Melissa Piasecki

Acceptance-Based Treatment for Smoking Cessation

This pilot study applied a theoretically derived model of acceptance-based treatment process to smoking cessation, and compared it to a pharmacological treatment based on a medical dependence model. Seventy-six nicotine-dependent smokers were randomly assigned to one of two treatments: Nicotine Replacement Treatment (NRT), or a smoking-focused version of Acceptance and Commitment Therapy (ACT). There were no differences between conditions at posttreatment; however, participants in the ACT condition had better long-term smoking outcomes at 1-year follow-up. As predicted by the acceptance process model, ACT outcomes at 1 year were mediated by improvements in acceptance-related skills. Withdrawal symptoms and negative affect neither differed between conditions nor predicted outcomes. Results were consistent with the functional acceptance-based treatment model.

A Preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone-maintained opiate addicts

The present study compared methadone maintenance alone to methadone maintenance in combination with 16 weeks of either Intensive Twelve-Step Facilitation (ITSF) or Acceptance and Commitment Therapy (ACT) in a preliminary efficacy trial with polysubstance-abusing opiate addicts who were continuing to use drugs while on methadone maintenance. Results showed that the addition of ACT was associated with lower objectively assessed opiate and total drug use during follow-up than methadone maintenance alone, and lower subjective measures of total drug use at follow-up. An intent-to-treat analysis which assumed that missing drug data indicated drug use also provided support for the reliability of objectively assessed total drug use decreases in the ACT condition. ITSF reduced objective measures of total drug use during follow-up but not in the intent-to-treat analyses. Most measures of adjustment and psychological distress improved in all conditions, but there was no evidence of differential improvement across conditions in these areas. Both ACT and ITSF merit further exploration as a means of reducing severe drug abuse.

Cultural Change in a Medical School: A Data-Driven Management of Entropy

Medical school organizations are incredibly complex entities operating within multifaceted systems that exert multiple environmental pressures on the internal practices of the schools. Moreover, the components of medical schools operate within the contingencies of the medical school as a whole, such as the recent curricular change that occurred at the University of Nevada School of Medicine. That change required organizational and cultural changes in many different areas within the school and at all levels of the school’s organizational hierarchy. Three separate studies were conducted during this time of transition to evaluate the practices of major stakeholders within the organization: emerging leader interviews and a Faculty Forward© survey for faculty and the application of the Implicit Relational Assessment Procedure for students. The results are depictive of ways by which behavioral systemic assessments can serve as important tools for guiding comprehensive and empirically based success in complex organizational systems.

Problem-Based Behavioral Science and Psychiatry

How to Use This Book.- Human Behavior.- Childhood Development.- Effects of Experience on Brain Development.- Learning Principles of Human Behavior.- Sexuality Throughout the Life Cycle.- Adaptation and Coping in a Medical Setting.- Violence and Abuse.- Healthcare Principles.- The Physician-Patient Relationship.- Ethics and Professionalism.- Adherence in Medicine.- Stress and Health.- Health Care 101.- Stigma and Medicine.- Culture, Ethnicity, and Medicine.- Quantitative Measures in Healthcare.- Death, Dying, and End-of-Life Care.- Behavioral Neuroscience and Clinical Psychiatry.- Basic Principles of Evaluation: Interviewing, Mental Status Examination, Differential Diagnosis, and Treatment Planning.- Disorders of Childhood.- Substance Use Disorders.- Psychotic Disorders.- Mood Disorders and Suicide.- Anxiety Disorders.- Somatoform Disorders.- Personality Disorders.- Cognitive Disorders.- Sleep Disorders.- Eating Disorders.- Sexual Disorders.- Other Disorders.

How to Use This Book

Welcome to the second edition of Problem-Based Behavioral Sciences and Clinical Psychiatry: A Review for Medical Students! In this chapter, our aim is to illustrate how the problem-based learning process works so that you can apply it to other cases in this textbook.

The Forensic Assessment of Substance Abuse

Publisher Summary This chapter reviews the interaction between criminal behavior and substance use. It discusses legal guidelines and precedents in the courts. The chapter provides an overview of assessment tests, tools, and techniques that can be applied to evaluate substance use. There are legally two general issues in the relationship between criminal behavior and substance use. One relates to the possession, sale, and use of illegal drugs as criminal behavior and the other concerns with antisocial behavior resulting from the effect of drug. The majority of arrests for the offense of drug abuse violations are for possession of marijuana. Alcohol and other drugs have been addressed in innumerable cases in both civil and criminal law. Two landmark cases underlie current legal thinking on criminal responsibility and alcoholism and drug addiction. Many measures of substance use are based on the Diagnostic and Statistical Manual of Mental Disorders. The most commonly employed method of assessment used in alcohol treatment agencies to diagnose substance use disorders is the clinical interview. The chapter concludes with a briefly discussion on the literature on the treatment of individuals with a substance use disorder.