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Author: Grafiati

Published: 4 June 2021

Last updated: 20 February 2023

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1

Khouzam, Hani Raoul. Psychiatry and Chronic Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199981830.003.0007.

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This chapter reviews some of the connections between psychiatry and chronic pain, highlighting the role that psychiatrists can play in diagnosing and treating chronic pain. Identifying and addressing the various psychiatric components of chronic pain can significantly contribute to successful rehabilitation, recovery, and improved overall functioning.Psychiatric models (gate control, diathesis/stress, biopsychosocial–spiritual approaches, cognitive-behavioral transactional and cognitive-behavioral fear avoidance) are described to provide a theoretical basis for understanding the development and the clinical management of chronic pain.This chapter also describes how psychiatrists can collaborate with primary care providers in managing chronic pain within the framework of multidisciplinary treatment teams.It is important for healthcare professionals, regulators, law enforcement personnel, and legislators to identify the connection between psychiatry and chronic pain in the context of its diagnosis, management, and treatment.

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2

McCarron, Robert M., Amir Ramezani, Ian Koebner, Samir J. Sheth, and Jessica Palka. Integrated Chronic Pain and Psychiatric Management. Edited by Robert E. Feinstein, Joseph V. Connelly, and Marilyn S. Feinstein. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.003.0023.

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Both physical pain and psychiatric disorders are widely prevalent, and collectively they account for the most frequently presenting complaints in the primary care setting. These conditions are a complex challenge for both the patient and provider, with frequent high use of medical services and increased morbidity. The Integrated Behavioral Pain Medicine (IBPM) treatment model incorporates a multidisciplinary, biopsychosocial, team-based approach for patients who have chronic and largely treatment-refractory pain. IBPM uses an integrated care team of providers and coordinators, who collectively work with the chronic pain patient to individualize a pain management plan, which may include pharmacologic management, cognitive-behavioral therapy, trauma-focused therapy, biofeedback, mindfulness, acupuncture, nutrition, behavioral weight and sleep management, and physical therapy. Ideally, primary care providers will refer patients to an IBPM model of care, but if the treatment model is not available in a specific area, a piecemeal approach with partial use of services is recommended.

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3

Choinière, Manon, and M. Gabriella Pagé. Three determinants of pain. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0008.

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Building on the foundations laid by the gate control theory, Melzack and Casey theorized in 1968 the existence of three separate, yet related determinants of pain: sensory–discriminative, affective–motivational, and cognitive–evaluative. These determinants have roots in separate neurophysiological pathways that modulate the pain experience. The importance of this paper lies in its theoretical contribution to our understanding of pain. Melzack and Casey’s seminal paper, written almost 50 years ago, is not only still contemporary, as evidenced by the internationally agreed upon definition of chronic pain (the IASP taxonomy) but has also contributed to moving from a biomedical understanding of pain to a biopsychosocial model of evaluating and treating pain. This conceptualization of pain continues to influence the way pain is evaluated and is the foundation of the use of non-pharmacological and non-interventional modalities for the treatment of pain (e.g. psychological techniques), and multidisciplinary approaches to pain treatment.

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4

Lal, Mira, and Johannes Bitzer. Disease severity, pain, and patient perception: themes in clinical practice and research. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749547.003.0006.

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Chapter 6 begins with a discussion of how to assess disease severity. It then moves on to the concepts of physical and emotional pain, which are particularly useful for understanding pelvic floor problems, infertility, pregnancy loss, and chronic pelvic pain. All of these have biological, psychological, and social features associated with their aetiopathogenesis, and presentations. To manage these conditions effectively, it is crucial to understand the patient's perception. First, pelvic/perineal dysfunction is addressed. This includes the loss of urinary and bowel continence, with deleterious effects on biopsychosocial health. The condition is common, and can cause severe morbidity following any delivery mode, including a planned caesarean. This is illustrated by an evaluation of biopsychosocial morbidity, quantified by categorising patient perceptions of severity of incontinence, and related sexual problems. The psychosomatic repercussions of infertility, miscarriage, stillbirth, and chronic pelvic pain are then appraised. Since physical and emotional pain can affect these conditions, timely recognition and biopsychosocial management helps promote positive physical, mental and social health. A special focus is given to endometrial implants outside the uterine cavity (endometriosis). These can cause chronic pelvic pain, infertility, and pregnancy loss, but may be symptomless. Their aetiology remains unclear. Ovulation suppression relieves pain and treatment is tentative, with removal of the affected pelvic organs being an extreme option. Even after this, however, symptoms may persist. A pathway using the tailored psychosomatic approach is advocated to provide patient-centred care where indicated.

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5

Pridmore, Saxby. Managing Chronic Pain: A Biopsychosocial Approach. Taylor & Francis Group, 2002.

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6

Pridmore, Saxby. Managing Chronic Pain: A biopsychosocial approach. Informa Healthcare, 2002.

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7

Andrew, Block, Kremer Edwin F, and Fernandez Ephrem, eds. Handbook of pain syndromes: Biopsychosocial perspectives. Mahwah, N.J: Lawrence Erlbaum Associates, 1999.

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8

Fernandez, Ephrem, Andrew R. Block, and Edwin Kremer. Handbook of Pain Syndromes: Biopsychosocial Perspectives. Taylor & Francis Group, 2014.

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9

(Editor), Andrew R. Block, Ephrem Fernandez (Editor), and Edwin Kremer (Editor), eds. Handbook of Pain Syndromes: Biopsychosocial Perspectives. Lawrence Erlbaum, 1998.

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10

Fernandez, Ephrem, Andrew R. Block, and Edwin Kremer. Handbook of Pain Syndromes: Biopsychosocial Perspectives. Taylor & Francis Group, 2013.

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11

Fernandez, Ephrem, Andrew R. Block, and Edwin Kremer. Handbook of Pain Syndromes: Biopsychosocial Perspectives. Taylor & Francis Group, 2013.

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12

Fernandez, Ephrem, Andrew R. Block, and Edwin Kremer. Handbook of Pain Syndromes: Biopsychosocial Perspectives. Taylor & Francis Group, 2013.

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13

Fernandez, Ephrem, Andrew R. Block, and Edwin Kremer. Handbook of Pain Syndromes: Biopsychosocial Perspectives. Taylor & Francis Group, 2013.

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14

R, Roy, ed. Chronic pain in old age: An integrated biopsychosocial perspective. Toronto: University of Toronto Press, 1995.

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15

Roy, Ranjan. Chronic Pain in Old Age: An Integrated Biopsychosocial Perspective. University of Toronto Press, 2019.

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16

Roy, Ranjan. Chronic Pain in Old Age: An Integrated Biopsychosocial Perspective. University of Toronto Press, 1995.

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17

Chronic Pain in Old Age: An Integrated Biopsychosocial Perspective. University of Toronto Press, 1995.

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18

Cheatle, Martin D., and Lara Dhingra. Biopsychosocial Approach to Improving Treatment Adherence in Chronic Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.003.0006.

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Up to 53% of patients with chronic nonmalignant pain demonstrate medication nonadherence, and many are nonadherent with behavior-change interventions for pain, presenting a significant challenge to providers managing this population and compromising patient-reported outcomes related to treatment efficacy, symptom control, and quality of life. Patients with chronic pain are often highly complex and present with numerous medical and psychological comorbidities. Many of these comorbidities, including mood, sleep, and substance use disorders, in addition to maladaptive coping with pain and varied clinician, health system, and family-related factors, can influence adherence to pain interventions. This chapter applies a biopsychosocial framework to guide the clinical assessment of nonadherence behaviors in chronic pain, including the identification of risk factors, mechanisms, and underlying processes of nonadherence, and presents strategies providers can potentially implement to enhance patient adherence to pharmacologic and behavioral therapies for pain management.

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19

Lazar, Alina. Chronic Abdominal Pain in Children. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0019.

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Abdominal pain in the pediatric population is mostly functional. Patients with chronic abdominal pain (typically young females) have a high risk of anxiety, depression, and dysfunctional coping, which are also risk factors for postoperative pain and persistent postsurgical pain. In these patients, peripheral and central sensitization contribute to possible visceral hyperalgesia. When patients with chronic abdominal pain and visceral hyperalgesia undergo surgical procedures, perioperative pain can be difficult to treat. To manage the chronic pain of such patients, their complex biopsychosocial make-up should be considered. A comprehensive plan includes preventive and aggressive multimodal analgesia, adequate patient and parent education, realistic expectations, cognitive-behavioral therapy, and distraction and relaxation techniques.

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20

Moore, Rhonda J. Handbook of Pain and Palliative Care: Biopsychosocial and Environmental Approaches for the Life Course. Springer, 2019.

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21

Brown, Matthew. The chronic constriction injury model of neuropathic pain. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0067.

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The landmark paper discussed in this chapter is ‘A peripheral mononeuropathy in rat that produces disorders of pain sensation like those seen in man’, published by Bennett and Xie in 1988. This paper, in which the unilateral sciatic nerve chronic constriction injury (CCI) model was first presented, is one of the earliest and most comprehensive descriptions of a specific animal paradigm that was designed to model human neuropathic pain. The authors realized that human neuropathic pain rarely involves nerve transection but instead involves evoked changes in damaged and preserved nerve fibres. Furthermore, they systematically applied a barrage of sensory testing that demonstrated quantifiable hyperalgesia and cold allodynia reflecting some of the clinical observations of human neuropathic pain phenotype. CCI provided a high-quality template for the development of neuropathic pain models that impelled the subsequent development of other animal models striving to replicate the human condition faithfully and accurately.

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22

Jane, M.D. Derebery (Editor) and John R. Anderson (Editor), eds. Low Back Pain: An Evidence-Based, Biopsychosocial Model for Clinical Management. OEM Press, 2001.

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23

Jane, Derebery, and Anderson John R. DO, eds. Low back pain: An evidence-based, biopsychosocial model for clinical management. 2nd ed. Beverly Farms, MA: OEM Press, 2008.

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24

Low back pain: An evidence-based, biopsychosocial model for clinical management. 2nd ed. Beverly Farms, MA: OEM Press, 2008.

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25

Jane, Derebery, and Anderson John R. DO, eds. Low back pain: An evidence-based, biopsychosocial model for clinical management. Beverly Farms, MA: OEM Press, 2002.

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26

Jain, Rakesh, and Shailesh Jain. Disability in chronic low back pain. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0076.

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The landmark paper discussed in this chapter, ‘Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability’, published by Crombez et al. in 1999, investigates the issue of disability in chronic low back pain and explores the role of psychological factors in disability. The paper reports on three independent chronic low back pain studies in which behavioural performance and the degree of reported disability were correlated with psychological factors such as catastrophization, negative affect, anxiety, and pain-related fear (e.g. fear of re-injury). In a counterintuitive finding, pain-related fear was more disabling that the pain itself. This paper thus highlighted the need to assess and address the psychological domains of pain; it also validated three questionnaires that are important in the pain field, and established a biopsychosocial approach to understanding, explaining, and treating chronic low back pain.

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27

McAnally, Heath B., Lynda Welton Freeman, and Beth Darnall. Preoperative Optimization of the Chronic Pain Patient. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190920142.001.0001.

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Elective surgery on poorly prepared patients suffering with chronic pain and comorbid substance dependence is increasingly shown to confer suboptimal outcomes—both clinical and economic. Achieving biopsychosocial “fitness for surgery” for these patients often requires a process similar to preoperative optimization of cardiac and other chronic diseases, with modification/elimination of risk factors (in many cases shared with those diseases). These risk factors are not so much genetic or uncontrollable, but rather behavioral, and comprise toxic thoughts and toxic habits. The preoperative optimization program for chronic pain patients presented in this book focuses on high-yield modifiable targets that are supported by the literature and the authors’ clinical experience. These comprise tobacco cessation, preoperative opioid reduction or elimination, slow-wave sleep enhancement, nutritional and exercise “prehabilitation,” and reduction of anxiety and pain catastrophization.

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28

Peppin, John F., Pravardhan Birthi, Bill H. McCarberg, and Yvonne D’Arcy. Evaluation and Treatment of the Chronic Pain Patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199981830.003.0005.

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This chapter provides an overview of how, in an ideal world, a pain clinician would evaluate and treat a patient with chronic pain. Pain clinicians will adhere to some or perhaps all of these recommendations, but we are not suggesting that nonadherence yields poor medical practice, illegal practice, or a regulatory issue. This chapter discusses issues related to the evaluation of the chronic pain patient who is being considered for or is currently receiving opioids as a treatment modality. No one treatment, whether pharmacologic, physical, psychological, or interventional, is the answer to the treatment of chronic pain. Chronic pain is a very complex syndrome that requires a coordinated biopsychosocial multidisciplinary approach if there is to be any hope of success. One simple approach, such as opioids or injections, will rarely alleviate chronic pain.

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29

Landis, Carol A. DISTURBED SLEEP PATTERNS IN A RAT MODEL OF CHRONIC PAIN. 1988.

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30

Karoly, Paul. Chronic Pain and Psychopathology. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190627898.003.0010.

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This chapter presents a motivational model designed to forge conceptual and empirical links among chronic pain perception, cognitive-affective pain processing, everyday task performance, and the emergence of psychopathology. Organized around the GRASSP perspective (introduced in chapter 1), the current chapter first addresses the nature of multi-leveled (top-down and bottom-up) regulatory/control systems and the hypothesized motivational mechanisms around which such systems are organized. Based on the twin premises that (a) dysfunctions of the goal-guided, self-regulatory system underlie most forms of psychopathology, and (b) chronic pain can disrupt goal- and self-regulatory system functioning, the chapter seeks to locate chronic pain and two prominent forms of psychological disturbance—depression and anxiety—within a broad, heuristic “motivational context.” Among the key explanatory building blocks of the hypothesized model are goal episodes, extended goal striving processes, and four moderation pathways hypothesized to connect pain-related disruptions of self-regulation to the eventual emergence of depression and/or anxiety.

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31

Harrison, Anthony M., Christopher Graham, and Lance M. McCracken. Treatment Adherence in Chronic Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.003.0002.

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It is widely accepted that treatment adherence is a complex problem, and rates of nonadherence in chronic pain are around 50% or more. Nonadherence is important, not only because it may decrease treatment effectiveness but because it is dangerous and a potential confound in assessing treatment effectiveness, both in research and clinical service, and it is wasteful. Unfortunately, available interventions to promote better adherence appear limited. This chapter introduces the current models of adherence in the context of chronic pain and selectively summarizes related evidence. It also introduces the Psychological Flexibility Model, a newer organizing framework underpinning Acceptance and Commitment Therapy (ACT), and examines the potential applicability of ACT in this challenging context.

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32

Smith, George Davey. The biopsychosocial approach. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780198530343.003.0005.

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This chapter provides a critique of whether the biopsychosocial model is useful in understanding aetiological factors in chronic diseases. It illustrates the arguments by referring to studies on peptic ulcer and ischaemic heart diseases, and shows that bias and confounding can generate spurious findings and associations, especially in observational studies.

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33

Karoly, Paul. A Goal-Centered, Self-Regulatory Model of Motivation and Its Relevance for Advancing the Study of Chronic Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190627898.003.0001.

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This chapter presents an account of goal constructs and of self-regulatory processes as critical mediators and/or moderators of chronic pain’s effects on diverse aspects of human performance and adjustment. The joint influence of goal cognition and the assorted mechanisms of self-regulation provides a unique platform for adaptive failure or vulnerability when operating at low levels of effectiveness and efficiency, and for adaptive resilience when functioning at its peak. Organized around a motivational model dubbed the Goal-Centered, Self-Regulatory, Automated, Social Systems Psychology (GRASSP) perspective, the chapter considers the nature, functioning, and measurement of goals and a variety of potentially supportive regulatory mechanisms. Illustrating the explanatory and heuristic potency of a motivational framework, the chapter addresses both the deleterious effects of persistent pain on goal-related thinking and striving and the facilitative role of effective goal-based self-regulation in maintaining day-to-day performance and well-being in the face of chronic pain.

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34

Thakur, Anand C. Barriers to Optimal Pain Management in the General Surgery Population. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0003.

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Barriers to the implementation of adequate pain control are multifactorial and encompass all caregivers. A complete list of barriers to adequate pain control would involve biopsychosocial factors, physiological factors, pharmacological concerns, and medical legal concerns. A short list of barriers to adequate pain control can be separated into physician knowledge, expectations and perceptions, nurses’ and other ancillary providers’ knowledge, expectations and perceptions, patient expectations and perception, management of acute pain, management of chronic pain, discrepancies of pain perception and different population groups, and both regulatory and formulary issues. To have an understanding of up-to-date recommendations and standards regarding evidence-based pain management requires a multimodal approach with a team of physicians.

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35

Schult, Marie-Louise. Multidimensional Assessment of People With Chronic Pain: A Critical Appraisal of the Person, Environment, Occupation Model (Uppsala Dissertations from the Faculty of Medicine, 6). Uppsala Universitet, 2002.

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36

Lorig, Kate. What are the barriers to healthcare systems using a biopsychosocial approach and how might they be overcome? Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780198530343.003.0012.

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This chapter describes an expert patient-led psychological and behavioural programme aimed at improving health status for those with chronic conditions. It presents its structure, model, outcomes, and the barriers to healthcare systems using a biopsychosocial approach that must be overcome to achieve dissemination.

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37

Wood, John N., ed. The Oxford Handbook of the Neurobiology of Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190860509.001.0001.

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The Oxford Handbook of the Neurobiology of Pain represents a state of the art overview of the rapidly developing field of pain research. As populations age, the number of people in pain is growing dramatically, with half the population living with pain. The opioid crisis has highlighted this problem. The present volume is thus very timely, providing expert overviews of many complex topics in pain research that are likely to be of interest not just to pain researchers, but also to pain clinicians who are seeking new therapeutic opportunities to develop analgesics. Many of the topics covered are of interest to neuroscientists, as pain is one of the most amenable sensations for mechanistic dissection. The present volume covers all aspects of the topic, from a history of pain through invertebrate model systems to the human genetics of pain and functional imaging. Chapters include the role of ion channels, the opioid system, the immune and sympathetic systems, as well as the mechanisms that transform acute to chronic pain. Migraine and the interplay between sleep and pain are also discussed. New technology in the form of transgenic animals, chemogenetics, optogenetics, and proteomic analyses are providing significant advances in our research and are covered as well. Demystifying pain through an understanding of its fundamental biology, as outlined in this volume, is the most direct route to ameliorating this vast human problem.

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38

Gourlay, Douglas L., and Howard A. Heit. The Use of Drug Testing in Promoting Treatment Adherence in Pain Medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.003.0004.

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Drug testing has become an important component of a comprehensive risk assessment and mitigation program when prescribing controlled substances to patients with chronic pain. State and federal opioid prescribing guidelines strongly recommend the use of drug testing, although there is lack of evidence in the literature supporting the efficacy of drug testing in reducing prescription opioid abuse. Drug testing can be useful in facilitating adherence to prescribed medications. This chapter provides an overview of the strengths and weaknesses of drug testing in pain medicine, insights into laboratory and test selection, test interpretation, and communicating results to patients within a patient-centered model.

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39

McCracken, Lance M., and Whitney Scott. Motivation from the Perspective of Contextual Cognitive Behavioral Approaches and the Psychological Flexibility Model. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190627898.003.0014.

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In everyday uses, the term motivation may imply a kind of mechanistic, “inside” the person, type of process. Contextual approaches, on the other hand, adopt an evolutionary perspective on motivation that emphasizes the selection of behavior patterns through the joint actions of historical consequences and verbal or cognitive processes, themselves considered the product of the same contextual processes of selection by consequences. The contextual focus on building, maintaining, and elaborating behavior patterns from directly manipulable contextual features enables a focus on variables that are able to serve the purpose of prediction and influence over behavior. Current studies of these processes apply the psychological flexibility model, including its processes of values-based and committed action. Laboratory studies of these processes demonstrate their potential importance in healthy functioning in relation to chronic pain. Treatment studies, including studies of Acceptance and Commitment Therapy (ACT), also demonstrate that enhancing these motivation-related processes has clinical utility.

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40

Hans, Steiner, Daniels Whitney, Kelly Michael, and Stadler Christina. Comprehensive and Integrated Treatment of Disruptive Behavior Disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190265458.003.0005.

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This chapter maps evidence-based interventions on the biopsychosocial model of causation suggested by the current evidence. Medications and biological treatments are still second-line interventions, which should be considered only if there is insufficient progress with psychological and social-familial treatments. There is very little progress in the past decade in testing medication interventions. New findings from neuroscience suggest another subtype of disruptive behavior disorders (DBDs), which holds considerable promise to improve outcomes in this treatment category. Psychological treatments are best supported by the evidence, especially when delivered in manualized form with a high degree of treatment fidelity. Familial and community-based interventions are also well supported, especially in complex, severe and chronic cases. There is a dearth of intervention studies targeting the different phenotypes of antisocial and aggressive behavior and studies of integrated treatment However, many studies are now available that approach treatment from a medical evidence–based rather than criminological perspective.

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41

Janke, E. Amy, and David E. Goodrich. Adherence to Weight Loss and Physical Activity. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.003.0005.

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Maintaining a healthy weight and engaging in regular physical activity are two health behaviors that can provide significant benefit to individuals with chronic pain. However, adhering to lifestyle programs that promote weight loss and/or physical activity can be challenging. A socioecological model of adherence to healthy lifestyle behaviors in individuals with pain can assist providers in understanding the physiological, intrapersonal/behavioral, and social/environmental factors that influence adherence. Providers can optimize adherence to weight loss by facilitating an effective patient–provider relationship, tailoring intervention approaches to meet a patient’s specific needs, and applying the Five A’s model of behavior change. Providers can support long-term engagement in physical activity by developing patient-centered exercise prescriptions based on an assessment of physical limitations, comorbidities, and age and to engage in shared decision-making to best account for patient preferences and barriers to exercise.

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42

Zabrecky, George. The Role of Chiropractic in Mind–Body Health. Edited by Anthony J. Bazzan and Daniel A. Monti. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190690557.003.0009.

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The chiropractic approach is based on the principles that diseases, both psychiatric and medical, are caused by disturbances in the nervous system and that such disturbances are often related to musculoskeletal problems. Thus chiropractic therapies utilize an integrative approach to health and well-being that includes various spinal manipulations as well as an integrative approach to the patient. Chiropractic therapies are most well known for the management of chronic and acute pain, which frequently can be accompanied by anxiety and depression symptoms. There is little direct evidence that chiropractic care improves mental health outside of the benefits related to pain alleviation. However, based on the overall chiropractic model, chiropractic therapy can potentially benefit a wide variety of psychological symptoms, but more research is needed. This chapter reviews the principles of chiropractic care, particularly in the context of psychiatric conditions, and provides information for future clinical and research programs.

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43

O'Donohue, William, and Scott O. Lilienfeld, eds. Case Studies in Clinical Psychological Science. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199733668.001.0001.

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Case Studies in Clinical Psychological Science demonstrates in detail how the clinical science model can be applied to actual cases. It presents dialogues between leading clinical researchers regarding the treatment of a wide variety of psychological problems, from depression and Alzheimer's disease to Panic Disorder and chronic pain. Chapters describe what evidence-based practice consists of for various clinical problems and are followed by commentary sections in which other leading clinical researchers analyze the case at hand, pointing out additional assessment and treatment options and controversial issues. It examines the application of scientifically based interventions to actual cases and models thoughtful and collegial discussion among prominent clinical researchers

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44

Sullivan, Mark D. Health as the Capacity for Action. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780195386585.003.0006.

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Objective definitions of health and disease are favored because they promise a value-free measure of health problems and health care needs. But objective health does not simply cause the subjective experience of health. Self-rated health predicts mortality, disability, and hospitalizations for up to a decade after controlling for objective measures of health. Objective tissue abnormalities cannot be discovered to be pathological without reference to the experiences of patients acting in their natural environment. Patients adapt to chronic illness and its functional deficits over time with real improvements in their quality of life. Problems like pain and depression do not distort quality of life assessments, but are at their core. Since neither objective nor subjective models of health are valid, we must derive a different model: health as capacity for action. Any adequate approach to health must foster the patient’s sense of agency, her capacity to achieve her vital goals.

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45

Feinstein, Robert, Joseph Connelly, and Marilyn Feinstein, eds. Integrating Behavioral Health and Primary Care. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.001.0001.

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This book describes real-world examples and practical approaches for integrating behavioral and physical health services in primary care and some specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists who are working in ambulatory/office-based practices. We examine the integrated care literature and recommend applying collaborative care and other existing models of integrated care based on the existing evidence-based research. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems. We assume the use of a fully integrated team staffing model while also recognizing this an ideal that may need modification based on local resources and practice cultures. The full integrated team includes a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s). The book has four sections: Part 1: Models of Integrated Care provides an overview of the principles and the framework of integrated care focusing on five highly successful integrated practices. We also discuss team-based care, financing, tele-behavioral health, and use of mental health assessments and outcome measures. Part 2: Integrative Care for Psychiatry and Primary Care is a review of existing and proposed models of integrated care for common psychiatric disorders. Our continuity approach emphasizes problem identification, differential diagnosis, brief treatment, and yearlong critical pathways with tables and figures detailing “how to” effectively deliver mental health care and manage substance misuse in an integrated care environment. Part 3: Integrated Care for Medical Sub-Specialties & Behavioral Medicine Conditions in Primary Care focuses on two models of integrating behavioral health care: (1) integrating wellness with behavioral health and (2) integrating psychiatry and neurology. Other chapters are “Women’s Mental Health Across the Reproductive Lifespan,” “Assessing and Treating Sexual Problems in an Integrated Care Environment,” “Integrated Chronic Pain and Psychiatric Management,” and “Death and Dying: Integrated Teams.” Part 4: Psychosocial Treatments in Integrated Care describes brief office-based counseling and psychosocial treatment approaches including: health coaching, crisis intervention, family, and group interventions. All of these brief treatment approaches are patient–centered, tailored to be used effectively integrated care settings and as an important contribution to population management.

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