CLINICAL HANDBOOK OF SCHIZOPHRENIA

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318 V. SYSTEMS <strong>OF</strong> CAREvere mental illness: A review of research on case management. Schizophrenia Bulletin, 24(1), 37–74.Mueser, K. T., Noordsy, D. L., Drake, R. E., & Fox, L. (2003). Integrated treatment for dual disorders:A guide to effective practice. New York: Guilford Press.O’Hare, T. (2005). Schizophrenia. In T. O’Hare, Evidence-based practices for social workers: Aninterdisciplinary approach (pp. 56–102). Chicago: Lyceum Books.Scott, J. E., & Dixon, L. B. (1995). Assertive community treatment and case management for schizophrenia.Schizophrenia Bulletin, 21(4), 657–668.Williams, J., & Swartz, M. (1998). Treatment boundaries in the case management relationship: A clinicalcase and discussion. Community Mental Health Journal, 34(3), 299–311.Ziguras, S. J., & Stuart, G. W. (2000). A meta-analysis of the effectiveness of mental health case managementover 20 years. Psychiatric Services, 51, 1410–1421.
CHAPTER 32STRENGTHS-BASEDCASE MANAGEMENTCHARLES A. RAPPRICHARD J. GOSCHACase management has traditionally been viewed as an entity (usually a person) that coordinates,integrates, and allocates care within limited resources. The primary functionshave been seen as assessment, planning, referral, and monitoring. The notion is that a singlepoint of contact is responsible for helping people with psychiatric disabilities receivethe services they need from a fragmented system of care. The assumption is that peoplewho receive these benefits and services will be able to live more independently in the communityand that their quality of life will improve. The unadorned broker model of casemanagement has been shown in multiple studies to be an ineffective model of practice.Enhanced case management models, such as assertive community treatment, and clinicaland strengths-based models, have emerged over the last 25 years.The strengths model of case management was developed by a team at the Universityof Kansas School of Social Welfare beginning in the early 1980s. It has gone throughalmost 25 years of development, refinement, testing, and dissemination. This chaptersummarizes the research, theory, principles, and methods of the strengths model. It alsoprovides a case example for a glimpse of the model in practice and to help distinguish thepractice from more traditional problem- or pathology-based approaches.RESEARCH ON THE STRENGTHS MODELNine studies have tested the effectiveness of the strengths model in people with psychiatricdisabilities. Four of the studies employed experimental or quasi-experimental designs,and five used nonexperimental methods. Positive outcomes have been reported in the areasof hospitalizations, housing, employment, reduced symptoms, leisure time, social support,and family burden.In the four experimental studies, positive outcomes outweighed by a 13:5 ratio theoutcomes in which no significant difference was reported. In none of the studies did cli-319
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CLINICAL HANDBOOK OF SCHIZOPHRENIA
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© 2008 The Guilford PressA Divisio
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CONTRIBUTORSDonald Addington, MD, D
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ContributorsixGillian Haddock, PhD,
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ContributorsxiRoger H. Peters, PhD,
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PREFACESchizophrenia is arguably th
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Prefacexvcorporation of environment
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CONTENTSI. CORE SCIENCE AND BACKGRO
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ContentsxixCHAPTER 27 Illness Self-
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ContentsxxiCHAPTER 59 Sexuality 604
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CHAPTER 1HISTORY OF SCHIZOPHRENIAAS
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1. History of Schizophrenia 5ularly
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1. History of Schizophrenia 7PSYCHO
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1. History of Schizophrenia 9The ne
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1. History of Schizophrenia 11Since
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1. History of Schizophrenia 13Belli
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2. Epidemiology 15al., 2006), which
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2. Epidemiology 17not generally fou
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2. Epidemiology 19• Intrauterine
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2. Epidemiology 21function in socia
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2. Epidemiology 23KEY POINTS• Sch
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CHAPTER 3BIOLOGICAL THEORIESJONATHA
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3. Biological Theories 27cortex (in
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3. Biological Theories 29unchanged
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3. Biological Theories 31raclopride
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3. Biological Theories 33drives, mo
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CHAPTER 4BRAIN IMAGINGLISA T. EYLER
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4. Brain Imaging 37yet to be strong
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4. Brain Imaging 39with neuroleptic
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4. Brain Imaging 41events. However,
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4. Brain Imaging 43KEY POINTS• On
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5. Neuropathology 45TABLE 5.1. Summ
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5. Neuropathology 47schizophrenia i
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5. Neuropathology 49has been report
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5. Neuropathology 51also been demon
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5. Neuropathology 53results, especi
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CHAPTER 6GENETICSSTEPHEN J. GLATTTh
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6. Genetics 57Question 2: What Are
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6. Genetics 59nia. Each individual
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6. Genetics 61degree relatives desp
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6. Genetics 632A receptor (HTR2A) a
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CHAPTER 7ENVIRONMENTAL PRE-AND PERI
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7. Environmental Pre- and Perinatal
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8. Psychosocial Factors 75Steinberg
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8. Psychosocial Factors 77in terms
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8. Psychosocial Factors 79This mode
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8. Psychosocial Factors 81KEY POINT
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9. Psychopathology 83ations; change
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9. Psychopathology 85sity School of
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9. Psychopathology 87or “loose as
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9. Psychopathology 89lished WHO. Th
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CHAPTER 10COGNITIVE FUNCTIONINGIN S
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10. Cognitive Functioning in Schizo
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11. Course and Outcome 101DIAGNOSIS
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11. Course and Outcome 103TABLE 11.
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11. Course and Outcome 105DOMAINS O
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11. Course and Outcome 107mation gi
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11. Course and Outcome 109quency of
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11. Course and Outcome 111to a smal
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11. Course and Outcome 113spectivel
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CHAPTER 12DIAGNOSTIC INTERVIEWINGAB
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12. Diagnostic Interviewing 119psyc
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12. Diagnostic Interviewing 121not
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12. Diagnostic Interviewing 123tual
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CHAPTER 13ASSESSMENT OFCO-OCCURRING
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Time-Line Follow-BackThe Time-Line
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Testing and Risk Assessment for Inf
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13. Co-Occurring Disorders 131test
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13. Co-Occurring Disorders 133can i
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CHAPTER 14ASSESSMENT OFPSYCHOSOCIAL
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14. Assessment of Psychosocial Func
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TABLE 14.1. Measures of Psychosocia
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CHAPTER 15TREATMENT PLANNINGALEXAND
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15. Treatment Planning 147WHAT DOES
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15. Treatment Planning 149TABLE 15.
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15. Treatment Planning 151Poor adhe
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Occupational/School Functioning15.
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15. Treatment Planning 155Drake, R.
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CHAPTER 16ANTIPSYCHOTICSERIC C. KUT
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16. Antipsychotics 161for at least
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TABLE 16.3. Dosing of the First-Gen
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16. Antipsychotics 165are not avail
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16. Antipsychotics 167• Therapeut
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17. Side Effects of Antipsychotics
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18. Clozapine 179Plasma concentrati
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TABLE 18.1. Clinical tips for cloza
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18. Clozapine 183linergic effects t
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18. Clozapine 185• Common side ef
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19. Other Medications 187agitation
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19. Other Medications 189Small, ope
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19. Other Medications 191ANTIDEPRES
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19. Other Medications 193sation in
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19. Other Medications 195Citrome, L
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20. Electroconvulsive Therapy 197TA
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20. Electroconvulsive Therapy 199FI
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Missed SeizuresIf no seizure occurs
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20. Electroconvulsive Therapy 203(C
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PART IVPSYCHOSOCIAL TREATMENT
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208 IV. PSYCHOSOCIAL TREATMENTdisin
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210 IV. PSYCHOSOCIAL TREATMENTFIGUR
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212 IV. PSYCHOSOCIAL TREATMENTschiz
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CHAPTER 22FAMILY INTERVENTIONCHRIST
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216 IV. PSYCHOSOCIAL TREATMENTTABLE
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218 IV. PSYCHOSOCIAL TREATMENTcommi
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220 IV. PSYCHOSOCIAL TREATMENTother
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222 IV. PSYCHOSOCIAL TREATMENTtient
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224 IV. PSYCHOSOCIAL TREATMENTButzl
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CHAPTER 23COGNITIVE-BEHAVIORAL THER
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228 IV. PSYCHOSOCIAL TREATMENTThe a
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230 IV. PSYCHOSOCIAL TREATMENTAndre
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234 IV. PSYCHOSOCIAL TREATMENTtion.
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236 IV. PSYCHOSOCIAL TREATMENTnever
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238 IV. PSYCHOSOCIAL TREATMENTwith
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CHAPTER 24SOCIAL SKILLS TRAININGWEN
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242 IV. PSYCHOSOCIAL TREATMENTeach
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244 IV. PSYCHOSOCIAL TREATMENTThe m
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246 IV. PSYCHOSOCIAL TREATMENTCogni
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248 IV. PSYCHOSOCIAL TREATMENT• S
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250 IV. PSYCHOSOCIAL TREATMENTThe d
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252 IV. PSYCHOSOCIAL TREATMENTNone
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254 IV. PSYCHOSOCIAL TREATMENT• I
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256 IV. PSYCHOSOCIAL TREATMENTnance
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260 IV. PSYCHOSOCIAL TREATMENTMcGur
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262 IV. PSYCHOSOCIAL TREATMENTalong
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264 IV. PSYCHOSOCIAL TREATMENTappro
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266 IV. PSYCHOSOCIAL TREATMENTKEY P
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Page 329: PART VSYSTEMS OF CARE
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Page 348 and 349: 326 V. SYSTEMS OF CAREFIGURE 32.1.
Page 350 and 351: 328 V. SYSTEMS OF CAREREFERENCES AN
Page 352 and 353: 330 V. SYSTEMS OF CAREDESCRIPTION O
Page 354 and 355: 332 V. SYSTEMS OF CAREfor ACT have
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Page 358 and 359: 336 V. SYSTEMS OF CAREA team leader
Page 360 and 361: 338 V. SYSTEMS OF CAREof leverage t
Page 362 and 363: 340 V. SYSTEMS OF CAREcare of thems
Page 364 and 365: 342 V. SYSTEMS OF CAREframework for
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36. First-Episode Psychosis 369TABL
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36. First-Episode Psychosis 371have
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36. First-Episode Psychosis 373The
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36. First-Episode Psychosis 375divi
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36. First-Episode Psychosis 377Supp
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36. First-Episode Psychosis 379(200
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37. Treatment of the Schizophrenia
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38. Older Individuals 391TABLE 38.1
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38. Older Individuals 393answer, an
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38. Older Individuals 395rates (69%
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38. Older Individuals 397Patterson,
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39. Aggression, Violence, and Psych
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CHAPTER 40HOUSING INSTABILITYAND HO
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40. Housing Instability and Homeles
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41. Medical Comorbidity 425Medical
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41. Medical Comorbidity 427search s
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41. Medical Comorbidity 429TABLE 41
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41. Medical Comorbidity 431Caring f
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41. Medical Comorbidity 433Counseli
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41. Medical Comorbidity 435REFERENC
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CHAPTER 42INTELLECTUAL DISABILITYAN
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42. Intellectual Disability and Oth
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CHAPTER 43TRAUMA AND POSTTRAUMATICS
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43. Trauma and Posttraumatic Stress
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CHAPTER 44MANAGEMENT OFCO-OCCURRING
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44. Management of Co-Occurring Subs
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CHAPTER 45PARENTINGJOANNE NICHOLSON
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45. Parenting 473THE IMPACT OF PARE
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TABLE 45.1. Antipsychotic Medicatio
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Guidelines for Prescribing Antipsyc
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45. Parenting 479provide safe space
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CHAPTER 46CHILDREN AND ADOLESCENTSJ
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46. Children and Adolescents 483pri
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46. Children and Adolescents 485TRE
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46. Children and Adolescents 487Als
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46. Children and Adolescents 489KEY
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CHAPTER 47SUICIDEMARNIN J. HEISELSu
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TABLE 47.1. Selected Risk Factors f
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Clinical Course and Symptoms of Sch
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47. Suicide 497those with schizoaff
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47. Suicide 499assessment tools can
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47. Suicide 501yet focused on suici
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47. Suicide 503ACKNOWLEDGMENTSI gra
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PART VIIPOLICY, LEGAL,AND SOCIAL IS
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508 VII. POLICY, LEGAL, AND SOCIAL
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CHAPTER 49INVOLUNTARY COMMITMENTJON
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CHAPTER 50JAIL DIVERSIONJOSEPH P. M
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PART VIIISPECIAL TOPICS
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560 VIII. SPECIAL TOPICStion, restr
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562 VIII. SPECIAL TOPICSsion criter
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564 VIII. SPECIAL TOPICSbased on ev
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CHAPTER 55RECOVERYDAVID ROELARRY DA
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568 VIII. SPECIAL TOPICSatric disab
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570 VIII. SPECIAL TOPICSA RECOVERY
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572 VIII. SPECIAL TOPICSassumes fro
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574 VIII. SPECIAL TOPICSDeegan, P.
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576 VIII. SPECIAL TOPICSwhereas ado
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578 VIII. SPECIAL TOPICSalence of d
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580 VIII. SPECIAL TOPICS• Because
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582 VIII. SPECIAL TOPICScovering pa
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584 VIII. SPECIAL TOPICSGoldberg, 1
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586 VIII. SPECIAL TOPICSthe quality
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588 VIII. SPECIAL TOPICSof-life mea
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590 VIII. SPECIAL TOPICSBecker, M.,
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CHAPTER 58SPIRITUALITY AND RELIGION
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594 VIII. SPECIAL TOPICSbe related
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596 VIII. SPECIAL TOPICSmore or les
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598 VIII. SPECIAL TOPICSing with bo
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600 VIII. SPECIAL TOPICSExpressive
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602 VIII. SPECIAL TOPICSconsumer ab
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CHAPTER 59SEXUALITYALEX KOPELOWICZR
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606 VIII. SPECIAL TOPICSmay result
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608 VIII. SPECIAL TOPICSTABLE 59.1.
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610 VIII. SPECIAL TOPICSThis second
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612 VIII. SPECIAL TOPICSFIGURE 59.1
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614 VIII. SPECIAL TOPICSTo overcome
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CHAPTER 60SCHIZOPHRENIA INAFRICAN A
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618 VIII. SPECIAL TOPICSTABLE 60.1.
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620 VIII. SPECIAL TOPICSPHARMACOTHE
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622 VIII. SPECIAL TOPICSered a part
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CHAPTER 61ETHICSABRAHAM RUDNICKCHAR
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626 VIII. SPECIAL TOPICSinterests c
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628 VIII. SPECIAL TOPICSticipant re
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630 VIII. SPECIAL TOPICSvide an eth
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632 IndexAmerican CorrectionalAssoc
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634 IndexChildren/adolescents, 481-
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636 IndexDepressive symptoms, 106,
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638 IndexFirst-episode psychosis, 1
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640 IndexInformation technology, he
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642 IndexMotor symptoms, DSM-IV-TR,
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644 IndexPregnancydosing strategies
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646 IndexRisk factorsfor co-occurri
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648 IndexSTG. See Superior temporal
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650 IndexUrine testingfor nicotine
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