Rational Hospital Psychiatry

Clinicians who understand mental health care administration in addition to their clinical fields are likely to be valuable to the organizations in which they work. This handbook is an accessible source of information for professionals coming from either clinical or management backgrounds. Sections offer coverage in: mental health administrative principles, mental health care management, business, finance and funding of care, information technology, human resources and legal issues.

professional-standards-review organizations (PSRO) in defining quality of care for the Medicare program; it is a "shared responsibility of health professionals and government to provide a reasonable basis for confidence that action will be taken, both to assess whether services meet professionally recognized standards and to correct any deficiencies that may be found" (p. 14). Similar pronouncements have been made for the quality assurance activities of the Department of Defense's CHAMPUS program and of the 1980s successor to the PSROs, the federally designated peer-review organizations (PROs), established to ensure quality and utilization-efficient care for Medicare. Links between the federal and state gov ernments and between professional associations and private review entities have been developed to make this "shared responsibility" manifest in the delivery and reimbursement of health services. This responsibility is seen in light of both pro fessional and legal accountability, a view noted by Gibson and Singhas (1978) and Alger (1980). Accountability, then, becomes a concentric concept that elaborates on the pure view of quality and reflects the federal government's consumer protection activities during the 1970s. The Joint Commission on Accreditation of Hospitals (JCAH), which has pro vided another primary historical leadership role in defining quality assurance, has promoted the evolution of the concept of resource limitations as a part of the defini tion of quality assurance.

`Rofé's book is a unique scientific contribution to the understanding of psychopathological phenomena. He does more to unravel the mystery of the underlying causes of psychological disorders than we've seen in a long time. His book The Rationality of Psychological Disorders is a `true endeavor that presents a definite challenge to the scientific community of Psychology'. This book is a must-read for scientists, mental health professionals and others who search for the logic and rationale in the irrational and bizarre.' Elizabeth F. Loftus, University of Washington, Past President, American Psychological Society. `The notion of repression is crucial to many psychological theories, but serious questions have been raised about it. Indeed, some investigators have questioned whether repression even exists. In this book, Professor Rofé offers provocative ideas concerning repression and its role in psychopathology in general. His ideas merit attention and I can highly recommend his book for both researchers and clinicians.' David S. Holmes, Chancellor and Distinguished Professor, University of Kansas.

Reason and Rationality in Health and Human Services Delivery is the first book to discuss the topic of decisionmaking and services from a multidisciplinary approach. It uses theory and social considerations, not just technology, as a basis for improved services. Health and human service students and professionals will learn how to form rational and reasonable decisions that take their clients’cultural backgrounds into consideration when identifying an illness or appropriating any kind of intervention. With a particular emphasis on theories, models, organizational settings, technologies, and practitioner training methods that lead to culturally sensitive decisions, Reason and Rationality will help you deliver efficient and improved medical and social services to clients from all ethnic backgrounds. Recognizing reason as the centerpiece of most of Western philosophy, this text reveals how our idea of truth, fact, and order are wrongly thought to be universal; yet, Western principles are continually used in the decision-making process for health and social services. Focusing on the policy implications of decisionmaking in medical and social service settings, this text works to incorporate a broad range of factors into the reasoning process, such as cultural traditions and beliefs, that will result in better treatment for patients. Giving you suggestions and strategies for upgrading reasoning and decision-making processes and applying them to every area of service, Reason and Rationality discusses different themes that will help you improve services to patients, such as: the rationale currently used to justify decision-making strategies concerning medical and human services using computer technology to make clinical assessments revising administrative structure, management theories, and organizational strategies so that decision-making processes enhance the overall quality of service delivery how the practitioner/patient relationship is important in choosing the proper treatment soliciting community-based input to assess the public’s health and human service needs in order to lessen political involvement in decision-making stages In addition, Reason and Rationality provides information and examples that show why you should consider the “life-world”--the values, beliefs, and commitments of a culture’s history-- as the key to understanding the powers of reasoning that specify parameters of health and illness.

The term behavior modification refers to the systematic analysis and change of human behavior and the principal focus is on overt behavior and its relationships to environmental variables. Behavior modification can be applied in many settings, the nature of which helps to define its subsets. Thus, applied in clinical settings, toward clinical goals, it encompasses the subset behavior therapy. In Behavior Therapy with Children, Volume 2, Anthony M. Graziano focuses on behavior therapy--specifically, the behavioral treatment of children's clinical problems. The field of behavior modification encompasses an astonishingly wide and varied spectrum of concepts about and approaches to education, clinical problems, social programming, and rehabilitation efforts. A conceptually and technologically rich medium, it has been nourished by the psychology laboratory, the school, and the psychiatric clinic. It is an area with diffuse boundaries surrounding a highly active center, within which apparently solid landmarks have already been worn away by the dissolving action of corrective self-criticism--immeasurably aided by the catalysts stirred in by the field's many critics. The activity continues, the dynamic field boils, and the medium enriches itself. There appears to be a tendency, particularly among new behavior therapists, to limit their focus too narrowly to the client's systems of overt behavior. In this project, psychological therapy begins with a personal, interactive social situation in which the generally expected human response of interest, sympathy, and support, is the minimum condition. Graziano maintains that these clinical sensitivity skills must be preserved in behavior therapy and enhance its important contribution to advancing the therapeutic endeavor. Anthony M. Graziano is professor emeritus in the Department of Psychology, State University of New York at Buffalo. He has published a number of articles in journals on subjects such as teaching machine programs, behavior therapy with children, diagnostic testing, the history of psychology, and evaluations of the contemporary mental health professions. He has been on the editorial board of Behavior Modification and on the board of directors for the Eastern Psychological Association.