AMBHA's report card

This journal is beginning a quarterly column to provide "best practices." Good job of explaining the term "best practices.'

Employment of lowest possible effective dose is important in medication of children with psychological disorders when considering side effect and stress reactions.

Managed mental health care can successfully yield high-quality treatments with reduced hospitalization and costs while increasing accessibility.

Abuse, parental substance abuse, suicidal ideation, and destructive behavior lead to hospital and residential .

The child's developmental process should not be harmed by the use of medication during therapy.

Posttreatment support essential for the success of adolescents leaving substance rehabilitation services.

A history of substance abuse, leads to similar rise in symptom severity and treatment length as seen with current abusers.

The epidemiology and clinical characteristics of alcohol and drug addiction are presented and distinguished.

Intensive community placement programs offer promise for discharged homeless patients by maintaining access to psychiatric care and shelters.

A central data set was established by cataloging 1300 patients at admission by 32 demographic and clinical variables.

Structured Clinical Interview, Addiction Severity Index

Problem conducting research that appreciates importance of cultural, gender, and agedness of subpopulations are hampered by internal variability, mutual exclusion and definitions of subpopulations.

Costs of the Daily Living are less than usual standard costs for inpatient treatment.

Problems regarding cultural factors that lead to differentiation of presentation of symptoms and access to care are discussed.

The changing demographics of mental health care staff and the resulting implications for targeting care to specific subpopulations is addressed.

Standardized diagnostic criteria are useful to clinicians by providing efficient assessment, and sensitivity in research and comparisons.

Some violent patients respond to long-term psychotherapy and medication: carbamazepine, propranolol hydrochloride, and lithium carbonate.

Multiple levels of care are necessary to treat alcoholism with considerations for other medical / psychological problems and costs.

Client - Tx Matching

Discharges for homeless schizophrenic men were inadequate in areas of planning for living , aftercare and finances.

Patients with multiple previous admissions, low global functioning, violent behavior, and psychopathology are at increased risk of readmission.

Psychotherapy is effective as substance abuse treatment in a univeristy-affiliated, research-oriented context.

Cognitive-behavioral approach to substance abuse therapy are established forms of cost-efficient clinically effective treatment.

The clinician's therapeutic strategy yields greater benefits when considering the patient's frame of reference and need for structure.

Subjects treated in elderly peer group remained in treatment longer and completed treatment more often than those in age-mixed peer groups.

Use of peer-support and psychoeducational programs are presented for use in care of borderline personality disorder patients.

Disulfiram therapy was nearly 100% effective in cohabitating subjects but not with single subjects. The combined therapy was nearly 100% effective in all subjects.

Hospital records

Integration and coordination of services must overcome obstacle of opposing philosophies of care: psychosocial and psychiatric medical.

hing; and clinical issues in matching.

Reviews basic concepts underlying practice pattern profiling; describes roles that profiling can play in QI, assessment of provider performance, & utilization review; roles of profiling in achieving the goals of health care reform.

Client - Tx Matching

Delineates considerations for developing and implementing a Patient Placement Criteria (PPC) and the role of PPCs in research and Healthcare Reform. Provide good references, glossary and resource list.

Involuntary commitment shows limited success in reducing readmissions and length of stay.

Outlines six key conceptual and methodological issues that underlie attempts to match patients with optimal forms of tx and to conduct research on pt-tx matching.

A review of controlled studies that employed alternative treatments for successfully.

Advances in alcoholism treatment are presented. Assessing matched treatments often depends on the outcomes of interest.

Client - Tx Matching

Theories of evaluation of matching by pattern and by outcome are discussed.

Computer-assisted treatments are useful since it provides singular documentation, focuses attention given to symptoms and creates a large data base.

A two-fold effort exists to outreach to the elderly: to educate the elderly of psychological problems and treatment and to educate mental health professionals about the elderly society.

PGP enrollees achieved care twice as frequent as IPP, but IPP enrollees received care more often once care initiated.

In most studies heavy users consist of 10 to 30 % of clients and use 50 - 80 % of the services; this group often is characterized as psychotic with comorbid personality disorder and substance abuse history.

IPT is a proven / adjunct to medical care (acute, continuation, treatment.)

Alcohol expectancies correlate to posttreatment functioning; these expectancies should be addressed during treatment and relapse prevention endeavors.

The (adjusting the criterion threshold of a continuous variable) is proposed for application in evaluation of mental health and mental health care.

Hospital records

Long-term utilization should be discouraged when allowing recovery; although care is expensive, its use is often ; assessment should consider cost, treatment, and the client's ability to succeed under determined care.

Bellvue Hospital received the Gold Award for integrating a comprehensive clinical service program, including: dually dx inpatient, cocaine day treatment, MMT, a halfway house.

Research has neglected the ethnic hypothesis of addictive behavior.

Definitive treatment not minimal emergency care should become goal of emergency psychiatric care.

MMT is the basis for cocaine rehabilitation, but should be supplemented by various supportive protocols (day centers, residential environs, inpatient.)

Despite its benefits, MMT therapy alone does not effectively eliminate addictive problems, requiring supplemental therapies.

New medications are transforming emergency psychiatric care; follow-up care based in psychiatric facility reduces hospitalization length and improves integration into society.

drug patterns remain unlearned; low utilization of services will continue until consider the life.

Compliance improves drug-free outcome. Low methadone may lack efficacy.

The research of clinical services should concern itself with accuracy (and improvement) of dx, design of service, coordination of rehab with service, and effectiveness with regard to severely mentally ill.

Gender, compliance, homelessness, and history were related to recidivism.

Better documentation of program implementation will improve research and monitoring.

Adults receive mental health care twice as often as children; The educated receive care more often than non-educated in fee-for-service.

Readmission was less likely for men and women with follow-up visits; follow-up was associated with adjustment and affective disorder diagnoses.

Readmittants often exhibit high BPRS though disorder and self-neglect scores and high number of previous admissions.

Heavy users often are comorbid with personality disorder of longer treatments with poorer outcomes.

The interpretation of prognostic research should consider methodological and theoretical weaknesses.

The cognitive-social approach to relapse prevention demonstrates efficacy.

Large variation in hospital use and community services delivered occurred among regions of Washington state.

Client - Tx Matching

The integration of personality data with idiographic-based behavioral assessments is suggested.

The broadened concept of alcoholic problems has support of the scientific and professional communities.

ERR

The cognitive-behavioral theory of addiction has improved empirically-based treatment.

The marked effects of drug on psychological problems requires mental health and substance abuse centers to accurately identify drug use as clients enter their programs.

Discusses 3 specific Tx Models: "Serial, Parallel, & Integrated, and matches specific disorders with each. Also discusses methods of improving each Tx Model.