Treating Mental Illness and Behavior Disorders in Children and Adults with Mental Retardation

出版者:Amer Psychiatric Pub Inc

作者:Dosen, Anton (EDT)/ Day, Kenneth (EDT)

页数:576

出版时间:2001-1

价格:$ 143.51

装帧:HRD

isbn号码:9780880488501

具体描述

Since the 1970s, the development of normalization philosophy and the implementation of community care policies have highlighted the nature and treatment of psychiatric and behavior disorders in people with mental retardation and rekindled the interest of scientists, psychiatric practitioners, and service providers. With these changes has grown a substantial body of new research and information on the phenomenology, epidemiology, classification, and clinical features of mental illness and behavior disorders in mentally retarded persons. In response to this growing interest and awareness, the editors, together with internationally renowned contributors from the United States and Europe, have compiled the first comprehensive handbook of the current theory and practice of mental health treatment and care in mentally retarded children and adults. Both contemporary and in-depth, this multidisciplinary, multidimensional volume covers all available therapeutic methods, including psychopharmacotherapy, psychotherapy, behavior therapies, cognitive therapy, and the systems approach for all the main diagnostic disorders in people with mental retardation. Parts I and II present an overview of epidemiology and clinical presentation, including research trends, and therapeutic methods, including psychotherapy, psychopharmacology, behavioral therapies, cognitive and social learning treatments, and working with families and caregivers. Parts III and IV focus on psychotherapeutic interventions, such as rational emotive group treatment with dually diagnosed adults, pre-therapy for persons with mental retardation who are also psychotic, and systemic therapy, and how to apply these methods to the treatment of specific mental illnesses, such as schizophrenia, epilepsy, and mood and anxiety disorders. Parts V and VI discuss how to treat behavior disorders such as aggression/self-aggression (pharmacotherapy and strategic behavioral interventions) and self-injurious behaviors (multimodal contextual approach), including group therapy for sex offenders and a pedagogical approach to behavior problems, and which treatment methods, such as psychodynamically oriented psychotherapy and pharmacotherapy, are most effective with children, including developmental-dynamic relationship therapy with more severely mentally retarded children. Parts VII and VIII provide guidance on mental health services and staff training, including psychiatric treatment in community care and a model for inpatient services for mentally ill persons with mental retardation, and the editors final chapter, which draws together all the various therapeutic approaches described in previous chapters to provide a practical framework for an integrative approach. Filling a major gap in the literature, this indispensable resource for psychiatrists, psychologists, and educators working with mentally retarded persons is also intended for general practitioners, doctors, social workers, and therapists working in the same or related fields.

用户评价

如果非要用一个词来概括这本书的价值，那大概是“前瞻性”。它不仅仅总结了过去几十年在心智障碍和精神健康交叉领域的研究成果，更是在引领我们看向未来数年的发展方向。书中对于技术辅助治疗（Assistive Technology）的探讨，尤其让我眼前一亮，它细致地介绍了如何利用平板电脑应用、可穿戴设备等新兴工具，来辅助情绪调节和社交技能的训练，这些内容在现有的大多数参考书中还属于新兴或未被深入探讨的领域。作者的写作风格，在学术的严谨性之外，带有一种坚定的乐观主义色彩，这对于我们这个常常被挫败感包围的群体来说，是极其宝贵的精神食粮。它让我们相信，通过科学、人道和创新的多重努力，我们能够持续改善这些特殊群体的生活质量。这本书的阅读体验，更像是一次高强度的专业进修，而非简单的知识吸收。

这本书的编排结构非常巧妙，它没有采用传统的“从轻到重”或者“按年龄段划分”的模式，而是围绕“共病关系”这一核心主题展开了多维度的分析。我注意到，书中对焦虑障碍和重度抑郁在智力受损人群中的独特表现形式进行了详尽的对比分析，这解决了我长期以来在鉴别诊断中感到困惑的盲点。例如，如何区分因环境限制导致的情绪低落与内源性抑郁发作，书中的区分标准清晰得令人拍案叫绝。更值得称赞的是，它对心理治疗技术（如认知行为疗法CBT和辩证行为疗法DBT）在心智迟滞群体中的“适配性改造”提供了详尽的蓝图。它不是简单地把成人版本的技术“缩小”后套用，而是真正探讨了如何通过视觉提示、社交故事、以及对抽象概念的具体化处理，来实现治疗目标的有效传递。这种对技术本土化和情境化的深刻理解，使得整本书的实用价值倍增，远超一般教科书的范畴，更像是一部高阶的实践指南。

我必须承认，阅读这本书的过程是一次对既有观念的持续挑战。作者对传统“机构化”照护模式的批判，虽然措辞严谨，但力度十足，毫不留情地指出了许多在实践中被习以为常的弊端。他毫不讳言地探讨了在智力障碍群体中，药物滥用和过度镇静的风险，并提供了强有力的替代方案，如基于积极行为支持（PBS）的生态学干预框架。这种勇于直面行业阴暗面、并提供建设性出路的勇气，是很多同类书籍所缺乏的。此外，书中对于司法和伦理困境的讨论也极为深刻，特别是涉及到自主权、知情同意和能力评估的交叉问题时，作者给出的多方利益权衡模型，极具启发性，让我在思考如何维护个案权益时，有了一个更坚实的伦理基石可以依赖。这本书的深度，在于它不仅关注“治什么病”，更关注“如何以一个完整、有尊严的人去生活”。

这部作品的问世，无疑为长期在特殊教育和临床实践中摸索的同仁们带来了一股清新的气息。我特别欣赏作者在构建理论框架时所展现出的那种审慎与平衡。它并未简单地将智力障碍视为单一的、静止的标签，而是深入探讨了在各种共病精神健康问题出现时，传统治疗模式所面临的结构性困境。书中对评估工具的选择与解读，给出了极其细致的指导，这一点对于非精神病学背景的专业人士来说，简直是及时雨。例如，它详细剖析了如何区分智力障碍本身带来的适应性缺陷与真正意义上的精神障碍表现，这在临床实践中常常是模糊不清的边界地带。我尤其关注其中关于非语言沟通障碍者行为评估的部分，作者没有止步于行为描述，而是试图探究行为背后的功能性诉求，提供了大量基于功能性行为评估（FBA）的实际案例转化。这些案例不仅仅是理论的罗列，而是充满了实操的智慧，让人读完后立刻有想回到工作岗位上尝试新方法的冲动。这种对细节的执着和对实践的深刻理解，使得这本书的厚重感不仅仅体现在页数上，更在于其内容所蕴含的临床深度。它真正做到了架起理论与一线服务之间的桥梁，而不是仅仅停留在高深的学术讨论层面。

老实说，初次翻开这本书时，我有些担心它会陷入过于学术化、晦涩难懂的泥沼，毕竟处理“心智迟滞”这类复杂议题，常常意味着面对大量术语和复杂的神经生物学机制。然而，作者的叙事风格出乎意料地具有引导性，仿佛一位经验老到的导师，循循善诱地带领读者进入这个复杂领域。最让我感到震撼的是它对于“人性化干预”的坚持。在探讨药物管理和行为矫正技术时，书中始终强调个体化的尊严和权利，这在一些强调效率的当代医疗体系中，显得尤为珍贵。它不是简单地提供一套“如何驯服”或“如何管理”的SOP，而是引导读者去理解，每一个行为变化背后都隐藏着一个未被满足的需求和一套独特的认知世界。书中对于家庭支持系统构建的章节，更是写得充满温情与洞察力，它没有将家庭视为负担，而是视为核心的治疗伙伴，并提供了详尽的沟通策略和边界设定的建议。这种全人视角、将治疗融入日常生活的理念，对于我们这些长期与个案及家属打交道的从业者来说，无疑是一剂强心针，重新点燃了我们对长期照护工作的热情与责任感。