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This book developed out of the editors' longstanding interest in
the retraining of traumatically brain-damaged adults and the
management of their behavior by family members. A search for
relevant experimental evidence to support the clinical use of
behavioral principles for retrain ing, which began in 1977, turned
up little empirical support. Moreover, the literature on retraining
was dispersed among a variety of journals published in various
countries. Nowhere was there a compendium of literature that
addressed issues of assessment and retraining. There was no place
to turn if one wanted to move from a standard neuropsy chological
evaluation to the retraining of skill deficits revealed in the
evaluation. We have attempted to edit a book that represents what
we had hoped to find in the literature and could be used by
professionals in clinical psychology, clinical neuropsychology,
rehabilitation medicine, physical therapy, speech therapy, and
other disciplines that address rehabilitation of brain-damaged
adults-a book that addresses assess ment and rehabilitation issues
and is sufficiently detailed to offer the reader a starting point
in developing behavioral assessment and re habilitation programs.
The book contains conceptual foundations, re views of research,
descriptions of successful rehabilitation programs, and relatively
detailed approaches to the retraining of specific skills. A shift
from an assessment-based practice to one encompassing both
prescriptive assessment and treatment has become a recognized
transition in the neuropsychological literature and was best
articulated in an article by Gerald Goldstein in March of 1979."
During the past several decades, the field of mental health care
has expanded greatly. This expansion has been based on greater
recognition of the prevalence and treatability of mental disorders,
as well as the availability of a variety of forms of effective
treatment. Indeed, throughout this period, our field has witnessed
the introduction and the wide spread application of specific
pharmacological treatments, as well as the development, refinement,
and more broadly based availability of behavioral, psychodynamic,
and marital and family interventions. The community mental health
center system has come into being, and increasing numbers of mental
health practitioners from the fields of psychiatry, psychology,
social work, nursing, and related professional disciplines have
entered clinical practice. In concert with these developments,
powerful sociopolitical and socioeconomic forces-including the
deinstitutionalization movement of the late 1960s and early 1970s
and the cost-containment responses of the 1980s, necessitated by
the spiraling cost of health care-have shaped the greatest area of
growth in the direction of outpatient services. This is
particularly true of the initial assessment and treatment of
nonpsychotic mental disorders, which now can often be managed in
ambulatory-care settings. Thus, we decided that a handbook focusing
on the outpatient treatment of mental disorders would be both
timely and useful. When we first began outlining the contents of
this book, the third edition of the American Psychiatric
Association's Diagnostic and Statistical Manual of Mental Disor
ders (DSM-III) was in its fourth year of use."
Applied gerontology and geriatrics always entail a
multidisciplinary perspective and usually demand an
interdisciplinary treatment approach. Providing a unique
combination of perspectives, treatment approaches, and expertise,
The Practical Handbook of Clinical Gerontology explores issues
relevant to practitioners who work with the elderly. A leading cast
of contributors--representing the fields of psychology, medicine,
neuropsychology, nursing, and law--examines what is known about
specific disorders and discusses treatment techniques and the
development of intervention plans. This comprehensive volume begins
with an overview of several broad topics pertinent to the treatment
of older adults and discusses special considerations in assessment.
It then presents up-to-date information on treatment of specific
psychological and behavioral disorders of older adults. The final
section covers interdisciplinary issues, including information
about common medical problems, rehabilitation, and the
psychopharmacological treatment of mental health problems. Written
in a language that is accessible to a general health care audience,
this extensive volume will be a valuable resource for mental health
care providers, medical students, researchers, and graduate
students in such fields as geriatrics, gerontology, nursing,
psychology, and social work. **Please note the following three
quotes are from the same person** "This handbook has a variety of
attributes that make it a highly desirable desk reference for
today's mental health practitioners in geriatrics and gerontology.
Few stones have been left unturned in the 22 reader-friendly
chapters that comprise the handbook. Not only are general treatment
issues addressed in great detail but assessment procedures, the
treatment of specialized psychological and behavioral problems, and
even issues in effective collaboration with medical geriatricians
are considered. The scope and breadth of clinical knowledge and
wisdom found within the covers of this volume are certainly
impressive." --Lenard W. Kaye, Professor, Bryn Mawr College "The
authors have succeeded in drawing on the expertise of a broad range
of recognized authorities in clinical gerontology who have the
capacity to communicate to the reader with considerable clarity
both current information and best-practice strategies of mental
health intervention with older adults." --Lenard W. Kaye,
Professor, Bryn Mawr College "It would be difficult to find another
reference source in clinical gerontological practice that is able
to deal with the challenges of practice in this area with greater
comprehensiveness and authority. The multidisciplinary perspective
of the handbook ensures it being a valuable addition to the
clinical practice collections of psychologists, social workers,
nurses, gerontologists, and other allied health professionals. And,
once obtained it should not gather dust given the currency and
utility of the information." --Lenard W. Kaye, Professor, Bryn Mawr
College
During the past several decades, the field of mental health care
has expanded greatly. This expansion has been based on greater
recognition of the prevalence and treatability of mental disorders,
as well as the availability of a variety of forms of effective
treatment. Indeed, throughout this period, our field has witnessed
the introduction and the wide spread application of specific
pharmacological treatments, as well as the development, refinement,
and more broadly based availability of behavioral, psychodynamic,
and marital and family interventions. The community mental health
center system has come into being, and increasing numbers of mental
health practitioners from the fields of psychiatry, psychology,
social work, nursing, and related professional disciplines have
entered clinical practice. In concert with these developments,
powerful sociopolitical and socioeconomic forces-including the
deinstitutionalization movement of the late 1960s and early 1970s
and the cost-containment responses of the 1980s, necessitated by
the spiraling cost of health care-have shaped the greatest area of
growth in the direction of outpatient services. This is
particularly true of the initial assessment and treatment of
nonpsychotic mental disorders, which now can often be managed in
ambulatory-care settings. Thus, we decided that a handbook focusing
on the outpatient treatment of mental disorders would be both
timely and useful. When we first began outlining the contents of
this book, the third edition of the American Psychiatric
Association's Diagnostic and Statistical Manual of Mental Disor
ders (DSM-III) was in its fourth year of use."
This book developed out of the editors' longstanding interest in
the retraining of traumatically brain-damaged adults and the
management of their behavior by family members. A search for
relevant experimental evidence to support the clinical use of
behavioral principles for retrain ing, which began in 1977, turned
up little empirical support. Moreover, the literature on retraining
was dispersed among a variety of journals published in various
countries. Nowhere was there a compendium of literature that
addressed issues of assessment and retraining. There was no place
to turn if one wanted to move from a standard neuropsy chological
evaluation to the retraining of skill deficits revealed in the
evaluation. We have attempted to edit a book that represents what
we had hoped to find in the literature and could be used by
professionals in clinical psychology, clinical neuropsychology,
rehabilitation medicine, physical therapy, speech therapy, and
other disciplines that address rehabilitation of brain-damaged
adults-a book that addresses assess ment and rehabilitation issues
and is sufficiently detailed to offer the reader a starting point
in developing behavioral assessment and re habilitation programs.
The book contains conceptual foundations, re views of research,
descriptions of successful rehabilitation programs, and relatively
detailed approaches to the retraining of specific skills. A shift
from an assessment-based practice to one encompassing both
prescriptive assessment and treatment has become a recognized
transition in the neuropsychological literature and was best
articulated in an article by Gerald Goldstein in March of 1979."
Accountability in clinical training implies a strong relationship
between the training outcomes touted by a training program and the
performance of its graduates. The training program and its faculty
must be able to ensure that students have the competencies
necessary for entering the profession and can offer competent
services. In addition, responsibility for the quality and value of
training must be assumed by the profession. Pressure for
accountability is becoming increasingly apparent as the public
learns about fraud, waste, and abuse in publicly funded pro grams
(Fishman & Neigher, 1982). Federally supported clinical
training programs have had to defend their training practices
against threats of funding loss without the hard data needed to
support their practices. Funding seems to have been forthcoming
mostly because of our ability to demonstrate the need for clinical,
counseling, and school psychol ogists. Graduates seeking
professional careers in such applied fields demand considerable
trust from their clientele and the public-at-large when they
establish themselves, offer and advertise their services, make
claims on public monies, and profess to do good and no harm.
Neither their clien tele nor the public are in the position to
evaluate the services of the profes sion or the claims made for
these. (American Psychological Association lAPA], 1982, p."
Americans are "healing themselves" (Heckler, 1985) and prevention
has taken root (McGinnis, 1985a). We are altering our lifestyle to
reduce physical and mental health risks. Perhaps as important is
the fact that the science of prevention is beginning to catch up
with the practices of prevention, although some might argue that
the popularity of these practices far outstrips sound theoretical
and empirical foundations. The chapter authors in this volume
examine the theoretical and empirical foundations of many current
prevention practices and, where data exist, discuss the status of
prevention efforts. Where substantial prevention is not yet on the
horizon, the authors attempt to point us in the right direction or
at least share with the reader some of the risk factors that should
be addressed in our research. We hope that readers will be
stimulated to discuss the issues raised, advance the current
research, and, where possible, adopt the prevention and health
promotion strategies that are supported by sound theoretical and
empirical work. This volume can in no way be comprehensive with
respect to the current work in prevention; however, we hope that we
have provided a sampling of prevention activities and issues that
appear together in one volume for perhaps the first time. The
primary intent of this volume is modest, and the reader should not
attempt to find continuity among the various chapters. The only
binding among these contributions is their focus on prevention.
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