The Training Effects of Solution-Focused Brief Counseling on Telephone-Counseling Volunteers in Taiwan

This study investigates the effects of a solution-focused brief counseling training program on telephone-counseling volunteers in Taiwan, with an emphasis on promoting their counseling self-efficacy. There were 14 hotline volunteers recruited from Taipei Lifeline, they received 24 hours of solution-focused brief counseling training over 3 days. All participants were required to fill in an open-ended course feedback form after the solution-focused brief counseling training program and 1 month later. We used open coding to analyze the verbal data from the course-feedback forms. There were 6 features contributing to the effect of this solution-focused brief counseling training program that were found: helpful solution-focused brief counseling skills, the usefulness of solution-focused brief counseling’s stages, the establishment of basic knowledge of solution-focused brief counseling, enhancing the confidence and stability of telephone-counseling volunteers, the positive influence on volunteers’ personal life, and effective ways to learn and master solution-focused brief counseling. Using the research results, this study discusses solution-focused brief counseling training as it relates to telephone-counseling volunteers and suggests further research directions in relevant fields.     

Becoming Solution-Focused

Summary

This preliminary paper addresses how therapists, students, and professionals go about the business of learning to accept the concepts and philosophy of becoming brief, solution-focused therapists. What is it that “clicks” for them to make that paradigmatic shift? This paper is a beginning exploration to this overarching question as we research therapists' experiences in moving from one model of therapy into the solution-focused approach. We incorporate an open dialogue between ourselves as we begin the process of exploring how individuals become solution-focused therapists. This paper is offered as a starting point. We hope to continue to collect data from a wide variety of individuals as they reflect on their personal journeys in becoming brief, solution-focused therapists.     

A Feminist-Informed Integration of Emotionally Focused and Solution-Focused Therapies

ABSTRACT

This article outlines the integration of emotionally focused and solution-focused therapies through a feminist family therapy lens. Integrating therapy models using a feminist-informed lens strengthens traditional family therapy models by addressing gender, ethnic, racial, and social inequities in the family and therapeutic relationships. The epistemology, theoretical framework, and brief overview of each model are provided and a proposed integration is described in-depth, with a table presenting the merging of the models in regards to the stages and steps of emotionally focused therapy so one can move from abstractly discussing feminist issues to integrating them in theoretically consistent, intentional manner.     

The International Consortium on Mental Health Policy and Services: objectives, design and project implementation

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a consequence, over the past decade, mental disorders have ranked increasingly highly on the international agenda for health. However, the fact that mental health and nervous system disorders are now high on the international health agenda is by no means a guarantee that the fate of patients suffering from these disorders in developing countries will improve. In most developing countries the treatment gap for mental and neurological disorders is still unacceptably high. To address this problem, an international network of collaborating institutions in low-income countries has been set up. The establishment and the achievements of this network--the International Consortium on Mental Health Policy and Services--are reported. Sixteen institutions in developing countries collaborate (supported by a small number of scientific resource centres in industrialized nations) in projects on applied mental health systems research. Over a two-year period, the network produced the key elements of a national mental health policy; provided tools and methods for assessing a country's current mental health status (context, needs and demands, programmes, services and care and outcomes); established a global network of expertise, i.e., institutions and experts, for use by countries wishing to reform their mental health policy, services and care; and generated guidelines and examples for upgrading mental health policy with due regard to the existing mental health delivery system and demographic, cultural and economic factors.     

Development of Mental Health Indicators in Korea

Objective

Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea.

Methods

This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries.

Results

We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders.

Conclusion

Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation.     

Preparing for bioterrorism at the state level: report of an informal survey

Members of 18 states' departments of mental health were interviewed about their plans for managing the psychosocial impacts of a bioterrorism event. Questions were developed from recommendations of an international conference on planning for bioterrorism ("Planning for bioterrorism," 2000). Information derived from the survey highlights the need for, and the importance of, mental health consultation to the state's planning process. Familiarity with the unique psychological and behavioral consequences of a bioterrorism event in contrast to natural disasters is essential. Realistic training scenarios that incorporate likely psychosocial impacts and appropriate mental health response must be developed.     

Commentary: The failure of social inclusion: an alternative approach through community development

Mental health services have not resulted in broad-based inclusion of people with psychiatric disabilities. Rather, many maintain their community lives only through the support of formal mental health services, which is financially unsustainable given current fiscal realities. Fundamental assumptions about sources of support for everyday life need to be reassessed. The economic and social development of the mental health recovery community provides an alternative approach to helping people maintain successful community lives and shifts some of the supports from mental health providers to business infrastructure within the mental health recovery identity community. Some projects that have utilized this approach, such as business incubators and work integration social enterprises, are described, and community development that builds on concepts of recovery is discussed.     

Towards a Model of Time-Effective Family Psychotherapy

Significant numbers of people now receive mental health services in managed health care settings (HMOs). The growth of HMOs, and with them, the need to provide quality cost-efficient mental health treatment have served to challenge the HMO clinician to develop more parsimonious, time-efficient and effective mental health treatment approaches. In the current paper, the author describes the application of a brief therapy model in working with children and families in a HMO. Principles and illustrative case examples are presented and support the idea that the family psychotherapies are especially well-suited for mental health practice in managed care settings. The model discussed is relevant to clinicians in other settings which emphasize time-efficient mental health practice.     

Better mental health services for young people: responsibility, partnerships and projects

OBJECTIVE: This paper argues that adolescent psychiatry is best linked with child psychiatry and opposes separate youth mental health programmes for 12-25-year-olds. It reports on the current status of services and considers how adult mental health services (AMHS) can improve services for young adults (18-25-year-olds). METHOD: Factors in development, psychopathology, prevention, training and service systems are reviewed to suggest that current child and adolescent mental health service systems (CAMHS) are appropriate for 0-17-year-olds. Improvements in CAMHS are described from a Victorian perspective, including the model of specialist clinical programmes or teams for specific patient populations. Mechanisms are outlined for AMHS to better assist young adults from 18 to 25 years of age. RESULTS: The model of clinical projects or clinical programme teams, developed in partnership with primary health and others, is a suitable vehicle to help AMHS to improve clinical services to their young adult populations. These may be funded from a variety of sources, including re-engineering existing service resources. CONCLUSIONS: Such developments complement the work of specialist research units and build local competencies. More programme development and evaluation is needed, which will require the support of the College and State and Commonwealth Mental Health Branches.     

The clinical effectiveness of a brief consultation and advisory approach compared to treatment as usual in child and adolescent mental health services

A brief consultation and advice (BCA) approach to dealing with routine referrals was introduced into a child and adolescent mental health service (CAMHS) over an 18-month period. This is a time-limited, client-centred and solution-focused approach to dealing with common non-complex referrals. The model proposes that all families are seen for an initial 'consultation' appointment followed by a maximum of two further appointments. A randomized controlled study compared the clinical effectiveness of BCA treatment with treatment as usual (TAU) over a 6-month period. The parents of children referred to CAMHS were eligible to participate if their child was deemed 'non-complex'. Ethical approval was granted by the relevant ethics committee. Families who consented to participate in the study were randomly allocated to either the BCA or TAU group. Sixty children enrolled in the study. Both groups showed improvements on a number of variables at 3 months post treatment, but only those receiving BCA showed continued improvement at 6 months. Participants in both groups showed high levels of satisfaction with the treatment received. Participants in the TAU group expressed dissatisfaction with long waiting times and had a higher drop out rate than the BCA treatment group. During the time frame studied, the introduction of the BCA approach did not lead to a decrease in overall mean waiting time. These results and the usefulness of a BCA model are discussed.     

Introduction: research at the interface of medicine and psychiatry

Linkages between psychiatry and other medical specialties have become increasingly evident over the past decade. Reinstatement of the medical internship for psychiatric trainees, expansion of psychiatric liaison services, growth of general hospital psychiatric units, determination of the extensive role served by nonpsychiatric physicians in providing mental health care, and research evidence of the economic benefits of incorporating mental health services in general health settings all have served to break down artificial boundaries between mental health and general health concerns. The psychiatric consultation-liaison service initiated in 1981 by the NIMH at the NIH Clinical Center in Bethesda has afforded opportunity for numerous collaborative research projects with clinical investigators of various categorical disease programs. In addition to offering new etiological insights into psychiatric and general medical illnesses, the work described in this symposium promises to move clinical practice closer toward the Engel model of biopsychosocial medicine.     

Therapist efficiency and clinic accessibility with the mental health research institute brief therapy model

A health maintenance organization (HMO) mental health clinic used the Mental Research Institute (MRI) brief therapy model to achieve striking therapist efficiency and clinic acessibility. In the two-year period from January 1985 through December 1986, the clinic averaged 834 separate patients per therapist, copared with a regional average of 456 patients. The rate of hospitalization from the clinic catchment area was two thirds that of the region. This article describes the MRI approach as practiced at the clinic and discusses its applicability to community mental health centers and other mental health clinics.     

Class action litigation in correctional psychiatry

Class action litigation has been instrumental in jail and prison reform during the past two decades. Correctional mental health systems have significantly benefited from such litigation. Forensic psychiatrists have been crucial in the litigation process and the subsequent evolution of correctional mental health care systems. This article summarizes information concerning basic demographics of correctional populations and costs of correctional health care and provides a brief history of such litigation. The role of psychiatric experts, with particular reference to standards of care, is described. Specifically discussed are issues relevant to suicide prevention, the prevalence of mentally ill inmates in supermax prisons, and discharge planning.     

Solution-Focused Approaches in Psychiatric I Mental Health Nursing

Multiple social and financial factors dictate that therapies of all kinds be oriented toward producing measurable changes in clients. Crisis intervention is one therapy approach that often produces measurable changes in clients. However, this approach may not be useful for individuals unable to identify a precipitating event, or who want change beyond returning to a previous level of functioning. This article reviews the basic tenets of solution-focused therapy in order to orient nurses to its potential utility for psychiatric/mental health practice.     

Factors Influencing Korean International Students’ Preferences for Mental Health Professionals: A Conjoint Analysis

Asian students comprise over half of all international students in the United States, yet little is known about their help-seeking behaviors and preferences for mental health professionals. The purpose of this study was to use conjoint analysis to examine characteristics of mental health professionals influencing Korean international students’ preferences when choosing a mental health professional. Korean international students from three universities in the United States were recruited on a volunteer basis to participate in this study (N = 114). Results indicated that mental health professional characteristics, including ethnicity, age, professional identity, and training institution, were significant factors in students’ preference formation; however, gender of the mental health professional was not found to be a significant factor in the present study. Ethnic similarity was the most powerful predictor of preference formation. Implications for promoting help-seeking and mental health service utilization among Asian international students are discussed.     

Planning mental health services: II. Current Canadian initiatives.

A brief overview of recent policy developments across Canada and a discussion of the common themes and challenges they address demonstrates the scope of activity in this field. The federal level of mental health planning and a summary of recent of policy developments in each province are described. Significant progress has been made in Canada in the development of mental health services since deinstitutionalization. Major challenges remain, however, which are being addressed to varying degrees across the country. The challenges related to the key issues of major mental illness, integration and consumerism are illustrated.     

The Centre for International Mental Health approach to mental health system development

Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to develop mental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka.     

Sectorisation psychiatrique : évolution et perspectives

Authors make a brief history of the french sectorization system. They show how this mental health policy was continuously carried out since 1960, creating the conditions of a progressive deinstitutionalization. They compare the french sector model as it was conceived in 1960, with the Assertive Community Treatment (ACT) model described in the United States by Stein and Test. Authors also describe how the sector model was able to adapt itself to the changes in needs for psychiatric care in France, particularly in the fields of emergency and liaison psychiatry.