bluuebunny/crossref_metadata_2025 huggingface dataset:
Rehearsal and Review of Adaptive Thinking Skills
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter completes the discussion of adaptive thinking for clients with ADHD. It includes a description of how to review thought records on which clients have developed rational responses. It describes how to work with clients on identifying additional situations that may require adaptive thinking and cognitive restructuring. Information is given on how to evaluate the need for the optional procrastination session described in Chapter 11. A case vignette illustrates how to put these strategies into place.
Handling Slips
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This final chapter of the guide covers strategies for preventing slips and relapses after the client completes the treatment program for ADHD. The chapter includes a review of all of the skills that were taught in the treatment program. The therapist should discuss with clients which skills they found to be helpful and which did not. The chapter includes a troubleshooting worksheet and a worksheet that clients can use after treatment has ended to review things that are going well as well as skills that need to be practiced. Advice for maintaining the gains made in treatment and terminating treatment is offered.
Parent Preparation for Treatment: Goals, Targets, and Initial Plans
Authors: Kolko David J. , Vernberg Eric M.
Published: June 2017

Chapter 5 specifically addresses working with the parent(s) concerning their child and fire, by: describing the purpose of the treatment (to reduce the risk of firesetting), discussing the parent’s treatment goals, and providing information about the treatment program. It explores ways to: Identify child and family strengths, Understand child and family stressors; and Learn about the parent’s use of monitoring, supervision, and discipline. The chapter includes discussion of how the parent reacts to stress, and includes encouraging the parent to relax. It discusses some common behaviors associated with firesetting and possible strategies for managing them, and explores the area of consequences to target these behaviors. The chapter makes use of forms (available in appendix c), which help educate the parent and elucidate information for the practioner.
Skill Review, Follow-up Plans, and Termination
Authors: Kolko David J. , Vernberg Eric M.
Published: June 2017

This chapter prepares practitioners for the final treatment session and termination. It further reviews home practice of skills and interventions with the family and summarizes topics covered in previous chapters. It seeks to identify specific applications of the skills that the child and parent(s) have used. This discussion seeks to understand the benefits of applying these skills, any potential challenges they faced, and any possible changes needed in the plan. The chapter provides considerations for potential future problems the family might face, follow-up with the practitioner, and outside referrals. The family is prepared for upcoming termination by encouraging persistence in using the learned skills, and discussing referral options and community resources. A sample certificate for graduation is provided.
Typical Forms Used in a Private Practice
Authors: Wiger Donald E.
Published: June 2017

Filling out forms in the practice of mental health is much more than “dull paperwork.” With proper training, most forms can be filled out during the session rather than spending valuable time afterward. On-target forms can provide the required documentation that the services provided are medically necessary. Too many mental health clinics have gone out of business or have suffered severe financial loss after an audit or review of records by third parties such as insurance companies, licensing boards, clients, or the court. The discussion of forms in this chapter provides information about what is necessary to clearly document the client’s diagnosis, treatment plan, progress of therapy, need for continued services, discharge, outcomes, Health Insurance Portability and Accountability Act (HIPAA) compliance, and financial policies.
Entrepreneurship Basics for Practitioners
Authors: Baedke Laurie K.
Published: June 2017

This chapter explores the attributes of success in clinical practice and entrepreneurship and the traits and roles of individuals who are best suited for clinician entrepreneurship. Traditional business models are reviewed and compared to alternative and innovative new private practice arrangements, such as telepractice, that are available to today’s mental health professional. Entrepreneurial myths and stereotypes are identified and examined so that the reader can avoid common pitfalls in business ownership. The advantages and disadvantages of entrepreneurship are outlined, and the importance of vision is emphasized. Resources and recommended readings are provided to further inform and educate the reader about entrepreneurship, strategic planning, business development, and business success.
Envisioning Your Ideal Practice
Authors: Verhaagen Dave
Published: June 2017

Before embarking on the difficult but exciting journey of starting a private practice, it’s wise for mental health practitioners to envision what their ideal practice would look like. The authors use their own experience starting a practice, Southeast Psych, to illustrate this envisioning process. This chapter takes novices through the process of envisioning their practice, beginning with why they are starting a business, then establishing clearly defined values that guide the development of their unique business culture. The chapter addresses issues related to financial and emotional risk taking and the importance of taking “good risks” to establish a successful business, attract and retain clients, and provide excellent customer service. The chapter also addresses how to create a strong strategic plan to help the business flourish and find its niche in the community.
Financial Planning for the Private Practitioner
Authors: Gresham Mary
Published: June 2017

Financial planning is an essential but often neglected activity for private practitioners. Research indicates that mental health practitioners can be “money avoidant” when it comes to personal finance. This chapter describes a four-level model useful in money management. Essential topics and rules of thumb for a basic financial plan are covered as follows: personal cash flow, net worth, debt management, insurance, investing, taxes, retirement, and estate planning. Useful references and resources are listed at the end of the chapter.
Mentorship in the Life and Work of the Private Practitioner
Authors: Johnson W. Brad
Published: June 2017

Private practitioners need mentoring relationships to achieve success professionally and personally throughout their careers. This chapter describes the nature of mentorship and outlines its goals and its many potential benefits for mentor and mentee alike. The value of participating in mentoring relationships is illustrated, including the benefits of becoming a mentor to others. The role of mentoring relationships throughout one’s career (early, middle, and late) as a private practitioner is highlighted. Recommendations are made for getting the most out of mentoring relationships whether one is a mentor or mentee.
Fees and Financial Arrangements in Private Practice
Authors: Barnett Jeffrey E.
Published: June 2017

This chapter addresses the issue of fees for mental health professionals in private practice. Important issues discussed include the meaning of fees and money for practitioners and how to resolve conflicts about money that may adversely impact one’s practice. Guidance is provided on ethical and practical aspects of setting, raising, and collecting fees, including what to do when clients fail to pay. How to address fee issues as part of the informed consent process in an ethical and proactive manner is emphasized. Client hardship, sliding scales for fees, and pro bono fees are discussed, and practical advice is provided regarding fees for nonclinical services. Specific recommendations for ethical practice are provided that are consistent with each mental health profession’s code of ethics.
The Use of the Media in Marketing a Private Practice
Authors: McGarrah Nancy A.
Published: June 2017

This chapter describes the ways mental health professionals in private practice can use the media for marketing their practice as well as for educating the public. The processes for engaging in media work are addressed and the concept of being an “expert” in this field is explained. Ethics issues are emphasized, such as what mental health professionals can and cannot say in interviews. Specific guidance for providing effective interviews and ideas for receiving applicable training are given. Media-trained mental health providers can assist with interview preparation and answer questions about ethics and media work.
How to Promote Your Practice Through Community Presentations
Authors: Kennedy-Moore Eileen , Ducharme Elaine
Published: June 2017

Offering community presentations is a great way to educate people about important mental health issues as well as a very effective way to promote your own psychotherapy private practice. Clinicians understand issues that matter in people’s lives and have strong communication skills, which means they have the potential to be excellent speakers. This chapter offers practical answers to questions psychotherapists frequently ask about giving community presentations. It describes how to pick a topic, how to find speaking venues, and how to figure out how much to charge. It also offers tips for engaging audiences, avoiding common speaker mistakes, and handling fear of public speaking.
Collaborating with Healthcare Professionals
Authors: Tovian Steven M.
Published: June 2017

This chapter highlights and summarizes several specific aspects of collaboration with healthcare professionals in healthcare settings that have and will continue to support professional advancement in independent practice. Several best practices in integration or in collaboration with primary healthcare and tertiary healthcare are described. Successful strategies to use in the marketing of professional services as well as suggestions for developing a professional image in collaborative care are provided. The necessary skills for successful practice in collaborative care are delineated. Ethical parameters for practice in collaborative care are also discussed. Suggested readings are provided to further educate the reader on independent practice parameters and collaborative healthcare.
Consulting Psychology in the Business World
Authors: Maides-Keane Shirley A. , Liebowitz Bernard J.
Published: June 2017

Consulting psychologists working in the private sector of the business world have many roles. This chapter discusses several types of business consulting engagements. The differences between psychotherapy practice and business consulting are explained. Case illustrations are supplied based on the authors’ more than 30 years of experience. Information is given about the type of additional training required to become a consultant. Topics covered are executive coaching, leadership development, family business consulting, executive selection, team building, leadership succession, organizational analysis and design, mergers and acquisitions, and strategic planning.
HIPAA 101 for the Private Practitioner
Authors: Hecker Lorna
Published: June 2017

This chapter introduces basic requirements of the Health Insurance Portability and Accountability Act (HIPAA), including privacy regulations applicable to HIPAA-covered entities and security regulations applicable to both HIPAA-covered entities and business associates. The privacy regulations covered in this chapter include the definition of psychotherapy notes under HIPAA regulations, the “minimum necessary” requirement, HIPAA authorizations, personal representatives, and the need for an accounting of certain disclosures of client’s protected health information. Also explored is the interaction and state law and HIPAA regulations, especially in relation to the practitioner’s Notice of Privacy Practices. The security regulation’s administrative, physical, and technical safeguards are discussed, including an introduction to the HIPAA required security risk assessment. Also explained is the breach notification law that was enacted through the 2009 Health Information Economic and Clinical Health (HITECH) Act.
Considerations in Closing a Private Practice
Authors: Thomas Janet T. , Walfish Steven
Published: June 2017

The prospect of closing a practice can be daunting. It is a task eventually faced by nearly all psychologists, counselors, family therapists, and social workers who provide psychotherapy, assessment, or forensic services in the context of an independent practice. Retirement, financial difficulties, license suspension or revocation, and serious health problems are among the circumstances prompting a practice closing. Clinicians must think through and develop a practice closing plan that takes into account client needs, legal and ethical requirements, and the need for emotional preparation. This chapter addresses related clinical issues such as client notification, continuity of care, transference, and countertransference. The authors describe common ethical challenges and make recommendations regarding informed consent, confidentiality, and the maintenance and storage of clinical records for both closing and selling a practice.
Sustaining Self-Care and Thriving as a Private Practitioner
Authors: Rupert Patricia A. , Baker Ellen K.
Published: June 2017

The importance of self-care for the well-being and professional functioning of mental health service providers has been increasingly recognized. Emphasizing a proactive, prevention-oriented approach, this chapter offers practical ideas and guidance on self-care for mental health professionals in private practice. The demands and rewards of private practice, as well as the challenges of making and sustaining a commitment to self-care, are discussed. An approach to developing a self-care plan is presented. This approach uses an organizing framework that views self-awareness, work-life balance, and connections as critical goals of self-care. Each of these areas is discussed in detail, with examples of ways to integrate self-care into daily life and questions to consider in assessing individual self-care needs, identifying resources, and planning for self-care. The importance of viewing self-care as a process and paying attention to evolving self-care needs and opportunities is emphasized.
How Social Policy Impacts Private Practice
Authors: Ling Catherine Gaines , Huffman Sarah , DeLeon Patrick H.
Published: June 2017

All aspects of clinical private practice are influenced by public policy. Public policy can be neutral or it can promote or inhibit practice. This chapter addresses how social policy shapes practice through legislation, regulation, payer, and care delivery systems. The authors illustrate how behavioral health professionals practice in response to federal, state, and local policies. Policy and practice are evolving to meet increased demand. The chapter discusses how parity of access and compensation for mental health care versus physical health care are playing a greater part in policy. The authors emphasize how advancement and advocacy occur by working collaboratively with and building on parity with other health professions.
Counseling Women with Breast Cancer
Authors: Haber Sandra
Published: June 2017

Counseling women with breast cancer is a niche practice that is a significant but often overlooked part of the breast cancer treatment protocol. With appropriate training and experience, mental health clinicians can facilitate medical decision making, manage the side effects of treatments such as chemotherapy and mastectomy, and improve coping skills for posttreatment reactions. Mental health clinicians can also provide significant interventions with the patient’s partner, children, parents, and friends at each stage of the treatment process. This chapter describes the author’s involvement and development of this niche specialty, the joys and sorrows of work in this area, and the business obstacles that can be encountered and overcome. Resources to assist those interested in developing this niche area of practice are provided.
Treating Obsessive-Compulsive and Related Disorders
Authors: Jenne Helen G.
Published: June 2017

The treatment of obsessive-compulsive and related disorders is an important area of niche practice because there is a lack of mental health professionals to support the patient need. There are a variety of training programs that focus on serving this patient population. This chapter describes this niche area of practice. Patients with obsessive-compulsive and related disorders make up almost all of the author’s caseload. The chapter includes information ranging from the business to the clinical aspects of this important niche area. Resources are provided for those interested in developing this niche area of practice.
Treating Trauma and Abuse
Authors: Ducharme Elaine
Published: June 2017

This chapter explores the challenges and benefits of developing a private practice that specializes in the treatment of trauma and abuse. It identifies key areas a clinician must consider in formulating a treatment approach with these clients. The chapter discusses the importance of understanding how to run a business and the clinician’s need to get beyond fears of asking for payment with these often-challenging clients in order to make a living. Concrete ideas for developing this interest into a niche practice are offered. Key resources are also presented.
Counseling Clients with Asperger’s
Authors: Gaskill Frank W.
Published: June 2017

Children, teens, and young adults who are Asperger’s have a unique set of clinical needs. Mental health practitioners with the appropriate training and clinical skills may provide these individuals with valuable and much-needed individual and group treatment as well as address relevant family issues to better support these clients. This chapter describes the joys and challenges of providing treatment to these individuals and explains the business aspects of developing and running a niche practice that specializes in meeting their clinical needs. This chapter also describes the education and training needed to be successful in counseling children, teens, and young adults who are Asperger’s. Resources are provided to assist those mental health practitioners interested in pursuing this area of niche practice. A sample social skills group curriculum and letter to share with parents of Asperger’s clients is provided.
Counseling Clients with Borderline Personality Disorder
Authors: Edwards Lauren Moffitt , Santorelli Noelle
Published: June 2017

Counseling clients with borderline personality disorder requires a variety of skills and lends itself to multimodal treatments such as dialectical behavior therapy. Working with borderline personality clients in private practice can be highly rewarding but requires managing challenges, such as boundaries, effectively. The logistics of managing a private practice outside of managed care with emotionally dysregulated clients are discussed. Recommended training experiences and positive self-care strategies are explored. Key resources are provided to assist practitioners who are interested in developing this niche area of practice.
Developing a Sport Psychology Practice
Authors: Hays Kate F.
Published: June 2017

This chapter focuses on creating a practice in sport psychology. As a hybrid field, training and skill development includes knowledge of both sport sciences and counseling or psychotherapy. Training may be acquired at a graduate or postgraduate level. Potential clients are typically interested in growth and change, are goal-directed, and are used to practicing particular skills in order to improve. This chapter addresses clinical and ethical issues relevant to the practice of sport psychology, including the knowledge and skills professionals must possess to be successful. It also shares information on how to develop a sport psychology niche practice, the joys and challenges associated with this area of practice, the business aspects of being a sport psychologist, and key resources for those interested in developing a niche practice in sport psychology.
Collaborative Divorce
Authors: Gabardi Lisa
Published: June 2017

Collaborative divorce is a non-adversarial divorce settlement option. Mental health professionals can develop a challenging and fulfilling niche practice in this area by serving on a divorce team as a divorce coach, a neutral mental health coach, or a child specialist. This chapter describes how to become involved in this niche. The author outlines the training and skills necessary to function in these roles for divorcing families and the resources to obtain such training and skills. The author explains the mental health roles of the divorce coach, the neutral mental health coach, and the child specialist. This chapter also describes the business aspects, and the joys and challenges of this professional niche, and offers further resources.
Dating Skills Coaching and Psychotherapy
Authors: Engle Jessica
Published: June 2017

Many single adults find themselves increasingly isolated and overwhelmed by the modern dating world. As complex dating technologies replace traditional community structures, dating coaching and psychotherapy can provide the guidance and support singles need to build healthy relationships. In this chapter the author describes the development of her dating skills niche private practice. She offers guidance regarding niche motivations, business structures and development, and the challenges and joys of this area of practice. She explains the differences between coaching and psychotherapy. A list of helpful resources is provided.
Family Considerations in Supporting Bereaved Students
Authors: Hagan Melissa J. , Morford Allie
Published: June 2017

This chapter reviews the role of the family in a student’s grieving process and the role the school-based mental health professional can play in supporting the families of bereaved students. Key challenges that caregivers face in supporting bereaved youth are addressed. Strategies that school-based professionals can use to engage family supports around the student are discussed. Key considerations, including the age and developmental level of the student, and family cohesion, are highlighted. The differing impacts of varying types of death, including the death of a parent or a sibling, expected versus sudden deaths, and stigmatized deaths, are also discussed.
The Role of Digital and Social Media in Supporting Bereaved Students
Authors: Sofka Carla J.
Published: June 2017

This chapter describes the benefits and challenges that can occur with adolescents’ use of digital media and social media in relation to a death, beginning with the pros and cons of death notification via digital and social media such as Facebook, Twitter, and texting. Digital and social media resources can be used to gain information about grief, to facilitate the provision of tangible assistance to the bereaved, and to offer emotional support. The use of social media as a tool for survivor advocacy will be discussed. Online resources available to facilitate cybersafety are covered. A list of questions to facilitate conversations with students about their use and impact of digital and social media use is included.
Using Cognitive and Behavioral Methods to Support Bereaved Students
Authors: Flanagan Rosemary
Published: June 2017

This chapter addresses cognitive and behavioral interventions for students experiencing grief and bereavement. The evidence-based treatment package called Trauma-Focused Cognitive-Behavioral Therapy is covered in detail. The components of this treatment package for bereaved students are discussed. Other group treatment options are also mentioned. Practical considerations and implementation issues for this treatment package are reviewed.
Using Play Therapy to Support Bereaved Students
Authors: Swan Karrie L. , Rudd Rebecca
Published: June 2017

Using the tenets of child-centered play therapy, this chapter describes interventions that school-based mental health professionals can use to support bereaved children. Children’s reactions to death, and the interventions that professionals can use, vary based on their developmental stage. Strategies are presented for helping children process the early period of bereavement, facilitate a developmentally and culturally appropriate understanding of death, promote adjustment to changes in family constellation and dynamics, and memorialize loved ones. Instructions are provided for using play techniques to help children organize, make sense of, and express their losses in a concrete manner. The play interventions described in this chapter involve using a sand tray and miniature figures to help a child prepare for a memorial service and to start to understand the concept of death, using puppets to explore the changes in family dynamics that occur after a death, and creating a memorial book.
Using Writing Interventions to Support Bereaved Students
Authors: Toye Lysa , Warnick Andrea
Published: June 2017

This chapter describes in detail several writing interventions that school-based mental health professionals can use to assist bereaved students in processing their grief. The chapter reviews some of the benefits of using writing to explore, express, and process grief, to support meaning making, and to build and maintain a connection with the deceased person. The strategies that are described, including memory writing, poetry writing, journal keeping, and writing a letter to or preparing a dialog with the deceased person, can be used individually or with groups. Variations are provided for students of all ages. Lists are provided of key considerations and “red flags” that counselors should remember when using writing techniques to support bereaved students.
Using Acceptance and Commitment Therapy to Support Bereaved Students
Authors: Renshaw Tyler L. , Bolognino Sarah J. , Roberson Anthony J. , Upton Shelley R. , Hammons Kelsie N.
Published: June 2017

This chapter discusses how the acceptance and commitment therapy (ACT) approach can be used to support bereaved students. ACT is focused on understanding how psychological problems develop and how they can be treated. The goal is not simply to reduce problem behavior, but rather to change the way youth relate to their problems by empowering them with mindfulness skills that contribute to increased well-being behavior. ACT’s core therapeutic processes are described, along with a review of the research regarding its relevance to supporting bereaved youth. An outline is provided for how ACT strategies can be implemented in schools to support grieving students at the class-wide, small-group, and individual levels.
Prospection, well-being, and mental health
Authors: MacLeod Andrew
Published: June 2017

The ability to think about the future is essential for functioning, and is also central to individual well-being and mental health. This book reviews the growing evidence for the link between prospection and well-being. A variety of aspects of prospection are discussed, including prediction and anticipation for future events, judging how we will feel when events do happen to us, and how we feel in the here-and-now when contemplating what will happen in the future. Each of these aspects of prospection is connected to experiences of well-being and mental health in different ways. Questions of bias and accuracy in prediction are also addressed in the context of discussing optimism and pessimism. Qualities of goals for the future that are strongly implicated in aspects of well-being and mental health are reviewed, along with the role that difficulties in planning how to reach goals play in states of low well-being. The book also attempts to reconcile the seeming contradiction between being mindful in the present and thinking about the future. Ways of trying to change problematic prospection are also reviewed in light of their ability to improve well-being and reduce psychological distress. It is not possible to think about the future without remembering the past, and the involvement of memory in prospection is discussed, especially in relation to memory difficulties producing difficulties in prospection. The book concludes by arguing that our well-being and mental health are intimately bound up with our subjective sense of a future life trajectory.
Expectancies
Authors: MacLeod Andrew
Published: June 2017

Heightened expectancies for negative events and reduced expectancies for positive events happening to oneself are characteristic of emotional disorders. Chapter 2 reviews evidence relating to these two distinctive kinds of difficulties with thinking about the future. The evidence points to anxiety being primarily related to elevated judgements about the future likelihood of negative events and depression to reduced expectancies for positive events. Anticipation describes a more active form of looking forward to or not looking forward to personally-relevant future experiences. Again, anxiety relates to increased negative anticipation only, whereas depression and hopelessness are characterized by a reduction in having things to look forward to, in the absence of any increase in negative anticipation, a pattern that is found in those who have suicidal thoughts and feelings. Mechanisms underlying by future likelihood judgements are discussed.
Optimism and pessimism
Authors: MacLeod Andrew
Published: June 2017

Optimism and pessimism are commonly used ways of talking about a future outlook. Chapter 3 discusses questions such as whether people are, in general optimistically biased and whether those who are depressed are more accurate in their predictions for the future. A variety of ways of defining optimism–pessimism have been developed, from describing a broad attitude to the future through to beliefs in the likelihood of events happening to oneself compared to others. Evidence suggests that, on the whole, people have an optimistic outlook, although the extent of this might depend on how it is measured as well as on other factors such as culture and age. Those low in well-being and those suffering from psychological disorders are less optimistic and more pessimistic than average, but the idea that they are less biased and more accurate has not received consistent support.
Predicting feelings
Authors: MacLeod Andrew
Published: June 2017

As well as predicting outcomes, we also anticipate how we are going to feel when those outcomes happen, This chapter discusses affective forecasting. These affective predictions are likely to be important in guiding our behaviour. There is evidence that people overestimate the strength of feeling that they will experience in response to future events, both positive and negative, although the conclusion that we are poor at judging our future feelings has been overstated. Those who are depressed do show lowered expectations of feeling good in future positive situations, something that is an important component in their of lack of motivation and engagement. Evidence about how depressed people actually do respond emotionally when situations do occur is very mixed. Similarly, studies examining whether those who are high in depression are more (or less) accurate, or are biased, in predicting their feelings have also produced mixed findings.
Plans
Authors: MacLeod Andrew
Published: June 2017

Chapter 8 reviews the relationship between planning for the future and well-being. Plans are the future steps we think of to reach our goals. Specific plans bridge the gap between intention, and acting on the intention and low states of well-being and mental health, including suicidal behaviour, are related to lack of planning specificity. Highly specific behavioural plans (implementation intentions), have also been shown to promote the ability to carry through desired but difficult behaviour. Planning links to well-being in a number of ways. First, through providing a sense that future outcomes will be achieved and creating a sense of progress, plans facilitate in-the-moment positive affect. Planning also provides structure and direction, and promotes engagement in activities. Finally, having formed plans frees up resources to think on the present, and reduces intrusive thoughts about what is going to happen in the future.
The Structure, Specificity, and Validity of Depression Symptoms
Authors: Watson David , O’Hara Michael W.
Published: June 2017

This chapter examines key symptom criteria of major depression. It begins by developing a comprehensive measurement model based on six symptom dimensions: dysphoria, lassitude, insomnia, suicidality, appetite loss, and appetite gain. It then demonstrates that these symptom dimensions are robust and show impressive convergent and discriminant validity across multiple methods (self-reports, clinicians’ ratings, interview assessments). Three types of symptoms—dysphoria, lassitude, and suicidality—exhibit strong criterion validity and significant specificity in relation to diagnoses of major depression. In contrast, symptoms of insomnia and appetite disturbance display unimpressive criterion validity and poor specificity. Moreover, these nonspecific symptoms provided little or no incremental information in logistic regression analyses. Taken together, these results suggest that the diagnosis of depression can be improved by focusing primarily on strong and specific symptoms (such as dysphoria and lassitude) and deemphasizing weak and nonspecific symptoms (i.e., insomnia and appetite disturbance).
The Structure, Validity, and Specificity of OCD Symptoms
Authors: Watson David , O’Hara Michael W.
Published: June 2017

This chapter reviews early attempts to assess obsessive-compulsive disorder (OCD) symptoms, as well as the structural evidence that eventually led to the identification of core, consensual dimensions within the disorder. It then reviews instruments (the Obsessive-Compulsive Inventory; the Schedule of Compulsions, Obsessions, and Pathological Impulses; and the Yale-Brown Obsessive-Compulsive Scale) that have been developed to assess these core symptom dimensions and discusses the validity (including convergent, discriminant, criterion, and incremental validity) and specificity of the scales included in these measures. Three sets of OCD-related items (representing Cleaning, Checking, and Ordering) marked clear, replicable factors in the IDAS-II scale development samples. Indicators of checking and ordering/rituals produced the most impressive results overall, exhibiting the strongest criterion validity, good diagnostic specificity, and significant incremental validity in logistic regression analyses. Washing/cleaning symptoms also showed good diagnostic specificity, but they displayed more moderate criterion validity.
Suicide and the American Military’s Experience in Iraq and Afghanistan
Authors: Tomlins Joseph , Bliss Whitney , James Larry , Bongar Bruce
Published: June 2017

Suicide rates in all branches of service have climbed to record levels, with the highest rates seen in the branches with the greatest percentage of forces devoted to combat operations and for veterans of Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn relative to veterans of other cohorts. Given the operational stressors inherent in these conflicts, it to look to deployment and combat stressors as primary reasons for these increases in suicide rates. At the same time, the research on the role of deployment and wartime mental health sequelae suggests that the connections between these variables and suicide is more complicated than originally expected. Studies exploring these relationships were sometimes contradictory and yielded even more questions about mediating and moderating factors. This chapter attempts to flush out many of the inherent complexities of suicide, its prevention, and the American military’s experience in Iraq and Afghanistan.
Combat Experience and the Acquired Capability for Suicide
Authors: Bryan Craig J. , Clemans Tracy A. , Hernandez Ann Marie
Published: June 2017

A startling surge in suicide rates among US service members since the initiation of combat operations in Iraq and Afghanistan spawned renewed interest in the association between combat exposure and suicide among scientists, practitioners, and policymakers. An ever-growing discourse of theoretically and empirically derived mediators and moderators provides a basis from which to clarify the potential link between combat engagement and suicide. This chapter focuses on one potential intermediary, namely the acquired capability for suicide, as proposed by the interpersonal-psychological theory of suicide (IPTS). According to the IPTS model, acquired capability for suicide is necessary in order for one to engage in suicidal behavior, as is perceived burdensomeness and thwarted belongingness. Data suggest that combat exposure and military training may enhance one’s capability for self-harm. The relevance of acquired capability for suicide within military populations, as well as potential avenues for intervention, are discussed.
Driving Themselves to Death
Authors: Sullivan Glenn , Kroke Phillip C. , Hostler Timothy B.
Published: June 2017

Suicide by means of a motor vehicle is more common than is generally realized. Vehicular suicide accounts for approximately 1% of all completed suicides in the United States. Vehicle-related suicidal ideation is common among both psychiatric patients and veterans. This chapter examines the phenomenon of vehicular suicide and its relationship to postdeployment adjustment. The chapter proposes that various war zone experiences may increase the risk of postdeployment risky driving. It also provides recommendations regarding both assessment and treatment based on the idea that clinical awareness of combat veterans’ propensity for risky driving and vehicle-related suicidal ideation is an essential element of veteran suicide prevention.
Person-Centered Suicide Prevention in Primary Care Settings
Authors: Duberstein Paul R. , Wittink Marsha , Pigeon Wilfred R.
Published: June 2017

The increase in the availability of mental health services in primary care settings in large health systems is a positive development for suicide prevention, but challenges remain. Unhelpful power asymmetries in the patient–primary care physician (PCP) relationship, supply-side economic factors, and the disease-centered (biomedical) model make it difficult for PCPs to elicit patient priorities. Thus many of the drivers of suicide risk are marginalized if not ignored in the patient–PCP encounter. Drawing from self-determination theory and systems theory, this chapter offers a person-centered vision of suicide prevention in primary care. It calls for policy initiatives to that accommodate PCPs’ needs for self-determination and outfit primary care settings with the technological and human resources needed to improve the way PCPs and patients communicate about difficult issues. These initiatives are expected to mitigate suicide risk and improve other patient outcomes as well as PCP job satisfaction.
Disinfectant Treatments That Reduce Transmission of Stagonosporopsis citrulli During Cucurbit Grafting
Authors: Keinath Anthony P. , DuBose Virginia B.
Published: June 2017

Gummy stem blight can develop in greenhouses on cucurbit seedlings grown as scions and rootstocks for grafting. When diseased seedlings are cut during grafting, Stagonosporopsis spp., the fungal pathogens causing gummy stem blight, may be transferred to healthy seedlings. The objective of this study was to evaluate efficacy of disinfectant treatments to prevent or reduce transmission during cutting and grafting. A blade contaminated with mycelium and spores from a culture of S. citrulli transferred the pathogen to 72%, 73%, and 55% of the second, third, and fourth seedlings, respectively, cut in sequence when 100% of the first seedlings cut were infected. Kleengro (didecyl dimethyl ammonium chloride), Physan 20 (dimethyl benzyl ammonium chloride), and Virkon S (potassium peroxymonosulfate) were ineffective when sprayed onto watermelon seedlings before or after cutting hypocotyls with a contaminated blade. Dipping a contaminated blade in 0.3% sodium hypochlorite, 0.4% Physan 20, or 70% or 95% ethanol before cutting watermelon hypocotyls significantly (P = 0.01) reduced incidence of gummy stem blight compared with water but did not prevent transmission. Soaking a contaminated blade for 3 s in 95% ethanol, 30 s in 0.8% sodium hypochlorite, or flaming the blade after dipping in 95% ethanol, prevented transmission. In a grafting experiment, both the watermelon scion and the interspecific hybrid squash rootstock were cut with contaminated or contaminated and treated blades before grafting. Sterilizing a contaminated blade by flaming significantly (P = 0.01) reduced incidence of gummy stem when compared with a 1-s dip in ethanol, a 1-s dip in Physan 20, or water. Disease incidences in these treatments were 11%, 45%, 100%, and 100%, respectively. Using heat, ethanol, or sodium hypochlorite to disinfest cutting tools may reduce transmission of S. citrulli during cucurbit grafting.
Experimental Simulation of Clinical Borderline Situations in Temporal Bone Specimens After Ossiculoplasty
Authors: Jakob Till F. , Kromeier Jan , Baumann Tobias , Pfeiffer Jens , Neudert Marcus , Laszig Roland , Zahnert Thomas , Offergeld Christian
Published: June 2017

Objectives:

One reason for insufficient hearing improvement with a distinct air–bone gap after ossiculoplasty with implantation of partial or total ossicular replacement prostheses can be the dislocation or minimal shifting of the prosthesis. The aim of this study was the simulation of common clinical borderline situations with minimal shifting of the prosthesis in temporal bone specimens after ossiculoplasty. It was furthermore the goal to identify these specific situations through imaging by cone beam computed tomography (cbCT) and direct visual inspection using the operation microscope. Additionally, the functional status was evaluated using laser-Doppler vibrometry (LDV).

Design:

We used a total of four temporal bone specimens for this study. A reconstruction with a partial ossicular replacement prostheses was performed in three specimens and with a total ossicular replacement prostheses in one specimen, with good initial acoustic properties. Subsequently, one specific type of prosthesis failure was simulated in each specimen, respectively, by minimally shifting, tilting, or bending the prostheses from their initial positions. These changes were introduced step-by-step until a borderline situation just short of complete acoustic decoupling was reached. Each step was examined using both LDV and cbCT and observed through the operation microscope.

Results:

LDV was able to quantify the mechanic function of the ossicular chain after most of the manipulation steps by demonstrating the effect of any shifting of the prosthesis on the middle ear transfer function. However, in some situations, the middle ear transfer function was better with a visually more advanced failure of the prosthesis. In addition, cbCT showed most of the steps with excellent resolution and was able to delineate changes in soft tissue (e.g., cartilage covering).

Conclusion:

cbCT seems to be a promising imaging technique for middle ear problems. As cbCT and LDV exhibited slightly different advantages and disadvantages regarding the demonstration of borderline situations, the combination of both techniques allowed for a more precise evaluation of middle ear reconstructions. Knowledge of the specific characteristics of these methods and their possible combination might help otologists and otosurgeons to refine indications for revision surgery and improve their personal patient counseling.
A Sandwich Method Using Kapandji Intrafocal Pinning to Facilitate Palmar Plating of Displaced Distal Radius Fractures
Authors: Huang Hui-Kuang , Huang Yi-Chao , Wang Jung-Pan , Chang Ming-Chau
Published: June 2017

The use of palmar plating in the treatment of dorsally displaced distal radius fracture is very common, and can result in a good functional outcome. We present an easy “sandwich method” to reduce the fracture and to facilitate osteosynthesis. Firstly, the dorsal Kapandji intrafocal wire was applied to achieve the reduction of the dorsally displaced fracture and provide a volar-directed force. Then the intra-articular fractures were reduced or the metaphyseal defect is stuffed with bone graft if necessary. Finally, the anatomical plate is used to buttress and push back the distal fragment to complete the osteosynthesis. The postoperative radiographic parameters, comparing with the contralateral noninjured side, could achieve similar radial height, radial inclination, volar tilt, and ulnar variance without significant difference.
Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project
Authors: Hark Lisa A. , Leiby Benjamin E. , Waisbourd Michael , Myers Jonathan S. , Fudemberg Scott J. , Mantravadi Anand V. , Dai Yang , Gilligan John P. , Resende Arthur F. , Katz L. Jay
Published: June 2017

Purpose:

To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project.

Patients and Methods:

Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated.

Results:

Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence.

Conclusions:

This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.