David S. Hargrove

Clinical supervision in rural settings: A telehealth model

The task of providing supervisory services to clinical interns, trainees, and new psychologists in rural settings is often complicated by a host of environmental and economic constraints. Given the re-emergence of telecommunication applications as a means of transcending similar obstacles in service delivery, the authors discuss the use of telecommunication technology as a means of enabling the traditional supervisor-supervisee relationship in settings in which face-to-face contact is difficult if not impossible. The evolution of telesupervision is discussed, followed by an outline of an integrated model of telesupervision and the goals, benefits, and challenges associated with the use of telecommunications technology in clinical supervision.

Critical issues in reforming rural mental health service delivery

Critical issues in reforming rural mental health service delivery systems under health care reform are outlined. It is argued that the exclusive focus on health care financing reform fails to include obstacles to effective mental health service delivery in rural areas, which should focus on issues of availability, accessibility, and acceptability, as well as financing and accountability. Characteristics of rural areas are delineated and three assumptions about the structure of rural communities which are shaping the dialogue on rural health and mental health service delivery are examined. These assumptions include the notion that rural communities are more closely knit than urban ones, that rural services can be effectively delivered through urban hubs, and that rural dwellers represent a low risk population which can be effectively served through existing facilities and by extending existing services.

Recommendations for education and training in primary care psychology.

American Psychological Association Publications +The development of this curriculum was funded in 1999 and 2000 by an Interdivisional Grant from the American Psychological Association.

Opportunities and Challenges of Rural Practice: Managing Self amid Ambiguity

Living and practicing psychology in a small, rural community has opportunities and challenges. We describe the context of rural communities and identify several of those challenges and opportunities. A case study demonstrates the influence of multigenerational involvement, complex professional and social situations, and the potential difficulties facing the responsible clinician. We suggest both a theoretical perspective and specific procedures for treating prototypical cases in a rural practice.

Emotional expression and modality: an analysis of affective arousal and linguistic output in a computer vs. paper paradigm

The authors hypothesized that writing longhand and typing about a stressful experience are equivalent in terms of emotional arousal and essay content. 168 college students were randomly assigned to describe either a neutral or emotional topic by typing or writing longhand, in a 2×2 factorial design. Compared with students in the neutral conditions, students instructed to describe an emotional topic reported greater negative affect following the writing task and produced essays that contained significantly more personal and psychological content. Consistent with the hypothesis, participants writing longhand and typing were equivalent in the direction and degree of this difference. These findings suggest that at least a portion of the population (i.e. college students) is now comfortable and/or adept in expressing themselves emotionally on a computer.

Training Ph. D. Psychologists for rural service : a report from Nebraska

The Clinical Psychology Training Program at the University of Nebraska-Lincoln developed a rural mental health speciality to train psychologists to work in rural settings. Preliminary data indicate that the project was relatively successful in placing graduates in rural practice. But the needs for practitioners in rural communities clearly are greater than training programs can meet. Relying on doctoral psychologists for clinical work in rural communities may not be the best strategy in workforce planning.

Balance theory as a model for coordinating delivery of rural mental health services

Abstract The chaotic nature of rural mental health services is due, at least in part, to a lack of consistent theory guiding their purpose and structure. The failure to plan mental health care systematically for rural areas is a result of diverse opinions and policies grounded in changing social, political, and economic conditions. The Balance Theory of Coordination ( Litwak & Meyer, 1966 ) offers a viable perspective to guide service system development and evaluation. This article identifies current difficulties in the rural mental health systems, offers balance theory as a basis for further work, and posits a model for case management rooted in balance theory. The intent is to stimulate research and theory development for rural mental health systems.

Recruitment, motivation, and reinforcement of preprofessionals for public sector mental health careers

The labor intensive public mental health system needs to encourage trainees in mental health professions to consider careers in the public sector. Recent evidence is that younger professionals are choosing other carrer paths following their training. This paper suggests that the availability of relevant training opportunities, positive role models, financial support while in training, and a supportive group of peers are important components of training for public sector careers.

An Analysis of the Effectiveness of Telephone Intervention in Reducing Absences and Improving Grades of College Freshmen

A telephone intervention to reduce student absences was implemented during the 2000–2001 academic year in freshmen English classes at a southern university. A total of 345 students were included in 2 experimental studies. Students in the intervention group who obtained more absences than allotted by class professors received telephone intervention, whereas students with excessive absences in the control group did not receive telephone intervention. Results revealed that students in the intervention groups had significantly fewer absences and higher grades (p < .01) than students in the control groups during both semesters of the study. Also, more students in the intervention group were retained from the Spring 2001 semester to the Fall 2001 semester as compared to students in the control groups.

Toward the Financial Integration of Public Mental Health Services

The public treatment of seriously mental ill patients continues to be frustrated by the lack of administrative and financial integration of state and community mental health services. Several states have initiated attempts to improve the costeffectiveness of public mental health services through mechanisms that create financial incentives fostering community-based alternatives to psychiatric hospitalization. Examples of such mechanisms include capitation financing systems, performance contracts, regional mental health authorities, utilization review, and bed-targets. This paper reviews evidence supporting the need for and success of these efforts, and also addresses their limitations.