi-dimensional, ongoing approach to evaluation in a sex therapy training program. The Yale Sex Therapy Training program set out to train psychotherapists working in public agencies throughout Connecticut who would meet or surpass pre-determined standards for sex therapists. Because sex therapy is a new discipline, it was deemed essential that program evaluation be developed and carried out from the very beginnings of the program and throughout its course. Evaluative findings proved essential to monitoring the quality of teaching and supervisory efforts, in assessing change in knowledge and professional activity of trainees, and in measuring impact upon the communities served. Continuous feedback led to changes in program content and format through identification of needs and problem. The experience in the Yale program confirms the recommendations of others regarding the conduct of a continuing education program. These findings strongly imply that multi-dimensional, ongoing evaluation should be an integral component in any continuing education program. [ABSTRACT FROM AUTHOR]

The young adult chronic patient is a recently designated dysfunctional group which is growing significantly in numbers. These patients' multiple deficits in independent functioning and their extreme dependence-independence conflict make them difficult to engage and help in traditional forms of outpatient therapy. A day-treatment program which systematically and flexibily intervenes over many levels would seem to increase the likelihood of successful treatment. F. S. DuBois Day Treatment Center, Stamford, Connecticut, has established such a program based on an integration of general systems theory and separation-individuation theory. This systemic-developmental model of day treatment involves both systems-oriented multimodality therapy and developmentally phased expectations for gradually increasing independent functioning. This paper presents theory and applications of the systemic-developmental day-treatment model and a 2-year pilot program evaluation demonstrating its effectiveness.

This study evaluated two Internet-based versions of Parent Management Training (PMT) and the effects of greatly reducing the contact required of a mental health professional on treatment of children referred for conduct problems. We were interested whether reduced contact with a therapist influenced treatment outcome, therapeutic alliance, parent adherence to treatment prescriptions, and parent reactions to and evaluations of the treatment procedures. Sixty children and their caregivers were assigned to receive either Full Contact PMT (with the amount of weekly contact similar to traditional PMT; approximately 50 min of direct therapist contact each week) or Reduced Contact PMT (with most information provided through recordings; approximately 10 min of direct therapist contact each week). Children in both groups showed significant and similar reductions in antisocial behaviors specifically, internalizing and externalizing symptoms more generally, and improvements in overall adaptive functioning. Therapeutic alliance also was similar across the two treatment groups. However, parents rated Full Contact treatment as more acceptable than the reduced version. Both treatments were similar in outcomes to in-person treatment as evaluated by a nonrandomized matched sample used as a benchmark in supplementary analyses. Overall, the findings indicate that therapist contact can be reduced while positive treatment outcomes are maintained but that interventions that reduce direct time with a therapist may be viewed less positively by clients. [ABSTRACT FROM AUTHOR]

This article summarizes a study in which before and after interviews and questionnaires were administered to 73 women who had registered for feminist conciousness-raising groups in the state of Connecticut, and three groups were observed over a period of 10 to 16 weeks, in order to explore the unintended psychological benefits of participation. The results show that consciousness raising may help women to increase their sense of control and externalize their attributions of blame, and may consequently increase self-esteem and reduce depression among participants. The article concludes with a discussion relating these results to studies on race and class differences in mental health, and comparing consciousness raising to psychotherapy. [ABSTRACT FROM AUTHOR]