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Morrison-Valfre’s

FOUNDATIONS of
MENTAL HEALTH CARE
in CANADA
This page intentionally left blank

     
Morrison-Valfre’s

FOUNDATIONS of
MENTAL HEALTH CARE
in CANADA
CANADIAN AUTHORS US AUTHOR

Boris Bard, RN, MSc, ACMHN Michelle Morrison-Valfre, RN, BSN,

Manager, Neurology Service MSN, FNP
Health Care Educator/Consultant
University Health Network Health and Educational Consultants
Toronto, Ontario Forest Grove, Oregon

Eric MacMullin, RN, MSN

Professor
Bridging to University Nursing Program
School of Community and Health Studies
Centennial College
Toronto, Ontario

Jacqueline Williamson, RN, MEd, PhD

Professor
Practical Nursing Program
School of Health and Community Services
Durham College
Oshawa, Ontario
MORRISON-VALFRE’S FOUNDATIONS OF MENTAL HEALTH CARE
IN CANADA ISBN: 978-1-77172-233-9
Copyright © 2022 by Elsevier, Inc. All rights reserved.

Adapted from Foundations of Mental Health Care, Sixth Edition, by Michelle Morrison-Valfre,
Copyright © 2017, by Elsevier, Inc.

978-0-323-35492-9 (softcover)

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval
system, without permission in writing from the publisher. Reproducing passages from this book without such
written permission is an infringement of copyright law.

Requests for permission to make copies of any part of the work should be mailed to: College Licensing Offi-
cer, access ©, 1 Yonge Street, Suite 1900, Toronto, ON M5E 1E5. Fax: (416) 868-1621. All other inquiries should
be directed to the publisher, www.elsevier.com/permissions.

Every reasonable effort has been made to acquire permission for copyrighted material used in this text and to
acknowledge all such indebtedness accurately. Any errors and omissions called to the publisher’s attention will
be corrected in future printings.

This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).

Notice

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds or experiments described herein. Because of rapid advances
in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be
made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or con-
tributors for any injury and/or damage to persons or property as a matter of products liability, negligence
or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in
the material herein.

Library of Congress Control Number: 2020947856

VP, Education Content: Kevonne Holloway

Content Strategist (Acquisitions, Canada): Roberta A. Spinosa-Millman
Director, Content Development: Laurie Gower
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Publishing Services Manager: Catherine Jackson
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Design Direction: Bridget Hoette

Last digit is the print number: 9 8 7 6 5 4 3 2 1

 To my wife, Kira Bard, who always loves and supports me.
To the memory of 6 million Jewish victims of the Holocaust and the memory of
the Righteous Among the Nations who helped some to survive, leading, among
other things, to the new edition of this book.
Boris Bard

To my family, Rita, Bob, Rose, Colin, Linda, and Shirley for a lifetime
of support and encouragement. Special thanks to Chris Gray just for
being there and more thanks than I have words to express to my mentor
and friend, Professor Jonathon Bradshaw.
Eric MacMullin

To my beloved husband, Adolph; my cherished friend Marian

McCollum; and to you, dear reader.
May you leave this book richer in the knowledge of human behaviour.
Michelle Morrison-Valfre
This page intentionally left blank

     
 REVIEWERS

Sharon Clegg, BSc(PT) Kelly McNaught, RN, MN

Physiotherapist Nursing Faculty
Faculty of Physiotherapy Technology Nursing Education and Health Studies
Dawson College Grande Prairie Regional College
Montreal, Quebec Grande Prairie, Alberta

John Collins, PhD, MA, Dip. Ed(NT), BA(Hons), DPSN, Holldrid Odreman, RN, MScN-Ed, PhD
CMS(dist.), RN, RPN Professor of Nursing
President/CEO, John Collins Consulting Inc. School of Nursing
Instructor, BSN Program Niagara College
Vancouver Community College Welland, Ontario
Vancouver, British Columbia
Kathlyn Palafox, BSN, BCPID
Cheryl Derry, RN, CAE Practical Nursing Program Coordinator
Instructor, Practical Nursing Secondary Senior Educational Administrator
School of Health and Human Services Canadian Health Care Academy
Assiniboine Community College Surrey, British Columbia
Brandon, Manitoba
Angela Rintoul, NP, MN-ANP
Thomas Gantert, RN, MBA, PhD Coordinator
Professor of Nursing Bachelor of Science in Nursing Program
Fanshawe College Algonquin College
London, Ontario Pembroke, Ontario

Treva Job, RN, PHCNP, RN(EC), MEd, PhD(c)

Professor
Faculty of Nursing
Georgian College
Barrie, Ontario

Eric MacMullin, RN, MSN

Professor
Bridging to University Nursing Program
School of Community and Health Studies
Centennial College
Toronto, Ontario

vii
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 TO T H E I N ST RU C TOR

Morrison-Valfre’s Foundations of Mental Health Care in Unit IV, Patients With Psychological Problems, explores
Canada, first edition, is intended for students and practition- common behavioural responses and therapeutic interven-
ers of the health care professions. Basic and advanced learn- tions for illness, hospitalization, loss, grief, and depression.
ers will find the information in this text useful and easy to Maladaptive behaviours and mental health disorders are
apply in a variety of practice settings. Students in fields such described in chapters on somatoform, anxiety, eating, sleep-
as nursing, social work, respiratory therapy, physiotherapy, ing, mood, sexual, and dissociative disorders.
recreational therapy, occupational therapy, rehabilitation, The chapters in Unit V, Patients With Psychosocial
and medical assisting will find concise explanations of adapt- Problems, relate to the important social concerns of anger
ive and maladaptive human behaviours, as well as the most (and its expressions), suicide, abuse and neglect, acquired
current therapeutic interventions and treatments. immunodeficiency syndrome (AIDS), and substance use.
Practising health care providers—all who care for patients Sexual and personality disorders are also discussed. Chapters
in a therapeutic manner—will find this book a practical and on schizophrenia and chronic mental illness focus on a multi-
useful guide in any health care setting. disciplinary approach to treatment. The text concludes with
At its core, this text has three main goals: a chapter titled “Challenges for the Future,” which prepares
1. To help soften the social distinction between mental students for the coming changes in mental health care.
“health” and mental “illness”
2. To assist all health care providers in comfortably work-
ing with patients who exhibit a wide range of maladaptive
STANDARD FEATURES
behaviours • Several key features are repeated throughout the text:
3. To apply the concepts of holistic care when assisting Objectives stated in specific terms and a list of Key Terms
patients in developing more adaptive attitudes and behav- (most with pronunciations) and page numbers.
iours • The nursing process is applied to specific mental health
Unit I, Mental Health Care: Past and Present, provides a challenges throughout the text, with emphasis on multi-
framework for understanding mental health care. The evolu- disciplinary care. This helps readers understand the inter-
tion of care for persons with mental challenges from primitive actions of several health care disciplines and determine
to current times is described. Selected ethical, legal, social, where they fit in the overall scheme of managed care.
and cultural issues relating to mental health care are explored. • A continuum of responses describes the range of behav-
Community mental health care is explained, followed by iours associated with each topic.
chapters pertaining to theories of mental illness and comple- • Development throughout the life cycle relates to the
mentary and alternative therapies. A chapter on psychothera- aspect of each personality being studied.
peutic medication therapy ends the unit. • Clinical disorders include behavioural signs and symp-
Unit II, The Caregiver’s Therapeutic Skills, focuses on toms based on the DSM-5.
the skills and conditions necessary for working with patients. • Therapeutic interventions include multidisciplinary treat-
Eight principles of mental health care are discussed and then ment, medical management, application of the nursing pro-
applied to the therapeutic environment, the helping rela- cess, and pharmacological therapy.
tionship, and effective communications. Material devoted • Each chapter concludes with Key Points that serve as a
to self-awareness encourages readers to develop introspec- useful review of the chapter’s concepts.
tion—a necessary component for working with people who
have behavioural difficulties. Readers explore common basic
human needs, personality development, stress, anxiety, crisis,
FEATURES OF THE FIRST CANADIAN EDITION
and coping behaviours. The section concludes with a descrip- The First Canadian Edition builds on the work of the venerable
tion of the basic mental health assessment skills needed by US-based text. Information specific to Canada and Canadian
every health care provider. research, programs, and practices has been included, giving
The patients for whom we care are the subject of Unit III, readers a current and clinically relevant perspective on the
Mental Health Challenges Across the Lifespan, which focuses state of mental health care in Canada.
on the growth of “normal” (adaptive) mental health behaviours Throughout the text, a focus on the Canadian health care
during each developmental stage. The most common mental system and the influence of the Canada Health Act have been
health challenges associated with children, adolescents, adults, maintained. Medications referenced are currently used and
and older persons are discussed using the Diagnostic and available in Canada.
Statistical Manual of Mental Disorders (DSM-5) as a frame- Where applicable, DSM-IV diagnoses and references from
work. A chapter on dementia and Alzheimer’s disease discusses the American Psychiatric Association have been updated to
the care of patients who have cognitive impairments. the current DSM-5.

ix
x TO THE INSTRUCTOR

Increased attention to Indigenous health and healing prac- • Th

 e holistic approach to care offers readers a view of the
tices has also been included, along with expanded exploration “whole person” context of health care delivery.
of other vulnerable populations in Canada. • NEW Critical Thinking Questions at the end of each
An appendix featuring the Canadian Standards for chapter encourage students to reflect on specific topics
Psychiatric-Mental Health Nursing, from the Canadian and scenarios, develop problem-solving skills, and con-
Federation of Mental Health Nurses, has been added to the sider how they might address current health care issues in
end of the book for student reference. practice. Suggested Answers to these questions, to guide
The authors have worked from the perspective that men- class discussion, are found on the Evolve website.
tal health and addiction disorders are primarily chronic and • References encourage further exploration of the topics
genetic, setting treatment goals to maximum recovery as presented in the chapter. For easy access, the references are
opposed to curative. found at the end of each chapter in the book.
• The Glossary of Key Terms, written in an easy-to-under-
stand format, follows the text and is also available on the
LEARNING AIDS Evolve website.
Because the majority of mental health care takes place outside
the institution, the book emphasizes the importance of using ANCILLARIES
therapeutic mental health interventions during every patient
interaction. The following features encourage the reader’s For Instructors
understanding and are designed to foster effective learning We recognize that educators today have limited time to pre-
and comprehension: pare for classroom and clinical activities. Therefore we provide
• The two-colour design stimulates learning and calls atten- a rich collection of supplemental resources for instruct-
tion to the important terms and concepts within the text. ors within the Evolve Resources with TEACH Instructor
• Selected Key Terms with phonetic pronunciations and a Resource, including:
specific page reference to where the term can be found are • TEACH Lesson Plans, based on textbook learning object-
listed at the beginning of each chapter, and each Key Term ives and providing a roadmap to link and integrate all
appears in colour at the first or most detailed mention in the parts of the educational package. These straightforward
text. Complete definitions are located in the Glossary. Terms lesson plans can be modified or combined to meet your
with phonetic pronunciations were selected because they are unique teaching needs.
either (1) difficult medical, nursing, or scientific terms or (2) • PowerPoint Presentations, including approximately
words that may be difficult for students to pronounce. 800 slides with i-clicker questions and talking points for
• Throughout the text, cultural aspects of various mental instructors.
health principles are explored in Cultural Considerations • ExamView Test Bank, with more than 800 multiple-choice
boxes to encourage further thought and discussion. and alternate-format examination-style questions. Each
• Critical Thinking boxes pose questions designed to question provides the correct answer, rationale, topic,
stimulate critical thinking. client need category, step of the nursing process, objective,
• Case Studies with thought-provoking questions encour- and cognitive level.
age readers to consider the psychosocial aspects of pro- • Open-Book Quizzes for each chapter in the textbook,
viding therapeutic care in both community and hospital with separate answer guidelines.
settings. • Suggested Answers to the Textbook Critical Thinking
• Medication Alert boxes prepare readers for the com- Exercises offer instructor guidance for classroom discus-
plexity of therapy with psychotherapeutic medications, sion about the Critical Thinking Questions found at the
including identifying drug interactions and potentially end of each chapter.
life-threatening side effects. • Answer Key to the Study Guide.
• Descriptions of each mental health disorder are drawn
from DSM-5 criteria. For Students
• Multidisciplinary Sample Patient Care Plans demonstrate In the Student Resources section of the Evolve website, there
the application of the therapeutic (nursing) process to the are more than 300 Review Questions with rationales for both
care of individuals with various mental health disorders. correct and incorrect responses; an accompanying online
• Nursing diagnoses are stated in multidisciplinary terms Study Guide; Suggested Answers to the in-text Critical
within a holistic framework. Thinking Questions; and an Audio Glossary.
 TO THE STUDENT

Critical Thinking Boxes contain thought-provoking scenar-

READING AND REVIEW TOOLS ios and critical thinking questions.
Objectives introduce the chapter topics.
Cultural Considerations address the mental health needs of
Key Terms are listed with page number references, and culturally diverse patients.
selected difficult medical, nursing, or scientific terms are
accompanied by simple phonetic pronunciations. Key terms Medication Alert boxes identify the risks and possible
are considered essential to understanding chapter content adverse reactions of psychotherapeutic medications.
and are defined within the chapter. Key terms are boldfaced in
the narrative and are briefly defined in the text, with complete Sample Patient Care Plans are multidisciplinary and address
definitions in the Glossary. how members of the health care team work collaboratively to
meet patient needs.
Each chapter ends with (1) Key Points that reiterate the chap-
ter objectives and serve as a useful review of concepts, (2)
Additional Learning Resources, and (3) Critical Thinking
EVOLVE RESOURCES
Questions. Be sure to visit your textbook’s Evolve website (http://evolve.
elsevier.com/Canada/Morrison-Valfre/) for a Study Guide, an
Complete References at the end of each chapter cite evi- Audio Glossary, Review Questions, and more!
dence-informed information and provide resources for
enhancing knowledge.

CHAPTER FEATURES
Case Studies contain critical thinking questions to help you
develop problem-solving skills.

xi
This page intentionally left blank

     
 ACKNOWLED GEMENT S

Canada is a country of immigrants. English is my fifth language. I am grateful to my daughter,

Shelly Bard, for her help with this book.
Boris Bard

Much appreciation to Professor Lisa-Marie Forcier for her assistance with research and clinical
scenarios and for her dedication to battling the stigma of mental illness.
Eric MacMullin

No text is written alone. The continued support of my husband, Adolph; of my friend Marian
McCollum; and of other colleagues has provided the energy to complete this project when
my own energy was low. The guidance, expertise, and encouragement from my editors Nancy
O’Brien, Becky Leenhouts, and Mike Sheets are much appreciated. I also thank all the health care
providers who so freely share their time and expertise with those who want to learn more about
the dynamic and complex nature of human behaviour.
Michelle Morrison-Valfre

The product you are holding in your hands or viewing on your screen exists as a result of a great
deal of work, research, and review. Although authors tend to get the most obvious credit (after all,
it is our names that appear on the cover), a text of this nature would be entirely impossible if not
for the work of many dedicated publishing professionals.
Although we have worked diligently to “Canadianize” the venerable Morrison-Valfre text,
many other unsung heroes have toiled away to make this text as valuable to you, the reader, as
humanly possible. Although it would be almost impossible to list them all, there are three individ-
uals we would like to thank specifically.
Content Strategist/Acquisitions person extraordinaire Roberta Spinosa-Millman recognized
the need for a specifically Canadian, fundamental text that addresses how we—as Canadians—
approach, treat, and recognize mental health. Roberta pulled together three very different auth-
ors/mental health practitioners and set the foundation for us to work together to produce what
we consider to be an excellent text and reference. Thank you, Roberta, for the dual opportunities
of producing a text of this nature and of allowing us the honour to work together.
Somehow balancing Zen-like patience along with a subtle ability to kindly motivate and dir-
ect, Content Development Specialist Martina van de Velde worked extensively to ensure that our
efforts were consistent and relevant. Many, many thanks to her for her collaboration, profession-
alism, and kindness. Again, for the times we did not get chapters completed on time, missed a
deadline, or simply forgot, we offer apologies and, in equal measure, sincere admiration.
Finally, our “almost at the finish line” copy editor, Jerri Hurlbutt, who has a keen eye for detail,
word, and idea flow and for use of reference and Internet-accessible information, took a some-
times rough draft and turned it into something of equal measures of accuracy and art. Jerri has
also motivated and inspired us with her efficiency and work ethic. We simply cannot imagine this
final product without Jerri’s input and direction.
There are many, many others who were involved in getting this text from our brains into your
hands, and to those far-too-anonymous people, we also give our sincere thanks. Sales staff, printers,
clerical workers, technicians, and others have all played a vital role in making this text available.
Boris Bard
Eric MacMullin
Jacqueline Williamson

xiii
This page intentionally left blank

     
 CONTENTS

UNIT I Mental Health Care: Past and Ethics, 23

Present Ethical Principles, 23
Codes of Ethics, 24
1 The History of Mental Health Care, 2 Ethical Conflict, 24
Early Years, 3 Laws and the Legal System, 25
Ancient Societies, 3 General Concepts, 25
Greece and Rome, 3 Legal Concepts in Health Care, 25
Middle Ages, 4 Laws and Mental Health Care, 26
The Renaissance, 5 Patient–Caregiver Relationship, 26
The Reformation, 5 Adult Psychiatric Admissions, 26
Seventeenth Century, 5 Areas of Potential Liability, 26
Eighteenth Century, 5 Patient Restraint, 27
Nineteenth Century, 6 Care Providers’ Responsibilities, 28
Twentieth Century, 7 The Reasonable and Prudent Caregiver Principle, 28
Psychoanalysis, 7 4 Sociocultural Issues, 31
Influences of War, 7 The Nature of Culture, 31
Introduction of Psychotherapeutic Medications, 8 Characteristics of Culture, 32
Adult Community Mental Health Programs, 8 Influences of Culture, 33
Twenty-First Century, 8 Health and Illness Beliefs, 33
2 Current Mental Health Care Systems, 10 Cultural Assessment, 35
Mental Health Care in Canada, 10 Communication, 35
Mental Health Care in Industrialized Countries, 11 Environmental Control, 36
Norway, 11 Space, Territory, and Time, 37
The United Kingdom, 11 Social Organization, 37
Australia, 11 Biological Factors, 38
The United States, 11 Culture and Mental Health Care, 38
Care Settings, 12 5 Theories and Therapies, 41
Inpatient Care, 12 Historical Theories, 42
Outpatient Care, 12 Darwin’s Theory, 42
Delivery of Community Mental Health Services, 13 Psychoanalytical Theories, 42
Community Care Settings, 14 Psychoanalytical Therapies, 44
Advocacy, 15 Transference and Countertransference, 44
Therapy, 15 Analytical Psychotherapy, 44
Crisis Intervention, 15 Other Theories, 45
The Multidisciplinary Mental Health Care Team, 15 Developmental Theories and Therapies, 45
Care Team, 16 Cognitive Development, 45
Patient and Family, 16 Psychosocial Development, 46
Patient Populations, 16 Behavioural Theories and Therapies, 46
Impact of Mental Illness, 18 B.F. Skinner, 47
Incidence of Mental Illness in Canada, 18 Other Behavioural Therapies, 48
Economic Issues, 18 Humanistic Theories and Therapies, 48
Social Issues, 18 Perls and Gestalt Therapy, 48
3 Ethical and Legal Issues, 21 Maslow’s Influence, 48
Values and Morals, 22 Rogers’s Patient-Centred Therapy, 49
Acquiring Values, 22 Current Humanistic Therapies, 49
Values Clarification, 22 Systems Theories, 49
Rights, 23 Cognitive Theories and Therapies, 50
Patient Rights, 23 Cognitive Restructuring Therapies, 50
Care Provider Rights, 23 Coping Skills Therapies, 50

xv
xvi CONTENTS

Problem-Solving Therapies, 50 Special Considerations, 78

Reality Therapy, 50 Adverse Reactions, 78
Sociocultural Theories, 51 Nonadherence, 78
Mental Illness as Myth, 51 Informed Consent, 79
Biobehavioural Theories, 51
Homeostasis, 51
Stress Adaptation Theory, 51 UNIT II The Caregiver’s Therapeutic
Psychobiology, 52 Skills
Psychoneuroimmunology, 53
Nursing Theories, 53 8 Principles and Skills of Mental Health Care, 82
Psychotherapies, 53 Principles of Mental Health Care, 83
Individual Therapies, 53 The Mentally Healthy Adult, 83
Group Therapies, 53 Mental Health Care Practice, 83
Online Therapy, 54 Do No Harm, 83
Somatic Therapies, 54 Accept Each Patient as a Whole Person, 83
Brain Stimulation Therapies, 54 Develop Mutual Trust, 84
Pharmacotherapy, 55 Explore Behaviours and Emotions, 84
Future Developments, 55 Encourage Responsibility, 85
Encourage Effective Adaptation, 86
6 Complementary and Alternative Therapies, 58
Provide Consistency, 88
Definition of Terms, 59
Skills for Mental Health Care, 89
Allopathic Medicine, 59
Self-Awareness, 89
Complementary Medicine, 59
Caring, 89
Alternative Medicine, 59
Insight, 90
Integrative Medicine, 59
Risk Taking and Failure, 90
Holistic Care, 59
Acceptance, 90
Health Canada’s Licensed Natural Health Products
Boundaries and Overinvolvement, 90
Database, 59
Commitment, 91
Body-Based CAM Therapies, 60
Positive Outlook, 92
Whole Medical Systems, 60
Nurturing Yourself, 92
Biologically Based Therapies, 61
Body-Based Practices, 62 9 Mental Health Assessment Skills, 95
Energy-Based CAM Therapies, 62 Mental Health Treatment Plan, 95
Mind-Body Medicine, 62 DSM-5 Diagnosis, 96
Energy Medicine, 64 Nursing (Therapeutic) Process, 96
Technology-Based CAM Applications, 65 About Assessment, 97
CAM Approaches to Mental Health Care, 65 Data Collection, 97
CAM Mental Health Therapies, 65 Assessment Process, 98
Words of Caution, 66 The Patient at Risk, 100
Adverse Effects, 66 Obtaining a History, 100
Implications for Care Providers, 66 Effective Interviews, 100
Physical Assessment, 101
7 Psychotherapeutic Medication Therapy, 68
Mental Status Assessment, 102
How Psychotherapeutic Medication
General Description, 102
Therapy Works, 69
Emotional State, 102
Classifications of Psychotherapeutic
Experiences, 102
Medications, 70
Thinking, 103
Antianxiety Medications, 71
Sensorium and Cognition, 104
Antidepressant Medications, 72
Mood-Stabilizer Medications, 73 10 Therapeutic Communication, 107
Antipsychotic (Neuroleptic) Medications, 74 Theories of Communication, 108
Signs and Symptoms, 76 Ruesch’s Theory, 108
Patient Care Guidelines, 76 Transactional Analysis, 108
Assessment, 77 Neurolinguistic Programming, 109
Coordination, 77 Characteristics of Communication, 109
Medication Administration, 77 Types of Communication, 109
Monitoring and Evaluating, 78 Process of Communication, 109
Patient Teaching, 78 Factors That Influence Communication, 110
 CONTENTS xvii

Levels of Communication, 110 Self-Esteem Needs, 137

Verbal Communication, 110 Self-Actualization Needs, 137
Nonverbal Communication, 111 Variables of the Therapeutic Environment, 138
Intercultural Communication, 111 Admission and Discharge, 138
Intercultural Differences, 111 Adherence, 138
Therapeutic Communication Skills, 112
Listening Skills, 112
Interacting Skills, 112 UNIT III Mental Health Challenges Across the
Nontherapeutic Communication, 114 Lifespan
Barriers to Communication, 114
Nontherapeutic Messages, 114 13 Challenges of Childhood, 142
Problems With Communication, 114 Normal Childhood Development, 143
Communicating With Mentally Troubled Common Behavioural Challenges of Childhood, 143
Patients, 117 Mental Health Challenges of Childhood, 145
Assessing Communication, 117 Environmental Issues, 145
Homelessness, 145
11 The Therapeutic Relationship, 120
Abuse and Neglect, 147
Dynamics of the Therapeutic Relationship, 120
Problems With Parent–Child Interaction, 148
Trust, 121
Parent–Child Conflicts, 148
Empathy, 121
Emotional Challenges, 148
Autonomy, 121
Anxiety, 148
Caring, 122
Depression, 149
Hope, 122
Somatoform Disorders, 149
Characteristics of the Therapeutic
Post-Traumatic Stress Disorder, 149
Relationship, 123
Behavioural Challenges, 149
Acceptance, 123
Children and Violence, 149
Rapport, 123
Children and Electronic Media, 150
Genuineness, 123
Attention-Deficit/Hyperactivity Disorder, 150
Therapeutic Use of Self, 124
Disruptive Behavioural (Conduct) Disorder, 151
Phases of the Therapeutic Relationship, 124
Challenges With Eating and Elimination, 152
Preparation Phase, 124
Eating Disorders, 152
Orientation Phase, 125
Elimination Disorders, 152
Working Phase, 125
Developmental Challenges, 153
Termination Phase, 126
Intellectual Development Disorder, 153
Roles of the Care Provider, 126
Learning Disorders, 153
Change Agent, 126
Communication Disorders, 154
Teacher, 126
Pervasive Developmental Disorders, 154
Technician, 127
Autism, 154
Therapist, 127
Schizophrenia, 155
Problems Encountered in the Therapeutic
Therapeutic Actions, 155
Relationship, 127
Meet Basic Needs, 155
Environmental Problems, 127
Provide Opportunities, 156
Problems With Care Providers, 127
Encourage Self-Care and Independence, 156
Problems With Patients, 128
14 Challenges of Adolescence, 160
12 The Therapeutic Environment, 131
Adolescent Growth and Development, 161
Use of the Inpatient Setting, 132
Physical Development, 161
Crisis Stabilization, 132
Psychosocial Development, 161
Acute Care and Treatment, 132
Common Challenges of Adolescence, 162
The Chronically Mentally Ill Population, 132
Internal (Developmental) Challenges, 162
Goals of a Therapeutic Environment, 133
External (Environmental) Challenges, 162
Help Patients Meet Needs, 133
Teens and Electronic Media, 165
Teach Psychosocial (Adaptive) Skills, 133
Mental Health Challenges of Adolescence, 165
The Therapeutic Environment and Patient
Behavioural Disorders, 165
Needs, 134
Emotional Disorders, 166
Physiological Needs, 134
Mood Disorders, 167
Safety and Security Needs, 135
Eating Disorders, 167
Love and Belonging Needs, 136
xviii CONTENTS

Chemical Dependency, 168 Therapeutic Interventions, 205

Personality Disorders, 169 Assessment, 205
Sexual Disorders, 169 Interventions for Patients Living With Alzheimer’s
Psychosis, 170 Disease, 205
Suicide, 170 Caregiver Support, 207
Therapeutic Interventions, 171
Surveillance and Limit Setting, 171
Building Self-Esteem, 171 UNIT IV Patients With Psychological
Skill Development, 171 Challenges
15 Challenges of Adulthood, 174
18 Managing Anxiety, 211
Adult Growth and Development, 174
Continuum of Anxiety Responses, 212
Common Challenges of Adulthood, 176
Types of Anxiety, 212
Internal (Developmental) Challenges, 176
Types of Anxiety Responses, 212
External (Environmental) Challenges, 178
Coping Methods, 212
Mental Health Challenges of Adults, 180
Defence Mechanisms, 213
Therapeutic Interventions, 180
Crisis, 213
Health Care Interventions, 180
Self-Awareness and Anxiety, 215
Preventing Mental Illness, 180
Theories Relating to Anxiety, 215
16 Challenges of Late Adulthood, 183 Biological Models, 215
Overview of Aging, 183 Psychodynamic Model, 215
Facts and Myths of Aging, 184 Interpersonal Model, 216
Physical Health Changes, 185 Behavioural Model, 216
Mental Health Changes, 185 Other Models, 216
Research and Aging, 185 Anxiety Throughout the Life Cycle, 216
Common Challenges of Older Persons, 186 Anxiety in Childhood, 216
Physical Adaptations, 187 Anxiety in Adolescence, 217
Health Care Services, 187 Anxiety in Adulthood, 217
Psychosocial Adaptations, 188 Anxiety in Older Persons, 217
Mental Health Challenges of Older Anxiety Disorders, 217
Persons, 190 Separation Anxiety Disorder, 218
Elder Abuse, 191 Selective Mutism, 218
Dementia, Depression, and Delirium, 191 Specific Phobia, 218
Therapeutic Interventions, 192 Social Anxiety Disorder, 218
Age-Related Interventions, 192 Panic Disorders, 218
Mentally Ill Older Persons, 192 Agoraphobia, 219
Mental Health Promotion and Prevention, 193 Generalized Anxiety Disorder (GAD), 219
Obsessive-Compulsive and Related
17 Cognitive Impairment, Alzheimer’s Disease, and
Disorders, 219
­Dementia, 196
Obsessive-Compulsive Disorder (OCD), 219
Confusion Has Many Faces, 196
Body Dysmorphic Disorder, 220
Normal Changes in Cognition, 196
Hoarding Disorder, 221
The Three “D’s” of Confusion, 197
Hair-Pulling Disorder (Trichotillomania), 221
Medications and the Older Population, 197
Excoriation Disorder (Skin Picking), 221
Patients With Delirium, 197
Substance-/Medication-Induced Obsessive-
Finding the Cause, 199
Compulsive and Related Disorder, 221
Treating Delirium, 200
Obsessive-Compulsive and Related Disorder
Patients With Dementia, 200
Due to Another Medical Condition, 221
Symptoms of Dementia, 200
Other Specified Obsessive-Compulsive and Related
Gentle Persuasive Approach, 201
Disorder, 221
Dementia Care, 201
Unspecified Obsessive-Compulsive and
Causes of Dementia, 202
Related Disorder, 221
Alzheimer’s Disease, 202
Trauma- and Stressor-Related Disorder, 221
Symptoms and Course, 202
Reactive Attachment Disorder, 221
After the Diagnosis, 204
Disinhibited Social Engagement Disorder, 222
Principles of Management, 204
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Other documents randomly have
different content
 “It would depend upon how he flew. He’ll get about sixty or sixty-
five; if he conserves it,” answered Kramer.

“Great, then he would have to come down in Texas. Feel like

eating something? There is a little left but believe me it has taken
great self-restraint on our parts to save anything.”

“He may have a little, then more before we leave,” Zargo decided,
so they arranged a roll of blankets to raise Kramer’s head, and he
was ready to eat.

“I can feed him, Old Man,” Bob offered. “Don Haurea wants to go
up the cliff to where the plane took off. When you come back we’ll
go home. It’s been a nice large night and a good time was had by
all.”

“That is an excellent suggestion,” Don Haurea smiled at the

irrepressible young fellow. “We shall leave the officer with you,” he
added and turned to Carl Summers. “You are both armed, I do not
anticipate further attacks, but it is always well to—as the Boy Scouts
say—to be prepared.”

“Yes, sir,” Carl agreed, but he wasn’t especially keen about being
left behind, for although he had caught occasional glimpses of the
owner of the Box-Z this was the first time he had come into close
contact with the man who was something of a mystery to his
neighbors, and more so to the natives of Crofton, so the deputy
greatly regretted not being a member of the investigating party.

“You are a good soldier,” said the tall man, who was, on close
acquaintance, proving so very unformidable.

“Thank you, sir.” Carl was immediately eager to take his part in
upholding the law and guarding the wounded. The rest of the party
got into great coats, wrapped mufflers about their necks, and pulled
fur caps over their ears. The three men had strong flashlights, and
presently they stepped out into the night anxious to explore the
vicinity as quickly as possible. Their first journey was to the scene of
the explosion, which interested Don Haurea very little, and finally
they made their way to the trail where they began the steep climb to
the ledge.

They had to exercise care, for the explosion had loosened huge
chunks of rock and ice and as they proceeded Jim was amazed that
the plane had not been damaged. At last they reached the spot, but
as far as the boy could see there was nothing gained by the trip.
However, Don Haurea made his way close to the steep cliff, which
rose almost straight as a wall with several broken sections. Carefully
the man investigated all of them and a moment after he disappeared
into the last one, they heard him call sharply to his servant, who
responded immediately, the Austins following close on his heels. To
their utter astonishment they saw something huddled in a heap
against a rock and as the lights turned fully upon it, they whistled.

“It—why Dad, it’s Jute—Pigeon Jute. I’d forgotten him.” Zargo was
bending over the Indian, his capable fingers moving swiftly, then he
said something to the Don, and an instant later picked the man up in
his arms.

“He was shot,” Don Haurea explained briefly. “We will get him
where it is warm and see if we can help him.”

“Shall I go ahead with a light?” Jim asked softly.

“It would be a good plan,” the Don answered, so the boy led the
way down the treacherous trail. Zargo might have been carrying an
infant for all the effort it took, and finally they were again in the
bunkhouse. Bob was too amazed for even the mildest of
exclamations, but he jumped in and arranged a bunk.

“We found him near where the plane was,” Mr. Austin explained.
Then they waited silently while Zargo examined the Indian, and after
what seemed hours, he looked up.
 “In a moment he will return to consciousness,” he announced, and
he was right. Pigeon Jute opened his dark eyes, looked from one to
the other, then tried to raise himself. Don Haurea spoke to him in his
own language and the Indian’s eyes lighted. After a minute, he
spoke a few sentences, and when he was finished the Don nodded.

“He says that for some time he has been selling—or delivering
long distance flying pigeons to Arthur Gordon. He was in the north
at the time of the trouble at the Box-Z, so did not hear of it until a
few days ago after he had delivered several carriers to a ranch
outside of Crofton. When he learned of the difficulty he started to
find young Gordon to collect his money. He trailed him to the ranch,
but could not locate him until this morning. When you boys left the
dugout Jute started up the trail. He was behind the cliffs when the
place blew up and was coming back to see if you were hurt when he
saw Gordon leap into the plane. He tried to prevent it, but was shot
for his pains.”

“Jute can speak English!” Jim remarked.

“Yes, but not so well as his own tongue, which is less effort while
he is so weak,” Don Haurea replied.

“Whistling Pigs,” exclaimed Bob, “reckon that’s why Gordon did not
favor us with any more lead.”

“Undoubtedly it is,” Don Haurea agreed.

“What was Gordon going to do, or doing with carrier pigeons?”

Jim wanted to know. “Are they kept on that ranch?”

“Merely shipped from there. The man told Jute they had sold the
place and were waiting for the last birds he brought down.”

“Shipped by rail?”
 “Truck, and probably that truck will not appear in the
neighborhood again. From the plane, Gordon no doubt dropped a
warning, or several of them, and every trace will be obliterated at
once.”

“Tough luck,” Jim muttered.

“How many of the wounded can be moved?” Mr. Austin asked

practically.

“Both of them,” was the decision. “I shall take Jute to the Box-Z.”

“Kramer is booked for the K-A,” Jim grinned.

“Boy, you’ll have a vacation as is a vacation,” Bob promised. “You

can do a Caesar; wire your firm that you came, you saw, and you
conquered—”

“Were conquered,” Kramer corrected. “I’ve had a grand trimming

—”

“Well, don’t broadcast it, why shouldn’t you have some glory!”

They lost no time in getting the two wounded men into the
limousines and although Mr. Austin urged Carl to come to the ranch,
the deputy decided to wait for instructions from the sheriff, so at last
they drove off, leaving the young fellow alone, but this time there
was no anxiety regarding his safety. Seated beside his father, Jim’s
eyes stared ahead and his mind was busy. He felt it was a beastly
shame that the new plane should have been lost before they had
had it twenty-four hours, and although they had made the trip for
the mail and newspapers, the bag was now no-one-knew where and
the family was deprived of its second investment. The boy was
feeling too blue over the theft to discuss the matter so he resolutely
tried to put it out of his mind. He thought of young Gordon, with his
limited supply of gas, but he had absolutely no hope that the outlaw
would be captured. In the first place, it had been hours from the
time the machine took off from the cliff before the sheriff could send
the alarm, and by that time Gordon would have made good his
escape. There were dozens of ways by which he might replenish the
fuel supply and go on to the Mexican border, or almost any place. To
be sure, a description of the machine would be sent forth but that
did not help matters much.

Finally the two cars reached the point in the road where the
Austins turned into their own ranch house. As he sped by, Don
Haurea waved to the occupants in the other car. Then Jim wondered
how it was the Indian had been discovered. He recalled the man’s
interest in the cliff, his investigating each crevice, and the finding of
Jute. Then another query popped into his mind.

“I say, Dad, is Jute an American Indian?”

“Yes, full-blooded. What made you ask?”

“Just wondered how Don Haurea knew his language,” Jim

answered.

“I have heard that as a boy, the Don was always interested in the
various tribes and made a point of learning all he could about them.
Here we are—and, oh what a shame—” He broke off quickly when
he saw the house lighted from top to bottom and knew that Mrs.
Austin had not gone to bed, although it was nearly morning. Before
they drove to the door, it was thrown open.

“The doctor came from Crofton and is waiting,” Mrs. Austin called,
and a moment later the medical man came to help his patient into
the house. Over the eastern rim of the mountains the first faint
streaks of dawn were breaking before the buddies were ready for
bed.

“Kind of rotten about the bus,” Bob said softly.

 “All of that,” Jim replied. They turned in to catch up on some of
their lost sleep and it was noon before either of them opened his
eyes again. The pair joined the family for a “brunch,” which was the
name Bob gave to a combination breakfast and lunch. As they
lingered over the meal, the telephone rang and Jim went to answer.

“Yes, this is the K-A.” There was a slight pause, then, “yes, wait,”
“Oh, Galloping Snails, that’s great, Sheriff! Will you hold the wire a
moment please? I say, Dad they found the plane—”

“They did, that is splendid—”

“Did they get Gordon?” Bob demanded.

“No, not a trace of him. Dad, they have got the plane near an
aviation field. It’s smashed up some, but not bad, just a few little
things—”

“Can they fix it?” Mr. Austin asked.

“Yes, easily, so she’ll be all hunkie-dorie.”

“Ask them to do it, and if they have a pilot, have him fetch it home
as soon as it is ready. We are certainly fortunate.”

“All right, Sheriff. Thanks a lot for calling us.” Jim hung up the
receiver, and everyone was eager to hear the details.

“I suppose Gordon came down in the night and sneaked off,” Bob
suggested.

“They haven’t any idea of what happened to him. One of the

airmen saw the plane roaring along and he rode beside her just for
companionship. When he looked for the pilot, Gordon, the cock-pit
was empty. The fellow thought he was seeing things. Then in a
couple of minutes our engine conked, stopped, and began to go
down, but she spun around in grand style, going forward, and finally
she dropped in a nice smooth section of the plain. The mail-man
followed, but she was absolutely empty when he investigated. There
was a bag of things on the floor, everything seemed just as it should
be, but there wasn’t a trace of the fellow who started off in her,” Jim
explained.

“Isn’t that rather amazing?” Mrs. Austin inquired.

“It surely is, Mom. I say, Buddie, was the parachute there?”

“Two; one on the front seat and one on the back.”

“The third one was gone. Gosh, Gordon must have hopped
overboard when he saw he couldn’t get very far. Did his exit before
anyone could start a search for him. She’s one grand little bus—
intelligent animal, to make her own landing all by her lonesome.
That ought to make Kramer feel pretty cocky—some talking point for
his advertising department.”

“Better run up and tell him. He was feeling badly last night over
the loss, and now that the machine will—”

“Be coming home to roost,” Bob grinned. “I’ll break the good news
to him gently.” He raced upstairs to tell the salesman, who was
delighted and no end set up over the achievement of the machine.
While they were discussing the matter, the Box-Z limousine drove
up, and Jim went to admit the caller. He discovered that it was
Zargo.

“I had to be in this direction and Don Haurea asked me to stop

and see if you wish to return with me.”

“Thanks a lot. I’ll be ready in a jiffy. How is Jute?”

“Doing very well, thank you. And Mr. Kramer—”

“Top of the world,” Jim replied.

 “That is good news.” The boy hurried into the house.

“Oh, Bob, going to the Don’s this afternoon? Zargo is outside!”

“Guess not, Old Timer. I’ll linger around and keep Kramer from
getting rusty, but you ooze along.” Ten minutes later, Jim was in the
big car, which was a particularly powerful, smooth-running machine,
and now it ate up the miles as it rushed over the road that wound
along the edge of Cap Rock.

“Dad told me that when he was a boy this was the stage-coach
road. The drivers used to go lickity-split—mostly split—and when the
passengers got out most of them would be black and blue from the
bumps,” Jim remarked.

“Those days are not so far distant,” Zargo replied. “Your father’s
generation has seen many changes.”

“Yes, sir, from covered wagons to airplanes. Besides that there

have been the cables, radio, submarines, automobiles and television.
When you come to think of it they have had to do some mental
jumping to grasp it all. The inventors and discoverers in these days
are everlastingly lucky they were not born earlier, during the time
when the mob pitch-forked everything that was different and called
any kind of progress heresy. Great guns, I never can understand
why those old ducks were so opposed to people using their own
brains. What a lot of good men and women they cooked when half
the world had to believe what a couple of fellows dictated. Zargo, do
you believe there is a hell?”

“What is your definition of hell?” the man asked.

“That’s a hot one. A bad place where bad people go when they
are dead. Where they have to atone for their sins,” Jim answered.

“And what would you classify as sin?”

 “You sure are not going to commit yourself,” the boy chuckled.
“Well, I don’t believe God punishes people for their ignorance, but if
he does, there’s an army—an everlasting big one—of people who
have been powerful enough. I mean held high positions, inflicted
torture and suffering on their fellow men, who tried to show the
world how everybody could know more—like Galileo, and a lot of
fellows. I’d call destroying men like that a sin.”

“You would turn a great many—say standard saints, into sinners.”

“Sure, why not? If they were incapable of rightly classifying their

fellows, they just naturally over-estimated their own importance.”

“I should say you have given the matter a good deal of thought.”

“Well, I have some,” the boy flushed. “You know, when you are
flying, way up in the sky—through the heavens, no matter what they
were doing, it does set a chap’s thinking machine to working. Gosh,
I’ll be glad when we get our new plane fixed. When they fetch it
home, Bob and I are going to take it to bed with us so nothing can
happen to it—wow, here we are.”

The car went purring along the drive under the snow laden
willows whose long branches rustled and murmured as the breeze
stirred them. It stopped before the door, which was promptly opened
by the man servant, and a minute later, Don Haurea was welcoming
his pupil, who lost no time in divesting himself of outer garments.

“Your step-brother, I take it, is engaged in entertaining Mr.

Kramer.”

“Yes, sir. He’s still got some things he wants to read, and I guess
he thought if he stayed at home, it would be a little easier on Mom,
and Bob sort of likes to take care of sick things. It tickles him pink if
he can doctor a chicken, especially if it gets well,” Jim laughed, then
added earnestly, “Bob’s a great buddie.”
 “He certainly is,” the man agreed promptly.

“I say, Don Haurea, did you know that Pigeon Jute was up there in
those rocks? I’ve been wondering all night.”

“Suppose we go to the laboratory and see. It is nearing the hour

when I have a few minutes with my son—”

“That’s so, I’d like to say hello to Yncicea, haven’t done it for a
week. Does he celebrate Christmas, I mean the way we do?”

“With the rest of the world he enjoys a holiday,” the man nodded.

“I’m glad, because a year without a Christmas would be sort of—

well lonesome.”

The two went leisurely into the long, cheery living room, to the
panel in the wall which was now a familiar object to Jim, but he
recalled that first day the Don had opened the way to the little
elevator, which had been installed during the days of the present
owner’s grandfather. Without waiting, the boy pressed the tiny knot,
and as he did so, his mind leaped back to the summer day when the
Gordons and Burnam had led a crazy mob to the ranch, and an
airplane machine gunner viciously fired his deadly rounds into the
house in an attempt to destroy its occupants. The whole scheme had
failed because Jim had managed, despite wounds, to press his
bleeding hands against a small button on one of the pillars on the
veranda, releasing an invisible wall of electricity which caught the
invaders. Today the door slid smoothly, the pair stepped inside and
immediately began to descend to the beautifully built under-ground
work and experimental laboratories. Presently they were in the long
tiled hall, the boy went at once to his own closet where he changed
to the close-fitting white suit and soft sandals.

“This sure is a comfortable outfit,” he grinned. The Don was ready

too, so they hurried along to the turn, and finally they were admitted
to the outer room, which was exactly as it was on the boy’s first
visit, only now the attendant smiled his recognition, and they passed
inside. Here was a large class of scientific men; as before, some of
them glanced up from what they were doing, while others were too
absorbed to note the late arrivals. Austin nodded or spoke a soft
greeting as he passed on into the Don’s own department, and soon
they seated themselves on a long bench before a sort of desk with a
high frame at the back. Eagerly the young fellow looked up at the
man, who nodded, and then Jim’s fingers moved expertly across the
dial until at last he sat back and waited.

Over the screen in front of him passed a slight movement which

might have been water, but Austin knew that it was a film
composition rolling past and in a moment he made out blurred
objects which gradually shaped themselves into a back-ground of
blue sky, with a rushing stream in the foreground. Shrubs and trees
stood out in stately order, then a winding path which led over moss-
grown rocks to a wide terrace above. Then something moved and
Jim could not contain himself a moment longer as the boy he had
first seen in Vermont, stepped out from the garden.

“Yncicea,” he called.

“Jim, Old Scout,” came the laughing response. “In Texas you are
to have a white Christmas.”

“We surely are,” Jim laughed. “Bob’s mother is crazy about it, says
it’s exactly like when she was a girl in Vermont—you know—”

“When she lived on the farm, by the waters of Lake Champlain.”

“Right you are. Well, it’s great to see you, and your father wants
to speak to you. So long, Old Man.”

“So long, Jim, Old Scout; here’s to the membrane on your

proboscis.”

“Aw, go on, that’s no way to say—skin on your nose,” Jim laughed.

 “My son has not proved to be a very good student of slang,” the
Don chuckled, then, for several minutes the two spoke in that
strange language which Jim had not been able to attribute to any
race. Finally the father and son were finished, then the man moved
to the further end of the room. Again the two sat down before a dial
board, but this time the screen was more like a moving picture.

“Will this be yesterday—last night, I mean?” the boy asked.

“Yes, and perhaps it will answer your question.”

 VI

OUT OF THE SKY

Young Austin waited eagerly for the photo record of certain

observations made every day in the laboratory. In a moment the film
had rolled to the beginning of the picture and after a few preliminary
scenes passed, Jim saw the buildings of the Gordon ranch appear,
one after the other. There were the barns, corrals, bunkhouse, the
ancient home and the root house a short distance away. Beyond, the
cliff rose in ragged ridges to the strip of table land which the boy
knew so well. He saw Carl Summers, the deputy, gun on his arm,
and snowshoes on his feet, moving cautiously as he made his
rounds of the place in search of a sign of the return of Arthur. The
picture passed from the young chap to other sections, lingered an
instant on Pigeon Jute following the deputy, and at last it revealed
the outlaw emerging stealthily from a long, tumbled-down building.
Through the open door could be seen a pile of furniture, and as they
watched, Gordon returned to the room where he fell to work piling
the stuff into a deep hole at the further end. That done, the young
man covered it with burlap, earth, and finally snow so that it looked
as if it had been undisturbed and that the drifts had come down
through the broken sections of the roof.

“What do you know about that!” The boy exclaimed in

astonishment, but Don Haurea was occupied with something at the
further end of the room and made no reply. Keenly interested, Jim
continued his observation, and at last he followed Gordon into the
old root-house where Summers had made his headquarters. The
sheriff’s assistant was nowhere near the spot, and Gordon gave it an
indifferent inspection. He hurried to the end, moved the partition,
and quickly stepped inside. He went at once to the wall, which was
later blown out, removed a section cleverly covered with dirt, and
then stepped hastily into the strange vault-like room, where he
pulled out numerous record books, ran his fingers through them as if
in search for something, which he did not find. He examined the
wall, then proceeded to tear the papers.

At this point the picture changed and Jim found himself watching
a group of men who were apparently in some part of Don Haurea’s
laboratory. They too were interested in observing Arthur Gordon’s
actions, but that part of the record moved to another point in the
laboratory, where two men were busy before a huge piece of
machinery, with a complicated looking set of dials and wheels. One
of the men who had been watching Gordon came close to them. He
seemed to be giving some directions, and Jim saw a pointer set,
other wheels turned, then a small tube of liquid was poured into a
grooved opening, and the men waited. Again the scene changed and
Austin saw the new airplane land on the cliff, and he watched with
interest every move which he knew the four of them had made right
up to the minute when they left the dug-out with Carl and Jute
running on ahead. Their own part in what followed was cut off; the
picture showed the men in the laboratory and as they stood before
the mysterious machine they were observing the inside of the dug-
out.

Gordon was coming stealthily out of the small armoured room. He

stopped to listen at every step, then he heard an odd whirring and
jumped forward as if he recognized the sound as a warning, or as if
he had stepped on a powerful spring. He leaped furiously to the
partition, sprang out, raced through the room, his hand pressed over
his face, then came the rumble, the place shook, the further end
boomed and heaved convulsively, while the young fellow ran for his
life until he reached the cliff, tore madly toward the plane, stopping
barely an instant to fire at Kramer. In a moment he was jumping into
the cock-pit, but Jute caught his ankle. With an oath, Gordon kicked
out and fired, started the engine and the plane leaped into the air.
The Indian was in a heap on the snow but he crawled painfully
between the crevices.

“Oh, now I know why you examined those crevices.” The Don had
joined him and he nodded quietly.

“I thought the Indian would have a camp in the woods

somewhere and would get to it, but I decided to make sure before
we left last night.”

“Then the place was exploded from here?”

“Yes. Gordon was ready to leave and he had a bomb which he was
setting. He intended it to go off while Summers was alone so the
young fellow would be blown to pieces. Unfortunately we had to
wait until you boys and Mr. Kramer were a safe distance away, then
when we disturbed the bomb, it made a slight noise, which Gordon
recognized, so he ran for his life and managed to save it. He rigged
up the explosive earlier in the day and was going to start it while
Carl was making his rounds, so we decided to let the destructive
thing be his own undoing; it seemed the surest way of getting him.”

“Did you tell the sheriff he was there?” Jim asked.

“No. In order to do that we should have to explain how we knew

the fellow was there and it isn’t wise to reveal to the layman
something he cannot understand. We did hope to trap Gordon in
such a way that he could be captured, but when he showed the
determination to kill young Summers, we had to act quickly,” the
Don explained, then added, “I am very glad that your airplane has
been found.”

“So am I. We miss the bird no end.”

“Well, now you understand exactly what took place, shall we turn
our attention to aeronautics?”
 “Yes, sir, and I’d like to watch those chemical experiments.”

“Very good.” Presently the boy was seated in his own corner of the
great laboratory, a huge book on the table before him, and a
collection of shiny instruments and test-tubes waiting for use. He
glanced at the array affectionately, gave his head a little shake as he
thought how much he wanted to accomplish, then he set grimly to
work, forgetting everything else in the world. It wasn’t until Don
Haurea touched him on the shoulder to remind him that the hours
had passed, that he glanced away from his work.

“Zargo will run you home,” he offered.

“Thank you, sir.”

The next two days were uneventful, although they were full of
suppressed excitement because they were the last before Christmas,
and on every huge ranch great preparations were going forward for
the holiday. Kramer improved rapidly, and so did Jute, and at last the
great date arrived. Homes were decorated with greens, extra bells
were attached to harnesses, and cooks were putting the last touches
on feasts which were to be spread in homes and bunkhouses. The
repaired plane had arrived from the shop early Christmas Eve, and
the Flying Buddies went gleefully off to Crofton for newspapers and
mail, to say nothing of packages which had accumulated at the post
office. They came back as laden as a pair of Santa Clauses, and the
entire evening was spent in preparations for the next day. No word
had come from the sheriff, so the boys knew that young Gordon had
made good his escape. Not even a trace of the parachute had been
discovered.

Every man working at the Cross-Bar and the K-A was at

headquarters for the festival, and because of the tenderfoot guest, a
special party was being arranged—a real wild-west affair with rodeo
exhibitions such as only real wild west men can put on successfully.
The Austin family, even if there were no little members, were up
betimes, and Mom insisted that breakfast be eaten before presents
were opened. Everybody was in high spirits, and the air was filled
with shouted greetings which lingered in the clear atmosphere. The
meal was barely finished when from somewhere came the familiar
drone of a racing motor. The Flying Buddies glanced at each other,
then by one impulse ran out to see who might be arriving by
airplane. It took only a moment to locate the tiny speck in the blue
which they watched as interestedly as if they were a pair of small
boys. Cap Rock was too far west for them ever to see the air-mail-
men, and pilots flew their planes over that section very rarely.

“Gosh, she’s a bird,” Bob exclaimed.

“Looks as if she’s pure silver,” Jim added, and in the bright

sunshine the plane did look exactly like that, highly polished. She
was rapidly getting nearer, but as yet they could not make out her
pilot. However, they did not think much about that for the machine
was two thousand feet up and the man was probably protecting
himself from the cold. Without diminishing her speed she came
straight toward them and in a moment they decided that she was
going to pass over, but to their surprise she executed a wide graceful
curve, dipped as if she were making a salute, banked, zoomed
swiftly, curved again, dived and began to descend in narrowing
spirals.

“She’s decorated like a Christmas tree,” Bob laughed. “Somebody’s

coming to our party.”

“Somebody is a lucky guy if he owns that machine,” Jim gasped in

admiration. The motor had stopped and the beautiful plane was
dropping lightly into the clear space only a few feet away from the
house. With one impulse the boys leaped across the veranda, slid
over the frozen snow, and stopped at the same moment the plane
did. Then they stared at the stranger, and at length, stared at each
other.
 “There isn’t anyone in her,” exclaimed Jim incredulously. They
were standing by the fuselage, the cock-pit had a special transparent
cover, but no one was seated before the controls.

“See in the back.” There were two cock-pits, the machine was a
four-passenger, or three-passenger beside the pilot, and the Flying
Buddies walked around her, but the back was as empty as the front.
They even glanced at the rigging expecting to discover someone
hanging on, but not a soul did they see.

“Tell you what, bet somebody lost her. Remember, that’s the way
our plane came down, or it came something like that,” Bob declared.

“Sure. Well, we can soon find out about her. Gosh, isn’t she a
beauty, Buddy!”

“Boys, bring your guest inside,” Mom called from the veranda.
“You haven’t your big coats on.”

“Be with you in a minute,” Bob answered.

“By George, she looks as if she might have been made for
Lindbergh.” It took them only a moment to find a pair of small
latches on the outside of the cock-pit cover, but before they lifted it,
Bob exclaimed.

“I say, if anyone jumped out of this he was mighty particular to

close the roof after him.”

“That’s so, but perhaps it snaps shut.” They lifted the cover, much
as they would lift the hood of an automobile, and they saw that the
main section folded into a long narrow space. Everything about the
plane was brand new. The seats were heavy shiny brown leather
with lighter shade trimmings. In front of the pilot’s seat the control
board looked, at first glance, like any other machine’s, but on closer
inspection they found it was equipped with several extra dials and
indicators. On each side of the cock-pit were a pair of long slender
glasses. There was a radio, for receiving and transmitting, speaking
tube, hamper for the traveler’s convenience. The mirror was the
shape of a globe and it had a reflector to cut off any part, or act as a
protection for the whole sphere. It looked to the boys as if the
altitude meter registered not only the height above the sea level, but
it would automatically change according to the nature of the
territory over which it would fly.

“Why, Buddy!!!” Jim discovered a long white envelope hanging on

one of the parachute buckles and he detached it carefully.

“Does it give the chap’s name?”

“I’ll—why Buddy!” That was all Austin could say and he held out
the envelope, which he had turned over. “Look!” Caldwell stared, and
read mechanically.

“‘Merry Christmas to the Flying Buddies’—Flying?—Why Jim, that’s

—great guns—it can’t be our—Say, what’s inside that envelope?” Jim
was already opening it. He took out a folded sheet of heavy paper
that looked like some sort of parchment. Swiftly he scanned the
lines, then he jumped ten feet into the air and gave a whoop which
bounded and rebounded like a ball. Bob caught the sheet from his
hand and read.

“Flying Buddies: Christmas

Gentlemen:

I hope to find a place in your hearts and that I shall be

permitted to serve you through many happy excursions above
the world. No man of your race has ever ridden in such a plane,
but I am built so that you will miss none of the pleasure of good
piloting. If you will be seated and replace the cover, it will be my
pleasure to show you something extra in joy-rides.

I have no name, so I can only sign myself, at your service!”

 “Come a-hopping, Buddy,” Jim shouted. He jumped into the cock-
pit, but Bob hesitated.

“What is it?” he demanded.

“You haven’t a coat on.”

“The cabin is as warm as toast. Hustle, me brave lad, you are

retarding progress, which is sinful.” Bob took the second seat, which
was adjusted exactly the right size and shape, and Jim swiftly closed
the cover. The motor began to purr gently, like a dozen contented
lion cubs, and the plane lifted, spiraling in close circles until it
reached a thousand feet, then the nose was turned north and she
shot forward at a speed of nearly two hundred miles an hour. Austin
was busily examining the paraphernalia on the board before his
eyes, while Bob was simply too puzzled to do anything more than sit
back and wonder if he was experiencing some sort of fantastic
dream. In ten minutes the machine was dropping lightly in the
Haurea front yard, where the Flying Buddies saw Zargo and the Don
waiting for them.

“You did not fear to accept the invitation,” Don Haurea smiled as
Jim shoved the cover from over the cock-pit.

“Not so that you could notice it,” Jim declared. “Wow, what a bird.”

“Glad you like it.”

“Who wouldn’t! Golly, Don Haurea, it’s a wonderful present, but

it’s pretty steep—”

“Don’t you like it?”

“Crazy about it.”

“My son and I both feel that the several services you Flying
Buddies have rendered us certainly warrant some token—”
 “Token, great heavens, Don Haurea—oh, but she’s a beauty. How
did you send her over and bring her back?” Bob demanded.

“A very simple little instrument. You will notice one of the dials is a
little different color from the other controls. It is now set, in time as
it were, with a section of our plant here, and was controlled from the
laboratory. You have demonstrated that part; we will show you the
ordinary method of plane piloting in a very few minutes. One thing I
shall ask is that you do not mention the fact that she is equipped to
operate from a central power-control. There are five stations in the
world from which she can be directed, and in an emergency, even
though she ran out of gas she could be kept up. I’d suggest that you
keep the dial turned to the lowest notch, that will tune-in whenever
you are flying, and in case of accident it may save you some
trouble.”

“Jinks,” Bob whistled.

“May I ask where the power control comes from? but I suppose it
comes from here,” Jim said.

“It did for today’s demonstration. There are five stations in the
world; four beside this one of mine. One is in South America, one in
India, one in China, and the other in England.”

“I suppose there are more planes like this one,” remarked Jim.

“A few.”

“Well, jinks—I don’t know how to thank you.”

“Just the same, we do think it’s mighty good of you—”

“That’s all that is necessary. Now, I must go inside. Zargo will tell
you how she works, then I expect, although I regret that you cannot
pay me a visit this morning, that you would better get back, for you
are A.W.O.L., and Mrs. Austin will be anxious.”
 “She sure will, and Jim, they are waiting to open the packages,”
Bob reminded his step-brother.

“We’ll hustle.” It took Zargo only a few minutes to point out the
different parts and explain their use. At last the two were again
closed in the snug little cabin and Jim was in the pilot’s seat. He had
no difficulty getting home, but when they dropped down by their
own house, the elder Austins were looking for them.

“See what Santa Claus brought us,” Bob shouted. Then the gift
had to be admired, and although the two grown-ups thought it was
a pretty extravagant one, they could not protest against its
acceptance.

“It looks to me as if I shall certainly have to learn to fly if the

other plane is neglected for I expect that you boys will scorn my
purchase,” Mr. Austin told them.

“We do not scorn your purchase, Dad, but learning to fly isn’t a
half bad idea. While Mr. Kramer is here, why not have him give you
lessons? He’ll be glad to.”

“And Mom, too,” Bob added.

“That is an excellent idea,” Mrs. Austin agreed heartily. “I have

read of women doing remarkably well and I should like to try.”

“Hurrah for you,” the boys shouted.

“We still have unopened packages,” she reminded them, so they

trooped into the house, and presently were having a gala time as
gifts were distributed by Bob, who was rather glad that he was the
youngest member of the family, therefore entitled to that privilege.

After the feast early in the afternoon, they wrapped Mr. Kramer
warmly in blankets so he couldn’t possibly take cold, then he was
seated on the fence of the corral from which vantage point he could
have a first class view of the rodeo put on by the men of the K-A
and the Cross-Bar ranches. Jim brought him some peanuts, so it
would seem like a real circus, and the young man from the north
announced when the last horse had made his bow, that it was the
best he had ever witnessed.

“Seeing a horse do stunts like that makes me admire them no

end, but it also makes me feel that I am more at home in a plane.
They do not buck and snort—”

“They don’t,” Bob interrupted. “I say, where did you learn to fly?
In a kindergarten? The ones Buddy and I were taken up in did more
kinds of fan-fishing, and jumping than any bronc.”

“Well, of course they do put you through a course of stunts,”

Kramer grinned.

“And you have to do that for Dad and Mom,” Jim announced.

“I shall be very glad to do so.”

 VII

PARTS UNKNOWN

During the two weeks which followed, the elder Austins, under the
able tutelage of Mr. Kramer, and the additional assistance of their
sons, became remarkably proficient in flying the ranch plane, also,
the Sky Buddies became thoroughly acquainted with the “Lark,”
which was the name of their own super-machine. Then the salesman
removed himself to Crofton, where his firm had a new plane waiting
for him and he expected to demonstrate it for prospective
purchasers. Already the sheriff was watching its performance with
keen interest and it looked as if that worthy might become the
possessor of one of the birds. Although the boys spent a good deal
of time in the air, neither of them neglected his studies with Don
Haurea, and Caldwell could hardly wait until spring came in order to
put some of his information into practice. One afternoon, Mr. Austin
came out of his office with a letter which had come in the morning’s
mail.

“Oh, Jim.”

“Yes, sir.” The boy hurried to learn what was wanted, and
presently they were seated at the big desk.

“I may go to South America,” the man announced thoughtfully.

“Golly, what a trip that will be, Dad,” the boy exclaimed. “Be gone
long, sir?”

“I do not know. It’s a matter of business and I was rather hoping

that my part of it could be transacted from here, but I have received
a confidential letter in which one of my associates urges me to come
personally and look after my interests,” he answered thoughtfully.

“Taking Mom?”

“I do not believe I had better. I have no idea the sort of places I

shall be compelled to visit and I do not want to take her where she
may not be comfortable. There is always a risk. If it were earlier in
the winter, I should not hesitate, but it is a long trip, will take weeks,
and while I can rely upon my men to look after things here, I do not
see how I can get back before very late spring,” he said, as if he
were thinking the matter over instead of discussing it.

“Why don’t you go by airplane?” the boy asked. “Goodness, Dad,

no sense in wasting weeks.”

“Humph. That is a good suggestion, but I do not know that the air
service will help me. Although, come to think of it, I read recently
that they are running trips to the southern part of Chile—perhaps I
can get some information on the—”

“I say, Dad, what’s the matter with you? We have two planes right
here on the ranch. Furthermore, you can fly yours—”

“After a fashion. I should not think of attempting anything so—”

“No, of course not. I was just thinking that you could help out
some of the time. You aren’t like a tenderfoot in the air. We’ll take
you in the “Lark”—and it will be a grand lark—”

“Well, I don’t know about that,” his father hesitated.

“Didn’t we go traipsing all over the United States and Canada?”

“You did, and got into all sort of things,” Mr. Austin chuckled. “This
would have to be a very serious trip, few stop-overs, and return
home just as soon as I conclude my business. I don’t know about
taking you away from your studies.”

“We can take a couple of books along with the luggage. Now,
Dad, don’t be a kill joy. This business deal is important, isn’t it?”

“Very important to all of us,” the man admitted.

“All right, then, let’s all of us get at it as fast as we can. Nothing

can beat the “Lark”, and with two pilots—why Dad, Henry Ford
hasn’t a thing on you,” the boy urged.

“I guess I’d better talk the matter over with Mother.”

Such a project could not be undertaken without very serious

consideration and preparation. When the idea was presented to Mrs.
Austin, she, too, hesitated about letting the Flying Buddies pilot such
a trip, but she did understand the importance of her husband’s
arriving at Cuzco in Peru just as quickly as possible, and that the
shortest time by boat was eighteen days. Usually it took longer;
depending upon the weather conditions. Added to that must be the
time necessary to get to the nearest port, securing reservations at a
season of the year when ships sailing to southern points were
booked up full before leaving the north. By airplane it would take at
least two weeks less, which was a big item. Bob added his voice to
the plea that he and Jim be permitted to go.

“Goodness, Mother, didn’t we go all over the country, find our way
and come back without so much as a broken wire?”

“Yes, you did, but you got into so many adventures. Of course you
didn’t have anything serious happen to you, but you were in your
own country, or Canada, which is almost the same, and you did not
have to travel over long stretches of water,” she persisted.

“It’s just as safe over water as land, Mom. We’d stop at some port
to be sure that everything was ship-shape before we started to
cross, and it can be made in several hops, not all at a clip, as
Lindbergh did. His mother didn’t object, so you be a good sport,
please.”

“His mother must have had some awful hours. I’m sure that every
minute of them seemed like a life time,” she sighed in sympathy.

“Perhaps they did, but we’ll be just as cautious as Lindy was. We’ll
have everything in proper order, and take good care to keep it that
way,” Bob assured her. “Besides, if Dad can get there ahead of time,
and those fellows are planning to put something over on him, we’ll
get him there early and he can give them the laugh. Then, we’ll be
home in time to start things this spring.”

“It won’t be like when we went alone,” Jim added. “Dad will be
along and he will see that we do not go butting into any mischief.”

“Well—” She looked at her husband. “What do you think about it?”

“The more I think about it the more it appeals to me, my dear, but
I do not want to influence you unduly. As Jim says, I shall be along,
it’s a business trip, no sky-larking adventure, and I rather feel that
our Flying Buddies will be thoroughly reliable. They must both realize
that it is a serious undertaking—”

“Sure, Dad, we do; we aren’t kids any more, we’re grown up—”
The two real grown-ups smiled at this, and although they did not
dispute the argument, neither of them could agree that seventeen
and sixteen were exactly mature.

“Well, probably—since we have planes and pilots it is wisdom to

make use of them and not delay needlessly,” Mrs. Austin finally
announced.

“Atta girl!” Bob shouted. He picked her up in his arms and swung
her off the floor just to prove how big he really was.
 “Robert!” His mother protested, so he sat her down again.

“Gosh, Mom, you haven’t called me that since I put the cat in the
frying pan,” he grinned.

“Did it jump into the fire?” Jim drawled.

“It did, and after Mom got through with me, I felt as if I had been
sitting in it. Wow, she did wave a wicked palm! It makes me warm to
think of it,” he laughed.

“Dismiss such unpleasant memories. Come on, I’m going to the

Bar-Z. Probably Don Haurea can give me some valuable information
about air-currents and other jams.”

“Flap along by yourself, Old Timer. I’m going to the Cross-Bar to

look at my new hotbeds. I want to be sure I have them in order to
leave, and I’ll get one of the boys to look after them.”

“Shall I take you along in the “Lark”?”

“No, thanks. Dad isn’t using the freighter, so I’ll take that, and
carry some pots back,” Bob answered. The “Freighter” was the name
the Flying Buddies had named the ranch plane.

“I think it isn’t very respectful to call the plane Dad and I use a
freighter—are we the freight?” his mother demanded with assumed
indignation.

“Nope,” he answered quickly, “but she’s a slow-boat compared to

the “Lark”, Mom, and before we leave, I’ll clean her up spick and
span for you.”

A bit later the two boys took off from the open corral, and the
difference in the two machines was immediately evident. The “Lark”
rose, like the bird from which her name was borrowed, while the
other plane went into the air at a more gradual ascent, and by the
time Bob had reached sufficient altitude to set his course, Jim was
becoming a speck in the distance. It did not take him long to reach
Don Haurea’s and leaving the bus with one of the men. He
proceeded to the laboratory where he knew he would find the Don
busy at work.

“Good afternoon, my boy, something I can do for you?”

“I expect you can, sir. Fact is, Dad has to go to Peru, place in the
southern part called Cuzco—”

“Cuzco?”

“Yes sir, do you know it?”

“Rather.”

“Well, we persuaded him, Buddy and I did, to let us take him in

the “Lark”, and I thought I’d ask you about—well, the best route,
and the sort of air we are likely to hit, or get hit by.”

“How do you expect to go?”

“Haven’t had time to consider it much, but I thought of going to

Southern California and down that way, or shooting across Mexico,”
Jim told him. The Don pressed a button and one of the men
appeared.

“Bring me the atlas, if you please.” Presently an enormous book,

its pages of fine quality paper, and the cover of light wood, which
held the sheets together with clamps, was opened before them. The
maps were the best the boy had ever seen and as he examined
them he saw that land, water and air were all carefully charted so
one could tell the depths of the sea, the proprieties of its surface,
whether it was rugged or comparatively smooth, the direction of
tides and under-water streams, also the force of the various winds
and their usual course. Each section of the world was recorded in
the most complete detail, and air currents marked clearly.

“Golly, what a set of maps,” he exclaimed in wonder.

“They are exceptionally fine and were compiled after years of the
most careful study. Now, let me see, going directly across Mexico
would seem like the better course, but I advise you to go to Miami,
over the Keys, to Havana, to Belize in British Honduras (you’ll have
no trouble finding people with whom you can talk), then to Panama,
across and down the coast line to Lima. Cuzco is inland.”

“That sounds like a good route.” Jim examined the map carefully.
“It gives us plenty of places to come down.”

“Yes. A part of the way the N. Y. R. B. A. air lines have mail and
passenger service.”

“That’s the New York, Rio and Buenos Aires line!”

“Yes. I’ll have one of the boys make you an itinerary so that you
can be over the water during the daytime unless you get in too big a
hurry. May I ask why you are going?”

“Dad and some friends of his are interested in a project down

there with some other business associates. One of his friends wrote
confidentially that my father better be on the ground. He’s making
quite an investment,” Jim explained.

“I see. I take it you expect to go and return as soon as possible.”

“Yes, sir.”

“Well, this route will really be the better one, and with two pilots
you can stay in the air as long as you like. I have been in Peru, and
don’t forget to take light clothing. It is very hot, unless you get back
into the mountains. Cuzco is two hundred miles from Lima and is
more temperate than places west of the Andes.”

“Thank you.”

“Now, you better leave the “Lark” here until you are ready to start.
Our men will put her in order for you, and I’ll see that she has one
or two extra conveniences. She is built to withstand acids—”

“Oh, we don’t expect to get into any trouble,” Jim laughed.

“Of course not, but if your father is planning to give his associates,
some of them, a surprise, you want to be prepared. Men of this age
are frequently particularly vicious if their financial plans are
threatened. This is something you want to remember, and so, do not
take any chances.” The Don spoke so earnestly that Jim was
sobered.

“It’s kind of a wild country down there isn’t it?”

“Parts of it, certainly.”

“Not very thickly settled.”

“It isn’t always the isolated spots where the greatest evil is
committed. Be on your guard all of the time. I do not mean for you
to be stupidly fearful, but be precautious.”

“I understand. Thank you, Don Haurea, and you bet I’ll be glad to
have all the trimmings that the “Lark” will carry.”

“All right. You might study these maps while you are here, and
later I’ll send Zargo home with you, unless you will dine with me. I
have not had young company for some weeks.”

“I’ll be glad to stay, but jinks, I’m in working clothes.”

“Never mind that. Is the plane here?”

 “Yes, sir.”

“I’ll have the boys set to work on her at once. When do you
expect to leave?”

“Not for a couple of days anyway. I know that Dad can’t start
before that.”

“Fine. Now, I’ll get back to my observations.”

“I thought I could take some lessons with me,” Jim remarked.

“We’ll have some prepared.”

Jim bent over the maps, made a memorandum of the route the
Don had suggested, a rough sketch on which he marked various
items of importance, and when the man came to tell him it was time
to go to dinner, the boy could hardly believe it. Half an hour later
they were seated in the cheery living room, and the meal was being
served. Through the first course they discussed this and that, then
suddenly Jim remembered that Don Haurea had said he had been in
Peru.

“It must be an interesting country, down there, sir. Did you like it
when you were in Peru?”

“Very much indeed.”

“We studied its history in school, and I read some extra books
about the Conquistadores. Most of the writers soft peddled the old
duffers, but I got a hunch they were a pretty hot lot. Pizzaro and his
brothers—they were half brothers. Only one of them got back to
Spain, and he spent twenty years in prison. The Marquis Francisco
was assassinated, one brother was killed by the Indians, and the
other was hanged. Rather a come-down from being chief moguls,
but I wasn’t a bit sorry for them, they were a—” Jim saw Don
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