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Biomedical subjects

D H Schetky

Publications and source records attributed to D H Schetky.

At least 19 recordsLinked to original sources

Mourning in prison: mission impossible?

The author's interest in the issue of mourning in prison is twofold. As an active hospice volunteer, she became involved with bereavement work, which sensitized her to the issues of loss encountered upon joining the staff at the Maine State Prison. More often than not, the inmates with whom she met had unresolved issues of loss. The impetus for a grief support group came from an inmate who had experienced the death of five relatives during his period of incarceration; he commented on how difficult it is to mourn in prison, and he worried about how he would deal with all his losses when confronted with them upon his release. The author raised the possibility of a support group and the inmate offered to help organize it. This article describes the author's experience with such a prison-based support group and what she has learned, through this experience, about mourning in prison.

Grief↗

Psychiatric treatment of children and adolescents in rural communities. Myths and realities.

Rural child and adolescent psychiatry offers many challenges, a varied and interesting practice, and the satisfaction of performing needed and important work in an environment in which one's presence is valued. The successful psychiatrist can expect to be an integrated and appreciated member of the community. The fit is not a good one for every practitioner, however. Not only are incomes lower, although the cost of living is low as well, but practitioners may find they have only exchanged urban stresses for rural pressures. The characteristics important for the child and adolescent psychiatrist are the same for rural and urban settings: flexibility, creativity and innovation, competence, self confidence, a good sense of boundaries, a good balance between personal and private life, supportive personal relationships, and a sense of humor. One must be a child advocate, have a willingness to give of one's self and one's time, and be down to earth, comfortable with oneself, and capable of self entertainment. Training programs with access to rural populations can introduce residents to rural child and adolescent psychiatry while supporting those who are already in practice. The authors hope that this article will promote a dialogue with psychiatrists considering relocation to a rural area and encourage training programs to prepare residents for rural practice.

Adolescent↗

Ethics and the clinician in custody disputes.

This article stresses the need to separate the role of therapist from that of forensic evaluator in custody disputes. Common pitfalls for the therapist who testifies in custody disputes are discussed, and ethical guidelines for both the therapist and the forensic evaluator are provided.

Adolescent↗

Ethical issues in forensic child and adolescent psychiatry.

This article addresses the unique ethical conflicts that are encountered in forensic psychiatry. Special issues for the forensic child and adolescent psychiatrist in the areas of custody, sexual abuse, termination of parental rights and adoption, evaluation of juvenile offenders, and maternal-fetal conflicts are addressed. The need for neutrality, objectivity, and integrity in performing forensic evaluations is stressed.

Adolescent↗

Civil litigation and the child psychiatrist.

This paper reviews the legal principles involved in tort litigation and covers the evolution of case law regarding recovery of damages for psychic trauma. Concepts of zone of danger, foreseeability, and proximate cause are discussed. Issues for both plaintiff and expert witness are discussed. Case examples are provided, and recommendations are made regarding the child psychiatrist's involvement in these cases.

Adolescent↗

The sexual abuse victim in the courts.

This article explores the impact of court procedures on victims of sexual abuse and on the process of psychotherapy. Differences between civil and criminal litigation are described as is the psychiatrist's role in these cases. Recommendations are made as to how to render the experience of testifying in court less traumatic for the victim.

Adaptation, Psychological↗

The child as a witness.

The increasing participation of children in judicial proceedings raises two central issues: the competency of the child as a witness and the effects on the child of testifying about a traumatic experience. After discussing these issues, the authors present the recommendations of forensic child psychiatrists on how to improve the judicial process to elicit more accurate testimony from child witnesses--for example, by videotaping a child's testimony to avoid repeated interrogations, using anatomically correct dolls and pictures to allow the child to recount events through displacement, and using one skilled interviewer throughout the proceeding to allow rapport to develop between interviewer and child. They then discuss the role of the child psychiatrist in court proceedings involving child witnesses.

Adaptation, Psychological↗

Children and handguns. A public health concern.

Data on children who are killed by handguns each year are reported. Homicide, suicide, accidental death, as well as injuries by handguns, are reviewed. It is concluded that handguns are a major cause of death among children and adolescents. The medical profession is urged to take a more active role in finding solutions to this problem.

Accidents↗

Custody and visitation. Problems and perspectives.

Child custody and visitation remain vexing problems requiring input from mental health professionals as public policy decisions are formulated. Difficult problems do not have easy solutions, but through continued exploration of the issues using clinical and research methods, perhaps innovative programs will be developed and evaluated. Ultimately, this may lead to better ways of helping families cope with the trauma and the consequences of the family break-up and the resulting attempt to establish custody and visitation.

Adaptation, Psychological↗