Hospital Treatment Program Research Articles

Psychological consultation on a pediatric infant division.

A newly developed program of psychological services for infants in a pediatric hospital is described. In I year, 56 infants and toddlers were referred for evaluation and treatment-planning for problems such as delayed cognitive development, child abuse and neglect, chronic illness and prolonged hospitalization, and physical symptoms with a psychosocial basis, including environmentally based failure to thrive. An active visible presence and case conferences featuring live demonstration of developmental assessment facilitated treatment planning concerning such problems. Although psychological services for infants were well accepted by families and pediatric staff, the inconsistent coordination between hospital and community-based services limited the quality of services to infants following hospitalization. Moreover, the lack of services for infant psychosocial problems emerged as an important gap in community mental health services. The development of hospital and community-based treatment programs for infants at emotional risk is a priority for the growing field of infant mental health. Developmentally trained psychologists can play a leadership role in the implementation of mental health services for infants in pediatric hospitals.

Treatment by objectives: A partial hospital treatment program

AbstractA program of treatment by objectives focusing on identified problem areas is employed in a day treatment setting.

Attitudinal versus ecological approaches to the characterization of institutional treatment environments.

The relational and discriminative properties of attitudinal and ecological measures of environments were examined within the context of a state hospital for mentally retarted clients. Three hypotheses were advanced, and the results gave substantial support for one of these and partial support for a second: (a) that the correlations between attitudinal and ecological measures should not differ significantly from zero, and (b) that differences among hospital treatment programs and living units should be reflected in ecological but not in attitudinal measures. However, the results did not provide clear confirmation for a third hypothesis: that differences among staff demographic characteristics and employment history should be reflected in attitudinal but not in ecological measures. It was suggested that these background variables may not be appropriate measures of personality-linked attributes.

Book reviews

Book reviewed in this article:Social Psychology, It's a Funny Thing, Humour. Edited by Antony J. Chapman & Hugh C. Foot.Social Psychology, Attitudes and Opinions. By Stuart Oskamp.Social Psychology, Freud and the Dilemmas of Psychology. By M. Jahoda.Social Psychology, Adoption: A Second Chance. By Barbara Tizard.Clinical Psychology, Biofeedback and Self‐control, 1976/77. Edited by T. X. Barber, Joe Kamiya, Neal E. Miller, David Shapiro, Johann Stoyva & Leo DiCara.Clinical Psychology, On the Development of a Token Economy Mental Hospital Treatment Program. By Raymond A. Ulmer.Clinical Psychology, Who Do You Think You Are? Man or Superman: The Genetic Controversy. By Oliver Gillie.Clinical Psychology, Manual of the Eysenck Personality Questionnaire. By H. J. Eysenck & S. B. G. Eysenck.Clinical Psychology, Abnormality: Experimental and Clinical Approaches. By S. Reiss, R. A. Peterson, L. D. Eron & M. M. Reiss.

Assessment of alcoholics' moods at the beginning and end of a hospital treatment program

The Profile of Mood States was administered weekly to 122 completers and 91 noncompleters of a hospital alcohol rehabilitation program. Ss' initial mood scores were not significant predictors of whether they would complete the program or of whether they would attain abstinence or show improvement in drinking practices at 3-month follow-up. When Ss left the program their final mood scores indicated significant improvement in mood states compared to their initial scores. Completers who later were found to be abstinent showed a trend toward affective improvement on all 6 Profile scales. It is suggested that assessment of an alcoholic's mood can contribute to formulation of treatment plans.

Differences between alcoholics who complete or withdraw from treatment.

Significant differences on the Lie scale of the Minnesota Multiphasic Personality Inventory, the Marlowe-Crowne Social Desirability Scale and the number of favorable attitudes toward drinking were found between alcoholics who completed or withdrew from a hospital treatment program.

Irregular discharge as an unobtrusive measure of ... something: some additional thoughts.

In a recent article Davis (1973) suggested that irregular discharges represent a valid, unobtrusive measure of patients' discontent with hospital treatment programs. Craig (1973) took issue with Davis' conclusion on the grounds that many other factors contribute to the production of irregular discharges. Both papers are reviewed here. It is concluded that, while Craig's implied criticism of Davis' papers is unwarranted, the data adduced in Davis−study do not support the hypothesized link between patient discontent and irregular discharge. Some evidence of the connection between irregular discharge and patients' discontent is available from a number of other sources, however, along with support for Craig's contention that irregular discharge has multiple determinants.

Dimensions of change in the improving alcoholic.

An inventory encompassing six social-psychological dimensions that have been found to be related to problem drinking (Attitude toward Drinking, Environmental Support for Heavy Drinking, Impulsivity and Nonconformity, Alienation and Maladjustment, Looseness of Social Controls, and Unfavorable Expectations) was used to determine what areas of behavior were seen to change as an alcoholic improved. Three groups of social workers, psychologists, and psychiatrists rated an alcoholic just hospitalized for treatment, an alcoholic just released from a hospital treatment program as improved, and an alcoholic who had been hospitalized for treatment, had improved, and had remained sober for 4 months. These professionals concurred that change occurred only on Attitude toward Drinking.

Assessing the attitude of veterans toward a smoking cessation program in a hospital setting.

110 male patients in a V. A. Hospital were surveyed in regard to their smoking behavior, attitudes toward smoking, and their willingness to participate in a treatment program designed to eliminate smoking. Some of the more important findings were that 68% of the patient population smoked as compared to 50% for the ggeneral male population. Only 57% of the smokers felt that smoking was harmful to their health. Many of the smokers (60%) had tried to stop smoking but were unsuccessful. 58% of the smokers stated that they would participate in a smoking treatment program. The results of this survey are interpreted to indicate the need for hospital and institutional treatment programs for elimination of smoking.

Problems of Adjustment Reported by Alcoholics Prior to Leaving a Hospital Treatment Program

Problems of Adjustment Reported by Alcoholics Prior to Leaving a Hospital Treatment Program

Patterns of discord. Goals of patients, therapists, and community members.

A BASIC assumption in hospital psychiatry is that the patient and his therapists work toward the same treatment goals. This assumption has far-reaching implications because both the practice of hospital psychiatry and the design of research to evaluate hospital programs are based primarily on the values of clinicians. Clinicians believe that patients are admitted to psychiatric hospitals primarily because they are mentally ill. The hospital's treatment program is designed to treat the mental illness of patients so that they can return as soon as possible to productive community functioning. In order to evaluate the effectiveness of psychiatric hospitals the researcher first obtains, from the hospital administration, clear, concise statements about the goals of the hospital. He then translates these statements into quantifiable outcome criteria, which are applied to patients at various points in their hospital and posthospital careers, so that hospital programs can be compared and evaluated. 1 Since they

Factor analysis of psychiatric symptoms: alcoholics compared with schizophrenics.

Varimax factor analysis of 20 symptoms obtained at admission ratings of a consecutive sample of 201 chronic alcoholic patients in a Veterans Administration Hospital Treatment Program yielded 6 factors (eigenvalue ≥ 1): Depression-Anxiety, Uncooperative, Disorganized Thinking, Memory Deficit, Disoriented, and Unmotivated. Four of these same factors have been reported in a five-factor solution of these same 20 rating-scale variables on a large sample of Veterans Administration schizophrenic patients. The availability of follow-up data permitted additional factor analyses of these variables at 3 subsequent time points: hospital exit, at 1 mo. and at 12 mo. follow-up. In contrast to the schizophrenic sample which had also been analyzed at several time points, our factors did not all remain constant, pointing to a greater lability in symptoms in alcoholics before, during, and after treatment.

Organizational size and functional complexity

vidual and a bureaucratic organization is inversely related to the organization's use of the interchangeability principle within an employee (or member) generation. The explanation of the change-absence pattern could be improved by introducing other aspects of social structure and personality as intervening variables. This would carry further the account of leaving as an expression of fit, or poor fit, between the two systems. Such analysis demands, as Inkeles points out, . . a knowledge not only of the main facts about the social structure . . . but also of the main facts about the personalities operating in that structure. What is required, therefore, is an integration or coordination of two basic sets of data in a larger explanatory scheme-not a reduction of either mode of analysis to the allegedly more fundamental level of the other. 15 To enlarge upon Inkeles' suggestion, the type of variable most useful for refining the explanation of the pattern would be one which is both: a dominant characteristic of its own system, hence operating powerfully; and a characteristic which is salient 16 to dominant aspects of the other system, hence a point of articulation between the two. In the present case, the aide's affiliative needs and the hospital's treatment program may meet these criteria. An aide with strong needs, for example, would more likely suffer from a ward transfer than an individual not so concerned-if personal relationships between aides and patients are stressed in the treatment program. At the other extreme, the change-absence pattern should be least affected in aides with low affiliative needs working in a hospital setting that disregards such relationships. But the combinations of personality modes and social structural types are mediating screens through which actions -not static characteristics-of the organization affect individuals and actions of the individuals affect the organization.