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Stepped care provides the least intrusive intervention to individuals seeking treatment by providing a range of treatment intensities. In the past two decades, computers and the internet have provided a new and efficient medium that lends well to adding steps in a stepped-care model. While there is ample evidence to support the positive effects of bibliotherapy or self-help books, computer-aided therapy (also known as e-health) has the potential to take these effects even further. This volume will be of interest to practitioners and organizations attempting to serve rural and underserved communities. The book focuses on evidence-based treatment, making it consistent with quality improvement initiatives.
This book is a primer on Stepped Care 2.0. It is the first book in a series of three. This primer addresses the increased demand for mental health care by supporting stakeholders (help-seekers, providers, and policy-makers) to collaborate in enhancing care outcomes through work that is both more meaningful and sustainable. Our current mental health system is organized to offer highly intensive psychiatric and psychological care. While undoubtedly effective, demand far exceeds the supply for such specialized programming. Many people seeking to improve their mental health do not need psychiatric medication or sophisticated psychotherapy. A typical help seeker needs basic support. For knee pain, a nurse or physician might first recommend icing and resting the knee, working to achieve a healthy weight, and introducing low impact exercise before considering specialist care. Unfortunately, there is no parallel continuum of care for mental health and wellness. As a result, a person seeking the most basic support must line up and wait for the specialist along with those who may have very severe and/or complex needs. Why are there no lower intensity options? One reason is fear and stigma. A thorough assessment by a specialist is considered best practice. After all, what if we miss signs of suicide or potential harm to others? A reasonable question on the surface; however, the premise is flawed. First, the risk of suicide, or threat to others, for those already seeking care, is low. Second, our technical capacity to predict on these threats is virtually nil. Finally, assessment in our current culture of fear tends to focus more on the identification of deficits (as opposed to functional capacities), leading to over-prescription of expensive remedies and lost opportunities for autonomy and self-management. Despite little evidence linking assessment to treatment outcomes, and no evidence supporting our capacity to detect risk for harm, we persist with lengthy intake assessments and automatic specialist referrals that delay care. Before providers and policy makers can feel comfortable letting go of risk assessment, however, they need to understand the forces underlying the risk paradigm that dominates our society and restricts creative solutions for supporting those in need.
This timely new edition of Integrated Behavioral Health in Primary Care brings the reader up to speed with the changing aspects of primary care service delivery in response to the Patient-Centered Medical Home (PCMH), the Triple-Aim health approach, and the Patient Protection and Affordable Care Act. Drawing on research evidence and years of experience, the authors provide practical information and guidance for behavioral health care practitioners who wish to work more effectively in the fast-paced setting of primary care, and provide detailed advice for addressing common health problems such as generalized anxiety disorder, depression, weight issues, sleep problems, cardiovascular disorders, pain disorders, sexual problems, and more. New to this edition are chapters on population health and the PCMH; children, adolescents, and parenting; couples; managing suicide risk; and shared medical appointments. This paperback edition was previously published in hardcover in 2017.
Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for patients with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies.
This timely volume provides the practitioner with evidence based treatments for many of the clinical problems encountered in integrated care. It applies the core concepts of stepped care to integrating brief mental health interventions as a way to address ongoing problems in the modern healthcare landscape. It sets out in depth the state of the healthcare crisis in terms of costs, staffing and training issues, integration logistics and management, system culture, and a variety of clinical considerations. Central to the book is a best-practice template for providing behavioral stepped care in medical settings, including screening and assessment, levels of intervention and treatment, referrals, and collaboration with primary care and other specialties. Using this format, contributors detail specific challenges of and science-based interventions for a diverse range of common conditions and issues, including: Depression. Anxiety disorders. Adherence to chronic obstructive pulmonary disorder management. Alcohol and other substance misuse. Attention deficit hyperactivity disorder. Chronic pain. Neurocognitive disorders. Paraphilias: problematic sexual interests.[WU3] Sexual abuse and PTSD in children. A solid roadmap for widescale reform, Principle-Based Stepped Care and Brief Psychotherapy for Integrated Care Settings is deeply informative reading for health psychologists, social workers, psychiatrists, and clinical psychologists. It also clarifies the research agenda for those seeking improvements in healthcare quality and delivery and patient satisfaction.
This evidence-to-practice volume deftly analyzes the processes and skills of integrating mental healthcare with primary care, using multiple perspectives to address challenges that often derail these joint efforts. Experts across integrative medicine offer accessible blueprints for smoothly implementing data-based behavioral interventions, from disease management strategies to treatment of psychological problems, into patient-centered, cost-effective integrated care. Coverage highlights training and technology issues, key healthcare constructs that often get lost in translation, and other knowledge necessary to create systems that are rooted in—and contribute to—a robust evidence base. Contributors also provide step-by-step guidelines for integrating behavioral health care delivery in treating cancer, dementia, and chronic pain. Among the topics covered: The epidemiology of medical diseases and associated behavioral risk factors. Provider training: recognizing the relevance of behavioral medicine and the importance of behavioral health consultations and referrals. Screening for behavioral health problems in adult primary care. Health care transformation: the electronic health record. Meeting the care needs of patients with multiple medical conditions. Smoking cessation in the context of integrated care. This depth of clinical guidance makes Behavioral Medicine and Integrated Care an essential reference for practitioners on all sides of the equation, including health psychologists and other professionals in health promotion, disease prevention, psychotherapy and counseling, and primary care medicine.
Much of health care today involves helping patients manage conditions whose outcomes can be greatly influenced by lifestyle or behavior change. Written specifically for health care professionals, this concise book presents powerful tools to enhance communication with patients and guide them in making choices to improve their health, from weight loss, exercise, and smoking cessation, to medication adherence and safer sex practices. Engaging dialogues and vignettes bring to life the core skills of motivational interviewing (MI) and show how to incorporate this brief evidence-based approach into any health care setting. Appendices include MI training resources and publications on specific medical conditions. This book is in the Applications of Motivational Interviewing series, edited by Stephen Rollnick, William R. Miller, and Theresa B. Moyers.
This book demonstrates how clinical psychology and psychotherapy practices may reach a scientific level provided they change the three basic paradigms that have controlled those practices in the last century. These three, now outdated, paradigms, are: (1) one-on-one (2) personal contacts (3) through talk. These paradigms have served well in the past but they are no less helpful in the current digitally focused world.
This handbook and accompanying CD have been designed to help dentists, dental hygienists, and other dental personnel communicate with Spanish-speaking patients. Intended for novice learners as well as those who need to polish their rusty high school Spanish,Paso a Pasocan be used in emergency situations or as a source of phrases to make routine visits more comfortable for patients--or anywhere between those extremes. The book includes aspects of Latino culture vital for any dental professional as well as key dental health phrases and useful grammar.Paso a Pasofocuses on learning, practicing, and speaking both standard and colloquial Spanish for an office setting. The accompanying CD presents dialogues in which Latino patients interact with health professionals using a variety of accents and levels of fluency. Like the book, the CD will be useful in workshops, work-site training, and individual learning. The chapter structure permits work-site training of an hour a day for six weeks. The CD will not be sold separately. FromPaso a Paso/Step by Step, Chapter Two "In Latin America, more than one last name is used to describe family relationships. Latino names consist of a first and middle name, or "given names," followed by the father's last name, followed by the mother's paternal surname--in that order. Many people shorten their names by using only an initial for the maternal surname. For example, in the story, Marco's name would be written Marco Antonio Hernández Calderón or Marco Hernández C. So, the surname by which official records are kept is the first surname "It is important for Americans and Latinos to understand these differences, to record the correct surname on dental records, consistently. Among Latinos, the first last name is the equivalent of a last name in the US."