One of the more difficult aspects of treating children and adolescents is the issue of aggression. An expert consensus panel convened by the Center for the Advancement of Children's Mental Health at Columbia University and the New York State Office of Mental Health has released a new set of treatment guidelines that should help physicians give the best care possible.
The use of supportive psychotherapy, where the clinician acts as a watchful parent, may be of some use to certain patients as opposed to traditional psychoanalysis. This paper gives some examples of cases in which supportive psychotherapy may be more effective.
Once the potential for violent behavior has been identified in a patient, how should it be dealt with? What steps can the clinician take to ensure the physical and legal safety of themselves and their patients? Furthermore, what are the clinician's legal and ethical responsibilities if the patient does commit a violence act?
Although the prospect of online mental health care raises obvious questions, it also offers an opportunity to make cost effective services available to many who may not otherwise have access. By understanding issues such as confidentiality, emergencies and lack of face-to-face contact, psychiatrists can determine if this area of treatment is right for them.
Poetry of the Times
Confidentiality Under Fire - Poetry of the Times
Stereotypical portrayals of people with mental illness are as old as Hollywood itself. What are some of the clinical implications of the continued stigmatization of the mentally ill in television and film?
Theater, film, literature and poetry are forms of expression that allow artists and their audiences to explore the compelling issues of their lives. By understanding which pieces "speak" to patients and physicians, the dialogue and therapy may be enhanced.
In the wake of the report issued by the Institute of Medicine detailing the number of medical errors each year, the American Psychiatric Association has issued a set of patient safety recommendations. Will these recommendations reduce the number of psychiatric patient deaths and injuries?
The inability to create an accurate picture of self-awareness is a feature in many mental illnesses, such as schizophrenia, autism, ADHD, personality disorders and substance abuse. At a Kansas City, Mo., conference, researchers begin to establish a biological basis for self-awareness and hope to isolate the deficits in the brain that causes abnormal functioning.
Using music as a form of therapy for emotionally disturbed children seems quite natural, given children's innate love of music. How can this form of creativity be used as therapy to help children better communicate feelings and emotions?
In presenting the subject of dangerousness assessments at my hospital, I told a story about my grandchildren that illustrated the fact that we all make such assessments and act on them regularly in various contexts.
With a prevalence of approximately 10% for North American women, vulvar vestibulitis can have enormous quality of life implications for patients and their partners. When gynecologists and other medical specialists have difficulty finding an organic cause for the chronic pain associated with this disorder, patients find themselves referred to the mental health care professional, who must determine the diagnosis and course of treatment
Literature invites readers to see the world from another viewpoint, which can, in turn, lead to an increased capacity for empathy. In working with difficult-to-treat children, Alexandra Helper, MD, has found that the use of literature that focuses on alternative viewpoints helps such patients develop empathy and improve their functioning in the "real world."
Becoming more creative and improvising have certain dynamics that can be used by therapists in fostering a more healing process. Playfulness, imagination, dialogue, skill-building, narrative, inspiration and integration can all be employed in clinical settings. These tools create an environment where spontaneity can arise, anxiety is reduced, and patients are more receptive to their own intuition.
Poetry of the Times
Proponents of mental health care parity have reintroduced the legislation that died in the U.S. House of Representatives last year. While the idea of parity has broad bipartisan support, the debate continues over how much it will cost, who will foot the bill, and how it should best be administered. In a time of war and tight budgets, will the bill get the attention it deserves?
What does the state of psychiatry look like? Surveys have been conducted and data have been broken down into compensation levels, specialties, service costs and insurance coverage. Finally enough data exist to give an overall view of where most psychiatrists stand today in the medical workforce.
Substance abuse and addiction are among the most challenging health problems facing our society. Breakthrough discoveries in science continue to refine our understanding of drug abuse and addiction and are yielding new opportunities to translate basic research findings into tangible treatment products. Read about the progress being made by the National Institute on Drug Abuse, the world's largest supporter of research on the health aspects of addiction.
There are many factors that contribute to patients with schizophrenia not taking their medication, including side effects and lack of education. What can clinicians do to help their patients adhere to treatment? Should clinicians be spending more time educating their patients? How will long-acting medications affect adherence issues?
Although there is no pharmacological agent that has been approved by the U.S. Food and Drug Administration for the treatment of autism, new studies are showing promise in not only discovering the cause of autism, but pharmacological treatments as well.
The idea that drug response could be based on a patient's genetic background first surfaced over 100 years ago. Since then, technology has advanced to the point where prescribing medications based on a patient's genetic makeup no longer seems like science fiction. This article looks at the latest research on the pharmacogenetics of psychotropic medications and shows how far we still have to go.
Increasing variations in mechanisms of action of atypical antipsychotics, side-effect profiles, and efficacy among the atypicals enable clinicians to tailor treatments to individual response, side-effect history, and current medical conditions.
With all the various types of medications as well as different formulations that can be used to treat ADHD in adolescents, choosing the right one can be a difficult task. This analysis of the options will help make that choice easier.
In this introduction to our Trauma Special Report, Dr. Novac places the articles in historical perspective and reminds the reader of the importance of understanding trauma within today's global constructs and impending war.
As the U.S. Department of Homeland Security raises security levels, Americans frantically take extraordinary precautions to prepare themselves for disaster. How is the public affected by the media and what can mental health care professionals and the government do to help minimize this anxiety?
Inpatient care for the wealthy has arrived--fluffy bath robes, in-room Jacuzzis, a concierge at your beck and call. Do the luxuries of these "resorts" negate the care that is being provided, or can patients have the best of both worlds?
Poetry of the Times
In the wake of the deaths of seven astronauts aboard the Space Shuttle Columbia, many critics have called for an end to manned space flights. Psychiatrists, however, point to the intangible benefits--including the societal values and desired psychological traits that are modeled by astronauts.
What is secondary traumatization? The authors discuss current research and implications for this controversial and emerging field of study.