Psychiatric Home Care: Clinical and Economic Dimensions
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Table of contents
- Cover
- Contentsix
- Introductionxix
- Chapter 1. An Overview and Economic History of Psychiatric Services1
- Chapter Summary1
- National Expenditures for Mental Health Services2
- A Tale of Two Systems3
- Clinical Case Management4
- Development of the Managed Care Industry4
- Consolidations in the Behavioral Managed Care Field5
- Privatization of Public Psychiatry8
- References9
- Chapter 2. The New Players in Psychiatric Home Care11
- Chapter Summary11
- Current and Prospective Providers of Psychiatric Home Care12
- The Future of Behavioral Health Care17
- Reference18
- Chapter 3. Clinical Issues in Delivering Home-Based Psychiatric Services19
- Chapter Summary19
- Historical Background of Home-Based Psychiatric Services20
- Advantages of Office-Based Services21
- Advantages of Home-Based Services23
- Indications for Home-Based Services24
- Contraindications for Home-Based Services29
- Intervention Patterns in Home-Based Services31
- Home-Based Psychiatric Services in a Managed Care Context33
- Conclusion35
- References36
- Chapter 4. The Goals and Principles of Psychiatric Home Care39
- Chapter Summary39
- Goals of Treatment40
- Principles of Behavioral Home Care42
- References56
- Chapter 5. Home Care’s Interface with the Psychiatric Hospital System59
- Chapter Summary59
- Indications and Contraindications for Psychiatric Home Care60
- Options for Home Care61
- Collaborating with the Outside Home-Care Provider64
- Effecting a Transition to the Home-Based Team66
- Partnering with Families and Nonpsychiatric Providers67
- Differential Use of Staff68
- Variables Affecting the Outcome of Psychiatric Home Care69
- Utilization Patterns69
- Summary of Positive Factors in Home Care72
- Open Issues in Home Care72
- References73
- Chapter 6. Ingredients of a Successful Collaboration between a Social Worker and Psychiatrist in an75
- Chapter Summary75
- Part I: The Value of Collaboration75
- Part II: Mary„A Case Study78
- Elements of Success83
- Chapter 7. Families in Crisis : A Model for the 1990s87
- Chapter Summary87
- Historical Perspective and Theoretical Underpinnings88
- Description of the Family Response Team Approach90
- Case Studies and the Nature of Crisis94
- References97
- Chapter 8. From Hospital-at-Home to Community Living: The Family's Journey99
- Chapter Summary99
- Families as Caregivers99
- Origins of a Parent Support Group101
- The Life of the Group102
- References111
- Chapter 9. The Experiences of an Integrated Behavioral Health Organization113
- Chapter Summary113
- How the Family Support Team Got Started114
- Transferring Public Sector Models to Private Managed Care Agreements114
- Referral Profiles117
- Outcome Figures120
- Differential Profiles and Expectations: Department of Social Services versus Managed Care Organizati121
- Models of Reimbursement125
- Summary Comments132
- Reference133
- Chapter 10. Roles for Paraprofessionals in Psychiatric Home Care135
- Chapter Summary135
- Rationale for Paraprofessionals in Psychiatric Home Care135
- Competencies Needed by Home-Care Paraprofessionals137
- Applicable Training Models138
- Follow-up with Student-Trainees140
- Implications for Training and Service Delivery140
- Effective Use of Paraprofessionals: A Clinical Case Example141
- Conclusion142
- References142
- Appendix A. Outlines of a Focused Assessment: Symptoms, Stressors, Supports145
- The Value of a Psychosocial Assessment145
- Four Indexes to Help Guide Assessment146
- Appendix B. Designing and Maintaining a Behaviorally Anchored Treatment Plan151
- Targeting the Behaviors That Need Change151
- Preparing Service Plans155
- Appendix C. A Syllabus for Intensive Case Management Training157
- Training Objectives157
- Training Curriculum and Objectives158
- Index161
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.
Key Features
* Economic models of home care in a managed care environment
* Standard clinical goals of home care
* Recommended guidelines for home care services
* Clinical vignettes
* Family burdens of home care
* "New players" in psychiatric home care
* Managed care-friendly payment models
* Use of paraprofessionals in home care
* Coordination of inpatient and home care services
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.
Key Features
* Economic models of home care in a managed care environment
* Standard clinical goals of home care
* Recommended guidelines for home care services
* Clinical vignettes
* Family burdens of home care
* "New players" in psychiatric home care
* Managed care-friendly payment models
* Use of paraprofessionals in home care
* Coordination of inpatient and home care services