assessment and intervention approach with most common medical problems encountered in ... sound and solid conclusions about the added value offered by cognitive-behavioural ... comane souvent non volontaire. Ãgalement, ce livre met ...
Canadian Psychology / Psychologie canadienne 2012, Vol. 53, No. 2, 146 –149
© 2012 Canadian Psychological Association 0708-5591/12/$12.00
BOOK REVIEWS / COMPTES RENDUS DE LECTURE care. As a psychologist and clinician-investigator, I teach and conduct research in a university-affiliated hospital and also provide psychological services in a Family Health Team in primary care. I wish to underline to potential readers that this book is very well written and comprehensive enough to stand on its own as an invaluable volume to health care practitioners who wish to develop a combination of broad as well as in-depth understanding of all of the pertinent issues related to the integration of medical and mental health care services and, more specifically, how empirically supported cognitive-behavioural approaches can be applied and tailored to a variety of presenting problems in the primary care setting. Psychology and family medicine seem to blend together as natural and complementary allies throughout every chapter of this handbook. The volume is organized in five parts. Part 1 sets a tone and foundation by addressing general considerations from both theoretical and practical perspectives: how the biopsychosocial model and cognitive-behavioural approaches can benefit primary care; ethical and practical issues to develop for effective practice; the roles, functions, and ethical considerations of the cognitivebehavioural clinician in primary care; the relevance of interprofessional collaboration between the mental health clinician and the family physician; the various consultation models and processes inherent to consultation in primary care; the utmost importance of integrating and applying evidence-based practices and guidelines in primary care; the role of cognitive-behavioural clinicians as teachers and how they can contribute to the training of residents in family medicine; and finally, the role of spirituality in primary care. Part 2 focuses on reviewing a variety of cognitive and behavioural techniques as well as the notion of case conceptualisation and how they can be applied in primary care. Part 3 has a clinical focus, namely on how to effectively address common clinical, behavioural, and lifestyle problems encountered in primary care: the challenges of nonadherence to medical treatments, depression and anxiety as the most common mental disorders seen in every day medical practice, a cognitive-behavioural approach for understanding and addressing suicidality in primary care, identifying and managing substance abuse, managing patients presenting with challenging nebulous physical complaints and somatoform disorders, intervening with medical phobias that are significant enough to interfere with medical treatments, the complexities of assessing and treating patients with eating disorders, and tackling common pediatric issues in the primary care setting. Part 4 is also clinical and focuses on the cognitive-behavioural assessment and intervention approach with most common medical problems encountered in primary care: hypertension, asthma, Type 2 diabetes, obesity, acute and chronic pain, headaches, irritable bowel syndrome, and the evidence-based management of insomnia. Finally, in Part 5 the editors share their wisdom through 10 sound and solid conclusions about the added value offered by cognitive-behavioural approaches over and above traditional medicine in the primary care setting, as well as the utmost importance of ongoing collaboration with primary care providers as an essential ingredient for success and long-term sustainability.
Handbook of Cognitive-Behavioural Approaches in Primary Care, by Robert A. DiTomasso, Barbara A. Golden, & Harry J. Morris (Eds.). New York, NY: Springer Publishing Company, 2011, 753 pages (ISBN 978-082610383-3, US $95.00 Hardcover) Reviewed by JEAN GRENIER DOI: 10.1037/a0027784
Primary health care reform has been a major point of interest from various perspectives (clinical, health care, health policies, etc.) in many countries over the past 12 years. One of the premises of primary health care reforms across the world is the recognition that physical and mental health problems are more often than not intertwined and interact in complex and sometimes unknown ways. Left ignored, or addressed in silos, this complex mind– body connection or interaction often leads to physical and mental health problems that increasingly need to be addressed both from a physical as well as a mental health perspective. For this reason, there has been rising awareness that primary care physicians can benefit from collaborating with other health professionals such as psychologists, psychotherapists, mental health counsellors, and behavioural educators, and share the burden of health problems seen in primary care. Interprofessional collaboration and clinical best practices are two other major points of interest in primary care reforms. Interprofessional collaboration has been generally shown to improve some clinical outcomes and increase satisfaction with care for both patients and providers. It is hoped that the longer term impact of such collaboration amongst various health professionals with different expertise and scopes of practice will include not only better health outcomes for patients but also reduce costs to the health care system and society as a whole. As for best practices, one aim of reform is to increase population access to empirically supported treatments in primary care. This being said, early career as well as seasoned clinicians and scholars are not always sure as to how all of these knowledge bases get transferred and articulated efficiently in day-to-day practice. The Handbook of Cognitive-Behavioural Approaches in Primary Care takes these theoretical concepts, empirically supported knowledge bases, experiences in clinical health psychology and behavioural medicine, and the realities of primary care medical settings, and uses the solid judgment and accumulated wisdom of various author-contributors to help readers understand just how all of those elements can be efficiently integrated and articulated not only in day-to-day practice, but as part of a health practitioner’s practice philosophy and professional identity. This volume is impressively comprehensive and covers a broad spectrum of theory, research, and practice issues related to the growing awareness of the mind– body connection in primary care. Its broad micro-to-macro spectrum spans from the individual patient level all the way up to professional and health care systems level, and up again to the level of societal access to empirically supported interventions in primary care and primary mental health 146
BOOK REVIEWS / COMPTES RENDUS DE LECTURE
If I had to choose only one comprehensive and detailed volume on evidence-based approaches in primary care to guide my clinical practice and teaching, the Handbook of CognitiveBehavioural Approaches in Primary Care would probably be the one. Dr. Jean Grenier, CPsych. is a psychologist at the Montfort Hospital and clinician-investigator with the Montfort Hospital Research Institute and the CT Lamont Primary Health Care Research Centre. His research interests focus on primary mental health care, interprofessional collaboration between psychologists and family physicians, as well as evidence-based treatments for anxiety disorders. Dr. Grenier also practices on a part-time basis in a Family Health Team in primary care where he provides psychological services and trains doctoral level interns in clinical psychology to work in primary care.
The´rapie bre`ve centre´e sur la solution dans les services me´dicosociaux, par Yvonne M. Dolan et Teri Pichot, Bruxelles, Belgique : Satas E´diteur, 2010, 300 p. Traduit de l’anglais par Armelle Touyarot (ISBN 978-2-87293-114-9, 23, 75 CAD) Compte rendu par : Raynald Poulin DOI: 10.1037/a0027721
C’est a` partir de pre´occupations de plus en plus grandissantes ve´cues par l’auteure au cours des 10 dernie`res anne´es que se de´couvrent les origines de ce livre. En effet, lors de se´minaires de formation sur la the´ rapie centre´ e sur la solution et l’hypnothe´rapie e´riksonienne, Yvonne M. Dolan constatait chez ses colle`gues, de fac¸on presque ge´ne´ralise´e, de l’e´puisement, de l’insatisfaction et de l’abattement dans le cadre de leur travail. Paralle`lement, l’auteure e´tait te´moin du fonctionnement d’un centre d’intervention en toxicomanie a` Denver (Substance Abuse Counselling Program). Dans ce centre, dirige´ par Teri Pichot et finance´ par des fonds publics, les the´rapeutes manifestaient une e´nergie et un dynamisme hors du commun. Ce livre pre´sente notamment les apprentissages re´alise´s dans l’inte´gration de the´rapie centre´e sur la solution dans un contexte communautaire aupre`s d’une cliente`le toxicomane souvent non volontaire. E´galement, ce livre met en e´vidence l’utilisation des outils de la the´rapie bre`ve centre´e sur la solution (TBCS), tels que la question miracle, les e´chelles d’e´valuation et les questions exceptionnelles. On retrouve aussi dans cet ouvrage les re´flexions et les de´bats de l’e´quipe de the´rapeutes sur les aspects techniques de la transition a` l’inte´gration du mode`le TBCS. On y fait e´galement e´tat du changement de paradigme, a` savoir le passage d’une orientation centre´e sur le proble`me a` une orientation centre´e sur la solution, de the´rapeute expert a` client expert. Cet ouvrage pre´sente e´galement le processus d’inte´gration de la TBCS sur le plan administratif, tout en mettant en lumie`re la subtilite´ et les particularite´s de l’approche dans l’encadrement des the´rapeutes. La TBCS y est de´crite comme un outil pratique : the´orie, techniques, interventions individuelles et de groupe, strate´gies d’orientation en fonction des politiques et du concept
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d’e´quipe. Cette approche se pre´sente comme une me´thode nouvelle et efficace qui redonne de l’e´nergie aux the´rapeutes et aux administrateurs lorsqu’elle est applique´e dans son inte´gralite´ et adopte´e par tous. La base et la philosophie de la TBCS sont pre´sente´es de fac¸on descriptive, e´tape par e´tape. Les interventions sont claires et les points qui contrastent avec les approches plus traditionnelles sont bien pre´sente´s. De nombreux cas cliniques ainsi que des re´flexions des the´rapeutes sur l’approche sont abondamment illustre´s. Il revient alors au lecteur d’en saisir les ide´es directrices, l’esprit et la pratique. Ce livre comporte 10 chapitres. Le premier pre´sente les principes de base de la the´rapie bre`ve centre´e sur la solution sous la forme de « recette passe-partout » mettant en valeur la dimension cre´atrice de l’approche tout en conside´rant des e´le´ments incontournables. Parmi ceux-ci notons l’utilisation de la question miracle, des questions sur les exemptions, de l’utilisation des e´chelles d’e´valuation, des questions sur les diffe´rences et des questions relationnelles. De plus, ce chapitre met en e´vidence, dans son application, les contrastes entre les principales approches traditionnelles, centre´es sur le proble`me, et l’approche centre´e sur la solution dans un contexte d’un organisme communautaire. Les deux prochains chapitres concernent la mise en pratique de la the´rapie. Le Chapitre 2 fournit un guide sous forme de « feuille de route », pre´sente´e e´tape par e´tape, sur la fac¸on dont l’organisme communautaire a mis en application la the´rapie bre`ve centre´e sur la solution avec des clients en se´ance individuelle, qu’ils soient toxicomanes, sous injonction de la cour ou autres. Le Chapitre 3, en comple´ment du chapitre pre´ce`dent, pre´sente de quelle fac¸on l’application de cette « feuille de route » en se´ance individuelle peut eˆtre adapte´e aux the´rapies de groupe. Le Chapitre 4 met l’accent sur l’adaptation de la question miracle et sur ses principes sous-jacents, et propose diffe´rentes adaptations dans son application : la porte magique, la machine a` voyager dans le temps, la baguette magique, le coup de fil provenant du futur, etc. Le Chapitre 5 met en lumie`re l’importance de maintenir l’objectif de changement et de pre´venir les rechutes, en s’assurant que le client a la capacite´ de maintenir ce changement dans sa vie quotidienne, particulie`rement en pe´riode de stress ou de crise. On y pre´sente notamment le « kit de de´pannage d’urgence », analogie utilise´e pour aider les clients a` de´couvrir les outils qu’ils posse`dent de´ja` pour surmonter d’e´ventuelles difficulte´s. Le Chapitre 6 aborde l’application de la the´rapie bre`ve centre´e vers la solution aupre`s d’une cliente`le adolescente et en quoi la me´thode peut eˆtre utile et approprie´e en fonction des caracte´ristiques des adolescents. Le Chapitre 7 traite de la complexite´ des communications pour les the´rapeutes centre´s sur la solution avec les autres professionnels exerc¸ant des approches the´rapeutiques diffe´rentes. On met en valeur les compe´tences et les strate´gies qui ont e´te´ mises en place pour que les communications entre les professionnels soient efficaces et respectueuses des diffe´rents mode`les the´rapeutiques utilise´s. Le Chapitre 8 de´crit la structure et les principes de la supervision clinique applique´s au sein de cet organisme en montrant l’importance de la supervision clinique centre´e sur la solution aupre`s de ses propres the´rapeutes ainsi que les effets be´ne´fiques sur leur engagement et le climat organisationnel.
