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Objective: Empirical support for the effectiveness of group therapies for women with a history of childhood sexual abuse is scant. This study examined the feasibility of conducting abuse-focused research and group treatment on a short-term unit and evaluated the effectiveness of the Women's Safety in Recovery group., Methods: Eighty-six women with a history of childhood sexual abuse participated in treatment as usual (N=38) or in the Women's Safety in Recovery group (N=48). The latter group met three times weekly for one hour, focusing on patients' current safety and self-care. Participants completed the Symptom Checklist-Revised at baseline, discharge, and six-month follow-up. Patients rated their experience in treatment at discharge and six-month follow-up, and therapists rated patients' treatment experiences at discharge. The feasibility of the treatment group was measured by enrollment rates, group attendance, and attrition., Results: Eighty-two percent of eligible patients agreed to enroll in the study. Women's Safety in Recovery participants attended an average of ten group meetings. Seventy percent of enrollees completed discharge assessments, and of these, 82 percent completed the six-month follow-up. Compared with treatment-as-usual patients, Women's Safety in Recovery participants reported greater symptom improvement and reported that their childhood sexual abuse issues had been more thoroughly addressed. These differences were present at discharge and at six-month follow-up. Therapists also perceived that abuse issues of these participants had been more thoroughly addressed., Conclusions: Women's Safety in Recovery participants reported significant reductions in distress compared with those receiving treatment as usual. The abuse-focused research program and the Women's Safety in Recovery group proved feasible, despite attrition.

People with schizophrenia smoke more than the general population and more than other psychiatric diagnostic groups. The rate of smoking in the general population is 30 percent, and reported rates for people with schizophrenia range between 62 percent and 81 percent. The author briefly reviews evidence that nicotine's augmentation of dopamine release may account for the high prevalence of smoking in this group. The affective, cognitive, and social difficulties and the symptoms experienced by many patients with schizophrenia indicate that existing smoking cessation programs may not be appropriate for them. The author describes three programs developed for use with this population and reviews evidence of their effectiveness. Preliminary evidence suggests that transdermal nicotine patches are effective and that patients do not misuse them. The author concludes that stopping smoking is possible for individuals with schizophrenia, especially if the treatment is specifically designed for them.

The combined problems of substance abuse, mental illness, and homelessness among the urban poor represent a major public health issue. The study evaluated 340 patients attending a cocaine day treatment program that integrates peer leadership and professional supervision. Thirty-six percent of the sample had a major mental illness, and 39 percent were homeless. Sixty-nine percent achieved an acceptable final urine toxicology status, and the median number of program visits was 46. Homelessness, a longer history of cocaine use, and a diagnosis of schizophrenia were associated with positive treatment outcomes. The results support the feasibility of a cocaine abuse treatment model combining professional and peer leadership.

Objective: The authors sought a practical means of monitoring and evaluating group psychotherapy, using existing clinical resources, for purposes of quality improvement and education on a large general hospital psychiatric service., Method: Monitoring indicators were developed which addressed 1) the integration of group psychotherapy into treatment planning and 2) the competence and technique of group psychotherapists. The second indicator was assessed by skilled observers using a newly constructed Group Psychotherapy Rating Scale in direct observation of group psychotherapy sessions. The rating scale was examined for interrater reliability and, as a measure of construct validity, for its ability to distinguish the performance of professional staff therapists from that of trainees., Results: The indicators provided useful monitors of the use and quality of group psychotherapy. The rating scale had satisfactory interrater reliability and construct validity. The immediate constructive educational critique given by the observers of the therapy groups was highly valued by group therapists., Conclusions: The monitoring and evaluation program proved to be a practical, positive, and inexpensive means of assuring and improving the quality of group psychotherapy in a clinical setting.

In this two-year study, patients referred for group therapy were extensively screened and carefully prepared for the therapy. In spite of this effort there was a 29% dorpout rate after group therapy began. All of the therapists reported that they disliked the patients who dropped out, and many of these patients were seen as hostile toward the therapists. The author suggests that for many groups the dropout phenomenom may be basic to the establishment of group cohesiveness and that instead of trying to prevent or reduce the dropout phenomenon, efforts should be directed toward reconceptualizing the more positive aspects of it.