bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychotherapy with Older Adults
Authors: Knight Bob G. , Nordhus Inger Hilde , Satre Derek D.
Published: November 2003

Psychotherapy with older adults and psychotherapy integration are two important clinical movements of recent years. In this chapter, we discuss psychotherapy with older adults in an integrative framework. We first review the evidence for the effectiveness of psychological interventions with a range of problems faced by older clients, including chronic illness and disability, depression, anxiety, alcohol problems, and sleep disorders. In the following sections, we discuss integrative trends in psychotherapy with older adults using the common factors theme, the metatheoretical framework, and the prescriptive eclecticism integrative approach. In the final section, we begin to explore the potential for theoretical integration in psychotherapy with older adults, using the integrative model developed at the older adult clinical program associated with the University of Bergen (Norway). The Bergen Model, which we illustrate with a case example, emphasizes identification and modification of cyclical maladaptive patterns in interpersonal relationships. Our intertwined themes in the chapter are that the integrative approaches are useful in thinking about psychotherapy with older adults and that working with older clients may provide particular impetus to thinking in integrative terms.
Ethical Issues in Clinical Psychology
Authors: Jones Stanley E.
Published: November 2003

This chapter includes the sources of ethical principles and standards, the major ethical issues in clinical practice, and methods of regulation. An overview of the American Psychological Association (APA) Ethics Code is provided, including its history, revisions, and content. The content of the Ethics Code is discussed in terms of competence, confidentiality, autonomy and informed consent, multiple relationships, sexual misconduct, advertising and public statements, and supervision. Frequent problem areas are covered, including sexual misconduct, forensic and child custody evaluations, managed care, and raw data release. A model for ethical decision making is presented. In addition to the APA Ethics Code, good practice requires considering other guidelines and standards, laws, and psychology licensure laws and regulations. The chapter discusses the basic enforcement of ethics codes, including direct enforcement by APA and by state or other psychological associations that adopt it and apply it to their members, as well as states that incorporate the code into licensure legislation or licensure board regulations as the profession's code of conduct. A brief section is provided regarding the role of the APA Ethics Committee Rules and Procedures that govern the process for conducting ethics investigations of members.
Health Care Marketplace in the United States
Authors: Drum David J. , Sekel Andrew
Published: November 2003

As the twenty‐first century begins, the United States healthcare system has endured a turbulent, unremitting change cycle for over two decades. It is truly a system in motion, configuring and reconfiguring itself on a regular basis. The Self‐Regulatory Era in health care lasted from the late nineteenth century until the late 1930s and was a time when healthcare evolved naturally in the marketplace. That era was overturned by providers in the late 1930s, when they organized to create the Fee‐for‐Service/Third‐Party Payer system, which gave the era its name. The present‐day Cost‐Containment Era has resulted from the revolts of purchasers against increasingly higher healthcare costs. Today the healthcare system has been restructured around free market principles: there has been a dramatic shift in the way healthcare services are organized, delivered, and financed. Healthcare is now treated like other commodities. Behavioral health care has felt these changes keenly, and practicing psychologists are in a very different health care world than existed through the mid‐1980s.
Role of Technology in Clinical Psychology
Authors: Rudestam Kjell Erik , Giannetti Ronald A. , Stamm B. Hudnall
Published: November 2003

This chapter highlights the current impact of technology on the practice of clinical psychology. Within the field of education and training, computer conferencing systems are increasingly used to offer coursework at a distance. The pedagogy goes beyond the presentation of didactic materials to include collaboration, “communities of practice,” and the learning of meta‐skills such as reflective thinking and real‐world problem solving. Online supervision of graduate students within a psychology training program is part of the larger domain of “telehealth,” which uses telecommunication technology to provide health information and intervention, and consultation and supervision across distances. The technology is expanding to include interactive videodisks and expert system‐based, computer‐assisted training programs (ESCATs).

The Internet offers a rich lode of counseling and psychotherapy to the public both in self‐help form and from professionals. Such Internet information and resources help to demystify psychology and provide business opportunities to enterprising psychologists for products and consultations. There are, however, ethical concerns ranging from privacy and cross‐jurisdictional licensing issues to responding appropriately to serious mental disorders online. Many psychologists today employ desktop computers to provide administration, scoring, and interpretation of psychological tests. The most common psychotherapy applications are cognitive‐behavioral interventions and manualized therapies for specific dysfunctions and the greatest resistance to their adoption seems to come from relationship‐oriented therapists. There is a need for more outcome and validation research, for determining what aspects of clinical practice and training are most easily automated, and how to provide an optimal blend of the technological with the human.
Health Psychology: Overview and Professional Issues
Authors: Marks David F. , Sykes Catherine M. , McKinley Jennifer M.
Published: November 2003

This chapter provides an introductory overview of the definition and scope of health psychology. The overview begins by discussing relationships with other professions, the clinical and community approaches to health psychology, conditions which promote and maintain health, the inalienable right to health and health care for all, and the centrality of the scientist‐practitioner model in current conceptions of training. Two contrasting approaches to education and training in the United States are described, the clinical model and the community model. Next, the rationale for education and training in Europe is outlined. The European training guidelines prioritize complementarity with other fields of applied psychology, professional autonomy and complementary independence, and stages of competency. Implementation of training is illustrated by the example of training in the United Kingdom which falls into five broad areas: professional competence, research competence, consultancy competence, teaching and training competence, and a set of optional competences, including interventions. Then, the U.S., European, and UK models are compared and contrasted exposing some interesting similarities and differences. This is followed by a critique of professionalization in health psychology. The chapter concludes with a brief discussion of ethical and policy issues concerned with poverty and inequality, economics, new technologies, and the aging population.
Stressful Life Events
Authors: Schwarzer Ralf , Schulz Ute
Published: November 2003

Stressful life events are commonly seen as independent variables, called stressors, that lead to a number of negative outcomes. However, this bivariate relationship is too simplistic. Stress is a process that takes place in context, and the amount of stress actually perceived is different from the objective magnitude of a stressor. Characteristics of the taxing event, such as intensity, duration, predictability, and controllability, have some bearing on the way this actual event is cognitively appraised by individuals, along with other determinants, such as personality, social networks, and coping resources or vulnerabilities.

A distinction is the one between normative and non‐normative events, another one between natural and technological disasters. We characterize the impact ofnatural and human disastersand address their health‐hazard potential. Further, we discuss events that are characterized by personal harm and loss, such asconjugal bereavementandcriminal victimization. Finally, we address the stress of immigrants and refugees.

Most individuals who experience stress do not develop illness. But the cumulative exposure to aggravating daily hassles over a long time may have detrimental health effects. Extreme stressors can create both acute and prolonged distress and ailments.
Coping and Social Support
Authors: Manne Sharon
Published: November 2003

Coping and social support are among the most widely written about and researched topics in health psychology. Both constructs have been hypothesized as reasons why particular individuals are at increased risk for developing illnesses such as cardiovascular disease and cancer and why some individuals do not adapt well once they develop a disease. More recently, coping and social support have been linked with disease course and survival. In this chapter, I review theories of coping, definitions of social support, evidence supporting the role of coping and social support in health and psychological outcomes, theoretical and methodological challenges to both areas of research, and directions for future research.
Asthma
Authors: Schmaling Karen B. , Lehrer Paul M. , Feldman Jonathan M. , Giardino Nicholas D.
Published: November 2003

Asthma is a common and costly condition in the United States; 7.5% of the population reports having asthma. Asthma prevalence and mortality rates have been increasing in recent decades; purely biological mechanisms are insufficient to explain asthma onset, exacerbation, or its rising prevalence. This chapter reviews the application of psychological theories to the understanding of asthma; the effects of stress and mood states on asthma; and the prevalence and effects of comorbid psychiatric disorders among persons with asthma. We also provide an overview of medical treatments for asthma, and discuss challenges related to adherence with those treatments. Behavioral and other psychological interventions are reviewed that directly or indirectly affect asthma. Suggestions for future research needs and directions conclude the chapter.
Obesity
Authors: Corsica Joyce A. , Perri Michael G.
Published: November 2003

Obesity rates have increased dramatically and constitute a major public health problem. Environmental factors appear to be the major contributor to this epidemic of overweight. Continuous exposure to high‐calorie and high‐fat foods, combined with decreased occupational and leisure‐time physical activity, have produced the significant increases in body weights observed over the past two decades. Weight loss can reverse many of the complications and disadvantages associated with obesity, and progress has been made in the development of weight‐loss treatments. Behavioral interventions can produce weight reductions of sufficient magnitude to decrease the risk for many diseases; new drug treatments can enhance the effectiveness of lifestyle interventions; and gastric bypass surgery provides a viable treatment option for the very severely obese.

Unfortunately, with the exception of surgery, all weight‐loss interventions suffer from the problem of poor long‐term maintenance. Providing obese patients with long‐term care has shown some benefit in this regard, but more research on the long‐term management of obesity is clearly needed. Moreover, reversing the epidemic of obesity will require a major public health initiative aimed at identifying and implementing effective behavioral, educational, and environmental strategies for the prevention and control of obesity.
Tobacco Dependence
Authors: Swan Gary E. , Hudmon Karen S. , Khroyan Taline V.
Published: November 2003

Tobacco dependence results in an estimated 430,000 premature deaths and $72 billion in related costs per year in the United States. This chapter takes a multidisciplinary approach to reviewing the problem of tobacco dependence. Findings from preclinical animal studies of the neurobiology of nicotine and its reinforcing effects have been integrated with human clinical and population studies examining sex and ethnic differences, cognitive effects, various environmental risk factors, complex genetic traits, and prevention and cessation methods for tobacco dependence. In many respects, examination of social, behavioral, and genetic risk factors in humans has developed independently from basic animal research. Fortunately, there has been a greater collaboration and exchange of findings between the human and animal fields of research, prompted mainly by significant progress at the molecular genetic level. For example, present and future research is addressing the following important issues: the study of nicotine pharmacokinetics and gene‐environment interactions in families as they relate to tobacco dependence; the examination of gene‐environment interactions in the development and maintenance of nicotine addiction in well‐controlled conditions using animal models; and the extent to which genetic variation influences response to treatment for tobacco dependence. These converging lines of research will lead to an improved understanding of the complexities of tobacco dependence and its treatment.
Arthritis and Musculoskeletal Conditions
Authors: Burke Heather M. , Zautra Alex J. , Davis Mary C. , Schultz Amy S. , Reich John W.
Published: November 2003

Arthritis and other musculo‐skeletal conditions collectively represent the most common causes of disability in the United States (Lawrence, Helmick, Arnett, et al., 1998). Currently, more than 35 million Americans suffer from some form of arthritis (Lawrence, et al., 1998). The widespread prevalence and disability associated with these conditions highlights the importance of identifying mechanisms that affect arthritis onset, course, and outcome. Traditionally, researchers attempting to understand these chronic diseases have focused on indices of disease activity to evaluate the effectiveness of treatment. However, the lack of a one‐to‐one correspondence between objective disease activity and subjective suffering underscores the futility of applying a strict biomedical model to these conditions. Instead, consideration of psychosocial in addition to traditional biomedical factors may yield more accurate predictions of reactions to stress and treatment outcomes. Furthermore, we wish to emphasize that just as there exist predisposing sources ofvulnerability, there may exist predisposing sources ofresilienceto stress. Thus, the purpose of this chapter is to illustrate the biological, psychological, and social sources of vulnerability and resilience in the most common forms of arthritis in the United States: rheumatoid arthritis (RA), osteoarthritis (OA), and fibromyalgia (FM).
Diabetes Mellitus
Authors: Landel‐Graham Julie , Yount Susan E. , Rudnicki Susan R.
Published: November 2003

Recent clinical trials have found that tight glycemic control is of paramount importance in avoiding associated complications in type 1 and type 2 diabetes. However, achieving such beneficial outcomes is contingent upon persons with diabetes performing a variety of self‐care behaviors and working effectively with their health care team. Research indicates that adherence rates to clinical recommendations for diabetes management are problematic, especially for those behaviors that require lifestyle modification (e.g., diet and exercise). Importantly, research indicates that psychosocial factors may play both direct and indirect roles in diabetes management. This chapter focuses upon diabetes knowledge, stress, depression, social support, patient‐practitioner interactions, and coping as correlates of adherence and blood glucose control. Results of investigations into the efficacy of interventions designed to target these correlates and thus improve diabetes management are reported. In addition, sexual dysfunction, hypoglycemia, and weight management are all discussed as special issues for persons with diabetes. The chapter concludes with a discussion of the role of health psychology in diabetes as well as future directions for the field of behavioral diabetes.
AIDS/HIV
Authors: Carey Michael P. , Vanable Peter A.
Published: November 2003

This chapter provides a basic orientation to human immunodeficiency virus (HIV) and the resulting acquired immunodeficiency syndrome (AIDS). This orientation includes a succinct overview of HIV/AIDS epidemiology, disease transmission, natural course, treatment, and psychosocial and economic effects. The authors note that HIV is disproportionately a disease of young adults, and that its economic impact includes the obvious costs associated with medical care but also lessened productivity and increased child care costs. The majority of the chapter provides a through review of intervention research conducted to prevent infections and enhance adjustment among those who become infected. Reviewed are primary prevention interventions that have been implemented to reduce transmission of HIV; this review focuses on research conducted in the United States, and is organized conceptually according to two themes: first, whether the intervention is targeted at the high‐risk groups or general population and, second, where the intervention is conducted (e.g., school, health care setting, or community). Secondary prevention approaches are also reviewed, including those designed to help infected persons cope with the psychosocial challenges associated with HIV disease, adhere to complex and demanding treatment regimens, and eliminate HIV transmission behaviors. The chapter concludes by identifying important research needs and outline the authors’ expectations regarding future developments.
Pain Management
Authors: Turk Dennis C. , Okifuji Akiko
Published: November 2003

This chapter reviews the major unidimensional perspectives on chronic pain (i.e., biomedical, psychogenic, operant, and motivational) and describes the inadequacies of each. The authors review the important contributions of cognitive, affective, and environmental factors and the principles of learning to the maintenance and exacerbation of pain and acceptance of and response to treatment. They present a multidimensional, cognitive‐behavioral formulation that integrates features of each of the unidimensional models. The authors describe an approach to assessment based on the cognitive‐behavioral formulation. The approach described incorporates assessment of medical‐physical, psychosocial, and behavioral factors. The rationale for a comprehensive approach to treating chronic pain patients based on the cognitive‐behavioral perspective and the assessment protocol is discussed. The objectives of the cognitive‐behavioral treatment and specific cognitive and behavioral techniques are described in detail. In addition to covering specific techniques, important issues related to treatment are reviewed, including adherence/compliance, relapse, the “patient‐uniformity myth”, and treatment matching. The necessity of demonstrating the clinical effectiveness and cost‐effectiveness of treatment is described. Finally, the authors present data the potential of matching treatments to patients' psychosocial and behavioral characteristics and outcomes data confirming the effectiveness of integrating the cognitive‐behavioral approach within general rehabilitation of chronic pain patients is described.
Insomnia
Authors: Morin Charles M. , Savard Josée , Ouellet Marie‐Christine , Daley Meagan
Published: November 2003

There is extensive evidence showing that sleep and health are related. Among all of the sleep disorders, insomnia is the most prevalent and one of the most frequent health complaints brought to the attention of health‐care practitioners. A variety of environmental, psychosocial, and biological variables have been linked to insomnia complaints. Insomnia is also associated with significant consequences in health, quality of life, social and occupational functioning, economics, and public safety. The multidimensional nature of insomnia has thus led to the development of various evaluative and diagnostic tools as well as diverse pharmacological and psychological treatment options. This chapter offers an overview of insomnia, providing clues as to its etiology, impact, and clinical presentation and management. We begin with some basic facts about sleep, followed by a description of the nature, diagnosis, epidemiology, and risk factors associated with insomnia. The relationship between sleep and health, mental as well as physical, is then discussed, and a thorough description of assessment methods for the clinical management of insomnia is provided. Finally, we present a review of empirically validated psychological, pharmacological, and combined therapies for insomnia, and underline their benefits and limitations.
Chronic Fatigue Syndrome
Authors: Jason Leonard A. , Taylor Renee R.
Published: November 2003

This chapter explores chronic fatigue syndrome (CFS), an illness that is not easily explained, and the societal response to it. Within the chapter we provide the current case definition and discuss complexities involved in diagnosing CFS. We also cover recent research on sociodemographics and the epidemiology of CFS, which suggests that CFS affects individuals from a wide range of socioeconomic and ethnic backgrounds. The chapter also explores research on CFS subtypes, and illustrates how subtyping individuals with CFS can provide clarification for researchers and clinicians who encounter an otherwise confusing heterogeneity of symptom profiles that characterize this syndrome. In addition, we describe several etiological models of this syndrome and attempt to synthesize the findings according to a model of psychoneuroimmunology. The natural course and prognosis of CFS is also covered, as is evidence on empirically validated treatment approaches, including pharmacological and alternative treatments and nonpharmacological interventions. There are also sections on medical utilization, treatment attributions, and the social impact of this syndrome. The final sections of this chapter review research on stigma and CFS and make suggestions for future directions for research and intervention.
Spinal Cord Injury
Authors: Elliott Timothy R. , Rivera Patricia
Published: November 2003

Spinal cord injury is a high‐cost, low‐incidence neurological disability. This condition has a significant impact on the individual, the family, health care service delivery systems, and society in general. Medical advancements have improved the likelihood of survival following spinal cord injury, and estimated life spans for persons with this condition now approach life expectancies of other people. Unfortunately, the costs associated with ongoing care and assistance escalate as financial support for these services decline. In this chapter, we review the major aspects of spinal cord injury and current information about the condition and its concomitants. We will then provide a model of adjustment and present evidence concerning the major components of the model. We consider the alternative views of adjustment, assistance and service delivery espoused by health care programs, professionals, and by consumers and their families. We conclude with an overview of intervention strategies and issues in health and public policy that affect persons with SCI.
Child Health Psychology
Authors: Barakat Lamia P. , Kunin‐Batson Alicia , Kazak Anne E.
Published: November 2003

This chapter aims to integrate the literature in child health psychology—a broad, multifaceted, and multidisciplinary field that encompasses the well‐being of infants, children, adolescents, and young adults and includes an emphasis on health, illness and injuries. Four basic assumptions are presented: (1) Children's health and illness must be viewed contextually, (2) pediatric psychology provides an umbrella through which child health can be summarized and integrated, (3) competence and stress‐and‐coping paradigms define our understanding of child health, (4) outcome studies are important in establishing psychological interventions within child health. A model describing three levels of child and family response to health care issues and suggesting three levels of psychological intervention is proposed as a framework for understanding the state of research on interventions in child health psychology. The empirical literature on universal (disease preventions: immunizations and primary care settings, prevention of unintentional injuries), selective (management of procedure‐related and disease‐related pain and distress, improving treatment adherence), and targeted (cognitive rehabilitation for children with traumatic brain injuries, social skills training for survivors of brain tumors, and interventions in transplantation) is reviewed and evaluated. Future goals for research in child health psychology are discussed.
Adolescent Health
Authors: Phillips Sheridan
Published: November 2003

The health status of adolescents represents an interaction of physical and psychosocial development. This chapter focuses on those unique aspects of adolescence that have particular salience for teenagers' health and health care. These include the psychosocial effects of early and late pubertal maturation and special conditions associated with puberty (gynecomastia, amenorrhea, short and tall stature). Developmental issues (e.g., increased risk taking) are associated with morbidity and mortality. Of the 10 leading causes of death among adolescents and youth (age 12 to 24), four are behavioral in origin: unintentional injury/accidents, homicide, HIV, and suicide. These behaviorally based threats to health have eclipsed the previous causes of pediatric mortality and morbidity as medical advances eradicated many childhood diseases. Improvements in health care have not led to better health status for American teenagers. Adolescents are the only age group in the United States whose mortality rate has increased over the past 30 years. Recognition of this “new morbidity” has prompted increased attention to psychosocial aspects of health care, including the unique needs of the adolescent patient, strategies to promote compliance with medical regimens, broader prevention efforts, and focus on particularly salient areas of health: accidental injury, violence, substance misuse, and risky sexual behavior.
Adult Development and Aging
Authors: Siegler Ilene C. , Bosworth Hayden B. , Elias Merrill F.
Published: November 2003

This chapter will address the health psychology aging within the context of known diseases. Age has potential interactions with all of the important causal and mediating variables in health psychology and is a major risk factor for most chronic diseases. We start with an overview of important aging concepts and issues, including definitions of normal aging and the role of geriatric medicine and epidemiology to the study of the health psychology of aging. We then turn to the study of hypertension, as it is especially useful in illustrating the issues that aim to separate the effects of aging from the effects of disease on changes in cognitive functioning. We next turn to a review of methodological issues in the field with a particular emphasis on longitudinal studies and the special problems that age poses in traditional epidemiologic designs. We then summarize work in personality and social factors on disease with age with an emphasis on behavioral risk indicators for heart disease, social support, and self‐rated health. Finally, we point out some emerging areas in developmental health psychology with particular attention to genetics, stress, decision making, coping, adherence, and problems associated with cancers.
Women's Health Psychology
Authors: Geller Pamela A. , Graf Maria C. , Dyson‐Washington Faith
Published: November 2003

This chapter provides an introduction to women's health with attention to biological, psychological, and sociological aspects of women's lives. We suggest that further exploration of gender differences in symptom presentation, diagnosis, prognosis, risk factors, treatment effectiveness, and psychosocial factors for various disease entities is needed in order to enhance appropriate prevention and intervention strategies for women and their families. Specifically, we present overviews of the five leading causes of death among women (i.e., CHD, lung and breast cancer, stroke, COPD, and HIV/AIDS); the leading cause of injury to women (i.e., domestic violence); and chronic diseases common in women (i.e., arthritis, fibromyalgia, and osteoporosis). Mental health conditions prevalent among women, as well as information on the association between mental and physical health, are addressed, followed by a discussion of women in mental health treatment, health insurance, and relationships with healthcare providers. Stressful conditions related to pregnancy (i.e., miscarriage, infertility, postpartum reactions, and peripartum cardiomyopathy) are highlighted. Last, we discuss social and cultural influences on women's health focusing on the relationship between socioeconomic status, multiple roles, sex roles, and socialization as they relate to psychological and physiological illness. We conclude with the current status of women in health care and psychology and future directions in the field.
Cultural Aspects of Health Psychology
Authors: Whitfield Keith E. , Weidner Gerdi , Clark Rodney , Anderson Norman B.
Published: November 2003

The U.S. population consists of a broad array of economic and cultural diversity that correlates with and impacts the study of behavioral aspects of health. There are many challenges to providing accurate, detailed descriptions of behavioral aspects of health among people from diverse populations. There are, however, opportunities for significantly advancing science related to health from studying behavior among culturally and economically diverse populations. The purpose of this paper is to provide a broad selective overview of research that address mortality and morbidity, health status, and biological and behavioral risk factors among sociodemographically diverse populations, with a focus on ethnicity, gender, and socioeconomic status. We also provide suggestions for methodological refinement of research and insights into possible future directions in behavioral research on ethnically and economically diverse populations.
Occupational Health Psychology
Authors: Quick James Campbell , Tetrick Lois E. , Adkins Joyce , Klunder Charles
Published: November 2003

Occupational health psychology (OHP) integrates several psychology specialties applying them to organizational settings for the improvement of the quality of work life, the protection and safety of workers, and promotion of healthy work environments. Healthy work environments are ones where people feel good, achieve high performance, and have high levels of well‐being. OHP is founded on strong traditions both throughout Europe and the United States. The chapter has seven sections. Section 1 provides a brief historical overview of OHP. Section 2 reviews the ecological dimensions of OHP, which are the work environment, the individual, the work‐family interface, and goodness‐of‐fit among these dimensions. Section 3 presents a framework for preventive health management based on applying the public health concepts of primary, secondary, and tertiary interventions to occupational settings. Section 4 presents an organizational health center model using data‐based assessment, surveillance, and evaluation in the scientist‐practitioner model. Section 5 presents an OHP training model. Section 6 presents an organizational case study in which a Transition Life Advisor Program was designed to aid 13,000 employees through a transition while minimizing the adverse impacts of suicides and incidences of workplace violence. Nearly $33,000,000 in cost avoidance was realized.
Complementary and Alternative Therapies
Authors: Nezu Christine Maguth , Tsang Solam , Lombardo Elizabeth R. , Baron Kim P.
Published: November 2003

This chapter describes the major complementary and alternative medicine approaches which serve as either adjunct or alternative treatment to standard medicine practices. These approaches are often rooted in the philosophy that psychological or emotional experiences have a reciprocal relationship with physical experiences, with a growing body of research supporting this link. As such, complementary and alternative therapies, and the treatments described under the rubric of clinical health psychology, share many fundamental concepts and philosophies with regard to health prevention, promotion, and maintenance. This chapter provides an overview of complementary and alternative therapies within a psychological context. These include practices that have originated from western (e.g., Homeopathy, Osteopathy, Chiropractic) and eastern (e.g., Ayruveda, Traditional Chinese Medicine) cultures. Herbal remedies, lifestyle modifications, tactile therapies, movement therapies, and mind/body interventions are also included as important treatment components for promoting health across cultures.

The specific objectives of this chapter are to (a) familiarize the reader with these complementary and alternative approaches to healing, their clinical applications, and a brief summary of supporting research, (b) discuss and integrate the common themes of complementary and alternative approaches within a psychological context, and (c) suggest how psychological treatments may facilitate the benefits of complementary and alternative treatments for promoting health.
The Assessment Process
Authors: Weiner Irving B.
Published: November 2003

Assessment psychology is the field of behavioral science concerned with methods of identifying similarities and differences among people in their personal characteristics and capacities. Psychological assessment involves integrating information about people gleaned from test protocols, interview responses, behavioral observations, collateral reports, and historical documents. These assessment procedures are employed in diverse ways for the purpose of responding to a broad range of referral questions in such companion fields as clinical, educational, health, forensic, and industrial/organizational psychology. This chapter introduces a volume that elaborates the diversity of assessment procedures, the nature of the assessment questions that arise in various settings, and the types of assessment methods commonly employed to address these questions. Assessment is conceptualized in this introduction as a three‐stage process consisting of: (1) collecting assessment data of appropriate kinds and in sufficient amounts to address referral questions in meaningful and useful ways, (2) interpreting assessment data in a manner that provides accurate descriptions of respondents' psychological characteristics and behavioral tendencies, and (3) utilizing descriptions of respondents to formulate conclusions and recommendations that help to answer referral questions. The discussion identifies distinctive tasks and critical decision‐making issues associated with each phase of this process.
Clinical Judgment and Mechanical Prediction
Authors: Garb Howard N.
Published: November 2003

Computers can be used to make judgments and decisions. In this chapter, the strengths and limitations of mechanical prediction and clinical judgment are described. Judgments made by computers have generally been more accurate than judgments made by humans. However, only a few present‐day mechanical prediction rules have been shown to be powerful. Mechanical prediction rules will be briefly described, and reasons will be given for why it has been difficult to build ones that are powerful. With regard to clinical judgment, mental health professionals can make reliable and valid judgments if they are careful about the information they use and if they avoid common judgment errors. A large body of research illustrates that it can be difficult to learn from clinical experience. This is because psychologists sometimes use invalid information, their cognitive processes are fallible, and in clinical practice they are unlikely to receive accurate feedback on whether their judgments are right or wrong. Recommendations are made for improving the way that judgments and decisions are made. One recommendation is that psychologists place less emphasis on their clinical experiences and more emphasis on training that is based on scientific research.
Psychometric Characteristics of Assessment Procedures
Authors: Wasserman John D. , Bracken Bruce A.
Published: November 2003

In this chapter by Wasserman and Bracken, the most salient psychometric characteristics of psychological tests are described, incorporating elements from both classical test theory and item response theory. Guidelines are provided for the evaluation of test technical adequacy across a wide array of psychological tests in the areas of sampling, norming, scaling, validity, reliability, and fairness. Sampling, norming, and scaling guidelines address appropriate sample sizes, the accuracy and recency of norms, item and scale gradients, and floor and ceiling effects. Evidence of test score validity is described as occurring in two broad classes (internal and external), both of which ultimately are concerned with construct validity. Evidence of test score reliability includes the extent to which measurement results are precise and accurate; free from random and unexplained error; and consistent, accurate, and uniform across occasions, time, observers, and samples. Fairness is described as an important additional area of psychometric emphasis. A holistic and systemic approach to test score fairness is described, extending from test conception through applied consequences. Finally, the study of psychometrics is criticized for its historical over‐reliance on internal sources of evidence, and recommendations are made for an increased focus on external, applied sources of evidence of psychometric adequacy.
Bias in Psychological Assessment: An Empirical Review and Recommendations
Authors: Reynolds Cecil R. , Ramsay Michael C.
Published: November 2003

In this chapter, the authors present a multifaceted treatment of the persistent controversy over ethnic bias in ability tests. After introducing the controversy and the widely misunderstood concept of bias, we address objections to tests and testing raised by minority advocacy groups and explore the origins of such objections. We touch upon proposed sources of test bias, such as differential predictive validity and inequitable social consequences of testing. Next, we distinguish bias from similar concepts: unfairness, offensiveness, culture fairness, and culture loadedness. We also distinguish similar controversies, such as the etiology of putative ethnic differences. The crux of the test bias debate is intergroup score differences observed for over a century. Authors have proposed numerous explanations for these differences, primarily social inequalities, genetic potential, an interaction between the two, and test bias. Some authors have assumed a priori that any mean ethnic difference in ability scores must result from bias. We evaluate the merits of these approaches, particularly the latter, before reviewing the bias literature. Our review includes predictive, construct, and content bias and related issues such as situational bias. Results provide little evidence for substantial ethnic test bias. We conclude, in part, with recommendations for clinicians, researchers, and others.
Psychological Assessment in Treatment
Authors: Maruish Mark E.
Published: November 2003

Changes that have taken place in the delivery of behavioral healthcare during the past several years have led to changes in the way in which third‐party payers and even psychologists think about and/or use psychological assessment in day‐to‐day clinical practice. Some question the value of psychological assessment in the current time‐limited, capitated service delivery arena, while others argue that it is in just such an arena that the benefits of psychological assessment can be most fully realized and contribute significantly to the delivery of cost‐effective treatment for behavioral health disorders. Consequently, psychological assessment could assist the healthcare industry in appropriately controlling or reducing the utilization and cost of healthcare over the long term. The intent of this chapter is to provide an overview of how psychological assessment can facilitate treatment of mental health and substance abuse problems in this new era of healthcare. More specifically, its use as an aid for screening and diagnosing behavioral health disorders and problems, planning and monitoring the course of treatment, assessing the outcomes of treatment, and even as a therapeutic intervention are discussed. Predictions about future trends in the development and use of psychological test instrumentation and related technology are also presented.
Computerized Psychological Assessment
Authors: Butcher James N.
Published: November 2003

Computer‐based psychological assessment has come far since it began to evolve over 40 years ago. Many practitioners use some computer scoring and computer‐based interpretation and consider computer‐assisted test interpretation to be an ethical professional activity. The application of computerized methods has broadened both in scope and in depth. However, the merger of computer technology and psychological test interpretation has not been a perfect relationship. Past efforts at computerized assessment have not gone far enough in making optimal use of the flexibility and power of computers for making complex decisions. Computerized applications are limited, to some extent, by available psychological expertise and psychotechnology. To date, computer‐human interactions are confined to written material and do not take into account potentially valuable information such as critical nonverbal cues (e.g., speech patterns, vocal tone, and facial expressions). Research has supported the view that computer‐administered tests are essentially equivalent to booklet‐administered instruments. Research thus far appears to point to the conclusion that computer‐generated reports should be viewed as valuable adjuncts to clinical judgment, rather than as substitutes for skilled clinicians. In spite of some limitations and unfulfilled hopes, computer‐based psychological assessment is an enormously successful endeavor.
Ethical Issues in Psychological Assessment
Authors: Koocher Gerald P. , Rey‐Casserly Celiane M.
Published: November 2003

Psychologists who conduct assessments face many ethical challenges in conducting their work. Assessment is unique among the services offered by professional psychologists because it is service seldom performed solely at the behest of a single individual. More typically, people who arrive at the psychologist's office for assessment have been sent by concerned parents or school teachers, potential employers, disability insurance companies, attorneys, or other professionals. The referring parties are invariably seeking answers to questions that may or may not be found in the analysis of psychometric data. The people being tested may benefit or suffer as a consequence of the assessment, no matter how competently it is carried out. Ethical issues arise before assessments are undertaken, during the testing process or collection of data, and after the information collected is scored, interpreted, and translated into a report. This chapter explores the ethical problems inherent in the sequence of steps involved in psychological assessment (i.e., before, during, and following the actual contact with the person being assessed). In addition, because the chapter was completed during a period of flux in the evolution of the American Psychological Association's (APA) Ethical Standards of Psychologists and Code of Conduct, proposed changes in the professional standards and the reasoning behind them are discussed.
Education and Training in Psychological Assessment
Authors: Handler Leonard , Clemence Amanda Jill
Published: November 2003

This chapter concerns key issues in teaching and learning personality assessment, including a discussion of: (1) the difference between “testing” and “assessment”, (2) reasons for teaching and learning assessment, (3) methods of helping students to develop critical thinking skills in the interpretation and integration of data, (4) material on teaching students how to select appropriate assessment batteries, and (5) methods to help students overcome their natural resistance to the application of their assessment knowledge, lest they make errors and injure the patient/client. The chapter focuses on the experience of the student as he or she learns the material and on methods to make assessment more meaningful to the student and the patient/client. It also deals with ethical and political issues in teaching assessment, the influence of cultural diversity on assessment data, and assessment on internship. Several controversies are discussed, such as the preference for self‐report measures or projective measures and whether the academic programs or internship faculty should be primarily responsible for teaching assessment. The chapter concludes with a discussion of new and innovative issues in teaching personality assessment, use of computers and the Internet, therapeutic assessment, assessment of healthy aspects of personality, development of focused personality measures, and an expanded concept of intelligence to include personality variables.
Psychological Assessment in Adult Mental Health Settings
Authors: Bagby R. Michael , Wild Nicole , Turner Andrea
Published: November 2003

The goal of this chapter is to provide a general outline for the psychological assessment of adult psychiatric inpatients and outpatients. We regard psychological assessment as a problem‐solving process in which psychological tests, structured diagnostic interviewing, and unstructured clinical interviewing are employed to answer specific referral requests. The fundamental premises of the approach recommended in this chapter is that psychological assessments must be evidenced based and multimodal. Consistent with this approach, psychological assessment should evaluate a client's psychiatric symptoms in relation to the diagnostic criteria according to the most recent version of theDiagnostic and Statistical Manual for Mental Disordersand use objective tests supplemented with structured interviews that have proven reliability and validity. Examples of such tests and interview techniques that meet these standards are discussed as are various practical issues, including selecting the appropriate tests, addressing referral questions, and the requisite skills required to conduct psychological assessments.