The definition of narcissism can be a moving target. Is it an excess of self-love? Profound insecurity? Low self-esteem? Too much self-esteem? Because of the multifaceted nature of narcissistic ...personality disorder (NPD), treating this disorder presents clinicians with a range of wholly unique challenges. Narcissism and Its Discontents recognizes the variable nature of NPD and provides a template for adjusting treatment to the patient rather than shoehorning the patient into a manualized treatment that may prove to be less effectual. This guide offers clinicians strategies, including transference and countertransference, to deal with the complex situations that often arise when treating narcissistic patients, among them, patient entitlement, disengagement, and envy. The authors provide a skillful integration of research and psychoanalytic theory while also addressing psychotherapeutic strategies that are less intensive but also useful-being cognizant of the fact that a majority of patients do not have access to psychoanalysis proper. A chapter on the cultural aspects of narcissism addresses the recent societal fascination with NPD in the discourse on politics and celebrity, particularly in the age of social media. Regardless of the treatment setting-psychoanalysis, psychotherapy, pharmacotherapy, partial hospital, or inpatient-clinicians will find a wealth of approaches to treating a diverse and challenging patient population in Narcissism and Its Discontents.
One of the challenges the field of clinical neuropsychology faces is to develop an assessment process that is relevant and responsive to the needs of patients. Indeed, it has been suggested that the ...survival of neuropsychology as a clinical discipline may be threatened due to an overemphasis on diagnosing cognitive deficits as opposed to developing methods that meet patients' needs. One way to meet this need is for psychologists to extend their services by developing clinical interventions that contribute to enhancing patients' cognitive and emotional well-being. Providing feedback from the results of neuropsychological tests is one method suggested as a way to enhance patient care and satisfaction with the assessment process while providing a link between clinical assessment and therapeutic interventions. In current practice, providing feedback to patients about the results of neuropsychological assessments has been considered an optional procedure by clinicians and thus received little attention in the literature. Yet there is evidence that when feedback is provided to patients the effects are overwhelmingly positive. Feedback provides a bridge between assessment and treatment by facilitating the development of applicable treatment plans. There is no agreed upon conceptual framework for providing feedback from neuropsychological assessment, although researchers have made recommendations. However, these recommendations have done little to affect clinical practice and training despite the fact that including patient-oriented feedback enhances the likelihood that neuropsychological assessment will remain a relevant and important component of patient care. The purpose of this proposed book is to first describe developments in methods of neuropsychological assessment feedback that involve active collaboration with patients in an open exchange of information and results. Second, we will present a comprehensive model for conducting neuropsychological assessment feedback. The authors of this book are expert clinical practitioners and academic researchers who are at the forefront of the development and implementation of Collaborative Therapeutic Neuropsychological Assessment methods. Table of contents follows.
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This concise, practical guide shows how to enable girls and young women with ASD to reach their full potential, by adopting more individualised approaches. Drawing on clinical experience and clients' ...testimonies, it covers diagnosis, comorbidities, sensory issues, self-harm, emotional regulation, assessments, interventions and strategies.
This volume covers many of the ways of speaking that create problems between doctor and patient. The questions under consideration in the present book are the following: How is the doctor-patient ...interaction structured in a particular culture? What takes place during the process? What causes misunderstandings, lack of cooperation and even total non-compliance? What is the outcome of the interaction and how does the patient benefit from it? Finally, and this is the ultimate purpose of this book: How can the interaction be improved so that an optimum outcome is assured for the patient with maximum satisfaction to the physician?.
Virtually all medical and behavioral health treatments require at least some degree of patient adherence to succeed. Despite the relationship between health behaviors and outcomes, little attention ...is paid to developing proven methods for identifying and addressing patient non-adherence. Improving Patient Treatment Adherence: A Clinicians Guide offers new and updated information on the subject by focusing on practical tactics for clinicians that can improve patient adherence to a wide variety of treatments. This book is organized by behaviorslooking at topics that range from dietary adherence and smoking cessation to chronic pain, HIV and substance abuseand examines the impact of patient non-adherence, including costs, clinical outcomes, and health-related quality of life. Helpful tables, questions, and scoring algorithms make this book a useful guide for any practicing physician.
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This is a book that assembles and integrates Jackie Gerrard’s clinical work and thinking over the many years of her working life. Part I focuses on patients with specific types of psychopathology and ...explores particular difficulties in technique and thinking. Part II addresses the issues of love, hate, and the erotic. In Part III, specific challenges to the psychotherapeutic frame are demonstrated in chapters on enactments and on work with an absent patient. Richly illustrated throughout with clinical vignettes, above all, Gerrard stresses the importance of the enquiring mind and the struggle not to “know” but to be ever ready to “not know” and to explore. The book should be of interest to qualified practitioners, to those who are training in psychodynamic or psychoanalytic work, and to anyone who has an interest in psychoanalysis and the “impossibility of knowing”.
"Understanding Clinical Negotiation" means finding and holding common ground with patients. The requisite skills are fundamental to patient-centered care. Thus, this book is addressed mainly to ...practicing generalist physicians, nurse practitioners, and physicians' assistants, as well as students and post-graduate trainees aspiring to become accomplished clinicians.
With a mix of theory, practical advice, and clinical material, this resource for any clinician interested in applying the object relations model to their clinical or academic work. The book outlines ...object relations theory, leveraging clinical vignettes to underline the framework's applicability both in therapy and acute care settings.
Education and health literacy potentially limit a person's ability to be involved in decisions about their health. Few studies, however, have explored understandings and experiences of involvement in ...decision making among patients varying in education and health literacy. This paper reports on a qualitative interview study of 73 men and women living in Sydney, Australia, with varying education and functional health literacy levels. Participants were recruited from a community sample with lower educational attainment, plus an educated sample of University of Sydney alumni. The transcripts were analysed using the ‘Framework’ approach, a matrix-based method of thematic analysis. We found that participants with different education conceptualised their involvement in decision making in diverse ways. Participants with higher education appeared to conceive their involvement as sharing the responsibility with the doctor throughout the decision-making process. This entailed verifying the credibility of the information and exploring options beyond those presented in the consultation. They also viewed themselves as helping others in their health decisions and acting as information resources. In contrast, participants with lower education appeared to conceive their involvement in terms of consenting to an option recommended by the doctor, and having responsibility for the ultimate decision, to agree or disagree with the recommendation. They also described how relatives and friends sought information on their behalf and played a key role in their decisions. Both education groups described how aspects of the patient–practitioner relationship (e.g. continuity, negotiation, trust) and the practitioner's interpersonal communication skills influenced their involvement. Health information served a variety of needs for all groups (e.g. supporting psychosocial, practical and decision support needs). These findings have practical implications for how to involve patients with different education and literacy levels in decision making, and highlight the important role of the patient–practitioner relationship in the process of decision making.
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This book introduces a unique model of medical discourse that identifies the forms of talk - voices - that doctors and patients use during the consultation, and studies the dynamic interaction as it ...unfolds particularly in follow-up visits. Natural recordings, semi-structured interviews, questionnaires and ethnographic observations provide the data for the research, which was carried out in an Outpatient Clinic in Santiago, Chile. Using an interactional sociolinguistic approach, analysis of the data identifies doctor-patient communication as a micro-performance of broader socio-cultural realities, in which social status, power, knowledge and personal beliefs and values all find expression in the consultative setting. Importantly, while both doctor and patient voices are shown to contribute to an essentially asymmetrical exchange, the study also identifies the holistic and empathic Fellow Human voice, which places doctors and patients on a more equal footing. In connection with this voice, the Spanish concept of simpatía is also discussed.While the model in this study was developed within a specific socio-cultural framework, it is hoped that it will be adapted and modified more widely and contribute to a better understanding between doctors and their patients.
