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EPPP Community 2


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Caplan's three types of prevention
1. Tertiary prevention - "closest", prevent recurrence, reduce duration/consequences
2. Secondary prevention - early detection and tx of problem to ease symptoms
3. Primary prevention - "furthest", preventive, carried out before onset of illness
Suicide risk factors
1. over age 65
2. Male (commit, more females attempt)
3. White
4. non-married (highest divorced, then widows, then never-married)
5. Past suicide attempt
6. family history of attempts
7. depressed ind. whose symptoms have recently improved
8. state intention, have plan, have means
9. feelings of hopelessness
Age range with greatest increase in suicide rates
15-24 year olds, especially males
Age range with highest suicide rate
over 85 years of age
Most common reason is physical illness
Age ranges of highest suicide rate for African American and Native American males
AA - 15-44
NA - 15-24
Most consistent predictors of adolescent suicide
1. diagnosis of depression
2. use of drugs/alcohol
3. antisocial behavior

other: previous suicidality and exposure to suicide of another person
Risk factors of suicide in older adults
1. poor health status
2. depressive symptoms
3. recent death of loved one
4. self-destructive behaviors
5. altering a will
6. hostile interpersonal relations
Describe Caplan's Tertiary Prevention
"closest" to illness
prevents recurrence, reduce duration and consequences
ex: rehab, AA, halfway house
Describe Caplan's Secondary Prevention
early detection and tx before full blown illness develops, or keep from getting worse
ex: suicide prevention, hot-lines, screening tests for ppl with no symptoms
Describe Caplan's Primary Prevention
"furthest" from illness and most preventive in nature conceptually
Carried out BEFORE onset of disease and involves preventing occurrence
ex: prenatal nutrition for low SES moms, Head Start, sex ed
Compare/contrast consultation vs. supervision
1. consultation ad-hoc, supervision continuous
2. consultant no administrative authority
3. consultant not member of org
4. consultation focus is specific vs. general
5. consultation relationship is voluntary
mental health consultation
Caplan's work
Focus on maximizing the social/emotional dev of clients under consultee's care
4 types - client-centered, consultee-centered, program-centered, consultee-centered administrative
Client-centered case consultation
helping consultee develop a plan to work more effectively with particular client
Consultee-centered case consultation
Focus on problems within the consultee, rather than problems within client/s
ex: theme interference
consultee-centered administrative consultation
focus on difficulties w/consultee that limits his effectiveness in administering a program or bringing out program change
systems (process) consultation
entire organization is viewed as consultee and targeted for change.
Assumpton: improving satisfaction among members will improve organization, typically focuses on improving interpersonal skills
Advocacy consultation
focuses on bringing about institutional change (i.e. through political system) of a disenfranchised group
Inpatient hospitalization: rates males v. females
admission rates higher for males although mental illness rates higher for females. Reason: males engage in more "acting out" behaviors considered threatening to society
Inpatient hospitalization: demographics
25-44 year olds
never married
white (although minorities are overrepresented based on population proportions)
not successful
80% readmission rate in 2 years of discharge
lack of adequate support systems in communities
involuntary commitment
use of behaivoral criteria - dangerous to self or others
2-PC rule: two physicians must agreeits necc
characteristics of abused children
young - less than 2 y.o.
premature/difficult births
poorer school achievement and cognitive delays
develop attachment to those how cause them distress
characteristics of abusive parents
lower SES in known cases, but likely = across SES cat.
abused a children
existence of psychological disorder
Lenore Walker's "Cycle of Violence"
1. tension-building (may include minor battering incidents)
2. acute battering incident
3. honeymoon phase (complicates intervention - time most difficult for women to leave)

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