Psychiatric Program Research Articles

Predictors for Readmission into Children’s Inpatient Mental Health Treatment

The goal of this study was to examine factors associated with time to first and subsequent readmissions of youth (N = 1,432) to one of Florida's residential mental health treatment programs, known as State Inpatient Psychiatric Program (SIPP). Results of multivariate Cox regression analysis indicated that greater maltreatment severity, shorter length of time spent in SIPP during the initial episode, and longer time to provision of targeted case management services were associated with earlier readmission. When time to subsequent readmission was examined, results of multivariate Cox regression analysis indicated that shorter length of stay during the second hospitalization and having more than one mental health diagnosis increased the odds of experiencing subsequent readmission. One consistent finding across initial and subsequent readmissions was that the timing of service provision but not the amount of services was crucial for preventing readmissions to inpatient residential programs.

897 – European federation of psychiatric trainees (efpt) exchange programme: building links across europe

Introduction This is the first European psychiatric exchange programme and it aims to promote an intercultural professional exchange and cooperation among psychiatric trainees across Europe, with a focus on individual experience. Objectives To provide trainees with the opportunities to: • promote awareness of intercultural aspects of psychiatry • engage in clinical, and/or research, and/or teaching activities • become acquainted with different mental health systems • gain experience of different illness manifestations and treatment options • experience a different training programme • socialise with peer group, promote networking and discuss coping strategies regarding work life balance Methods The programme was developed by the exchange working group of the EFPT in 2011 and it offers 2-6 weeks in observational placements across Europe in diverse areas. Results Feedback from pilot phase (January-July 2012) has shown excellent overall satisfaction of participants in the project. In the 2nd phase (August-December 2012) the programme has expanded offering more observational placements in 8 countries such as: Croatia, Denmark, France, Italy, Portugal, Slovenia, Spain and UK. In the 3rd phase (January-July 2013) it expanded further to include Ireland, Netherlands and Romania in a total of 11 hosting countries. Placements are offered in many subspecialties such as: psychotherapy, emergency psychiatry, child and adolescent psychiatry, eating disorders, family therapy, liaison psychiatry and psychosomatics, drug addictions, learning disabilities, forensic psychiatry and old age psychiatry. Conclusions We hope that the diversity of placements offered by this innovative programme will constitute a new approach to the improvement of psychiatric training and practice across Europe.

834 – Fighting stigma of psychiatric disorders in czech republic

The most stigmatized patients are those suffering from schizophrenia and bipolar disorder, and highly affected are also patients with personality disorders, eating disorders, anxiety and OCD. There can also be a stigma in the psychiatric treatments. Psychopharmacs can be labelled as toxins that alter the psyche or body, psychotherapy as a brainwashing. Stigma of mental disorder is connected with a lack of knowledge about psychiatric disorder, fear, prejudice and discrimination of the patients. Czech mass media significantly contribute to the stigmatization of patients with mental disorder. There are already some programs with destigmatization message in the Czech Republic. These programs are in charge of organizations focused on patients with mental disorders, as well as individual professionals or even nonspecialists. The Czech psychiatric association declared the National Psychiatric Program. This program aims to improve the quality of psychiatric care with emphasis on the humane condition of the care and destigmatization. There are also several articles and TV relations describing the psychiatric patients non-stigmatization way published in local newspapers and magazines every year wrote by leading experts in psychiatry. Directly to the patients and their families there were published more than 45 books and about 40 booklets with most often psychiatric problems. Many patients found the information and stories helpful and were more comfortable seeking the treatment. IGA MZ CR NT 11047-4/2010

The benefits of an adolescent psychiatric day service: the Harrow experience – a pilot study

PurposeThe purpose of this study is to describe the characteristics of severely psychiatrically impaired adolescents requiring day hospital management and the effectiveness of the service using standardised outcome measures.Design/methodology/approachThe data was collected on adolescents aged 13‐17 years in two London boroughs, attending the day service over a period of one year. Outcome measures were HoNOSCA, CGAS, SDQ and qualitative data from feedback forms from adolescents and parents.FindingsThe adolescents (n=22) had varied disorders, but mainly depression, (n=9) and psychosis (n=4). HoNOSCA score on admission was mean 18.14 (SD 3.78) but by discharge it had reduced to mean 15.39 (SD 7.31) (p=0.07), and CGAS reduced from initial mean score of 43.83 (SD 9.90) to 53.17 (SD 12.04) (p=0.003). Attendance for 19 (86 per cent) adolescents was for less than six months. Following discharge 14 (64 per cent) returned to education or employment. Adolescents and their carers reported high levels of satisfaction. The findings indicate substantial improvement and satisfaction with the service. The size of the improvement in outcome scores and the consistency across the HoNOSCA and CGAS associated with high service satisfaction also suggest that the data is reliable.Research limitations/implicationsThe small size of the sample and loss of data made it difficult to extrapolate from the results to other groups of impaired adolescents. There was no control group in the study and therefore it was not possible to demonstrate whether the improvement was due to spontaneous changes over time, Tier 3 CAMHS input or the attendance at the day service. It is difficult to demonstrate what proportion of adolescents who were admitted to the day service would have required a Tier 4 in patient admission had the service not been available. A larger study using a more robust design involving randomisation to the day‐service or in‐patient service would provide important comparative data regarding the service benefits.Originality/valueCurrently there is little provision for severely psychiatrically impaired adolescents who require a day treatment programme. Day patient programmes appear to offer a useful and accessible treatment method. The service is much cheaper than an in‐patient service, and may also reduce the demands for or duration of inpatient admission. Unfortunately the service did not obtain continuation funding in view of NHS funding cuts, rather than dissatisfaction by local commissioners, and so needed to close. The data presented here can hopefully be used to support the case for child and adolescent psychiatric day programmes.

A Biopsychosocial Approach to HIV/AIDS Education for Psychiatry Residents

AIDS psychiatry has been described as a paradigm for teaching psychosomatic medicine with a biopsychosocial approach (1–7). The need for HIV/AIDS education has been emphasized in descriptions, studies, and surveys of psychiatric residency training programs (3–6). HIV/AIDS psychiatry provides opportunities for psychiatry residents to learn about preventing illness and managing chronic and acute illness in persons with psychiatric disorders. It magnifies the significance of assessing acute mental status changes in medically ill persons, discussing sexual and drug-use behaviors, and integrating a cognitive assessment into every psychiatric consultation. The complexities of AIDS and its treatments also magnify the complicated interactions of medications as influenced by mechanisms of drug metabolism and the necessity for building rapport to facilitate the recognition and management of psychiatric symptoms and disorders that affect adherence to medication and participation in treatment. HIV/AIDS complexities also substantiate the value of integrating palliative approaches to care throughout the course of illness, not only at the end of life. AIDS is similar to most other complex and severe medical illnesses, such as cancer, cardiovascular illnesses diabetes mellitus, emphysema, and systemic lupus erythematosis. Severe, complex illnesses have a profound impact on the lives of individuals, their loved ones, and families. Nonadherence tomedical care heightens suffering,morbidity, andmortality. Most persons with severe, complex illnesses can benefit from a comprehensive, compassionate, biopsychosocial approach to care. Integrating medical and psychiatric care for persons with HIV and AIDS can improve adherence, ameliorate suffering, and decrease morbidity and mortality. AIDS differs from many other complex and severe illnesses because it leads to other multi-morbid and debilitating medical illnesses, such as endocrine, hematologic, renal, pulmonary, neoplastic, and cardiac illness, as well as concomitant illnesses, such as hepatitis C (HCV). AIDS is also associated with specific psychiatric disorders, such as mood disorders, anxiety disorders, psychosis, and HIV-associated neurocognitive disorders (HAND). AIDS differs from many complex and severe illnesses in two ways that are very relevant to HIV/AIDS education. The first is that it is an unusual illness because it is almost entirely preventable, and adherence to risk-reduction behaviors has public health implications. The second is that HIV and AIDS are associated with sex, drug use, and AIDS-associated stigma and discrimination, or AIDSism (8). Whereas nonadherence to prevention and treatment of all illnesses has tragic consequences to patients, families, and loved ones, nonadherence to prevention and treatment of HIV and AIDS also results in HIV transmission and has significant public health implications. The most significant challenges to AIDS education in psychiatric residency training include illness-related and training-related factors. Illness-related challenges include an illness with rapidlychanging prevalence, incidence, and treatments, as well as stigma and AIDSism. Training-related factors include pressures of time and productivity, as well as complacency and denial regarding HIV and AIDS. During 4 years of training, psychiatry residents rotate through the inpatient and outpatient units of psychiatry and general care, the emergency room, and intensive care units. Each of these settings provides an opportunity for HIV training. In this article, we document the relevance of AIDS education for psychiatry residents and describe an HIV and AIDS curriculum Received February 11, 2012; accepted April 19, 2012. From the Dept. of Psychiatry, Mount Sinai Medical School, New York, NY, Dept. of Psychiatry, Harvard Medical School, Boston, MA. Send correspondence to Mary Ann Cohen, M.D., e-mail: macohen@nyc.rr.com Copyright © 2012 Academic Psychiatry

A Multi-Modal Pilot Intervention with Violence-Exposed Mothers in a Child Psychiatric Trauma-Focused Treatment Program

This multi-method pilot study implemented a relationally-based intervention with mothers of school-aged children receiving treatment for exposure to domestic violence. Grounded in psychodynamic and attachment theories, the short-term intervention consisted of targeted individual and group sessions. Quantitative as well as qualitative data were examined for trends and exemplars of important process outcomes. Improvements were evidenced in a number of key areas including psychiatric symptoms, isolation, defensive avoidance, coping skills, attributional style, and reflective functioning. Results converged to portray improved functioning in critical areas of dysfunction often displayed by these mothers.

Psychiatry training in Europe: Views from the trenches

Background: In the majority of European countries, postgraduate psychiatry training schemes are developed and evaluated by national bodies in accordance with national legislation. In order to harmonise training in psychiatry across Europe, the European Union of Medical Specialists (UEMS) issued a number of recommendations for effective implementation of training programs in psychiatry.Aims: To describe the structure and quality assurance mechanisms of postgraduate psychiatric training in Europe.Method: The European Federation of Psychiatry Trainees (EFPT) conducted a survey, which was completed by the representatives of 29 member national psychiatric associations.Results: In most countries (N = 19), the duration of the training programme is 5 years or more. Twenty-six countries have adapted a basic training programme that includes the ‘common trunk’ (according to UEMS definition) or a modified version of it. In 25 countries, trainees are evaluated several times during their training with a final exam at the end. In 25 countries, official quality assurance mechanisms exist. However, results demonstrate great variations in their implementation.Conclusions: Overall, psychiatric training programmes and assessment methods are largely compatible with one another across Europe. Quality assurance mechanisms, however, vary significantly. These should receive adequate attention by national and international educational policy makers.

Cognitive Remediation and Psychosocial Rehabilitation for Individuals with Severe Mental Illness

Individuals with severe mental illnesses (SMI) such as schizophrenia are more likely to have impaired cognitive functioning in areas such as attention and concentration, psychomotor speed, memory, executive functions, and social cognition. These cognitive challenges are strongly associated with reduced psychosocial adjustment, such as the capacity for independent living, work or school, and social relationships, as well as the ability to benefit from rehabilitation programs targeted at improving outcome in these areas of adjustment. Cognitive remediation is the systematic use of methods aimed at improving cognitive functioning through the practice of cognitive exercises on either computer-based or paper and pencil tests, teaching more effective strategies for addressing cognitive challenges, and teaching coping or compensatory skills to reduce the effects of cognitive impairment on psychosocial functioning. For over 30 years, research has examined the feasibility and effects of cognitive remediation on cognitive functioning and psychosocial adjustment in people with SMI. Recent meta-analyses of controlled research have shown that cognitive remediation is associated with significant improvements in both cognitive functioning and psychosocial adjustment. However, these reviews of research have also found that the impact of cognitive remediation on psychosocial adjustment is contingent upon the provision of adjunctive or integrated psychiatric rehabilitation, such as supported employment or social skills training. That is, studies that have added or integrated cognitive remediation and psychiatric rehabilitation programs have been found to improve psychosocial functioning more than psychiatric rehabilitation alone, whereas studies that have added cognitive remediation to usual services have found little to no differences in psychosocial outcomes compared to usual services alone. This issue on cognitive remediation and psychiatric rehabilitation brings together six papers addressing topics critical to improving the long-term psychosocial functioning of people with SMI. Four of these papers provide pertinent reviews of research that point the field in important new directions, and two papers are original research contributions. While the research suggests that combining cognitive remediation with psychiatric rehabilitation is more effective at improving psychosocial outcomes, very little is known about how such programs should be combined. The review by R. Penades and colleagues addresses this question by providing a framework and hierarchical flowchart for integrating cognitive remediation with other evidence-based psychosocial interventions. D. L. Roberts and D. L. Velligan review relevant research suggesting that programs specifically developed for and targeting social cognition (e.g., emotion recognition, ability to infer other's mental states) may be more effective and efficient than broad-based cognitive remediation programs. This review has important implications for developing or refining cognitive remediation and psychiatric rehabilitation interventions in order to maximize their cost effectiveness. N. Contreras and colleagues provide a theoretical review of strategies for improving workforce participation in people with a SMI, with a particular focus on the Australian context. The review highlights the Individual Placement and Support (IPS) model of vocational rehabilitation, the most empirically validated program for improving employment outcomes in people with SMI, which has recently been combined with cognitive remediation in the USA. The authors suggest that Australia may be in a prime position to implement such combined interventions. N. Boycott and colleagues also focused in their review on the IPS model, with a particular aim at evaluating the effects of supplementary interventions on work outcomes, including cognitive remediation. While prior research has evaluated the impact of adding cognitive remediation to vocational rehabilitation for people with SMI, scant attention has been paid to integrating cognitive remediation with supported education for this population. The paper by S. A. Kidd and colleagues addresses this lacuna by providing encouraging pilot data from such an integrated program, supporting both the feasibility of integrating cognitive remediation with supported education, and suggesting benefits in education-related outcomes. Finally, the research paper by M. N. Levaux and colleagues provides a useful case illustration of how cognitive remediation can be individually integrated and tailored into helping a person accomplish everyday life tasks. We believe that the papers compiled in this issue make an important contribution to the cognitive remediation field by providing useful syntheses of the research literature, suggesting new directions for research and clinical implementation, and presenting new data on promising programs and approaches to integrate cognitive remediation and psychiatric rehabilitation into people's daily lives. Susan R. McGurk Shaun M. Eack Matthew Kurtz Kim T. Mueser

Treatment Setting and Outcomes of Patients With Co-Occurring Disorders

This study examined the potential differential benefits for patients with co-occurring psychiatric and substance use disorders (SUDs) entering treatment at one of three types of treatment programs: dual-diagnosis, SUD, and psychiatric treatment programs. This quasiexperimental study compared 6-month substance use and psychiatric symptom outcomes of 257 adults with co-occurring substance use and psychiatric disorders who had sought treatment at one of four outpatient treatment programs that used group treatment as the main treatment modality: a dual diagnosis, a psychiatric, or one of two SUD treatment programs. At treatment initiation, patients received a structured diagnostic interview and a survey assessing SUD and psychiatric symptoms; the survey was readministered 6 months later. Multiple and logistic regression analyses examined patient SUD and psychiatric outcome indicators to compare potential benefits of initiating treatment at a dual-diagnosis treatment program. At treatment entry, patients who e...

Improving psychiatric hospital care for pediatric patients with autism spectrum disorders and intellectual disabilities.

Pediatric patients with autism spectrum disorders (ASD) and/or intellectual disabilities (ID) are at greater risk for psychiatric hospitalization compared to children with other disorders. However, general psychiatric hospital environments are not adapted for the unique learning styles, needs, and abilities of this population, and there are few specialized hospital-based psychiatric care programs in the United States. This paper compares patient outcomes from a specialized psychiatric hospital program developed for pediatric patients with an ASD and/or ID to prior outcomes of this patient population in a general psychiatric program at a children's hospital. Record review data indicate improved outcomes for patients in the specialized program of reduced recidivism rates (12% versus 33%) and decreased average lengths of inpatient stay (as short as 26 days versus 45 days). Available data from a subset of patients (n = 43) in the specialized program showed a decrease in irritability and hyperactivity behaviors from admission to discharge and that 35 previously undetected ASD diagnoses were made. Results from this preliminary study support specialized psychiatric care practices with this population to positively impact their health care outcomes.

Assessment of Psychiatric Training Program for Non-Psychiatric Residents in a Japanese Postgraduate Rotation System

Assessment of Psychiatric Training Program for Non-Psychiatric Residents in a Japanese Postgraduate Rotation System

Temperament, Post-Partum Depression, Hopelessness, and Suicide Risk Among Women Soon After Delivering

The aim of the authors in this study was to assess the prevalence of postpartum depression and evaluate the association of affective temperaments with emotional disorders in a sample of 92 pregnant women consecutively admitted for delivery between March and December 2009. In the first few days postpartum, women completed the Suicidal History Self-rating Screening Scale, the Beck Hopelessness Scale, the Edinburgh Postnatal Depression Scale, the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire, and the Gotland Male Depression Scale. Fifty percent of the women reported an Edinburgh Postnatal Depression Scale score of 9 or higher, and 23% a score of 13 or higher. Women with a dysphoric-dysregulated temperament had higher mean scores on the Beck Hopelessness Scale (p < 0.05), the Gotland Male Depression Scale (p < 0.001), the Edinburgh Postnatal Depression Scale (p < 0.001), and the Suicidal History Self-Rating Screening Scale (p < 0.01) than other women after adjusting for covariates. Multiple logistic regression analysis with the temperament groups as the dependent variable indicated that only the Gotland Male Depression Scale was significantly associated with temperament when controlling for the presence of other variables. Women with a dysphoric-dysregulated temperament were 1.23 times as likely to have higher depressive symptom scores. Future studies should evaluate the effectiveness of psychiatric screening programs in the postpartum period as well as factors associated with depression and suicidality during the same period.

Psychosocial processes influencing weight management among persons newly prescribed atypical antipsychotic medications

The purpose was to generate a theory of the psychosocial processes influencing weight management among persons newly prescribed atypical antipsychotic medications. A grounded theory research design was used to guide the study. Semi-structured interviews were the method of data collection, and analysis was performed using constant comparison. Using theoretical sampling, a sample of 11 participants with first-episode psychosis prescribed atypical antipsychotics for at least 8 weeks, and five participants with a diagnosis of chronic schizophrenia prescribed atypical antipsychotic medication for at least 3 years were recruited from an outpatient psychiatric programme. Contextual factors influencing weight management were: accessibility to resources, unstructured lifestyle, and others' perception of weight. Conditions influencing weight management were: rapid weight gain, insatiable hunger and lack of motivation boosters. Participants' early responses to weight gain included discontinuing medications, choosing lower-calorie foods, using walking in daily activities as exercise, accepting weight gain and trying to manage weight but giving up. The consequences revealed from data analysis were contemplating weight management and not trying, as the barriers to weight management exceeded the facilitators. The theoretical framework developed in this study can assist with the understanding and management of weight gain among this unique population.

Differences in Therapeutic Goal Attainment for Adolescents With Substance Abuse Issues in General and Dual Diagnosis Crisis Residence Programs

Adolescents with dual diagnosis and admitted to either a general or dual diagnosis acute care psychiatric program were matched ex post facto according to sex, age, diagnosis, and ethnicity. A multivariate analysis of covariance (MANCOVA) was conducted to evaluate differences in therapeutic goal attainment based on the two programs, while controlling for length of stay in the hospital programs. Adolescents with dual diagnosis had significantly higher scores in coping skills in the general psychiatric program than in the dual diagnosis program. Implications of the findings are discussed.

Mental health care in Fiji

Fiji is one of the largest island nations in the South Pacific. It is multicultural and has an economy based on tourism and sugar production. Like many developing countries Fiji faces the double burden of communicable and non-communicable diseases as well as a third emerging burden of accidents and injuries. Fiji lacks data on the national prevalence and burden of disease of mental disorders. Using World Health Organization estimates there is over a 90% treatment gap for mental disorders. Contributing to this treatment gap are the misconceptions and stigma surrounding mental illness leading people to seek alternative treatments. Fiji's mental health services were established in 1884, comprising a single ward to care for mentally ill expatriates. Services have since expanded to include a 136-bed inpatient facility (St. Giles Hospital), which provides outpatient, psychosocial rehabilitative and community psychiatric services. Mental health services remain centralized at St. Giles, with follow-up in the community supported by a well-established public health hierarchy and by medical personnel at the divisional hospitals. St. Giles is also responsible for conducting mental health awareness and training for health workers and the public and provides input at a national level for mental health policy, plans and legislation. Psychiatric training is available at the undergraduate nursing and medical levels. The Fiji School of Medicine is in the process of developing a postgraduate psychiatric program. With its limited resources Fiji needs to integrate mental health services into the general and public health systems to achieve a comprehensive and integrated mental health system.

P01-474 - Culturally defined community psychiatry in slovenia

IntroductionCommunity psychiatry is to be acknowledged as evidence based psychiatric treatment in Slovenia with some decades of lag behind other EU countries. Nevertheless some community psychiatric programmes were developed by four Slovenian psychiatric hospitals, one of them covering the most deprived region regarding BDP and service provision region with 220000 population. Team work of psychiatrist, two nurses and social worker covers only several patients and families with most severe disability and social deprivation. Communication and cooperation with other community agencies is, regardless their scarcity, crucial. Community work has to be adapted to specific cultural environment defined by multiethnicity and prevailing protestant ethics that influence workers, patients and carers alike.Case reportRevolving door patient with severe mental illness living in extreme poverty in suburb area was approached with family visits. Her mother also presented signs and symptoms of mental disorder and was strongly reluctant to treatment. A number of interventions applied targeted to their living circumstances. Their needs were different from those defined by health and social workers, which resulted in absence of any community care in previously. With personal involvement of team workers, consensus was made and continuity of psychopharmacological treatment with the patient was achieved after many years of non-compliance. Further steps were planned regarding their actual local and social circumstances.ConclusionCommunity psychiatric interventions need to be culturally and socially adapted to the needs of their consumers. The case presented is to reflect special cultural, individual and social particularities that define specific community psychiatric work.

P03-576 - Fighting stigma of psychiatric disorders in czech republic

In the Czech Republic people with mental illness are still stigmatized and exposed to various forms of discrimination not only from the community but also from the professional society. The most stigmatized patients are those suffering from schizophrenia and bipolar disorder, and highly affected are also patients with personality disorders, eating disorders, anxiety and OCD. There can also be a stigma in the psychiatric therapy; psychiatric medication can be labeled as toxins that alter the psyche, psychotherapy as a brainwashing. Stigma of mental disorder is connected with a lack of knowledge about psychiatric disorder, fear, prejudice and discrimination of the patients. Czech mass media significantly contribute to the stigmatization of patients with mental disorder.There are already programs with destigmatization message in the Czech Republic. These programs are in charge of organizations focused on patients with mental disorders, as well as individual professionals or even nonspecialists. The Czech psychiatric association declared the National Psychiatric Program. This program aims to improve the quality of psychiatric care with emphasis on the humane condition of the care and destigmatization. There are also several articles and TV relations describing the psychiatric patients non-stigmatization way published in local newspapers and magazines every year wrote by leading experts in psychiatry. Directly to the patients and their families there were published about 40 books and about 30 booklets with most often psychiatric diagnoses. Many patients found the information and stories helpful and were more comfortable seeking the treatment.Supported by project IGA MZ ĈR NS 10301-3/2009

Clinical Manual of Couples and Family TherapyClinical Manual of Couples and Family Therapy KeitnerGabor I.M.D. HeruAlison MargaretM.D. GlickIra D.M.D. ; Washington D.C., American Psychiatric Publishing, 2010, 336 pages, $65

Back to table of contents Previous article Next article Book ReviewsFull AccessClinical Manual of Couples and Family TherapyWilliam Vogel, Ph.D., A.B.P.P.William VogelSearch for more papers by this author, Ph.D., A.B.P.P.Published Online:1 Feb 2011https://doi.org/10.1176/ps.62.2.pss6202_0227aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Clinical Manual of Couples and Family TherapyKeitnerGabor I.M.D.HeruAlison MargaretM.D.GlickIra D.M.D.; Washington D.C., American Psychiatric Publishing, 2010, 336 pages, $65This book is written by three distinguished professors of psychiatry and is a clinical training manual for family and couples therapy.The manual is designed for psychiatric residents rather than for more advanced therapists and, as the authors acknowledge, will probably be most useful when used with ongoing supervision. As such, it meets its purpose most admirably and is one of the best introductory texts of its kind that I have seen. I recommend it most highly for any psychiatric program. It may also be useful for other trainees, such as those in clinical psychology or clinical social work, and as a basic introductory text in family and couples treatment.The theoretical approach used is McMaster's model of family functioning. It is particularly useful for training psychiatrists because it uses the biopsychosocial model, integrating medical, biological, psychological, and sociological formulations so that it combines individual psychotherapy, family and couples psychotherapy, and medical and psychopharmacological treatment approaches into a comprehensive model. A DVD, included in the package, provides training examples. Theory, clinical practice, research, and training are all points of focus.The book is well written, jargon free, and deserves a place on the bookshelf of every psychiatric trainee.The reviewer reports no competing interests.Dr. Vogel is associate professor with the Department of Psychiatry, UMassMemorial Health Care, Worcester, Massachusetts. FiguresReferencesCited byDetailsCited ByNone Volume 62Issue 2 February 2011Pages 227-227 Metrics PDF download History Published online 1 February 2011 Published in print 1 February 2011

Clinical Manual of Couples and Family Therapy

Back to table of contents Previous article Next article Book ReviewsFull AccessClinical Manual of Couples and Family TherapyWilliam Vogel, Ph.D., A.B.P.P.William VogelSearch for more papers by this author, Ph.D., A.B.P.P.Published Online:1 Feb 2011https://doi.org/10.1176/ps.62.2.pss6202_0227aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Clinical Manual of Couples and Family TherapyKeitnerGabor I.M.D.HeruAlison MargaretM.D.GlickIra D.M.D.; Washington D.C., American Psychiatric Publishing, 2010, 336 pages, $65This book is written by three distinguished professors of psychiatry and is a clinical training manual for family and couples therapy.The manual is designed for psychiatric residents rather than for more advanced therapists and, as the authors acknowledge, will probably be most useful when used with ongoing supervision. As such, it meets its purpose most admirably and is one of the best introductory texts of its kind that I have seen. I recommend it most highly for any psychiatric program. It may also be useful for other trainees, such as those in clinical psychology or clinical social work, and as a basic introductory text in family and couples treatment.The theoretical approach used is McMaster's model of family functioning. It is particularly useful for training psychiatrists because it uses the biopsychosocial model, integrating medical, biological, psychological, and sociological formulations so that it combines individual psychotherapy, family and couples psychotherapy, and medical and psychopharmacological treatment approaches into a comprehensive model. A DVD, included in the package, provides training examples. Theory, clinical practice, research, and training are all points of focus.The book is well written, jargon free, and deserves a place on the bookshelf of every psychiatric trainee.The reviewer reports no competing interests.Dr. Vogel is associate professor with the Department of Psychiatry, UMassMemorial Health Care, Worcester, Massachusetts. FiguresReferencesCited byDetailsCited byNone Volume 62Issue 2 February 2011Pages 227-227 Metrics PDF download History Published online 1 February 2011 Published in print 1 February 2011

Using Motivational Interviewing to Meet Core Competencies in Psychiatric Resident Training

the authors propose that motivational interviewing (MI), a brief intervention designed to manage ambivalence regarding complex behavior change, is well suited for integration into psychiatric residency training programs. the authors provide a brief description of MI. In addition, based on a review of the literature the authors explore which core competencies the empirically validated, client-centered, and directive method of MI would address. the authors argue that psychiatric residency programs can effectively address several core competencies through the addition of MI training in their curricula, including Brief Psychotherapy, Patient Care, and Interpersonal and Communication Skills. the implementation of MI training offers psychiatric residency programs potential benefits in several key areas. However, the authors provide guidance for important research questions to more confidently ascertain whether MI training for psychiatric residents is worthwhile.