Senior Psychologists Research Articles

The physician's perspective on clinical assessment skills by nurses in psychiatry: A case study

The physician's perspective on clinical assessment skills by nurses in psychiatry: A case study Abstract: Background: People with a mental and physical illness receive less good somatic care compared to the general population. Patients in psychiatry receive better medical care when nurses have in-depth medical expertise. Therefore, in a psychiatric institution in Switzerland in 2017, the Clinical Assessment and Decision Making (CADM) by nurses was implemented. Aim: The aim of the study was to investigate how physicians and senior psychologists experience the implementation of CADM by nurses in order to derive recommendations on how to optimize the collaboration and promote a sustainable establishment. Methods: An embedded single case study was used, and the data analysis was based on grounded theory strategies by Charmaz. Semi-structured expert interviews (n = 11) and open unstructured observations were conducted in a psychiatric institution in Switzerland. Results: The results showed nine relevant aspects regarding collaboration and CADM by nurses: "Strengths", "Weaknesses", "Risks", "Opportunities", "Expectations", "Challenges", "Benefits", "Competencies of CADM nurses" and "Wishes for the future". Conclusions: The physicians and senior psychologists considered the CADM by nurses as an added value for the interprofessional team and for the patients. Lack of clarity regarding the scope of responsibilities, role definitions and possible applications made the implementation of CADM difficult.

“The whole elephant”: “What works best” consultation practices of learning support teams in primary schools

ABSTRACT This study explored the consultation practices of Learning Support Teams (LSTs) in three NSW primary schools engaged in learning and wellbeing support for diverse students. An organisational ethnographic case study approach was used to explore behaviour, language and interactions within the school sites. Participants included learning support teachers, senior executive staff, school counsellors and psychologists. To elicit specific practices from participants, an Interview to the Double technique was employed to collect qualitative data. Findings showed that teams used specific data-driven decision-making and problem-solving practices to address challenges in supporting student learning and wellbeing. LSTs identified shared purpose, effective membership structures, communication and relationships as critical in consultation. This study has implications for understanding “what works” for LST consultation and recognised the need for explicit measuring and monitoring of team impact.

The Staff Mental Health Service in Cambridgeshire and Peterborough: a new model for assessment and treatment of healthcare workers in the context of COVID-19 pandemic

AimsStaff mental health is a major determinant of a well-functioning health system that has become ever more important during the COVID-19 pandemic. Poor mental health is the most common reason for NHS staff sickness absences, usually accounting for 25% of all reported sick leave. At a time when the NHS most needs an available and efficient workforce, government and NHS employers lack the necessary evidence to inform decisions about how best to support the mental health needs of its staff. In this report, we share our experience and the initial figures from a newly developed multidisciplinary assessment and treatment service for NHS staff.MethodThe Staff Mental Health Service (SMHS) at the Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) launched in September 2020. The SMHS is commissioned by the Cambridgeshire and Peterborough sustainability and transformation partnership and is accessible to the 25,513 staff based at five NHS trusts within the region. The service received 235 referrals within 5 months of the launch. All patients had a first clinical contact within three working days and more than 80% had their initial assessment within two weeks. The SMHS clinical team is comprised of consultant psychiatrists, senior clinical psychologists, specialist mental health nurses, and an occupational health nurse set to provide rapid access, confidential, evidence-based treatments for the NHS staff. As part of service evaluation within CPFT, we collected routine screening data (Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), and Posttraumatic Symptom Check List – 6 (PCL-6)) from patients completing the initial assessment (n = 130).ResultAccording to the initial figures (n = 130) from a diverse group of healthcare staff, on average the patients presented with moderate level of depressive symptoms (PHQ-9: 16.22 ± 5.94). Anxiety levels were in moderate to severe range (GAD-7: 13.45 ± 4.70). Average score of PCL-6 checklist for traumatic stress symptoms was higher than the established cut-off (>14): 19.43 ± 5.65.ConclusionThe Staff Mental Health Service offers an innovative, multi-disciplinary rapid assessment and treatment clinic for NHS staff. The demand for the service has been immense, reaching double the number of predicted referrals. Initial data suggested high rates of moderate to severe depression, anxiety, and traumatic stress symptoms in healthcare workers. Our clinical observations was that many healthcare workers have had longstanding significant mental health conditions that saw deterioration during the COVID-19 pandemic. We hope that our experience in the SMHS will help inform models across the UK to address the clear unmet need for staff mental health.

Case study of a stepped-care psychological service for healthcare professionals working in critical care.

Psychological injury is common among healthcare professionals and is expected to be further exacerbated by the current global pandemic, with the far-reaching impacts of this workplace trauma yet to be fully realised. Our Intensive Care Unit and Emergency Department sought to proactively introduce strategies that might reduce the anticipated short- and longer-term negative impact of the pandemic on staff and ultimately patients and families. Our organisation facilitated the temporary redeployment of senior psychologists to provide staff-focused support. Interventions included leader targeted training to increase the skills in this group, specifically for this situation, and site visits to allow for staff to meet with psychologists. Staff experiences of the intervention were explored through the direct observations of the psychologists leading the approach maintained through contemporaneous activity tracking records. An internal and embedded staff psychological service fosters help-seeking behaviours and is considered a desirable and acceptable model for healthcare leaders and professionals. What is known about the topic? Healthcare professionals are at increased risk of psychological distress and injury caused by the inherent stress of their role. What does this paper add? This paper provides service providers with insights into the benefits of an embedded staff psychological service to support the psychological wellbeing of healthcare professionals and teams within an Australian public health service context. What are the implications for practitioners? An embedded staff psychological service can better meet the psychological needs of healthcare professionals and teams by focusing on prevention and early intervention strategies through targeted and tailored systems, teams, and individual interventions.

Vertical vs horizontal bullying: A need of socio‐interactive ethical trainings at workplace

Bullying at workplaces is a growing problem associated with several antecedents and outcomes of psychological disorders. Extant literature shows the relationship of victimization with the owning-up curriculum to confront bullying, but so far there is little research to cure the issue of bullying through ethics and there is no study to check the impact of ethical lessons and exercises in training materials to curb bullying at workplace. The current paper is based on a literature review of aggression and bullying, and chiefly addresses the HR practices in rescuing the people from peer victimization. Conceptually segregating supervisor-subordinate (vertical) and peer-peer (horizontal) bullying psychology, this paper attempts to see what possible corrective steps can be taken by senior managers, supervisors and psychologists to resolve this critical problem through interior capacities. In this paper, we have developed three propositions for conducting a future empirical investigation in connection to a cohort study. By addressing the counterproductive/deviant behavior, the present report is likely to be beneficial for psychology scientists and HR practitioners in noticing and resolving the bullying issues at the workplace for the well-being of employees.

Clothes Don’t Maketh the Man Nor a Criminal Profiler an Expert Witness

The article by Kocsis and Palermo, published in 2016, examined the findings of research which had assessed the validity of the investigative technique colloquially known as criminal profiling. These findings were subsequently considered within the framework of their relevance to the admissibility of the technique as a form of expert witness evidence. The overall conclusion was that a discrete facet of the profiling technique may satisfy some of the requisite legal criteria for admissibility in jurisdictions within the United States. However, this conclusion was based upon studies which used samples of senior forensic psychiatrists and psychologists as the tested profilers. In this regard, it was noted that this parameter may preclude the generalization of this conclusion to other professional groups who do not possess such qualifications. Accordingly, the present article explores the potential admissibility of law enforcement personnel who are not qualified forensic mental health practitioners tendering expert witness evidence in the nature of criminal profiling. The conclusion of this analysis is that law enforcement personnel who possess suitable expertise in the analytic task of criminal profiling arguably possess an analogous knowledge base akin to the aforementioned senior forensic psychiatrists and psychologists. On this basis, the conclusions in Kocsis and Palermo, published in 2016, may extend to such personnel and their potential to likewise provide expert witness evidence.

Systematic development of practice guidelines for psychological interventions in stroke rehabilitation

Purpose: We aimed to develop evidence-based practice guidelines that can support decision-making in individual cases and be used by a multidisciplinary team in stroke rehabilitation.Materials and methods: We conducted a literature search (step 1), and a survey of all neurological rehabilitation facilities in Germany concerning their structural working conditions and current practices (step 2). Based on this information, we drafted a first version of the practice guidelines, and discussed them with a group of experts (step 3). We also consulted concurrently with senior psychologists, head physicians (step 4), and patients after stroke (step 5). We revised the guidelines until consensus on the final version was reached (step 6).Results: Referring to the ICF for guidance, the practice guidelines comprise of psychological recommendations in five problem areas (“Participation – Major Aims of Rehabilitation”, “Cognition”, “Affect & Behavior”, “Risk Factors”, and “Specific Problems & Aspects”), and provide preliminary remarks on general frame conditions and procedural requirements. The practice guidelines were widely accepted by head psychologists and physicians of in- and outpatient neurological rehabilitation with an average agreement of 97% (range: 88–100%).Conclusions: Our practice guidelines include detailed recommendations for psychological interventions that can guide individual decision-making by a multidisciplinary team. Specific aspects to foster implementation were considered, and attempts were made to promote their dissemination.Implications for RehabilitationWe developed practice guidelines for psychological interventions in rehabilitation after stroke based on the best available evidence.The practice guidelines include detailed recommendations for psychological interventions that can guide individual decisions by a multidisciplinary team.The practice guidelines are highly specific, and have been widely agreed upon by a group of experts from different professions as well as by researchers, patients, and clinicians (average agreement: 97%).The practice guidelines offer knowledge on different areas of psychological impairment, can help guide diagnostic and therapeutic procedures for individual patients, and thus, improve standard care in neurological rehabilitation.

Development of practice guidelines for psychological interventions in the rehabilitation of patients with oncological disease (breast, prostate, or colorectal cancer): Methods and results.

The goal of this project was to develop evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of patients with oncological disease (breast, prostate, or colorectal cancer). First of all, we conducted a literature search and survey of all oncological rehabilitation centers in Germany (N=145) to obtain a thorough perspective of the recent evidence, guidelines, the structural framework, and practice of psychological services in oncological rehabilitation. Next, an expert workshop was held with national experts from scientific departments, clinicians from rehabilitation centers, and patients. In this workshop, we drafted and agreed upon an initial version of the practice guidelines. Afterwards, the practice guidelines were sent to all head physicians and senior psychologists at oncological rehabilitation centers in Germany for approval (N=280 questionnaires). In addition, key recommendations were discussed with a group of rehabilitation patients. Finally, the practice guidelines were revised by the expert panel and made available online to the public. The practice guidelines have been widely accepted by both the expert panel and the surveyed clinicians and patients. They include recommendations for psycho-oncological interventions that should be offered to all rehabilitation patients with breast, prostate, or colorectal cancer. They also comprise recommendations for specific problem areas concerning psychological functions, body functions, and environmental and personal factors. The practice guidelines provide detailed recommendations for high-quality psychosocial care in an oncological rehabilitation context. It is their aim to guide the multidisciplinary team, especially psychologists and physicians, in their daily practice.

Acceptability and challenges of implementing the NICE guidelines for schizophrenia in Lagos, Nigeria

This study aimed to examine the suitability and challenges of implementing in a Nigerian tertiary mental health facility the guidelines for the management of schizophrenia produced by the UK National Institute for Health and Care Excellence (NICE). The study was based on a group discussion at the Psychiatric Hospital, Yaba, Lagos. A panel of ten individuals (consultants, senior registrars, senior psychologists and senior social workers and nurses) discussed the guidelines, having been given ample time to study the document. Five patients were also interviewed. Some of the recommendations of the NICE guidelines are already being practised in the hospital to various extents. Full implementation would be hampered by a shortage of human resources and financial constraints. The guidelines need to factor in sociocultural differences. The NICE guidelines with modifications are suitable for use in a Nigerian setting.

I'm Dead, but I Don't Know It: Senior Psychologists Still Active in the Workforce

I'm Dead, but I Don't Know It: Senior Psychologists Still Active in the Workforce

Morbidity profile of patients attending the centers for mental health service provided jointly by the Government of Nepal and Community mental health service of Community Mental Health and Counseling- Nepal (CMC-Nepal)

Introduction: Community mental health program initially conducted in Lalitpur district by UMN and later in the western region demonstrated the possibility of providing mental health services in the primary health care level if proper mental training is provided to different levels of health workers and the program is well supervised. Community Mental Health and Counseling- Nepal (CMC-Nepal) extended the same model of community mental health program to several other districts of the country after taking permission from the Ministry of Health and Population. The basic objective of the study was to prepare morbidity profile of patients attending the centers for mental health conducted jointly by the government of Nepal and Community Mental Health and Counseling- Nepal (CMC-Nepal). Material and method: Ten days block training in mental health for health assistant (HA) and Auxiliary Health Workers (AHW) was conducted by the CMC-Nepal. Senior psychiatrists, psychologists and psychiatric nurse were the trainers. Materials like mental health manual, audiovisuals, flip charts and case stories were used during training by the facilitators. An especially developed patient record card was used for case record, diagnosis and treatment. The study was carried out in between July 2010 to June 2011. A total of 6676 cases were studied during the study period. Results: Community mental health program identified 4761 total new cases in 12 months (July 2010 to June 2011), out of which 2821 were females (59%) and 1940 were males (41%). Similarly total old cases both females and males were 6676 registered in these centers for treatment. Out of all new cases patients with Anxiety Neurosis emerged as the largest group (50%) followed by Depression (24.88%). Other commonly diagnosed conditions were Epilepsy (7.5%), Psychosis (5.3%) and Conversion disorder (5.7%) and unspecified cases (6.5%). The implications of the results are discussed, in the current context. Conclusion: Mental health services need to be provided at the community so as to prevent cases of prolonged subjection to mental illness and also prevent cases of stigma and discrimination. DOI: http://dx.doi.org/10.3126/jpan.v2i1.8569 J Psychiatrists’ Association of Nepal Vol .2, No.1, 2013 14-19

TeamGAINS: a tool for structured debriefings for simulation-based team trainings

BackgroundImproving patient safety by training teams to successfully manage emergencies is a major concern in healthcare. Most current trainings use simulation of emergency situations to practice and reflect on relevant...

Die Entwicklung von Praxisempfehlungen für psychologische Interventionen in der Rehabilitation von Patienten mit koronarer Herzkrankheit: Methoden und Ergebnisse

Available guidelines and treatment standards are not sufficiently detailed to give practical guidance for psychological interventions in the rehabilitation of patients with coronary heart disease. We therefore aimed at developing evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of individual patients with coronary heart disease. The following steps were taken: (1) A systematic search for guidelines and reviews, and a survey of rehabilitation centres concerning present structures and the practice of psychological services, (2) development of a first draft of the practice guidelines in an expert workshop, (3) a survey of all senior psychologists and chief physicians of the rehab centres for their approval, as well as focus groups with rehab patients, and (4) revision of the recommendations and final consensus development in an expert workshop. Significant aspects of the guidelines that go beyond present practice are routine screening for psychological comorbidity, neuropsychological screening for cognitive dysfunction in particular patients, and employment of defined psychologically grounded interventions by the entire rehab team. So far, the practice guidelines have been widely accepted by professionals in the field of rehabilitation.

Terrorists meeting their victims: a case study of psychologists' experiences of former terrorists meeting survivors

PurposeActs of violent extremism have become more regular in the past decade. Little research has managed to analyse the interplay between the individuals who have carried out these acts and those who have experienced them. By bringing two such groups together in direct contact with each other, The Summit Against Violent Extremism (SAVE) offered a unique opportunity to explore the experiences of former violent extremists and victims of terrorist acts. This article aims to focus on this initiative.Design/methodology/approachThe article is designed to take the reader through the discussions of three senior psychologists who attended SAVE to offer support to all involved. Their experiences and insights were gathered, within a focus group, to develop themes with the aim to discuss and share.FindingsPsychologists outlined social development, self‐identity, family and peer groups as critical to the development of extremist views and to the de‐radicalisation of such views. It was reported that the summit gave survivors a chance to express their anger in a positive setting but that this setting could be improved for future summits. Challenges that faced the psychologists included the multi‐lingual environment and confidentiality issues.Practical implicationsThe summit was seen as a successful means for developing an understanding of those who have taken part in acts of extreme violence and terror. The psychologists provide practical suggestions for future de‐radicalisation of people in extremist groups.Originality/valueThe role of therapeutic psychologists in such a summit was viewed as critically important as a support to both formers and survivors.

Everybody's business: from policy to lived practice – the benefits of embedding specialist mental health workers in physical health-care systems

As Britain's population ages, health- and social-care systems face the challenge of continuing to provide high-quality care in the face of increased demand on services. Government policy has proposed meeting this challenge through integrated partnership working to enable people with complex, multiple needs to receive timely care closer to home. Co-morbid mental health needs, including dementia, are common in people with physical health issues, and must be addressed appropriately if systems are to provide the best possible all-round patient care. This paper describes how two senior clinical psychologists have developed an embedded living mental health resource within physical health care, and demonstrates how this has directly and positively impacted on both service performance indicators and patient experience.

Proposed Prescribing Bills Put Patients at Risk

Back to table of contents Previous article Next article From the PresidentFull AccessProposed Prescribing Bills Put Patients at RiskCarolyn Robinowitz, M.D.Carolyn RobinowitzSearch for more papers by this author, M.D.Published Online:7 Mar 2008https://doi.org/10.1176/pn.43.5.0003Recently, I had the opportunity to testify before the Missouri State Senate in strong opposition to proposed legislation that would allow psychologists to prescribe psychotropic medications (and related medications to treat side effects), including controlled substances, without necessary medical education (see article Original article: APA, DBs Prepared to Battle Psychology Prescribing Bills). I was astounded to learn that through this proposed legislation, the board approving and licensing such psychologists would be composed of other nonmedically trained psychologists! How can you oversee what you do not know?©Sylvia Johnson Photography 2007Such a proposal puts patients at risk. Psychologists wishing to be deemed“ prescribers” often state that psychiatric medications comprise only a small portion of the Physicians Desk Reference; this is disingenuous. Psychotropic medications, as all medications—even aspirin—affect the whole body and have the potential for dangerous side effects. Their impact is not limited to the brain or the specific“ behavioral” symptoms for which they are being prescribed. Half of the patients who require psychotropic medication have other medical conditions that also require medication. Interactions of these medications can influence both physical function and behavior. Further, medical students have long been taught that patients do not arrive at a clinician's office knowing the etiology of their symptoms or even what systems are involved, and just as psychiatric disorders present with physical symptoms, psychiatric symptoms may be indicators of nonpsychiatric medical disorders. One needs to know that a condition exists to consider diagnosing it.Basically, the professions come from an entirely different background, educational focus, and understanding of illness. Psychiatry is a medical specialty, using a biopsychosocial paradigm, addressing the interplay of genetic and constitutional factors with the environment and experience. Psychology is based on a psychosocial model rather than a medical model. The focus of psychologists' training is not on normal/cellular/physiological function or pathophysiology of diseases as it is for physicians. Moreover, psychology trainees are not trained to diagnose and treat patients with medical disorders other than mental disorders. Additionally, there are strong differences in education time and type of experience: the proposed 400 hours (10 weeks) of didactics for psychologists to be licensed to prescribe in Missouri is way less than four years of medical school (at least two of which are spent in many hours of hands-on supervised interaction with patients with a broad range of psychiatric and other medical conditions) in addition to the 24/7 rigors of a medical internship that includes at least two months of neurology followed by a psychiatry residency involving hospitalized severely ill patients as well as ambulatory care.Often the “success” of the Department of Defense (DoD) pilot program to train psychologists to prescribe is cited as a rationale for further efforts. Such citations ignore the 1997 report of the General Accounting (now Accountability) Office that criticized the program, as well as the recognition of the program's major limits. The DoD program, which was promoted by a U.S. senator and a staff member (who during his tenure on the senator's staff also was president of the American Psychological Association), was designed to have the best possible outcome. Participants were handpicked senior psychologists with extensive clinical experience. The program included a year's intensive didactic and clinical experience with close medical supervision. Patients were young, healthy adults; children, the elderly, and patients with preexisting (nonpsychiatric) medical conditions were excluded. Training the 10 psychologists who completed the program cost taxpayers $610,000 for each, for a total cost of over $6 million in 1996—the equivalent of tuition for a class of 200 students at a private medical school! Ironically, two of the psychologists in the program eventually went to medical school.Those wishing to expand psychologists' scope of practice without appropriate training often cite the need for services in rural areas. Yet, psychologists' demographics resemble those of other professionals (for example, psychiatrists, attorneys) in that they are congregated in urban and suburban settings. Family physicians (who are already trained in medicine and have residency and certification-based experience in the treatment of mental illness) are much more likely to practice in the less-populated areas, as are physician assistants and nurse practitioners. In New Mexico, where some psychologists became licensed to prescribe after completing “crash courses,” there are no data showing an influx of those licensed psychologists to underserved areas.Our voices must take action to protect our patients, many of whom by virtue of their illness, stigmatization, or lack of resources are underserved, by educating policymakers and the public about the need for access to safe and appropriate care. ▪ ISSUES NewArchived

Issues for the consulting behavior analyst: Don't just implement a treatment plan, use the ecology to practice a treatment plan.

Currently distance consulting takes place mental health rehabilitation centers, mental retardation rehabilitation centers, educational, preschool and even home locations. In each of these locations, but especially home programs, the distance consultant can encounter very different education, training and experience backgrounds within Applied Behavior Analysis this articles talks about the importance of taking into account this part of the ecology designing a treatment plan. ********** Gillat & Sulzer-Azaroff (1994), Page, Iwata, & Reid (1982), speak of the importance of teaching those involved a program how to provide effective training, consultation, and supervision to those who will implement a program. In this example they are speaking of training the trainers which differs slightly from the relationship that we are speaking of currently. In distance relationships involving the education and rehabilitation system, there no guarantee, but generally individuals are available with an acceptable working knowledge about behavioral technology and its application. In addition there are usually senior staff members available, psychologists, social workers, or other specialists who can assist with training and supervision and add considerable assurance to the treatment effort. In an home program the relationship that we are speaking of much more direct, the distance consultant the trainer, consultant and supervisor to those who will implement the program. This relationship spread across a number of visits each year and may vary length, but generally a short six to eight hours every six to eight weeks and some cases even longer. The amount of supervision that the distance consultant may provide between visits varies but generally limited to videotapes, telephones and advice via data analysis and email. In this type of environment the importance of face-to-face time and instruction of the trainers at a premium. Additionally, an home program, where implementers are often implementing the treatment plan while there are considerable competing events, the distance consultant must take into account the ecology of treatment when training the implementer to deal with the complexities of the treatment plan. As Malouf & Schiller (1995) have pointed out there are events the ecology that are not conducive or may impeded or compete with standards of the treatment plan, like the other children the family, the phone, preparation of dinner and other events the ecology that are rarely considered a behavioral change plan. While it remains clear that practicing the application of treatment perhaps the most important use of the distance consultant's time, it becomes more a question of how to practice the application of the treatment plan. As Willems (1974) points out there are interdependencies among ecology, organism and behavior that leave the door open to widespread unintended effects. The possibility exists that the most highly advanced and technically perfect treatment plan may have contradictory effects without the consideration of the ecology. In fact it seems rare that a treatment plan developed for a school setting will be successful as is the home or other settings. The plan simply must be developed considering the ecology, which includes the implementers themselves, their willingness to be implement the treatment plan, their knowledge and experience and the likelihood of resistance (see Cautilli & Santilli Connor, 2000 for more information) to follow the treatment plan. The distance consultant working with an home program must maximize the amount of time that spent with a team working the child's milieu and instructing those who will implement the treatment plan while they are implementing the treatment plan. A simple day of explanation and training about the treatment plan may have little effect once the instructors are left to implement treatment in the real world alone. …

Attention-Deficit Hyperactivity Disorder: How Much Do We See?

A postal questionnaire survey of senior clinical psychologists, child psychiatrists and community paediatricians in the Trent region (85% response) revealed that a total of 826 new ADHD cases were seen over the index period, 1997–1998. Approximately a third of these were adolescents. Wide variations in individuals' clinical caseloads, both within and between professional groups, were revealed. No respondent could identify any local formal transitional arrangements or adult services for older ADHD cases. This would suggest that there is a pressing need to establish such services for patients with ADHD irrespective of their age.

Attention-Deficit Hyperactivity Disorder: How Much Do We See?

A postal questionnaire survey of senior clinical psychologists, child psychiatrists and community paediatricians in the Trent region (85% response) revealed that a total of 826 new ADHD cases were seen over the index period, 1997–1998. Approximately a third of these were adolescents. Wide variations in individuals' clinical caseloads, both within and between professional groups, were revealed. No respondent could identify any local formal transitional arrangements or adult services for older ADHD cases. This would suggest that there is a pressing need to establish such services for patients with ADHD irrespective of their age.

Handbook of Counseling and Psychotherapy With Older Adults

Back to table of contents Previous article Next article Book ReviewFull AccessHandbook of Counseling and Psychotherapy With Older AdultsRichard Zweig, Ph.D., and Eileen Rosendahl, Ph.D.Richard ZweigSearch for more papers by this author, Ph.D., and Eileen RosendahlSearch for more papers by this author, Ph.D.Published Online:1 Nov 2000https://doi.org/10.1176/appi.ps.51.11.1462AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Despite the growing numbers of older adults, evidence of their neglected mental health needs, and empirical support for their responsiveness to psychotherapy, older adults continue to encounter barriers to obtaining psychotherapeutic treatments. Whether because of ageist or misinformed attitudes of practitioners, limited training opportunities in geriatric psychiatry and psychology, or the youth-oriented culture in which we live, mental health clinicians have been slow to recognize that—quoting Longfellow— "age is opportunity no less than youth" in relation to psychotherapeutic potential.The Handbook of Counseling and Psychotherapy With Older Adults challenges such barriers by presenting one of the most comprehensive volumes to date of psychosocial interventions applicable to older people. Written "for practitioners . . . by practitioners," with a decided emphasis on treatment rather than on diagnostic issues, the book assembles some of the most distinguished voices in clinical gerontology. Edited by Michael Duffy, a leading authority on counseling and psychotherapy with the elderly, and consisting of 39 chapters by more than 50 authors, it addresses a broad range of treatment issues and interventions. Perhaps owing to the editor's integrative and humanistic orientation, it presents an unbiased sampling of state-of-the-art psychosocial interventions, favors descriptions of therapeutic process rather than outcome studies, and emphasizes specific and practical psychotherapeutic techniques illustrated with rich case examples.More than half the volume is devoted to various modalities of psychosocial intervention, ranging from individual psychotherapy to group and expressive therapies, couples and family therapies, and community and preventive interventions. The rest focuses on psychotherapeutic strategies for specific psychological problems of older adults and includes mood, anxiety, and personality disorders and dementia among its many topics.The contributors provide excellent reviews of psychodynamic, interpersonal, cognitive-behavioral, and reminiscence techniques; all are well written and well referenced. The broadening scope of psychosocial interventions for the elderly is compellingly illustrated by superb chapters on couples therapy, interdisciplinary approaches to treating sexual dysfunction, and the dynamics and treatment of narcissism in later life. Particularly unusual is inclusion of topics rarely covered in standard texts, such as family system reorganization when an elderly member is impaired, existential issues in psychotherapy with the aged, and nonverbal strategies to "reach the person behind the dementia." Throughout, the authors present strong support, grounded in phenomenological case description, for the broad utility of psychosocial techniques for addressing psychological problems in older adults.Of course, any such edited textbook has chapters of variable quality and omits topics of interest to some readers. Most authors, for example, draw on their experience in outpatient settings or nursing homes, although increasing numbers of practitioners treat elderly persons in acute care, rehabilitation, day hospital, or hospice settings and may need to tailor psychotherapeutic techniques to the setting as well as to the client. Nonetheless, because of its comprehensive scope and unique focus on practice techniques, the Handbook of Counseling and Psychotherapy With Older Adults will be of great interest and value to all mental health practitioners seeking to expand their knowledge and to unlock the potential of their elderly clients.Dr. Zweig and Dr. Rosendahl are senior staff psychologists in the geriatric psychiatry division of Hillside Hospital of the North Shore-Long Island Jewish Health System in Glen Oaks, New York, and are assistant professors of psychiatry at Albert Einstein College of Medicine.edited by Michael Duffy, Ph.D.; New York City, John Wiley & Sons, 1999, 721 pages, $85 FiguresReferencesCited byDetailsCited ByNone Volume 51Issue 11 November 2000Pages 1462-1462 Metrics History Published online 1 November 2000 Published in print 1 November 2000