Stepped Care 2 0 The Power Of Conundrums

Stepped Care 2.0: A Paradigm Shift in Mental Health, by Dr Peter Cornish, made a compelling argument for why the existing mental health care system has consistently struggled to meet the needs of clients from all walks of life, and laid out key principles and guidelines for how the system could be changed. But what challenges are involved in putting these ideas into practice? Stepped Care 2.0: The Power of Conundrums features essays, interviews, and arguments from a wide range of contributors who have tried to do just that. The Power of Conundrums dives deep into the practical application of the Stepped Care 2.0 model (SC2.0), looking at the ways SC2.0 has succeeded, the difficulties administrators face when implementing it, and how it could be improved. Chapters touch on topics including: the evidence for stepped care, the way SC2.0 can be stymied by the Western cultural values that dominate mental healthcare, implementation science and SC2.0, the risk paradigm and SC2.0, the model’s one-at-a-time approach to therapy, what co-design means in an SC2.0 context, a case study on how implementing SC2.0 can go wrong, the understanding of recovery put forward by the model, and how SC2.0 can work for clients experiencing complex, persistent, or chronic mental health issues. Each chapter is followed by a reflection from Cornish, and the book concludes with a roundtable discussion about how SC2.0 can evolve to meet the challenges it faces. This text brings theory and practice together by including an updated version of Stepped Care 2.0: A Paradigm Shift in Mental Health, as well as the full text of Stepped Care 2.0: The Power of Conundrums.

This book is a primer on Stepped Care 2.0. It is the first book in a series of three. This primer addresses the increased demand for mental health care by supporting stakeholders (help-seekers, providers, and policy-makers) to collaborate in enhancing care outcomes through work that is both more meaningful and sustainable. Our current mental health system is organized to offer highly intensive psychiatric and psychological care. While undoubtedly effective, demand far exceeds the supply for such specialized programming. Many people seeking to improve their mental health do not need psychiatric medication or sophisticated psychotherapy. A typical help seeker needs basic support. For knee pain, a nurse or physician might first recommend icing and resting the knee, working to achieve a healthy weight, and introducing low impact exercise before considering specialist care. Unfortunately, there is no parallel continuum of care for mental health and wellness. As a result, a person seeking the most basic support must line up and wait for the specialist along with those who may have very severe and/or complex needs. Why are there no lower intensity options? One reason is fear and stigma. A thorough assessment by a specialist is considered best practice. After all, what if we miss signs of suicide or potential harm to others? A reasonable question on the surface; however, the premise is flawed. First, the risk of suicide, or threat to others, for those already seeking care, is low. Second, our technical capacity to predict on these threats is virtually nil. Finally, assessment in our current culture of fear tends to focus more on the identification of deficits (as opposed to functional capacities), leading to over-prescription of expensive remedies and lost opportunities for autonomy and self-management. Despite little evidence linking assessment to treatment outcomes, and no evidence supporting our capacity to detect risk for harm, we persist with lengthy intake assessments and automatic specialist referrals that delay care. Before providers and policy makers can feel comfortable letting go of risk assessment, however, they need to understand the forces underlying the risk paradigm that dominates our society and restricts creative solutions for supporting those in need.

Look out for David Owen's next book, Where the Water Goes. The Conundrum is a mind-changing manifesto about the environment, efficiency and the real path to sustainability. Hybrid cars, fast trains, compact florescent light bulbs, solar panels, carbon offsets: Everything you've been told about living green is wrong. The quest for a breakthrough battery or a 100 mpg car are dangerous fantasies. We are consumers, and we like to consume green and efficiently. But David Owen argues that our best intentions are still at cross purposes to our true goal - living sustainably and caring for our environment and the future of the planet. Efficiency, once considered the holy grail of our environmental problems, turns out to be part of the problem. Efforts to improve efficiency and increase sustainable development only exacerbate the problems they are meant to solve, more than negating the environmental gains. We have little trouble turning increases in efficiency into increases in consumption. David Owen's The Conundrum is an elegant nonfiction narrative filled with fascinating information and anecdotes takes you through the history of energy and the quest for efficiency. This is a book about the environment that will change how you look at the world. We should not be waiting for some geniuses to invent our way out of the energy and economic crisis we're in. We already have the technology and knowledge we need to live sustainably. But will we do it? That is the conundrum.

Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

One afternoon, every single machine in sixteen-year-old Adam’s high school computer lab stops working. Outside, cars won’t start, phones are down, and a blackout is widespread. Soon Adam will discover that the problem has paralyzed not just his town but the whole country and beyond. As resources dwindle, crises mount, and chaos descends, he will see that his suburban neighborhood must band together for protection. Violence will erupt and Adam will understand that having a police captain for a mother and a retired government agent living next door are not just the facts of his life but the keys to his survival. Set in the here and now but with a distinctly dystopian feel, this is Eric’s most exciting and commercial title yet!

From the creator of the popular website Ask a Manager and New York’s work-advice columnist comes a witty, practical guide to 200 difficult professional conversations—featuring all-new advice! There’s a reason Alison Green has been called “the Dear Abby of the work world.” Ten years as a workplace-advice columnist have taught her that people avoid awkward conversations in the office because they simply don’t know what to say. Thankfully, Green does—and in this incredibly helpful book, she tackles the tough discussions you may need to have during your career. You’ll learn what to say when • coworkers push their work on you—then take credit for it • you accidentally trash-talk someone in an email then hit “reply all” • you’re being micromanaged—or not being managed at all • you catch a colleague in a lie • your boss seems unhappy with your work • your cubemate’s loud speakerphone is making you homicidal • you got drunk at the holiday party Praise for Ask a Manager “A must-read for anyone who works . . . [Alison Green’s] advice boils down to the idea that you should be professional (even when others are not) and that communicating in a straightforward manner with candor and kindness will get you far, no matter where you work.”—Booklist (starred review) “The author’s friendly, warm, no-nonsense writing is a pleasure to read, and her advice can be widely applied to relationships in all areas of readers’ lives. Ideal for anyone new to the job market or new to management, or anyone hoping to improve their work experience.”—Library Journal (starred review) “I am a huge fan of Alison Green’s Ask a Manager column. This book is even better. It teaches us how to deal with many of the most vexing big and little problems in our workplaces—and to do so with grace, confidence, and a sense of humor.”—Robert Sutton, Stanford professor and author of The No Asshole Rule and The Asshole Survival Guide “Ask a Manager is the ultimate playbook for navigating the traditional workforce in a diplomatic but firm way.”—Erin Lowry, author of Broke Millennial: Stop Scraping By and Get Your Financial Life Together

In a world of rising tensions between Russia and the United States, the Middle East and Europe, Sunnis and Shiites, Islamism and liberalism, Turkey is at the epicentre. And at the heart of Turkey is its right-wing populist president, Recep Tayyip Erdo?an. Since 2002, Erdo?an has consolidated his hold on domestic politics while using military and diplomatic means to solidify Turkey as a regional power. His crackdown has been brutal and consistent - scores of journalists arrested, academics officially banned from leaving the country, university deans fired and many of the highest-ranking military officers arrested. In some senses, the nefarious and failed 2016 coup has given Erdo?an the licence to make good on his repeated promise to bring order and stability under a 'strongman'. Here, leading Turkish expert Soner Cagaptay will look at Erdo?an's roots in Turkish history, what he believes in and how he has cemented his rule, as well as what this means for the world. The book will also unpick the 'threats' Erdogan has worked to combat - from the liberal Turks to the Gulen movement, from coup plotters to Kurdish nationalists - all of which have culminated in the crisis of modern Turkey.

WINNER OF THE 2019 NATIONAL BOOK AWARD FOR FICTION NATIONAL BESTSELLER “Electrifying” (People) • “Masterly” (The Guardian) • “Dramatic and memorable” (The New Yorker) • “Magic” (TIME) • “Ingenious” (The Financial Times) • "A gonzo literary performance” (Entertainment Weekly) • “Rare and splendid” (The Boston Globe) • “Remarkable” (USA Today) • “Delicious” (The New York Times) • “Book groups, meet your next selection" (NPR) In an American suburb in the early 1980s, students at a highly competitive performing arts high school struggle and thrive in a rarified bubble, ambitiously pursuing music, movement, Shakespeare, and, particularly, their acting classes. When within this striving “Brotherhood of the Arts,” two freshmen, David and Sarah, fall headlong into love, their passion does not go unnoticed—or untoyed with—by anyone, especially not by their charismatic acting teacher, Mr. Kingsley. The outside world of family life and economic status, of academic pressure and of their future adult lives, fails to penetrate this school’s walls—until it does, in a shocking spiral of events that catapults the action forward in time and flips the premise upside-down. What the reader believes to have happened to David and Sarah and their friends is not entirely true—though it’s not false, either. It takes until the book’s stunning coda for the final piece of the puzzle to fall into place—revealing truths that will resonate long after the final sentence. As captivating and tender as it is surprising, Susan Choi's Trust Exercise will incite heated conversations about fiction and truth, and about friendships and loyalties, and will leave readers with wiser understandings of the true capacities of adolescents and of the powers and responsibilities of adults.