The traditional practice of psychiatry has been focused on reducing or eliminating distressing, unwanted symptoms. But what if the key to health and well-being is not to be symptom free, but rather to function effectively in life even when symptoms are present? What if symptoms serve an adaptive and motivational function, rather than being signals of a latent illness? What if the key to personal health is the ability to accept symptoms for what they are and to do what matters in life at the same time? This is the underlying proposition of Acceptance and Commitment Therapy (ACT), and this book – a collaboration among six clinicians from diverse practice backgrounds – is the first to systematically describe the principles and practices of ACT as they apply to psychiatric assessment, case analysis, and treatment.The guide begins with an in-depth analysis of the ACT model, from its scientific origins in the study of the functions of human language to a fully elaborated model for clinical assessment and intervention and outlines the clinical benefits of ACT in everyday practice.The second section of the book shows the reader how to conduct a streamlined assessment of the patient's life context, how to detect and intervene with the patient's unworkable emotional and behavioral avoidance strategies, and how to blend the use of medication treatment and behavioral interventions in a way that augments the beneficial effects of both approaches.Chapter-length examples in the third section discuss how to deliver ACT in an ambulatory psychiatric setting, in a hospital consultation-liaison service, and in an inpatient psychiatric context. The section also includes a chapter examining the all-important issue of teaching ACT to psychiatric residents as well as affiliated health professionals working in medical or psychiatric treatment team contexts.Learning Acceptance and Commitment Therapy uses a diverse array of case examples and clinical dialogues to offer readers a real-life view of the methodology in practice. Each chapter also includes additional reading resources to pursue should a particular theoretical or applied clinical concept create a desire to learn more. Additionally, readers have unlimited access to an online instructional library that includes video demonstrations of core ACT clinical strategies «in action» as well as a host of written practice support tools and worksheets.This book is a must for clinicians who want to expand their ability to improve clinical outcomes for the wide range of patients seen in clinical practice.
Physicians and psychiatrists typically see themselves as true professionals. But in the past, some displayed behavior far beneath the confines of professionalism, including exploding at nurses, not returning calls, or conducting insensitive interactions with patients, that was usually tolerated and seldom disciplined. Today, the rise of professionalism in medicine in general and psychiatry in particular has prompted a quiet revolution in how doctors are trained and how they are expected to behave in the workplace. The Accreditation Council for Graduate Medical Education (ACGME) has now advanced professionalism to be one of the core competencies all emerging practitioners must have. While almost all physicians believe in professionalism, the movement toward making it a core competency has challenged doctors everywhere to accept the practice of monitoring, observing and assessing what is not always welcome in a field where autonomy is so highly valued. In Professionalism in Psychiatry, the authors identify and expand on professional behaviors, such as being a good team player, being accountable, pursuing improvement in an ongoing way, and behaving compassionately toward patients and families. The importance of treating all co-workers with respect and of being attuned to the management of healthcare resources in a way that reflects fairness and integrity is also thoroughly reviewed. Important features of this book are: Tailoring professionalism principles from medicine to the unique features of psychiatry in order to enhance educators' teaching and improve the behaviors of psychiatrists and residents in the work setting. Development of guidelines for professionalism in cyberspace to provide psychiatrists with an ethical framework for dealing with patients in the online realm. Discussion of the ethical principles that apply when academic departments approach donors. Focus on cultural competency and empathy in an effort to improve patient care through greater understanding and sensitivity to ethnic, racial, gender and sexual orientation issues encountered in clinical practice. Use of numerous clinical examples to articulate the new professionalism in psychiatry, which illustrates the importance of going beyond «one size fits all» thinking. Professionalism in Psychiatry is an important contribution toward beginning to characterize the ever-evolving professional behaviors and clinical strategies of the contemporary psychiatrist and place them in a systematic framework.
This first book of its kind for the medical profession brings the real-world translation of ethics to the care of patients, conduct of protocols, and training of professionals. An interactive, case-oriented approach to mental health ethics, Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals consists of questions and answers developed by the authors and fourteen contributors from backgrounds as diverse as family medicine, research ethics, social psychology, and public health. They draw on personal experience in the care of people with mental illness, in mental health research, and in clinical training to generate scenarios that pose ethical questions. Some questions are narrow and to the point, such as responding to a suspicion of child abuse; others require a more nuanced approach, such as dealing with conflict of interest posed by a pharmaceutical company. They then resolve these questions in alignment with an understanding of ethical principles, the standards of their fields, the law, and the expectations of mental health professionals. The brief case descriptions that frame each ethical question echo the real-life complexities of clinical practice and are presented in single-answer, multiple-choice format modeled after key medical licensure and specialty certification organizations. Following an overview of ethics and professionalism, questions cover four broad areas: core concepts, clinical care, medical research, and interactions with colleagues and trainees. Explanations following the questions offer background information about relevant ethical concepts and related legal and clinical considerations. A subsequent section features another set of questions for self-assessment, followed by answers with citations to appropriate references. The book's overall approach is geared to underscore the following areas of concern: Essential ethical skills, such as understanding how personal values affect patient care, recognizing high-risk situations in which ethical problems arise, and building ethical safeguards Core ethical principles, including nonmaleficence, beneficence, autonomy, respect, justice, veracity, fidelity, and privacy Key clinical ethics issues, including maintaining therapeutic boundaries, patient non-abandonment, informed consent and treatment refusal, alternative decision making and advance directives, confidentiality, reporting colleague misconduct, and caring for difficult patients. Trainees and experienced clinicians alike will be richly rewarded by considering the dilemmas posed here. Developed with an extensive review process, reference verifications, and iterative crosschecks, this book facilitates professionalism as a core competency in medicine as it instills the need for ongoing consideration of ethical behaviors and principles in the daily practice of psychiatry.