Effects of peer review on outpatient psychotherapy: therapist and patient follow-up survey.

Interviews with 80 therapists and 50 patients at a community mental health center revealed that peer review effectively monitored the appropriateness of treatment and allocated limited treatment funds without unduly interfering with established treatment patterns, relationships, or outcomes. Most therapists reported receiving helpful consultation from the peer review committee, and the process encouraged them to focus more clearly on treatment goals. On the other hand, patients were concerned about the committee's role in making decisions about their treatment. Therapists noted as a problem the lack of certainty in establishing a treatment contract prior to peer review since the contract with the patient must remain fluid during the evaluation period. The therapists and patients demonstrated remarkable agreement in their assessment of treatment progress and whether further therapy was needed.

Day treatment programs for the Spanish speaking: a response to underutilization.

This article describes how a hospital-based Community Mental Health Centre in California, United States, addressed the problem of underutilization by its Spanish-speaking population. The authors present a clinical program model which can be duplicated without hiring large numbers of bilingual professionals. The program offers a comprehensive range of psychiatric treatment services to a particular minority population, and can be readily adapted to deliver mental health care to any national minority or ethnic subpopulation. All of the services for the Spanish-speaking seek to promote community integration, and are designed to provide therapeutic experiences in a foreign environment while maintaining cultural ties.