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Article fun with 330 denier cordura have tone on pet responses considered, and decisions made on the basis of email communication must comply with clinical standards of care. Read the article for yourself; it's shorter than the numbers imply. Stop Avoidng ECT for Suicidal Patients I continue to be very disappointed that acutely depressed and suicidal patients rarely have opportunity for electroconvulsive therapy malpractice cases that involve suicide the majority of such cases and the number one malpractice cause of action against psychiatrists and psychiatric hospitals ECT, one of the fastest, best and safest treatments, has rarely been adequately considered. The psychiatric literature is currently touting ketamine treatment for depressive episodes. spite of lack of proof of lasting benefit, and being fraught with potential for adverse effects, some authors want to place a ketamine trial before ECT treatment algorythms. Other authorities cooler heads, view 't recommend that Kellner and others, experts ECT, succinctly outline the fact that ECT is a proven, standard treatment; ketamine is not Failure to adequately consider ECT acute, potentially suicidal depression is routinely below the standard of care. This treatment saves lives, and ECT consultation goes a way toward showing that the treating clinician has exercised good judgment patient care and risk mitigation. Assessing Risk of Violence: 't Be DISTURBED I recently read article that brought up old, but continuing, problem inherent acronym-based checklists for assessing violence risk The problem: Such acronyms rarely differentiate highly important or critical risk factors from those that are much less useful. Without meaning to castigate Drs. Newman and Xiong, who were no doubt trying to encourage clinicians to think about a broad range of risk factors when evaluating patients or clients for violence risk, their acronym DISTURBED unfortunately mixes important risk factors with relatively unimportant ones, and doesn't prioritize the items. Some of their factors are virtually useless when assessing risk For example, demographics refers to age, gender, education, financial hardship, etc., all of which, while with violence, are poor and unfair predictors of individual violent behavior. Correlation, after all, is a large-group statistic. Further, correlations of violence with the demographics mentioned are generally low anyway. That's a lot of false positives. It's also opportunity to downplay real risk people who 't fit the demographic model. point is that if one is trying to assess individual risk of violence, or trying to develop a screening instrument to help that effort, it is crucial to pay far more attention to factors that are very highly correlated with violence than to those with little predictive value one person. addition, anyone asked to evaluate risk of violence should first ask what of violence is being contemplated, and what People take risk evaluators seriously; let's be careful out there. Cognitive Behavioral Therapy Suicide Prevention, and Risk Reduction for Both Patients and Psychiatrists Suicide is far and away the most common cause of action malpractice lawsuits against psychiatrists and other mental health clinicians and entities. The civil portion of forensic practice is filled with clinicians accused of being negligent assessing or managing suicide risk, whose alleged negligence allowed or was said to have caused a preventable suicide. The most vulnerable defendants are those who fail to provide adequate assessment and protection for patients at acute risk, but I am continually amazed at the number of both acutely and chronically suicidal patients who 't receive the psychotherapy that could really help them, could lower their risk, and could decrease their risk of malpractice suits and the heartache that comes from having a patient kill himself or herself. The fact is, competent counselors and psychotherapists should the kinds of therapy that often work with suicidal patients. The research is there, and has been well-known for years. Good training programs teach it. Continuing education programs regularly feature the counseling techniques that can save lives It's just not rocket science! Cognitive-behavioral therapy is one of the best, most reliable, and most studied treatment formats for suicidal patients, and for of the disorders such as severe depression and anxiety associated with suicide. A quick search of the professional literature reveals scores of articles and studies that illustrate its effectiveness. Here's what I'm talking about: I'm not talking about the kind of counseling or -called therapy that most hospitals and practitioners rely on for patients with thoughts of killing themselves. Virtually every psychiatric hospital and partial hospital program I know of gives all patients the same, cookie-cutter group therapy that's rarely therapy at all. I'm tired of seeing completely generic groups that focus on daily living, activities, and supportive counseling being sold to patients, families, and insurance companies as if they were individualized treatment for patients who need specific, truly individualized care order to address their mental disorders and reduce their suicide risk. If you're a clinician, advocate for much broader and better care for your patients. If you're a patient or a member of a patient's family, ask questions about the kind of counseling that's being used, and the qualifications of the counselors who provide it. The Effect of Suicide on Treating Psychiatrists There's a great article 2015, issue of on suicide and, part, its effect on treating psychiatrists. It's not really forensic, but it's a very good, non-technical,