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Biomedical subjects

E E Griffith

Publications and source records attributed to E E Griffith.

At least 19 recordsLinked to original sources
PubMed1999

Structure and provision of services in Black churches in New Haven, Connecticut.

Historically, Black (or African American) churches have played a central role as a center of religious and political life and also as a provider of human services and a healing community. This article examined the extent to which African American churches in 1 Northeastern urban environment are involved in the delivery of health and human service programs to their communities. It also explored how comfortable Black clergy are in referring their parishioners to the formal mental health system and identified the actual level of referrals. In addition, the analyses considered the individual and organizational characteristics that predict variations in the levels of support services and the likelihood of referral. Analyses revealed that African American churches deliver a broad range of services to the community. More than two thirds of the clergy feel comfortable in making a referral to a mental health agency or professional, and more than half have actually made a referral. Both service delivery and referral levels varied by several clergy and congregational characteristics. The implications of these findings for research and health policy are considered.

Adult↗
PubMed1999

Ten dimensions of public-sector managed care.

Managed care in the public sector remains a poorly defined concept. It is currently understood largely through case examples, an approach of limited usefulness because each managed care initiative is shaped by local forces and is constantly changing. The authors describe ten key dimensions on which such initiatives vary and suggest that they can be used to examine essential characteristics of the initiatives and core differences between them. The dimensions are objectives, scope, organizational structures and authority, enrollment, benefit package, strategies for managing utilization, best practices, financing, quality management and outcomes measurement, and the impact of the initiative on the public mental health system. Using these dimensions to assess existing initiatives, the authors conclude that most focus on one principal dimension to the exclusion of other critical dimensions. The authors argue for a comprehensive approach to planning and implementing managed care projects that should ultimately lead to better care for public-sector populations.

Health Plan Implementation↗
PubMed1999

Developments in clergy malpractice: the case of Sanders v. Casa View Baptist Church.

The courts have so far consistently refused to view misconduct by clergy counselors as constituting clergy malpractice. However, they have increasingly come to view it as a breach of fiduciary duty. More recently, they have also begun to differentiate between the secular and religious aspects of clergy counselors' work. The case discussed in this article (Sanders v. Casa View Baptist Church) provides an instructive example from the United States Court of Appeals, Fifth Circuit, in 1998. The court upheld a district court finding, based on a review of trial testimony, that the defendant's counseling work as a whole (and not merely his sexual misconduct itself) was essentially secular in nature. Thus the plaintiff recovered punitive damages for both breach of fiduciary duty and marriage counseling malpractice.

Clergy↗
PubMed1998

Prototypes of intrafamily homicide and serious assault among insanity acquittees.

Public concern with societal violence is intensified when persons who have been found not guilty by reason of insanity (NGRI) of having committed a homicide or serious assault are returned to the community. Successful management of such acquittees in the community requires a sophisticated understanding of the person and the illness within the larger context of the violent incident, the family, the community, and the culture. In this article, we present an analysis of psychotic violence within a family context. A qualitative study of 64 subjects who were found NGRI of killing or seriously injuring a family member resulted in four prototypes of intrafamilial homicide/assault: Till Death Us Do Part; Overwhelming Burden, Elimination of the Limit Setter; and Family-Focused Delusional Killing. The prototypes are presented as a model for developing management strategies both for future risk assessment and for successful transition of the insanity acquittee into the community.

Adolescent↗
PubMed1998

Ethics in forensic psychiatry: a cultural response to Stone and Appelbaum.

Dr. Alan Stone has argued that forensic psychiatrists lack clear guidelines about what is proper and ethical with respect to their professional activity and consequently, that they ought to stay out of the courtroom. Dr. Paul Appelbaum and others have responded to Stone's critique with proposals that provide a countervailing framework of ethical guidance for forensic psychiatrists. It is this author's contention that both sides in the debate have ignored the issues that are important to forensic psychiatrists who belong to culturally nondominant groups in the United States. As a result, African-American forensic psychiatrists are likely to be troubled by an ethics framework that ignores their special struggles linked to the matter of race. By gutting the debate of any reference to a cultural context, the participants have enunciated a culture-free theory of ethics that is an ineffective tool for the black professional. The author argues for a reworking of the theoretical reasoning behind the debate that would ultimately render the debate more relevant to the professional life of African-American forensic psychiatrists and those from other nondominant groups.

Beneficence↗
PubMed1998

Reconsideration of sexual misconduct by clergy counselors: the case of F.G. v. MacDonell.

In the last decade, concerns about clergy counselors' liability for malpractice has focused on allegations of sexual abuse. Thus far, courts have not adjudicated a complaint of clergy malpractice. Their reasons have centered on concern for freedom of religion under the First Amendment. Therefore, there is a need to find another way to deal with the obvious reality that violating others' rights to satisfy one's own sexual appetites is not a valid expression of religious belief or practice. The authors, upon reviewing cases decided up to a few years ago, concluded that the complaint of breach of fiduciary duty provides a highly fitting way for courts to fairly assess complaints of sexual misconduct brought against clergy counselors. Now, the New Jersey Supreme Court has clearly recognized this complaint as an approach to the problem.

Clergy↗
PubMed1995

Sociocultural and therapeutic perspectives on violence.

Violence is a complex behavior and like all behaviors it occurs in the context of culture. The causes of violence and the various ways that it becomes manifest are influenced by the prevailing attitudes of a society and that society's perspective on the aims and legitimacy of particular forms of violence. Violence encompasses a wide range of human behavior that has interacting biologic, psychological, and social components. This article has addressed the various theories of aggression and violence, diagnostic issues related to victimization by violence, and therapeutic concerns in treating both victims and perpetrators of violence.

Anticonvulsants↗
PubMed1995

Forensic and policy implications of the transracial adoption debate.

The adoption of black children by white families continues to garner significant attention from legislatures, the media, and scholars in many disciplines. Still, forensic psychiatrists have said little about this form of transracial adoption, and they seem willing to allow other disciplines to map out singlehandedly the public policy in this area. This policy is expected to affect an estimated 175,000 black children nationally who live in some form of out-of-home placement. Forensic psychiatrists should increase their understanding of and involvement in the debate over this special form of adoption. This article highlights several principles that must be better understood if forensic psychiatrists are to participate in the debate with clarity and understanding.

Adoption↗
PubMed1995

Regulating pastoral counseling practice: the problem of sexual misconduct.

Growing concern about sexual abuse covers many kinds of perpetrators. Therapist and clergy abusers have been increasingly targeted, yet clergy counselors who sexually abuse their clients have so far largely escaped effective sanctions from the courts. This article identifies the justifications given by these courts, identifying and evaluating their supporting arguments. This analysis suggests that the courts have decided not to enter this public policy fray, or to do so with considerable caution because of their fundamental respect for the freedom of religion. It is a choice especially problematic in regard to pastoral counselors practicing outside the discipline of either a central church authority or a professional counseling organization. The authors suggest potential legal bases for reaching sexually abusive clergy counselors without encroaching on religious freedom. They urge the churches to meet their responsibility and assume a more active stance toward helping to resolve this problem. The question of whether society does in fact value religious freedom above protection of clients sexually abused by clergy counselors remains an important policy issue.

Criminal Law↗
PubMed1995

Personal storytelling and the metaphor of belonging.

The author uses the idiom of autobiographical storytelling to explicate two important themes: How the complex phenomenon of 'belonging' results from the interactions of members of a nondominant group and those of a dominant group; and how the author himself has dealt with this phenomenon in his own developmental adaptation over the years. The concept of belonging is a cultural principle that should be thoroughly understood by mental health professionals if they are to deal effectively with the problem of cross-cultural adaptation.

Culture↗
PubMed1994

Clinical perspectives on the Rastafari movement.

Members of the Rastafari movement, which originated in Jamaica, are found in the Caribbean and in parts of the United States and Europe with a large Afro-Caribbean population. To help mental health professionals serve members of this group more effectively, the authors review literature on the movement and present clinical case examples with analyses and recommendations for interventions. The Rastafari movement is both a political and a religious group with a life-style that includes the wearing of dreadlock hairstyles and the sacramental use of marijuana. The group also advocates opposition to traditional government and support members' repatriation to Africa. Clinicians involved in caring for Rastafari are encouraged to make diagnoses based on phenomenological grounds rather than on social behavior. Many blacks who became engaged in the antithetical transformation to membership in the Rastafari movement may be attempting to resolve racial, religious, class, and gender conflicts. The Rastafari movement may provide an affirmation of black identity and a moral framework for black people emerging from centuries of slavery, colonization, and oppression.

Adolescent↗
PubMed1994

Defining managed care in public-sector psychiatry.

Although managed care is an established force in the private sector, there is growing interest and experimentation with this concept in the public sector. This interest has been generated by the increased demand for services, the shrinking resource base due to cutbacks in state budgets, and the fragmentation of care that has accompanied the shift from a centralized, hospital-based model to a decentralized, community-based model for treating individuals with serious mental illness. But despite this interest, no consensus exists about the form or functions of managed care in the public arena. Simply importing private-sector versions of managed care is inadequate given the substantial differences in the patient population and service delivery mechanisms. The authors present a functional analysis of managed care in the public sector. Drawing on their conceptualization of managed care, they outline a functional approach to evaluating the strengths and weaknesses of treatment systems, innovations such as privatization and capitation, and recent health care reform proposals.

Community Mental Health Services↗
PubMed1991

Recent developments in the transracial adoption debate.

This article places the controversy over transracial adoption (TRA) in its historical context and analyzes recent developments in the law governing TRA policy. Because unfounded "authority" from the field of mental health infuses current debate, the authors alert psychiatrists to two powerful forces that improperly influence today's legal arena: community preference for same-race families and biased professional norms of mental health professionals.

Adoption↗
PubMed1991

Understanding due discretion of judgment in Catholic marriage courts.

Psychiatrists and psychologists provide consultation to the Catholic Church's marriage courts. Operating under the Church's legal code, these tribunals assess the validity of weddings that have ended in divorce. This report describes one of the standards used for this purpose, the lack of due discretion of judgment, which is concerned with the maturity, understanding, and appreciation that the couple brought to the ceremony. This normal capacity is vulnerable to various mental illnesses, which if present with sufficient severity may nullify the marriage vows as seen by the Church (though not necessarily by the state). Such a finding results in freedom to marry again despite the Church's ban on divorce, provided that due discretion of judgment is regained. Case examples and discussion of the assessment process for due discretion of judgment prepare the consultant to apply psychiatric findings to this unique and urgent legal issue.

Adult↗