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J Dincin

Publications and source records attributed to J Dincin.

9 recordsLinked to original sources

Assertive community treatment: correcting some misconceptions.

Discusses historical, policy, and research perspectives on assertive community treatment (ACT) and their relationship to 5 commentaries accompanying our recent article (Bond et al., 1990). Collectively, the commentaries focused on self-help groups, missing the point of the study. Further, the commentaries contained several misconceptions centering on a confusion between deliberate sampling based on policy-driven considerations and self-selection into voluntary organizations. In the time since the Stein and Test (1980) demonstration, programs based on ACT principles have become one of the dominant approaches to community mental health services, especially for consumers who do not readily use office-based treatment. The research foundation is robust and is rapidly evolving. Some community psychologists may be responding to outdated and inaccurate stereotypes of mental health services.

Assertiveness

Assertive community treatment for frequent users of psychiatric hospitals in a large city: a controlled study.

Evaluated a large-city adaptation of the assertive community treatment (ACT) model (Stein & Test, 1980). Outcomes were examined after 1 year for 82 clients, averaging over 17 lifetime psychiatric hospitalizations, randomly assigned either to ACT or to a drop-in (DI) center. After 1 year, 76% of the ACT clients and only 7% of DI clients were involved in the respective programs. The ACT team averaged 2 home and community visits per week to each client. ACT clients averaged significantly fewer state hospital admissions and state hospital days than did DI clients. ACT clients reported greater satisfaction with program services, fewer contacts with the police, and less difficulty with practical problems associated with psychiatric readmission. More ACT clients were known to have stable community housing. Annual per-client treatment costs for ACT were estimated to be $1,500 less than for DI.

Adolescent

A comparison of two crisis housing alternatives to psychiatric hospitalization.

This study compared outcomes for demographically matched clients four months after their admission to two short-term crisis programs. The programs provided crisis housing and case management services as alternatives to psychiatric hospitalization for clients with severe and persistent mental illness. One program met housing needs by purchasing shelter in hotels and boarding houses, and the other provided lodging in an eight-bed crisis house. In both programs, two-thirds of the clients avoided hospitalization during four-month follow-up, and both programs were effective in stabilizing clients' housing and financial situations. Clients in the purchase-of-housing program showed an increase in substance abuse problems at follow-up. Average client costs were similar in the two programs. A critical program difference was the substantially higher staff turnover in the crisis house, which was later replaced with scattered-site crisis housing.

Adult

Restructuring parental attitudes--working with parents of the adult mentally ill.

The Thresholds parents group gives the parents of clients an opportunity that has rarely been presented to them. They are able to discuss openly, with their peers, many issues that have not been expressed previously except in the greatest privacy. Often their children's mental illness has been a well-kept secret or has been handled in a guilty and shamefaced way. They do not find it easy, as a rule, to discuss mental illness in the same way they might discuss diabetes or congenital heart disease. It is an enormous relief to be open about their problems with others who are in similar circumstances. The main issues addressed in the group are a redefinition of good parenting to include mutual disengagement, emancipation, and separation; reduction of parental guilt, with its consequent implications of parents getting more out of their own lives, and a reduction of manipulation; and the handling of management issues such as money, medication, visiting, parental expectations, holidays, siblings, and parents' united front. Parents of the emotionally ill are a much maligned group. Too often they are regarded by the mental health community as enemies and not allies. Too often the suffering that they have endured is ignored. Too often parents' strengths are overlooked by mental health professionals treating their offspring. And, finally, too often basic change in the parents is demanded as a prerequisite for meaningful change in the member.

Adolescent