Reviewed Books & Films

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February 2012

Thursday, February 23, 2012

Can Investing in Psychological Services Reduce Medical Costs in the Long Run?

APA Robert McGrath and Gillian Donovan call Nicholas Cummings and William O'Donohue's Understanding the Behavioral Healthcare Crisis: The Promise of Integrated Care and Diagnostic Reform "timely, informative, and important." However, they question the authors' unqualified endorsement of the medical cost offset argument for psychological services, noting,

Although there is good evidence for the possibility of a medical cost offset resulting from the provision of psychosocial services (Chiles, Lambert, & Hatch, 2002), there are also notable failures to demonstrate this offset (e.g., Bickman, 1996; Polen, Freeborn, Lynch, Mullooly, & Dickinson, 2006). In the absence of extensive information about the circumstances under which the offset is demonstrable, using this argument as the primary justification for involvement in healthcare has the potential to backfire.
In toto, does the extant evidence support claims that psychological services actually save money in the long run by reducing medical costs?

Read the Review
ReviewBehavioral Health Care in the Brave New Health Care World
By Robert E. McGrath and Gillian Donovan
      PsycCRITIQUES, 2012 Vol 57(7)

Thursday, February 16, 2012

Romance Gone Bad...But Why?

APA The popular film Blue Valentine is an engaging and interesting drama that explores the vicissitudes of a romantic relationship, times when it is going well and vibrating with excitement, periods when it is languishing into a downward spiral, and those mundane experiences somewhere in between. In her review of the film, Karen Conner notes that there is a paucity of research that explores the origins of those emotional dynamics that lead to early divorce (e.g., stonewalling, defensiveness, cynicism). In this vein, she poses some interesting questions for viewers/readers to consider, including the following: What happens to a relationship when one partner is in romantic love and the other is not? Under what circumstances does such a relationship survive and thrive, or devolve into one of wounding accusations and bitter disappointment?

Read the Review
ReviewThe Love That Wasn't
By Karen Conner
      PsycCRITIQUES, 2012 Vol 57(4)

Thursday, February 09, 2012

Promising More Than Can Be Delivered

APA Elaine Walker and Carrie Holtzman say in their review that "Schizophrenia: Current Science and Clinical Practice brings together international experts in the field of schizophrenia to present overviews of contemporary scientific findings on the etiology and treatment of the disorder," highlighting findings from neurobiological, genetic, social, and neurocognitive research. They also note that these experts call attention to the "complex etiologic processes that give rise to schizophrenia" and to the growing recognition of the need for intervention at the various stages of the disorder, including the "putative prodromal stage," which might have implications for "preventing or at least delaying the onset of psychosis." There is also a discussion of how "advances in our understanding of the biological underpinnings of the disorder may directly inform efforts toward individually tailored treatments."

When I began my career in psychology, it was frequently asserted that the cutting-edge genetic and neurobiological research of the time would change the course of treatment for serious mental illnesses, particularly schizophrenia. Three decades have passed since I began my training, and the promise of biologically and genetically informed treatments remains. However, I find that I am much less enthusiastic about each of the latest findings than I once was. Certainly the introduction of atypical antipsychotic medications has changed the prognosis and quality of life for those diagnosed with schizophrenia, and we understand much more about the value of tailoring interventions to the stage of the disorder. Despite advances, I find myself wondering whether the resources devoted to genetic, neurocognitive, and neurobiological research have delivered all that has been promised. Or, perhaps, I am simply impatient with the pace of translation of findings into practice. Do you think research in these areas is delivering on its promise? Or should we be adjusting our expectations?

Read the Review
ReviewThe Science of Schizophrenia: Synthesizing the Latest in Research and Practice
By Elaine F. Walker and Carrie W. Holtzman
      PsycCRITIQUES, 2012 Vol 57(2)

Thursday, February 02, 2012

Should Health Be Considered a Basic Human Right?

APA The words that we memorize from the United States Declaration of Independence—"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness"—should serve as an impetus to us to question why, as a society, we choose to make health a commodity to be bought and sold. How can individuals have a right to life without the basic resources that ensure health, including basic housing, sanitation, clean water, nutrition, and health care? And yet, as a nation, we have struggled for several decades with the issue of how to deliver health care to all of our citizens. And if we cannot or will not deliver it within our own borders, how great could our real commitment to global health be?

In his review of the book Rights-Based Approaches to Public Health, Will Ross points the reader to the UN's General Comment 14 on the Right to the Highest Attainable Standard of Physical and Mental Health: "Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life of dignity." Ross goes on to describe the rights-based approach (RBA) framework that is presented in the book as one that "cannot be easily dismissed as political in nature or hegemonic." He describes the book as the editors' attempt to have "respected public health practitioners and human rights advocates…craft sensible methods of operationalizing the basic human rights principles outlined in the UN's (2003) Human Rights Based Approach Statement of Common Understanding." However, I question whether sensible strategies for operationalizing the human rights principles discussed are our major implementation problem. Rather, it seems that this is more about politics and how our democracy will act at home and abroad as the social and economic demands of an age of global connectedness press us to live up to the ideals espoused in the Declaration of Independence and the United States Constitution.

Psychology is a discipline with a wealth of knowledge in decision making, conflict resolution, intergroup relations, altruism, health behavior, mental health, and well-being. Given criticisms that RBA approaches are "costly, time-intensive," and "lack solid evidence supporting their effectiveness," are we psychologists willing to support efforts to at least engage in dialogue to determine whether this framework can lift the level of the debate? Will we support advocacy on the part of the American Psychological Association even if we are unwilling to engage in such advocacy as individuals?

Read the Review
ReviewPublic Health and Human Rights: Realigning Approaches to Improve Global Health Problems
      By Will Ross
      PsycCRITIQUES, 2012 Vol 57(5)

Editor of PsycCRITIQUES

Danny Wedding, PhD

Chair of Behavioral Sciences,
College of Medicine,
American University of Antigua

Associate Editors of PsycCRITIQUES

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