This paper suggests that some neuroscience concepts particularly concerned with brain pathways in trauma and fear, as well as the neurobiology of emotion, provide an additional vertex to the psychoanalytic understanding of patients' material. The role of the body has been neglected in psychoanalytic thought and formulations in favour of purely…

Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…

This study examined changes in the diagnostic patterns among children and adolescents treated for mental health problems between the years 1995 and 2000. Using a large database (MarketScan[R]) which compiles claims information from private health insurance plans nationwide, our sample consisted of 100,716 children (under the age of 18) who…

To estimate the variability in outcomes attributable to therapists in clinical practice, the authors analyzed the outcomes of 6,146 patients seen by approximately 581 therapists in the context of managed care. For this analysis, the authors used multilevel statistical procedures, in which therapists were treated as a random factor. When the…

This article describes the early experience of an Information Officer appointed within a newly formed primary health care team in the new township of Cambourne, west of Cambridge. The post was jointly defined and funded through a partnership between Cambridgeshire Libraries, the Primary Care Trust and Monkfield Medical Practice. The article…

The objective of this study was to compare enhanced access to geriatric assessment and case management to usual home care service provision for the frail elderly. This was a demonstration project, with randomized allocation to control or intervention groups of frail elderly persons who had been referred to the Home Care service in Winnipeg. Of the…

To care for the whole person, nurses must provide spiritual care (Narayanasamy, 1995; Wright, 1998). The inability to consistently and effectively provide spiritual care has been linked to the lack of educational preparation in our basic nursing programs (Govier, 2000; Piles, 1990). This lack of preparation is unacceptable because patients…

Objective: To describe our experience of learning clinical psychopharmacology during residency, in order to assist educators planning psychopharmacology curricula. Methods: We describe how psychopharmacology teaching was structured in our program, dividing our experience into two phases, early residency (PGY-I and PGY-II) and late residency…

Objective: Alcohol and drug dependence disorders have become common public health hazards. Psychiatrists encounter these problems in a major portion of their patients. However, recent data suggest that their training does not provide them the confidence to treat these disorders. Current methods of evaluating residents fail to adequately ascertain…

Patients who had taken part in a randomized clinical trial of the treatment of chronic PTSD by either cognitive therapy or imaginal exposure were reassessed after 5 years. At 5-year follow-up a clear superiority of cognitive therapy over imaginal exposure emerged, although there had been no difference between the two treatment groups up to 12…

Although suicidal behavior is a serious public health problem, few effective treatments exist to treat this population. This article describes a new cognitive therapy intervention that has been developed for treating recent suicide attempters. The intervention is based on general principles of cognitive therapy and targets the automatic thoughts…

Individual cognitive behavioral therapies (CBT) are now considered the first-line treatment for posttraumatic stress disorder (PTSD; Foa, Keane, & Friedman, 2000). As mental health reimbursement becomes more restricted, it is imperative that we adapt individual-format therapies for use in a small group format. Group therapies have a number of…

Much of the psychosocial morbidity experienced by cancer patients goes undetected and therefore untreated. This paper describes infrastructure to routinely screen patients for psychosocial problems and provide targeted intervention in the cancer care setting. Cancer patients will complete a psychosocial screening survey via touchscreen computer at…

In health care education a balance needs to be struck between theoretical and practical teaching. Undergraduates typically split their time between clinical placement and university-based teaching blocks. A proportion of the time spent in preparation for clinical practice placements will be spent in the classroom or in simulation suites. The…

Although multivariate generalizability theory was developed more than 30 years ago, little published research utilizing this framework exists and most of what does exist examines tests built from tables of specifications. In this context, it is assumed that the universe scores from levels of the fixed multivariate facet will be correlated, but the…