This thoughtful, compassionate book makes a major contribution to our understanding of the Southern Appalachian child—his mental disorders and his adaptive strengths. Drawing upon his extensive fieldwork as a clinical child psychiatrist in Eastern Kentucky, Dr. Looff suggests means by which these children can be helped to bridge the gap between their subculture and the mainstream of American life today. The children described in this book, the author points out, are in a real sense not "all children." Since no child grows up in a vacuum, the children of Eastern Kentucky cannot be understood apart from the historical, geographic, and socioeconomic characteristics of the area in which they grow. Knowledge of the children requires some knowledge of the lives of parent, teachers, and the many others upon whom they are dependent. That is to say, mental disorder—or mental health—is embedded in a social matrix. Dr. Looff therefore examines the milieu of these Southern Appalachian children, their future as adults, and how they can achieve their potential—whether in their native or an urban setting. In viewing the children within their own cultural framework, Dr. Looff shows how they develop toward mental health or psychopathology, suggesting supportive techniques that build upon the strengths inherent in each child. These strengths, he suggests, rise out of the same culture that burdens the child with handicaps. Dr. Looff's position is one of guarded optimism, based on the successes of the techniques he has used and observed in seven years of work in Appalachian field clinics. Although he details instances of mental disorder in children, and instances of failure in family functioning, he notes at the same time family strengths and sees these strengths as sources of hope. Although this book is based on fieldwork techniques within a specific area and culture, it is paradigmatically suggestive of wider application. Dr. Looff demonstrates effectively and clearly the profound need for increased concern about what is happening to the rising generation—the children of Eastern Kentucky, the children of the Southern Appalachian region, and the children of the rural south.

This volume is the first to explore broadly many important theoretical and applied issues concerning the mental health of Appalachians. The authors—anthropologists, psychologists, social workers and others—overturn many assumptions held by earlier writers, who have tended to see Appalachia and its people as being dominated by a culture of poverty. While the heterogeneity of the region is acknowledged in the diversity of sub-areas and populations discussed, dominant themes emerge concerning Appalachia as a whole. The result of the authors' varied approaches is a cumulative portrait of a strong regional culture with native support systems based on family, community, and religion. Some of the contributors examine therapeutic approaches, including family therapy, that consider the implications of the cultural context. Others explore the impact of Appalachian culture on the impact of Appalachian culture on the development of mental health problems and coping skills and the resulting potential for conflict between Appalachian clients and non-Appalachian health providers. Still others examine cultural considerations in therapeutic encounters and mental health service delivery. The book is rich in case studies and empirical data. The practical, applied nature of the essays will enhance their value for practitioners seeking ways to improve mental health care in the region.

Health and human service practitioners who work in Appalachia know that the typical “textbook” methods for dealing with clients often have little relevance in the context of Appalachian culture. Despite confronting behavior and values different from those of mainstream America, these professionals may be instructed to follow organizational mandates that are ineffective in mountain communities, subsequently drawing criticism from their clients for practices that are deemed insensitive or controversial. In Appalachian Cultural Competency, Susan E. Keefe has assembled fifteen essays by a multidisciplinary set of scholars and professionals, many nationally renowned for their work in the field of Appalachian studies. Together, these authors argue for the development of a cultural model of practice based on respect for local knowledge, the value of community diversity, and collaboration between professionals and local communities, groups, and individuals. The essays address issues of both practical and theoretical interest, from understanding rural mountain speech to tailoring mental health therapies for Appalachian clients. Other topics include employee assistance programs for Appalachian working-class women, ways of promoting wellness among the Eastern Cherokees, and understanding Appalachian death practices.Keefe advocates an approach to delivering health and social services that both acknowledges and responds to regional differences without casting judgments or creating damaging stereotypes and hierarchies. Often, she observes, the “reflexive” approach she advocates runs counter to formal professional training that is more suited to urban and non-Appalachian contexts. Health care professionals, mental health therapists, social workers, ministers, and others in social services will benefit from the specific cultural knowledge offered by contributors, illustrated by case studies in a myriad of fields and situations. Grounded in real, tested strategies—and illustrated clearly through the authors’ experiences—Appalachian Cultural Competency is an invaluable sourcebook, stressing the importance of cultural understanding between professionals and the Appalachian people they serve.

In 1964 President Lyndon Johnson traveled to Kentucky's Martin County to declare war on poverty. The following year he signed the Appalachian Regional Development Act,creating a state-federal partnership to improve the region's economic prospects through better job opportunities, improved human capital, and enhanced transportation. As the focal point of domestic antipoverty efforts, Appalachia took on special symbolic as well as economic importance. Nearly half a century later, what are the results? Appalachian Legacy provides the answers. Led by James P. Ziliak, prominent economists and demographers map out the region's current status. They explore important questions, including how has Appalachia fared since the signing of ARDA in 1965? How does it now compare to the nation as a whole in key categories such as education, employment, and health? Was ARDA an effective place-based policy for ameliorating hardship in a troubled region, or is Appalachia stillmired in a poverty trap? And what lessons can we draw from the Appalachian experience? In addition to providing the reports of important research to help analysts, policymakers, scholars, and regional experts discern what works in fighting poverty, Appalachian Legacy is an important contribution to the economic history of the eastern United States.

In this collection of fourteen essays, scholars of Appalachian culture and society examine how the people contend with and adapt to the pressures of change thrust upon them. Appalachia and America will appeal to a broad range of people interested in the southern mountains or in the policy issues of social welfare. It deals cogently with the newest form of conflict affecting not only communities in Appalachia, but urban and rural communities in America at large—the struggle for local values and ways of life in the face of distant and powerful bureaucracies.

This book summarizes and integrates theory and research on adolescents from a diversity of ethnic, economic, and geographic contexts. The book aims to present a more balanced picture of these understudied and misunderstood adolescents by focusing on positive, healthy development.