December Releases from APA Books!

entrenchment Entrenchment and the Psychology of Language Learning 

How We Reorganize and Adapt Linguistic Knowledge

Edited by Hans-Jörg Schmid

Copublished with De Gruyter Mouton

This volume enlists more than two dozen experts in the fields of linguistics, psycholinguistics, neurology, and cognitive psychology to investigate the concept of entrenchment—the ongoing reorganization and adaptation of communicative knowledge.  Entrenchment posits that our linguistic knowledge is continuously refreshed and reorganized under the influence of social interactions.  Contributors examine the psychological foundations of linguistic entrenchment processes, and the role of entrenchment in first-language acquisition, second language learning, and language attrition. Critical views of entrenchment and some of its premises and implications are discussed from the perspective of dynamic complexity theory and radical embodied cognitive science.

 

geropsych Ethical Practice in Geropsychology

Principles, Procedures, and Practices

by Shane S. Bush, Victor A. Molinari, and Rebecca S. Allen

Psychologists who work with older adults find themselves encountering a number of novel issues. Determining a client’s decision-making capacity, balancing a client’s autonomy with his or her well-being, and juggling differing priorities from various parties—the clients, their families, other healthcare professionals, etc.—give rise to a number of complicated ethical and legal quandaries. The easy-to-follow decision-making model provided in this book will help clinicians make the most ethically sound decisions possible in these challenging situations. Clinical vignettes illustrate how to handle ethical and legal issues in a variety of contexts.

 

integrated-behavioral Integrated Behavioral Health in Primary Care

Step-By-Step Guidance for Assessment and Intervention

SECTOND EDITION

by Christopher L. Hunter, Jeffery L. Goodie, Mark S. Oordt, and Anne C. Dobmeyer

This timely new edition of Integrated Behavioral Health in Primary Care brings the reader up to speed with the changing aspects of primary care service delivery in response to the Patient-Centered Medical Home (PCMH), the Triple-Aim health approach, and the Patient Protection and Affordable Care Act. Drawing on research evidence and years of experience, the authors provide practical information and guidance for behavioral health care practitioners who wish to work more effectively in the fast-paced setting of primary care, and provide detailed advice for addressing common health problems such as generalized anxiety disorder, depression, weight issues, sleep problems, cardiovascular disorders, pain disorders, sexual problems, and more.  New to this edition are chapters on population health and the PCMH; children, adolescents, and parenting; couples; managing suicide risk; and shared medical appointments.

 

starting-career Starting Your Career in Academic Psychology

by Robert J. Sternberg

This book provides a systematic guide for jump-starting a career in academic psychology—from applying and interviewing for academic positions, to settling in at a new job, to maximizing success during the pre-tenure years. The chapters cover all key skills in which new faculty must become proficient: teaching, conducting and funding faculty-level research, serving the department and field, and “softer” activities such as networking and navigating university politics. Given the demands and competition in the field, this guide is an essential roadmap for new faculty.

 

 

supervision-aedp Supervision Essentials for Accelerated Experiential Dynamic Psychotherapy

by Natasha Prenn and Diana Fosha

Utilizing insights from attachment theory and research in neuroplasticity, Accelerated Experiential Dynamic Psychotherapy (AEDP) clinicians help clients unearth, explore and process core feelings in order to transform anxiety and defensiveness into long-lasting, positive change.  In this book, AEDP founders and leaders Natasha C. N. Prenn and Diana Fosha offer a model of clinical supervision that is based on the AEDP approach.  Using close observation of videotaped sessions, AEDP supervisors model a strong focus on here-and-now interactions, with a full awareness of affective resonance, empathy, and dyadic affect regulation phenomena.  The goal is to offer trainees a visceral, transformative experience that complements their growing intellectual understanding of how change occurs in AEDP.

What is Telemental Health?

shh_headshot-smallBy Susan Herman

Telemental health (TMH) is the use of telecommunication technologies to provide behavioral health services such as assessment, education, treatment, counseling and consultation. It refers both to live, real-time interactions as well as data sharing via asynchronous communication.

Over the phone and video teleconferencing systems, clinicians can provide care for most, if not all, the same conditions they treat in the office. Having a distance care option can increase access and decrease costs for consumers. However, telemental health can present certain logistical and safety complications. According to David Luxton, Eve-Lynn Nelson, and Marlene Maheu in their new book A Practitioner’s Guide to Telemental Health, complications can arise in regard to:

  • establishing informed consent
  • adapting intake and assessment protocols for the long-distance environment
  • involving emergency or support services, if necessary, at the client’s location
  • handling emotionally charged conversations when the client can easily power off their device, or when there might be another person in the room out of the clinician’s view

Asynchronous communication in TMH can include messaging technologies such as text or email—say, to ask follow-up questions or to check in on how well a patient is following a prescribed routine.

Software, apps, and peripheral devices for self-care and remote monitoring are also proliferating in the marketplace. These tools are broadly referred to as eHealth, or mHealth when deployed via mobile devices such as cell phones or wearables. They can be useful adjuncts to care, but cannot be used to diagnose mental health problems.

telemental-healthSome eHealth technologies provide alerts to prompt care providers to check in, similar to blood glucose monitoring systems for diabetics. According to the National Institutes of Mental Health (2016), “Such apps might use the device’s built-in sensors to collect information on a user’s typical behavior patterns. If the app detects a change in behavior, it may provide a signal that help is needed before a crisis occurs.”

Apps and wearable devices may include various coaching functions, self-monitoring, journaling, and/or stimuli (music, imagery) for help with:

  • Anxiety and stress management
  • Breathing and heart rate
  • Challenging thoughts
  • Recording moods
  • Activity, sleep, food intake
  • Meditation and mindfulness

Though it can be difficult to keep pace with innovation, providers and consumers alike should evaluate all telemental health tools carefully to make sure their data stays secure, and that actually using the technology doesn’t introduce more complications.

For a complete list of practice and ethical standards and guidelines in telehealth, including information on provider reimbursement for TMH and legal/policy issues, click here.

References

Luxton, D. D., Nelson, E., & Maheu, M. M. (2016). A Practitioner’s Guide to Telemental Health: How to Conduct Legal, Ethical, and Evidence-Based Telepractice. Washington, DC: American Psychological Association.

National Institutes of Mental Health (2016). Technology and the Future of Mental Health Treatment. Retrieved September 30, 2016 from https://www.nimh.nih.gov/health/topics/technology-and-the-future-of-mental-health-treatment/index.shtml

 

A Conversation With Russell A. Barkley, PhD, About Adult ADHD 

 

russell-barkley-photo

Russell A. Barkley, Ph.D., is a Clinical Professor of Psychiatry at the Virginia Treatment Center for Children and Virginia Commonwealth University Medical Center. He holds a Diplomate (board certification) in three specialties: Clinical Psychology, Clinical Child and Adolescent Psychology, and Clinical Neuropsychology.  Dr. Barkley is a clinical scientist, educator, and practitioner whose publications include 22 books, rating scales, and clinical manuals, 7 award-winning DVDs, and more than 260 scientific articles and book chapters related to the nature, assessment, and treatment of ADHD and related disorders.  He is also the founder and Editor of the clinical newsletter, The ADHD Report, now in its 24th year of publication.  Dr. Barkley has presented more than 800 invited addresses internationally and appeared on nationally televised programs such as 60 Minutes, the Today Show, Good Morning America, CBS Sunday Morning, CNN, and many other television and radio programs to disseminate the science about ADHD.  He has received awards from the American Psychological Association, American Academy of Pediatrics, American Board of Professional Psychology, Association for the Advancement of Applied and Preventive Psychology, the Wisconsin Psychological Association, and Children and Adults with ADHD (CHADD) for his career accomplishments, contributions to ADHD research and clinical practice, and for the dissemination of science about ADHD.  His websites are www.russellbarkley.org and ADHDLectures.com. 

shh_headshot-smallBy Susan Herman

Did you know that adults can have ADHD? It’s true—ADHD is not confined to children and teens.

The trademarks of Attention Deficit Hyperactivity Disorder (ADHD) are inattention, combined (for some) with hyperactivity and/or impulsive behaviors. According to the National Institutes of Mental Health, some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity. It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors are more severe, occur more often, and interfere with or reduce the quality of how they function socially, at school, or in a job…Children and adults with ADHD need guidance and understanding from their parents, families, and teachers to reach their full potential and to succeed.

Professor, researcher, and clinician Russell A. Barkley recently published a self-help book with APA LifeTools for family members of adults with ADHD, titled When an Adult You Love Has ADHD: Professional Advice for Parents, Partners, and Siblings. You can find more information about the book and purchase it here.

I recently interviewed Dr. Barkley about his work with adults who have ADHD, and how loved ones in their inner circle can support them.

How recently was adult ADHD recognized? 

A German-language textbook published in 1775 has a remarkably accurate description of what we now call ADHD in adults. But, aside from very periodic mentions in the literature—as “minimal brain dysfunction” in the 1950s, and as “hyperkinetic reaction” or “hyperkinetic disorder” in the 1960s—neither the public nor the research community much recognized it. It wasn’t until the 1970s that a series of longitudinal studies was conducted to find out whether ADHD continued beyond childhood. Interest in this picked up throughout the 1980s and 1990s as it was found that half to two-thirds of kids who were diagnosed with ADHD continued to have symptoms into their twenties. This was the first real evidence base that began to show us how ADHD, like mental retardation, dyslexia, and autism, can continue into adulthood.

What would you say has been your greatest contribution to the field of adult ADHD?

In 1991 I started an adult ADHD research clinic at University of Massachusetts Medical School, and the same year my psychiatrist colleague Joe Biederman started one at Massachusetts General Hospital in Boston. We were collecting data on a variety of domains of impairment and symptoms on these adults to see if it was equivalent to the childhood form of the disorder – it clearly was.  Later, Alan Zametkin and colleagues at the NIMH did the first PET scan study showing brain related deficits in functioning in adults with ADHD.  Other studies on never-before-diagnosed adults were done to learn whether they responded to the same types of drugs that children were being given for ADHD.  Results showed that they did so.

In 2008 I published a monograph where I compared results of my own 20-year longitudinal studies on children with ADHD followed to an average age of 27.  Drs. Kevin Murphy and Mariellen Fischer and I compared them with adults diagnosed with ADHD alongside data I’d been collecting in the

clinic from adults who were not diagnosed as ADHD. This was the first time anyone had compared the two groups directly (children with ADHD grown up vs. adults diagnosed with ADHD). The monograph was massive, but I chose that format over journals because with journal articles you have page limitations and you have to peel off tiny bits of your research and present it over multiple, disparate articles. Instead I presented it all at once, and this allowed adult ADHD to really hit the research map. Others followed up my work with various methods of neuroimaging to show differences in brain activity for adults with ADHD.

Why did you decide to focus on parents, siblings, and partners of people with ADHD in your latest book?

Ever since I wrote a self-help book for adults who have ADHD, called Taking Charge of Adult ADHD (in 2010), I’d been wanting to write one for the family members who support them. At the time there was no science-based trade book available for loved ones of people with ADHD. Also, ADHD is in my family. I had been trying to help various of my own family members, get them treatment and offer a safety net, so I knew there were others out there also feeling frustrated after picking up and dusting off their loved one again and again.

I was ready to write the book when my twin brother died. He had ADHD, and I know that it indirectly contributed to his death. He was driving 40 miles per hour on a country road in the Adirondacks. He never wore a seatbelt, and he had a habit of going too fast and drinking while driving. He ran off the road and was killed. I put the book aside while I was grieving him. Not long after my sister, who had physical disabilities, also died. And about three years after that, my deceased brother’s son, who also had ADHD, hanged himself.  So I just “couldn’t go there” for a while due to all this grieving.

Finally, in 2015 the time was right. Several books on how ADHD affects marriage had appeared by that time. Writing about how to love someone with ADHD was cathartic for me. I feared that re-living events would make me feel worse, but actually I felt better.

Thank you for sharing that personal story. I’m glad you decided to include some of it in the book, too. 

adult-adhdLet’s back up a bit and talk about how ADHD can affect adults who have it. Also, how many adults have ADHD—how common is it in the population?

Four to five percent of adults in the USA have ADHD. The percentage is closer to 3-4% worldwide. It’s higher in Western countries because of longer life expectancy and better access to care. In children the ratio of boys to girls with ADHD is three to one; for adults there’s less of a split; it’s closer to 1.4 to 1 male to female. It’s been great seeing more women come out of the woodwork to talk about ADHD. I recently consulted on articles in Elle, Glamour, and Cosmopolitan magazines about adult ADHD.

ADHD is genetic in about two thirds of all cases; in about one third it is acquired either prenatally or after birth because of head trauma or environmental conditions that affect the brain’s frontal lobe development.

Adults who have ADHD typically achieve a lower level of education than they are capable of, and they have problems in the workplace with boring tasks that require sustained attention. Adults with ADHD tend to do well in non-traditional careers, often those that involve performing, music, athletics, police work, and the military. There are people with ADHD in law and medicine, but fewer than you’ll find in the more physically active careers.

Money management is a challenge for many people who have ADHD, as is driving. Adults with ADHD are 2-3 times more likely to be dead by age 46 from accidental injuries, many of which involve driving. About one third of adults with ADHD exhibit antisocial behavior and may even get involved with crime.

New research areas in adult ADHD include risky sexual behavior, along with marriage and parenting problems. ADHD is really one of the most impairing outpatient disorders there is—I would venture to say it’s even more impairing than depression—because it affects so many diverse areas of life. Clinical care and family counseling for adult ADHD exists and is increasingly available but is far from where it needs to be. As of ten years ago, only about one in ten adults with ADHD was diagnosed. The percentage is better now but there is still much progress to be made.

What do family members and partners need to understand about ADHD to best support their loved one who has it?

It’s important to adopt a biologically-based view of ADHD. ADHD is a neuro-genetic disorder. You can’t attribute your loved one’s behaviors to personality quirks, defective morality, laziness, or poor lifestyle choices or say they deserve whatever they get. You can’t be a good support person if you keep thinking, “My loved one could change if they wanted to, but they don’t want to.” People in the inner circle are their loved one’s best safety net and closest influence, but they can’t step up as stakeholders if they don’t adopt a more compassionate outlook about ADHD.

What kinds of support can family members provide to an adult who has ADHD? 

In my clinical work I walk through six steps with adults who have ADHD and their families. Step One is to get a thorough mental health evaluation to document not only ADHD, but any other disorders that the person might also have. Eighty percent of adults with ADHD have an additional disorder, and about half have two additional disorders. These might be anxiety, depression, a learning disability, bipolar, or something else. Detecting secondary disorders affects the course of ADHD treatment. Psychologists, psychiatrists, and behavioral neurologists can diagnose ADHD.

So the support person might offer to set up various appointments for their loved one and help them follow through getting to the specialist’s office.

Yes.

Step Two is to help the patient “own” their ADHD as a part of their identity. It’s easier to accept a diagnosis intellectually than it is to incorporate it as a part of your own view of yourself. Treatment will be superficial if the person doesn’t accept ADHD as a part of their self-view. When the patient starts to grieve their old self-image, that’s when we know we are getting through. Accepting the new you is also a positive thing because it means you’re giving up the old view of yourself as stupid, lazy, or immoral.

Step Three is to read widely and educate yourself about ADHD. I like to say that “truth is an assembled thing.” You can’t just depend on one source for all your information. Jeff Copper’s podcast, Attention Talk Radio, is a great resource, and I offer many more in the book. Think about it: if you’re diabetic, you have to understand how diet plays into your condition, and hygiene [for blood tests and insulin monitoring], and a host of other things. Because ADHD is a chronic disease I sometimes refer to it as the diabetes of psychiatric conditions.

Step Four is to get on medication. Medication is the best treatment for ADHD. And I’m saying this as a psychologist—there is no longer any “us versus them” going on between psychologists [who typically do not prescribe medication] and psychiatrists when it comes to ADHD treatment. Medication is two to three times more effective than behavioral methods alone for treating ADHD. Most adults with ADHD, 80-90%, need medication as part of the treatment package. Family members can help their loved one remember to take their ADHD medication regularly.

Step Five is behavior modification. Cognitive behavioral therapy (CBT) boosts the benefits of ADHD medication for self-control and executive functioning. Outside of formal therapy, there’s a lot family members can do to encourage their loved one to adopt exercise routines and other healthy habits. Often times people with ADHD need to get additional treatment to cut back or eliminate their use of alcohol, tobacco, and marijuana.

Step Six is accommodation. This means altering the environment so the person with ADHD is more likely to succeed. It might mean dedicating one computer for work only and another one for games and social networking. Family members can help their loved one find and download software that blocks distracting content. At home and on the job, adults with ADHD can advocate for themselves by finding support people to keep them accountable for changes they want to make and goals they want to accomplish.

A new type of accommodation that’s becoming more popular is called ADHD coaching. An ADHD coach makes daily contact via text or other channels to help the person stay organized, cope with frustration, and/or work through social problems. The field of ADHD coaching is still developing and is beginning to police itself. Some people are coming to ADHD coaching from financial planning or life coaching and are not currently held to a specific standard of knowledge or experience within psychology or behavior modification. I expect within five years certification requirements and accreditation for ADHD coaching will be in place.

 

Note: The opinions expressed in this interview are those of the author and should not be taken to represent the official views or policies of the American Psychological Association.

 

October Releases From APA Books!

language-autismInnovative Investigations of Language in Autism Spectrum Disorder

Edited by Letitia R. Naigles

In recent decades, a growing number of children have been diagnosed with autism spectrum disorder (ASD), a condition characterized by, among other features, social interaction deficits and language impairment. Yet the precise nature of the disorder’s impact on language development is not well understood, in part because of the language variability among children across the autism spectrum. The contributors to this volume—experts in fields ranging from communication disorders to developmental and clinical psychology to linguistics—use innovative techniques to address two broad questions: Is the variability of language development and use in children with ASD a function of the language, such that some linguistic domains are more vulnerable to ASD than others? Or is the variability a function of the individual, such that some characteristics predispose those with ASD to have varying levels of difficulty with language development and use?

 

supervision-emotion-focusedSupervision Essentials for Emotion-Focused Therapy

by Leslie S. Greenberg and Liliana Ramona Tomescu

The authors introduce a model of supervision that is founded on the fundamental principles of emotion-focused therapy (EFT): a safe supervisory alliance and relationship, an agreed-upon focus for each supervision session, and the identification of appropriate task markers (moments of uncertainty that present opportunities for supervisory intervention). Together, EFT supervisors and supervisees carefully deconstruct recorded therapy sessions, with moment-by-moment processing of the supervisee’s responses and emotional understanding.  Through close observation, supervisors enable trainees to develop seeing, listening, and empathic skills, as they become more attuned to both verbal and non-verbal cues that indicate clients’ emotional responses.

 

 

supervision-integrativeSupervision Essentials for Integrative Psychotherapy

by John C. Norcross and Leah M. Popple

This book presents integrative supervision applicable to integrative and single-system psychotherapy alike. Distinctive features include its synthesis of supervisory methods aligned with multiple theoretical traditions, a research-informed fit of supervision to the individuality of the supervisee, its insistence on frequent feedback from both clients and trainees, and a modeling of the philosophical pluralism and pragmatic flexibility of integration itself. In reviewing videotaped therapy sessions, integrative supervisors offer key insights into common problems, demonstrate how to adjust treatment to clients’ transdiagnostic needs, and guide trainees to clinical competence.

 

  

trauma-meaning-spiritualityTrauma, Meaning, and Spirituality

Translating Research into Clinical Practice

by Crystal L. Park, Joseph M. Currier, J. Irene Harris, and Jeanne M. Slattery

Trauma represents a spiritual or religious violation for many people. Survivors attempt to make sense out of painful events, incorporating that meaning into their current worldview in either a harmful or a more helpful way. This volume helps mental health practitioners—many of whom are less religious than their clients—understand the important relationship between trauma and spirituality, and how to best help survivors create meaning out of their experiences.  Drawing on relevant theories and research, the authors present a new conceptual framework, the Reciprocal Meaning-Making Model, demonstrating how it can guide both assessment and treatment. Through the use of case material, the authors examine a range of spiritual views, traumas, and posttraumatic reactions that are reflective of the population as a whole rather than targeting only specific religions or cultural perspectives.   Given the lack of scientific literature on the topic, this book fills an important gap, and will appeal to clinicians and researchers alike.

Meet Me in Illinois: A Behind-the-Scenes Look at Making APA Psychotherapy Videos

By Resarani Johnson, APA Video Supervisor

The APA Psychotherapy Video Series presents distinguished psychologists demonstrating specific approaches to a wide range of patient problems. Designed for clinical training and continuing education, these videos and DVDs were created to provide psychology students and practitioners with expert introductions to various therapeutic approaches and hands-on knowledge of how to treat particular patient issues. To learn more, including how to use these in classes or workshops, see About the APA Psychotherapy Video Series.

Making a psychotherapy training video is uniquely challenging. Imagine you are a psychologist, having spent most of your career either in the therapy room or writing scholarly articles and books. Now try to condense all of your knowledge and expertise into 90-minute therapy demonstration video. Now, imagine someone—let’s say a video producer, like me—puts a kibosh on your expectations and tells you to not try to be so comprehensive and not cover everything you know, but instead to just “be natural… as if you’re not being filmed.”

Simplifying a great body of scientific and scholarly knowledge down to its most concise points is indeed a hardy task that is easier said than done, and it certainly should not be mistaken for “dumbing down.” I understand their frustration, but will never know it firsthand. Although I am in the world of psychology, I am neither a therapist nor an academic, and so I try to put myself in their shoes as much as possible.

Setting Expectations

It’s a thin tightrope to walk. Our target audience consists in part of practicing therapists, researchers, and professors, but the main audience is graduate students. So, my first goal is getting guest experts to understand that they are talking not to their peers, but to the students that will one day be their colleagues. My second goal is convincing the guest experts not to second guess their on-camera performances. I’ve found that lending them a final video of a related topic or approach well before the shoot commences helps them to ease into the idea of being on-camera, and visualize what the end result may look like. That doesn’t mean, of course, that we don’t come across little snags, such as when the guest therapist forgets to look at the roundtable participants and not the cameras when they’re answering a question. But these are small things, and we can usually stop and reshoot whenever they crop up.

Often there are moments toward the end of the day where the guest therapist has a moment to reflect on their performance. This usually includes self-criticism and lamentations, “I wish I would’ve…,” or “Do you think we could redo…,” or the more infamous request: “Can we edit the beginning of the [said] therapy session and mix that in with the latter part of the other session?” The answer is always no. I advise them, as the oil canvas in my office says: “Don’t overthink it.”

Filming

On the first day, three therapy sessions are shot. The guest therapist selects the best one, which goes into the final video product. The next day, university counseling and psychology students and instructors at Governors State University, in University Park, Illinois—where our sessions are filmed—screen the chosen therapy session and participate in a question-and-answer session. They also get to meet and have lunch with the guest therapist, and make fruitful networking connections.

Many key players help make our productions successful: the guest therapists, client volunteers, roundtable participants, as well as our studio crew, and coordinators. Sometimes, we’ll hire actors to perform roles based on actual case material with identifying characteristics removed, or we’ll have actors play roles that are completely fictional and conceived to help illustrate the guest therapists’ approach. We do this whenever we may be demonstrating a sensitive presenting issue or difficult topic.

Group Therapy Sessions

The most challenging demonstrations often are those featuring group therapy. Getting one person to commit to recording a therapy session is hard enough. Asking a group of strangers to divulge their intimate thoughts and feelings in front of other people, on-camera, is even harder. Which is why I’m always on pins and needles the day that these shoots occur. We always have backup client participants on speed dial, in the event anyone decides to renege at the last minute (and yes, this has happened on several occasions). By contrast, the easiest sessions usually depict couples’ therapy. These client participants are less likely to cancel their session and usually are the most eager to get their issues resolved.

Shortly after a shoot has wrapped, most guest therapists say that the process wasn’t as bad as they originally anticipated—in fact, most enjoy it. From viewer feedback, we know that students, therapists, and instructors alike enjoy these videos and find them to be a valuable teaching aid. Overall, what makes this work rewarding is seeing the client volunteers leave the sessions feeling so much better than they were when they arrived.