Raymond J. Waller

Application of the Kindling Hypothesis to the Long-Term Effects of Racism

Abstract This theoretical article proposes that the kindling hypothesis has significant potential impact in the conceptualization of the global impact of racism over time in the lives of black Americans. The kindling hypothesis describes how repeated shocks within the brain can trigger seizure activity. This same phenomenon has been applied to mental health in the areas of affective disorders and psychological trauma. In these circumstances, repeated minor traumas occurring over time are theorized to trigger clinical threshold depression and trauma.

Feasibility and Implementation of a Statewide Evaluation of Substance Abuse Services

Statewide evaluations of mental health services are colossal undertakings, reports of which are few in the published literature. Social workers are often called on to conduct program evaluations of both small-and large-scale mental health systems. A statewide evaluation system was implemented in the state of Georgia in 1999 to measure the impact of services on mental health, mental retardation, and substance abuse programs. This report delineates the evaluation of substance abuse services for the state of Georgia using the Addiction Severity Index. System-wide outcomes were assessed across 13 mental health regions, and 19 substance abuse programs participated. Consumers admitted to American Society of Addiction Medicine level II services were assessed at intake and 60 days posttreatment. Difficulties with the implementation of the statewide evaluation system, such as attrition, are identified and discussed. Recommendations for improving the evaluation system are also discussed.

Spontaneous recovery of previously extinguished behavior as an alternative explanation for extinction-related side effects.

Extinction is accepted as a viable intervention for behaviors that are hypothesized to be maintained by contingent attentional reinforcement. However, it is frequently acknowledged that extinction has potential numerous side effects, including the generation of aggressive behavior. This explanation does not provide a behavioral conceptualization of such side effects. This article offers that spontaneous recovery of previously extinguished behavior as a behavioral explanation of side effects sometimes observed during the extinction process.

A Correlational Study of the Impact of Discrimination on Disposition During Hospital Emergency Services Contacts

Abstract Racial discrimination is a phenomenon that is reported to occur throughout many domains of service provision in health care and mental health care, and is a major research concern of the National Institute of Health. Many service delivery venues have received attention to address the potential presence of racial discrimination, although a form of mental health service delivery in hospital emergency rooms known as emergency services has received sparse attention. The current study is an investigation into the presence of racial discrimination and the potential impact of such discrimination in a rural Southeastern three county public mental health system. Methodological considerations of the research approach are also discussed.

Sederer, L. I., & Dickey, B. (1996). Outcomes Assessment in Clinical Practice. Baltimore: Williams & Wilkins. 301 pp., ISBN 0-683-07630-2

professionals in a variety of human service fields, such as clinical social work and social program administration and research. The books presentation of scientific methods serves as a good introduction to a beginning student, practitioner, administrator, or researcher, and is a good review for the more knowledgeable human service professional. The text provides a good first look at quality improvement issues and the means for acquiring some of the tools necessary to develop and maintain a quality improvement process. However, the content of this volume should not be viewed as a comprehensive approach to developing and maintaining a quality improvement system (or range ofsystems) that combine scientific and artistic factors to achieve and maintain such a process. The presentation ofpotential types ofoutcomes, besides the general outcome of improved client outcomes intervention (p. 340), is limited. In this sense, the text is somewhat narrow in its focus. In particular, minimal attention is paid to how outcome is directly related to process. Taking these points into account, instructors will probably want to develop a supplemental reading list to deepen the students understanding of certain aspects of building and maintaining a quality improvement process and system; for example, the significance ofN when analyzing data at the program level and the use of more sophisticated data analysis techniques such as regression analysis. Instructors will probably find the chapter questions and exercises useful teaching aids, and may also want to seek out research studies and case examples to fill out the content. This book should be useful in teaching at the masters and doctoral levels, so long as supplementation, particularly case examples in which comprehensive quality improvement systems have been established, is provided.