Brief Treatment and Crisis Intervention - current issue

Posttraumatic Success: Solution-Focused Brief Therapy

Bannink, F. P. — 2008-09-23

Results of several studies suggest that traumas need not be debilitating and that most people are resilient and even grow in the wake of a trauma. Understanding and highlighting the sources of this resilience and posttraumatic growth and focusing on hope and optimism help professionals foster these strengths in their clients, as opposed to focusing on what is wrong with them, which can have a discouraging effect. From a solution-focused perspective, the focus in treatment shifts from posttraumatic stress to posttraumatic success.

Reducing Child Abuse Potential in Families Identified by Social Services: Implications for Assessment and Treatment

Harnett, P. H., Dawe, S. — 2008-09-23

Improving the functioning of families at high risk of child maltreatment poses considerable challenges. One issue is the dilemma of how and when it is appropriate to provide an intervention designed to improve family functioning when the level of risk of the family to the child has not been fully established. A recently reported proposal is to assess the family's capacity to change by assessing the family's response to a brief intervention. This proposed model for assessing capacity to change rests on the assumption that brief interventions can achieve meaningful short-term change in high risk families. The current study evaluated the effectiveness of a home-based intensive treatment program in families referred by child protection services. The program, Parents Under Pressure, was designed for multiproblem families and addresses problems across ecological domains, including problem child behavior, parental stress, family relationships, social isolation, and coping with life demands. Ten families completed the program. Statistically significant improvement was found between the pre- and postassessment measures on measures of parent functioning, child functioning, parent–child relationships, and social contextual measures. The majority of families showed clinically significant improvement, although a small proportion of the families showed no change or deteriorated. The presenting problems and pattern of change varied between families. The study adds to the increasing body of evidence that intensive, ecologically informed interventions can achieve short-term change in some but not all multiproblem families. Implications of the results for assessing parental capacity to change are discussed.

Law Enforcement Response to the Mentally Ill: An Evaluative Review

Tucker, A. S., Van Hasselt, V. B., Russell, S. A. — 2008-09-23

Rarely does a police officer list providing services to the mentally ill as a reason for becoming a law enforcement professional. However, a review of case records illustrates the frustrating, and often tragic, outcome of police service calls for "mental disturbance." A closer examination of these cases demonstrates the reality that police are usually the initial contact into both the criminal justice and the social service systems for mentally ill persons. Unfortunately, there exists a disconnect in the process from the first police contact to the next level of appropriate care due largely to a lack of proper training, resources, and collaborative community support. The purpose of this paper is to provide an overview of the research and public policy on law enforcement response to the mentally ill. An evaluative review of investigative efforts in this area reveals methodological shortcomings in the extant research which (a) prevent definitive conclusions regarding efficacy of police interventions (e.g., Memphis Crisis Model), (b) have significant implications for the development of policy, standard operating procedures, and training of law enforcement personnel, and (c) are potentially relevant to the safety of mentally ill persons who, as subjects or suspects, also become potential victims. Suggestions for directions that future research on policing and the mentally ill might take are offered.

Bridging the Gap between Two Cultures: An Analysis on Identity Attitudes and Attachment of Asian Americans

Akiyama, C. — 2008-09-23

A commonly observed weakness of American and European psychologists and developmental theorist is that their theories are most applicable to white, middle-class, two-parent households. In context of today's immigration patterns of our nation, we must take into consideration individuals and families that are immigrating to the United States from nations of non-Western cultures and that Western developmental and psychological theories do not apply to those of non-Western cultures. The adjustment and adaptation of non-Western Americans is something that must be addressed by every profession from psychology to social work to education to public health, considering that the population of Asian immigrant groups is growing at rapid rates. This review paper will look specifically at the Asian American experience and the way that attachment theory may or may not apply to understanding their social and psychological behaviors, while looking at other factors that contribute to their ethnic identity in defining who they are. Often it is the later generations of Asian Americans that have difficulty answering the question of "who am I?" Consequently, this paper will focus heavily on identity formation and various other factors that play a major role in identity development of Asian Americans.

Unintended Impact of Psychiatric Safe Rooms in Emergency Departments: The Experiences of Suicidal Males With Substance Use Disorders

2008-09-23

In general hospital emergency departments (EDs), management of psychiatric crises is challenging. We analyzed issues related to use of psychiatric assessment rooms using semi-structured interviews with adult, male, suicidal ED patients, and ED staff (physicians, nurses, and others). An iterative, thematic analytic process was employed. Although ED psychiatric assessment rooms were designed to provide a safe and therapeutic environment, participants held negative attitudes about the physical attributes and the emotional responses to these rooms. Many patients presented at the ED because they were alone, scared, and lacking social supports, but felt punished when assigned to a psychiatric room. Physical separation and observation were said to escalate symptoms leading participants to question the therapeutic value of the rooms. Although believed to be in the best interest of patients and staff, these rooms may have an unintended negative impact.

The Dynamics of Murder-Suicide in Domestic Situations

van Wormer, K. — 2008-09-23

This paper explores dynamics involved in the commission of homicide followed by suicide. British and U.S. government and advocacy sources are used in addition to news accounts to examine this phenomenon. Domestic violence-related crimes are contrasted with elderly "altruistic" murder-suicide, school shootings, and political terrorism. Suicide is argued to be a primary motive in many domestic homicide situations. Limitation of the availability of firearms is seen as an important means of prevention in conjunction with a harm reduction safety plan.

Maternal Filicide and Its Intersection With Suicide

Friedman, S. H., Holden, C. E., Hrouda, D. R., Resnick, P. J. — 2008-09-23

Maternal filicide, child murder by the mother, may occur either alone or as part of a joint filicide–suicide. This study considered differences among 3 groups of mothers who committed filicide: those who did so without a concomitant suicide attempt, those who made a nonfatal suicide attempt, and those who completed suicide. Traditional predictors of completed suicide did not distinguish mothers who completed or attempted suicide from those who did not. Mothers who completed suicide following filicide often had altruistic motives and more frequently utilized firearms.