Wherever people are working, there is some type of stress-and where there is stress, there is the risk of burnout. It is widespread, the subject of numerous studies in the U.S. and abroad. It is also costly, both to individuals in the form of sick days, lost wages, and emotional exhaustion, and to the workplace in terms of the bottom line. But as we are now beginning to understand, burnout is also preventable. Burnout for Experts brings multifaceted analysis to a multilayered problem, offering comprehensive discussion of contributing factors, classic and less widely perceived markers of burnout, coping strategies, and treatment methods. International perspectives consider phase models of burnout and differentiate between burnout and related physical and mental health conditions. By focusing on specific job and life variables including workplace culture and gender aspects, contributors give professionals ample means for recognizing burnout as well as its warning signs. Chapters on prevention and intervention detail effective programs that can be implemented at the individual and organizational levels. Included in the coverage: * History of burnout: a phenomenon. * Personal and external factors contributing to burnout. * Depression and burnout * Assessment tools and methods. * The role of communication in burnout prevention. * Active coping and other intervention strategies. Skillfully balancing scholarship and accessibility, Burnout for Experts is a go-to resource for health psychologists, social workers, psychiatrists, and organizational, industrial, and clinical psychologists.

Throughout the last decade, the field of clinical psychology has expanded dramatically. Clinical psychologists are involved in the treatment and research of a wider range of problems and disorders than they have ever been before. Evidence has been rapidly ac cumulating regarding the role of psychological variables and stress in the etiology and maintenance of a range of medical and psychiatric disorders. New models of psy chotherapy have been developed and refined, and the specific efficacy of psychother apeutic interventions for an increasing number of disorders (or sUbtypes of disorders) has been documented. However, concurrent with research that demonstrates the impact of psychosomatic factors in various disorders and the efficacy of psychological or psychosocial interven tions, dramatic progress has been made with regard to the investigation of biological factors that may mediate certain disorders. That physical factors may underlie many in stances of psychiatric illness has been repeatedly demonstrated. Also, the efficacy of so matic treatments for different disorders, or for subtypes of disorders, has been reported with increasing methodological rigor."

This volume contains fifteen papers by invited participants delivered at the NATO International Workshop on Coping and Health held March 26 through March 30, 1979, at the Rockefeller Foundation's Bellagio study and Conference Center, Bellagio, Italy. The editors of the book were co-directors of the workshop as well as participants. The conference was a small conference consisting of only 20 scientists and was designed to be an intensive period of exchange of ideas dealing with a range of topics varying from experimental models of coping through coping and its psychosomatic implications. The exceptional beauty of the Bellagio Study and Conference Center, the hospitality of the staff at the Conference Center as well as the support of the administrative staff of the Rockefeller Foundation, combined with the intensity and enthusiasm of the participants made the conference a most memorable one for those who attended it. A special thanks is in order for the help and assistance of Dr. B. A. Bayraktar, Executive Officer of Human Factors Program, Scientific Affairs Division, NATO, and Miss Susan Garfield, Program Director of the Rockefeller Foundation. Needless to say, without their participation and help at all points in the organization and planning of this conference, the conference would not have occurred.

Despite advances in detection and treatment, cancer remains a source of pain and distress to patients and of complex challenges to the loved ones caring for them. The trend toward shorter hospital stays in particular has increased the physical, psychological, and financial burden on caregivers, often leading to adverse effects on patients.

"Cancer Caregiving in the United States" illuminates these complex concerns with authoritative detail. This wide-ranging volume provides a comprehensive survey of cancer-related issues, including those affecting the care triad (patients-family members- professionals) and quality of care as well as the numerous physical, emotional, and financial challenges that caregivers may need to confront. Sources of caregiver difficulty at each stage of the disease, from diagnosis to end of life, are explored. Each chapter analyzes its topic in terms of practice, research, education, and policy, providing a wealth of literature reviews, assessment and care models, interventions, and recommendations for future study and practice.

Coverage includes:

Caregiving issues for cancer patients with long-term, short-term, and intermittent needs.Family caregivers as members of the treatment team.The impact of health disparities on caregivers.Cancer care policy and advocacy.End-of-life issues for cancer caregivers.Legal, financial, and ethical issues.

"Cancer Caregiving in the United States" is a core reference for researchers, professionals/scientist-practitioners, and graduate students in such caregiving fields as clinical psychology, social work, nursing, public health and medicine, social policy, and educational policy."

This is a book that grew out of frustration. The frustration was rooted in our failed attempts to help people modify health-related behavior. From a behavioral medicine perspective, it was readily apparent to us that there were many things people could do to improve their health. Some of these were preventive behaviors, whereas others were much more therapeutic or rehabilitative in nature. Put another way, there were specific well-known behavioral strategies that people could use to maintain or regain their good health. Yet despite our good intentions, enthusiasm, and considerable efforts, something was wrong. People dropped out of therapy or failed to follow behavioral prescriptions. Workshops and clinics were half-empty. If people would attend workshops or follow therapeutic programs, their health would benefit. Yet in our experience and in the experience of most of our colleagues, compliance to treatment programs was a major problem. Faced with such a situation, it is easy to blame the victim-in this case the client. It is common to hear therapists talk of poorly motivated clients, complain that people are just not interested in improving their health, or even speculate about people's self-destructive tendencies. Although this may be comforting to the thera pist, it does very little to solve the problem. What was needed was an approach to improve adherence to therapeutic programs rather than comforting excuses for their failure. It is in this context that we became exposed to the area of social marketing."

In this groundbreaking work, distinguished contributors explore the myriad relationships between networks of social support and the development, treatment, and rehabilitation of individuals with cardiovascular disease. Chapters span the range from conceptual to methodological issues, and take into account gender, environmental, and cultural differences. The book will provide a wealth of information for clinicians and students in the fields of behavioral medicine, psychophysiology, and cardiovascular disease.

Public health has a legacy of neglect regarding social and behavioral research. Too often, prompted by technical and scientific progress, we have ignored even marginalized-the vital "human element" in health thinking and prac tice. Thus, for example, while family planning programs focused on providing a choice among safe and effective contraceptive methods (a supremely worthy goal), the central issue of sexuality and sexual behavior was generally neglected. Similarly, the enormous and important efforts to develop rapid and reliable diagnostic and treatment methods for sexually transmitted diseases helped divert attention away from the crucial issues of sexual practice. In short, we seem to have difficulty addressing the fundamental behaviors-including sex, drug taking and other intoxications, and violence-that are central to the major causes of preventable morbidity, disability, and premature mortality in the world today. Our collective reluctance to examine and understand ourselves is also expressed in the oft-repeated pipedream that scientific progress will "take care of" the HIV / AIDS pandemic by delivering a preventive vaccine, an effective cure, or both. Yet even a cursory glance at the relationship between scientific/ technical progress and health shows that meeting the scientific challenges is only one step toward effective application of the vaccine or drug. It is typical, not atypical, that hepatitis B vaccine is only now becoming relatively freely available to large populations in the developing world, more than a decade after the vaccine's licensure.

A landmark contribution to chronic pain literature, this contemporary text measures the intricate relationship between chronic pain and life transition events. Researchers and clinicians will appreciate The Changing Nature of Pain Complaints Over the Lifespan for its linking of life transition theories to health and illness. Drawing on nearly 20 years of research, the authors bring together the epidemiological and psychosocial aspects of chronic pain and suggest expanding options for pain management. Their coverage encompasses every stage of the human life cycle.

With all the enormous resources that are invested in medicine, it is sometimes a mystery why there is so much sickness still in evidence. Our life span, though higher than at any time in history, has now leveled off and has not significantly increased in the last two generations. There is a one-third increase in long-term illness in the last 20 years and a 44% increase in cancer incidence, which are not related to demographic issues. In some modern countries, the level of morbidity (defined as days off work because of sickness) has increased by two thirds in this time. Despite $1 trillion spent on cancer research in 20 years, the "War On Cancer" has recently been pronounced a complete failure by the u. s. President's Cancer Panel. Evidently we still have a long way to go. The goal of "Health for All by the Year 2000" as the World Health Organization has put it, is another forgotten dream. As ever, the answer will be found in breaking out of the old philosophical patterns and discovering the new, as yet unacceptable concepts. The problems of medicine today require a Kuhnian breakthrough into new paradigms, and new ways of thinking. And these new ways will not be mere variations of the old, but radical departures. This book, and the conference upon which it was based, is part of a search for these new pathways.

This book focuses on a problem frequently encountered by sex and family therapists, psychologists and primary care physicians: women's sexual desire or lack thereof. The book covers both research and clinical interventions, and outlines factors that contribute to the decline in sexual desire in women of various ages. The text describes therapeutic steps which can be undertaken with the guidance of a therapist or by the woman herself.

This book is an effort to integrate some clinical observations, theoretical concepts, and promising clinical procedures that relate psychological variables to physiological variables. My primary emphasis is on what psychological and behavioral concepts and procedures are most likely to enable us to influence physiological functions. The book covers ques tions that have fascinated me and with which I have struggled in daily clinical practice. What types of people are most at risk for physical disor ders or dysfunctions? Why do some people present psychosocial con flicts somatically and others behaviorally? What is the placebo effect and how does it work? How do you arrange the conditions to alter maladap tive belief systems that contribute to psychopathology and patho physiology? Do beliefs have biological consequences? When I was in private clinical practice, and even today in my medi cal school clinical practice situation, I set aside one day each week to puzzle over the theoretical questions that my clinical experience gener ates. Often isolating these underlying theoretical questions provides guidance into the most relevant empirical literature. I have found that this weekly ritual, which I started in private practice many years ago, appears to increase my clinical efficacy or at least makes clinical work more exciting. I find the unexamined clinical practice hard to endure. Kurt Lewin once said, "There is nothing so practical as a good theory."

Leading researchers examine how behavior genetics provides crucial insights into genetic and environmental influences in the development of biobehavioral disorders. These influences are illustrated by using the examples of cardiovascular disease, obesity and eating disorders, alcohol use and abuse, and smoking behavior. Contributors discuss the relevance of molecular genetic approaches and twin and family designs to the complex field of behavior medicine research.

Although it has been assumed since early recorded history that psycho logical factors influence health and illness, it has only been within the past few years that a group of investigators and clinicians with a shared interest in the application of psychological principles and techniques to health and illness has existed. Over this same period of time, a number of multi-author books on the topic of health psychology and an associ ated field, behavioral medicine, have been published. Although these books are major resources for the investigator and the clinician in the field, it is often difficult for students, both undergraduate and graduate, to learn the basics of health psychology from such books. Thus, Health Psychology: A Psychobiological Perspective was written to provide such basics. The need for such a textbook in health psychology became appar ent to the first author when he was searching for reading material for an undergraduate course in health psychology at McGill University. This book grew out of the course in health psychology, and its structure represents the course content. The purpose of the book is to present the theoretical, empirical, and clinical aspects of the rapidly developing field of health psychology. Data from a number of subdisciplines within psychology and the behav ioral and health-related sciences are integrated throughout each chapter in an effort to provide a balanced perspective. Health Psychology explores the development of the field and its research methodologies, theoretical models, and intervention possibilities."

Eight years ago, four psychologists with varying backgrounds but a common in terest in the impact of environmental stress on behavior and health met to plan a study of the effects of aircraft noise on children. The impetus for the study was an article in the Los Angeles Times about architectural interventions that were planned for several noise-impacted schools under the air corridor of Los Angeles Interna tional Airport. These interventions created an opportunity to study the same chil dren during noise exposure and then later after the exposure had been attenuated. The study was designed to test the generality of several noise effects that had been well established in laboratory experimental studies. It focused on three areas: the relationship between noise and personal control, noise and attention, and noise and cardiovascular response. Two years later, a second study, designed to replicate and extend findings from the first, was conducted."

This volume creates a multi-disciplinary dialogue about clinician-patient communication. It offers a description of the relevance of culture as a contextual effect that impacts the clinician-patient relationship. Some topics addressed include: oncology care, quality of life issues, supportive survivorship, etc. It is for physicians, nurses, hospice and palliative care professionals and public health professionals.

The permanent effects of traumatic brain injury (TBI) are not limited to the person who suffers the injury. People who care for the individual, particularly family members, suffer in various ways. Family members are often confused as to the behavioral and neuropsychological changes that they see in a brain-injured rela tive. They can become frustrated and angry when the individual does not return to premorbid levels of functioning. They can become tired and worn down from repeated problems in trying to manage the individual's difficulties while having only fragmented information regarding them. Drs. Smith and Godfrey have provided a useful service for family members by summarizing important neuropsychological changes associated with TBI and providing practical guidelines for coping with these problems. While the neuropsychological problems they describe are not completely understood, the authors provide a useful description of many of the neuro behavioral problems seen following TBI in young adults. They attempt to provide guidelines for family members that have practical utility in understanding and managing these patients. Theirs is a cognitive-behavioral approach that can have utility for this group of individuals. I applaud their efforts to provide something systematic and practical for family members.

This is a practitioner's guidebook presenting steps to assessing and treating a problem that borders on health and psychology. It is an invaluable resource for psychologists, nurses, physicians, and allied health professionals and all those who deal with sufferers of chronic sleep problems.

Alcoholism: A Review of Its Characteristics, Etiology, Treatment, and Controversies provides an accurate picture of the current state of research and treatment effectiveness in the field of alcoholism. Using compelling evidence, Irving Maltzman describes how the field has been distorted by the behavior therapy approach. A distinguished experimental psychologist at the University of California, Los Angeles, Professor Maltzman has written a comprehensive, important work marked by incisive argument. Alcoholism is an excellent reference for academics as well as professionals working in addictions treatment.

Methodological problems have hampered researchers' efforts to understand and control AIDS since the beginning of the epidemic. This practical book addresses these problems by using actual health research case studies to develop strategies regarding design and sampling, measurement, and analysis and modeling issues. Researchers working on both biological and behavioral aspects of the disease will find this work a singularly effective tool to improve their study designs.

This book contains the proceedings of the First International Conference on Health Hazards and Challenges in the New Working Life, held January 11-13, 1999, in Stockholm, Sweden. The globalisation of the economies has enormous implications for work and labour market structures. Demands for rapid adjustment and flexibility can be perceived as threatening to the employees' need for security and can cause ill health, but it is also important to try to foresee the possible benefits that could result and the constructive adaptations that individuals make. These changing conditions raise new issues and research questions concerning health consequences and people's actions and constructive adaptation. The interdisciplinary research conference in Stockholm on Health Hazards and Challenges in the New Working Life covered areas such as health and social consequences of unemployment, job insecurity, labour market constraints, flexibility in working conditions, and new forms of employment relations and contracts. The proceedings give an overview of the latest research results on these issues, which will be of the utmost importance to working life in the next millennium.The book presents a selection of contributions from highly qualified researchers in psychology, occupational health and sociology and covers three main sections: unemployment and downsizing, flexibilization and stress, and opportunities and constraints in the labour market. It provides an excellent summary and overview of earlier research, together with new findings about adaptation and actions among the unemployed, the effects of new and changing employment contracts upon health, and the polarization of the labour market and its exclusion of vulnerable groups.

This book advances a serious consideration of how the goals and practices of psychology can be informed and enriched by Buddhist traditions that transcend the individual to consider the interconnectedness of all things, and the responsibility we have towards the other. Individualistic and psychotherapeutic applications of Buddhism in psychology are examined, followed by a bold step into the community arena, with consideration given to the intersection between community psychology and Buddhist approaches to empowerment, social change, and prevention.

Howard J. Shaffer, Ph. D. More than 20 years ago, I first noted that young people in North America were growing up in a context of legalized gambling for their entire lifetime. By the 1980s, for young people, gambling had become an average and expectable part of the social landscape. Amid legal opportunities to gamble in all but two of the United States and with illicit opportunities to gamble in every state, gambling is now ubiquitous in America. With few social sa- tions to limit a young person's interest in gambling-like their adult co- terparts-young people now gamble in larger numbers and for seemingly higher stakes. Gradually, gambling-related problems became more visible for young people and the culture slowly but increasingly took notice. By the late 1990s, every sector of American and Canadian society had started to c- sider the effects of legalized gambling on youth. For different reasons, r- resentatives of the gambling and health care industries led the movement to prevent youthful gambling and reconcile existing problems whenever p- sible. Scientists also recognized that there was much to be learned by stu- ing young gamblers. Toward the end of the 20th century, there was a rapid increase in gambling research focusing on developmental issues; half of what is known about gambling emerged during the 1990s. This volume represents an important event in the continuing growth of a field.

This volume contains current evidence-based diagnosis and therapeutic interventions for people with mental disorders. Students and professionals alike will find the mental health field addressed as a whole in a coherent and understandable way. Readers are offered a unified presentation of psychological and sociological approaches to diagnosis and treatment.

Promoting Reproductive Security in Developing Countries provides a comprehensive approach to developing and implementing reproductive health programs in the developing world. It fills a major gap in the literature by responding to the global need for a detailed guide to comprehensive reproductive health services. Promoting Reproductive Security in Developing Countries furnishes an innovative conceptual model - reproductive security - and offers an in-depth analysis of major reproductive health issues. The need for skilled, dedicated professionals is great. Those who choose to pursue the discipline are promised an endlessly rewarding and absorbing profession that will touch upon the most intimate aspects of life while reverberating globally. This book will be of great interest to public health professionals on both a local and global level, international policy makers, and relief workers.

Globally, action to prevent HIV spread is inadequate. Over 16,000 new infections occur every day. Yet we are not helpless in the face of disaster, as shown by the rich prevention experience analyzed in this valuable new compendium. "Best pr- tice" exists-a set of tried and tested ways of slowing the spread of HIV, of persuading and enabling people to protect themselves and others from the virus. Individually, features of best practice can be found almost everywhere. The tragedy, on a world scale, is that prevention is spotty, not comprehensive; the measures are not being applied on anywhere near the scale needed, or with the right focus or synergy. The national response may concentrate solely on sex workers, for example. Elsewhere, efforts may go into school education for the young, but ignore the risks and vulnerability of men who have sex with men. Action may be patchy geographically. AIDS prevention may not benefit from adequate commitment from all parts and sectors of society, compromising the sustainability of the response. In some countries matters are still worse-there is still hardly any action at all against AIDS and scarcely any effort to make HIV visible. It is no wonder that the epidemic is still emerging and in some places is altogether out of control.