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.