Literatura científica selecionada sobre o tema "Clinical perfectionism"

This chapter is devoted to the detailed assessment of the trait vulnerability component of imminent suicide risk. Demographic, clinical historic, biological, and cultural aspects of trait vulnerability are discussed in dedicated sections. The demographics section includes age, gender, ethnicity, and LGBT issues. The clinical history section addresses history of mental illness, history of suicide attempts, childhood trauma, parenting style, and attachment style. The biological traits section describes impulsivity, hopelessness and pessimism, perfectionism, fearlessness, and pain insensitivity.

Obsessive-compulsive disorder (OCD) can be a very disabling and distressing problem. Cognitive behavioural therapy (CBT) has been shown to be very effective in helping people to overcome OCD. OCD is a highly heterogeneous disorder, often complicated by contextual factors, and therapists are often left wondering how to apply their knowledge of treatment to the particular problems as they face them in clinical practice. This book guides the reader through understanding the background to and principles of using CBT for OCD in a clear practical ‘how to’ style. It also elucidates the particular cha

Narrative psychiatry empowers patients to shape their lives through story. Rather than focusing only on finding the source of the problem, in this collaborative clinical approach psychiatrists also help patients diagnose and develop their sources of strength. By encouraging the patient to explore their personal narrative through questioning and story-telling, the clinician helps the patient participate in and discover the ways in which they construct meaning, how they view themselves, what their values are, and who it is exactly that they want to be. These revelations in turn inform clinical d

The Royal College of Physicians (RCP) has defined professionalism as a ‘set of values, behaviours, and relationships that underpins the trust the public has in doctors’. Dame Janet Smith has described professionalism as ‘a basket of qualities that enables us to trust our advisors’. The RCP has imagined some of the qualities that might be included within Dame Janet’s basket as ‘integrity, compassion, altruism, continuous improvement, excellence, and working in partnership’. The General Medical Council (GMC) has taken this further in the ‘Professionalism in action’ section of Good Medical Practice (2013). According to the GMC, good doctors ‘make the care of their patients their first concern: they are competent, keep their knowledge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy, and act with integrity and within the law. They also work in partnership with patients and respect their rights to privacy and dignity. They treat each patient as an individual. They do their best to make sure all patients receive good care and treatment that will support them to live as well as possible, whatever their illness or disability’. The Medical Protection Society (MPS) has, however, been clear that ‘professionalism’ is not the same as ‘perfectionism’. Although professionalism encompasses the ambition to provide high- quality care, mistakes are an inevitable part of working as a doctor. For the MPS, ‘true professionalism comes into play when mistakes are made . . . knowing what to do when things go wrong and how to react appropriately can make all the difference in ensuring high standards of patient care are maintained and a speedy resolution is reached’. Situational judgement questions within this section will test your probity by exploring responses to scenarios that might require you to challenge unacceptable behaviour, maintain confidentiality, and, as always, prioritize patient safety. You need to demonstrate a commitment to achieving your various clinical responsibilities, as well as a desire for continued learning and a commitment to helping the development of others. These scenarios test your honesty towards patients and colleagues, and a willingness to admit mistakes.

In the past 20 years, the incidence of anorexia nervosa (AN) in industrialized countries has remained stable at 4.2–7.7 new cases per 100,000 per year. During this period, the incidence of bulimia nervosa (BN) has decreased from 12.2 to 6.1 per 100,000. The lifetime prevalence of AN in females in the United States in the past decade was 0.9% and 0.3% in males, and that of BN was 0.88% in females and 0.12% in males in a European study. Binge eating disorder (BED) is the most common eating disorder (ED), with a lifetime prevalence of 3.5% in women in the United States and 2.0% in men. AN has the highest standardized mortality rate of 5.86, followed by BN with a standardized mortality rate of 2.29. Less than half of AN patients have a full recovery, compared to two-thirds of BN patients who recover. The prevalence of EDs is increasing in the Middle East and Asian countries, as well as among Latinos, African-Americans, and Asians in the United States. Body dissatisfaction and a family history of ED are consistent risk factors across all EDs. Perfectionism is a greater risk factor for restricting AN and conduct disorders, and substance abuse and sexual abuse are risk factors for BN and BED. ED prevention programmes have mainly targeted at-risk persons in specific age groups and environments. Both Internet-based and group session programmes have reduced ED-related symptoms. There are multiple issues concerning the implementation and maintenance of prevention programmes, including clinician training, costs, attrition rate, and effectiveness over time.