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psychiatric treatment approaches there are opportunities for trial
and error, exploration and reconsideration, revision of treatment
approach, and correc tion of errors. Revisions and corrections are
based on observations of pro gress and on response from patients
about the impact of treatment efforts. But emergency interventions
usually are one time efforts involving a sequence of evaluation,
therapeutic intervention, and referral out. Response is limited or
absent and there are no opportunities for corrections over time.
Therefore, interventions and referrals must be made on the basis of
first evaluations, with positive conviction related to current best
effort and despite the lack of guidance derived from tracking the
patient's progress over time. The staff must tolerate the
risk-taking required, and must also be prepared to forego the
gratification of seeing the beneficial results of the work done.
Even in pro grams structured to allow return visits, and despite
the occasional information provided by other agencies after
referrals, the majority of patients are lost to follow up. The
usefulness of specific interventions is hard to evaluate and the
satisfaction of seeing a task completed is rarely available. The
emergency program staff must tolerate a considerable amount of
stress in the environment. Emergency care centers are collection
points for an extraordinary volume of human suffering. The
anxieties and strains asso ciated with persistent urgency of need,
alarm related to unexpected difficul ties, fearfulness about
outcome, closeness of death, and presence of pain pervade the
atmosphere."
Easy-to-follow guide has 60 step-by-step illustrations for making seats of cane, splint, rush, rope, twine, grass.
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