An electronic newsletter of the Coalition's Center for Rehabilitation and Recovery
Elizabeth Saenger, PhD, Editor
The Center for Rehabilitation and Recovery provides assistance to the New York City mental health provider community through expert trainings, focused technical assistance, evaluation, information dissemination and special projects.
When I was a little girl, I leveraged my allowance by buying stamps, and 101 Things You Can Get for Free. Then I sent post cards to embassies and companies for free booklets. I even wrote to an august financial institution for free information, and received a technical publication I couldn’t understand, addressed to, “Mr. Elizabeth Saenger.” I was so pleased someone thought I was a grown-up, albeit a man!
Now there is more free information available than ever before—and the problem of how to separate the wheat from the chaff. Here are my suggestions, as addict and aficionado, of what you might want to download or request.
Frequently Asked Questions about Recovery and Recovery Oriented Practice
Do you ever come across clients, family members, and behavioral health professionals who wonder whether people really recover? That is the first question in an excellent collection of thirty Q&A from the Substance Abuse and Mental Health Services Administration (SAMHSA). The answer is more substantial, and positive, than that in many guides for stakeholders.
Besides noting that 45-65% of people diagnosed with schizophrenia will recover from the disorder over time, the resource describes the “clinician’s illusion.” This sampling error arises when professionals in clinical settings invariably see only sick people, and see them when they are at their sickest.
Other questions address the role of trauma in recovery; the interface between mental illness and substance abuse; and how to instill hope in clients who may not want care, or have personal goals.
References are included in answers, and targeted recommendations for further reading follow questions.
A Therapist’s Guide to Brief Cognitive Behavioral Therapy
Are you a supervisor struggling to pack the power of evidence-based psychotherapy into fewer sessions because of budget cuts? Or a therapist who uses cognitive behavior therapy (CBT) tips here and there, but wonders whether other CBT techniques might be helpful? Do you wonder about the best way to assign homework in a session, and what to say if the client fails to do it?
If so, this free, 111-page guide to brief CBT is for you. In 14 modules it explains essential psychotherapy skills, and then specific CBT skills, from orienting the patient to CBT to ending treatment. Topics include not only the ubiquitous techniques for challenging maladaptive thoughts, and for relaxation, but also less well-known, but powerful, ideas you can apply, such as behavioral activation.
Appendices include handy patient handouts on cognitive distortions, guided imagery, and other popular topics, and sample treatment outlines.
The guide delivers what it promises: “information condensed and packaged to be highly applicable for use in a brief therapy model and to aid in rapid training.”
Antipsychotic Medications in Primary Care: Limited Benefit, Sizeable Risk
Interested in antipsychotics, but unsure about how to find unbiased information? The Independent Drug Information Service and The Alosa Foundation offer several useful items.
Although the publication date is 2012, the general landscape for antipsychotics remains the same, with weight gain and metabolic disturbances regarded as common, and serious, side effects. In addition, prescribing drugs for patients unlikely to benefit continues. For example, the results of randomized, controlled trials indicate that “70-80% of patients with dementia will not derive a significant behavioral benefit from the use of an antipsychotic medication,” but the drugs will increase the rate of death.
Clozapine (Clozaril), on the other hand, is underprescribed for treatment-resistant schizophrenia. While this drug requires blood tests, which makes it more labor-intensive than other antipsychotics, it is often a godsend for the 30% of individuals with schizophrenia who do not respond to first-line treatments.
The good news is that behavioral health professionals showed less stigma than the general population in response to vignettes of people with major depression or schizophrenia. The bad news is that we still have a ways to go ourselves, especially in terms of stereotypes about schizophrenia and violence.
Professionals with less stigmatizing attitudes tended to have a:
The researchers in this April 2014 study concluded that there “is a need to invest in developing interventions that shift providers’ and public attitudes.”
1) You may have heard the old saw, “Women are more likely to attempt suicide, but men are more likely to succeed.” With bipolar disorder, however, both groups are about equally likely to die by their own hand. Perhaps this is because women are more likely to have the following risk factors for suicide, EXCEPT:
2) Patients hospitalized with bipolar disorder tend to leave the hospital sooner if their windows face what direction?
3) Which of the following is a little-known risk factor for bipolar disorder?
Answers on Bipolar Disorder
1) d. Severe sleep disturbance. Women with bipolar disorder are more likely than their male counterparts to spend more time in depressive episodes, mixed episodes, and periods of rapid cycling, all powerful risk factors for suicide.
2) c. East. Patients with bipolar disorder in rooms with windows facing east receive beneficial morning light which reinforces typical circadian rhythms. This observation, confirmed by controlled studies, suggests why bipolar disorder treatments establishing regular patterns of sleep and activity, such as IPSRT (Interpersonal and Social Rhythm Therapy), work.
3) a. Maternal flu while in utero. If a woman has the flu while pregnant, the chances that her child will have bipolar disorder increase nearly fourfold, according to a 2013 study of 19,000 women in California.
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