http://www.behavioral.net/ME2/Console/XmlSyndication/Display/RSS.asp?xsid=1589762DEE3D4BD79161A35B8FB978A1 Behavioral Healthcare Current News http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=58F4FD0BD70D4B29893D20D20A2D8B1A Leeds, UK — People who spend a lot of time browsing the net are more likely to show depressive symptoms, according to the first large-scale study of its kind in the West by University of Leeds psychologists. Researchers found striking evidence that some users have developed a compulsive Internet habit, whereby they replace real-life social interaction with online chat rooms and social networking sites. The results suggest that this type of addictive surfing can have a serious impact on mental health. Lead author Dr. Catriona Morrison, from the University of Leeds, said: "The Internet now plays a huge part in modern life, but its benefits are accompanied by a darker side. "While many of us use the Internet to pay bills, shop, and send e-mails, there is a small subset of the population who find it hard to control how much time they spend online, to the point where it interferes with their daily activities." These 'Internet addicts' spent proportionately more time browsing sexually gratifying Web sites, online gaming sites, and online communities. They also had a higher incidence of moderate to severe depression than non-addicted users. "Our research indicates that excessive Internet use is associated with depression, but what we don't know is which comes first—are depressed people drawn to the Internet or does the Internet cause depression? "What is clear, is that for a small subset of people, excessive use of the Internet could be a warning signal for depressive tendencies." Incidents such as the spate of suicides among teenagers in the Welsh town of Bridgend in 2008 led many to question the extent to which social networking sites can contribute to depressive thoughts in vulnerable teenagers. In the Leeds study, young people were more likely to be Internet addicted than middle-aged users, with the average age of the addicted group standing at 21 years. "This study reinforces the public speculation that over-engaging in Web sites that serve to replace normal social function might be linked to psychological disorders like depression and addiction," added Dr Morrison. "We now need to consider the wider societal implications of this relationship and establish clearly the effects of excessive Internet use on mental health." This was the first large-scale study of Western young people to consider the relationship between Internet addiction and depression. The Internet use and depression levels of 1,319 people aged 16-51 were evaluated for the study, and of these, 1.2 percent were classed as being Internet addicted. While small, this figure is larger than the incidence of gambling in the UK, which stands at 0.6 percent. The research will be published in the journal Psychopathology on Feb. 10. Mon, 08 Feb 2010 08:27:22 EST 58F4FD0BD70D4B29893D20D20A2D8B1A http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=6E390E1C883B4DA2A307D8B0711C3515 Alexandria, VA — Mental Health America today commended the Obama Administration for proposing a Fiscal Year 2011 Budget that contains increases for most of the nation's public health agencies, which highlights the need to invest in critical mental health supports and services beyond important steps that would be taken through healthcare reform. The budget, which was released on Feb. 1, prioritizes public health programs, including increases in funding for the Substance Abuse and Mental Health Services Administration (SAMHSA), despite a difficult fiscal landscape. Mental Health America looks forward to working with Congress and the Administration to build upon the proposed budget, which includes a $110 million increase (3.1 percent) for SAMHSA, a $1 billion increase (three percent) for the National Institutes of Health, and a $5.2 billion increase (eight percent increase) for mental healthcare services at the Department of Veterans Affairs. The Administration's proposed funding increases would expand the crucial services and supports, research, and prevention interventions for people living with, or at risk of, mental illness that are provided or supported not only through SAMHSA, but at other agencies such as NIH, the Health Resources Services Administration (HRSA), the Agency for Healthcare Research and Quality, and Centers for Disease Control and Prevention. The budget also recognizes the importance of consumer and family participation in one's recovery (for example, the budget proposes a modest increase for Center for Mental Health Services' Consumer and Family Network Grants), as well as the need for integration of behavioral health with primary care (for example, the budget proposes allocating $25 million towards the integration of behavioral services into primary care health systems at HRSA). The budget also includes $25 billion to extend for six months—until July of next year—a Medicaid funding increase (called FMAP) for the states that was included in last year's stimulus bill. The initiative helps cover critical services and programs that are under pressure because of declining state revenues. "The message the Administration is sending with this budget is clear and important," said David Shern, PhD, president and CEO of Mental Health America. "Funding for health, including behavioral health, complements healthcare reform efforts and is vital for delivering prevention, early intervention, treatment services, and research to communities throughout the nation." Fri, 05 Feb 2010 12:29:10 EST 6E390E1C883B4DA2A307D8B0711C3515 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=595699A460AB4CF7B0675F4DF882F7B4 Plantation, FL — The National Association for Continuing Education (NACE) announces new CE courses for psychologists, social workers, marriage and family therapists, and licensed mental health professionals. With online continuing education booming, NACE has responded to the requests of members to provide more online courses on post-traumatic stress disorders. NACE now offers the following new online course at http://www.naceonline.com Ethical Decision Making for Counselors: A Practical Model – 3 Credits The purpose of this course is to provide counselors with an intuitive method of resolving ethical dilemmas that is grounded in best practices as outlined in the professional literature as well as the American Counseling Association Code of Ethics (2005). Topics include the differences between ethics and the law, identifying moral principles which underlie the ethical practice of counseling, and how to apply a practical approach to ethical decision-making. This program is available for 3 continuing education (CE) credits. Completing this program should: 1. Identify differences between ethics and the law. 2. List the purposes of an ethics code. 3. Name moral principles that underlie the ethical practice of counseling. 4. Identify ways of recognizing and resolving ethical dilemmas. 5. Utilize a practical approach to ethical decision-making in counseling and other roles enacted by counselors. 6. Identify moral principles associated with select portions of the ACA Code of Ethics (2005). Mental health providers can search online at NACEonline.com to see the requirements for their state and their profession. Fri, 05 Feb 2010 12:04:52 EST 595699A460AB4CF7B0675F4DF882F7B4 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=51A9C6C1BBFD4C14A82D70BE7C21A0FA Wayne, PA — Core Solutions Inc. announced today that it will hold an award ceremony Thursday, February 11, 2010, in recognition of Wedge Medical Center, a local, highly respected behavioral health organization’s dedication to advancing patient care through electronic health record (EHR) technology. PA House of Representatives Majority Chair, Rep. W. Curtis Thomas will be there for the presentation of the award. The Wedge Medical Center, a provider of comprehensive drug and alcohol and mental health treatment for people in the Philadelphia area, will receive the Client Innovation Spotlight award from Core Solutions. Core executives say the agency, which serves over 7,000 clients in more than 10 locations, provides a great example of how organizations can collaborate to achieve improved results in healthcare technology. Under the leadership of Wedge’s CEO Pat Palmer and Chief Compliance Officer Dr. Lawrence M. Schoen, the agency expressed its goal to find a way to keep track of a variety of clinician notes for clients on an individual level, as well as a note that tied them together in a group environment. Core was then able to craft this idea of a group encounter note and will offer this feature as part of its flagship software product, Web Care. “We hope this award will not only highlight Wedge’s commitment to providing quality service through health information technology,” said Core President Ravi Ganesan, “but also show our appreciation for their passion and ingenuity.” Core Solutions, a market leader in EHR solutions for the behavioral health industry, will present its longtime client with the award at an afternoon ceremony in Philadelphia, which will also include a photo opportunity. “As we grow, Web Care collects data in a way that hasn't existed before in Philadelphia. It allows us to look at data that no one has ever looked at before,” says Dr. Schoen. “Styles of treatment and patterns emerge which allows for treatment analysis and increased efficacy and efficiency outcome measures." Fri, 05 Feb 2010 08:57:48 EST 51A9C6C1BBFD4C14A82D70BE7C21A0FA http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=AC43B4A19AE04997A7536C30A7594425 San Diego, CA — Companies such as 3M, Caterpillar, General Electric, and Time Warner Cable will share their insights and strategies at the Disability Management Employer Coalition’s (DMEC’s) 5th annual Behavioral Risk in the Workplace conference, taking place April 21-23, 2010, in Minneapolis. The three-day conference will provide disability management and HR professionals with real-world examples of best practices as well as emerging strategies that can minimize the costs of behavioral health risk management in the workplace. Attendees will learn about “Cost Containment in a New Economy” at 16 sessions plus an employer-only roundtable and scheduled networking opportunities. The conference keynote address will be presented by Barbara Campbell, Assistant Vice President, Risk Management, in The Hartford’s Group Disability Benefits Division, and will address the impact of stage—not age—on employees’ physical and behavioral health. For the first time ever, DMEC and the Employee Assistance Roundtable (EAR) have teamed up to offer an employer-only roundtable summit. This three-hour interactive session will explore emerging issues and challenges in behavioral risk: • Stress and Resiliency—Stress plays a significant role in the onset of mental and physical illness, and people vary in their ability to “roll with the punches.” In the best interests of employers and employees alike, how are we building skills, strategies, and sound corporate practices to best identify stressors and build resiliency in both our workforce and organizations? • Mental Health Parity—What have we seen so far? Are the “parity benefits” having the expected impact on employees and their families? Are there new challenges to ensure success? Educational sessions at the conference will cover 4 focus areas, and include sessions on: • Employer Response to Employee Financial Distress, with Dianne Carroll, Director Employee Assistance, Health Alliance of Greater Cincinnati. • Managing Ambivalence and Resistance: Unique Employer Solutions for Solving Complex Behavioral Health Impairments, with Jennifer Hertzfeld, Team Leader, Integrated Disability, Ohio State University; Cortney Silva, Disability Program Manager, Ohio State University; and Kenneth Mitchell, PhD, Consultant, Unum/Managing Partner, WorkRx Group Ltd. • Cost-Effective Management of Stress, Anxiety, and Depression, presented by Linda Weaver, PhD, JD, Clinical Psychologist, Clinical and Behavioral Health Solutions Group, Mercer. • Behavioral Disability and the Role of the Employee Assistance Program, presented by Chris Pawson, Manager, EAP/Behavioral Health & Life Balance Solutions, Owens Corning and Kathleen Cavinee, Disability Management Leader, Integrated Case Management. Fri, 05 Feb 2010 08:53:11 EST AC43B4A19AE04997A7536C30A7594425 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=D02DD24CE7C54AB198CAF88FA0D5F89A Houston, TX — Innovative neuroscience research and expanded clinical care have been launched at the new Center of Excellence on Mood Disorders at The University of Texas Medical School at Houston. “New research here is trying to pinpoint the neurobiological mechanisms involved in mood disorders,” said Jair Soares, MD, co-director of the center and chairman of the Department of Psychiatry and Behavioral Sciences at The University of Texas Medical School at Houston. “We need to link those discoveries to a better way to treat the disease. In the new center, we’ll be able to combine high-level care with research.” According to the National Institute of Mental Health (NIMH), 9.5 percent of the United States population age 18 years and older has a mood disorder in a given year. Mood disorders include bipolar disorder and depression. “All of us, if we don’t have a family member with a mood disorder, we have a friend or co-worker who suffers from one,” said Soares, who is executive director of the UT Harris County Psychiatric Center and chief of psychiatry at LBJ General Hospital and Memorial Hermann-Texas Medical Center. “New research is showing that a mood disorder has nothing to do with will. These conditions are brain diseases.” The new center will be able to link with other strong resources of The University of Texas Health Science Center at Houston, including the Center for Neurobehavioral Research on Addictions and the Department of Diagnostic and Interventional Imaging, both at the medical school, as well as The University of Texas School of Public Health, which is based in Houston. “Mood disorders ruin lives; break up families; shorten lives through suicide and medical illnesses. Every phase of life is affected by mood disorders,” said Alan Swann, MD, professor and co-director of the UT Center on Mood Disorders. “There’s a tremendous need for this center. We will evaluate people, treat, and conduct research in a single place. We will be able to educate our students and residents, our patients and their families, and the general public.” Giovana Zunta-Soares, MD, assistant professor of psychiatry and behavioral science at the medical school, said researchers including those at the UT Medical School at Houston are beginning to learn more about the relationship between changes in the brain and mood disorders. “We know bipolar patients have subtle abnormalities in key brain regions involved in modulation of emotions, but we don’t know why,” Zunta-Soares said. “We would like to eventually have a way to diagnose the disease physiologically just as we do in other diseases such as high blood pressure, for example.” Brain imaging, cognitive neuropsychology, neurophysiology, and genetics are components of new research at the Center: • Adult patients with bipolar disorder are being recruited for an imaging study that will look for changes in the brain that may indicate how mood-stabilizing medications help them. • For an imaging study looking at the anatomy and biology of important areas of the developing brain, researchers are seeking children ages 7 to 17 who have been diagnosed with bipolar disorder as well as healthy children of the same age. The children with bipolar disease will be treated with mood-stabilizing medications. • A double-blind, placebo-controlled medication trial is studying uridine, a naturally occurring chemical made by the liver that is involved in many of the body’s processes, including the use of energy by cells. Researchers are testing uridine for safety and to assess whether it is beneficial for the depressive symptoms of bipolar disease in adults. • Researchers will analyze blood levels from the new Serum Markers of Ilness Pathophysiology in Mood Disorders, a repository of samples, in search of biochemical and genetic abnormalities to help understand biological conditions associated with bipolar disorder. • Anatomical and biochemical measurements of certain brain regions will be taken in an imaging study looking at the differences along the bipolar spectrum, which includes bipolar disorder type I, bipolar disorder type II, cyclothymia, and bipolar disorder not otherwise specified. • Two studies will look at families. The first is enrolling parents diagnosed with bipolar disease and their children age seven to 17 regardless of whether the children have the disease. The second is recruiting a family member with bipolar disease and a non-affected, first-degree relative (sibling, parent, or child). • Researchers will investigate neurophysiological and neurochemical studies of bipolar disorder and its relationships to impulsivity, personality disorders, and substance-use disorders. In addition to mood disorders, the faculty practice at UT Physicians’ clinics of the Department of Psychiatry and Behavioral Sciences treats patients with anxiety disorders, childhood disorders, personality disorders, schizoaffective disorder, schizophrenia, and substance-related disorders. For more information, call (713) 500-2627 or visit: www.utmooddisorders.org . Fri, 05 Feb 2010 08:41:38 EST D02DD24CE7C54AB198CAF88FA0D5F89A http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=C18781C758124A19B5757A47532BD379 Princeton, NJ — Labopharm Inc. today announced the U.S. Food and Drug Administration (FDA) has approved OLEPTRO (trazodone hydrochloride) Extended Release Tablets, a novel once-daily formulation of the antidepressant trazodone, for the treatment of major depressive disorder (MDD) in adults. OLEPTRO utilizes CONTRAMID, Labopharm's clinically validated technology that controls the release of active substances within oral medications. "OLEPTRO represents Labopharm's second CONTRAMID technology-based product to receive FDA approval in just over a year," said James R. Howard-Tripp, President and Chief Executive Officer, Labopharm Inc. "We are excited about the opportunity for OLEPTRO and are preparing the product for launch into the $11 billion-plus U.S. antidepressant market. We are working towards finalizing a commercialization path for OLEPTRO that will maximize the value of our product in this market." MDD is a common mental illness often characterized by a combination of social and somatic symptoms. It affects more than 14 million adults in the U.S. and is the leading cause of disability globally. OLEPTRO will offer physicians another therapeutic alternative for their MDD patients. "There's a large body of evidence demonstrating the efficacy of trazodone in the treatment of MDD," said Dr. Stephen Stahl, Adjunct Professor of Psychiatry, University of California, San Diego School of Medicine. "Labopharm has developed a novel formulation of trazodone that effectively treats depression and provides a tolerable adverse event profile." Labopharm is actively exploring several alternatives for the U.S. commercialization of OLEPTRO. Such alternatives range from out-licensing the product to a distribution partner while retaining the right to some degree of co-promotion, through to a full co-promotion arrangement under which Labopharm would share the sales function with a partner. The Company currently expects to finalize the commercialization plan for OLEPTRO in the near term. Labopharm expects OLEPTRO to be available for prescription in the U.S. later this year, with specific timing for its launch to be determined within the context of the final commercialization plan. The company believes it is well advanced in its preparations for the U.S. launch of OLEPTRO. The company has completed market research with physicians and third-party payors, developed a positioning and marketing campaign for OLEPTRO, and finalized product manufacturing and packaging arrangements. Thu, 04 Feb 2010 08:19:48 EST C18781C758124A19B5757A47532BD379 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=82A12C513C334281BD9A7EA447DA482F Philadelphia, PA — American Psychological Association has denied the appeal of The Association for Comprehensive Energy Psychology, a non-profit association of practitioners and researchers in Energy Psychology, to provide APA Continuing Education credit for Energy Psychology.. Energy Psychology methods have been used successfully throughout the world to treat thousands of traumatized disaster survivors and U.S. soldiers and have been adopted by three international disaster relief organizations as a core modality. One "Energy Psychology" technique involves the stimulation of acupuncture points by tapping on them at the same time that a traumatic memory or stressful trigger is brought to mind. The procedure is believed to send signals to the brain that counteract the stress response. Early research is finding it to be surprisingly effective. A paper presented at the American Academy of Anti-Aging Medicine Conference in San Jose last September, for instance, showed that symptoms of traumatic stress were dramatically reduced in 19 military veterans with PTSD after six hour-long sessions using the method, and that 16 of the 19 of the veterans no longer scored within the PTSD range. Scores for a comparison group that did not receive treatment were unchanged. These outcomes are stronger than outcomes reported for conventional treatments such as Cognitive Behavior Therapy, where a 50 percent success rate with PTSD after 12 sessions is considered a highly favorable response. Despite findings such as these, the APA will not allow its CE providers to give credit for course offerings in Energy Psychology. For the last two years, The Association for Comprehensive Energy Psychology has been working to end this practice by becoming the first APA-approved CE provider offering courses in Energy Psychology.   The essence of the CE Committee's (CEC) denials that prompted the appeal was that Energy Psychology remains "controversial and of uncertain acceptance" and that, "the CEC decision found that sufficient controversy existed to render uncertain the credibility of their claims and theory in the broader communities." In June, 2009, ACEP filed an appeal with the APA listing 17 counts where the APA CE committee's decision was 1) arbitrary or capricious or 2) not supported by substantial evidence. On Dec. 14, the appeal was heard. During that meeting the representatives of the APA CE committee claimed that they followed proper procedure. Upon further questioning, the CEC Committee Chair stated that the CEC Committee did not have measurable criteria for their decision and that it was based solely on their "professional judgment." ACEP repeatedly asked what the threshold was for Energy Psychology reaching credibility in their eyes. They stated that there was "no line." Greg Nicosia, Ph.D., the President, Association for Comprehensive Energy Psychology and Member of the American Psychological Association, stated, "Frankly we were stunned by the APA's lack of ability to give a measurable objective that could be used to demonstrate the effectiveness of energy psychology. We can only hope that the APA will someday soon see fit to support the education of psychologists in a method that has the potential to significantly improve treatment of PTSD for our soldiers, as well as caregivers and victims in disasters such as Haiti." Wed, 03 Feb 2010 09:54:06 EST 82A12C513C334281BD9A7EA447DA482F http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=6B3597E9FF4C48AAA753BE1E6F53436A Manchester, UK — Preventing patients from leaving psychiatric wards without staff agreement could avoid up to 50 suicide deaths every year, say University of Manchester researchers. A new report by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness suggests that the ward environment may play a part in the level of patients leaving the ward, and that attempts should be made to optimize it. It also urges mental health services to improve awareness among staff of the antecedents of suicide among high-risk groups. The study, published in the journal BMC Psychiatry, collected data on 50,352 people who had died by suicide or unexplained causes in England and Wales between 1997 and 2006. During this 10-year period there were 13,331 suicide deaths in individuals who had been in contact with mental health services in the year prior to death, of which 1,851, or 14 percent, were suicides by current psychiatric patients. The report noted that patient deaths had fallen sharply over the course of the study period, from 221 in 1997 to 141 in 2006. The majority of the 1,851 patient cases—1,292, or 70 percent—occurred off the ward: 469 of these suicides were by patients who had absconded from the ward. The remaining 761 had been given permission to leave the ward. "Our findings have confirmed previous studies that a substantial proportion of in-patient suicide deaths occur after absconding from the ward," said Dr Isabelle Hunt, who led the research in the University's Centre for Suicide Prevention. "Over the 10-year study period, while the number of in-patient suicide deaths declined, the proportion of these deaths which occurred among patients who had absconded remained unchanged at about 40 percent." The team was also able to identify different character traits of vulnerable patients, as well as the most likely method of suicide by different patient groups. "Compared to individuals who died when they were off the ward with staff agreement, those who absconded were more likely to be young, unemployed, and homeless," said Dr Hunt. "Schizophrenia was the most common diagnosis, and rates of previous violence and substance misuse were high. "Those who died following absconding were more likely than in-patients on agreed leave to have been formally detained for treatment, be non-compliant with medication, and to have died in the first week of admission. The method of suicide was also more likely to be violent compared to other in-patients, with nearly half of absconders dying by jumping." The researchers suggest that improving the ward environment to provide a more supportive and less intimidating experience may contribute to reduced risk. They also state that tighter control of ward exits and more intensive observation of patients, particularly in the early days of admission, might be one way to limit the likelihood of a patient taking their own life. Dr Hunt added: "It is clearly a challenge to prevent patients leaving a general psychiatry open ward but our findings can inform staff of the clinical characteristics associated with absconding suicides, such as schizophrenia, substance misuse, and noncompliance. "Particular attention could be paid by staff in observing not only the patients themselves but also ward exits, while improved ward security through video monitoring or swipe-card systems to regulate patients' entry and exit may be effective. "Other measures to prevent in-patient suicide might include regular risk assessments during recovery and prior to granting leave, staff-training programs in the management of risk, and improved staff communication." Wed, 03 Feb 2010 09:39:07 EST 6B3597E9FF4C48AAA753BE1E6F53436A http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=503A8933C97B4C059C483BCF602EA692 Richmond, VA — Reducing obesity and smoking have become national priorities in the United States. Research has shown that intensive counseling can positively impact each problem. However, because such counseling is typically not covered by medical insurance, cost can be a barrier. In a study published in the March 2010 issue of the American Journal of Preventive Medicine, researchers from Virginia Commonwealth University, Richmond, Virginia, found that when primary care clinicians and community counselors collaborated to offer free counseling services to patients, there was an overwhelming positive response. Yet, when the same services were offered at a cost to the patient, there was a significant drop in participation. An electronic linkage system (eLinkS) was used to prompt healthcare providers to suggest intensive healthcare counseling for adult patients with unhealthy behaviors. eLinkS then helped to facilitate and automate referrals and communication between primary care practices and community programs. During a five-week period when funding was available, 5,679 patients were evaluated, 1,860 had at least one unhealthy behavior (triggering an eLinkS prompt), and 407 (21.8 percent) were referred for intensive counseling. In a three-week period after funding was exhausted, 2,510 patients visited the practices, 729 triggered an eLinkS prompt, but only five (0.7 percent) were referred for intensive counseling. Compared to the coverage period, the overall referral rate for patients with an unhealthy behavior decreased by 97 percent. Practice nurses asked 22 percent fewer patients about health behaviors (37 percent vs. 29 percent). When prompted by eLinkS, clinicians offered referrals to 79 percent fewer patients (29 percent vs. six percent). If a referral was offered, 81 percent fewer patients accepted (76 percent vs. 14 percent). Patients confirmed that costs introduced a barrier to counseling. Some patients were explicit that charges would prevent participation while others who had deferred counseling in the past were motivated to enroll because it was free. Clinicians reported that removing cost as an impediment, combined with an easy means to refer patients, allowed patient discussions to focus on behavior change. The heightened patient interest reversed when charges were reinstituted. Fewer successes also diminished motivation for the counselors. Alex H. Krist, MD, MPH, Virginia Commonwealth University, Department of Family Medicine, and his co-investigators comment, "Our quantitative and qualitative data underscore that clinicians, not just patients, are influenced by costs. Despite prompts, nurses were less likely to record patients' BMI and smoking status during the no-coverage period, triggering fewer eLinkS prompts. Clinicians were also less likely to discuss health behaviors with patients. However, even when clinicians did offer a referral, 81 percent fewer patients accepted. This study indicates that policymakers and payers should support clinical-community partnerships and eliminate cost as a barrier to intensive smoking cessation and weight loss counseling. Modifying health behaviors is daunting enough for patients and clinicians—cost can be the tipping point in their decision to forego the effort." Wed, 03 Feb 2010 08:35:27 EST 503A8933C97B4C059C483BCF602EA692 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=A10CA0B6C1224336B2085E7375EFEE01 Los Angeles, CA — Everyone checks themselves in the mirror now and then, but that experience can be horrifying for individuals suffering from body dysmorphic disorder, or BDD, a psychiatric condition that causes them to believe, wrongly, that they appear disfigured and ugly. These people tend to fixate on minute details—every tiny blemish looms huge—rather than viewing their face as a whole. Now researchers at UCLA have determined that the brains of people with BDD have abnormalities in processing visual input, particularly when examining their own faces. Further, they found that the same systems of the brain are overactive in both BDD and obsessive-compulsive disorder, suggesting a link between the two. The research appears in the February issue of the journal Archives of General Psychiatry. "People with BDD are ashamed, anxious, and depressed," said Dr. Jamie Feusner, an assistant professor of psychiatry and lead author of the study. "They obsess over tiny flaws on their face or body that other people would never even notice. Some refuse to leave the house, others feel the need to cover parts of their face or body, and some undergo multiple plastic surgeries. About half are hospitalized at some point in their lifetimes, and about one-fourth attempt suicide." Despite its prevalence—BDD affects an estimated one to two percent of the population—and severe effects, little is known about the underlying brain abnormalities that contribute to the disease. To better understand its neurobiology, Feusner and colleagues examined 17 patients with BDD and matched them by sex, age, and education level with 16 healthy people. Participants underwent functional magnetic resonance imaging (fMRI) while viewing photographs of two faces—their own and that of a familiar actor—first unaltered, and then altered in two ways to parse out different elements of visual processing. One altered version included only high–spatial frequency information, which would allow detailed analysis of facial traits, including blemishes and hairs. The other showed only low–spatial frequency information, conveying the general shape of the face and the relationship between facial features. Compared to the control participants, individuals with BDD demonstrated abnormal brain activity in visual processing systems when viewing the unaltered and low–spatial frequency versions of their own faces. They also had unusual activation patterns in their frontostriatal systems, which help control and guide behavior and maintain emotional flexibility in responding to situations. Brain activity in both systems correlated with the severity of symptoms. In addition, differences in activity in the frontostriatal system varied based on participant reports of how disgusting or repulsive they found each image. Basically, how ugly the individuals viewed themselves appeared to explain abnormal brain activity in these systems. The abnormal activation patterns, especially in response to low-frequency images, suggest that individuals with body dysmorphic disorder have difficulties perceiving or processing general information about faces. "This may account for their inability to see the big picture—their face as a whole," Feusner said. "They become obsessed with detail and think everybody will notice any slight imperfection on their face. They just don't see their face holistically." Some of the patterns, said Feusner, also appear to be similar to those observed in patients with obsessive-compulsive disorder, supporting hypotheses that the two conditions share similar neural pathways. However, future studies are needed to further elucidate the causes and development of body dysmorphic disorder. Tue, 02 Feb 2010 09:39:48 EST A10CA0B6C1224336B2085E7375EFEE01 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=5E8DECA58D4744439212B5949452B963 Chicago, IL — Potentially beneficial brain changes (an increase in the volume of an area known as the hippocampus) occur in response to exercise both in patients with schizophrenia and healthy controls, according to a report in the February issue of Archives of General Psychiatry, one of the JAMA/Archives journals. The findings suggest that the brain retains some plasticity, or ability to adapt, even in those with psychotic disorders. Schizophrenia is known to be associated with a reduced volume in the area of the brain known as the hippocampus, which helps regulate emotion and memory, according to background information in the article. "In contrast to other illnesses that may display psychotic features, such as bipolar disorder, schizophrenia is often characterized by incomplete recovery of psychotic symptoms and persistent disability," the authors write. "These clinical features of illness may relate to an impairment of neural plasticity or mechanisms of reorganizing brain function in response to a challenge." The formation of new neurons is one component of plasticity; previous studies have shown that neuron growth in the hippocampus of healthy individuals can be stimulated by exercise. Frank-Gerald Pajonk, MD, of The Saarland University Hospital, Homburg, and Dr. K. Fontheim's Hospital for Mental Health, Liebenburg, Germany, and colleagues assessed changes in hippocampal volume in response to an exercise program in both male patients with schizophrenia and men who had similar demographics and physical characteristics but did not have the condition. Eight participants with schizophrenia and eight controls were randomly assigned to exercise (supervised cycling) three times per week for 30 minutes, whereas an additional eight patients with schizophrenia instead played tabletop football for the same period of time. The game enhances coordination and concentration but does not affect aerobic fitness. All participants underwent fitness testing, magnetic resonance imaging of the hippocampus, neuropsychological testing, and other clinical measures before and after participating in the program for 12 weeks. Following exercise training, hippocampal volume increased 12 percent in patients with schizophrenia and 16 percent in healthy controls. "To provide a context, the magnitude of these changes in volume was similar to that observed for other subcortical structures when patients were switched from typical to atypical antipsychotic drug therapy," the authors write. Conversely, patients with schizophrenia who played tabletop football instead of exercising experienced a one percent decrease in hippocampal volume. Aerobic fitness also increased among all who exercised, and improvement in test scores for short-term memory was correlated with increases in hippocampal volume among patients and healthy controls. "Further clinical studies are needed to determine if an incremental improvement in the disability related to schizophrenia could be obtained by incorporating exercise into treatment planning and lifestyle choice for individuals with the illness," the authors conclude. Tue, 02 Feb 2010 09:33:43 EST 5E8DECA58D4744439212B5949452B963 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=567DE337381847999E3D395FE2EFB32A East Lansing, MI — Children with autism would likely receive better treatment if supporters of the two major teaching methods stopped bickering over theory and focused on a combined approach, a Michigan State University psychologist argues in a new paper. For years, the behavioral and developmental camps have argued over which theory is more effective in teaching communication and other skills to preschool-aged children with autism. Basically, behaviorists believe learning occurs through reinforcement or reward while developmental advocates stress learning through important interactions with caregivers. But while the theories differ, the actual methods the two camps ultimately use to teach children can be strikingly similar, especially when the treatment is naturalistic, or unstructured, said Brooke Ingersoll, MSU assistant professor of psychology. In the January issue of the Journal of Positive Behavior Interventions, Ingersoll contends that advocates of the behavioral and developmental approaches should set aside their differences and use the best practices from each to meet the needs of the student and the strengths of the parent or teacher. “We need to stop getting so hung up on whether the behavioral approach is better than the developmental approach and vice versa,” Ingersoll said. “What we really need to start looking at is what are the actual intervention techniques being used and how are these effective.” An estimated one out of every 110 children in the United States has autism and the number of diagnosed cases is growing, according to the Centers for Disease Control and Prevention. Symptoms typically surface by a child’s second birthday and the disorder is four to five times more likely to occur in boys than in girls. Ingersoll said the behavioral and developmental treatment methods both can be effective on their own. But historically, advocates for each have rarely collaborated on treatment development for children with autism, meaning it’s unknown whether a combined approach is more effective. Ingersoll expects it is. She is trained in both methods and has created a combined curriculum on social communication that she’s teaching to preschool instructors in Michigan’s Ottawa, Livingston, and Clinton counties. Through the MSU-funded project, the instructors then teach the method to parents of autistic children. Ingersoll said the combined method works, but it will probably take a few years of research to determine if it’s more effective than a singular approach. “I’m not necessarily advocating for a new philosophical approach—the reality is that neither side is likely to change their philosophy,” Ingersoll said. “What I am advocating is more of a pragmatic approach that involves combining the interventions in different ways to meet the needs of the child or the caregiver. I think that will build better interventions.” Mon, 01 Feb 2010 08:53:25 EST 567DE337381847999E3D395FE2EFB32A http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=76419E2F9DA9443ABFE8BF1C26AE4084 Harrisburg, PA — The mental health advocacy and provider communities in Pennsylvania support the decision by the PA Department of Public Welfare (DPW) to close Allentown State Hospital (ASH), an institution for people who have mental illnesses.  Up to 125 people from ASH and Wernersville State Hospital (WeSH) will return to communities of their choice, and up to 65 will transfer from ASH to WeSH. Although it would be ideal if every person was discharged to the community, mental health advocates and providers endorse DPW's decision, as it will enable the reintegration of approximately 125 people into the community and support community-based recovery and the development of recovery services that work. "Having been a psychiatric patient myself, both in the community and a state hospital, I have experienced the full spectrum of treatment," said Pennsylvania resident Dan Craig. "I learned to participate in the community and form relationships by living in the community. Having mental illness symptoms doesn't limit the possibilities of anyone's life. Everyone is capable of holding jobs, volunteering, being a member of a church, synagogue, mosque, or temple, participating politically, or going back to school. These are all things that build our society, and enhance everyone's quality of life. Recovery is possible for everyone!" "We have evidence that people living with mental illness are best served in supportive communities," said Judy Banks, deputy director of the Disability Rights Network of PA (DRN). "Recovery comes from living in small, integrated community settings with individualized supports, not from institutionalization. We want this reality for every person who currently is in a state hospital and the closure of ASH is another step toward achieving that goal." The importance of community integration to the recovery of people with serious mental illnesses has been endorsed by such experts as the Office of the Surgeon General (in its 1999 report, "Mental Health: A Report of the Surgeon General") and by the President's New Freedom Commission on Mental Health in its 2003 report. Pennsylvania statewide organizations that support the decision to close the state hospital include MHAPA, PMHCA, and DRN and PCPA.   Mon, 01 Feb 2010 08:19:16 EST 76419E2F9DA9443ABFE8BF1C26AE4084 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=779BAE7930D94BF8994831597E10219A Washington, DC — The National Association of Psychiatric Health Systems (NAPHS) Board of Trustees has elected 2010 officers. These individuals will serve as the NAPHS Executive Committee throughout the year. Serving as 2010 officers are: • Chair of the Board Kevin P. Sheehan, chairman, CEO, and president, Youth and Family Centered Services, Inc., Austin, TX; • Board Chair-Elect Marina Cecchini, interim chief operating officer, Shands at the University of Florida; administrator, Shands Vista and Shands Rehab, Gainesville, FL; • Immediate Past Chair Brent Turner, executive vice president, Finance and Administration, Psychiatric Solutions, Inc., Franklin, TN; • First Vice Chair Debra Osteen, president of behavioral health, Universal Health Services, Inc., King of Prussia, PA; • Second Vice Chair Joey A. Jacobs, chairman, CEO, and president, Psychiatric Solutions, Inc., Franklin, TN; • Third Vice Chair Leonard F. Dziubla, DCSW, FACHE, president and chief executive officer, Phoenix Care Systems, Inc., Milwaukee, WI; • Treasurer Bob Nykamp, vice-president & chief operating officer, Pine Rest Christian Mental Health Services, Grand Rapids, MI; and • Secretary Kathi Lencioni, MPH, FACHE, senior vice president/CEO, Sharp Mesa Vista Hospital, San Diego, CA. The National Association of Psychiatric Health Systems (NAPHS) advocates for behavioral health and represents provider systems that are committed to the delivery of responsive, accountable, and clinically effective prevention, treatment, and care for children, adolescents, adults, and older adults with mental health and substance use disorders. Its members are behavioral healthcare provider organizations that own or manage more than 600 specialty psychiatric hospitals, general hospital psychiatric and addiction treatment units and behavioral healthcare divisions, residential treatment facilities, youth services organizations, and extensive outpatient networks.  The association was founded in 1933. Fri, 29 Jan 2010 15:26:20 EST 779BAE7930D94BF8994831597E10219A http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=C5745FB3F68C46ACAFFAE4884CB81C25 Washington, DC — Psychodynamic psychotherapy is effective for a wide range of mental health symptoms, including depression, anxiety, panic, and stress-related physical ailments, and the benefits of the therapy grow after treatment has ended, according to new research published by the American Psychological Association. Psychodynamic therapy focuses on the psychological roots of emotional suffering. Its hallmarks are self-reflection and self-examination, and the use of the relationship between therapist and patient as a window into problematic relationship patterns in the patient's life. Its goal is not only to alleviate the most obvious symptoms but to help people lead healthier lives. "The American public has been told that only newer, symptom-focused treatments like cognitive behavior therapy or medication have scientific support," said study author Jonathan Shedler, PhD, of the University of Colorado Denver School of Medicine. "The actual scientific evidence shows that psychodynamic therapy is highly effective. The benefits are at least as large as those of other psychotherapies, and they last." To reach these conclusions, Shedler reviewed eight meta-analyses comprising 160 studies of psychodynamic therapy, plus nine meta-analyses of other psychological treatments and antidepressant medications. Shedler focused on effect size, which measures the amount of change produced by each treatment. An effect size of 0.80 is considered a large effect in psychological and medical research. One major meta-analysis of psychodynamic therapy included 1,431 patients with a range of mental health problems and found an effect size of 0.97 for overall symptom improvement (the therapy was typically once per week and lasted less than a year). The effect size increased by 50 percent, to 1.51, when patients were re-evaluated nine or more months after therapy ended. The effect size for the most widely used antidepressant medications is a more modest 0.31. The findings are published in the February issue of American Psychologist, the flagship journal of the American Psychological Association. The eight meta-analyses, representing the best available scientific evidence on psychodynamic therapy, all showed substantial treatment benefits, according to Shedler. Effect sizes were impressive even for personality disorders—deeply ingrained maladaptive traits that are notoriously difficult to treat, he said. "The consistent trend toward larger effect sizes at follow-up suggests that psychodynamic psychotherapy sets in motion psychological processes that lead to ongoing change, even after therapy has ended," Shedler said. "In contrast, the benefits of other 'empirically supported' therapies tend to diminish over time for the most common conditions, like depression and generalized anxiety." "Pharmaceutical companies and health insurance companies have a financial incentive to promote the view that mental suffering can be reduced to lists of symptoms, and that treatment means managing those symptoms and little else. For some specific psychiatric conditions, this makes sense," he added. "But more often, emotional suffering is woven into the fabric of the person's life and rooted in relationship patterns, inner contradictions and emotional blind spots. This is what psychodynamic therapy is designed to address." Shedler acknowledged that there are many more studies of other psychological treatments (other than psychodynamic), and that the developers of other therapies took the lead in recognizing the importance of rigorous scientific evaluation. "Accountability is crucial," said Shedler. "But now that research is putting psychodynamic therapy to the test, we are not seeing evidence that the newer therapies are more effective." Shedler also noted that existing research does not adequately capture the benefits that psychodynamic therapy aims to achieve. "It is easy to measure change in acute symptoms, harder to measure deeper personality changes. But it can be done." The research also suggests that when other psychotherapies are effective, it may be because they include unacknowledged psychodynamic elements. "When you look past therapy 'brand names' and look at what the effective therapists are actually doing, it turns out they are doing what psychodynamic therapists have always done—facilitating self-exploration, examining emotional blind spots, understanding relationship patterns." Four studies of therapy for depression used actual recordings of therapy sessions to study what therapists said and did that was effective or ineffective. The more the therapists acted like psychodynamic therapists, the better the outcome, Shedler said. "This was true regardless of the kind of therapy the therapists believed they were providing." Fri, 29 Jan 2010 13:50:30 EST C5745FB3F68C46ACAFFAE4884CB81C25 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=E59B0E0FB1E5426DBC2D85248FDDCB34 Hatfield, UK — A new thought-operated computer system which can reduce the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in children will be rolled out across the UK this month. Professor Karen Pine at the University of Hertfordshire’s School of Psychology and assistant Farjana Nasrin investigated the effects of EEG (Electroencephalography) biofeedback, a learning strategy that detects brain waves, on 10 children with an attention deficit from Hertfordshire schools. They used a system called Play Attention, supplied by not-for-profit community interest company, Games for Life, three times a week for 12 weeks. The system involves the child playing a fun educational computer game whilst wearing a helmet similar to a bicycle helmet. The helmet picks up their brain activity in the form of EEG waves related to attention. As long as the child concentrates they control the games, but as soon as their attention waivers the game stops. The researchers found at the end of the study that the children’s impulsive behavior was reduced, compared to a control group who had not used the system. “Children with a diagnosis of ADHD find it hard to control their impulses and inhibit inappropriate behavior,” said Professor Pine. “This can lead to educational and behavioral difficulties. The Play Attention method may prevent long-term problems by helping the children to be less impulsive and more self-controlled.” Professor Pine and Dr. Rob Sharp, a senior specialist educational psychologist, are continuing to work on futuristic projects with Ian Glasscock, Managing Director of Games for Life. A means of assessing learning in children with severe communication and physical difficulties by a thought-controlled computer game method is likely to have considerable potential for these children who cannot operate a computer manually. “Attention-related difficulties including ADHD affects many children, young people, and adults and has a significant impact on their lives,” said Glasscock. "Mind-controlled educational computer games technology is the only intervention shown to reduce the core symptoms of ADHD. Historically, medication may have been prescribed for the child.” Games for Life plans to roll out this new system across the UK this month. Fri, 29 Jan 2010 13:40:08 EST E59B0E0FB1E5426DBC2D85248FDDCB34 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=EC442AAEFEF54502ADA229EC746F4F4E London — People being treated for schizophrenia are more likely than the general population to have encounters with the criminal justice system in the U.S. A study published in the open access journal BMC Psychiatry has shown that schizophrenia patients' involvement with the criminal justice system is primarily driven by their being victims of crime and that the average annual per-patient cost of involvement with the criminal justice system was $1,429. Haya Ascher-Svanum led a team of researchers from Eli Lilly and Company, USA, who used data from a study of around 600 people with schizophrenia to estimate the prevalence and cost of involvement with the criminal justice system. They found that 46 percent had had at least one encounter, and these patients were more likely to be younger, with poorer mental health, and less likely to adhere to their medication regime. Being a crime victim was the most prevalent type of encounter, comprising 67 percent of these patients. The team also estimated, for the first time, the direct economic impact of legal involvement. According to Ascher-Svanum, "These encounters may comprise approximately six percent  to 11 percent of the annual per-patient direct total costs. When assessing the costs of schizophrenia, future studies should account for potential criminal justice system involvement whenever possible.” Fri, 29 Jan 2010 08:25:03 EST EC442AAEFEF54502ADA229EC746F4F4E http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=4A74B9ADA1574526A8D3D7168ACDFF13 Pittsburgh, PA — Developing comprehensive behavioral health services for children, youth, young adults, and families will be the subject of the annual spring conference of Community Care, a nonprofit behavioral health managed care organization that is part of UPMC and based in Pittsburgh. "Creating Hope: Developing Communities of Care for Children, Youth, Young Adults and Families," will put special emphasis on successful programs both regionally and nationally. Presenters will provide information for healthcare clinicians, families, and communities to promote positive behavioral health and to address children's behavioral health topics. According to the U.S. Surgeon General, more than 14 million American adolescents (or, roughly one in five) have a mental health disorder. "Behavioral health services for children, youth, young adults, and families can be challenging, complex, and effective," said James Gavin, President of Community Care. "The development of comprehensive services is essential for managing behavioral health symptoms and for the well-being of individuals in the home, school, and community." Marc Cherna, the director of Allegheny County Department of Human Services, will be one of two keynote speakers at the conference. He will discuss the success of many Allegheny County behavioral health initiatives and the continued growth of children and youth programs. Lucille Eber, the Illinois State Director of Positive Behavior Support, will discuss emerging interagency school and community-based models that connect effective learning and behavior change with system-of-care principles. Among the scheduled workshops are sessions on adolescent substance use, engaging families in interventions, leadership in service plans, and integrating care for foster children. Continuing education credit is available for mental health professionals, national certified counselors, psychologists, social workers, and educators who attend the conference. The conference runs from 8:30 a.m. to 5 p.m. on March 23, 2010, at the Omni William Penn Hotel in downtown Pittsburgh. Tuition is $95 for behavioral health professionals. The conference is free for Community Care members and their families as well as medical residents and other students. Thu, 28 Jan 2010 14:14:21 EST 4A74B9ADA1574526A8D3D7168ACDFF13 http://www.behavioral.net/ME2/dirmod.asp?type=news&mod=News&mid=B20DF0482CF84DBA94F725711F709DD7&tier=3&nid=7696572AEC5C4D6CAD510F376196C03E Vincennes, IN — Samaritan Center is preparing to cut $2.6 million out of its budget for fiscal year 2011 as a result of federal and state Medicaid changes. The Indiana Division of Mental Health and CMS are implementing changes that will affect how Samaritan Center is reimbursed on the state and federal level for services provided to chronic mentally ill adults, severally emotionally disabled youth, and chronically addicted adults. John Manning, CEO of Samaritan Center, says a reduction in funding of this magnitude will create significant changes in the manner of which Samaritan Center provides services to the residents of Knox, Daviess, Martin, and Pike counties. Manning says the state is implementing “Service Packs” for Medicaid patients. “This means that the services patients get are based on their level of function and diagnosis, and that the services have to be received within a six month window in order to be paid by Medicaid,” Manning said. “If the patient is not well within that six months, an extension would have to be filed with the state. Then we would have to wait to hear back from the state to see if the extension has even been approved.” Manning says Samaritan Center is in the planning process to manage this funding decrease. He says the mental health center is looking at ways to reduce costs without sacrificing the quality of care that is provided to its patients. “We have to work hard to find a way to treat our Medicaid patients, especially those who have more serious conditions, in a shorter time period than we have done in the past,” Manning said. “It may be difficult, but these new Service Packs that will be implemented by the state will force us to do so.” In addition to this change in Medicaid funding by the state, Manning said the Samaritan Center has also had to deal with shortfalls in its $13.6 million total budget from a 100 percent increase in charity care and 100 percent increase in bad debt since the economic crisis. “As a result, planning is under way to deal with this reduction in funding as well,” said Manning. “We are sensitive to the needs of providers and consumers but will adapt our operations to meet the funding realities. We are committed to providing quality services that are patient centered, recovery based, and in the best interest of the consumer.” Manning says all changes to reflect the reduced budget will be in effect by July 1, 2010. Thu, 28 Jan 2010 14:09:05 EST 7696572AEC5C4D6CAD510F376196C03E