Biomedical subjects
Publications and source records attributed to G G Neffinger.
The young chronically psychiatrically disabled adult (YAC) is a challenging new clinical subgroup for whom specialized treatment approaches are being developed. This paper examines the role of the partial hospital in the treatment of YACs and asserts that it should play a central role in such treatment. Specific YAC partial-hospital program characteristics are explicated.
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Partial hospitalization is the generic term for a broad and amorphous treatment modality. This paper describes and delineates the spectrum of partial hospitalization services and programs, presents a brief history of the theoretical and practical development of partial hospitalization programming, and reviews the literature on partial hospitalization with respect to its efficacy, cost, and future trends.
The day treatment program of a community mental health center has evolved from a relatively unstructured drop-in-program set up ten years ago to a comprehensive four-part service. The acute day treatment program is able to provide transitional services to meet the needs of three local inpatient units and an alternative to inpatient care to clients with an adequate community support system. The unit has also developed an extended and less intensive program for clients who need services beyond the maximum 14 weeks of the basic program and a long-term aftercare medication and monitoring clinic.
Rats were trained in a discrete-trial paradigm with no intertrial interval. The first response changed an auditory stimulus for the remainder of the trial. Shocks were delivered only at the end of the trial cycle. Avoidance contingencies were defined by the conditional probability of shock, given no response (P(0)), and the conditional probability of shock given a response (P(1)). The maximal avoidance contingency was P(0)=1.0, P(1)=0, and noncontingent conditions were those for which P(0)=P(1). In Experiment I, after training on the maximal contingency, three groups of subjects experienced either P(0)=P(1)=0, P(0)=P(1)=0.5, or P(0)=P(1)=1.0. Eight of 10 subjects stopped responding under the noncontingent conditions. Experiment II studied partial contingencies by varying P(0) and P(1). For one group, P(0) was reduced holding P(1)=0. Responding decreased to zero as P(0) approached zero. A second group was studied under P(1)>0, holding P(0)=1.0. For three of the six rats in this group, responding decreased to zero with increasing P(1). The other three maintained responding as P(1) was increased up to the noncontingent, P(1)=P(0)=1.0 value. The P(0) group was also studied with P(0)=P(1)>0, and half of these subjects responded. The results demonstrated two modes of response to weakening or eliminating the avoidance contingency. Some subjects were sensitive to contingency only, and insensitive to changes in shock density. Approximately one half of the subjects were sensitive to both contingency and shock density. This shared control was observed only when P(1)> 0.