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Descriptors:
Health Services; Continuing Education; Research and Development; Theory Practice Relationship; Patients; Safety; Improvement; Differences; Stakeholders; Methods; Problems; Integrated Activities; Cooperation; Interdisciplinary Approach; Holistic Approach

Abstract:
Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the similarities and differences amongst the four domains in relation to their missions, stakeholders, methods, and limitations. This paper highlights the potential for a more integrated and collaborative partnership to promote networking and information sharing amongst the four domains. This potential rests on the premise that an integrated approach may result in the development and implementation of more holistic and effective interdisciplinary interventions. In conclusion, an outline of current research that is informed by the preliminary findings in this paper is also briefly discussed. The research concerns a comprehensive mapping of the relationships between the domains to gain an understanding of potential dissonances between how the domains represent themselves, their work and the work of their "partner" domains. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Surgery; Foreign Countries; Comparative Analysis; Counseling; Health Services; Medical Services; Tourism; Costs; Dentistry; Counselor Role; Counselor Training; Psychotherapy; Work Experience

Abstract:
With one of the world's most comprehensive universal healthcare systems, medical tourism in Costa Rica has increased significantly over the past few decades. American tourists save up to 80% of comparative costs for procedures, from heart surgery to root canal treatment. Although many Costa Rican healthcare professionals receive training in North America or Europe, there can be differences when compared to the same professionals in foreign countries. This paper examines the educational and role differences between counselors in the United States and Costa Rica. Implications for tourists in need of psychotherapeutic services while abroad or counseling professionals seeking foreign work experiences are discussed. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Child Abuse; Child Care; Medical Services; Mothers; Mental Disorders; Clinical Diagnosis; Chronic Illness; Symptoms (Individual Disorders); At Risk Persons; Fathers; Parent Child Relationship; Health Services

Abstract:
Although child maltreatment due to abuse or neglect is pervasive within our society, less is known about fabricated or induced illness by carers (FII), which is considered to be a rare form of child abuse. FII occurs when a caregiver (in 93% of cases, the mother) misrepresents the child as ill either by fabricating, or much more rarely, producing symptoms and then presenting the child for medical care, disclaiming knowledge of the cause of the problem. The growing body of literature on FII reflects the lack of clarity amongst professionals as to what constitutes FII, the difficulties involved in diagnosis, and the lack of research into psychotherapeutic intervention with perpetrators. This lack of clarity further complicates the identification, management and treatment of children suffering from FII and may result in many cases going undetected, with potentially life-threatening consequences for children. It has been suggested that there is a national under-reporting of fabricated or induced illness. In practice these cases are encountered more frequently due to the chronic nature of the presentations, the large number of professionals who may be involved and the broad spectrum including milder cases that may not all require a formal child protection response. Diagnosis of fabricated disease can be especially difficult, because the reported signs and symptoms cannot be confirmed (when they are being exaggerated or imagined) or may be inconsistent (when they are induced or fabricated). This paper highlights and discusses the controversies and complexities of this condition, the risks to the child and how it affects children; the paucity of systematic research regarding what motivates mothers to harm their children by means of illness falsification; how the condition should be managed and treated for both mother and child; and implications for policy and practice. (Contains 1 table and 1 note.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Psychopathology; Health Services; Self Destructive Behavior; Behavior Modification; Therapy; Personality Problems; Resource Allocation; Counseling Services; Student Problems; Surveys; Suicide; Hospitals; Outcomes of Treatment; College Students

Abstract:
Trends in college mental health literature suggest many college and university counseling centers are facing increased demands for services. Moreover, survey data suggest that counseling center directors and staff perceive increases in serious psychopathology, suicidality, and nonsuicidal self-injurious behavior, along with other typical student problems. At Sarah Lawrence College, a marked increase in the number of students hospitalized for psychiatric reasons, many meeting criteria for borderline personality disorder (BPD), required Health Services to rethink clinical service delivery, staff training, and resource allocation. Owing to its proven efficacy in the treatment of BPD, dialectical behavior therapy (DBT) was adapted at our setting. An overview of DBT is presented, followed by a brief history and a detailed description of the Sarah Lawrence College DBT Program, initial data on its impact for student retention and hospitalizations, and a discussion of the potential benefits of employing DBT with students in other collegiate settings. As one of few college counseling centers offering such treatment, the DBT Program at Sarah Lawrence College represents a promising model of treatment for college students with BPD. (Contains 1 table.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Social Work; Hospitals; Focus Groups; Caseworkers; Urban Areas; Health Services; Counselor Attitudes; Qualitative Research; Computer Software; Counselor Role

Abstract:
Social workers delivering services in health care settings face unique challenges and opportunities. The purpose of this study was to solicit input from social workers employed in urban hospitals about their perceptions of the roles, contribution, and professional functioning of social work in a rapidly changing health care environment. Using qualitative methods, the university and hospital-based research team conducted seven focus groups (n = 65) at urban hospitals and analyzed the data using an interpretive framework with ATLAS.ti software. Seven major themes emerged from the participants' description of their roles: bouncer, janitor, glue, broker, firefighter, juggler, and challenger. Along with descriptions of the ways social workers fulfilled those roles, participants articulated differences in status within those roles, the increasing complexity of discharge planning, and expectations to provide secondary support to other health care professionals on their teams. Implications for practice and research are discussed. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Homosexuality; Social Work; Data Analysis; Human Services; Hospitals; Patients; Caseworkers; History; Presidents; Standards; Guidelines; Health Services; Role

Abstract:
In April 2010, President Obama issued a directive to the Secretary of Health and Human Services (HHS) regarding patient visitation, advance directives, and other initiatives to improve the lives of lesbian, gay, bisexual, and transgender people and their families. The HHS response to this directive has implications for hospital social workers. The purpose of this secondary data analysis was to explore indicators of social work readiness to support implementation of the resulting initiatives. A historical context for the changes is provided, inclusive of the cases that spurred the presidential memorandum. The findings are presented within the framework of the profession's standards for social work practice in health care and end-of-life care. Recommendations for enhancing social work readiness for a critical role in implementation of the new regulations are presented. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Disabilities; Immigrants; Mental Health; Asian Americans; Foreign Countries; Health Services; Aging (Individuals); Correlation; Barriers; Asians; Telephone Surveys; Physical Health; Regression (Statistics); Cultural Differences; Cultural Background; Socioeconomic Background; Prevention

Abstract:
This study examined the relationships between service barriers and health status of aging South Asian immigrants. Data were obtained through a structured telephone survey with a random sample of 220 South Asians 55 years of age and older. The effect of the different types of service barriers on the physical and mental health of participants was examined using hierarchical multiple regression, while adjusting for participants' sociocultural demographic backgrounds. An average of 5.9 types of service barriers were reported. Among the four major types of barriers--cultural incompatibility, personal attitude, administrative problems, and circumstantial challenges--more barriers related to personal attitude predicted less favorable physical and mental health. In regard to health prevention, culturally appropriate strategies should be developed and implemented to help aging South Asians to overcome barriers related to personal attitude so that they can have better access to appropriate services. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Guidelines; Psychology; Hospitals; Delivery Systems; Psychologists; Responsibility; Counselor Role; National Standards; Best Practices; Ethnic Diversity; Minimum Competencies; Interdisciplinary Approach; Collegiality; Professional Identity; Health Services

Abstract:
Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These guidelines revise and build upon earlier guidelines regarding hospital privileges, credentialing, and bylaws specific to hospital settings. Renamed "Guidelines for Psychological Practice in Health Care Delivery Systems," they were developed by the Committee on Professional Practice and Standards (COPPS). (Contains 1 footnote.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Mental Health; Depression (Psychology); Life Satisfaction; Well Being; Residential Care; Family Environment; Therapy; Mental Disorders; Futures (of Society); Health Services; Measures (Individuals); Foreign Countries; Intervention; Interviews; Children; Adolescents

Abstract:
The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental health disorders, depression in particular, though youth also reported a sense of well-being and a positive outlook for the future. Many youth were able to articulate the improvements in their mental health and functioning after accessing intensive mental health treatment. Youth also divulged perceptions of their treatment and care. Implications are discussed. (Contains 1 note.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Mental Health; Health Services; Social Exchange Theory; Mental Health Programs; Counseling Services; Social Work; Consumer Economics; Economic Impact; Purchasing; Ethics; Risk

Abstract:
The present paper discusses literature concerning the practice of bartering for counseling, psychological, or social work services in lieu of traditional monetary payment. The author contrasts the language concerning the practice of bartering found in the respective ethical codes for each profession, and presents literature describing both risks and potential benefits of bartering arrangements. The primary risks of bartering include liability concerns and the potential for harmful or exploitive dual relationships. The primary benefits are that bartering makes mental health services available to those who cannot afford traditional fees, and allows for a culturally relevant compensation method for those whose cultural backgrounds emphasize the practice of bartering. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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