Family environment and shame: is there a relationship?

This study was designed to examine the relationship between dysfunctional families in childhood and shame experienced by adults and compare feelings of guilt and shame. The results indicated that the shame young adults feel is correlated with their perceived family environment as a child. Greater feelings of shame on the Test of Self-Conscious Affect (TOSCA) were correlated with lower Family Environment Scale scores on Cohesion, Expressiveness, Intellectual-Cultural Orientation, Moral-Religious Emphasis and Organization and higher Conflict scores. Other variables were also examined. The results support the hypothesis that people coming from dysfunctional families experience more shame as adults and that guilt and shame are differentially related to dysfunctional families.

Two models of suicide treatment: evaluation and recommendations.

Treating suicidal patients is one of the most stressful aspects of psychotherapeutic work. This paper describes and evaluates two models of therapy with suicidal patients. The crisis-intervention model, which assumes suicidal feelings are acute and suicide is preventable; and the continuing-therapy model, which emphasizes chronic suicidal feelings and posits that suicide is not preventable. Ethical and legal issues as well as treatment strategies from each model are described. Both therapy models stress the importance of assessing, understanding, and validating the patient's feelings as well as establishing a good therapeutic relationship. The crisis intervention model recommends an active, directive intervention while the continuing therapy model emphasizes ongoing therapy principles. After reviewing the different models, this article concludes that the assumptions of the crisis-intervention model are not supported while those of the continuing-therapy model are. In addition, it is concluded that there are more therapeutic advantages to employing the continuing-therapy model. These include taking short-term risks to acquire long-term gain, treating the patient as a responsible adult and seeing the suicidal behavior in the context of the total personality.

Comparison of mental health services in rural and urban Washington.

Rural mental health has been an area of increased study in recent years because of unique problems in service of rural areas and underrepresentation of professionals in rural areas. This study collected information from mental health centers in the state of Washington via the state management information system. Rural/urban differences were examined. Results showed that (1) rural therapist were more likely to be generalists than urban therapists, (2) psychologists performed more of the direct service work in rural centers than they did in urban centers, (3) rural centers spent less time in direct activities, and more time in support activities, but did not differ from urban centers in indirect activities, and (4) rural and urban centers did not spend different percentages of time in specific direct, indirect, and support activities with the exception of day treatment where urban centers put more of their time than rural centers.