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Chapter XXV

Contents

CHAPTER XXV

The Technicians

Lt. Col. Charlotte R. Rodeman, ANC, USA (Ret.), Morton A. Seidenfeld, Ph. D., and Myron J. Rockmore, M.A.

Section I. The Neuropsychiatric Technician

Lt. Col. Charlotte R. Rodeman, ANC, USA (Ret.)

DEVELOPMENT AND DIFFICULTIES

The history of the neuropsychiatric technicians (psychiatric ward aids) during World War II paralleled, somewhat, that of the neuropsychiatric nurses. With the vast increase in the number of psychiatric patients in Army hospitals during the war and the shortage of nurses, most of the care and supervision of neuropsychiatric patients was provided by the enlisted technicians.

Very few of these men had had any previous training or experience in the care of neuropsychiatric patients, and consequently, their attitudes and approaches to such patients were governed by their own misconceptions of mental illness and their fears of and prejudices toward the mentally ill. These misconceptions and feelings at times resulted not only in neglect but also in mistreatment of these patients. It was difficult, at times, for the untrained technician to see the patient as a sick person; rather, he might see him as a fellow soldier who was "goldbricking" to avoid his military duties.

The untrained technician might not be able to consider mental illness as an illness. Such technicians have been heard stating, in very derogatory tones: "He's not sick, he's just nuts."

On the other hand, it has been the experience of most workers in the field that many technicians, even without training or experience in psychiatric wards and techniques, provided good care and devoted many hours of their own time to the care of patients, even though they may not have understood the patient's behavior. It has also been the rule rather than the exception that once the technician became aware that the patient was indeed sick his attitude toward and treatment of the patient improved. Further, when the psychiatrist or the nurse was interested in teaching the technician psychiatric care, the technician almost invariably became very


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interested in the patients and sometimes became a dedicated person, making every effort to provide good care (figs. 58 through 63).

Experienced psychiatrists and psychiatric nurses made it a practice to set up and carry out an informal training program at their installations. Although some technicians voiced disbelief in some of the concepts taught, a change in attitude usually occurred within a few months, and many of these technicians not only gave good psychiatric care but also gave it with understanding and sincerity.

There is rather limited material available on the neuropsychiatric technician during World War II. Other subjects of more general interest occupied the limited time of authors in the related medical professions. Excerpts from annual and quarterly reports from various hospitals provide the only data.

ZONE OF INTERIOR

Assignment

In the Zone of Interior, while there was more formal training given, the rapid turnover in personnel in most hospitals meant that care was usually given by inexperienced personnel. As with nurses, there seemed

FIGURE 58.-Training chart showing materials and equipment used in the wetpack (wet cold sheet sedative pack). [From the film "Shades of Gray."]


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FIGURE 59.-Neuropsychiatric technicians preparing the bed for a patient to receive a wetpack. [From the film "Shades of Gray."]

FIGURE 60.-Neuropsychiatric technicians wrapping a patient in the wetpack. [From the film "Shades of Gray."]


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FIGURE 61.-Neuropsychiatric technicians securing the last blanket of a wet sheet pack. An icecap has been placed on the patient's head. [From the film "Shades of Gray."]

to be little effort to select men for this work with any regard for personal qualifications. In a number of station and general hospitals early in the war, the cadres of enlisted men sent into newly formed hospitals came from posts with divisions in training. These divisions would utilize the request for a cadre as an opportunity to transfer ineffective or undesirable soldiers. Not unknown was the practice of including in the cadre as many of the current prisoners in the stockade as possible within limits of respectability and table of organization requirements. When the cadre arrived at the new hospital, the best qualified men were placed on the surgical service while the least qualified were assigned to the neuropsychiatric service. These soldiers were quick to recognize that there were few valid distinctions between themselves and the patients. Because of a basic lack of adaptability, they gradually eliminated themselves. Excellent replacements were occasionally available by transfer from the patient population who were not able to do full field duty but were competent for "limited duty." At all times, the turnover was a problem.

Utilization and Training

An annual report1 from Battey General Hospital, Rome, Ga., stated:

Few of the enlisted personnel had any psychiatric or hospital training. With "A Guide for Attendants in Locked Wards" utilized as a textbook, this handicap was

1Annual Report, Battey General Hospital, 1945.


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FIGURE 62.-Neuropsychiatric technician assisting nurse with a patient in a "continuous tub." [From the film "Shades of Gray."]

overcome. Training films were shown to all groups as soon as they came on duty. These were found effective, but at all times constant direction, supervision, and explanation by the ward officer was considered paramount. Fear, prejudice, antagonism, carelessness, and a tendency to use unnecessary physical force had to be constantly combated.

At this general hospital, members of the WAC (Women's Army Corps) had 2 weeks' experience on the neuropsychiatric service as part of their medical training course. Many of them asked for assignments to the closed wards where they were utilized as nurses' assistants. They were also utilized in insulin therapy where their assistance was beneficial and they functioned quite intelligently.

The greatest problem at Mason General Hospital,2 Brentwood, Long Island, N.Y., was the constant turnover of enlisted men, necessitating constant classroom instruction and on-the-job training to inexperienced personnel. Along with this constant shortage of personnel, which was as high as 61 percent at times, the minimum of personnel safety requirements resulted in an increase in accidents and injury to both patients and personnel and seriously affected the general morale of these personnel (fig. 64).

At Darnall General Hospital,3 Danville, Ky., the ward attendants assigned had no previous experience and "were completely oblivious to psychiatric problems prior to their assignment here." Lectures, demonstrations, and on-the-job training were given to all men assigned, with

2Annual Reports, Mason General Hospital, 1944-45.

3Annual Reports, Darnall General Hospital, 1944-45.


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FIGURE 63.-Neuropsychiatric technician, watching the "continuous tub" patient, prevents dehydration by forcing liquids. [From the film "Shades of Gray."]

emphasis on concepts of mental illness and attitudes. It was believed that training was effective "as demonstrated by the devotion of the personnel to patients under their care." One difficulty here, besides the usual loss of trained men, was the frequent assignment of men not qualified. Men returned from overseas with psychoneuroses and other neuropsychiatric diagnoses, the emotionally unstable, and completely unfit were assigned for neuropsychiatric duty. It was necessary to discharge some of these men from the service on a CDD (certificate of disability for discharge). It was believed that such assignments were detrimental both to the welfare of the patients and to other personnel. Shortages at Darnall General Hospital were frequently due to the use of neuropsychiatric technicians as escorts for patients discharged to veterans' facilities or home, but unable to go under their own care. This use of technicians as escorts, however, occurred in most hospitals.

At Valley Forge General Hospital,4 Phoenixville, Pa., all enlisted men assigned were given careful orientation and supervised instruction on the ward with several "general talks" by the chief of neuropsychiatric service.

At Kennedy General Hospital,5 Memphis, Tenn., a neuropsychiatric school for enlisted men was organized in 1945 to train the wardmen in the proper care of neuropsychiatric patients. This was a local arrangement

4Annual Reports, Valley Forge General Hospital, 1944-45.

5Annual Report, Kennedy General Hospital, 1945.


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FIGURE 64.--Neuropsychiatric technician demonstrates one of the hazards of the neuropsychiatric ward. A patient has moistened the capsule medication and secreted it under his bedside table to take in one large dose as a possible suicidal attempt. [From the film "Shades of Gray."]

for men assigned and a total of 26 men completed the course which consisted of lectures, demonstrations, and on-the-job training.

The situation was much the same in other hospitals. Men who were trained were sent overseas and replaced by men new in the Army or by oversea returnees, many of whom were unsuitable or uninterested.

There is no record of any attempts being made to organize an authorized school for the neuropsychiatric technician. In view of the difficulty encountered in attempting to organize such a school for nurses, it is extremely doubtful if any such attempt for technicians would have been successful. However, after the cessation of hostilities, there seemed to be a greater awareness of the need for such training for technicians by the authorities, and a course for neuropsychiatric technicians was established at the Army Medical Service School at the Brooke Army Medical Center, Fort Sam Houston, Tex., in 1947.6

6This course has been revised over the years to keep up with standards and is still given several times a year to supply the constant demand for trained neuropsychiatric technicians in our Army hospitals.-C. R. R.


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OVERSEA THEATERS

In Hospitals

In oversea theaters, not only the care of the patients but also, at times, the physical facilities available for patients were dependent on the interest and ingenuity of the technicians. With a minimum of equipment in the hospitals, the enterprising and interested technician frequently increased the comfort of the patient by obtaining equipment from places unknown. In one situation in the Southwest Pacific Area, a technician obtained bomb crates for use as bedside tables and various native materials for the patients to utilize for occupational therapy.7

Training technicians depended on the particular situation and on the interest of the physicians and nurses in such training.

In the author's situation in the Southwest Pacific Area, it was on an individual basis because there was usually only one technician assigned to the ward. Some hospitals set up formal programs, as is indicated in the reports which follow.

The 18th Station Hospital8 in the Southwest Pacific Area gave a 6-week course in the understanding and care of psychiatric cases to all enlisted men whose duties involved contact with patients. The course was concluded with a written examination and was repeated as necessary when new men were assigned.

The 51st General Hospital,9 also in the Southwest Pacific Area, reported that this hospital was fortunate in that "our ward men for the most part are experienced and are doing an excellent job." Here, too, lectures were given on psychiatric disorders and therapeutic procedures with emphasis on the technician and his role in the therapeutic regimen.

The 116th Station Hospital,10 in the European theater, gave two lectures a week on psychiatric nursing as part of the routine training for all enlisted personnel during June 1944.

There is no indication of training in the reports of hospitals in other theaters, but it seems that the neuropsychiatric technicians, despite severe shortages in some cases, did a good job.

The 96th General Hospital (NP),11 in England, reported that the wardmen on the whole did a very excellent job but that the number of ward attendants was not sufficient for the number of patients.

In the 30th General Hospital,12 in Belgium, the "ward personnel * * *

7Additional information concerning the neuropsychiatric technicians is contained in "Medical Department, United States Army. Neuropsychiatry in World War II. Volume II. Oversea Theaters." [In preparation.]

8Quarterly Report, 18th Station Hospital, 1 July-30 Sept. 1944.
9Quarterly Report, 51st General Hospital, 1 Oct.-31 Dec. 1944.

10Annual Report, 116th Station Hospital, 1944.
11Annual Report, 96th General Hospital (NP), 1944.
12Annual Report, 30th General Hospital, 1945.


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did very good work in the management of the ward and in the supervision of outdoor activities."

The 262d Station Hospital,13 in the Mediterranean theater, stated that there were six wardmen with previous experience and the rest developed such experience on the neuropsychiatric section.

In Iceland, at the 92d Station Hospital,14 with one closed and one open ward, there were nine technicians assigned but there was always a rapid turnover and very few men were trained but some had a little experience. There was "some slight inservice training here but no real course for wardmen."

In Divisions

The experiences of division psychiatrists15 who utilized psychiatric technicians in the neuropsychiatric treatment centers located in the clearing companies of divisions were perhaps not nearly so unfavorable as has previously been described. Undoubtedly, the realistic surroundings of the combat zone and the identification with combat psychiatric casualties which could readily be established created conditions for high motivation and superior performance of the psychiatric technician. Almost invariably, the psychiatrists were given technicians who had little or no previous experience with psychiatric patients. Either they were general medical corpsmen or were selected from patients who had recovered from wounds or disease. These men, however, rapidly learned to handle psychiatric problems. They came to understand what was occurring to the trembling, apprehensive soldier who displayed a startled reaction at slight noises, or who sat and stared bemused with his traumatic combat experience, and had to be urged to speak and take part in recreational activities.

In the main, the psychiatric technicians were readily indoctrinated to assume a firm but sympathetic manner with psychiatric casualties. They became invaluable observers for the division psychiatrists in noting disturbances in eating, sleeping, and sociability, and in general behavioral abnormalities. The psychiatric technicians also became effective in "scrounging" for supplies, in arranging ingenious substitutes for showers and feeding utensils, and in providing diversionary activities. The psychiatric technicians worked closely with the division psychiatrist and learned quickly by doing and by example, to become identified with the goals of rapid and forward psychiatric treatment. They took the initiative in supervising recreational and reconditioning activities. In time, some of the psychiatric technicians were utilized as assistants in the employment of catharsis induced by barbiturates. They learned to be good listeners

13Annual Report, 262d Station Hospital, 1944.

14Annual Report, 92d Station Hospital, 1944.
15This section is based on information furnished by Col. Albert J. Glass, MC, USA (Ret).


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as the patients related accounts of their combat experiences, permitting them to ventilate without making value judgments.

One can say in summary that the division psychiatrist faced with the problem of handling large numbers of terrified, anxious patients leaned heavily upon his enlisted aids who quickly perceived their role with the support and approval of the psychiatrist. Thus, the psychiatric technicians became indispensable members of the treatment team which sought to aid the sick soldier regain emotional composure and motivation for return to combat duty from a forward treatment site.

SUMMARY

Psychiatry was "the Cinderella of military medicine" in World War II, and the neuropsychiatric technician was one of its many "forgotten men." Again and again, it becomes evident that although the recruitment, classification, and assignment of psychiatric personnel in general was not adequately planned, there was a need for properly trained personnel. The civilian experiences of the psychiatrists and psychiatric nurses, the prewar drives for better mental care, and, no doubt, the "selfish" desire of these more experienced people to have their personal burdens of mental patient responsibilities eased prompted the almost universal attempt to train ward attendants to become more efficient neuropsychiatric technicians. There is no doubt that this succeeded to a great extent and that this success in military hospitals established a trend in civil mental hospitals after the war that materially improved this and other levels of mental care in all hospitals and institutions.

Section II. Psychology Technicians

Morton A. Seidenfeld, Ph. D.

SELECTION

Hundreds of men and women serving in the enlisted ranks were pressed into neuropsychiatric services and sections as psychology technicians (psychology assistants). They made remarkable and worthy contributions to the clinical psychology program of the Army. It is indeed unfortunate that, just as for other activities and services carried during the peak pressures of a war, almost nothing was recorded regarding these willing and able workers.

The use of enlisted psychology technicians initially appeared to have developed largely as a matter of expediency. Hospital commanders, on request, often permitted their chiefs of neuropsychiatry to make use of


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selected enlisted personnel in carrying out services which were badly needed and for which experienced professionals were not available.

One of such services which was always lacking enough trained workers was, of course, clinical psychology. Like psychiatry, clinical psychology suffered markedly from an inability to procure enough trained people, and even when minimal standards were applied so as to increase the number of men available for training, the time required to prepare workers before they could be sent to the treatment installations was generally far too long to serve the demands that already existed.

It is not surprising then that harassed and overburdened psychiatrists with only one and more often no trained clinical psychologists, but with a definite feeling of need for the services which the psychologist could render, requested permission to search for the best available enlisted personnel to assume some of this responsibility, at least until qualified professionals were made available.

Let it be said at once that, although the psychology technician may have come into being as a matter of expediency, the services rendered were generally of the highest order. As a rule, these workers were selected only after a review of personnel records of the command in order to locate by military occupational specialty classification and educational records those individuals who had at least a baccalaureate degree in psychology or whose training and experiences were weighted with a preponderant amount of psychological background. Thus, those who had majored in psychology in undergraduate colleges, those who had worked in the fields of personal or educational activities, and the like were most frequently selected. Occasionally, when people with even such limited backgrounds were not available, a further compromise was made in the direction of taking the most intelligent and trainable persons for the job.

TRAINING

The training of the psychology technician on the job was, like his selection, often a matter of expediency. Generally, the psychiatric staff, including the psychiatrist, clinical psychologist, and social worker (to whatever extent they were represented at a given installation), did the training. This varied in every situation, extending from a few hours of orientation on how to give the more simple individual tests and record the observations made, to rather detailed courses running for an hour or two daily, for a period of several weeks. These more elaborate courses covered most of the important elements of clinical testing, counseling, group psychotherapy, and other matters of clinical importance.

Here again, one cannot but be impressed at the degree to which these young enlisted workers took to the training, at the interest and effort they exhibited in mastering the more formal aspects of the training, and at the alacrity they demonstrated in learning how to apply their formal training


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to the practical problems presented by their patients on the wards. Not all the psychology technicians were expert on their job, but a very high percentage of them did succeed so well in what was expected of them that both psychiatrists and clinical psychologists, working with them, have repeatedly commented upon their outstanding contribution.

It is worthy of note that it was not solely the rapidity and the effective manner in which these psychology technicians applied the briefly taught psychological skills that was such a great contribution. There was an equally great if not greater value that accrued from utilizing these psychology technicians. These workers, being out of the rank and file of enlisted personnel, very often engendered confidence and removed the resistance of the patient to the authoritarian concept that many soldiers had toward the officer, be he psychologist or psychiatrist. There was an easily established empathy that often seemed to work to the advantage of all, and by the time the enlisted technician had established his rapport with the patient, he opened the way for members of the medical teams to do a more effective job.

It is of interest to repeat here that 346 enlisted men in the Army who met the proper professional and military qualifications in force at the time were directly commissioned as second lieutenants and assigned to clinical psychology. Later, the ever-present need for more clinical psychologists resulted in the appointment of WAC enlisted women to officer status in this field (p. 576).

SUMMARY

Though the psychology technician was born of necessity, the program of the future should contemplate the continued use of such enlisted personnel. If better trained and with a role more clearly defined, they can indeed be utilized to increase the extent of psychological services offered. They can also be of great value in therapeutic situations that otherwise might be less effectively met when initial contacts are threatened by the officer-enlisted man's barrier.

Section III. Psychiatric Social Work Technician

Myron J. Rockmore, M.A.

NEED FOR TECHNICIANS

The historical development of the role of psychiatric social work has been well chronicled in chapter XX.

The development of the technician category originated out of program needs at a time when the military psychiatric social worker was demon-


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strating his importance to the function of psychiatric services in the military organization. It has been implied in the documentation in chapter XX that there was a lag between the operational demonstration of these services and their incorporation into Army-wide regulations. For example, at Fort Monmouth, N.J., a classification clinic was organized (p. 610) in which the function of the military psychiatric social worker was established.16 This civilian specialization was not incorporated officially into Army administrative structure until 23 August 1943 when SSN (Specification Serial Number) 263 was established. During this interval, considerable clinical experience was amassed.

With the establishment of the Classification Clinic, the Adjutant General's Office, on 20 April 1942, requested that it furnish periodic reports of its service. A report covering the first 5 months of the work of the clinic received Army-wide distribution and a commendation from Col. Patrick S. Madigan, MC. This was before the appointment of Col. Roy D. Halloran, MC, as chief of the Neuropsychiatry Branch in the Surgeon General's Office. In a report of his inspection of the Fort Monmouth mental hygiene unit on 9 December 1942, Colonel Halloran said: "It is to be noted that the psychiatric social worker was not listed in the Adjutant General's occupational listing. Since such workers are fundamental to the functioning of this unit, the need for formal recognition of this profession was indicated and provisions made for giving some workers ratings and commissions." Colonel Halloran further reported "* * * the Unit was willing and able to train a certain number of psychiatric social workers for use elsewhere * * * that the training period should not be less than 6 weeks."

QUALIFICATIONS

This impetus stimulated the professional civilian-trained social workers in the Fort Monmouth unit to submit a "Suggested Outline and Considerations for a Training Program for Military Psychiatric Social Workers," dated 8 July 1943. It was recognized that the identification of civilian social workers by SSN 263 would include a wide variety of training and experience which would require additional orientation to the military setting before effective performance could be expected. The original specification for this enlisted classification required "a graduate degree in social work from a recognized school of social work or at least 2 years' supervised experience in social work activities in a private or public agency." In practice, personnel were identified in various installations as qualifying for the specification who could not be expected to carry the degree of responsibility expected from a professionally trained person. Nevertheless, the urgency of the need to utilize assigned persons for

16Freedman, H. L.: The Unique Structure and Function of the Mental-Hygiene Unit in the Army. Ment. Hyg. 27: 608-653, October 1943.


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expanding functions demanded an analysis of the job content so that further delegation of partialized responsibility would make maximum use of skilled manpower.

This was dramatically illustrated when, on 20 October 1943, five psychiatric social workers were ordered to the relatively new military installation, "The Reconditioning Facility," at Thomas M. England General Hospital, Atlantic City, N.J., to assist in the development of a program for the reconditioning of neuropsychiatric casualties.17 In the complexity of this installation, many duties and responsibilities were delineated which did not require professional training. It was further recognized that the unique conception of supervision, which is highly developed in professional social work training and civilian practice, was an adequate safeguard in allocating responsibilities to nonprofessionally trained social workers.

The conception of supervision in the social work context underscored not only the administrative responsibility of the supervisor but also highlighted his additional responsibility for the educational growth and development of the worker in his charge. Professional social work training has carefully conceived this role as the basis of its fieldwork instruction. Accordingly, it was possible through job analysis to extend the skill of the military psychiatric social worker through the assignment of "The

FIGURE 65.-Intake interview by a psychiatric social worker assistant, who had been a patient himself but upon recovery was found to have sufficient background to be reassigned to his present duties. [From the film "Shades of Glory."]

17Freedman, H. L.: The Mental-Hygiene-Unit Approach to Reconditioning Neuropsychiatric Casualties. Ment. Hyg. 29: 269-302, April 1945.


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Technician." Numbers of military installations were staffed by one professionally trained social worker who was able under supervision to select and train technicians to render service of a high qualitative order18 (fig. 65). This move was perhaps accelerated by the issuance, on 29 February 1944, of War Department Circular No. 90, relating to the procurement of female technicians, which undercut the graduate school requirements of SSN 263.

As the Army committed more troops to combat and as the manpower needs became more urgent, reconditioning facilities expanded. Concurrently, the need for specialized personnel, technically trained to service and administer programs, expanded. The effectiveness of the military psychiatric social work technician was recognized further as the psychiatric social worker achieved an officer classification (MOS 3605).

The effectiveness of this category of nonprofessional personnel was governed by four major variables, as follows: (1) Competent supervision by professionally trained social work personnel, (2) proper selection of the person to be trained, (3) training content and practice, and (4) assignment experience.

TRAINING

Selection

The graduate schools of social work have developed certain criteria19 which are used in selecting candidates for admission to their programs. These criteria have also been utilized in selecting personnel in large public agencies, and the methods of selection were found to have validity.20 The cornerstone of this selective process is the interview conducted by a trained person who has some orientation to the method his profession has developed. Through the interview method, it is possible to elicit material in a variety of areas which reflects the candidate's personality in action. Some of these are related to warmth and responsiveness, sensitivity, judgment and discrimination, and subjectivity-objectivity; psychological mindedness, that is, insight into himself and empathy with others; work capacity; and recreational and cultural interests. This personality complex of factors in a person who has the intellectual capability to conceptualize is primary in the selection of technician trainees.

Curriculum

Essential to the performance of the social work technician is successful

18Greving, F. T., and Rockmore, M. J.: Psychiatric Casework as a Military Service. Ment. Hyg. 29: 435-506, July 1945.

19Berengarten, Sidney: Pilot Study: Criteria in Selection for Social Work. In Social Work as Human Relations. New York: Columbia University Press, 1949, pp. 170-195.
20U.S. Department of Health, Education, and Welfare, Social Security Administration, Children's Bureau: Interviewing for Staff Selection in Public Welfare. Children's Bureau Publication No. 355-1956. Washington: U.S. Government Printing Office, 1956.


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completion of basic military training. Without this, one cannot expect acceptance of the Army's purpose and administrative structure which is so necessary to assist soldiers with problems of adjustment to the military environmental demands. Selection of the candidate should take place during this initial period and should be followed by a carefully developed inservice curriculum. The content should be geared to a specific Army mission with the emphasis of practical application of theoretical content. Subject matter should be taught both didactically and in seminar, concurrently, with supervised fieldwork. The following suggested material might be included:

1. A historic survey of neuropsychiatric services in the Army.

    a. Emphasis of military necessity of these services.

    b. Growth and development of outpatient military psychiatry.

2. Army administration and regulations pertaining to-

    a. Mental health of troops as a command function.

    b. Classification and assignment.

    c. Articles of War.

    d. Plans and training.

    e. Medical Services.

    f. Induction and separation.

    g. Others pertinent to prevention and control of military behavioral maladjustment.

3. The concept of the "Clinical Team" and its operation in a variety of military installations.

4. Neuropsychiatric problems in relation to Army adjustment emphasizing-

    a. Survey of common psychopathology.

    b. Symptomatic causes and effect in combat and noncombat areas.

    c. Analysis of dynamic factors in military life and environment and their behavioral implications (everyday psychopathology of everyday Army life!).

5. Interrelationships between psychiatric and other Army community resources:

    a. Use of military channels.

    b. Methods and purpose of interpretation (Public Relations).

6. The interview as a helping process.

7. Case seminars.

8. Fieldwork supervision.

The time allotted to the topics as well as the content may vary depending upon the academic level of the group. Fieldwork should begin by the end of the second week with the case seminars utilizing this content for integrating theory and practice. In 6 to 8 weeks, through joint evaluation of the instructional staff, there should be sufficient knowledge of the trainee to predict his capacity to continue to profit from supervision in an assignment in an installation.


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ASSIGNMENT

The mission of the specific installation to which the technician is assigned will have a bearing on the extent to which his beginning skills will be used. The function of the specific psychiatric service and the availability of professionally trained and untrained personnel in relation to the demands for service will also be a factor. The quality of the supervision and the readiness to assign the technician to increasing responsibility which will tax his potential is vital. The type of personnel required for assignment must show increasing skill with experience under supervision or reassignment is indicated.

The initial technicians' assignments should be designed to familiarize them with the function of the specific psychiatric service and its relationship with the installation. This can best be done through such assignments as reception work, duty with regard to clinical records, data collection, liaison with other sections, and escort duty. This should acquaint the technicians with the flow of cases through the service and establish the relatedness of the service to other segments of the installation. It will also serve as orientation to the problems to which the service addresses itself and some of the variety of case dispositions. Simultaneously, the supervisor should be developing an individualized appreciation of his technician through observation and performance. In this fashion, the timing toward increased use of the technician for special or general interviewing can be gaged. Regularly scheduled conferences with the technician should extend his training, evaluate his progress, and show the pace at which increased responsibility or broadening duties can be assumed.

The closing of the war aborted plans for proposed training centers for military psychiatric social workers and technicians. Training centers were planned on the east and west coasts for simple deployment. The basic experience was, however, carefully noted and subsequently assimilated within the Army administrative structure. It was recognized that civilian professionally trained psychiatric social workers needed a period of training to adapt their civilian skills to the military setting and also that a course of instruction could develop a technically proficient category of personnel to assist the psychiatric social work officer in the discharge of his duties.21

21The implementation of these principles was contained in the "Program of Instruction for Psychiatric Social Workers Course," 15 September 1947, at the Medical Field Service School, Brooke Army Medical Center, Fort Sam Houston, Tex.-M. J. R.

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