Clinical Reasoning And Decision Making In Psychiatry

Mental health professionals routinely make treatment decisions without necessarily having an overarching perspective about optimal next steps. This important new book provides them with reader-friendly, pragmatic strategies to approach clinical problems as testable hypotheses. It discusses how to apply concepts based on decision analytic theory using risk-benefit analyses, contingency planning, measurement-based care, shared decision making, pharmacogenetics, disease staging, and machine learning. Readers will learn how these tools can help them craft optimal pharmacological and psychosocial interventions tailored to the needs of an individual patient. The book covers topics such as diagnostic ambiguity, interview technique, applying statistical concepts to individual patients, artificial intelligence, and managing high-risk, treatment-resistant, or demanding and difficult patients. Valuable clinical vignettes are featured throughout the book to illustrate common dilemmas and scenarios where the relative merits of competing treatment options invite a more iterative than definitive approach. For all healthcare professionals who prescribe psychotropic medications.

This book applies the theory and research of decision analytics to the field of mental health, with particular focus on how to improve clinical decision making.

Decision making is the physician's major activity. Every day, in doctors' offices throughout the world, patients describe their symptoms and com plaints while doctors perform examinations, order tests, and, on the basis of these data, decide what is wrong and what should be done. Although the process may appear routine-even to the physicians in volved-each step in the sequence requires skilled clinical judgment. Physicians must decide: which symptoms are important, whether any laboratory tests should be done, how the various items of clinical data should be combined, and, finally, which of several treatments (including doing nothing) is indicated. Although much of the information used in clinical decision making is objective, the physician's values (a belief that pain relief is more important than potential addiction to pain-killing drugs, for example) and subjectivity are as much a part of the clinical process as the objective findings of laboratory tests. In recent years, both physicians and psychologists have come to realize that patient management decisions are not only subjective but also prob abilistic (although this is not always acknowledged overtly). When doc tors argue that an operation is fairly safe because it has a mortality rate of only 1 %, they are at least implicitly admitting that the outcome of their decision is based on probability.

Brain, Decision Making, and Mental Health acknowledges that thinking is not a constant phenomenon but varies considerably across cultures. Critical thinking is particularly important in bridging thinking divisions and its applicability across sciences, particularly medical sciences. We see critical thinking as educable and the arts as means to achieve this purpose. We address the multidimensional relationship between thinking and health and related mechanisms. Thinking mainly affects emotion regulation and executive function; in other words, both mental and physical health are related as a function of thoughts. Considering the thinking‐feeling‐emotion regulation/executive function pathway, it would be reasonable to propose thinking capacities‐based interventions to impact emotion regulation and executive function, such as mindfulness and psychotherapy. We review decision-making taking place in integrated and social contexts and discuss the decision-making styles-decision outcomes relation. Finally, artificial thinking and intelligence prepare us for decision-making outside the human mind.

Policy-capturing models, data-based aids, expert systems and decision analysis are the main decision-making techniques introduced here, with attention to their methodological bases and practical evaluation.

Praise for Critical Thinking in Clinical Practice, Third Edition "Eileen Gambrill is unparalleled in her ability to describe common flaws and biases in clinical decision making. The result in this revised edition is a steadfast call for change that also acknowledges the demands of practice. A must-read for clinicians and researchers alike." —Elizabeth K. Anthony, PhD, Assistant Professor, School of Social Work, Arizona State University "This Third Edition builds upon the impressive strengths of Gambrill's prior treatments of the topic to support the notion that critical thinking is a teachable skill and one essential for contemporary practice in the human services. This book should be the default authority on the topic of critical thinking for human service professionals and would be an excellent textbook." —Bruce A. Thyer, PhD, LCSW, Professor and former Dean, Florida State University College of Social Work "I was skeptical about how Critical Thinking in Clinical Practice could be improved, but Eileen Gambrill has succeeded! Her articulation of critical thinking skills for clinical decisions ultimately will benefit the people we serve." —Joanne Yaffe, PhD, ACSW, Associate Professor of Social Work and Adjunct Associate Professor of Psychiatry, University of Utah A balanced and illustrative guide to incorporating critical-thinking values, knowledge, and skills into clinical education and practice Now in a third edition, Critical Thinking in Clinical Practice is written for helping professionals who want to think more clearly about the decisions they make and the context in which they make them. It is a practical volume for clinicians who would like to expand their knowledge of common pitfalls and fallacies in clinical reasoning. As in earlier editions, this Third Edition draws on research related to problem solving and decision making, illustrating the relevance of research findings to everyday clinical practice and policy. Revised throughout, the new edition includes discussion of: The influence of pharmaceutical companies on the helping professions, including disease mongering—the creation of bogus risks, problems, and needless worries Different kinds of propaganda in the helping professions that compromise informed consent Additional coverage of classification, pathology, reliance on authority, and hazards in data collection The development of decision aids of value to both professionals and clients The relative contribution of specific interventions compared to nonspecific factors to positive outcome Factors related to decision making in multidisciplinary teams New developments regarding intuitive and analytic reasoning The pragmatic theory of fallacies Designed to enhance the quality of services offered to clients, Critical Thinking in Clinical Practice, Third Edition is filled with insightful examples, useful lists, websites, and guidelines, presenting an essential resource for all helping professionals and students in the helping professions.