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Conflicts in the multiple mandates—legislative, community and professional—under which the West Philadelphia Community Mental Health Consortium operates serve to obstruct its progress toward the goals of a Community Mental Health Center. The first paper explains the structure of the Consortium and the setting in which it operates. The two papers that follow discuss the impact of the conflicts on research and evaluation services, and the implications for race relations—a critically pervasive issue at the Consortium.

While acknowledging the importance of primary prevention, mental health agencies continue to devote their major resources to diagnosis, treatment, and rehabilitation efforts. This paper attempts a comprehensive understanding of the multiple and related barriers to the design and implementation of preventative programs. Barriers are discussed under the categories of definitional problems, systemic complexity, difficulties of demonstration, and lack of constituent demands.

The new behavior technologies raise obvious ethical and legal questions, particularly when employed in institutional contexts. This paper offers a conceptual framework for the discussion of legal interventions designed to prevent Orwellian abuses of the new technologies, without preventing legitimate therapeutic applications.

Clinicians and administrators have emphasized crisis intervention as a means of extending services and reducing costs. This paper asserts that ghetto children, because of their multiple deprivations, complex problems, and family structures, are particularly unsuitable for short-term contacts. Modalities other than crisis intervention are indicated as alternatives to long-term child treatment.

This paper describes a program of group therapy aimed at grappling with the core problem of most blacks in this society—loss of self-identification and lack of projection of a productively healthy existence. The black experience is seen as being akin to that of a control group in a laboratory experiment; implications of decontrolling a control group in the even more rigidly defined setting of a therapeutic community are explored.

This paper traces the development of psychiatry in the People's Republic of China—with special reference to the social aspects of treatment and prevention—and delineates the salient features of the Chinese approach. Implications of this approach for mental health workers in other countries are discussed.

This paper describes and evaluates a two-year parent education program designed to involve whole families. The program begins when the child is a year old, and includes in-home training of the mother, plus several weekend sessions for the entire family. In its second year, mother and child participate in a nursery school setting, and father is involved in evening meetings. Bilingual training is emphasized. Significant achievements on the part of both program children and program mothers, as compared to controls, are reported on a number of measures.

Barriers of culture and language have tended to keep poor Spanish-speaking people from using community mental health center treatment facilities. This paper describes a program of brief group therapy, conducted in Spanish by a bilingual social work assistant, that helped patients with their presenting problems and helped prepare them to accept referral to the longer term treatment facilities of the center.

This paper describes a black therapy group in a predominantly white hospital. It focuses on the beginnings of the group process, examines group development over thirty weeks, and offers case material regarding differences and similarities between the all-black group experience and the white or integrated group. Leadership roles are addressed in an attempt to clarify the role of co-leaders of a black group operating in a white hospital.

How does the stereotype image of the Negro affect the Negro child's identity? How does it emerge in treatment? This paper describes the effects of the distorted self-concept in several Negro children in an otherwise white treatment center. It describes staff reactions, peer relationships, specific problems in psychotherapy, and the methods used to deal with the emerging problems that are related to race.

This paper, and the one that follows, are drawn from a special Plenary Session on “Values and Economics in the Delivery of Human Services” at the 49th annual meeting of the American Orthopsychiatric Association. This, the session's keynote address, examines the problems that pollution poses to the nation's economy, and foresees an era of diminished growth necessitating a redistribution of wealth and a new approach to the funding of human services. A concerted Crusade by professionals on behalf of human welfare is called for, to replace the current competition for available funds.

This paper examines the validity of the premise that there is only one effective learning environment for the very young child—an intrafamily environment characterized by minimal disruption of primary social relationships. New evidence pointing to (1) the importance of the first three years for priming cognitive development and (2) the inability of many parents to provide the child with the priming ingredients suggests that alternative models involving home supplementation should be considered. If such supplementation is to have maximum effectiveness, careful thought should be given to the advisability of beginning it during the very earliest years of life during which time the child is maximally receptive.

This paper compares the progress of 25 retarded children who attended an experimental summer camp based on principles of behavior modification, with a matched group of 15 retarded children who did not attend camp. The campers showed significantly greater progress than did controls in predetermined target areas, suggesting that a camping experience may have beneficial effects, and that a program of behavior modification may provide even further benefits.

Of the many institutions in our society that have changed their perspective on the father's participation in the family, psychiatric clinics have been among the most prominent. Currently, an attempt is being made to involve more fathers in various treatment procedures. This paper deals with the writer's experience in working with a group of fathers, each of whom refused to participate in a one-to-one treatment relationship. While described as passive, weak, and poor treatment candidates they all responded positively to a Fathers' Guidance Group. Feeling that their pathology would not be intensively explored, they could discuss their conflicts and frequently resolve them within a sympathetic male group.

The Board of Directors of the American Orthopsychiatry Association has established early child care programs as an area of top priority during the current year, with special emphasis on day care. In keeping with this commitment, the Association has authorized and endorsed this statement on early childhood services. The four papers and one book review that follow cover a range of conceptual and practical approaches to the provision of day care.

Observations of two experienced teachers of disturbed children suggest the possibility of developing a coding system for differentiating between teaching styles. This paper presents pilot efforts, and poses questions about philosophies of teaching in therapeutic nursery schools which may help to refine training methods in this relatively new field.

Working with disorganized families of the low socioeconomic population requires adaptations of family therapy techniques which take the specific characteristics of those families into account. This paper discusses changing family subgroupings and shifting observational sets to help family members learn to experience their feelings more clearly and begin to see how they can change their ways of behaving.