Psychiatric Home Care : Clinical and Economic Dimensions

Note: Supplemental materials are not guaranteed with Rental or Used book purchases.

ISBN: 9780124909403 | 012490940X
Cover: Hardcover
Copyright: 7/1/1999

eBook

Available Instantly

Online: 1825 Days

Downloadable: Lifetime Access

$65.19

In this economic-clinical review of home care services, the reader finds a brief economic history of psychiatric services in this country, several models of psychiatric care, an illustration of the burdens borne by families when such services are unavailable, and strategies for developing "managed care-friendly" services programs. This book addresses real-world issues of designing services models that meet the clinical needs of an underserved population while also appealing to the economic imperatives of managed care.

Introduction

xix

An Overview and Economic History of Psychiatric Services

Alan Menikoff

Chapter Summary

(1)

National Expenditures for Mental Health Services

(1)

A Tale of Two Systems

(1)

Clinical Case Management

(1)

Development of the Managed Care Industry

(1)

Consolidations in the Behavioral Managed Care Field

(3)

Privatization of Public Psychiatry

(1)

References

(2)

The New Players in Psychiatric Home Care

Alan Menikoff

Chapter Summary

(1)

Current and Prospective Providers of Psychiatric Home Care

(5)

Hospitals as Providers of Psychiatric Home Care

(1)

Commercial Home-Health Agencies

(2)

Not-for-Profit Home-Health Agencies

(1)

Family Service Organizations and Psychiatric Rehabilitation Programs

(1)

Outpatient Behavioral Health Care Organizations

(1)

Integrated Behavioral Health Organizations

(1)

The Future of Behavioral Health Care

(1)

Reference

(1)

Clinical Issues in Delivering Home-Based Psychiatric Services

Joel Kanter

Chapter Summary

(1)

Historical Background of Home-Based Psychiatric Services

(1)

Advantages of Office-Based Services

(2)

Economy

(1)

Privacy

(1)

Control

(1)

Comfort and Security

(1)

``Holding Environment''

(1)

Responsibility

(1)

Structure and Socialization

(1)

Improvement of Social Skills

(1)

Advantages of Home-Based Services

(1)

In Vivo Assessment

(1)

Engagement of Social Network

(1)

Treatment of ``Home-Bound'' Patients

(1)

Engagement of Reluctant Patients

(1)

Professional and Social Responsibility

(1)

Indications for Home-Based Services

(5)

In Vivo Assessment

(2)

Engaging Reluctant Patients

(1)

Ongoing Home-Based Psychiatric Care

(2)

Contraindications for Home-Based Services

(2)

Physical Risk to Clinicians

(1)

Patient Unavailability

(1)

Intense Transference Reactions

(1)

Environmental Chaos

(1)

Evidence of Manipulativeness

(1)

Intervention Patterns in Home-Based Services

(2)

Assessment and Crisis Intervention

(1)

Short-Term Assessment and Engagement

(1)

Ongoing Low-Intensity Outreach

(1)

Ongoing Home-Based Treatment

(1)

Ongoing Support and Monitoring

(1)

Home-Based Psychiatric Services in a Managed Care Context

(2)

Staffing Patterns

(1)

Facilitating Transitions between Home- and Office-Based Care

(1)

Conclusion

(1)

References

(3)

The Goals and Principles of Psychiatric Home Care

Alan Menikoff

Chapter Summary

(1)

Goals of Treatment

(2)

Stabilization

(1)

Recovery

(1)

Maintenance and Prevention

(1)

Principles of Behavioral Home Care

(14)

Establish and Maintain a Therapeutic Alliance

(2)

Monitor Clinical Condition (i.e. Ongoing Assessments)

(2)

Educate the Patient and Significant Others

(2)

Encourage Treatment Compliance

(1)

Foster Structured, Fulfilling Daily Activities

(2)

Enhance Patient's Grasp of the Illness, Identify New Episodes Early, and Help Patient Adapt to Psychosocial Effects of the Illness

(2)

Reduce the Morbidity and Sequelae through the Use of Community Supports

(2)

References

(3)

Home Care's Interface with the Psychiatric Hospital System

Winifred Christ

Chapter Summary

(1)

Indications and Contraindications for Psychiatric Home Care

(1)

Options for Home Care

(3)

Short-Term, Low-Intensity Treatment

(1)

Short-Term, High-Intensity Treatment

(1)

Long-Term, Low-Intensity Treatment

(1)

Long-Term, High-Intensity Treatment

(1)

Collaborating with the Outside Home-Care Provider

(2)

Effecting a Transition to the Home-Based Team

(1)

Partnering with Families and Nonpsychiatric Providers

(1)

Differential Use of Staff

(1)

Variables Affecting the Outcome of Psychiatric Home Care

(1)

Utilization Patterns

(3)

Clinical Outcome

(1)

Cost Comparisons

(1)

Patient Satisfaction

(1)

Summary of Positive Factors in Home Care

(1)

Open Issues in Home Care

(1)

References

(2)

Ingredients of a Successful Collaboration between a Social Worker and Psychiatrist in an Extended Recovery Program

Lisa Toth

Adella Wasserstein

Chapter Summary

(1)

The Value of Collaboration

(3)

Ingredients for Success

(1)

Defining Success

(1)

The Process of Reintegration

(1)

Mary---A Case Study

(5)

Elements of Success

(4)

Families in Crisis: A Model for the 1990s

Linda A. Keller

Gerald M. Arndt

Chapter Summary

(1)

Historical Perspective and Theoretical Underpinnings

(2)

Description of the Family Response Team Approach

(4)

Case Studies and the Nature of Crisis

(3)

The Situational Crisis

(1)

The Life-Cycle Crisis

(1)

The Repetitive Crisis

(1)

The Stockpile Crisis

(1)

References

(2)

From Hospital-at-Home to Community Living: The Family's Journey

Glynn Rudich

Carla Daichman

Chapter Summary

(1)

Families as Caregivers

(2)

Origins of a Parent Support Group

101

(1)

The Life of the Group

102

(9)

Breaking the Isolation

103

(3)

The Family's ``Recovery''

106

(2)

Increased Independence

108

(3)

References

111

(2)

The Experiences of an Integrated Behavioral Health Organization

Elizabeth G. Brenner

Stuart Koman

Chapter Summary

113

(1)

How the Family Support Team Got Started

114

(1)

Transferring Public Sector Models to Private Managed Care Agreements

114

(3)

Referral Profiles

117

(3)

Outcome Figures

120

(1)

Differential Profiles and Expectations: Department of Social Services versus Managed Care Organizations

121

(4)

Level of Care Criteria

123

(2)

Models of Reimbursement

125

(7)

The Per Diem Rate

127

(1)

The Per Session Rate

128

(1)

The Weekly Rate

129

(1)

The Case Rate

129

(2)

Fee-for-Service or Hourly Rate

131

(1)

Capitation

132

(1)

Summary Comments

132

(1)

Reference

133

(2)

Roles for Paraprofessionals in Psychiatric Home Care

Jessica Wolf

Chapter Summary

135

(1)

Rationale for Paraprofessionals in Psychiatric Home Care

135

(2)

Competencies Needed by Home-Care Paraprofessionals

137

(1)

Applicable Training Models

138

(2)

Follow-up with Student-Trainees

140

(1)

Implications for Training and Service Delivery

140

(1)

Effective Use of Paraprofessionals: A Clinical Case Example

141

(1)

Conclusion

142

(1)

References

142

(3)

Appendix A Outlines of a Focused Assessment: Symptoms, Stressors, Supports

The Value of a Psychosocial Assessment

145

(1)

Four Indexes to Help Guide Assessment

146

(5)

The Clinical Index

146

(2)

The Historical Index

148

(1)

The Social Index

148

(1)

The Sufficiency Index

149

(2)

Appendix B Designing and Maintaining a Behaviorally Anchored Treatment Plan

Targeting the Behaviors That Need Change

151

(4)

Identifying General Domains of Functioning

152

(1)

Setting Goals

152

(1)

Establishing Behaviorally Stated Objectives

153

(2)

Preparing Service Plans

155

(2)

Appendix C A Syllabus for Intensive Case Management Training

Training Objectives

157

(1)

Training Curriculum and Objectives

158

(3)

The Philosophy of Home-Based Care

158

(1)

A History of Clinical Case Management Services

158

(1)

Psychiatric Rehabilitation Principles: The Patient as Active Agent

159

(1)

High-Risk Factors in a Community Setting: Noncompliance, Transition Periods

159

(1)

Persistent Psychotic Illness from a Patient's Perspective

159

(1)

Engaging Families as Allies in Treatment: Helping Families ``Recover'' and Indentifying the Supports They Need

160

(1)

Coordinating Services among Several Providers---Psychiatrists, Day Hospitals, Inpatient Services, Residential Programs

160

(1)

Engaging a Client in a Extramural Setting

160

(1)

Index

161

Please wait while the item is added to your bag...

FREE SHIPPING

Amazon no longer offers textbook rentals. We do!

Psychiatric Home Care : Clinical and Economic Dimensions

Summary

Table of Contents

Supplemental Materials