James K. Morrison

The public's current beliefs about mental illness: Serious obstacle to effective community psychology

A demythologizing, educational approach to the community is outlined and recent empirical studies are summarized which demonstrate that beliefs in favor of the mental illness concept can be significantly changed. Such conceptual change, reflecting an acceptance of a psychosocial paradigm of psychological problems, apparently induces a seminar participants a number of desirable effects from a community psychology perspective: an increased positive image of the mental patient, increased positive self-attributions, decreased fear ratings of mental patients, and a decreased fear of becoming insane. The importance of these findings for community psychology is discussed.

The client as consumer and evaluator of community mental health services.

Discussion of ethical issues which concern community psychologists and other mental health professionals has generated new emphasis on the psychiatric client as consumer. In light of the studies questioning the efficacy and ethics of various clinical procedures, it would seem that the client-consumer is being asked to accept treatment which is often less than desirable. In light of recent trends to safeguard the rights of the client-consumer, it is now appropriate to focus on the client as evaluator of services contracted. Having clients evaluate clinical services finds its logical fruition in the creation of client advisory boards. Avoiding many of the problems of citizen mental health advisory boards, client boards ensure continued and systematic client evaluation of community mental health services. The accomplishments of one client board are offered as evidence that there should be increased emphasis on the consumer as evaluator.

Attitudes of Mental Patients and Mental Health Professionals about Mental Illness

In support of the construct validity of the Client Attitude Questionnaire, 16 psychologists and 25 social workers reported attitudes more characteristic of the controversial psychosocial position about “mental illness” than 20 psychiatrists, 23 psychiatric nurses, or 40 previously hospitalized psychiatric outpatients.

Halfway to where? A critique of research on psychiatric halfway houses.

Following a critical review of halfway house outcomes studies, the authors concluded that the effectiveness of halfway houses in facilitating the independent functioning of psychiatric clients in the community is open to question. It appears that because major deficiencies in the areas of autonomous atmospheres, employment training and community adjustment are often concealed by limitations in statistical indices of success. Further research is necessary before more definitive conclusions can be drawn related to the effectiveness of psychiatric halfway houses. Specific, suggested requirements for future research efforts are presented.

Changing negative attributions to mental patients by means of demythologizing seminars

As compared with a group of matched controls, psychiatric clients exposed to demythologizing seminars made significant and positive changes in the qualities that they attributed to the mental patient. Implications of this study for further research were discussed.

Effect of demythologizing seminars on attributions to mental health professionals.

16 persons enrolled in an adult education course completed the Client Attitude Questionnaire and a semantic differential. Analysis showed change in attitude toward mental health professionals from pre- to immediate posttest; the change held over 3 mo.

Comparative effectiveness of directive vs. nondirective group therapist style on client problem resolution.

This study was designed to determine the utility of two newly developed self-report measures of group therapy effectiveness. Repeated administrations of these instruments indicated that group therapy was effective in inducing significant problem resolution and that these changes were stable on a 3-month follow-up. One of the measures also suggested that the nondirective style of therapy appeared to be more effective than the directive style. Results suggest that two self-report measures may be useful in studies designed to determine both the outcome as well as the process of group psychotherapy.

The child's right to give informed consent to psychiatric treatment

Abstract Following a review of the rights of children under the law, the authors conclude that there are some recent legal developments which may herald an eventual recognition in law that age by itself cannot be meaningfully used as the sole criterion for restricting to adults the right to give informed consent to psychiatric treatment. The authors argue that the right to informed consent is actually in the best interests of children as well as service providers. Furthermore, there is extensive evidence that developmental stage is a more accurate determinant of cognitive ability than is age, thereby suggesting that at least some persons under eighteen (e.g., children at the stage of formal operations, or perhaps even those at the concrete operational level) are intellectually capable of rendering truly informed consent to treatment. Recommendations are made which, until the law clearly recognizes the legal right of certain children to make certain contracts (e.g., consent to treatment), will continue to ...

Ethical Conflict among Clinical Psychologists and other Mental Health Workers

In a small geographical area a study was undertaken to determine the ethical conflicts experienced by mental health workers related to their clinical interventions. An Ethical Conflict Questionnaire, a 20-item, self-report attitude measure, was sent to all mental health workers in a tri-city area. A multivariate analysis of variance of the 164 returned questionnaires indicated that sex, years of clinical experience, and occupation (psychologist, psychiatrist, psychiatric social worker, psychiatric nurse, and a combined group of mostly vocational rehabilitation counselors and mental health therapy aides) significantly affect reported ethical conflict.

Comparative Effectiveness of Individual Imagery Psychotherapy vs Didactic Self-Help Seminars

Twenty-three clients undergoing 15 sessions of individual imagery psychotherapy (emotive-reconstructive therapy) were compared with 23 persons participating in 8 2-hr., 20-min. didactic, self-help seminars to assess the comparative effectiveness of each treatment on self-attributions as measured by the semantic differential. As predicted, results indicated that both treatments were effective in producing a significant increase of positive self-attributions, but that the clients in individual therapy reported significantly more positive attributions than the self-help group. The superior effect produced by individual therapy is discussed within the context of its greater cost in time and money. It is suggested that some therapeutic effects, e.g., increased self-image, may be more inexpensively and efficiently obtained by means of didactic seminars rather than individual psychotherapy.