Attitudes of case managers toward people with serious mental illness.

Negative attitudes toward people who have serious mental illnesses held by mental health professionals threaten the effectiveness of psychiatric treatment. In this study, attitudes held by case managers working within the public sector were investigated. Differences between supportive and intensive case managers were compared with community controls using the Opinions about Mental Illness Scale. The results showed a complex interplay among client level of functioning, type of case management approach, case management philosophy, and attitudes. Among other findings, intensive case managers held more authoritarian attitudes than did their supportive case manager counterparts.

Multimodal evaluation of therapy versus consultation components in a large inner-city early intervention program.

Cincinnati's Social Skills Development Program (SSDP) used a social competence model to direct its interventions for children. Systematic screening identified 15-25% of the primary grade children who showed behavioral problems and deficits in social skills at seven elementary schools. Multimodal evaluations comparing therapy and consultation interventions included three types of assessments over a 1 year period. Tests of social skills revealed that children who received both therapy and consultation services, compared to those who received only consultation, improved in a basic empathy skill and increased their externality in locus of control. School record data showed that therapy and consultation children improved in grades; but, consultation children improved most. Finally, trained observers found that therapy children, compared to children in consultation only, increased cooperative interactions with teachers and maintained appropriate solitary behaviors. The data are discussed as providing some support for the hypothesis that therapy produced increased benefits for children compared to the less costly consultation intervention. However, since therapy and consultation conditions were not differentiated on many assessments (e.g., tests of interpersonal problem-solving and advanced empathy skills; lateness; achievement), more intense behaviorally oriented interventions may be warranted.