Dangerous Patients


Book Description

This thought-provoking new collection - the fourth volume in the Forensic Psychotherapy Monograph Series - investigates the inherent difficulties in risk assessment. We have all read the lurid headlines when things go wrong but what is it like for the professional who has to make such vital decisions? Ronald Doctor has assembled an impressive group of clinicians who specialise in various aspects of forensic psychiatry and psychotherapy to present their experiences and theories on this formidable subject. The book begins with a general overview of current psychodynamic approaches and covers various mental health settings, including medium- and high-security units, general medical hospitals and psychiatric wards. This collection will prove to be an indispensable guide to any healthcare professional and a fascinating insight for all into this highly-pressured environment.







Concise Guide to Assessment and Management of Violent Patients


Book Description

Clinicians encounter violent patients in any treatment setting -- from private offices and medical units to psychiatric inpatient units. Written by one of the foremost experts on violence, the second edition of this concise, practical guide provides psychiatry residents, psychiatrists, and other mental health professionals with vital information required to manage potentially violent patients. Considerably updated, this book contains current information on psychopharmacology and the management of violent patients, an expanded section on the safety of clinicians, and a new section on how to deal with threats of violence to the clinician. This guide will be especially useful and relevant to psychiatric residents, given the number of violent patients they encounter.




Understanding and Treating Violent Psychiatric Patients


Book Description

One of the major challenges for mental health professionals today is to successfully treat violent patients. The mental health professional is obligated to go beyond containment and control to provide understanding, complete assessment and accurate diagnosis, and humane and effective treatment. Understanding and Treating Violent Psychiatric Patients is a one-of-a-kind, comprehensive guide to assessment, management, understanding, and treatment of violent patients. The first section encompasses practical guides to treatment for both children and adults. It discusses commonly encountered problems in the treatment of violent adult inpatients and includes a brief guide to pharmacological treatments. A chapter is devoted to the treatment of abnormal aggression in children and adolescents. The second section delves into a more conceptual and broadly focused approach to understanding violent patients. It covers the relationship between dissociation and violence, as well as the relationship between psychiatric disorders and violence, and addresses impulse control and the treatment of impulsive patients. Heavily researched and clinically focused, this new title is a "must read" for psychiatrists, psychologists, psychiatric social workers, psychiatric nurses, or any mental health professional needing a better approach to understanding and treating violent patients.




The American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients With Dementia


Book Description

The guideline offers clear, concise, and actionable recommendation statements to help clinicians to incorporate recommendations into clinical practice, with the goal of improving quality of care. Each recommendation is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms.




Mental Disorder and Crime


Book Description

Contributors to this volume present and discuss new data which suggest that major mental disorder substantially increases the risk of violent crime. These findings come at a crucial time, since those who suffer from mental disorders are increasingly living in the community, rather than in institutions. The book describes the magnitude and complexity of the problem and offers hope that humane, effective intervention can prevent violent crime being committed by the seriously mentally disordered.




Patient Violence and the Clinician


Book Description

Patient Violence and the Clinician presents clinically relevant information on violent patients and how clinicians can deal with threats of potential violence in their everyday practice. This book describes the clinical information known about the characteristics of assaultive patients and the characteristics of their assaults. It also reviews special issues of clinician safety related to women, psychiatric residents, and psychiatric nurses. Patient Violence and the Clinician provides concrete strategies for enhancing clinician safety through architecture, alarm systems, and behavioral strategies. It addresses staff issues and the humane treatment of violent patients. This book helps the clinician think about the cultural issues that surround treatment of violent patients - before violence erupts.




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Environmental Illness


Book Description

Environmental illness: certain health professionals and clinical ecologists claim it impacts and inhibits 15 percent of the population. Its afflicted are led to believe environmental illness (EI) originates with food, chemicals, and other stimuli in their surroundings -as advocates call for drastic measures to remedy the situation. What if relief proves elusive-and the patient is sent on a course of ongoing, costly and ineffective ""treatment""? Several hundred individuals who believed they were suffering from EI have been evaluated or treated by Herman Staudenmayer since the 1970s. Staudenmayer believed the symptoms harming his patients actually had psychophysiological origins-based more in fear of a hostile world than any suspected toxins contained in the environment. Staudenmayer's years of research, clinical work-and successful care-are now summarized in Environmental Illness: Myth & Reality. Dismissing much of the information that has attempted to defend EI and its culture of victimization, Staudenmayer details the alternative diagnoses and treatments that have helped patients recognize their true conditions-and finally overcome them, often after years of prolonged suffering.




Definition of Serious and Complex Medical Conditions


Book Description

In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.