A Clinician's Guide to Pathological Ambivalence


Book Description

Resistant. Oppositional. Borderline. Mental health professionals commonly use such terms to describe patients who, despite expressing a strong desire to reduce their emotional distress, repeatedly reject or ignore their therapist's interpretations andadvice. When this continues session after session, both patient and therapist end up feeling stuck and frustrated.This book offers an alternative interpretation of patients' apparent resistance, termed pathological ambivalence, which is rooted in early experience, biological functioning, and psychological narrative. The concept of pathological ambivalence draws from several established theoretical perspectives in explaining why some people seem to sabotage their progress in psychotherapy and how some therapists become unintentional enablers.




Psychological Approaches to Generalized Anxiety Disorder


Book Description

Concise, yet without skimping on information, this book reviews current theory and research, addresses important diagnostic issues, and provides salient details in a number of key areas related to GAD. Assessment procedures and treatment planning are covered, along with the latest therapy outcome data, including findings on newer therapies. Also detailed are specific cognitive behavioral therapy techniques, including cognitive strategies, psychoeducation, and anxiety monitoring.




Pathological Gambling


Book Description

The past five years have witnessed dramatic advances in research on pathological gambling -- a diagnosis often overlooked by clinicians who are unaware not only of the personal and social consequences of pathological gambling, but also of the possible treatment options. Today, clinicians can choose from an array of treatment options to substantially improve the lives of patients with this disabling illness. Eloquently attesting to this extraordinary progress, this remarkable clinician's guide comprises the most extensive coverage on public health, clinical characteristics and treatment, psychotherapy and psychopharmacology, and interventions for adolescents, adults, and older adults. Written by the world's leading researchers on psychiatric aspects of gambling, this truly comprehensive volume discusses how to diagnose pathological gambling and provides the tools to do so. Here, 32 experts detail the clinical phenomenology, etiology, and treatment of pathological gambling, highlighting the current clinical approaches most likely to lead to early identification, symptom remission, and improvement maintenance. Useful appendixes provide specific tests, scales, and diagnostic criteria following four major sections of the book: Public Health and Epidemiology discusses prevalence and definitions of recreational, problem, and pathological gambling; the relationship between the different levels of gambling severity; and gambling's effects on societal, familial, and individual health and well-being. Clinical Characteristics covers the symptoms and sequelae of pathological gambling and the differences among adolescents, older adults, and men and women, and shows that pathological gambling -- rather than being categorized as a single disorder -- shares important features with many disorders, among them obsessive-compulsive spectrum disorders, affective spectrum disorders, addiction, and impulse-control disorder. Etiology details the realms of both psychology (behavioral, cognitive, and dispositional theories) and neurobiology (noradrenergic, serotonergic, dopaminergic, and opioidergic systems as well as familial and inherited factors) to explain the behavior of pathological gambling -- knowledge that may prove useful in understanding a range of addictive and impulsive disorders. Prevention and Treatment emphasizes the vital role of the clinician in prevention efforts, including a prevention strategy tailored specifically for adolescents and young adults; discusses a variety of behavioral and pharmacological interventions for patients including self-help and professional-based interventions for family members; and concludes with assessments useful in diagnosing pathological gambling and monitoring symptom change. Psychiatrists, psychiatric researchers, and other mental health care professionals will welcome this book as their most up-to-date source for invaluable knowledge about and research from the world's recognized experts on pathological gambling.




Transference-Focused Psychotherapy for Borderline Personality Disorder


Book Description

Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide presents a model of borderline personality disorder (BPD) and its treatment that is based on contemporary psychoanalytic object relations theory as developed by the leading thinker in the field, Otto Kernberg, M.D., who is also one of the authors of this insightful manual. The model is supported and enhanced by material on current phenomenological and neurobiological research and is grounded in real-world cases that deftly illustrate principles of intervention in ways that mental health professionals can use with their patients. The book first provides clinicians with a model of borderline pathology that is essential for expert assessment and treatment planning and then addresses the empirical underpinnings and specific therapeutic strategies of transference-focused psychotherapy (TFP). From the chapter on clinical assessment, the clinician learns how to select the type of treatment on the basis of the level of personality organization, the symptoms the patient experiences, and the areas of compromised functioning. In order to decide on the type of treatment, the clinician must examine the patient's subjective experience (such as symptoms of anxiety or depression), observable behaviors (such as investments in relationships and deficits in functioning), and psychological structures (such as identity, defenses, and reality testing). Next, the clinician learns to establish the conditions of treatment through negotiating a verbal treatment contract or understanding with the patient. The contract defines the responsibilities of each of the participants and defines what the reality of the therapeutic relationship is. Techniques of treatment interventions and tactics to address particularly difficult clinical challenges are addressed next, equipping the therapist to employ the four primary techniques of TFP (interpretation, transference analysis, technical neutrality, and use of countertransference) and setting the stage for and guiding the proper use of those techniques within the individual session. What to expect in the course of long-term treatment to ameliorate symptoms and to effect personality change is covered, with sections on the early, middle, and late phases of treatment. This material prepares the clinician to deal with predictable phases, such as tests of the frame, impulse containment, movement toward integration, episodes of regression, and termination. Finally, the text is accompanied by supremely instructive online videos that demonstrate a variety of clinical situations, helping the clinician with assessment and modeling critical therapeutic strategies. The book recognizes that each BPD patient presents a unique treatment challenge. Grounded in the latest research and rich with clinical insight, Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide will prove indispensable to mental health professionals seeking to provide thoughtful, effective care to these patients.




Hypochondriasis and Health Anxiety


Book Description

In the recently updated Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic concept of hypochondriasis was eliminated and replaced by somatic symptom disorder and illness anxiety disorder. Hypochondriasis and Health Anxiety: A Guide for Clinicians, edited by Vladan Starcevic and Russell Noyes and written by prominent clinicians and researchers in the field, addresses current issues in recognizing, understanding, and treating hypochondriasis. Using a pragmatic approach, it offers a wealth of clinically useful information. The book also provides a critical review of the underlying conceptual and treatment issues, addressing varying perspectives and synthesizing the current research. Specific topics the text covers include: clinical manifestations, diagnostic and conceptual issues, classification, relationships with other disorders, assessment, epidemiology, economic aspects, course, outcome and treatment. Additionally, the book discusses patient-physician relationship in the context of hypochondriasis and health anxiety and presents cognitive, behavioral, interpersonal and psychodynamic models and treatments. The authors also address the neurobiological underpinnings of hypochondriasis and health anxiety and pharmacological treatment approaches. Based on the extensive clinical experience of its authors, there are numerous case illustrations and practical examples of how to assess, understand and manage individuals presenting with disease preoccupations, health anxiety and/or beliefs that they are seriously ill. It approaches its subject from various perspectives and is a work of integration and critical thinking about an area often shrouded in controversy.










Gabbard's Treatments of Psychiatric Disorders


Book Description

The definitive treatment textbook in psychiatry, this fifth edition of Gabbard's Treatments of Psychiatric Disorders has been thoroughly restructured to reflect the new DSM-5® categories, preserving its value as a state-of-the-art resource and increasing its utility in the field. The editors have produced a volume that is both comprehensive and concise, meeting the needs of clinicians who prefer a single, user-friendly volume. In the service of brevity, the book focuses on treatment over diagnostic considerations, and addresses both empirically-validated treatments and accumulated clinical wisdom where research is lacking. Noteworthy features include the following: Content is organized according to DSM-5® categories to make for rapid retrieval of relevant treatment information for the busy clinician. Outcome studies and expert opinion are presented in an accessible way to help the clinician know what treatment to use for which disorder, and how to tailor the treatment to the patient. Content is restricted to the major psychiatric conditions seen in clinical practice while leaving out less common conditions and those that have limited outcome research related to the disorder, resulting in a more streamlined and affordable text. Chapters are meticulously referenced and include dozens of tables, figures, and other illustrative features that enhance comprehension and recall. An authoritative resource for psychiatrists, psychologists, and psychiatric nurses, and an outstanding reference for students in the mental health professions, Gabbard's Treatments of Psychiatric Disorders, Fifth Edition, will prove indispensable to clinicians seeking to provide excellent care while transitioning to a DSM-5® world.




Family-Oriented Primary Care


Book Description

A family orientation in health care can provide a wider understanding of illness and a broader range of solutions than the classic biomedical model. This volume thus offers practical guidance for the physician who would like to take greater advantage of this resource. The result is a readable guide, structured around step-by-step protocols that are vividly illustrated with case studies drawn from the authors extensive experience at the University of Rochester School of Medicine.




On Learning From the Patient


Book Description

"On Learning from the Patient is concerned with the potential for psychoanalytic thinking to become self-perpetuating. Patrick Casement explores the dynamics of the helping relationship - learning to recognize how patients offer cues to the therapeutic experience that they are unconsciously in search of. Using many telling clinical examples, he illustrates how, through trial identification, he has learned to monitor the implications of his own contributions to a session from the viewpoint of the patient. He shows how, with the aid of this internal supervision, many initial failures to respond appropriately can be remedied and even used to the benefit of the therapeutic work. By learning to better distinguish what helps the therapeutic process from what hinders it, ways are discovered to avoid the circularity of pre-conception by analysts who aim to understand the unconscious of others. From this lively examination of key clinical issues, the author comes to see psychoanalytic therapy as a process of re-discovering theory - and developing a technique that is more specifically related to the individual patient. The dynamics illustrated here, particularly the processes of interactive communication and containment, occur in any helping relationship and are applicable throughout the caring professions. Patrick Casement's unusually frank presentation of his own work, aided by his lucid and non-technical language, allows wide scope for readers to form their own ideas about the approach to technique he describes. This Classic Edition includes a new introduction to the work by Andrew Samuels and, together with its sequel Further Learning from the Patient, will be an invaluable training resource for trainee and practising analysts or therapists."--