Establishing Culturally Sensitive Therapeutic Communities in Ghana for Individuals with Severe and Persistent Mental Illnesses

This paper makes a proposal for the establishment of therapeutic communities for people with severe and persistent mental illnesses in Ghana. It discusses the history and features of therapeutic communities, as well as the elements that make it compatible with the agenda of the new 2012 Ghana mental health bill. This paper also discusses the present state of mental health care in this West African country and how the establishment of therapeutic communities will promote recovery of people with severe and persistent mental illness, and change the perception of chronic mental illness in Ghana. A discussion of potential modifications of the therapeutic community is offered as well as justifications for maintaining other structural aspects should this establishment materialize in Ghana. The costs of setting up therapeutic communities in this third world country are addressed with the offered conclusion that costs far outweigh the benefits. Finally, given the endeavor of the proposed therapeutic communities to assist in deinstitutionalization of care, cautions are made in this paper to ensure that the trends experienced in the United States with deinstitutionalization are not replicated in Ghana. A proposal is made in the conclusion for Ghana to move past therapeutic communities when developmentally able- to community mental health centers which were in part established to account for some of the fallouts of deinstitutionalization by providing a comprehensive and extensive range of services for people with severe and persistent mental illness.

Group Dynamics in Sex Offender Treatment Involving Individuals with Personality Disorders

This qualitative investigation primarily employing a phenomenological perspective and psychoanalytic interview approach intends to provide contextual understanding of group dynamics in sex offender treatment involving individuals with strong features of personality disorders or Axis II psychopathology according to the Diagnostic and Statistical Manual of Mental Disorder (4 ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000). Of note, this study particularly focuses on the cluster B type (Narcissistic, Borderline, Histrionic, and Antisocial Personality Disorders), based on the assumption that this type is more interpersonally operational in its nature. The present study is based on semi-structured interviews of three clinicians who arecurrently providing group treatment for sex offenders. The interview was designed to elicit the participants' clinical observations of group dynamics involving group members with features of the Axis II, Cluster B type. In this study, 11 therapeutic factors postulated by Yalom (2005) were utilized to qualitatively investigate group dynamics. Analyses of qualitative data highlighted how group members with features of the Axis II, Cluster B type may distinctively affect group dynamics. Based on the results, group members with Axis II diagnoses, as reported bythe therapists who responded to this study, were observed to present with altruistic behaviors in group. In addition, motivation appeared to be one of the most influential factors in promoting and maintaining therapeutic group behaviors. Group members with antisocial features appeared to present with low motivation for treatment, and individualswith a pervasive history of criminal institutionalization seemed more prone to disengagement in group. Individuals with borderline and histrionic traits seemed to be interpersonally oriented and affectively engaged in group process. Persons with a narcissistic tendency also appeared to be interpersonally invested and showed altruistic behaviors, yet the importance of confirming their superiority seemed to outweigh the need for acceptance or approval from other group members. As briefly discussed above, the qualitative analyses of the current data showed that individuals with Axis II disorders, Cluster B type uniquely affect group dynamics, which suggest clinical considerations foreffective treatment planning, maintenance, and outcomes.

Adaptive Institutional Transference in the Treatment of Individuals with Borderline Personality Disorder.

This paper introduces "adaptive institutional transference" (AIT) and describes how it develops in some clients in response to psychotherapist transfer in psychology training clinics. Individuals with borderline personality disorder are especially likely to develop AIT because of difficulties related to abandonment depression. Directors, supervisors, and student psychotherapists in psychology training clinics should be aware of these dynamics because they have important treatment implications, which are described. Limitations and ideas for future exploratory and qualitative research are also discussed .

The Perceived Effects of Dance for Individuals with Parkinson’s Disease and Healthy Amateurs

The objective of the present study was to compare the effects of dance participation on physical and psychological functioning as perceived by two distinct groups of dancers: dancers with Parkinson's disease (PD) and healthy amateur (HA) dancers. Dancers in the Parkinson's sample group were gathered from participants in the Dance for PD® program, while healthy amateur dancers were recruited from university dance departments and through social media. Both groups were administered measures related to affect, self-efficacy, quality of life, and which aspects of dance classes were most helpful and/or challenging. Several open-ended questions for both groups were included, along with questions specific to each group. Results of the study indicated that there was no difference between the two groups on positive affect experienced while dancing, but that HA dancers experienced higher levels of negative affect than PD dancers. HA dancers exhibited higher levels of self-efficacy, but there was no difference between the groups on perceived quality of life. Additionally, both groups identified the same two components of dance classes as the most helpful: "moving and getting some exercise" and "doing something fun." Thematic analysis of responses to open-ended questions found that, in general, HA and PD dancers identified similar factors which made dance unique from other forms of exercise. The primary differences were that HA dancers more strongly emphasized artistic and spiritual components of dance, whereas PD dancers focused on the importance of the dance instructors and tailoring movements to individuals with PD. More differences were found between the two groups with respect to the negative aspects of dance classes. Notably, PD dancers identified almost no negative aspects, while HA dancers described internal and external pressure, criticism, and competition as problematic. Future research could benefit from ensuring that both groups are administered the same standardized measures to allow for additional comparisons between groups and with normative samples.