Social Psychiatrist Research Articles

David Paul Brandes Goldberg: social psychiatrist who highlighted the role of GPs in mental health treatment

David Paul Brandes Goldberg: social psychiatrist who highlighted the role of GPs in mental health treatment

A Relational Dialogue with Maurizio Andolfi: Master Family Therapist and Social Psychiatrist

Maurizio Andolfi, MD, an internationally renowned Master Family Therapist and Social Psychiatrist, was recently awarded an Honorary Fellowship in the World Association of Social Psychiatry for his many contributions to child psychiatry, family psychotherapy, and social psychiatry. This article offers an overview of Dr. Andolfi’s origins, professional training, and career achievements and identifies the key themes and techniques he elaborated throughout his career as a child psychiatrist, family psychotherapist, and social psychiatrist. The heart of this encounter with Dr. Andolfi is based on a comprehensive interview which is presented as a relational dialogue, inspired by his approach to relational psychology and relational therapy. A relational dialogue is an exchange between interlocutors who alternate fluidly in the roles of active listening and speaking to each other respectfully. Dr. Andolfi’s responses to a dozen questions are edited into a narrative with numerous direct quotes, organized by thematic labels in his own words, from what motivated him to become a psychiatrist and family psychotherapist to how he sees the relationship between family work and social psychiatry, and finally, to how he sees the nature of change and transformation in psychotherapy and how he now experiences authenticity with maturity and the voice of experience.

Social Psychiatric Consultation to a Rural Public Primary Care Team: From Individual to Planetary Health

This article describes some of the experiences that resulted from the hybrid (online and on the ground) consultations that a social psychiatrist gave to a public family and community medical team in a rural setting in South Brazil. The consultation works on several levels: orienting the approach to difficult cases, with continuing education, helping with team relational difficulties among themselves and with the city administration, helping design innovative approaches to cases and to preventive mental health work, and also, helping to shape the approach to planetary health in town.

Reflecting Team as an Evaluation/learning Instrument for Self-reflection of Teachers

Abstract The Reflecting Team (RT) is a method derived from systemic therapy in the 1980s by the social psychiatrist Tom Andersen. It is increasingly being used in training and evaluation contexts. The aim of the method is to create a space for the development of diverse perspectives and appropriate ideas and solutions in which the integrity of the students/customers/clients is preserved and the acceptance of proposals is facilitated. To this end, the systems involved (advice seekers, consultants, and observers) enter a common process of alternately directed and non-directed communication. The RT is not only suitable to address communication problems in group work and other educational situations, but it can also help to consider the traditional teaching and learning processes in a reflective way. Reflecting teams can also significantly improve the feedback and quality of teaching and learning. The article deals with the use of RT in the context of the collective exchange of teaching staff with their students. It uses a problem as an evaluation form and learning instrument to reflect on their pedagogical approach and, at the same time, their relationship with students during the lessons. This is to present the RT method for collegial exchange (Process Flow: Advice-seeker, teacher, Interviewer, RT) and their need for teacher reflection as well as the experience of self-efficacy (empowerment and self-sufficiency).

From boxing to geriatric psychiatry : Facets from the work of East German social psychiatrist Bernhard Schwarz (1918-1991)

For the first time, this study presents publications representative for the work of the neurologist and sports physician Bernhard Schwarz, whose career spans from the 1950s to the 1970s. His work is characterized by exceptional originality. Schwarz acted as the physician of the GDR national boxing team and conducted asystematic long-term study of 800 boxers. He found increased occurrences of depression, Alzheimer's and Parkinson's diseases and suggested that these were linked to recurring craniocerebral injury. He was concerned about avoiding such long-term health effects in boxers and suggested arange of preventive measures that were later reflected in the guidelines of international boxing associations. Schwarz was distinguished by his drive to directly implement social psychiatric approaches in the hospital. As head of the psychiatric clinic at Leipzig University, he initiated aclub for geriatric patients to help older patients with the problematic transition from hospitalization to outpatient assistance at home. Influenced by holistic anthropological thinking, he regarded geriatric mental illness as aconsequence of social isolation. In addition, Schwarz was involved in amodel project that assessed the work resilience of patients in the hospital with the goal of optimizing psychiatric rehabilitation. Both projects were successes, according to his published accounts.

Social psychiatry in a rapidly changing world

Many societies around the world are experiencing a period of unprecedented change in traditional social roles and customs. Globalisation has contributed to materialism and a me-first individualism that heightens awareness of income inequality that itself is one of the most robust markers of unhappiness in society. Ever increasing urbanisation has driven an erosion of large ‘joint’ family arrangements to be replaced by smaller and relatively isolated nuclear families and single parent living. Mass migration has unmasked deep seated fear and prejudice towards the outsider in society. These global changes are fertile ground for the social conditions that have long been known to be risks for mental illness – poverty, poor quality child care, social isolation and the active discrimination and exclusion of the alien, the physically disabled and mentally ill. While there is little we can do to reverse global change, there is much a social psychiatrist can do to mitigate the effect, ensuring his/her voice is added to other calls for reducing discriminatory practice, promoting evidence-based social interventions such as parenting advice and peer support and ensuring that the success of a treatment is measured not just in terms of symptomatic improvement but in whether it results in an outcome that is valued by the patient.

Listening to voice hearers

Summary This article considers what the Hearing Voices Network can offer to mental health social work. It combines an extensive literature review of voice hearing by Bob Sapey and the expertise by experience of Peter Bullimore who runs a peer support group for voice hearers. Findings The re-framing of auditory hallucinations as voice hearing has significantly changed the way many voice hearers have been able to understand their experience. This new approach to working with voices was developed at the University of Maastricht, principally by social psychiatrist Marius Romme. By moving away from biological explanations of brain disease to psychological understandings of emotions, Romme and his colleagues have found ways of helping people cope with voices, rather than trying to get rid of them through medication. This has led to a network of voice hearing groups throughout the world. There is much of what happens in these groups and within the social psychiatric responses known as the Maastricht approach that can be practiced by social workers. Applications The Maastricht approach to working with voices challenges the basis of pharmacological responses to psychosis and moves beyond anti-psychiatry by offering positive alternatives to the current biomedical treatment of schizophrenia. This approach can be undertaken by experts by experience and mental health professionals. We describe these approaches and argue that in adopting them, social workers can help voice hearers cope both with the content of their voices and the stigmatising responses to being diagnosed with schizophrenia.

Distress management in a community oncology center.

107 Background: NCCN and the Institute of Medicine recommend distress screening for all cancer patients. Surveys have found that 20% to 47% of newly diagnosed and recurrent cancer patients experience significant levels of distress. Less than half of distressed patients with cancer are actually identified and referred for psychosocial help. The development of screening tools, processes, appropriate timing, and systems for follow up on concerns is an ongoing challenge for many cancer programs. Mountain States Tumor Institute p,iloted a distress screen process as part of our work with NCCCP. Methods: From October 24, 2011, to April 30, 2012, 133 patients completed distress screens. Most frequently reported concerns included fatigue (50%), sleep changes (32%), and anxiety/worry (31%). 51% of patients reported three or more concerns. 90% of all patients reporting anxiety also reported fatigue or sleep problems. All patients who reported concerns were offered social work and other supports. Screens were reviewed by social workers and discussed at weekly multidisciplinary psychosocial care rounds by social workers, psychiatrist, nurse practitioners, and chaplains. A variety of interventions were used to respond to distress including symptom management, education and referrals to on-site social workers, chaplains, supportive care clinic, integrative medicine and psychiatry. Results: A task was created in Mosaiq Electronic Medical Record to cue Health Information Specialists to schedule patients for distress screening as close as possible to 45 days from first chemotherapy treatment. Patients completed screens before seeing their medical provider. The majority of patients screened received one or more interventions in follow-up. Conclusions: EMRs can be effective tools to cue scheduled screening of patient distress. The use of multidisciplinary psychosocial care rounds can effectively help clinics plan interventions to alleviate patient distress. The use of rounds can ensure staff from different disciplines are not duplicating efforts and can help determine appropriate timing of various psychosocial interventions. Project funded with Federal funds from the NCI, Contract No HHSN261200800001E.

Help‐Seeking from Mental Health Professionals or Clergy: Perceptions of University Students

University students (N = 186) responded to 14 problem‐situations (personal/emotional problems, moral problems, social/relational problems, and religious visions/hallucinations) for which one might seek help. Options for help included: (a) a licensed mental health professional (clinical social worker, counselor, clinical psychologist, or psychiatrist), (b) a clergy person, (c) a clergy person with a graduate degree and license in a mental health discipline, or (d) no one—this situation could be handled by oneself or family. Overall, moral problems were perceived to be best handled by oneself and one's family. Social/relational and personal emotional problems were believed to be handled best by mental health professionals. Psychotic/religious problems were seen primarily as the domain of clergy and clergy with advanced training in a mental health discipline. Those who had received religious education differed from those who had not received any religious education in their perceptions about help‐seeking for serious relationship problems and if a young person thought s/he might be gay or lesbian. Responses from minority respondents were significantly different from responses of the dominant culture in 8 of the 14 situations. There were significant differences in perceptions between those who had and those who had not received help from a mental health professional in the past in several situations (young person who might be gay or lesbian, serious relationship problems, abusing spouse or partner, job loss, hearing the voice of God, and seeing Jesus). When having received or not received help previously from a clergy person was analyzed with the 14 situations, significant differences were observed in serious relationship problems, teenage drug use, complicated bereavement, anxious and unable to cope, hearing the voice of God, and all the moral situations.

Skilled help for mental health concerns: comparing the perceptions of Catholic priests and Catholic parishioners

This study compares the data from a study investigating the perceptions of 203 functioning Catholic priests (Kane, 2003) to the data from a study of the perceptions of 473 practicing lay Catholics (Kane & Williams, 2000) regarding who is best qualified to assist people in 11 moral, emotional, family or personal situations in which skilled help might be necessary. Choice options for 11 hypothetical situations in which skilled help might be needed included (a) a Catholic priest, ( b) a Catholic priest with a graduate degree in social work, psychology, psychiatry or counselling, (c) a lay mental health professional (clinical social worker, counsellor, clinical psychologist or psychiatrist) or (d) no one—this situation should be handled by the individual without skilled help. There were significant differences between the perceptions of respondent Catholic priests and practicing Catholics in all 11 situations. Cultural differences appear critically important in the choice of skilled helpers. Additionally, there were significant differences between priests’ and parishioners’ use of skilled help in their personal past histories. Implications are discussed.

Rudolf Karl Freudenberg - from pioneer of insulin treatment to pioneering social psychiatrist.

Rudolf Karl Freudenberg was Physician Superintendent at Netherne Hospital, Couldsdon, Surrey from 1951 to 1973. In his work as superintendent and government adviser he made important contributions to mental hospital reform and to the establishment of community psychiatric services in Britain. Earlier, in Vienna and following emigration to Britain, he was one of the pioneers of insulin coma treatment with a series of publications on this topic. The paper gives an account of published papers of both phases, and it highlights the background to Freudenberg's shift in professional interest from physical to social intervention. It argues that the change of emphasis reflects important general trends, i.e. profound change due to new forms of physical treatment on the one hand and similarly convincing evidence of the impact of social factors on clinical course and outcome on the other hand.

Contemporary community psychiatry

When invited to give the Maxwell Jones lecture as part of the Fiftieth Anniversary Celebrations of the Henderson Hospital I was pleased and honoured, as well as somewhat surprised. I welcomed the opportunity to pay tribute to an outstanding social psychiatrist and to reflect on a decade of turbulent change within mental health services.

The Gentle Revolutionary: To Commemorate the Great English Social Psychiatrist Douglas Bennett

The Gentle Revolutionary: To Commemorate the Great English Social Psychiatrist Douglas Bennett

Working with Schizophrenia

Gwen Howe Jessica Kingsley, pounds sterling9.95, pp 208, ISBN 1 85302 242 X Those who speak from personal experience are the best teachers of what it is like to have schizophrenia or to care for someone with it. But though their accounts can be harrowing, and damning of the way service professionals respond—whether nurse or social worker, general practitioner or psychiatrist—they can also be hopeful and uplifting, enabling others with, or caring for those with, schizophrenia to learn new ways of coping and making sense of their perplexing and often frightening world. In Working with Schizophrenia Howe provides a varied selection of the first …

Pain Consult: A Cancer Center's Outreach

Patients with advanced cancer and chronic pain have problems that strain the resources of primary physicians and emergency room staff, frequently leading to unnecessary hospital admissions. The Supportive Care Program of the pain service at Memorial Sloan-Kettering Cancer Center (MSKCC), which concentrates on continuity of care, works to maintain these patients at home while improving the quality of their lives. It is also a source of expert information and a link between MSKCC and community health practitioners(1). Two nurses, a social worker, neurooncologist, psychiatrist, music therapist, and chaplain make up the team. Most of our patients have advanced cancer and intractable pain. Unlike hospice patients, many choose to continue active treatment, including experimental drugs, until shortly before death. The nurse, not the physician, is responsible for day-to-day pain management, symptom control and supportive care of the patient and family. The nurses hold master's degrees in nursing and have additional training in pain management, symptom control, and delivery of community services. Their backgrounds-in mental health, public health, and neuro-oncology-are complementary. Each nurse works with 12 to 15 patients and their families in collaboration with the patients' primary physicians and in consultation with the other team members. She follows patient and family through home visits, clinic visits, and hospital visits. Most intervention, however, is by telephone contact with the patient, family, or a community health worker (usually a visiting nurse but sometimes a private duty nurse, social worker, or physician). Telephone calls are extremely effective in monitoring symptoms, adjusting or initiating management approaches, anticipating problems, reducing anxiety, and in bereavement follow-up. While community health professionals help manage patients at home, the team nurse and social worker remain available to the patient, family and community health worker on a 24-hour basis. Since 1981, when the program started, 175 patients (ages 22 to 83) have been admitted based on one or

Task-centred Casework with Marital Problems

This paper uses part of the material gathered by the Southampton self poisoning project in the years from 1975 to 1977 (Gibbons et al.1). One of the aims of the project was to assess the effectiveness of social work intervention with people who have taken an overdose. During the year from April 197 5 to March 1976,539 people who had taken an overdose and had been seen in the casualty department of the Southampton General Hospital were included in the study. After baseline assessment by a research psychiatrist, the patients who were not in current contact with a social worker or psychiatrist and were not in need of immediate psychiatric care were allocated to the trial programme of task-centred casework. They were then randomly assigned to either the experimental or control group until there were 200 in each. The control group received the routine follow-up service: referral to a general practitioner, to psychiatric out patients or to other services, usually the social services department. All those in the experimental group were offered a period of contact with one

Comment: Communication and cancer—A social psychiatrist's view

Comment: Communication and cancer—A social psychiatrist's view

A SOCIAL PSYCHIATRIST'S VIEW OF MEDICAL CARE

A SOCIAL PSYCHIATRIST'S VIEW OF MEDICAL CARE

Psychiatric Case Register Conference, 1965

Case registers are a relatively new tool for research in the field of psychiatry. Problems of definition and classification in psychiatry and the impact of mental illness on the individual and the community pose unique problems for psychiatric register studies. While many of the technical solutions to case register problems have now been solved through the computer and statistical methodology developed especially by psychiatric registers, a number of problems and issues still remain. Despite these difficulties and the cost of registers, the yield to better community mental health services and knowledge about mental disorders may be immeasurable. The involvement of the various professional disciplines in register research such as the clinical and social psychiatrist, the program director, the demographer and sociologist will enhance the register's intrinsic value and broaden its application.

INTEGRATION OF THE SOCIAL GROUP WORKER AND PSYCHIATRIST IN THE PSYCHIATRIC HOSPITAL.

INTEGRATION OF THE SOCIAL GROUP WORKER AND PSYCHIATRIST IN THE PSYCHIATRIC HOSPITAL.