Measuring the effectiveness of community action approaches to mental health is difficult because they occur in community settings and impact a wide variety of people, and it is difficult to find and assess valid outcome measures. Nevertheless, research has found that a variety of community interventions can be effective in preventing a variety of psychological disorders (Price, Cowen, Lorion, & Ramos-McKay,1988). 1
Data suggest that federally funded prevention programs such as the Special Supplemental Program for Women, Infants, and Children (WIC), which provides federal grants to states for supplemental foods, health-care referral, and nutrition education for low-income women and their children, are successful. WIC mothers have higher birth weight babies and lower infant mortality than other low-income mothers (Ripple & Zigler, 2003). 2And the average blood- lead levels among children have fallen approximately 80% since the late 1970s as a re sult of federal legislation designed to remove lead paint from housing (Centers for Disease Control and Prevention, 2000). 3
Although some of the many community-based programs designed to reduce alcohol, tobacco, and drug abuse; violence and delinquency; and mental illness have been successful, the changes brought about by even the best of these programs are, on average, modest (Wandersman & Florin, 2003; Wilson, Gottfredson, & Najaka, 2001). 4 This does not necessarily mean that the programs are not useful. What is important is that community members continue to work with researchers to help determine which aspects of which programs are most effective, and to concentrate efforts on the most productive approaches (Weissberg, Kumpfer, & Seligman, 2003). 5 The most beneficial preventive interventions for young people involve coordinated, systemic efforts to enhance their social and emotional competence a nd health. Many psychologists continue to work to promote policies that support community prevention as a model of preventing disorder.
- Outcome research is designed to differentiate the effects of a treatment from natural improvement, nonspecific treatment effects, and placebo effects.
- Meta-analysis is used to integrate and draw conclusions about studies.
- Research shows that getting psychological therapy is better at reducing disorder than not getting it, but many of the results are due to nonspecific effects. All good therapies give people hope and help them think more carefully about themselves and about their relationships with others.
- Biomedical treatments are effective, at least in the short term, but overall they are less effective than psychotherapy.
- One problem with drug therapies is that although they provide temporary relief, they do not treat the underlying cause of the disorder.
- Federally funded community mental health service programs are effective, but their preventive effects may in many cases be minor.
EXERCISES AND CRITICAL THINKING
- Revisit the chapter opener that focuses on the use of “psychiatric service dogs.” What factors might lead you to believe that such “therapy” would or would not be effective? How would you propose to empirically test the effectiveness of the therapy?
- Given your knowledge about the effectiveness of therapies, what approaches would you take if you were making recommendations for a person who is seeking treatment for severe depression?