Allan M. Josephson

Self-harming Behavior in Incarcerated Male Delinquent Adolescents

This report describes self-harming behavior in males in a juvenile incarceration center. Three groups of adolescents were examined: self-harmers, those referred for a psychiatric examination, and the incarcerated general population. Compared to the general population, the youth in the two mental health groups were younger, had greater family needs, had more educational problems, were more likely to have escaped from a previous placement, and committed more rule violations. The self-harming group, when compared with the psychiatrically referred group, had a greater number of prior offenses, were more disruptive in school, performed worse on a problem-solving task, and committed more rule violations. Issues of psychopathology and treatment are discussed.

Child and adolescent psychiatric emergencies: family psychodynamic issues

Given the impact of the family on the etiology, identification, and treatment of child mental health problems, this article addresses the role of the family in psychiatric emergencies. This article covers relevant aspects of family evaluation in an emergency context, factors that determine the familys role in disposition, and planning of family considerations in several specific clinical emergencies. Improved understanding of the familys contribution leads to a more accurate diagnostic consideration and more appropriate disposition recommendations. A correct diagnosis and appropriate discharge plan lead to an improved prognosis for overall follow-up care and treatment.

A Clinical Theology of the Developmental Process: A Child Psychiatrist's Perspective

Christians have historically faced challenges when they have chosen a professional mental health career. These challenges, framed in the idiom of prevailing theories or in the behavior of colleagues, continue in contemporary practice. This work reviews aspects of the process of human emotional development which, rather than challenging a Christian position, are confirmatory of a Christian world view. As an apologetic derived from professional experience, this article takes several observations of C.S. Lewis about the natural world and applies them to the study of development. The author describes a recurring theme in human development: All individuals desire that their developmental needs are met, and protest when this does not occur. Through an analysis of several developmental needs, widely accepted as critical in human development, the author concludes these developmental observations are strongly supportive of the Christian position.

The reported prevalence of physical and sexual abuse among a sample of children and adolescents at a public psychiatric hospital

In this retrospective analysis of inpatient charts, a total of 298 children and adolescents admitted to a public psychiatric hospital over a 1-year period were examined for the prevalence of reported histories of physical or sexual abuse. Physical abuse was reported in 15% of the cases, while sexual abuse occurred in 13%. A variety of comparisons were made examining possible differences in gender, age, race, diagnosis, and personality trait disturbance among the abused and nonabused patients. Relative to known prevalence rates as reported to child protective agencies, physical or sexual abuse occurred much more frequently among our sample of patients, suggesting the need for careful assessment of such histories upon admission and during treatment.

Didactic Modules for Curricular Development in Child and Adolescent Psychiatry Education

A group of child and adolescent psychiatry educators in the Association for Academic Psychiatry have developed didactic aids, termed modules,for curricular development in child psychiatry training programs. These modules consist of sets of references designed to communicate the essence of a subject area. The design is flexible, allowing the modules to be used by programs with varying amounts of time available for teaching the designated subject. The project has been endorsed by the major organizations representing education in child psychiatry. Eight modules are available for distribution, and a mechanism is in place for creating others. The authors believe this concept will be equally useful in adult psychiatry programs.

Assessment of the family. Systemic and developmental perspectives.

Why was Elizabeth the symptomatic family member? This challenging question is informed by the family assessment, which examines family process patterns, family structure, family history, and developmental challenges of individual family members and the family as a whole. Although the answer to this question may never be explained completely, the family assessment does contribute to the biopsychosocial formulation on which rational therapeutic intervention is based. The family assessment does not replace a clinical assessment of the identified patient. Rather, the use of the family assessment provides a greater breadth from which to view children and adolescents presenting complaints.