This book reinterprets psychotherapy from a social role perspective, permitting a grand synthesis that explains many of the apparent contradictions in contemporary therapy, and challenging the usual definitions of therapy in terms of personality, behavior, and mental illness. Dr. Fein surveys all major therapies, placing them in a role-change context. He documents how each approach specializes in different aspects of role change, and shows that therapies differ only in their level of intervention, phase of resocialization addressed, or barrier to change tackled. All therapies, Fein argues, are inherently psychosocial.

In the work's early chapters, Fein demonstrates that a sociological role perspective offers a full account of what therapy is and how it works; summarizes the resocialization paradigm; and discusses the different levels of intervention (support, socialization, and resocialization). Chapter 3 shows how ostensibly different forms of therapy compare in the aspects of role change in which they specialize, and begins the translation of psychotherapeutic jargon into role-change language by giving a brief overview of how prominent therapies fit into the classifications. In Chapter 4, after presenting a succinct history of Freud's contributions to psychoanalysis, Fein relates particular parts of Freud's work to resocialization. Chapters 5, 6, 7, and 8 discuss various therapy styles and their relation to the author's resocialization approach, including the ecological therapies (family and community), the Romantics (Jungian, Gestalt, Primal Scream, Existential) and the Academics (Behavior Modification, Cognitive, and Stress Management). Chapter 9 asserts that some therapies are actually nontherapeutic because they encourage non-role-change solutions. In his conclusion, Fein emphasizes the ubiquity of resocialization interventions and reiterates the place of sociology in this scheme. This book is excellent reading and analysis for scholars and practitioners in sociology, psychology, and psychotherapy, as well as for anyone interested in understanding how psychotherapy actually works.

This handbook examines state-of-the-art research and clinical findings on attenuated psychosis syndrome (APS) across the globe. It addresses symptoms, assessment methods, and treatment approaches as they differ and converge across countries and cultures. The handbook explores how the illness impairs many aspects of daily functioning, with high rates of suicide and a reduced life span. It details how early detection is critical and may greatly reduce the public health burden of the illness. Chapters describe the early identification and intervention efforts that are currently underway across the world. The book offers international findings from prominent researchers, elaborating culturally relevant illness symptoms, help-seeking behaviors, and assessment and intervention strategies. In addition, chapters illustrate wide variations in symptom expression and experience, reinforcing the necessity of culturally attuned practice in patient-centered care. The book concludes by examining the implications - challenges and opportunities - for future research and clinical practices from an international perspective. Topics featured in the Handbook include: Barriers to service in low-resourced countries. The role of traditional or culturally acceptable care in developing early intervention models. The reliability and validity of tools for assessing and identifying APS. Possible medical diagnoses that can present with APS symptoms and how to differentiate these conditions from APS. The Handbook of Attenuated Psychosis Syndrome Across Cultures is a must-have resource for researchers, professors, clinicians, and related professionals as well as graduate students in child and school psychology, psychiatry, social work, and related disciplines.

This book addresses the phenomenology, demographics, and neurobehavioral aspects of suicidal behavior and its risk factors, underscoring common neurobehavioral threads among different approaches which may underlie such extreme behavior. It additionally provides an overview of new approaches, such as imaging techniques to identify at-risk individuals or in response to drug treatment associated with suicidal behavior, neurodevelopmental approaches, genetic and epigenetic linkages to suicidal behavior, animal models of specific risk factors, as well as potential biomarkers being employed to help assess risk.

Inflammation has invaded the field of psychiatry. The finding that cytokines are elevated in various affective and psychotic disorders brings to the forefront the necessity of identifying the precise research domain criteria (RDoCs) that inflammation is responsible for. This task is certainly the most advanced in major depressive disorders. The reason is that a dearth of clinical and preclinical studies has demonstrated that inflammation can cause symptoms of depression and conversely, cytokine antagonists can attenuate symptoms of depression in medical and psychiatric patients with chronic low grade inflammation. Important knowledge has been gained on the symptom dimensions that inflammation is driving and the mechanisms of action of cytokines in the brain, providing new targets for drug research and development. The aim of the book "Inflammation-Associated Depression" is to present this field of research and its implications in a didactic and comprehensive manner to basic and clinical scientists, psychiatrists, physicians, and students at the graduate level.

This engagingly written survey covers the history of anxiety disorders and current approaches to their definition and treatment. Anxiety disorders are significant mental health illnesses that impair lives and cost society millions of dollars in health care expenses and lost productivity. Greater awareness of anxiety disorders is essential for both the general public and health professionals if those who suffer from them are to be identified, receive proper treatment, and have a chance at leading fulfilling lives. To that end, Anxiety begins with a historical overview of the ways in which anxiety disorders have been understood, from the prehistoric era until the present time, examining the disorders from the perspectives of conceptualization, classification, research, and treatment. Subsequent chapters examine these themes in light of our current understanding and approaches to anxiety disorders. Current diagnostic and assessment methods are discussed, as are modern treatment options. The book concludes with a survey of the future directions in research for the understanding and treatment of anxiety disorders.

With the growing interest in the great number of culturally, linguistically, and ethnically different families entering the United States, it is essential for researchers and mental health practitioners to acquire a working knowledge that can aid in a healthier adjustment of these families. Although it is impossible for any therapist to understand the traditions, values, and languages of all immigrant groups, a therapist may be guided by a conceptual operational principle that can be implemented across diverse groups and circumstances. Dr. Gopaul-McNicol introduces a model for assessment; the techniques and strategies proposed by this model range from cognitive behavioral interventions to multimodal and multisystems approaches to treatment.

The book covers historical and contemporary perspectives of the influence of culture on an individual's functioning. Assessment issues include intellectual, educational and visual motor assessment and its applicability with culturally diverse clients. The author also highlights ways of misassessing the personality of culturally different individuals and examines the major treatment approaches in counseling the culturally different.

This book comprises the conferences and discussions presented at the 5th Symposium on the "Search for the Causes of Schizophrenia," which took place for the second time in Guaruja, Brazil, April 2003. This series of symposia started in 1986, on the occasion of the 600th anniversary of the University of Heidelberg, Germany, followed by symposia in 1989, 1993 and 1998. Four volumes that have been widely used as a reference for comprehensive reviews on the state of the art in schizophrenia research have resulted from these meetings. They reflect the progress resulting from the most relevant studies on the etiology of the disease.

The topics covered in the six sections of the book are Epidemiology and Environment, Precursors, Pathophysiological Mechanisms, Genetics, Controversies in Schizophrenia, and Treatment.

This book is a comprehensive guide to psychiatry for undergraduate medical students. Beginning with an introduction to the field, the next chapters discuss biological sciences, psychosocial sciences, and classification and evaluation. The following sections cover the diagnosis and treatment of numerous psychiatric disorders, including schizophrenia, depression, bipolar and other mood disorders, OCD, sleep disorders, eating disorders, and many more. All sectors of the population are covered, from children and adolescents, to geriatrics, and a complete chapter is dedicated to culture bound syndromes (a combination of psychiatric and somatic symptoms that are considered to be a recognisable disease only within a specific society or culture). The book concludes with discussion on psychopharmacology and psychotherapies, legal and ethical issues, community and preventive psychiatry, and the history and future of the field. Key points Practical guide to psychiatry for undergraduate medical students Covers diagnosis and treatment of numerous disorders Complete chapter dedicated to culture bound syndromes Includes discussion on legal and ethical issues, and preventive psychiatry

This book extends the critical scope of the previous volume, De-Medicalizing Misery, into a wider social and political context, developing the critique of the psychiatrization of Western society. It explores the contemporary mental health landscape and poses possible alternative solutions to the continuing issues of emotional distress.

An intensely moving, frequently shocking account of a child's life in an adult mental hospital.

This book examines assessment and treatment methods for anxiety disorders in four- to- seven-year-olds. It discusses risk and protective factors in the preschool years, comorbidities, and how conditions such as separation anxiety disorder, social anxiety disorder, and selective mutism present in this age group. The book examines limitations of current definitions, assessment methods, and interventions. Chapters offer a theoretical framework from which to understand how traditional cognitive-behavior therapy (CBT) strategies can be used effectively in this age group. It offers a detailed description of the Taming Sneaky Fears program, an innovative, evidence-based group CBT program for four- to seven-year-old anxious children and their parents. It provides step-by-step instructions on how to implement Taming Sneaky Fears. The book concludes by addressing common challenges, influences, and outcomes for four- to seven-year-old anxious children and their families and provides recommendations for reducing the barriers to healthy development. Topics featured in this book include: Screening and assessment tools for young anxious children. Innovative assessment approaches for young anxious children. The use of Bravery Ladders to teach young children to overcome their fears and anxieties. Specific adaptations of the Taming Sneaky Fears program for selective mutism and social anxiety disorder. The pivotal role of parents in the success of the Taming Sneaky Fears program. Assessing and Treating Anxiety Disorders in Young Children is a must-have resource for researchers, clinicians and related professionals, and graduate students in child and school psychology, pediatrics, social work, and psychiatry.

This book focuses on extrapyramidal signs and symptoms of all types of dementia, and addresses the issue of the artificial boundary between dementias and Parkinsonism, which represent the two most common symptoms found in degenerative central nervous system diseases. In Movement Disorders in Dementias, movement disorder specialists from around the world write on topics generally restricted to dementia experts. Important motor issues related to either medication in demented patients (drug-induced movement disorders) or manifestations common to all forms of dementia, regardless of underlying cause (gait disorders, falls, fear of falling), is followed by analysis of the relationship between motor and cognitive symptoms, from their common pathogenesis to specific medical treatments. Movement Disorders in Dementias is aimed at general neurologists, dementia specialists, movement disorders specialists, neuropsychologists and geriatricians.

This open access book is the first comparative study of public, voluntary and private asylums in nineteenth-century Ireland. Examining nine institutions, it explores whether concepts of social class and status and the emergence of a strong middle class informed interactions between gender, religion, identity and insanity. It questions whether medical and lay explanations of mental illness and its causes, and patient experiences, were influenced by these concepts. The strong emphasis on land and its interconnectedness with notions of class identity and respectability in Ireland lends a particularly interesting dimension. The book interrogates the popular notion that relatives were routinely locked away to be deprived of land or inheritance, querying how often "land grabbing" Irish families really abused the asylum system for their personal economic gain. The book will be of interest to scholars of nineteenth-century Ireland and the history of psychiatry and medicine in Britain and Ireland.

Written with disarming honesty by a long-term sufferer of bipolar disorder, with more than half a century's experience of intervention and treatment, this highly personal volume traces the effectiveness of a therapy modality for mental illness that has gained much ground in the past two decades: art. The author began to use art, and in particular doodling, from 1998 as a way of externalizing his feelings. Its expressiveness, accessibility and energy-efficiency was ideally suited to the catatonia he experienced during the bouts of depression that are a feature of bipolar disorder, while as the low moods lifted and his energy surged, he completed more ambitious and elaborate works. As well as being highly eclectic, Wheatley's assembled oeuvre has afforded him both insights and therapeutic intervention into his condition, once deemed highly debilitating and taboo, but much more socially accepted now that well known sufferers such as Stephen Fry have recounted their experiences of the condition. After an opening account of how the images were generated, the volume reproduces a 'gallery' of selected work, and then offers an extended epilogue analyzing the art's connections with the disorder as well as the author's assessment of how each attempt at visual self-expression was, for him, a therapeutic intervention. Wheatley, a cell biologist who has enjoyed a full career in cancer research, has had no formal training in art, yet his haunting pictures, many of them resembling life forms, are brought to life by his perceptive, self-aware commentary. This book will be of interest to psychologists and psychiatrists among the wider medical profession as well as people suffering from any form of bipolar disorder whatever the severity.

This book presents a longitudinal study of cultural influence on psychiatric disorders, from late imperial China to contemporary China, drawing on both reviews and lab results to do so. While predominantly offering evidence of cultural influences on psychiatric disorders from a Chinese perspective, it will also be of global benefit since "the national exemplifies the international." It presents the Chinese "emic" components of culture, including Chinese personality traits, Chinese forms of emotional regulation, and Chinese styles of family structure and function, which will stimulate international interest and research in related areas. The intended readership includes cultural psychiatrists and psychologists, family therapists, personality psychologists, literature-related researchers, and members of the general public who are interested in cultures expressed in fictions.

Cost-Outcome Methods for Mental Health provides an overview of the choices and judgments used to evaluate the cost effectiveness of mental health treatment. It presents economic concepts of cost, discusses the various approaches to cost-outcome studies, and focuses on the way such studies apply to mental health. It is a practical guide rather than a theoretical treatment of cost-effectiveness analyses. Readers are guided through the process of designing cost-outcome studies; measuring costs, interventions, and outcomes; analyzing study results; and using findings to guide policy and practice. The book introduces readers who do not have a background in economics to apply economic methods of cost-outcome research, and prepares them for productive collaboration with economists in mental health services research.
Key Features
* Clearly explains key economic concepts for non-economists
* Integrates the presentation of both economic and clinical aspects of design
* Provides many examples of applications to mental health services
* Authored by leading mental health services investigators

Psychiatry and psychology have constructed a mental health system that does no justice to the problems it claims to understand and creates multiple problems for its users. Yet the myth of biologically-based mental illness defines our present. This book rethinks madness and distress reclaiming them as human, not medical, experiences.

'Mental Health Worldwide' offers a perceptive critique of the universalised model of psychiatry and its apparent exportation from the West to the developing world. Rooted in detailed analysis of the problems this causes, the book proposes new suggestions for advancing the field of mental health and wellbeing in a way that is ethical, sustainable and culturally sensitive.

The need to take the spiritual experience during illness into account is part of a broader trend in Western societies-a fascination with the practical uses of spirituality and its contribution to individual wellbeing, whether through a religious or a humanist tradition. This understanding of spirituality differs from traditional views embedded in religious traditions. This book takes a critical point of view at the biomedical representation of the function of spirituality in care. Medicine reorders notions such as life, death, health, sickness, and spirituality. This process is called here "sapientialization", i.e. the spiritual experience is expressed and understood under the auspices of and in terms of wisdom. This view tends to identify spirituality and ethics. I propose an alternate understanding of spirituality, grounded on its subversive power. Inspired by the work of the theologian John D. Caputo, it is critical of some problems that are associated with the sapientialization of spirituality in biomedicine, such as the medicalization of spiritual experiences or the instrumentalization of spirituality. It provides an understanding of spirituality that honours both the medical interest in it and its capacity to resist to instrumentalization.

This book focuses on the importance of understanding the experience of the person as the primary task of psychology and psychotherapy. It uses phenomenologically based, qualitative research methodologies to understand the experiences of four persons being seen in psychotherapy. It compares hypotheses generated from phenomenologically based assessment instruments to detailed analyses of psychotherapy sessions. Thus, therapists, students, and clients can see the relationship between the holistic understanding of the experience of persons and avenues for therapeutic movement.

The book is divided into four sections. Part I discusses the clinical theory on which the study is based. A chapter on qualitative research methodologies includes both the philosophical bases of this form of research and the compatibilities between qualitative psychology and personal construct theory. Part II deals with the process of assessing experience within personal construct psychology. It describes the two techniques--the role construct elicitation technique and the interview technique--that are used to elicit verbal meanings. In many ways, Part III consisting of four chapters, forms the heart of the volume. Each deals with a special person--a client being seen in experiential personal construct psychotherapy. After discussing clinical hypotheses derived from the constructs, each chapter presents an intensive interpersonal process analysis of the client's second therapy session. Each chapter then compares the clinical hypotheses generated from the client's personal meanings to the actual struggles in the therapy room. Part IV attempts to draw implications from the project that will be useful to persons engaged in the struggle to understand the inner meanings of others.

Schizophrenia is the most widely known and feared mental illness worldwide, yet a rapidly growing literature from a broad spectrum of basic and clinical disciplines, especially epidemiology and molecular genetics, suggests that schizophrenia is the same condition as a psychotic bipolar disorder and does not exist as a separate disease. The goal is to document and interpret these data to justify eliminating the diagnosis of schizophrenia from the nomenclature. The author reviews the changing diagnostic concepts of schizophrenia and bipolar disorder with a historical perspective to clarify how the current conflict over explanations for psychosis has arisen. That two disorders, schizophrenia and bipolar, known as the Kraepelinian dichotomy, account for the functional psychoses has been a cornerstone of Psychiatry for over 100 years, but is questioned because of substantial similarities and overlap between these two disorders. Literature in the field demonstrates that psychotic patients are frequently misdiagnosed as suffering from the disease called schizophrenia when they suffer from a psychotic mood disorder. Such patients, their families, and their caretakers suffer significant disadvantages from the misdiagnosis. Psychotic patients misdiagnosed with schizophrenia receive substandard care regarding their medications, thus allowing their bipolar conditions to worsen. Other adverse effects are substantial and will be included. Liability for medical malpractice is of critical importance for the mental health professionals who make the majority of the diagnoses of schizophrenia. The concept put forward in this work will have a discipline-altering impact.

Posttraumatic growth is an area in which investigations are now being undertaken in many different parts of the world. The view that individuals can be changed--sometimes in radically good ways--by their struggle with trauma is ancient and widespread. However, the systematic focus by scholars and clinicians on the possibilities for growth from the struggle with crisis is relatively recent. There are now a growing number of studies and scholarly papers on the antecedents, correlates, and consequences of posttraumatic growth, and there are also theoretical models that can help guide the research further. It is clear, however, that this phenomenon is not yet well understood. The Handbook of Posttraumatic Growth: Research and Practice provides both clinicians and researchers with a comprehensive and up-to-date view of what has been done so far. In addition, it uses the foundations of what has been done to provide suggestions for the next useful steps to take in understanding posttraumatic growth. The book offers contributions of important and influential scholars representing a wide array of perspectives of posttraumatic growth. This volume serves as an impetus for additional work, both in the academic aspects and in the possibilities for clinical applications of posttraumatic growth. This Handbook will appeal to students, practitioners, and researchers working in a broad array of disciplines and human services.

Anxiety is ubiquitous in everyday life and avoiding sources of anxiety is often at the core of our everyday choices and can even shape our life plans. But why are we all so anxious, when is this normal uniqueness as opposed to a diagnosable anxiety disorder, and why have anxiety disorders become more prevalent than ever? In All We Have to Fear, Horwitz and Wakefield argue that psychiatry has largely generated this epidemic by inflating our socially inconvenient, yet natural, fears into psychiatric disorders and ignoring our biologically designed natures, thus allowing the overdiagnosis of anxiety disorders and facilitating a culture of medicalization. The result is a society that is afraid of natural, biologically designed feelings of fear and, overall, anxious about feeling anxious. All We Have to Fear is a groundbreaking and fresh look at how to distinguish between anxiety conditions that are mental disorders, those that are natural reactions to threats, and those that are natural products of evolution. Building on the new science of evolutionary psychology, Horwitz and Wakefield demonstrate a mismatch between our basic biological natures and the environment that we have created for ourselves. Some of our natural anxiety is born from situations and objects that posed serious risks during prehistory, but that are no longer usually dangerous, for example, a city dweller who is terrified of snakes. This mismatch generates normal anxiety when there is, in fact, no real danger. Evolutionary psychology shows that beyond the context in which the symptoms occur, our biological heritage as a species must be considered in any psychiatric diagnosis as we are otherwise bewildered by our own primitive fears and beset by diffuse anxieties that seem to have no function in our lives. All We Have to Fear argues that only by paying attention to our evolutionary shaping can we understand ourselves, our fears, what is normal versus disordered in what we fear, and make informed choices about how to approach these fears. The mismatch between our natures, environment, and our fears is not pathological, but rather reveals the forces that shaped us and provides an "emotional time machine," shedding light on who we were when we were shaped as a species, and thus, allowing us more insight into who we are today.

Tessler and Gamache provide substantial research on the impact of mental illness on the family through interviews conducted with hundreds of family members between 1989 and 1997. According to the authors, how families experience the mental illness of a relative depends on many social factors, including how public mental health services are organized and financed, and whether families feel judged or supported by professionals. Most family members experience a range of emotions toward one another ranging from warmth and gratification to anger and rejection. Tessler and Gamache detail the family experience with mental illness in terms of both negative and positive feelings. They take a holistic approach to the family experience and present a variety of family responses and dilemmas. The family members whose stories are told are diverse in respect to race, gender, age, and relationship, and the demographic-clinical characteristics of their relatives with mental illness. Tessler and Gamache find that the amount of burden that family members experience depends, in part, on which dimension of burden is being addressed. When burden is defined as assistance in daily living, it is less than what was thought. On the other hand, the subjective burden associated with supervision and control is substantial. Family role and residence contribute to most dimensions of burden. For example, a mother living with an adult son with schizophrenia will experience mental illness differently than the brother who has moved out of the family home and moved to another state. In both studies, a major finding involved lower than expected expenditures by family members for medication and mental health treatment in both studies. Most expenditures were focused instead on personal or survival needs, which for a sub-sample of family members involves considerable expenditures. This work is an important research finding for scholars, students, and professionals involved with social work, public health, and public mental health policy.