Innovative Approaches for Difficult-to-treat Populations
Innovative Approaches for Difficult-to-treat Populations

Author: Scott W. Henggeler

Publisher: American Psychiatric Pub

Published: 1997

Total Pages: 868

ISBN-13: 9780880486804

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Innovative Approaches for Difficult-to-Treat Populations makes recommendations for developing and disseminating innovative mental health services. It is geared toward clinicians, administrators, and policy-makers struggling to develop both clinically effective and cost-effective mental health and substance abuse services, and it focuses on services for individuals who use the highest proportion of mental health resources and for whom traditional services have not been effective. These target populations include youth with serious behavioral and emotional disturbances and adults with severe and persistent mental illnesses. The innovative approaches reviewed include diverse treatment methods for differing clinical populations. These varied approaches have several common elements: * Social-ecological theory frameworks* An emphasis on delivering flexible, comprehensive, pragmatic, and goal-oriented interventions in persons' natural environments* Increased accountability on the part of service providers* The transition from centralized to community-based care is discussed, and normalizing a patient's daily routine as an important factor in the success of state-of-the-art community support programs is emphasized Innovative Approaches for Difficult-to-Treat Populations offers mental health professionals and students a firsthand look at the future direction of clinical services. Policy issues necessary to developing and disseminating progressive treatments are addressed, including the downsizing of state psychiatric hospitals, strategies for reforming state mental hospital systems, and ethical issues in research on child and adolescent mental disorders.

Field Trials of Health Interventions
Field Trials of Health Interventions

Author: Peter G. Smith

Publisher:

Published: 2015

Total Pages: 479

ISBN-13: 0198732864

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This is an open access title available under the terms of a CC BY-NC 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. Before new interventions are released into disease control programmes, it is essential that they are carefully evaluated in field trials'. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. Descriptions of the detailed procedures and methods used in the trials that have been conducted have rarely been published. A consequence of this, individuals planning such trials have few guidelines available and little access to knowledge accumulated previously, other than their own. In this manual, practical issues in trial design and conduct are discussed fully and in sufficient detail, that Field Trials of Health Interventions may be used as a toolbox' by field investigators. It has been compiled by an international group of over 30 authors with direct experience in the design, conduct, and analysis of field trials in low and middle income countries and is based on their accumulated knowledge and experience. Available as an open access book via Oxford Medicine Online, this new edition is a comprehensive revision, incorporating the new developments that have taken place in recent years with respect to trials, including seven new chapters on subjects ranging from trial governance, and preliminary studies to pilot testing.

Small Clinical Trials
Small Clinical Trials

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2001-01-01

Total Pages: 221

ISBN-13: 0309171148

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Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.

The Prevention and Treatment of Missing Data in Clinical Trials
The Prevention and Treatment of Missing Data in Clinical Trials

Author: National Research Council

Publisher: National Academies Press

Published: 2010-12-21

Total Pages: 163

ISBN-13: 030918651X

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Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.

Psychosocial Interventions for People with Schizophrenia
Psychosocial Interventions for People with Schizophrenia

Author: Neil Harris

Publisher: Bloomsbury Publishing

Published: 2017-03-14

Total Pages: 296

ISBN-13: 1403937591

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Mental health care for people experiencing schizophrenia has changed dramatically over the last twenty years. This book draws on the expertise of a group of experienced clinical practitioners to provide an up-to-date understanding of this condition, and a practical guide to implementing evidence-based psychosocial interventions for people with schizophrenia. Written in a clear and accessible format, this book -covers the historical, social and political perspectives which give meaning to the current position of mental health care -includes up-to-date interventions framed within the context of peoples lives -describes how these interventions translate into specialist areas of practice Using a variety of clinical examples, this text provides a clear overview of schizophrenia, and serves as a comprehensive, practical guide to the understanding, treatment and management of this mental condition.

Oxford Textbook of Community Mental Health
Oxford Textbook of Community Mental Health

Author: Graham Thornicroft

Publisher: Oxford University Press, USA

Published: 2011-08-18

Total Pages: 408

ISBN-13: 019956549X

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Community mental health care has evolved as a discipline over the past 50 years, and within the past 20 years, there have been major developments across the world. The Oxford Textbook of Community Mental Health is the most comprehensive and authoritative review published in the field, written by an international and interdisciplinary team.

Designing Mental Health Services for Children and Adolescents
Designing Mental Health Services for Children and Adolescents

Author: J. Gerald Young

Publisher: Taylor & Francis

Published: 2013-03-07

Total Pages: 502

ISBN-13: 1134940459

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An exceptional opportunity is being missed. A chance to alleviate suffering and to achieve health care cost reductions for society is available, but is being ignored. There is an explosion of new knowledge about the emotional and intellectual development of children, and the causes and treatment of psychiatric disorders of children and adolescents. Research from diverse disciplines such as the developmental neurosciences, psychoanalysis, psychopharmacology, developmental psychology, and genetics propels us forward,. However, the effects of this new knowledge reach children and adolscents slowly, or not at all. The long history of neglect of the mental health of children and adolescents is now exaggurated by sudden, disruptive economic and political influences on mental health services for children and adolescents in most countries. Prevention and treatment of emotional and intellectual problems in childhood and adolescence have vastly improved, but utilization of these advantages lags behind. This disappointing incongruity stimulates a need to document our knowledge about these services and systems and to make it more broadly available. This is the primary aim of this new volume by a team of distinguished contributors. It reviews the causes and prevalences of psychiatric disorders in children and adolescents, the problem of health care financing for these services, the underutilization of these services, our current understanding of the outcomes of treatment, and the new models for both treatment and prevention. The book also provides a survey of current mental health services and sytems for children and adolescents in countries across the world. Information drawn from these multiple perspectives is has been used by a group of international experts to develop the Venice Declaration, providing specific guidelines for families, clinicians, administrators, and policy-makers who are concerned with the development of children and adolescents, and are committed to a more efficient economic approach to mental health services.

Treating and Preventing Adolescent Mental Health Disorders
Treating and Preventing Adolescent Mental Health Disorders

Author: Dwight L. Evans M.D.

Publisher: Oxford University Press

Published: 2005-07-14

Total Pages: 859

ISBN-13: 0198038712

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Following on the heels of the widely acclaimed A Guide to Treatments That Work (OUP, 2002) by Nathan and Gorman, Treating and Preventing Adolescent Mental Health Disorders brings together a distinguished group of psychiatrists and clinical psychologists to provide a groundbreaking, evidence-based survey of treatments and preventions for adolescents with mental health disorders. The book, the very first to disseminate the findings of the Adolescent Mental Health Initiative sponsored by the Annenberg Foundation Trust at Sunnylands and the Annenberg Public Policy Center (APPC) of the University of Pennsylvania, addresses the current state of our knowledge about various mental health disorders in the teenage years, a developmental period when behavior and the brain are still "plastic." Here, six commissions established by the Sunnylands Trust and APPC pool their expertise on adolescent anxiety, schizophrenia, substance use disorders, depression and bipolar disorders, eating disorders, and suicide in sections that thoroughly define each disorder, outline and assess available treatments, discuss prevention strategies, and suggest a research agenda based on what we know and don't yet know about these various conditions. As a meaningful counterpoint to its primary focus on mental illness, the volume also incorporates the latest research from a seventh commission-on positive youth development--which addresses how we can fully prepare young people to be happy and successful throughout their lives. Concluding chapters discuss other critical issues of particular relevance: the stigma of mental illness, the role of primary-care doctors and school-based mental health professionals in the detection and treatment of adolescent mental health problems, and the research, policy, and practice context for the delivery of evidence-based treatments. Integrating the work of eminent scholars in both psychology and psychiatry, this work will be an essential volume for academics and practicing clinicians and will serve as a wake-up call to mental health professionals and policy makers alike about the state of our nation's response to the needs of adolescents with mental disorders. The Association of American Publishers' 2005 Award Winner for Excellence in Professional and Scholarly Publishing--Clinical Medicine

Advanced Methods in Family Therapy Research
Advanced Methods in Family Therapy Research

Author: Richard B Miller

Publisher: Routledge

Published: 2013-12-17

Total Pages: 488

ISBN-13: 1136192204

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Research is vital in moving the field of family therapy forward, but the myriad of possibilities inherent in working with systems and individuals can overwhelm even the most seasoned researcher. Advanced Methods in Family Therapy Research is the best resource to address the day-to-day questions that researchers have as they investigate couples and families, and the best source for learning long-term theory and methodology. The contributors of this volume share their wisdom on a wide variety of topics including validity concerns, measuring interpersonal process and relational change, dyadic data analysis (demonstrated through a sample research study), mixed methods studies, and recruitment and retention. The volume contains one of the most detailed descriptions of data collections and covers interviewing, using questionnaires, and observing brain activity. Also addressed are suggestions to meaningfully reduce cultural bias, to conduct ethical research, and, in the Health Services Research chapter, to examine interventions for clients in various income brackets. A separate, ground-breaking chapter also addresses psychophysiological research in a couple and family therapeutic context. As an added benefit, readers will learn how to become informed consumers of journal articles and studies, how to produce quality, publishable research, and how to write fundable grant proposals. Each chapter provides a clear and detailed guide for students, researchers, and professionals, and as a whole Advanced Methods in Family Therapy Research advances the field by teaching readers how to provide evidence that marriage and family therapy not only relieves symptoms, but also effects behavioral change in all family members.