Reaching out: mass media techniques for child and adolescent psychiatrists.
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Curriculum↗
Biomedical subjects
E V Beresin
Publications and source records attributed to E V Beresin.
Child and adolescent psychiatry residency training: current issues and controversies.
OBJECTIVE: To examine major current influences on child and adolescent psychiatry (CAP) residency training, highlighting the most common problems. Potential solutions and unresolved dilemmas are presented. METHOD: Data were gathered from empirical studies, review articles, national census data, and discussions over the past decade at national meetings on recruitment of residents and faculty; clinical, didactic, and research training; the impact of managed care and changes in graduate medical education funding; and the professional development of CAP residents. RESULTS: Overall there are significant problems recruiting U.S. medical students and attracting faculty into CAP training programs. Economic forces, including decreased reimbursements from managed care and the federal government, are threatening the survival and vitality of training programs. Managed care is harmful for sound residency training and identity formation of the child and adolescent psychiatrist. CONCLUSIONS: The integrity of CAP residency training in the future will depend on increased efforts of teaching hospitals and programs to develop fiscally viable systems of care integrated with residency training; seek new sources of training subsidies; modify traditional models of clinical and didactic curricula; and foster greater collaboration between training programs locally and nationally.
Adolescent Psychiatry↗
Developmental formulation and psychotherapy of borderline adolescents.
Treatment of the borderline adolescent requires a highly sophisticated, multimodal treatment formulation that is based on a developmental, psychodynamic formulation of the patient and family system. The therapeutic model chosen must fit the case as well as possible, but, of necessity, may change as the patient grows and develops. It is of utmost importance to understand the patient's process of growth and development and the utilization of each particular model of psychotherapy chosen. Therapeutic techniques should derive from the model(s) of treatment and should constantly be analyzed during the course of psychotherapy with these very difficult patients. The case example illustrates the treatment of a borderline personality patient who, in Goldstein and Jones's model, initially was in Group IV, the withdrawn and socially isolated group, but as therapy developed, fell into Group II in her defiance, disrespectful stance toward her mother, belligerance, and antagonism both in the family and in therapy. She progressively was able to relinquish her defensive stance of denial, projection, and splitting, and became more aware of her affect. As she progressed in therapy, her mood shifted from states of anger to states of depression and self-consciousness and her treatment was facilitated by use of pharmacotherapeutic agents and a very close-knit outpatient team. It is important to emphasize the value of a close-knit working outpatient team in the psychotherapy.
Adolescent↗
Training general psychiatry residents in child and adolescent psychiatry.
The authors describe the nature of current social and economic forces impacting on the education and future practice of general psychiatry residents in child and adolescent psychiatry. They review theoretical and practical reasons for training in child and adolescent psychiatry, analyze the form and content of what is currently taught based on a national survey of general training programs, and suggest guidelines for the training and postgraduate practice of general psychiatrists in evaluating and treating children and adolescents. The authors conclude that while social and economic changes necessitate general psychiatrists' clinical involvement with children and adolescents, insufficient general training may necessitate postgraduate education and supervision. They pose ethical and professional dilemmas for the field in meeting the national shortage of child and adolescent psychiatrists and propose strategies to enhance recruitment into child and adolescent residency training.
Adolescent Psychiatry↗
Child psychiatry fellowship training: a crisis in recruitment and manpower.
Eighty-three percent (104 of 126) of the accredited child psychiatry fellowships in the United States responded to a survey of current manpower and training problems facing child psychiatry. Thirty-five percent of the respondents were having trouble filling their classes with highly qualified fellows, and 45% were having difficulty recruiting faculty child psychiatrists. Other significant problems included developing faculty interest in research, providing didactic seminars in new areas such as developmental neurobiology and infant psychiatry, and funding fellow and faculty positions and research. The authors examine this crisis in manpower, recruitment, and training and suggest solutions on local and national levels.
Accreditation↗
The process of recovering from anorexia nervosa.
The authors describe the process of recovering from anorexia nervosa as it is revealed by 13 women who have recovered from the illness. Emphasizing the patient's perspective, the paper reviews the perceived causes of the disorder, helpful and harmful therapy-related and life experiences, features hardest to change, the defensive function of anorexia nervosa and residual traits. Generally, the movement toward health entails forming a therapeutic relationship in which the anorexic can identify and express feelings, experience the empathic, nonjudgmental understanding of another person, separate from a pathological family system, resolve hostile dependent attachment to parents, assuage primitive guilt, and engage in the trials of adolescent psychosexual development to enter adulthood with the beginnings of a firm, cohesive sense of self.
Adult↗
Imipramine in the treatment of chronic pelvic pain.
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Adult↗
Delirium in the elderly.
Delirium is an organic psychiatric syndrome characterized by acute onset and impairment in cognition, perception, and behavior. The most common and serious mental disorder in old age, delirium heralds death in about 25% of afflicted elderly patients. Despite this high mortality rate, it is usually a transient disorder, resulting in full recovery without progressing to a chronic mental disorder. Almost any physical illness may cause delirium in an elderly person. Prompt assessment, differential diagnosis, and treatment are essential to reverse the medical disorder and control behavior that may be life threatening. This paper presents an approach to the diagnosis of delirium, reviewing descriptive features of the syndrome, biological, psychological, and environmental variables predisposing to delirium in geriatric patients, and the most common medical etiologies. It describes effective therapeutics, including ward management, supportive psychotherapy, and pharmacotherapy.
Aged↗
The changing economics of child and adolescent psychiatry training.
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Adolescent Psychiatry↗