1st Edition

Emergencies in Mental Health Practice Evaluation and Management

Edited By Phillip M. Kleespies Copyright 1998

    Focusing on acute clinical situations in which there is an imminent risk of serious harm or death to self or others, this practical resource helps clinicians evaluate and manage a wide range of mental health emergencies. Authors examine how to distinguish crises that are emergencies from those that are not, and provide basic instruction in crisis theory and emergency interviewing. The volume then provides guidelines for intervening with suicidal patients, potentially violent patients, and vulnerable victims of violence, as well as patients facing life-and-death medical decisions, with careful attention to risk management and forensic issues. Also addressed are emergency-related conditions including self-mutilation, alcohol and drug-related crises, adverse reactions to psychotropic medication, and psychological symptoms of medical conditions. Finally, chapters consider the effects of emergency intervention on clinicians and offer suggestions for managing stress.

    Contents
    I. Foundations
    1. The Domain of Psychological Emergencies: An Overview, Kleespies
    2. Crisis Theory and Crisis Intervention in Emergencies, Callahan
    3. The Emergency Interview, Kleespies, Deleppo, Mori, and Niles
    II. The Evaluation and Management of Life-Threatening Behavior
    4. The Evaluation and Management of the Suicidal Patient, Clark
    5. Empirically Based Clinical Evaluation and Management of the Potentially Violent Patient, McNie
    l6. Crisis Assessment and Interventions with Victims of Violence, Yassen and Harvey
    7. Life and Death Decisions: Refusing Life-Sustaining Treatment, Kleespies and Mori
    8. The Emergency Telephone Call, Kleespies and Blackburn
    III. Risk Management in Psychological Emergencies
    9. Risk Management with the Suicidal Patient, Bongar, Greaney, and Peruzzi
    10. Risk Management with the Violent Patient, Eddy and Harris
    IV. Emergency-Related Crises and Conditions
    11. Responding to Self-Injurious Behavior, Deiter and Pearlman
    12. The Evaluation and Management of Alcohol and Drug-Related Crises, Trezza and Popp
    V. Medical Conditions Presenting as Psychological Crises
    13. Side Effects of and Reactions to Psychotropic Medications, Popp and Trezza
    14. Psychological/Behavioral Symptoms in Neurological Disorders, White, Marans, and Krengel
    15. Psychological Symptoms in Endocrine Disorders, Samson, Levin, and Richardson
    16. Psychological Factors in Cardiac Disease, Clark, Nash, Cohen, Chase, and Niaura
    VI. The Impact of Emergency Service on the Clinician
    17. Emergencies with Suicidal Patients: The Impact on the Clinician, Kleespies, Niles, Mori, and Deleppo
    18. The Stress of Violent Behavior for the Clinician, Guy and Brady
    19. The Ecstasy and the Agony: The Impact of Disaster and Trauma Work on the Self of the Clinician, Charney and Pearlman

    Biography

    Phillip M. Kleespies, PhD, ABPP, VA Medical Center and Tufts University School of Medicine, Boston, Ma .

    This book clearly and creatively lays out effective techniques for rapidly responding to a wide variety of real-world crises. Empirically solid and clinically astute, this work is without peer as a guide to providing urgent care. When time is of the essence, every practitioner will want to have Kleespies' book within arm's reach. --John Monahan, PhD, Doherty Professor of Law, University of Virginia

    This book provides an extraordinarily well-stocked workroom of tools necessary for today's clinicians. It begins with an awareness of the appalling deficiency in graduate clinical training to ready mental health clinicians to deal with a wide and anxiety-provoking range of psychiatric crises. It succeeds admirably in providing the essential knowledge and competencies that readers need in order to become effective interventionists. Moreover, it helps clinicians contain and manage both their affect and their exposure to malpractice risk should a patient threaten violence to self or others. With these tools, clinicians can build structures capable of weathering any and all storms. Timely and strategic, this book should be required reading for both novice and experienced professionals. --Alan L. Berman, PhD, author of Adolescent Suicide
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