Barry A. Edelstein – författare

This book developed out of the editors' longstanding interest in the retraining of traumatically brain-damaged adults and the management of their behavior by family members. A search for relevant experimental evidence to support the clinical use of behavioral principles for retrain­ ing, which began in 1977, turned up little empirical support. Moreover, the literature on retraining was dispersed among a variety of journals published in various countries. Nowhere was there a compendium of literature that addressed issues of assessment and retraining. There was no place to turn if one wanted to move from a standard neuropsy­ chological evaluation to the retraining of skill deficits revealed in the evaluation. We have attempted to edit a book that represents what we had hoped to find in the literature and could be used by professionals in clinical psychology, clinical neuropsychology, rehabilitation medicine, physical therapy, speech therapy, and other disciplines that address rehabilitation of brain-damaged adults-a book that addresses assess­ ment and rehabilitation issues and is sufficiently detailed to offer the reader a starting point in developing behavioral assessment and re­ habilitation programs. The book contains conceptual foundations, re­ views of research, descriptions of successful rehabilitation programs, and relatively detailed approaches to the retraining of specific skills. A shift from an assessment-based practice to one encompassing both prescriptive assessment and treatment has become a recognized transition in the neuropsychological literature and was best articulated in an article by Gerald Goldstein in March of 1979.

During the past several decades, the field of mental health care has expanded greatly. This expansion has been based on greater recognition of the prevalence and treatability of mental disorders, as well as the availability of a variety of forms of effective treatment. Indeed, throughout this period, our field has witnessed the introduction and the wide­ spread application of specific pharmacological treatments, as well as the development, refinement, and more broadly based availability of behavioral, psychodynamic, and marital and family interventions. The community mental health center system has come into being, and increasing numbers of mental health practitioners from the fields of psychiatry, psychology, social work, nursing, and related professional disciplines have entered clinical practice. In concert with these developments, powerful sociopolitical and socioeconomic forces-including the deinstitutionalization movement of the late 1960s and early 1970s and the cost-containment responses of the 1980s, necessitated by the spiraling cost of health care-have shaped the greatest area of growth in the direction of outpatient services. This is particularly true of the initial assessment and treatment of nonpsychotic mental disorders, which now can often be managed in ambulatory-care settings. Thus, we decided that a handbook focusing on the outpatient treatment of mental disorders would be both timely and useful. When we first began outlining the contents of this book, the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disor­ ders (DSM-III) was in its fourth year of use.

Applied gerontology and geriatrics always entail a multidisciplinary perspective and usually demand an interdisciplinary treatment approach. Providing a unique combination of perspectives, treatment approaches, and expertise, The Practical Handbook of Clinical Gerontology explores issues relevant to practitioners who work with the elderly. A leading cast of contributors--representing the fields of psychology, medicine, neuropsychology, nursing, and law--examines what is known about specific disorders and discusses treatment techniques and the development of intervention plans. This comprehensive volume begins with an overview of several broad topics pertinent to the treatment of older adults and discusses special considerations in assessment. It then presents up-to-date information on treatment of specific psychological and behavioral disorders of older adults. The final section covers interdisciplinary issues, including information about common medical problems, rehabilitation, and the psychopharmacological treatment of mental health problems. Written in a language that is accessible to a general health care audience, this extensive volume will be a valuable resource for mental health care providers, medical students, researchers, and graduate students in such fields as geriatrics, gerontology, nursing, psychology, and social work. **Please note the following three quotes are from the same person** "This handbook has a variety of attributes that make it a highly desirable desk reference for today′s mental health practitioners in geriatrics and gerontology. Few stones have been left unturned in the 22 reader-friendly chapters that comprise the handbook. Not only are general treatment issues addressed in great detail but assessment procedures, the treatment of specialized psychological and behavioral problems, and even issues in effective collaboration with medical geriatricians are considered. The scope and breadth of clinical knowledge and wisdom found within the covers of this volume are certainly impressive." --Lenard W. Kaye, Professor, Bryn Mawr College "The authors have succeeded in drawing on the expertise of a broad range of recognized authorities in clinical gerontology who have the capacity to communicate to the reader with considerable clarity both current information and best-practice strategies of mental health intervention with older adults." --Lenard W. Kaye, Professor, Bryn Mawr College "It would be difficult to find another reference source in clinical gerontological practice that is able to deal with the challenges of practice in this area with greater comprehensiveness and authority. The multidisciplinary perspective of the handbook ensures it being a valuable addition to the clinical practice collections of psychologists, social workers, nurses, gerontologists, and other allied health professionals. And, once obtained it should not gather dust given the currency and utility of the information." --Lenard W. Kaye, Professor, Bryn Mawr College

Americans are "healing themselves" (Heckler, 1985) and prevention has taken root (McGinnis, 1985a). We are altering our lifestyle to reduce physical and mental health risks. Perhaps as important is the fact that the science of prevention is beginning to catch up with the practices of prevention, although some might argue that the popularity of these practices far outstrips sound theoretical and empirical foundations. The chapter authors in this volume examine the theoretical and empirical foundations of many current prevention practices and, where data exist, discuss the status of prevention efforts. Where substantial prevention is not yet on the horizon, the authors attempt to point us in the right direction or at least share with the reader some of the risk factors that should be addressed in our research. We hope that readers will be stimulated to discuss the issues raised, advance the current research, and, where possible, adopt the prevention and health promotion strategies that are supported by sound theoretical and empirical work. This volume can in no way be comprehensive with respect to the current work in prevention; however, we hope that we have provided a sampling of prevention activities and issues that appear together in one volume for perhaps the first time. The primary intent of this volume is modest, and the reader should not attempt to find continuity among the various chapters. The only binding among these contributions is their focus on prevention.

Americans are "healing themselves" (Heckler, 1985) and prevention has taken root (McGinnis, 1985a). We are altering our lifestyle to reduce physical and mental health risks. Perhaps as important is the fact that the science of prevention is beginning to catch up with the practices of prevention, although some might argue that the popularity of these practices far outstrips sound theoretical and empirical foundations. The chapter authors in this volume examine the theoretical and empirical foundations of many current prevention practices and, where data exist, discuss the status of prevention efforts. Where substantial prevention is not yet on the horizon, the authors attempt to point us in the right direction or at least share with the reader some of the risk factors that should be addressed in our research. We hope that readers will be stimulated to discuss the issues raised, advance the current research, and, where possible, adopt the prevention and health promotion strategies that are supported by sound theoretical and empirical work. This volume can in no way be comprehensive with respect to the current work in prevention; however, we hope that we have provided a sampling of prevention activities and issues that appear together in one volume for perhaps the first time. The primary intent of this volume is modest, and the reader should not attempt to find continuity among the various chapters. The only binding among these contributions is their focus on prevention.

Accountability in clinical training implies a strong relationship between the training outcomes touted by a training program and the performance of its graduates. The training program and its faculty must be able to ensure that students have the competencies necessary for entering the profession and can offer competent services. In addition, responsibility for the quality and value of training must be assumed by the profession. Pressure for accountability is becoming increasingly apparent as the public learns about fraud, waste, and abuse in publicly funded pro­ grams (Fishman & Neigher, 1982). Federally supported clinical training programs have had to defend their training practices against threats of funding loss without the hard data needed to support their practices. Funding seems to have been forthcoming mostly because of our ability to demonstrate the need for clinical, counseling, and school psychol­ ogists. Graduates seeking professional careers in such applied fields demand considerable trust from their clientele and the public-at-large when they establish themselves, offer and advertise their services, make claims on public monies, and profess to do good and no harm. Neither their clien­ tele nor the public are in the position to evaluate the services of the profes­ sion or the claims made for these. (American Psychological Association lAPA], 1982, p.

Accountability in clinical training implies a strong relationship between the training outcomes touted by a training program and the performance of its graduates. The training program and its faculty must be able to ensure that students have the competencies necessary for entering the profession and can offer competent services. In addition, responsibility for the quality and value of training must be assumed by the profession. Pressure for accountability is becoming increasingly apparent as the public learns about fraud, waste, and abuse in publicly funded pro­ grams (Fishman & Neigher, 1982). Federally supported clinical training programs have had to defend their training practices against threats of funding loss without the hard data needed to support their practices. Funding seems to have been forthcoming mostly because of our ability to demonstrate the need for clinical, counseling, and school psychol­ ogists. Graduates seeking professional careers in such applied fields demand considerable trust from their clientele and the public-at-large when they establish themselves, offer and advertise their services, make claims on public monies, and profess to do good and no harm. Neither their clien­ tele nor the public are in the position to evaluate the services of the profes­ sion or the claims made for these. (American Psychological Association lAPA], 1982, p.

This book developed out of the editors'' longstanding interest in the retraining of traumatically brain-damaged adults and the management of their behavior by family members. A search for relevant experimental evidence to support the clinical use of behavioral principles for retrain­ ing, which began in 1977, turned up little empirical support. Moreover, the literature on retraining was dispersed among a variety of journals published in various countries. Nowhere was there a compendium of literature that addressed issues of assessment and retraining. There was no place to turn if one wanted to move from a standard neuropsy­ chological evaluation to the retraining of skill deficits revealed in the evaluation. We have attempted to edit a book that represents what we had hoped to find in the literature and could be used by professionals in clinical psychology, clinical neuropsychology, rehabilitation medicine, physical therapy, speech therapy, and other disciplines that address rehabilitation of brain-damaged adults-a book that addresses assess­ ment and rehabilitation issues and is sufficiently detailed to offer the reader a starting point in developing behavioral assessment and re­ habilitation programs. The book contains conceptual foundations, re­ views of research, descriptions of successful rehabilitation programs, and relatively detailed approaches to the retraining of specific skills. A shift from an assessment-based practice to one encompassing both prescriptive assessment and treatment has become a recognized transition in the neuropsychological literature and was best articulated in an article by Gerald Goldstein in March of 1979.

This book developed out of the editors' longstanding interest in the retraining of traumatically brain-damaged adults and the management of their behavior by family members. A search for relevant experimental evidence to support the clinical use of behavioral principles for retrain­ ing, which began in 1977, turned up little empirical support. Moreover, the literature on retraining was dispersed among a variety of journals published in various countries. Nowhere was there a compendium of literature that addressed issues of assessment and retraining. There was no place to turn if one wanted to move from a standard neuropsy­ chological evaluation to the retraining of skill deficits revealed in the evaluation. We have attempted to edit a book that represents what we had hoped to find in the literature and could be used by professionals in clinical psychology, clinical neuropsychology, rehabilitation medicine, physical therapy, speech therapy, and other disciplines that address rehabilitation of brain-damaged adults-a book that addresses assess­ ment and rehabilitation issues and is sufficiently detailed to offer the reader a starting point in developing behavioral assessment and re­ habilitation programs. The book contains conceptual foundations, re­ views of research, descriptions of successful rehabilitation programs, and relatively detailed approaches to the retraining of specific skills. A shift from an assessment-based practice to one encompassing both prescriptive assessment and treatment has become a recognized transition in the neuropsychological literature and was best articulated in an article by Gerald Goldstein in March of 1979.

During the past several decades, the field of mental health care has expanded greatly. This expansion has been based on greater recognition of the prevalence and treatability of mental disorders, as well as the availability of a variety of forms of effective treatment. Indeed, throughout this period, our field has witnessed the introduction and the wide­ spread application of specific pharmacological treatments, as well as the development, refinement, and more broadly based availability of behavioral, psychodynamic, and marital and family interventions. The community mental health center system has come into being, and increasing numbers of mental health practitioners from the fields of psychiatry, psychology, social work, nursing, and related professional disciplines have entered clinical practice. In concert with these developments, powerful sociopolitical and socioeconomic forces-including the deinstitutionalization movement of the late 1960s and early 1970s and the cost-containment responses of the 1980s, necessitated by the spiraling cost of health care-have shaped the greatest area of growth in the direction of outpatient services. This is particularly true of the initial assessment and treatment of nonpsychotic mental disorders, which now can often be managed in ambulatory-care settings. Thus, we decided that a handbook focusing on the outpatient treatment of mental disorders would be both timely and useful. When we first began outlining the contents of this book, the third edition of the American Psychiatric Association''s Diagnostic and Statistical Manual of Mental Disor­ ders (DSM-III) was in its fourth year of use.