Richard Dalton

The psychiatric hospitalization of children: An overview

This paper reviews significant outcome studies regarding the hospitalization of latency-age children and examines pertinent admission criteria. Essential diagnostic and therapeutic components, including milieu therapy, individual therapy, family work, pharmacotherapy and school are discussed. The future role of psychiatric hospitalization of children is examined.

Psychiatric Hospitalization of Preschool Children: Admission Factors and Discharge Implications

Abstract The psychiatric hospitalization of 18 preschool children is examined. Behavioral, diagnostic, developmental, family, and community factors contributing to the admissions are reviewed and discussed. Implications for treatment and discharge planning are noted.

Treatment outcome among child psychiatric outpatients in a community mental health center.

The study evaluated the effectiveness of mental health center treatments for children aged 5–12 years. The Child Behavior Checklist (CBCL) was administered before and after treatment to the parents of the treatment group (N = 71). The results were analyzed and compared to the results of the pretest and posttest CBCL administered to the parents of a matched group of comparison subjects (N = 33). The results showed that the treatment subjects significantly improved on both the externalizing and internalizing scales of the CBCL. The controls showed no significant change between pretest and posttest scores. As a result, it appears that clinic treatments can help clients with measurable problems decrease problematic behaviors. More data is needed to determine whether clinic treatments such as the ones described in this study can substantially help the most seriously disturbed school-age children.

Adolescent Treatment Outcome in a Community Mental Health Center

To assess the effectiveness of a community mental health center outpatient adolescent treatment program, outcome measures were completed by the parents of 50 consecutively admitted adolescent patients who were evaluated and treated with one of three therapy modalities. Their results were compared to outcome measures of 29 non-treated adolescent control subjects. Also, self-report outcome measures were completed by 30 treatment subjects. The results demonstrated a significant positive change in the study group following treatment as compared with the control group. Each of the treatment modalities used with the study group was associated with improvement. The staffing referral mechanism used to determine the particular treatment modality for each patient was shown to be consistently and appropriately implemented.

Mind, Brain, and Psychiatry

&NA; The question of how the mind and brain are related has interested philosophers and scientists for over 20 centuries. Psychiatry has approached this question indirectly, from the standpoint of trying to correlate mental and physical functioning. Recent neurobiological advances may help to resolve the mind‐body dichotomy. In this paper we review one particular neurobiologically based theory, the theory of neuronal group selection as proposed by Gerald Edelman. We describe the applicability of this theory to the clinical issues of attachment, character pathology, and depression to show how biological and psychological hypotheses of behavior can be assimilated into an integrated approach. We also briefly discuss limitations of Edelmans model, as well as alternative concepts in artificial intelligence, cognitive psychology, and quantum theory.

Alternative therapy with a recalcitrant fire-setter

This case report describes treatment of a 10-year-old white boy who had set a major fire in a group home. Various episodes of serious fire-setting continued to occur until one of the authors joined with the boy in constructing a controlled fire. The exercise was repeated three times, with positive results. A three-step intervention approach is described for working with latency-age boys who set fires.

Psychiatric hospitalization of preschool children : a follow-up study

This paper reviews the five year follow-up status of 18 patients initially studied while psychiatrically hospitalized during their preschool years. Only four are currently doing well. Outcome is correlated with patient, family and treatment variables. Possible clinical and research approaches are discussed.

Book Review: ADOLESCENTS, ALCOHOL, AND SUBSTANCE ABUSE: REACHING TEENS THROUGH BRIEF INTERVENTIONS, edited by Peter M. Monti, Suzanne M. Colby, and Tracy A. O'Leary. New York: The Guilford Press, 2001. 350 pp.

This edited book was written with the intent of describing and promoting brief therapeutic interventions with adolescents who use and abuse substances, primarily alcohol. It is directed toward mental health and substance abuse clinicians and researchers. The book consists of eleven chapters that review research findings that support the contention that brief interventions can be effective. The authors describe specific assessment techniques and intervention programs. Each chapter is thoroughly researched and presented in a straightforward manner. The chapters describing how the harm reduction model can be applied to adolescent substance use, how specific personality traits and early learning can increase the risk of later substance abuse, and the uses of motivational enhancement and integrative behavioral and family therapy as components of brief treatment are particularly insightful and helpful. In fact, the authors offer the sort of reasonable, well-supported treatment tips that therapists will find useful, regardless of the particular patient problems with which they are confronted. This book’s content is somewhat controversial. The harm reduction model that is presented and espoused flies in the face of the “Just Say No” approach to substance use popularized in the 1980s. The model intimates that total abstinence might not be the only therapeutic goal with adolescent substance users, despite legal prohibitions. The authors tactfully but directly refer to this potential controversy. They maintain, supporting their contentions with current research, that the harm reduction model and the use of brief therapeutic interventions are well reasoned and they remind the reader that outcome should be measured in functional terms (i.e., reduction in usage). Although well researched and written, there are some minor problems with this volume. Many of the chapters begin with a review of epidemiological data detailing adolescent alcohol use and the problems resulting from teen drinking. The data are redundant, and in some cases conflicting. Pharmacotherapy is dismissed, in a rather abrupt fashion, in the Introduction. The editors did note that pharmacotherapy of comorbid disorders was to be reviewed in Chapter 9, but no such review was found. Finally, despite the title, the authors primarily address alcohol usage. There are brief allusions to the use of marijuana and its treatment, but next to nothing is said about other substances. Despite these criticisms, this book is a positive addition to both the substance abuse and mental health literature and should be useful for both clinicians and researchers.