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An exploratory study of GP perceptions of the impact of a primary care counselling service on their practice
- Authors:
- SCHAFER Tim, AMOATENG Geoffrey, WRYCRAFT Nick
- Journal article citation:
- British Journal of Guidance and Counselling, 37(1), February 2009, pp.1-15.
- Publisher:
- Taylor and Francis
This paper presents the results of research into GP perceptions of the impact of on-site counselling on general practice. The research is part of a larger evaluation of a local enhanced primary care mental service. The initial survey and in-depth interviews with GPs reported here focused on the pre-existing counselling service. The results suggest that the benefits of on-site counsellors included reductions in prescribing, cost efficiencies and increased confidence amongst some GPs about providing psychological care themselves. These reported benefits appeared more likely to result when counselling service levels were perceived to be adequate and GPs were satisfied with their partnerships with the counsellors. The key mechanisms to explain the reported benefits were the provision of a safety net for GPs to extend their own practice, particularly when combined with close working relationships with the counsellor. The study has implications for the development of primary care mental health in the UK, particularly in relation to how the interface and working relationships between counsellors and GPs are designed and developed.
How sturdy is that digital couch? Legal considerations for mental health professionals who deliver clinical services via the internet
- Author:
- ZACK Jason S.
- Journal article citation:
- Journal of Technology in Human Services, 26(2/4), 2008, pp.333-359.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper covers US legal issues, dealing with jurisdiction, licensure, legal duties (competence, consent, confidentiality), business matters (referral fees, third party payments) and website issues (intellectual property, advertising). Potential criminal and civil liability issues are reviewed. The paper concludes that although providers face a variety of challenges, the online delivery of mental health services is both feasible and worthwhile. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Challenges to sanctuary: the clergy as a resource for mental health care in the community
- Authors:
- LEAVEY Gerard, LOEWENTHAL Kate, KING Michael
- Journal article citation:
- Social Science and Medicine, 65(3), August 2007, pp.548-559.
- Publisher:
- Elsevier
The transfer of psychiatric care from the institution to the community has presented community structures including faith-based organisations (FBOs) with an additional burden of care. In recent years there has been an increasing policy interest among government departments, public and non-statutory agencies for the inclusion of FBOs as partners in health and welfare services. However, despite their long historical involvement in healing and healthcare, clergy are seldom viewed by mental health professionals as partners in healing and restitution but with suspicion. This may be compounded by ignorance about mental health care provision within FBOs in the UK and the preparedness, confidence and willingness to undertake such care. This paper is based on a study which examined clergy contact with people with mental illness. Thirty-two interviews were conducted with male clergy (Christian ministers, rabbis, and imams) most of whom were London-based. The authors examine barriers and dilemmas for clergy in caring for people with mental illness. It was found that they play an important but often confined role the scale and impact of which is not recognised by their central organisation and training bodies. Low confidence about managing psychiatric problems, underscored by anxiety, fear and stereotyped attitudes to mental illness restrain their willingness to formalise their function. It is argued that any proposed extension of clergy involvement in mental health will require further research and thorough deliberation by mental health services and religious organisations
STEPS: going beyond the tip of the iceberg. A multi-level, multi-purpose approach to common mental health problems
- Authors:
- WHITE Jim, et al
- Journal article citation:
- Journal of Public Mental Health, 7(1), August 2008, pp.42-50.
- Publisher:
- Emerald
STEPS is a primary care mental health team that has attempted to develop a very high volume multi-level, multi-purpose service for those with mild to moderate problems. The service attempts to overcome many of the limitations of more traditional services. Whilst community mental health teams provide service to those with moderate to severe mental health problems, the remit of the primary care mental health teams (PCMHTs) is to provide care to adults (16 years onwards) with mild to moderate mental health difficulties. This paper describes the services contained within the six level model (individual therapy, group approaches, single contacts, non face-to-face work, working with others and population level work). It provides different levels of treatments such as individual therapy, groupwork and self-help approaches according to different needs.
Disaster mental health: theory and practice
- Authors:
- HALPERN James, TRAMONTIN Mary
- Publisher:
- Wadsworth
- Publication year:
- 2007
- Pagination:
- 352p.
- Place of publication:
- Belmont, CA
This practical book covers the psychology of disasters, and discusses how to assist those impacted by such dramatic, life-changing events. Its primary aim is to support and empower mental health practitioners and students who will be working in the aftermath of a disaster; the book is intended to be a tool in disaster preparedness and planning. The authors also hope to legitimise the relatively new field of disaster mental health by offering a synthesis of trends, discoveries and related concepts. They discuss what disaster mental health is and what it is not and presents a range of practical interventions appropriate in the wake of disaster. The book is divided into two main parts. Part one focuses on the theory including: the characteristics of disaster; a history of disaster mental health; reactions and risk factors; extreme reactions; and vulnerable populations. The second part of the book concentrates on practice covering: the challenges of counselling in chaos; psychological first aid; early interventions beyond first aid; debriefing and the impact of disaster trauma on first responders; long-term treatment - continuity of care; and new directions.
Etherapy: ethical and clinical considerations for Version 7 of the World Professional Association for Transgender Health's Standards of care
- Author:
- FRASER Lin
- Journal article citation:
- International Journal of Transgenderism, 11(4), October 2009, pp.247-263.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
This invited article provides background and exploratory material for the potential inclusion of etherapy in Version 7 of the Standards of Care (SOC). A brief overview of the literature, its applicability and extrapolation to transgender clients, the rationale for etherapy, and clinical and ethical considerations, both general and specific to transpeople, are described. Included in the discussion is an online psychotherapy case and commentary involving a Saudi-based American male-to-female transperson and a San Francisco therapist. The article concludes with specific content for a recommendation for the inclusion of etherapy (but not online evaluation and referral) in the next revision of the SOC.
Counselling military families: what mental health professionals need to know
- Author:
- HALL Lynn K.
- Publisher:
- Routledge
- Publication year:
- 2008
- Pagination:
- 303p., bibliog.
- Place of publication:
- New York
According to the United States Department of Defense, by the end of 1993 there were 2,036,646 reservists and family members and 3,343,235 active duty and family members for a total of 5,379,781 people affected by the military. Since then, because of the conflict in Iraq, the numbers have dramatically increased. While we have always had military families in our midst, not since the Vietnam War have their struggles been so vivid, particularly with alarming rates of increase of both suicide and divorce among military personnel. The face of the military has changed; for the first time a volunteer army is serving in a major combat zone, the level of reservists serving is unprecedented, the percentage of women soldiers in virtually all positions is unprecedented and most of the soldiers have left spouses and/or families behind. The objectives of Counseling Military Families are to help the practicing counsellor understand how the military works, what issues are constants for the military family, and what stressors are faced by the military member and the family. The book will begin with an overview of military life, including demographic information and examples of military family issues, before delving into specific chapters focused on the unique circumstances of reservists, career service personnel, spouses, and children. The final section of the book will present treatment models and targeted interventions tailored for use with military families. This book will help counsellors tailor their interventions to work well with families who are in transition, who may have an ingrained resistance to asking for help and who will, more than likely, be available for counselling for a relatively short period of time.
Counseling and mental health care for transgender adults and loved ones
- Authors:
- BOCKTING Walter O., KNUDSEN Gail, GOLDBERG Joshua M.
- Journal article citation:
- International Journal of Transgenderism, 9(3/4), 2006, pp.35-82.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Increasingly in the United States, transgender individuals and loved ones (partners, family, and friends) are seeking assistance from mental health professionals working in the community rather than in university or hospital-based gender identity clinics. Drawing on published literature specific to transgender mental health, interviews with expert clinicians, the authors' clinical experience, and three key guiding principles (a transgender-affirmative approach, client-centred care, and a commitment to harm reduction), the authors suggest protocols for the clinician providing mental health services in the community setting. Practice areas discussed include assessment and treatment of gender concerns, trans-specific mental health issues, and trans-specific elements in general counselling of transgender individuals and their loved ones. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Physicians’ views on men's mental health and the role of counselling services : a pilot study
- Authors:
- SMITH Jeffrey M., ROBERTSON Steve, HOUGHTON Bruce
- Journal article citation:
- Counselling and Psychotherapy Research, 6(4), December 2006, pp.258-263.
- Publisher:
- Wiley
This pilot study aimed to explore how physicians understand men's avoidance of mental health counselling services and to elicit physicians’ views on pairing mental health assessment with routine physical examination. Initially, physicians’ views on men's avoidance of mental health counselling services were explored through a focus group. A short survey exploring views on pairing mental health assessment with a routine physical examination was then developed and sent to 125 physicians at a local medical centre. Physicians discussions indicated that male socialisation processes, the stigma of needing help, and ignorance about counselling sessions, all contribute to men's avoidance of mental health counselling services. The survey results suggest that combining a mental health assessment with an annual physical examination was viewed positively by most physicians (80%), that they would encourage this approach (75%), and would appreciate the support of counselling services in this process (80%). However, these survey results were influenced by the age and sex of the physician. The focus group suggestion to pair mental health assessments with routine medical examinations, with support from counselling services, was viewed by most physicians as a positive way to engage men. Preliminary services could be established that utilise this approach and examine its efficacy.
Life space mapping: preliminary results from the development of a new method for investigating counselling outcomes
- Author:
- RODGERS Brian
- Journal article citation:
- Counselling and Psychotherapy Research, 6(4), December 2006, pp.227-232.
- Publisher:
- Wiley
Counselling outcomes are often measured in terms of standardised questionnaires. Though efficient for large numbers of participants, this method cannot capture the unique and subtle ‘shifts’ that clients often report when qualitative methods are utilised. Further, such questionnaires usually focus on the individual, missing the wider social implications of therapy. This paper presents the preliminary findings from a study that utilises the client's own perceptions of changes in their “Life Space” to establish the significance of their change process. These results are compared and contrasted with a standard outcome questionnaire and the participant's experiences of using the two methods are explored.