NCJ Number
50227
Journal
EVALUATION Issue: 1 Dated: SPECIAL MONOGRAPH (1973) Pages: 3-5
Date Published
1973
Length
3 pages
Annotation
THE VALUE OF USING CONCRETE THINKING TO COMMUNICATE GOALS AND TREATMENT TO PSYCHIATRIC PATIENTS AND OTHERS AND THE IMPLICATIONS OF CONCRETE THINKING FOR BETTER PATIENT CARE ARE EXAMINED.
Abstract
WHEN A COORDINATOR OF CLINICAL TRAINING WAS APPOINTED TO THE DAY HOSPITAL OF THE ROLLMAN PSYCHIATRIC INSTITUTE AT THE UNIVERSITY OF CINCINNATI (OHIO) IN 1970, HE FOUND THAT THE TERMINATION OF TREATMENT OFTEN SEEMED ARBITRARY OR EVEN OCCURRED BY DEFAULT. A TOTAL OF 30 TO 35 PATIENTS PARTICIPATED IN THE PROGRAM FROM 1 TO 5 DAYS PER WEEK, WITH A STAFF OF 3 FULL-TIME ACTIVITY THERAPISTS, 1 FULL-TIME SOCIAL WORKER, 1 PART-TIME NURSE, 1 PART-TIME SOCIAL WORKER, 2 TO 4 PART-TIME PSYCHIATRIC RESIDENTS, AND A FULL-TIME DIRECTOR. CONFUSION REGARDING GOALS OF TREATMENT BECAME APPARENT IN SEVERAL RESPECTS. FIRST, THE REFERRING PROFESSIONAL WOULD TYPICALLY INDICATE THAT THE PATIENT BE PROVIDED SOCIALIZATION AND, IF POSSIBLE, VOCATIONAL REHABILITATION. SECOND, THERE WAS A STAFF TENDENCY, PARTICULARLY AMONG THOSE WITH A MORE SOPHISTICATED LEVEL OF INTELLECTUAL TRAINING, TO EXPRESS AND REVIEW EACH PATIENT'S GOALS IN TERMS OF ABSTRACT CONCEPTS OF A PARTICULAR THEORY OF BEHAVIOR. STAFF AGREEMENT ON PATIENT TREATMENT AND PROGRESS WAS THUS HINDERED BY BROAD GOAL-SETTING AND DIVERGENT FRAMES OF REFERENCE. AN ADDED DIFFICULTY IN THE DETERMINATION OF PATIENT PROGRESS WAS THE USE OF VARIOUS ACTIVITIES AS AN ESSENTIAL PART OF TREATMENT. USING CONCRETE THINKING TO COMMUNICATE GOALS AND TREATMENT TO PATIENTS AND OTHERS SEEMED TO BE THE ONLY RATIONAL SOLUTION TO THESE PROBLEMS. IT WAS AGREED THAT BRIEF CONCRETE INFORMATION WOULD BE RECORDED ON AN INDEX CARD WHENEVER A CASE WAS TO BE REVIEWED FOR PROGRESS. THE CARD WAS TO CONTAIN FIVE TYPES OF INFORMATION: THE DATE OF THE REVIEW; CONCRETE GOALS SET FOR TREATMENT PRIOR TO THE TIME OF REVIEW; A DESCRIPTION OF THE METHOD USED TO ACHIEVE THE AGREED-UPON GOAL; A LIST OF STAFF PERSONNEL WITH MAJOR RESPONSIBILITY FOR THE CASE, AND THE DATE OF THE NEXT REVIEW. AS OF MAY 1972, THIS SYSTEM HAD BEEN OPERATIONAL FOR ABOUT 1.5 YEARS. EVEN THOUGH IT PRESENTED SOME DIFFICULTIES, IT WAS FOUND THAT THE SYSTEM PERMITTED A QUICK, RELIABLE, AND EASILY COMMUNICATED ASSESSMENT OF EACH PATIENT'S PROGRESS AT ANY PARTICULAR TIME. PLANS FOR SYSTEM REFINEMENT AND ITS IMPLICATIONS FOR BETTER PATIENT CARE ARE DISCUSSED. (DP)