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50 Signs of Mental IllnessA Beautiful MindA Beautiful MindA Bright Red ScreamA Casebook of Ethical Challenges in NeuropsychologyA Corner Of The UniverseA Lethal InheritanceA Mood ApartA Research Agenda for DSM-VA Slant of SunA War of NervesAbnormal Psychology in ContextADD-Friendly Ways to Organize Your LifeAddiction Recovery ToolsAdvance Directives in Mental HealthAggression and Antisocial Behavior in Children and AdolescentsAl-JununAlmost a PsychopathAlterations of ConsciousnessAm I Okay?American ManiaAmerican Psychiatric Publishing Textbook of Neuropsychiatry and Clinical NeurosciencesAn American ObsessionAngelheadAnger, Madness, and the DaimonicAnthology of a Crazy LadyApproaching NeverlandAs Nature Made HimAsylumAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderBeing Mentally Ill: A Sociological Theory Betrayal TraumaBetrayed as BoysBetter Than ProzacBetter Than WellBeyond AppearanceBeyond ReasonBinge No MoreBiological UnhappinessBipolar 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ChildrenEmotions and LifeEmpowering People with Severe Mental IllnessEssential PsychopharmacologyEssentials of Cas AssessmentEssentials of Wais-III AssessmentEthics and Values in PsychotherapyEthics in Mental Health ResearchEthics in Psychiatric ResearchEthics, Culture, and PsychiatryEverything In Its PlaceFamily Experiences With Mental IllnessFatigue as a Window to the BrainFear of IntimacyFinding Iris ChangFinding Meaning in the Experience of DementiaFlorid StatesFolie a DeuxFor the Love of ItForensic Nursing and Multidisciplinary Care of the Mentally Disordered OffenderFountain HouseFrom Madness to Mental HealthFrom Trauma to TransformationGandhi's WayGender and Its Effects on PsychopathologyGender and Mental HealthGenes, Environment, and PsychopathologyGetting Your Life BackGracefully InsaneGrieving Mental IllnessHandbook of AttachmentHandbook of DepressionHandbook of Self and IdentityHealing the SplitHerbs for the MindHidden SelvesHigh RiskHope and DespairHow Clients Make Therapy WorkHow People ChangeHow to Become a SchizophrenicHow We Think About DementiaHughes' Outline of Modern PsychiatryHumanizing MadnessHysterical MenHystoriesI Hate You-Don't Leave MeI Never Promised You a Rose GardenI Thought I Could FlyI'm CrazyImagining RobertImpulse Control DisordersIn Others' EyesIn Two MindsInsanityIntegrated Behavioral Health CareIntegrative MedicineIntegrative Mental Health CareIntuitionJust CheckingKarl JaspersKissing DoorknobsKundalini Yoga Meditation for Complex Psychiatric DisordersLaw and the BrainLaw, Liberty, and PsychiatryLegal and Ethical Aspects of HealthcareLiberatory PsychiatryLife at the BottomLife at the Texas State Lunatic Asylum, 1857-1997Life Is Not a Game of PerfectLithium for MedeaLiving Outside Mental IllnessLiving with AnxietyLiving With SchizophreniaLiving with SchizophreniaLiving Without Depression and Manic DepressionLost in the MirrorLove's ExecutionerLoving Someone With Bipolar DisorderMad in AmericaMad TravelersMad, Bad and 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Death of PsychotherapyThe Depression WorkbookThe Difficult-to-Treat Psychiatric PatientThe Early Stages of SchizophreniaThe Employee Assistance Treatment PlannerThe Employee Assistance Treatment PlannerThe Epidemiology of SchizophreniaThe Essential Family Guide to Borderline Personality DisorderThe Essentials of New York Mental Health LawThe Ethical WayThe Evolution of Mental Health LawThe Explosive ChildThe Fall Of An IconThe Fasting GirlThe Forensic Documentation SourcebookThe Forgotten MournersThe Gift of Adult ADDThe Good EaterThe Green ParrotThe Healing Power of PetsThe Heart of AddictionThe Heroic ClientThe Insanity OffenseThe Invisible PlagueThe Last Time I Wore a DressThe Limits of Autobiography The LobotomistThe Madness of Our LivesThe Mark of ShameThe Meaning of AddictionThe Meaning of MindThe Medical AdvisorThe Mind/Mood Pill BookThe Most Solitary of AfflictionsThe Mozart EffectThe Naked Lady Who Stood on Her HeadThe Older Adult Psychotherapy Treatment PlannerThe OutsiderThe Pastoral Counseling Treatment PlannerThe PDR Family Guide to Natural Medicines & Healing TherapiesThe Places That Scare YouThe Plural SelfThe Problem of EvilThe Psychology of Religion and CopingThe Quiet RoomThe Real World Guide to Psychotherapy PracticeThe Right to Refuse Mental Health TreatmentThe Rise of Mental Health NursingThe Roots of the Recovery Movement in PsychiatryThe Savage GirlThe Self-Help SourcebookThe Talking CureThe Trick Is to Keep BreathingThe Unwell BrainThe Virtuous PsychiatristThe Way of TransitionThe Wing of MadnessThe Wisdom in FeelingTheoretical Evolutions in Person-Centered/Experiential TherapyTherapy's DelusionsTheraScribe 3.0 for WindowsThis is Madness TooThoughts Without a ThinkerThrough the Looking GlassTo Have Or To Be?Toxic PsychiatryTransforming MadnessTraumaTraumatic PastsTraumatic Relationships and Serious Mental DisordersTreating Affect PhobiaTreating Chronic and Severe Mental DisordersTreating Self-InjuryTreatment and Rehabilitation of Severe Mental IllnessTreatment Plans and Interventions for Depression and Anxiety DisordersTwinsUnderstanding and Treating Violent Psychiatric PatientsUnderstanding Child MolestersUnderstanding DepressionUnderstanding ParanoiaUnderstanding the Stigma of Mental IllnessUnderstanding Treatment Without ConsentUnholy MadnessUnspeakable Truths and Happy EndingsUsers and Abusers of PsychiatryViolence and Mental DisorderVoices of MadnessVoices of RecoveryVulnerability to PsychopathologyWarning: Psychiatry Can Be Hazardous to Your Mental HealthWashing My Life AwayWhen History Is a NightmareWhen Someone You Love Is BipolarWhen the Body SpeaksWhen Walls Become DoorwaysWitchcrazeWomen and Borderline Personality DisorderWomen and Mental IllnessWomen Who Hurt ThemselvesWomen's Mental HealthWrestling with the AngelYou Must Be DreamingYour Drug May Be Your ProblemYour Miracle Brain
This book is what it says it is--a handbook for treating depression and anxiety disorders. It must also be noted that this is a cognitive handbook, although one of the authors, Stephen Holland, has some background in psychodynamic work. This theoretical undergirding is important because one needs a fair knowledge of cognitive work to be able to make best use of this book. A clinician coming to this work without some idea of how a C.B.T. (cognitive behavioral therapy) approach works will be disadvantaged. With this proviso, the book is very useful. There are eight chapters covering treatment plans for the main neuroses-Depression; Panic Disorders; Agoraphobia; Generalized Anxiety Disorder; Social Phobia; Post Traumatic Stress Disorder; Specific Phobias and Obsessive-Compulsive Disorder. Each chapter begins, helpfully, with a brief review of the literature on the outcomes of various treatment modalities on the topic discussed in that chapter I found this aspect of the book most irritating. Nowhere are non-C.B.T. models offered. So in the chapter on depression various current ideas are expounded as to the causes of depression, viz., depression as absence of rewards, or the inability to obtain rewards. Or it is seen as the result of passive, repetitious, unrewarding behavior. There is no mention of Freud's view of Melancholia or of Klein's Object Relation theories. (But perhaps I am simply carping! The authors did not, after all, set out to offer a comprehensive overview of all the major psychological schools currently offering opinions about treatment options.)
The treatment reviews at the beginning of the chapters are very confident. So, in the chapter on Panic Disorder and Agoraphobia, the authors comment "Outcome studies for cognitive-behavioral treatments of panic disorder and agoraphobia are extremely favorable (75-90% efficacy)". There seems little room for uncertainty here, which in some ways is reassuring. When one first begins working with patients a treatment method offering a 75-90% success rate is very comforting. As time goes by, however, one's caseload seems to consist of that difficult rump of patients who don't get better! At this point Leafy and Holland's book offers no comfort, which is a shame because they are clearly compassionate and competent clinicians who are "out there" in the front line. Perhaps this confidence highlights a major cultural difference between America and the UK. Leafy and Holland are writing from the perspective of private health care where part of the contract seems to be "What's the minimum number of sessions that we the insurance company will have to fund?" So for the clinician there seems to be a need to specify the optimum numbers of sessions that are therapeutically effective. Seen from this perspective one might see the need to be able to say with some certainty, "I can help this person make a fair recovery in x sessions." (It is an interesting point to wonder what private health insurance does for therapeutic optimism. If I know that I can only afford 20 sessions then do I indeed get better within that time frame?)
Let me now go through a chapter in some more detail since this will give a flavor of how the book is put together. The chapter on Depression begins with an overview of symptoms, prevalence and life course; genetic and biological features. It then goes on to offer a C.B.T. understanding of depression. Next comes a brief seven point outline of the treatment program covering Assessment, Socialization to Treatment; Establishment of goals; Behavioral Interventions; Cognitive interventions; Inoculation against future depressive episodes and Phasing out Therapy. A case study is included to demonstrate how this framework can be used in practice. Also included are charts that can be copied and used by the therapist and given to the patient. These charts include a Cognitive, Behavioral, and Interpersonal Assessment of Depression which gives examples of distorted automatic thoughts of the patient and underlying maladaptive assumptions. Then comes a five page Suicide Risk Assessment form that helps the therapist to evaluate their patient's "suicidality" in detail. An excellent handout about depression, which can be given to the patient, follows this. Interleaved between the handouts and charts are detailed interventions and guidelines to help the therapist in their work with a depressed patient. All told, this is typical of the high standard of material in this book.
The final item that comes with this book is a CD ROM containing more information about cognitive interventions; copyable care plans and treatment schemas; information on medication and its benefits.
Add to this the fact that the book is letter-page-size format and one is presented with a formidable amount of information on C.B.T. work with the neuroses. As somebody who is both English and psychodynamically oriented I found some aspects of this book not entirely to my taste. That notwithstanding this book would sit well in any general psychiatric ward, where there are always a number of patients suffering from varying degrees of anxiety and depression. If only some of these interventions are used, then the patients will probably find themselves somewhat helped. And if you are already an enthusiast of C.B.T. as a way of working, then this book really should be on your bookshelf at home.
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