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1
Kropf, Nancy, and Sherry Cummings. Evidence-Based Treatment and Practice with Older Adults. Oxford University Press, 2017. http://dx.doi.org/10.1093/acprof:oso/9780190214623.001.0001.
Full textAbstract:
Evidence Based Treatment with Older Adults: Theory, Practice, and Research provides a detailed examination of five research-supported psychosocial interventions for use with older adults: cognitive behavioral therapy, problem-solving therapy, motivational interviewing, psychoeducational and social support approaches, and life review/reminiscence. Taken together, these interventions address the diversity of mental health conditions and late-life challenges that older adults’ experience. Complementary chapters provide comprehensive treatment and research information for each intervention. In the first chapter for each treatment, theoretical concepts undergirding the intervention are explained and the specific skills and techniques employed are clearly described. Adaptations for use of each intervention with older adults are highlighted. Vignettes demonstrate the application of particular intervention strategies with older clients, while case studies provide a comprehensive presentation of the intervention. In a second chapter on the intervention, the research base supporting the use of the specific approach with older adults is reviewed and analyzed. In addition, the distinct issues, such as depression, anxiety, substance abuse/misuse, behavioral health challenges, and insomnia, for which evidence exists are highlighted. Research support for application of the interventions in community-based, acute care, and long-term care settings and in individual and group formats is discussed. Implementation issues encountered in therapeutic work with older adults are described, as are accommodations to enhance treatment efficacy. Finally, a chapter on future directions in geriatric interventions provides an overview of emerging therapies that hold promise for the treatment of older adult mental health. In sum, this book provides a comprehensive overview of research-supported psychosocial interventions for older adults and their care providers.
2
Beckman, Nancy J., and Marie B. Tobin. Psychiatric Comorbidities in Chronic Pain Syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0033.
Full textAbstract:
Psychiatric comorbidities are common in patients with chronic pain syndromes. Depression, anxiety, insomnia, somatic symptom disorder, substance use disorders, personality disorders, and problematic coping strategies present unique treatment challenges to pain medicine specialists. Patients with these comorbidities tend to have poorer response to treatment, higher rates of complications, and greater pain-related suffering. To reduce stigma, providers are encouraged to define pain as both a sensory and emotional experience. This intimate connection implies that optimal pain treatment requires concurrent attention to psychosocial well-being. Overlapping biological and psychologic mechanisms in the development of chronic pain and psychiatric disorders may contribute to the high rates of comorbidity. Methods for quickly identifying psychiatric disorders within busy clinic settings and brief interventions that pain specialists can deliver are described. Finally, indications for referral to specialty mental health and the benefits of multidisciplinary treatment, which can include psychiatric medications and evidence-based psychologic treatments, such as cognitive-behavioral therapy, are discussed.
3
Roth, Andrew, and Chris Nelson. Psychopharmacology in Cancer Care. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780197517413.001.0001.
Full textAbstract:
Clinicians who care for adult cancer patients have many tools to manage symptoms of depression, anxiety, cognitive changes, insomnia, and fatigue. Non-prescribing clinicians, such as psychologists, nurses, social workers, and occupational and physical therapists, provide frontline psychosocial interventions and physical support for cancer patients. Psychotropic treatments are sometimes required to resolve complex syndromes that mingle both medical and psychiatric features. Psychiatric medications are most frequently prescribed to cancer patients by oncologists, general medical practitioners, general psychiatrists, and psychiatric advanced practice providers such as nurse practitioners and physician assistants, as few oncology practices have dedicated psycho-oncologists. Non-prescribing practitioners who care for people with cancer are often the first to identify a psychiatric syndrome that requires a referral for psychopharmacologic intervention. They can also play an important role in educating patients about how psychopharmacologic agents can augment their cancer care. After psychotropic medications are started, non-prescribers can observe for improvement and detect problematic side effects if they arise, thus improving adherence with medication regimens. Practitioners who read this book will benefit from the highlighted clinical pearls to follow, and the potholes to avoid, regarding the tricky diagnostics and pharmacologic treatment of psychiatric syndromes. All clinicians will learn communication strategies that bridge distances of professional specialty and geography so that treatment by multiple providers may be more seamless, which it is hoped will enrich outcomes, both medical and emotional.
4
Gannon, Jessica M., and Shaun M. Eack. Psychosocial Treatment for Psychotic Disorders: Systems of Care and Empirically Supported Psychosocial Interventions. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199331505.003.0007.
Full textAbstract:
In this chapter, we discuss psychosocial interventions, including psychotherapies and other services useful for helping individuals with psychotic disorders. We explain the basics components of the systems of care through which these services are frequently offered, focusing on outpatient treatments. Psychosocial rehabilitation is highlighted, as it helps patients move towards recovery, which is an important model for psychosocial care. A number of evidence-based psychotherapies are explored, notably cognitive-behavioral therapy (CBT), family therapy, and cognitive remediation. Many of these treatments can be given individually or in groups, and although underutilized, can improve outcome when combined with somatic therapies. Other services have been shown to be useful in recovery, such as case management, assertive community treatment, and housing, and these are explored in this chapter as well. Finally, we review the role of hospitalization and involuntary treatment in the care of patients with psychotic disorders.
5
Rose, Raquel, and Nicolette Molina. Interventions. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190260859.003.0010.
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Despite the fact that suicide is one of the leading causes of death in the United States, there are currently no US Food and Drug Administration-approved treatments for suicidal behavior. However, interventions that provide potentially effective treatment are available. This chapter explores medications and biological interventions as well as psychosocial, alternative, and app/Internet-based interventions. The section on medications and biological interventions covers clozapine, lithium, and ketamine. The psychosocial intervention section covers dialectical behavior therapy, cognitive–behavioral therapy for suicidal patients (CBT-SP), Collaborative Assessment and Management of Suicidality (CAMS), attachment-based family therapy, and safety planning. The section on alternative and Internet-based interventions covers mindfulness meditation as well as online applications that can act as supplements to traditional treatments. The chapter concludes with a reminder of the importance of suicide risk assessment and clinician self-care in suicide prevention.
6
Soffer, Jocelyn, César A. Alfonso, John Grimaldi, and Jack M. Gorman. Psychotherapeutic Interventions. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0037.
Full textAbstract:
Psychotherapeutic care for persons with HIV is an important component of overall treatment, helping people to cope and decreasing the psychological suffering that may be attendant when navigating the complex array of biopsychosocial stresses and challenges of living with HIV. A combination of psychotherapeutic and psychosocial interventions can effectively address psychological aspects of functioning and reduce psychiatric symptoms, as well as improve adherence to risk reduction and medical care. This chapter reviews several psychotherapeutic interventions, including supportive, psychodynamic, and interpersonal psychotherapy, cognitive-behavioral therapy, and motivational interviewing. Both individual and group settings are discussed, as well as the particular settings of spiritual care, family therapy, and couples therapy.
7
Blonigen, Daniel M., John W. Finney, Paula L. Wilbourne, and Rudolf H. Moos. Psychosocial Treatments for Substance Use Disorders. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0023.
Full textAbstract:
The most effective psychosocial modalities for treating substance use disorders are cognitive-behavioral interventions, motivational interviewing and motivational enhancement, contingency management, community reinforcement, behavioral couples and family therapies, and 12-step facilitation approaches. The foci of these interventions include substance use behavior, patients’ life contexts, and their social and personal resources. Limited evidence is available for these interventions’ differential effectiveness. Brief interventions are highly effective in the treatment of alcohol use disorders. However, as stand-alone treatments, they are best suited for individuals with mild to moderate alcohol use problems. Therapists who are interpersonally skilled, empathic, and nonconfrontational, and who develop a strong therapeutic alliance, are more effective at helping patients achieve better outcomes.
8
Franklin, Martin E., Diana Antinoro, Emily J. Ricketts, and Douglas W. Woods. Treatment of Tic Disorders and Trichotillomania. Edited by Gail Steketee. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195376210.013.0095.
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This chapter briefly describes tic disorders and trichotillomania (TTM) and reviews the pharmacotherapy and psychosocial treatment outcome literature for each of these conditions. In contrast to anxiety or depression, distorted or maladaptive cognitions do not appear to play a central role in the etiology or maintenance of tic disorders and TTM, and therefore cognitive therapy is not emphasized in the psychosocial treatments studied to date. Treatment protocols are best characterized as “behavioral,” although some include ancillary cognitive interventions. Behavioral treatments that include habit reversal training (HRT) appear to hold the greatest promise for each of these conditions, and these are described in some detail. Future directions in treatment research are suggested.
9
Steinberg, Martin. Treatment of Depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199959549.003.0006.
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Most depression in the elderly can be effectively treated in the primary care setting. Psychiatric referral should be considered in the setting of severe depression, suicidal ideation, prior suicide attempts, multiple risk factors, psychotic symptoms, bipolar disorder, poor response to prior treatment, or high medical comorbidity. Combining pharmacological and psychosocial interventions is most likely to be effective. Available antidepressants include serotonin-specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, novel mechanism agents, tricyclic antidepressants, and monoamine oxidase inhibitors. Antidepressant selection should take into account adverse effects, medical comorbidities, potential medication interactions, and patient preferences. Additional strategies (e.g. augmentation) are available for treatment resistant depression. Available psychotherapies include supportive, cognitive-behavioral, interpersonal, and problem solving. Lifestyle interventions (e.g. exercise) may be helpful adjuncts. Given limited evidence for antidepressant treatment in cognitive impairment, for those with mild to moderate depression severity, non-pharmacological interventions should be attempted first.
10
Muralidharan, Anjana, David J. Miklowitz, and W. Edward Craighead. Psychosocial Treatments for Bipolar Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0010.
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Pharmacological interventions remain the primary treatment for bipolar disorder. However, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, decrease severity of symptoms, improve quality of life, and enhance mechanisms for coping with stress. Group psychoeducation, designed to provide information to bipolar patients about the disorder and its treatment, leads to lower rates of recurrence and greater adherence to medication among remitted bipolar patients at both short- and long-term follow-up. Cognitive-behavioral therapy as an ancillary treatment has found mixed results but generally supportive evidence indicating that it is useful in preventing relapse to depression in remitted patients. Family-based intervention, such as Family-Focused Therapy (FFT), may be combined with pharmacotherapy to reduce recurrences and hospitalization rates in adult patients.
11
Craighead, W. Edward, Benjamin N. Johnson, Sean Carey, and Boadie W. Dunlop. Psychosocial Treatments for Major Depressive Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0013.
Full textAbstract:
Behavior therapy, cognitive-behavioral therapy, and interpersonal psychotherapy have each been shown by at least two randomized controlled trials, as well as by numerous meta-analytic reports, to be effective psychosocial interventions for patients meeting criteria for major depressive disorder. All three psychosocial treatments have yielded substantial reductions in scores on the two major depression rating scales, significant decreases in percentage of patients meeting depression criteria at posttreatment, and substantial maintenance of effects well after treatment has ended. The data for outcomes of psychosocial and pharmacological interventions for major depressive episodes suggest that the two treatment modes are equally efficacious.
12
O’Dowd, Mary Alice, and Maria Fernanda Gomez. Insomnia and HIV: A Biopsychosocial Approach. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0023.
Full textAbstract:
Insomnia is a common complaint across populations and can influence health in many ways. Individuals with HIV may be at higher risk for insomnia owing to direct effects of the virus, pain, psychiatric comorbidities, and other health- and treatment-related issues and lifestyles. This chapter reviews the physiology of healthy sleep and sleep hygiene and addresses assessment and treatment of insomnia in persons with HIV. Careful interview of a patient and accompanying family or friends with the Epworth Sleepiness Scale or Pittsburg Sleep Quality Index may help define the nature of the insomnia and target interventions. Treatment for insomnia can include a form of cognitive-behavioral therapy designed specifically for insomnia as well as education aimed at restructuring bedtime habits in order to promote better sleep. Medication use, such as benzodiazepines, melatonin, orexin, and non-benzodiazepine hypnotics, in this population must take into consideration the specific risks and benefits these medications may present in persons with HIV.
13
Dud, Iulia, Louise Brennan, and Dene Robertson. Autism, Attention Deficit Hyperactivity Disorder, and Cognitive Enhancement. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190214401.003.0012.
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Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common neurodevelopmental disorders. Impairments in attention and executive functions are core characteristics of ADHD. ASD is primarily characterized by severe deficits in social communication, but cognitive impairments are common, including in attention and executive functions. Currently, there is only limited evidence for efficacy of either pharmacological or behavioral interventions for the treatment of the cognitive deficits associated with the disorders. This chapter presents the current evidence base for cognitive enhancements for ADHD and ASD. It summarizes evidence from available and experimental pharmacological interventions, as well as behavioral, cognitive, and psychosocial interventions. The chapter also discusses the limitations of current tools and future directions.
14
Biernacki, Carolina, Prerna Martin, Pablo H. Goldberg, and Moira A. Rynn. Treatments for Pediatric Depression. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0012.
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Practice guidelines recommend psychosocial interventions for mild or brief cases of pediatric depression. In moderate to severe cases, medication treatment is recommended, with or without cognitive-behavioral therapy (CBT). Fluoxetine and escitalopram are the only antidepressants approved by the U.S. Food & Drug Administration for acute pediatric depression. Among psychosocial interventions, CBT and interpersonal psychotherapy for adolescents (IPT-A) have the largest evidence base for treatment of depressed youth. Combination treatment with CBT and antidepressant medication is superior to treatment with either modality alone. In treatment-resistant depression, a switch in antidepressant is more likely to yield a positive response when medication is used with CBT. Antidepressants should be used judiciously in youths as higher rates of adverse events have been demonstrated, and data from adult trials cannot be systematically extrapolated to youths. Further studies are needed to assess alternative medication and psychosocial treatments as well as factors predictive of treatment response.
15
Price, Julie R., Micah J. Price, and Marc A. Huntoon. Psychology of Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0004.
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The role of psychosocial variables in the understanding, diagnosis, and treatment of pain has grown significantly in the past 30 years. Pain is no longer dichotomously thought of as either a purely psychological or physiological condition (mind–body dualism) but, rather, as a combination of biopsychosocial factors and experiences. The questions in this chapter consider the changing role of these psychosocial factors by exploring the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and other pain-related assessments and psychodiagnostics; cognitive–behavioral, acceptance and commitment, behavioral, and other psychological interventions for pain management; the role of stages of change in selection of interventions; and biopsychosocial theoretical models for understanding pain. The answers provide detailed and empirically supported explanations of the biopsychosocial impact of pain, along with references to texts commonly utilized in the training of anesthesiologists, so as to promote a better understanding of the associated materials.