Laura Weiss Roberts

The traditional practice of psychiatry has been focused on reducing or eliminating distressing, unwanted symptoms. But what if the key to health and well-being is not to be symptom free, but rather to function effectively in life even when symptoms are present? What if symptoms serve an adaptive and motivational function, rather than being signals of a latent illness? What if the key to personal health is the ability to accept symptoms for what they are and to do what matters in life at the same time? This is the underlying proposition of Acceptance and Commitment Therapy (ACT), and this book—a collaboration among six clinicians from diverse practice backgrounds—is the first to systematically describe the principles and practices of ACT as they apply to psychiatric assessment, case analysis, and treatment. The guide begins with an in-depth analysis of the ACT model, from its scientific origins in the study of the functions of human language to a fully elaborated model for clinical assessment and intervention and outlines the clinical benefits of ACT in everyday practice. The second section of the book shows the reader how to conduct a streamlined assessment of the patient's life context, how to detect and intervene with the patient's unworkable emotional and behavioral avoidance strategies, and how to blend the use of medication treatment and behavioral interventions in a way that augments the beneficial effects of both approaches. Chapter-length examples in the third section discuss how to deliver ACT in an ambulatory psychiatric setting, in a hospital consultation-liaison service, and in an inpatient psychiatric context. The section also includes a chapter examining the all-important issue of teaching ACT to psychiatric residents as well as affiliated health professionals working in medical or psychiatric treatment team contexts. Learning Acceptance and Commitment Therapy uses a diverse array of case examples and clinical dialogues to offer readers a real-life view of the methodology in practice. Each chapter also includes additional reading resources to pursue should a particular theoretical or applied clinical concept create a desire to learn more. Additionally, readers have unlimited access to an online instructional library that includes video demonstrations of core ACT clinical strategies "in action" as well as a host of written practice support tools and worksheets. This book is a must for clinicians who want to expand their ability to improve clinical outcomes for the wide range of patients seen in clinical practice.

Enlivened by detailed and engaging clinical dialogues - all based on real-world clinical practice - this book introduces the acceptance and commitment therapy (ACT) model, demonstrating how it applies to findings from crisis studies and can be integrated into clinical practice.

Like its pioneering predecessor, this new edition of Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals offers an interactive, case-oriented approach to mental health ethics. Organized around scenarios that pose important—sometimes thorny—ethical questions, the book draws on the diverse clinical and research experience of its contributors, who have backgrounds in medicine, ethics, psychology, law, medical education, religious studies, public health, and related fields. The editor, an internationally recognized scholar in bioethics, psychiatry, and medical education, oversaw a rigorous review process, ensuring that the content meets the highest standard, as befits a text on ethics and professionalism. The book begins with an overview of the role of ethics in caring for people with mental illness, concepts and models of professionalism, and ethics education, followed by a chapter examining ethics in the mental health professions, with emphasis on learning and applying essential skills. Questions and annotated answers follow, and the brief case descriptions that frame each question, presented in single-answer, multiple-choice format, echo the real-life complexities of clinical practice. Psychiatry has evolved significantly since the last edition, and the new edition's plentiful revisions and fresh material reflect these changes: • Assisted suicide and euthanasia, which pose controversial and difficult ethical questions, are explored in-depth, with attention accorded religious views, the complexity of informed consent, and the concern that some who choose euthanasia may be clinically depressed.• Navigating social media, experiencing the loss of anonymity, and engaging in self-disclosure of all kinds presents new challenges for practitioners; the pitfalls, both ethical and psychological, are thoroughly discussed. • The digital age poses many ethical dilemmas regarding patient privacy. Is it acceptable for clinicians to "Google" their patients, or is it merely voyeurism? What about consent? • Burnout among mental health practitioners is growing, and professional well-being is an emergent topic. The book examines the increased expectations of physicians and what setting reasonable limits in an era of the electronic health record might look like.• Over the past few decades, neuroscience has been accepted as the conceptual basis for understanding and treating mental illness, and neuroethics have achieved an attendant importance. Human subjects research and the active question of public trust in science, as well as emerging domains, including neurotechnologies, neurolaw, and philosophy of cognition, are carefully examined. Eloquent, instructive, and pragmatic, Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals offers critical learning to prepare professionals for ethical challenges in care and research and is an essential reference and tool for an increasingly complex world.

Detta är den självklara boken för alla som arbetar med potentiellt suicidala personer. Den kan revolutionera det svenska sättet att se på suicidprevention. En mycket välskriven och gedigen kunskapskälla, med konkreta behandlingsupplägg som bygger på det senaste inom suicidforskningen. Jag blir varm och glad över att se denna typ av kunskap paketeras så fint! Denna bok kan rädda liv!Ludmilla Rosengren, leg. läkare med grundläggande utbildning i KBT och medgrundare till Suicide Zero.Det finns ingen bok som varit så hjälpsam i mitt arbete med klienter som har komplexa problem. Att den äntligen kommer på svenska är otroligt viktigt och glädjande. Om du jobbar med suicidnära klienter, läs den!”Thomas Gustavsson, leg. psykolog, verksam på Segesholms behandlingshem i Skåne.Suicidala patienterär en efterfrågad handbok som här finns i en ny utgåva. Författarnas utgångsläge är att suicidalt beteende är ett farligt och kortsiktigt problemlösande beteende för att hantera intensiv känslomässig smärta. De tar upp akuta kriser, behandling inom primärvården och i psykiatrisk öppenvård respektive heldygnsvård, samt behandling av särskilda målgrupper som ungdomar, äldre och patienter med substansberoende eller psykos. Det praktiska förhållningssättet är grundat i ACT och KBT.Fackgranskning och svenskt förord av Johanna Morén, leg. psykolog, leg. psykoterapeut och handledare i KBT. Hon har även anpassat avsnittet om juridik till svenska förhållanden.John A. Chilesär psykiater och professor emeritus på Institutionen för psykiatri och beteendevetenskap, University of Washington School of Medicine. Kirk D. Strosahlär fil.dr, leg. psykolog och chef för Heart Matters Consulting i Portland. Laura Weiss Robertsär psykiater, innehar professuren till minne av Katharine Dexter McCormick och Stanley McCormick samt är prefekt på Institutionen för psykiatri och beteendevetenskap vid Stanford University School of Medicine. Hon har även en masterexamen i filosofi.

Although data exist to support the notion that physician self-care is correlated with patient care, the culture of medicine has traditionally valued the ideals of self-sacrifice and perfectionism—often to the detriment of clinicians themselves. Professional Well-Being: Enhancing Wellness Among Psychiatrists, Psychologists, and Mental Health Clinicians, the result of a collaboration by several psychologists and psychiatrists in the School of Medicine at Stanford University, posits a new culture, one that is supportive of the health and well-being of health care professionals and the patients and populations they serve. The book's first section examines individual and systemic barriers to professional well-being, chronicling the unique challenges faced by health care providers at different stages of professional and personal development. Detailed case studies and vignettes illustrate effective methods for reducing burnout while also enhancing professional fulfillment. Thought-provoking discussion questions encourage readers to focus on implementation tactics applicable to their own health care practices. Part II discusses personal resilience and realistic strategies—from the mental and social to the physical—to improve well-being. Specific exercises encourage mental health professionals to engage in pragmatic action for improved personal and professional well-being. Throughout the book, a wealth of tables and figures illustrate important points. The inclusion of "positive practices" and recommended readings offers readers the opportunity to integrate what they have learned and to expand their study. Patients benefit when treated by clinicians who value and model self-care. Professional Well-Being outlines for mental health care providers, including psychiatrists, psychologists, mental health clinicians, and trainees, how to become such a professional.

The domain of supportive psychotherapy has expanded in recent years, reflecting changes in how psychotherapy is conducted and the role psychotherapy plays in caring for individuals facing difficult life experiences or living with diverse mental and physical disorders. This new, thoroughly revised and up-to-date edition of Learning Supportive Psychotherapy: An Illustrated Guide (first published as Introduction to Supportive Psychotherapy) instructs beginning psychotherapists in the fundamentals of this treatment modality, which focuses on patients' overall health and well-being and their ability to adapt constructively to their life circumstances. The linchpin of supportive psychotherapy -- and, indeed, all psychotherapy -- is the establishment of a true therapeutic alliance. Accordingly, the authors provide readers with skills aimed at instilling trust and establishing a productive therapeutic relationship, including techniques for alliance building, enhancing ego functioning, and reducing and preventing anxiety. In addition, the authors explore the general framework of supportive psychotherapy, including indications, phases of treatment, initiation and termination of sessions, and professional boundaries; explain how to perform a thorough patient evaluation and case formulation; and describe the process of setting realistic goals with the patient. The following features and areas of focus enhance the book's utility: ? Integral to the text's practical approach are the video case vignettes that accompany several of the chapters. These videos model effective psychotherapeutic techniques and strategies, which readers can incorporate into their skill sets.? The chapter on crisis intervention has been thoroughly revised to integrate recent research findings on posttraumatic stress disorder, suicide, and critical incident stress management, and the illustrative multipart case vignette provides a therapeutic narrative that is compelling, relatable, and instructive.? The material on the therapeutic alliance focuses on skill building, including how to anticipate and avoid disruption in treatment, how to discuss the therapeutic relationship with the patient, how to modify distorted perceptions using clarification and confrontation, how to deal with negative transference and therapeutic impasses, and how to reframe statements in a supportive manner.? Outcome research receives its own chapter, in which the authors review the robust evidence base for the efficacy of supportive psychotherapy, including a number of outcome trials, bolstering the necessity of learning the techniques outlined in the book.? The book concludes with 75 questions and answers to test the reader's comprehension and identify areas for further study. This new edition of Learning Supportive Psychotherapy: An Illustrated Guide builds on the well-earned reputation of previous editions. Beginning clinicians first learning the techniques of psychotherapy and veterans who must assess competence in the psychiatry residents they supervise will find the help they need in this down-to-earth, clinically rich guide.

Since the first edition of Clinical Manual for Assessment and Treatment of Suicidal Patients was published in 2005, advances have been made that increase our understanding of suicidal and self-destructive behavior. Although clinicians cannot unerringly predict which patients will die by suicide, they can focus more successfully on early identification of suicidal behavior and effective intervention, and this new edition of the clinical manual thoroughly explores not only assessment of suicidality but what comes after an at-risk patient has been identified. The authors argue that treating specific psychiatric disorders is not enough to prevent suicide, and they offer clinicians the necessary information and strategies to bridge that gap. The authors' main premise is that suicide is a dangerous and short-term problem-solving behavior designed to regulate or eliminate intense emotional pain—a quick fix where a long-term effective solution is needed—and this understanding is the underpinning of the assessment and treatment strategies the authors recommend. The content of this new edition has been thoroughly reviewed and revised, and substantive changes have been made to specific chapters to ensure that the book represents the most current thinking and research, while retaining the strengths of the previous edition. • The chapter on assessment has been revised to put the fundamental components of effective treatment in a clinical, case-oriented context and includes an easy-to-use assessment protocol that allows clinicians to determine where individual patients stand on seven dimensions (cognitive rigidity, problem-solving deficits, heightened mental pain, emotionally avoidant coping style, interpersonal deficits, self-control deficits, and environmental stress and social support deficits).• The many issues involved in the use of psychotropic medications in suicidal patients are addressed in a new chapter, which includes information on the relevant classes of drugs (such as antidepressants and antianxiety agents) and the issues that may arise with their use, including side effects, degree of lethality, and tendency to aggravate suicidality on introduction and withdrawal of the medication. • The chapter on special populations has been expanded to include adolescents, elders, and patients with co-occurring substance abuse or psychosis. Because of additional vulnerabilities, treating these groups may call for the use of added or special techniques to ensure the best therapeutic outcomes.• Primary care physicians are the first point of contact for many patients, and they may require additional preparation in order to assess and respond to those experiencing suicidal thoughts. The chapter "Suicidal Patients in Primary Care" explores strategies for screening, recognizing, and assessing risk; treating the initial crisis; and developing a crisis management plan.• "Tips for Success" appear at intervals, and "The Essentials" are included at the end of each chapter, highlighting the most important concepts. In addition, there are scores of helpful charts and exercises. Practical, accessible, and reader-friendly, the Clinical Manual for Assessment and Treatment of Suicidal Patients is not an academic book but rather is one designed to become an indispensable part of clinicians' working libraries.

Most clinicians endorse the combination of pharmacotherapy and psychotherapy as more effective and beneficial than each modality alone, but combining these treatments can be a complicated and highly variable process. Competency in Combining Pharmacotherapy and Psychotherapy: Integrated and Split Treatment is designed to help psychiatrists at any stage of their career achieve competency in combining and coordinating pharmacotherapeutic and psychotherapeutic treatments for the benefit of their patients. This guide, now in its updated, second edition, addresses both integrated (single clinician) and split/collaborative (multiple clinicians) treatments, discussing for each: • The selection of medication and psychotherapy• The patient evaluation and opening• Sequencing• Evaluating, monitoring, and supervising treatment• Terminating and transitioning patient care The book also offers a chapter—new to this second edition—that focuses on primary care access for mental health services in the context of integrated and split/collaborative care. The rapid transformation of clinical care models in new health systems means that competence in integrated and split/collaborative care is absolutely vital for long-established clinicians as well as for psychiatric professionals in the early stages of their careers. Competency in Combining Pharmacotherapy and Psychotherapy offers an unrivaled introduction to the complex process of combining medication and psychosocial treatments, clearly defining the competencies of combining two modalities. Psychiatric educators should note that this resource relates to all six main competencies of the Accreditation Council for Graduate Medical Education: patient care and procedural skills, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.

In the video above, listen to the author, Dr. Roberts, discuss with Chief of Staff John M. Oldham the challenges that medical residents face in managing their own mental health and wellbeing. Professional ethics and decision making have become areas of heightened critical inquiry, as well as matters of normal but challenging psychiatric practice. Informed by the extensive clinical experience of the author and guest contributors, A Clinical Guide to Psychiatric Ethics approaches the ethical aspects of mental health care—both subtle and dramatic—with clarity, coherence, and optimism. This engaging text functions as both a review and a guide to issues on the horizon, as well as those encountered every day. The Guide achieves these objectives by employing several strategic features: • Structured logically into three parts (Fundamentals, Caring for Special Populations, and Evolving Topics), the book takes the reader from the general to the specific and from the traditional to the emergent.• Case scenarios at the end of each chapter not only focus the individual reader on the chapter's concepts and issues, but also may be used in independent study or small-group discussions.• The text emphasizes real experience over remote theories, attuning readers to clinical realities with keen sensitivity. It does not offer simple answers, but provides guideposts to impart information, foster skill development, and encourage openness, collaboration, and self-reflection among both veteran clinicians and trainees.• Significant focus is given to the care of individuals from distinct populations (e.g., children and veterans) and care occurring in unique contexts (e.g., small communities), underscoring the book's broad usefulness. The material is thoroughly current, aided by useful lists, tables, and figures to enhance its accessibility. A Clinical Guide to Psychiatric Ethics provides a trustworthy compass and expert companion for those traveling with their patients along the ethical frontier of mental illness.

Physicians and psychiatrists typically see themselves as true professionals. But in the past, some displayed behavior far beneath the confines of professionalism, including exploding at nurses, not returning calls, or conducting insensitive interactions with patients, that was usually tolerated and seldom disciplined. Today, the rise of professionalism in medicine in general and psychiatry in particular has prompted a quiet revolution in how doctors are trained and how they are expected to behave in the workplace. The Accreditation Council for Graduate Medical Education (ACGME) has now advanced professionalism to be one of the core competencies all emerging practitioners must have. While almost all physicians believe in professionalism, the movement toward making it a core competency has challenged doctors everywhere to accept the practice of monitoring, observing and assessing what is not always welcome in a field where autonomy is so highly valued. In Professionalism in Psychiatry, the authors identify and expand on professional behaviors, such as being a good team player, being accountable, pursuing improvement in an ongoing way, and behaving compassionately toward patients and families. The importance of treating all co-workers with respect and of being attuned to the management of healthcare resources in a way that reflects fairness and integrity is also thoroughly reviewed. Important features of this book are: • Tailoring professionalism principles from medicine to the unique features of psychiatry in order to enhance educators' teaching and improve the behaviors of psychiatrists and residents in the work setting. • Development of guidelines for professionalism in cyberspace to provide psychiatrists with an ethical framework for dealing with patients in the online realm.• Discussion of the ethical principles that apply when academic departments approach donors.• Focus on cultural competency and empathy in an effort to improve patient care through greater understanding and sensitivity to ethnic, racial, gender and sexual orientation issues encountered in clinical practice. • Use of numerous clinical examples to articulate the new professionalism in psychiatry, which illustrates the importance of going beyond "one size fits all" thinking. Professionalism in Psychiatry is an important contribution toward beginning to characterize the ever-evolving professional behaviors and clinical strategies of the contemporary psychiatrist and place them in a systematic framework.

Ethics plays an especially important and unique role in psychiatry, and this issue is a must-read for psychiatrists as they navigate these sometime tricky waters. With an eye on the most current developments in the psychiatric field, authors discuss topics such as ethics in research, ethics in clinical treatment, ethics in education, genetics, and the military. The section on clinical concerns contains separate articles on children, adults, and older patients, with special attention paid to women's mental health, forensics, addiction psychiatry, consultation/liaison psychiatry, and community psychiatry.