Michael Groat - Academia.edu (original) (raw)
Papers by Michael Groat
Journal of Addiction Research and Therapy, Aug 4, 2016
Projective measures utilize ambiguous stimuli and minimal directions to encourage the examinee to... more Projective measures utilize ambiguous stimuli and minimal directions to encourage the examinee to utilize perception, apperception, associative processes, and memory to create responses to the examiner's questions: the more ambiguous the stimuli, the greater freedom to form idiosyncratic responses that reveal aspects of individual personality. While intentionally opaque to the examinee, the majority of measures have been subjected to empirical validation, utilized in outcome research, and used to predict behavioral outcomes. The Rorschach inkblot method, for example, has surprisingly good accuracy in predicting suicide completion and attempt up to 60 days post-administration as well as predicting treatment response. In predicting treatment response, the Rorschach was found to be a better predictor of psychotherapy outcome than electrocardiogram stress tests in predicting subsequent cardiac disease. The broad empirical evidence base constructed over the last century aids clinicians in developing an accurate portrait of individual patient's personality—their frailties, strengths, and potential response to treatment. The diagnostic facets of projective testing are frequently integrated into treatment recommendations for specific patients to help the therapist develop a working model of the patient's functioning and to help predict potential therapeutic stalemates as well as positive developments.
Bulletin of The Menninger Clinic, Dec 1, 2011
Quality management in health care, Jul 1, 2014
Patient satisfaction is increasingly used as an indicator of health care quality. Few measures ar... more Patient satisfaction is increasingly used as an indicator of health care quality. Few measures are available to assess characteristics unique to inpatient psychiatric hospitals, especially those that provide longer-term care. Furthermore, there is limited guidance on how to utilize patient satisfaction data to guide quality improvement initiatives. The authors developed the 20-item, Menninger Quality of Care measure at The Menninger Clinic in Houston, Texas. Psychometric analyses were based on responses from 337 adult inpatients. The measure has excellent internal reliability (Cronbach α = 0.92) with adequate concurrent and construct validity. We present a methodology to identify targeted quality improvement efforts by (1) highlighting the perspective of patients who are generally satisfied but had at least some reservations regarding the care they received and (2) highlighting areas of concern that are most associated with overall quality of care. We discuss our findings in light of national health care quality trends.
Journal of the American Psychoanalytic Association, 2012
This study explored a psychodynamic model for suicide risk by examining risk factors for medicall... more This study explored a psychodynamic model for suicide risk by examining risk factors for medically serious suicide attempts, including assessments of affect flooding, negative self-schema / fragmentation, and impaired reality testing, closely approximating Maltsberger’s psycho-dynamic formulation of suicide crisis. Baseline risk factors including age, gender, psychiatric symptoms, high-risk behaviors, and the Implicit Risk for Suicide Index (IRSI) were used to detect medically serious suicide attempts monitored for up to a year after the assessment. Twenty-five psychiatric inpatients who made life-threatening suicide attempts after assessment were compared to 25 inpatients and 25 psychotherapy outpatients who made no suicide attempts during follow-up. Statistical analysis revealed that a history of at least one suicide attempt and elevated IRSI scores accounted for 60 percent of the variance in detecting medically serious suicide attempts. Elevated IRSI accurately identified suicide...
Bulletin of the Menninger Clinic, 2011
The authors collaborated in refining a psychoeducational group on mentalizing-attending to mental... more The authors collaborated in refining a psychoeducational group on mentalizing-attending to mental states in self and others-that has been conducted for several years in the Professionals in Crisis program at The Menninger Clinic. The group is intended to promote active engagement with the treatment program as a whole. Toward this end, the group leaders also advocate patient initiative and responsibility, albeit from contrasting perspectives. Coming from the tradition of a similar institution, the Austen Riggs Center, the senior author imported the concept of "authority" to complement the junior author's emphasis on "agency" at The Menninger Clinic. The group leaders then converged on "authorship" as a means of highlighting narrative construction as central to mentalizing in this psychotherapeutically oriented inpatient treatment program. This article chronicles this continuing evolution of the psychoeducational group and presents the experiential exercises the authors have developed to enhance patients' mentalizing in the treatment program. The article concludes with a discussion of the wider applicability of this intervention. (Bulletin of the Menninger Clinic, 75[4], 315-343) Albeit rare in usage, the word mentalizing has been in the English lexicon for two centuries and has appeared in the Oxford English Dictionary for a century. In 1989 John Morton employed the term mentalizing to refer to the core psychological deficit in au
Journal of Addiction Research and Therapy, Aug 4, 2016
Projective measures utilize ambiguous stimuli and minimal directions to encourage the examinee to... more Projective measures utilize ambiguous stimuli and minimal directions to encourage the examinee to utilize perception, apperception, associative processes, and memory to create responses to the examiner's questions: the more ambiguous the stimuli, the greater freedom to form idiosyncratic responses that reveal aspects of individual personality. While intentionally opaque to the examinee, the majority of measures have been subjected to empirical validation, utilized in outcome research, and used to predict behavioral outcomes. The Rorschach inkblot method, for example, has surprisingly good accuracy in predicting suicide completion and attempt up to 60 days post-administration as well as predicting treatment response. In predicting treatment response, the Rorschach was found to be a better predictor of psychotherapy outcome than electrocardiogram stress tests in predicting subsequent cardiac disease. The broad empirical evidence base constructed over the last century aids clinicians in developing an accurate portrait of individual patient's personality—their frailties, strengths, and potential response to treatment. The diagnostic facets of projective testing are frequently integrated into treatment recommendations for specific patients to help the therapist develop a working model of the patient's functioning and to help predict potential therapeutic stalemates as well as positive developments.
Bulletin of The Menninger Clinic, Dec 1, 2011
Quality management in health care, Jul 1, 2014
Patient satisfaction is increasingly used as an indicator of health care quality. Few measures ar... more Patient satisfaction is increasingly used as an indicator of health care quality. Few measures are available to assess characteristics unique to inpatient psychiatric hospitals, especially those that provide longer-term care. Furthermore, there is limited guidance on how to utilize patient satisfaction data to guide quality improvement initiatives. The authors developed the 20-item, Menninger Quality of Care measure at The Menninger Clinic in Houston, Texas. Psychometric analyses were based on responses from 337 adult inpatients. The measure has excellent internal reliability (Cronbach α = 0.92) with adequate concurrent and construct validity. We present a methodology to identify targeted quality improvement efforts by (1) highlighting the perspective of patients who are generally satisfied but had at least some reservations regarding the care they received and (2) highlighting areas of concern that are most associated with overall quality of care. We discuss our findings in light of national health care quality trends.
Journal of the American Psychoanalytic Association, 2012
This study explored a psychodynamic model for suicide risk by examining risk factors for medicall... more This study explored a psychodynamic model for suicide risk by examining risk factors for medically serious suicide attempts, including assessments of affect flooding, negative self-schema / fragmentation, and impaired reality testing, closely approximating Maltsberger’s psycho-dynamic formulation of suicide crisis. Baseline risk factors including age, gender, psychiatric symptoms, high-risk behaviors, and the Implicit Risk for Suicide Index (IRSI) were used to detect medically serious suicide attempts monitored for up to a year after the assessment. Twenty-five psychiatric inpatients who made life-threatening suicide attempts after assessment were compared to 25 inpatients and 25 psychotherapy outpatients who made no suicide attempts during follow-up. Statistical analysis revealed that a history of at least one suicide attempt and elevated IRSI scores accounted for 60 percent of the variance in detecting medically serious suicide attempts. Elevated IRSI accurately identified suicide...
Bulletin of the Menninger Clinic, 2011
The authors collaborated in refining a psychoeducational group on mentalizing-attending to mental... more The authors collaborated in refining a psychoeducational group on mentalizing-attending to mental states in self and others-that has been conducted for several years in the Professionals in Crisis program at The Menninger Clinic. The group is intended to promote active engagement with the treatment program as a whole. Toward this end, the group leaders also advocate patient initiative and responsibility, albeit from contrasting perspectives. Coming from the tradition of a similar institution, the Austen Riggs Center, the senior author imported the concept of "authority" to complement the junior author's emphasis on "agency" at The Menninger Clinic. The group leaders then converged on "authorship" as a means of highlighting narrative construction as central to mentalizing in this psychotherapeutically oriented inpatient treatment program. This article chronicles this continuing evolution of the psychoeducational group and presents the experiential exercises the authors have developed to enhance patients' mentalizing in the treatment program. The article concludes with a discussion of the wider applicability of this intervention. (Bulletin of the Menninger Clinic, 75[4], 315-343) Albeit rare in usage, the word mentalizing has been in the English lexicon for two centuries and has appeared in the Oxford English Dictionary for a century. In 1989 John Morton employed the term mentalizing to refer to the core psychological deficit in au