New Books in the Library!

Other new books recently received:

• Falls in Older People: Risk Factors and Strategies by Stephen Lord, et al


• Handbook of Multicultural Assessment edited by Lisa Suzuki, et al


• Managing Self-Harm: Psychological Perspectives edited by Anna Moltz


• Psychoanalytic Psychotherapy: A Practitioner’s Guide by Nancy McWilliams


• Inner Game of Stress by W. Timothy Gallwey, Edd Hanzelik and John Horton


• Severe and Persistant Mental Health Treatment Planner by Arthur Jongsma, et al


• Medical Illness and Schizophrenia edited by Jonathan Meyer, et al


• Mindful Way through Depression by Mark Williams, et al


• Stahl’s Essential Psychopharmacology: Prescriber’s Guide by Stephen Stahl


• Continuing Professional Development of Physicians by the American Medical Association


• Cognitive Behavior Therapy in Refractory Cases edited by Dean McKay, et al


• Severe Dementia edited by Alistair Burns, et al


• Coping With Chronic Illness Workbook by Steven Safren, et al


• The Art and Science of Mindfulness: Integrating mindfulness into psychology and the helping professions by Shauna Shapiro & Linda Carlson


• Movement Disorders in Clinical Practice by K. Ray Chaudhuri, et al


• American Psychiatric Publishing Textbook of Geriatric Psychiatry edited by Dan Blazer, et al

• Clinical Handbook of Schizophrenia edited by Kim Mueser, et al

Articles of Interest - June 8, 2010

Hi, all,

Here are this week's articles of interest. If you are interested in reading any of the articles listed below, send me an e-mail (to Carl Seele):

First, an article about suicide intervention from someone with much experience dealing with such matters:

"35 years of Working With Suicidal Patients: Lessons Learned" by Donald Meichenbaum, Canadian Psychology; 46(2) 64-72, 2005

Abstract:

Following a personal description of several patients who have committed suicide in my clinical practice and consultation, I summarize the literature on risk assessment for suicide. The form adopted is a set of specific questions that a knowledgeable clinical supervisor might use to help a clinical team examine their clinical decision-making and determine practical guidelines in caring for a suicidal patient. The factors covered include suicidal risk assessment, presence of comorbid and protective factors, immediate emergency interventions on both an outpatient and inpatient basis, and possible short-term and long-term interventions. The training and practical clinical implications of following these guidelines are considered. The checklist, in the form of probing questions, is not intended to foster an adversarial process, but rather to provide a framework in evaluating the assessment and care of suicidal individuals.


Individuals will sometimes complain of health problems that tests are unable to confirm. They may have somatization disorder. What to do? This article comes up with one approach:

"Affective-Cognitive Behavioral Therapy for Somatization Disorder", by Robert Woolfolk and Lesley Allen, Journal of Cognitive Psychotherapy, 24(2), 116-131, 2010.

Abstract:

Somatization disorder is the most severe and refractory of the somatoform disorders. In this article, we provide an overview of somatization disorder, reviewing both the experimental psychopathology and treatment outcome literatures. We also describe a new psychosocial intervention that we developed to treat somatization disorder, affective-cognitive behavioral therapy. We attempt to place the treatment within the context of contemporary cognitive behavioral therapy.

Finally, an article and a book chapter dealing with Cognitive Behavioral Therapy to treat schizophrenic delusions:

"Cognitive-Behavioral Therapy of Delusions: Mental Imagery within a Goal-Directed Framework", by Gail Serruya and Paul Grant, Journal of Clinical Psychology, 65(8), 791-802, 2009

Abstract:

Central to psychotic disorders, delusions are associated with disability and often respond inadequately to pharmacotherapy. Cognitive behavioral treatments have been developed over the last 20 years that successfully address delusions. However, meta-analyses suggest only a modest improvement in psychotic symptoms. Because delusions share considerable overlap with anxiety, adapting principles and techniques that have demonstrated efficacy in the treatment of anxiety disorders might improve the impact of cognitive-behavioral treatment of delusions. We report a case illustrating a cognitivebehavioral approach to delusions with an emphasis on mental imagery techniques. A 25-year-old male diagnosed with paranoid schizophrenia whose clinical presentation was dominated by paranoid delusions received 6 months of treatment. At the end of the follow-up period, the patient’s delusions were minimal and his negative symptoms had significantly improved. Mental imagery may be an important treatment tool for delusions.

"Cognitive Assessment and Therapy of Delusions", chapter 9 in the book, Schizophrenia: Cognitive Theory, Research and Therapy, by Aaron Beck, et al, New York: Guilford Pr., 2009

Summary:

This chapter is filled with practical advice regarding how to assess and treat delusions. It includes info on starting assessments, conducting functional assessments, setting therapeutic goals, ascertaining evidence, and socializating the Individual to the cognitive model of therapy. It instructs on what steps should be taken by the clinician initally and what later steps that should follow. It gives examples of Clinicians interacting appropriately with Individuals with delusions, and describes what they should focus on when in dialogue with Individuals.

Articles of Interest - April 20, 2010

This week's articles relate to depression/suicide.

"Responding to Suicide Risk", chapter 17 of Ethics in Psychotherapy and Counseling: A Practical Guide by Kenneth Pope, Jossey-Bass, 2007. Access here: http://kspope.com/suicide/index.php#copy

Summary: This book chapter, which gives the obligatory suicide warning signs, also offers concrete steps that hospital staff can take to reduce suicide risk in their hospitals. It gives 10 steps that staff can take in that regard, and also gives suggestions provided the experts (Linehan, etc.).

The Library has a book entitled Metacognitive Therapy for Anxiety and Depression by Adrian Wells which discusses a relatively new form of psychotherapy called Metacognitive Therapy. This kind of therapy, although owing a great deal to Cognitive Behavior Therapy, has rather a different focus than CBT--thinking about thinking rather than challenging faulty or irrational thoughts. It can be effective for those who traditional CBT doesn't reach as the following article indicates.

"Metacognitive Therapy in Recurrent and Persistent Depression: A Multiple-Baseline Study of a New Treatment"
Cogn Ther Res (2009) 33:291–300



Abstract:


"Metacognitive Therapy (MCT) for depression is a formulation-driven treatment grounded in the Wells and Matthews (Attention and emotion: A clinical perspective, 1994) self-regulatory model. Unlike traditional CBT it does not focus on challenging the content of depressive thoughts or on increasing mastery and pleasure. Instead it focuses on reducing unhelpful cognitive processes and facilitates metacognitive modes of processing. MCT enables patients to interrupt rumination, reduce unhelpful self-monitoring tendencies, and establish more adaptive styles of responding to thoughts and feelings. An important component of treatment is modification of positive and negative metacognitive beliefs about rumination. MCT was evaluated in 6–8 sessions of up to 1 h each across 4 patients with recurrent and/or chronic major depressive disorder. A non-concurrent multiple-baseline with follow-up at 3 and 6 months was used. Patients were randomly allocated to different length baselines and outcomes were assessed via self-report and assessor ratings. Treatment was associated with large and clinically significant improvements in depressive symptoms, rumination and metacognitive beliefs and gains were maintained over follow-up. The small number of cases limits generalisability but continued evaluation of this new brief treatment is clearly indicated."

If you are interested in reading this article, please drop me a line.

Articles of Interest - March 24, 2010

Hi, All,



How about for this week some Clinical Guidelines for Schizophrenia? These guidelines discuss pharmacotherapy and interventions for Schizophrenia, and also touch on refractory cases. Once you click on the link, it's free to save to your desktop.


Are you interested in Alzheimer's Disease and Mild Cognitive Impairment? Well Dialogues of Neuroscience has a whole issue devoted to this topic which you can download for free. Go here: http://www.dialogues-cns.org/brochures/41/html/41_3.asp and click on the Adobe icon on the top right.

Do your patients have substance abuse problems? Don't forget the TIPS (Treatment Improvement Protocols) provided by SAMSHA! For example, here's one on Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment.

Okay, without further ado, here are this week's articles:

"How to select pharmocological treatments to manage recidivism risk in sex offenders", Current Psychiatry, vol. 8(10), 60-66, 2009.

Provides different pharmacological treatment recommendations for sex offenders depending on their individual "patient factors" as well as the severity of their offense. Considers both hormonal and nonhormonal medications. Discusses the different drugs that can be used to manage such offenders. Finally, this article briefly touches on how to gauge the risk of re-offense.


If you are interested in receiving this article, send me an e-mail. Or, alternatively, you can go to Current Psychiatry Online and register and look at the articles there. Registration is free--no credit card no. is asked for, just your name and e-mail address for the most part.

"Management of Schizophrenia with Suicide Risk", Psychiatric Clinics of North America, vol. 32(4), 863-884.


Abstract: "Suicidal behavior remains a major source of morbidity and mortality among schizophrenics. The National Institute of Mental Health Longitudinal Study of Chronic Schizophrenia found that over a mean of 6 years, 38% of the patients had at least one suicide attempt and 57% admitted to substantial suicidal ideation. Suicide is also a major issue among inpatients with serious implications for clinical practice and patient-doctor relationships. The management of schizophrenic patients with suicide risk remains a difficult area for clinicians despite attempts to better understand it by gathering experts in the field. This article discusses the frequency of suicidal behavior in schizophrenia, offers a model for understanding it, and discusses various aspects of the management of the at-risk schizophrenic patient."


If you are interested in this article, send me an e-mail.

Articles of Interest - March 3, 2010

Hi, All,

Here are a few articles of interest for this week.

Non-Suicidal Self-Injury and Motivational Interviewing: Enhancing Readiness for Change
(after clicking on the link, you can read the whole article by looking at the leftmost column of the page)
Journal of Mental Health Counseling, vol. 30(4), Oct. 2008, pgs. 311-329

Abstract: "The authors advance motivational interviewing and the transtheoretical model of change as a conceptual framework for counseling clients who engage in nonsuicidal self-injurious behaviors. The major principles of motivational interviewing are applied in a case study of a client who self-injures. Recommendations are made for mental health counseling practice."

Cognitive therapy for violence: reaching the parts that anger management doesn't reach
Journal of Forensic Psychiatry and Psychology, v. 20(2), Apr. 2009, pgs. 174-201.
(NSH staff interested in reading the full-text of this article can e-mail me (Carl Seele))

Abstract: "In forensic clinical settings, the most popular model for working with violence has been anger management, which uses a cognitive behavioural approach to explain how stimuli may cause anger via a series of information processing biases. There seem to be a variety of cognitions and thinking processes that are either more common or more extreme in individuals who behave violently. Despite concerns about meta-analytic reviews of treatment effectiveness, and reservations about the relevance of anger management for reducing violence and reoffending, its use is widely advocated in prison and secure settings. We have suggested that low self-esteem is central to violence rather than high self-esteem, but that self-esteem may appear high. Combining cognitive behavioural and psychodynamic approaches produces a formulation that can be used for treatment incorporating not only emotional and behavioural work but also reconstruction of core beliefs and dysfunctional assumptions (rules). It is proposed that because important cognitions relating to violence also relate to self-esteem and the protection of (false inflated) low self-esteem in the face of humiliation, any intervention for violence must also account for a fragile inner sense of self-esteem which, it is proposed, has a causal relationship (along with other factors) with violence. The approach presented here includes a number of core therapeutic tasks. A case study is described to demonstrate its application. It offers a structured but flexible and individually tailored approach to working clinically with violence. "

Sources of Free or Inexpensive CME programs

Sources of Free or Inexpensive CME programs (from yours truly as well as the MLA News, January 2010):
* = Registration is required.

AHC Media: freeCME.com*
http://www.freecme.com/
Free courses. Courses can be sorted by specialty and by accrediting body. E-mail alerts about new courses are available.

CE Medicus: Your Center for Professional Continuing Ed. and Learning*
http://www.cemedicus.com/
9000+ hours of free CME credits. An option to keep track of earned credits is available, as are opportunities for specialty credits.

Cleveland Clinic: Center for Continuing Ed.*
www.clevelandclinicmeded.com
Live CME credit available, as are text-based programs, webcasts and podcasts.

MedPage Today: CME Spotlights
www.medpagetoday.com/CME-Spotlights/
This award-winning site has links to CME courses, sorted by specialty or title.

MedscapeCME Today*
www.cme.medscape.com/medscapetoday/
850+ CME courses. Some award Am. Academy of Family Physician Credit, as well as AMA credit.

Netce
www.netce.com
Not just for MDs, this site also offers continuing ed credits to psychologists and other healthcare professionals. There is a link to free/inexpensive new courses.

Online CME: Annotated List of Online CME
www.cmelist.com/list.htm
a portal to over 300 online sites that offer AMA category 1 credits. Users can search by medical specialty or topic.

Physician’s Travel and Meeting Network: CME Planner*
www.cmeplanner.com
Allows doctors to locate live CME activities by specialty or location.

Prime
www.primeinc.org
At this site courses are typically free. Here you can search by discipline or by topic.

Articles of Interest - Feb. 3, 2010

Hi, All!

I am reviving this blog as a way to post links to articles of interest for NSH staff. For this week, here are the links to 2 such articles along with their abstracts (Note that the links are titles of the articles, highlighted in green):

1) "Contracting for Safety with Patients: Clinical Practice and Forensic Implications", Journal of the American Society for Psychiatry and the Law, 37(3): 363-370 (2009) If after reading the abstract at this site (which is also listed below), you wish to read the full text of the article, click on the links on the right side of the page.

Abstract:
The contract for safety is a procedure used in the management of suicidal patients and has significant patient care, risk management, and medicolegal implications. We conducted a literature review to assess empirical support for this procedure and reviewed legal cases in which this practice was employed, to examine its effect on outcome. Studies obtained from a PubMed search were reviewed and consisted mainly of opinion-based surveys of clinicians and patients and retrospective reviews. Overall, empirically based evidence to support the use of the contract for safety in any population is very limited, particularly in adolescent populations. A legal review revealed that contracting for safety is never enough to protect against legal liability and may lead to adverse consequences for the clinician and the patient. Contracts should be considered for use only in patients who are deemed capable of giving informed consent and, even in these circumstances, should be used with caution. A contract should never replace a thorough assessment of a patient's suicide risk factors. Further empirical research is needed to determine whether contracting for safety merits consideration as a future component of the suicide risk assessment.

2) "Mindfulness-Based Interventions: Effective for Depression and Anxiety",Current Psychiatry, 8(12) December, 2009.

Abstract:
Briefly describes what Mindfulness is, how to teach it, what therapies employ mindfulness, and how mindfulness benefits clients. Describes the current research indicating the effectiveness of mindfulness. Gives instructions on Becoming a Mindfulness-Based Instructor.

In addition to these articles, I just recently received the following articles from the UK that you may be interested in: New guidelines for the Non-pharmaceutical Management of Depression and Preventing Suicide: A Toolkit for Mental Health Services. Both of these sites have downloadable pdf articles on their respective topics.