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For the first time in history, behavioral health providers are expected to understand and participate in activities intended to access and improve the quality of services they provide. This handbook is designed as a general resource in the field of behavioral health quality management for a very diverse group of readers, including graduate and undergraduate students, payors, purchasers and administrators within managed care organizations, public sector service system planners and managers, applied health services researchers and program evaluators. This volume provides a comprehensive context for the development of quality management (QM) in health services - behavioral health in particular - as well as an overview of tools, techniques, and programs reflecting QM in practice. It also offers perspectives on both internally- and externally-based QM activities.
Family and marital therapies are rapidly becoming highly used methods of treatment of mental disorders and are no longer ancillary methods to individual psychotherapy. The last few decades have brought about an increasing awareness of the fact that, excluding organic etiology, practically all mental disorders are caused, fostered, and/or related to faulty interpersonal relations. As a rule, the .earlier in life one is exposed to noxious factors, the more severe is the damage. Thus, early child-parents' and child-siblings' interactions are highly relevant determinants of mental health and mental disorder. Moreover, parents themselves do not live in a vacuum. Their marital interaction signific...
For two decades, I have been responding to questions about the nature of health psychology and how it differs from medical psychology, behavioral medicine, and clinical psychology. From the beginning, I have taken the position that any applica tion of psychological theory or practice to problems and issues of the health system is health psychology. I have repeatedly used an analogy to Newell and Simon's "General Problem Solver" program of the late 1950s and early 1960s, which had two major functional parts, in addition to the "executive" component. One was the "problem-solving core" (the procedural competence); the other was the representa tion of the "problem environment. " In the analogy, ...
This book provides a practical guide to crisis intervention. It emphasizes the role of violence, patient suicide, long-term sequelae of trauma, clinical assessment and risk management, professional boundaries and burn-out, and the neurophysiology of trauma, as well as the needs of underserved patient populations including minority group members, older adults, gays and lesbians, and children. It features critical reviews of controversial topics, including EMDR, critical incident stress debriefing, recovered memories, dissociative identity disorder, and alternative medicine.
professional-standards-review organizations (PSRO) in defining quality of care for the Medicare program; it is a "shared responsibility of health professionals and government to provide a reasonable basis for confidence that action will be taken, both to assess whether services meet professionally recognized standards and to correct any deficiencies that may be found" (p. 14). Similar pronouncements have been made for the quality assurance activities of the Department of Defense's CHAMPUS program and of the 1980s successor to the PSROs, the federally designated peer-review organizations (PROs), established to ensure quality and utilization-efficient care for Medicare. Links between the feder...
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This volume presents the work of clinical health care teams and natural work groups, quality improvement teams, committees, and task forces made up of employees in health care settings. It discusses proven multidimensional instruments that measure team performance along with future needs for measuring team performance. It will be a resource for medical instructors and students, public health workers, and health administrators interested in team management.
Throughout my clinical training and practice, I have been surprised by the number of times that sexual issues have emerged as an unexpectedly central feature in my work with older adults. I can vividly remember my own internal reaction on hearing one of my elderly female patients tell me that she was date raped a few years after the death of her elderly husband-when she was 68 years old. I can see in my mind's eye the blood splattered on the floor of an inpatient unit from an elderly man who smashed his arm through a window, furious that his antidepressant medication made it impossible to climax through masturbation. On a much less dramatic but equally important note, I think about the elder...
Entering a full-time private practice and forsaking the comforts of a regular paycheck was a difficult decision for me. Fortunately, I was able to begin my practice on a part-time basis in space rented from two physician friends. By using my behavior skills for self-management and organization, I was then able to help my practice grow so that, with some trepidation, I moved into a full-time practice. I have continued to maintain my practice according to the same ethical, professional, and business assumptions discussed in this book. One of the reasons for my writing this book is that, at the time I was beginning my practice, there was no one text that helped me begin or to explain what "nuts and bolts" issues I needed to consider. As my practice has grown, I continued to see a need for a resource text to help the beginning therapist get started. I decided to describe the assump tions, methods, and issues that I have used so as to present a discussion of timely issues relevant to the practice of behavior therapy.