Soul of an Agency: Psychodynamic Principles in Action in the World of Community Mental Health (original) (raw)
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Engaging high risk families in community based intervention services
Aggression and Violent Behavior, 1999
Involving high risk families in community based intervention services constitutes a major challenge facing service delivery in the fields of mental health and substance abuse. Mental health and substance abuse programs typically experience high rates of failure to enroll families in services, as well as high rates of drop-outs from treatment. With familybased intervention programs, those involving all the members of the family or household participation by the entire family is a key to having a successful program. The NIDA funded Youth Support Project tests such a home and family based Family Empowerment Intervention in a randomized field trial which targets families of juvenile offenders. This intervention is delivered three times a week by paraprofessionals who are supervised by a licensed clinician. We discuss the guiding principles and success of our enrollment activities and discuss their implications for other family-based services.
A family oriented community mental health centre. By Harry Procter and Roz Pieczora (1993)
Chapter in A.Treacher & J.Carpenter, J. (Eds.) Using family therapy in the 90's, pp. 131 - 144. Oxford: Blackwell.
This chapter describes a community mental health centre {CMHC), Southwood House in Bridgwater, Somerset, UK, which has used family therapy principles over the last twelve years. During this time the team has had the opportunity to develop and experiment with many new ideas and we hope to reflect some of this knowledge and experience here. One of the most important advantages of our approach is that it opens the door to a wider range of problems and client groups than was possible with more traditional methods of psychotherapy. Working with the family allows one to work with less verbally sophisticated clients as well as those whose problem makes them unable or unwilling to participate. Thus we are able to use our model to address the wide range of problems presented to us including families of low socio-economic status and those presenting with serious psychopathology. Often we are able to achieve good results briefly in a few sessions but the model also lends itself to longer-term involvement where this is indicated. In this way we are able to minimize the use of traditional psychiatric methods, such as physical treatments, daycare and admission to hospital. The approach opens the door to working with problems traditionally seen as resistant to psychological therapy, such as 'personality disorders' and 'psychopathy'.
Journal of Community Psychology, 2007
University-community partnerships are widely recognized as critical to the success of community research and advocacy work but difficult to form and sustain. This article will describe a unique facet of that partnership, namely the collaboration between mental health clinicians and community consultants, a partnership that our data suggest was a cornerstone of our schoolbased mental health service program called PALS, an ecological model designed to engage African American families living in urban poor communities in mental health services. The service model was designed to promote children's learning and positive behavior through supporting teachers and encouraging parental involvement in school. In PALS, parent representatives from the community and clinicians from the university worked together in school-based teams to support children, families, and teachers. This article will discuss the evolution of our clinician-consultant partnership and several lessons that emerged regarding the incorporation of community members into the world of academia, research, and mental health service delivery.
The purpose of this article is to propose a community structural intervention for low-income families who present to therapy with the concern of an adolescent at risk for gang involvement. Families are affected by multiple interacting systems. In congruence with systems theory, changing a part of the system will essentially affect the interrelated parts of the system. The proposed intervention utilizes structural family therapy and community family therapy as a model to impact change at the family system, its interrelated systems, and the system at which the family is embedded.
Intervention with At-Risk Families; Contributions from a Psycho-Educational Perspective
Psychology in …, 2010
classic conception, family is seen as a fundamental context where children grow-up, develop, socialize and acquire the competencies necessary to become active members of society. For adults, the importance of the family context is also wellestablished. Today, professionals and researchers understand that family constitutes the basic social scenario where the developmental needs of all its members should be covered. In approaching the study of the family context, understood in this light, ecologicalsystemic perspectives have undoubtedly been the most fruitful (Palacios, & Rodrigo, 1998), and from this approach, the family is conceived as a system made up of diverse subsystems under continuous development. As such, the whole is greater than the sum of its parts; and upon being open to the outside, it is subject to changes in an effort to adapt to the demands of the environment without losing its stability and identity over time. In summary, we are talking about an approach to studying the family that takes specifically takes into account its relational and functional features, as opposed to its more tangible and structural aspects (Minuchin, 1985). When meeting the developmental-educational needs of all its members as independent individuals and the family system as a whole, families may use different strategies. Therefore, family diversity, which has increased greatly in recent decades, should not be understood as a crisis of the family institution; nor does it represent, in itself, a threat to the family being able to continue fulfilling its basic functions. Although family diversity can be enriching, not all family lifestyles, nor all forms of interaction, are equally functional. Unfortunately, there are many family contexts in which the basic needs of minors are not met, with the consequent threat to their development and their physical and/or psychological integrity (López, 2008). When families neither promote family health nor ensure
Forging Partnerships with High-Risk Families through School-Based Mental Health Services
This descriptive study in the Cleveland (Ohio) public school system evaluated the impact of an intensive, school-based mental health program. Forty-two African American elementary school students were referred for school-based mental services due to overt behavioral problems. Children were evaluated for risk status across three domains: community, family, and individual child. Data collected included client demographic information, diagnostic assessment information, family history, standardized ratings of child emotional and behavioral functioning, and client satisfaction data. The study found that the community had higher ratings across significant risk factors than the broader surrounding community, that 83 percent of families lived in poverty above and beyond the high poverty levels of their neighborhoods, that less than 10 percent of families were intact, and that the mental health needs of the referred children were substantive. The intervention program emphasized family-focuse...
Family Process, 2009
Community mental health agencies are consistently challenged to provide realistic and effective home-based family-centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I-FAST) is developed based on existing evidence-based approaches for working with at-risk children, adolescents, and families and a strengths perspective. I-FAST identified 3 evidence-based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home-based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I-FAST for treating families with children at risk of out-of-home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I-FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre-to posttreatment with the families able to maintain these positive changes at 6-month follow-up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I-FAST.
Connecting Low-Income Families To Mental Health Services
Journal of Emotional and Behavioral Disorders, 1994
The family associate is a parent without professional mental health training who acts as a system guide to low-income families whose children have been referred to mental health services through the Early Periodic Screening, Diagnosis and Treatment program. The family associate provides emotional support, information about mental health services and community resources, and directs assistance, such as help with transportation and child care. Based on the belief that parent-to-parent support can be a powerful tool in overcoming the barriers to accessing services, the family associate role has been successfully implemented in three counties in Oregon. The family associate role and its implementation, characteristics of the families who participated, and the implications for introducing this role into traditional mental health service systems are described.