Paul Rodenhauser

Skills for Mentors and Protégés Applicable to Psychiatry

The authors address the elements and dynamics involved in the life cycle of mentoring relationships applicable to psychiatry, including a proposed model for explicating the developmental stages experienced by participants in the process. They provide a review of the mentoring literature for use in psychiatric education, research, and practice and offer various perspectives, describing skills for mentors, skills for protégés, the dynamics of the mentoring relationship, benefits and barriers, and issues related to gender, race, and culture.

Ability of prospective assessment of personality profiles to predict the practice specialty of medical students

Medical practice encompasses a diverse spectrum of specialties. Factors that impact selection of clinical disciplines by young physicians may have recently evolved associated with changes in medical school demographics. We assessed whether physicians gravitate to certain practice specialties due to preexisting personality traits. The Neuroticism-Extraversion-Openness Personality Inventory Revised Test was administered prospectively to 130 first-year students the week before they began medical school. Scores for five traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) were compared with the selection among nine medical residencies at the conclusion of medical school. Personality scores for medical students selecting psychiatry residencies showed greater degrees of neuroticism (P < 0.01) and openness (P < 0.03). Students electing family practice also deviated from other specialties, showing a lower degree of neuroticism (P < 0.03). Unexpectedly, personality traits in prospective surgical residents did not differ from those of students choosing nonsurgical residencies. Personality profiles present before medical school appear to predict the selection of some residencies and clinical specialties but not others.

Psychiatrists as treatment team leaders: pitfalls and rewards.

The multidisciplinary treatment team has become a conventional component of inpatient psychiatric care delivery. Treatment team dynamics and their implications for the patient, the team members, the organization, and the team leader in particular have been generally understated in the training of psychiatrists, however, as has its value as a model for learning about administration. This article highlights the history and evolution of the multidisciplinary treatment team in psychiatry, the mix of mental health disciplines, philosophies, and roles involved, the characteristics of mental health care professionals, the conflicting manifest and latent work group tasks, and the dynamics and functions of team leadership. While reviewing information on which to base a systematic approach to team leadership, the author advocates for application of universal standards for education in administrative psychiatry including supervised leadership of multidisciplinary treatment teams and discussions of complimentary readings, examples of which are provided.

Cultural barriers to mental health care delivery in Alaska.

Geographically diverse providers from all mental health disciplines attended a recent conference in Anchorage and discussed cultural barriers to the delivery of mental health care in Alaska. Based on their knowledge, experience, and perceptions, this article describes barriers contributed by the mental health care delivery system as well as those contributed by the American Indian and Alaska Native cultures. American Indians and Alaska Natives are experiencing deculturation, outmigration, alienation, distrust, and despair. The difficulties at the interface between Alaskan mental health care providers and consumers indigenous to Alaska have implications for administrative and clinical endeavors in culturally diverse settings elsewhere. Progress in this area will require special administrative skills.

The life cycles of professional associations: Organizational and administrative dynamics

The life cycles of professional associations have received little attention in the literature. Using the Canadian Group Psychotherapy Association as an example, the author discusses the general dynamic underpinnings of systems and organizations, and caveats for the leaders of professional associations.

Performance appraisal and organizational issues in a mental health setting

The authors report on the use of applied behavioral science techniques to develop a performance appraisal instrument and system in a mental health organization. The system integrated individual, professional, and institutional values into an overall framework including parts of the organization in conflict.

On the Future of Psychotherapy Supervision in Psychiatry

Because psychotherapy supervision skills are learned primarily through experience as a psychotherapy supervisee, today’s diminished training in psychodynamic psychotherapy can negatively influence future instruction in this important treatment modality. The author discusses role preparation for psychotherapy supervisors, suggests minimum standards for supervisor proficiency, and recommends ongoing instructional skills training.

Residency Education in Administrative Psychiatry

In 1989, the authors surveyed all general psychiatry residency programs to assess the availability, extent, and emphasis of administrative teaching currently being offered during residency training. With a return rate of 74.5%, the results reveal that 69.5% of the respondents presently include administrative training within their curricula and 56% offer didactic teaching about administrative issues. These results are compared with a similar survey performed 10 years previously in which 85% of the respondents reported offering some administrative training but only 39% offered didactic instruction in this area. An analysis of these data and a review of proposed curricula for training in administration are provided.

Regression as a cardinal factor in organizational destabilization

Leaders and organizations are particularly vulnerable to destabilization during periods of transition, severe frustration, or crisis. The author discusses four theoretical constructs that explain organizational destabilization based on regression. Stabilizing strategies are also presented.

Student Ratings of Outpatient Learning Favor Rural Community Mental Health Centers

All students (N = 185) in 8 consecutive rotations within a private Southern schools multisite, inpatient-based psychiatry clerkship completed a survey of perceived educational experiences while assigned to 1 of 5 part-time outpatient services (usable response rate 82%). The rural community mental health center (CMHC) students reported increased 1) appreciation for the nature and implications of psychiatric disorders; 2) appreciation for treatment effectiveness; 3) interest, enjoyment, and hopefulness; 4) firsthand experience with patient evaluation and treatment; 5) community treatment resource information; and 6) teaching model helpfulness. The rural CMHC and Veterans Affairs Medical Center students reported a learning model based on experience. The rural CMHC and university student mental health service better exemplified the biopsycho-social treatment approach.