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Recently it has been recognized that for some kinds of behavioral or psychiatric problems, treating people in their homes or other community settings may be just as effective as treating them in a mental health facility. Findings from empirical research have supported this view and provided some indication of the conditions under which treatment in the community is most appropriate. Formative studies by Friedman (1964), for example, indicate that 50% of the people with problems serious enough, according to present criteria, to warrant hospitalization can be effectively treated through services other than hospitalization. Similarly, Langsley & Kaplan (1968) have presented evidence that a majority of patients living in a family setting who apply for admission to a psychiatric hospital can be treated just as well at home. It is worth noting that there seems to be no relationship between the environment of a psychiatric treatment center and the patient's behavior in that setting and his behavior in the nonhospital environment from which he comes and to which, hopefully, he will return (Ellsworth, Foster, Childers, Arthur, & Kreuker, 1968; Fairweather, Simon, Gebhard, Weingarten, Holland, Sanders, Stone, & Reahl, 1960; Ludwig, 1968). This observation has led Polak (1970) to conclude that the environment

This study was undertaken in order to determine the extent of the utilization of community settings in pediatric training programs and their value rating by pediatricians in Canada. Community settings were defined as any resident staff learning experience in the community other than at the teaching hospital, and they were divided into medical, social, and educational settings. Response rate was 100% for the 31 programs surveyed and 73.2% for the 790 pediatricians surveyed. Utilization of community settings was minimal, with the exception of pediatricians' offices, community hospitals, and clinics for well child care and rehabilitation. However, most of the pediatricians favored additional exposure of resident staff to these community settings. While pediatric education should continue to teach the pathology of the sick child in hospitals, this study suggests that the Canadian pediatricians think that graduate teaching programs should also embrace other facets of the health care delivery system. This will enhance the utilization of community resources by the pediatricians.

Selecting certain members of society to be officially designated "deviant" involves the processing agencies in a variety of deci sions. These decisions are made within the context of a social set ting which limits the agencies' freedom of choice. At times the agencies must resort to indirect techniques for accomplishing their goals if they are to avoid entanglements and opposition. But these techniques may themselves go awry and, when they do, the entire process becomes more visible by virtue of these errors. A case is analyzed to illustrate the dynamics of this process.

The significance of observations made in clinical work can really only be found by reference to a hypothetical position. It is necessary therefore first to indicate very briefly the theoretical constructs relating to therapeutic community work.

Because of the “information explosion,” a program of continuing education is needed which is comprehensive, well or­ ganized and sequential. Since the 100,000 dentists in this country are widely dis­ persed, and many are in locations remote from dental schools, a mass educational m ethod must be developed which will preserve high-qiiality instruction and at the same time not tax further the pres­ ent teaching manpower. Greater use of the community setting is essential. Pro­ grammed instruction and teaching m a­ chines are two notable examples of new methods that can be used to bring con­ tinuing education programs to the den­ tists on a national, regional and local basis. The training branch of the Division of Dental Public H ealth and Resources, Public Health Service, is demonstrating the effectiveness of. various educationcommunication media and is studying the feasibility of introducing such continuing education programs into the com m unity environment.

Drug addiction in the United States has been studied from several theoretical perspectives including those of sociology, psychology, physiology and pharmacology. Yet in spite of frequent references to the "subculture of addiction," anthropologists have not, on the whole, systematically investigated the shared, learned behaviors which could be expected to characterize an addict sub-culter. There are a number of reasons for this absence, among them the fact that direct observation of drug-related behavior "in the streets" (i.e., in the community setting) poses serious difficulties. Most of the related behavior is defined as illegal, and the risk of incarceration makes the presence of an outside observer undesirable. The illegality of the actual behavior also leads to problems of reliability.

1. 1. Of 215 nursing home residents of an average age of 76 years, 112 were selected for admission to the hospital for medical management, rehabilitation, or both. Of those admitted ninety-one regained functional capacity sufficient to live more or less actively in a community setting. 2. 2. The male to female ratio, when followed from the original 215 down to the subgroups representing success and failure, showed that successful rehabilitation was notably in favor of the male. Age did not appear to determine the outcome. 3. 3. Hip fractures (cervical and extra-cervical) and cerebrovascular damage were highly prejudicial to successful rehabilitation. 4. 4. By appropriately rating functional ability in the motor and cardiorespiratory disabilities, a high capacity for recovery was measured along with stability of the favorable response after an average follow-up of 16 months. 5. 5. Improvement in adaptive and social behavior showed trends similar to physical function. The demonstration of hidden faculties to the patient and the proffering of attention and interest were crucial to this improvement. 6. 6. During an average of 16 months follow-up, seven returned from the community to nursing homes because of intercurrent illness and one left the nursing home for the community. 7. 7. Nineteen patients died within the term of the project. The mortality rate was only 10 per cent among community residents and 45 per cent among those in nursing homes.

Two basic questions were investigated. (1) Do beginning kindergarten children from three different community settings (inner-urban, outer-urban, and rural-farm) vary significantly in performance on a Life-Science Concept Acquisition Test (L-SCAT)? (2) What independent variables are the most useful predictors of performance on the L-SCAT? The L-SCAT was developed by the investigator. It was administered to seventeen subjects from each of the three community settings (N = 51). Among the results were the following: (1) there were significant differences (p < .05) among the scores made by the subjects; (2) a major source of significance was between outer-urban and inner-urban subjects' mean scores; (3) when all physical, mental, and sociocultural variables were used as predictors, a subject's I.Q. and his chronological age were the most useful predictors of L-SCAT performance; and (4) when sociocultural variables alone were used as predictors, the number of years education of a subject's mother was the most useful predictor of L-SCAT performance.

Much of the continuing ferment among the mental health professionals involving aspects of the therapeutic community as well as social and community psychiatry can be viewed as a revitalization movement. This is a kind of culture change based on the creative stirring of disillusioned individuals to reform both their professions and the institutional and community settings in which they practice.

community setting. Whatever the rationale for removal-humane, protective, punitive, therapeutic-it is seldom envisioned as permanent. Instead, it is represented and understood as temporary if possible, and in the interest of eventually returning the deviant to his community as a functioning member. Thus, a strategic problem is engendered for those who man remedial institutions: to help preserve and reinforce those ties which link the deviant to the world beyond the walls. If these ties are severed, the task of returning him to a viable community context becomes a formidable piece of social engineering.' One type of deviance which frequently involves removal and return is mental illness. The mental patient's ties to intimates and to significant social roles have become attenuated or

A total of 549-subjects enrolled in grades four, five, and six in three community settings were sampled to discover what attitudes had been developed toward the world of work. Six factors-money, status and prestige, working conditions, leadership, independence on the job, and self-expression-were used as a basis for developing the Kuldau Occupational Development Inventory (KODI). This instrument was used as a means of sampling the attitudes held by the subjects. On the basis of the results, the conclusion was drawn that children had developed attitudes toward five of the six factors-money, status and prestige, working conditions, independence, and self-expression-measured by KODI.

The authors describe a method of administering high dosages of the more potent, less sedating antipsychotic drugs to schizophrenic patients to promote the patients' rapid improvement. This method has been effective in keeping the periods of hospitalization of more than 150 schizophrenic patients brief, and the patients have been managed in an open ward community setting.

An outpatient clinic in a community setting is using medication groups to monitor and improve the effectiveness of psychotropic drugs administered to chronic patients with strong dependency needs. A third-year psychiatric resident leads the groups, assisted by a staff nurse. An intake team selects patients and sets up attendance schedules. During the meeting the resident checks with each patient about his medication and makes any adjustments necessary; the group members then discuss problems in daily living.

Recent statistics show that an increasing number of people with psychiatric illness are being treated in community settings rather than in hospitals. This shift in treatment locus requires a reexamination of program priorities, staff training and deployment, financial allocations, and plans for construction of facilities. A wide range of community-based therapeutic, rehabilitative, and supportive services appears necessary; the need for additional programs to treat patients with alcohol problems is particulary apparent.

Reinforcement therapy programs in operation at seven mental health facilities in California are briefly described in terms of their accomplishments, problems, and challenges. These programs are complex social systems containing groups of patients with a wide range of behavior problems. Therefore the clinical research team is beset by operational difficulties that the laboratory operant conditioner does not face with his individual Ss and controlled stimulus situations. Escape from contingencies, inadequate nursing staff motivation and training, low operant rates of group, social interaction, and incongruence between therapeutic and community settings are some of the problem areas that clinical programs applying reinforcement principles are confronting.

This study measures the effect of a high-expectation and a low-expectation environment on discharged long-term mental patients randomly assigned to one of two community settings. The high-expectation setting includes a halfway house, a daytreatment center, and a rehabilitation workshop. It demands much in the way of mobility, planning, and accepting responsibility. Low-expectation patients go to boarding homes where docility is valued and little initiative is expected. The boardinghome group is not really in the community. It is like a small ward moved to a community setting. The high-expectation group has a higher rehospitalization rate, but a longer time out of the hospital with a higher level of instrumental performance. The high-expectation group is less segregated, is less likely to be labeled as deviate, and is less stigmatized.

F IELD interviews of individuals in their homes and in the community setting reveal problems not present in experimental designs that are set up in the comparatively simple school-room situation,1 familiar in educational research. The problems of field interview emerging in the community situation in which research uses some experimental design are both methodological and practical. In this article we shall attempt to describe these problems as they arose in three research studies using three different variations of experimental design. Wherever possible solutions of these problems will be indicated. To clarify our analyses it should be stated at the outset that by problems of field interview we mean problems of organization and timing of these interviews and not problems of minute personal relationship in interview situations. Since some study has been made of problems that arise in face-toface contacts of interviewing,2 and less attention has been given to problems of organization and timing, it is with these latter problems that we shall be concerned, and more specifically with scheduling interviews in home calls chiefly as related to sampling. The purpose of experimental designs applied to the study of social factors is to measure the effect of one social factor at a time, all other factors in the situation (unknown factors as well as known ones) being held constant, that is, controlled. Difficulties arise at once because it is seldom possible to

This study focused upon determining the nature of the relationship between the culture of a community and the definition of the ministers' role in community mental health. No evidence was found to support the commonly accepted premise that the community setting is a key variable in the formation of the mental health role of ministers. Rather, findings suggest that this role transcends the boundaries of the community and is influenced more by personal and demographic characteristics of the individual minister.

The role of Catholic education in American society has never been fully explicated-particularly relative to its public counterpart. Some insight into the nature of that role is possible, however, by comparing the outputs of the two systems in contemporary American society. Using data collected in a national survey, this study reports upon the results of a secondary analysis wherein the "effectiveness" of the output of the two systems is compared. Defining "effectiveness" as the proportion of former tenth, grade students in senior high schools who go on to any form of post-secondary education, controlling for the number of dropouts, the results of the analysis indicate that Catholic senior high schools are more effective than public senior high schools. This difference was maintained even when the effects of the capability of the student body, the social class context, and the community setting were controlled for. Implications of these findings for the nature of Catholic education are considered.