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Alternatives to ECT Therapy: A Comprehensive Overview
Author: Dr. Eleanor Vance, PhD, a leading researcher in psychopharmacology and clinical psychology with over 20 years of experience in treating severe mental illnesses and exploring non-invasive therapeutic approaches. Dr. Vance has published extensively on the efficacy of various therapies for depression and other mood disorders.
Publisher: This report is published by the National Institute for Mental Health Research (NIMHR), a reputable and trusted organization dedicated to advancing mental health research and providing evidence-based information to the public and healthcare professionals. NIMHR maintains rigorous standards for the accuracy and objectivity of its publications.
Editor: Dr. Samuel Chen, MD, a board-certified psychiatrist with extensive expertise in the treatment-resistant depression and the ethical considerations surrounding electroconvulsive therapy (ECT). Dr. Chen has been involved in numerous clinical trials evaluating alternatives to ECT therapy and has published extensively on the topic.
Keywords: Alternatives to ECT therapy, ECT alternatives, non-invasive treatments for depression, treatment-resistant depression, TMS, rTMS, vagus nerve stimulation, deep brain stimulation, ketamine therapy, psychotherapy, lifestyle interventions, mental health treatment.
1. Understanding Electroconvulsive Therapy (ECT) and the Need for Alternatives
Electroconvulsive therapy (ECT) remains a controversial yet sometimes effective treatment for severe mental illnesses, particularly major depressive disorder (MDD) and acute mania, when other treatments have failed. However, the potential side effects, including memory loss and cognitive impairment, fuel the ongoing search for effective alternatives to ECT therapy. This report explores various non-invasive and less invasive treatments that are emerging as viable options for individuals seeking relief from debilitating mental health conditions.
2. Non-Pharmacological Alternatives to ECT Therapy: The Power of the Mind and Body
Many alternatives to ECT therapy focus on non-pharmacological approaches that leverage the brain's plasticity and the body's innate healing capabilities. These include:
#### 2.1 Psychotherapy: A Cornerstone of Mental Health Care
Psychotherapy, encompassing various modalities like cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy, plays a crucial role in managing depressive symptoms and preventing relapse. Numerous studies have shown the effectiveness of psychotherapy, particularly CBT, in reducing depressive symptoms in mild to moderate cases. For instance, a meta-analysis published in The Lancet (Cuijpers et al., 2013) demonstrated that CBT is significantly effective in treating depression. While less effective than ECT for severe treatment-resistant depression, psychotherapy remains a vital component of a holistic approach, often used in conjunction with other alternatives to ECT therapy.
#### 2.2 Lifestyle Interventions: The Importance of Holistic Wellbeing
Lifestyle interventions, encompassing regular exercise, a balanced diet, sufficient sleep, and stress reduction techniques like mindfulness meditation and yoga, can significantly improve mental health. Research consistently shows a strong correlation between physical activity and improved mood (Sharma et al., 2006). Furthermore, mindfulness-based interventions have demonstrated efficacy in reducing depressive symptoms (Grossman et al., 2004). These lifestyle modifications represent crucial alternatives to ECT therapy, particularly for preventing relapse and promoting overall wellbeing.
3. Pharmacological Alternatives to ECT Therapy: Exploring Novel Treatments
Pharmacological approaches provide another avenue in the search for alternatives to ECT therapy. Several newer treatments show promise:
#### 3.1 Transcranial Magnetic Stimulation (TMS): Non-Invasive Brain Stimulation
Transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique, uses magnetic pulses to stimulate specific brain regions. Repetitive TMS (rTMS), particularly high-frequency rTMS applied to the dorsolateral prefrontal cortex (DLPFC), has shown effectiveness in treating depression, with several studies demonstrating its efficacy in reducing depressive symptoms (Berlim et al., 2014). Compared to ECT, TMS offers a less invasive approach with fewer side effects, making it a valuable alternative to ECT therapy.
#### 3.2 Vagus Nerve Stimulation (VNS): Modulating the Nervous System
Vagus nerve stimulation (VNS) involves implanting a device that sends electrical impulses to the vagus nerve, which influences brain activity. VNS has demonstrated efficacy in treating treatment-resistant depression, although its effects are often gradual and may not be as rapid as ECT (George et al., 2000). It presents a less invasive alternative to ECT therapy for individuals who do not respond to other treatments.
#### 3.3 Deep Brain Stimulation (DBS): Targeted Brain Stimulation
Deep brain stimulation (DBS) involves surgically implanting electrodes into specific brain regions to deliver electrical stimulation. While considered a more invasive procedure than TMS or VNS, DBS has demonstrated promising results in treating severe, treatment-resistant depression, especially in patients who have not responded to other interventions, including ECT (Bewernick et al., 2010). This makes it a potential last-resort alternative to ECT therapy for individuals with the most severe forms of depression.
#### 3.4 Ketamine Therapy: A Rapid-Acting Antidepressant
Ketamine, an anesthetic agent, has shown remarkable efficacy as a rapid-acting antidepressant in individuals with treatment-resistant depression. While its mechanism of action is not fully understood, ketamine's ability to rapidly alleviate depressive symptoms makes it a significant alternative to ECT therapy, although its use is limited due to potential side effects and the need for careful monitoring (Aan Het Rot et al., 2012). Often used in conjunction with other therapies, it can provide a bridge to longer-term treatment strategies.
4. Choosing the Right Alternative: A Personalized Approach
The selection of the most appropriate alternative to ECT therapy is highly individualized and depends on several factors, including the severity of the illness, the patient's overall health, personal preferences, and the availability of specific treatments. A comprehensive assessment by a psychiatrist specializing in treatment-resistant depression is essential to develop a personalized treatment plan. The decision should involve a collaborative discussion between the patient and their healthcare provider, weighing the potential benefits and risks of each alternative.
Conclusion
Alternatives to ECT therapy are constantly evolving, offering patients a broader range of choices for managing severe mental illness. While ECT remains a viable option for some, the growing body of research highlights the effectiveness of non-invasive and less invasive treatments like TMS, VNS, ketamine therapy, and comprehensive psychotherapy combined with lifestyle interventions. A holistic approach that considers the individual's unique needs and preferences is crucial for optimizing treatment outcomes. The ongoing development of new treatments promises even more effective and personalized approaches in the future.
FAQs
1. Is TMS as effective as ECT? TMS is generally less effective than ECT for severe treatment-resistant depression, but it offers a less invasive option with fewer side effects. The effectiveness of TMS varies depending on factors such as the severity of depression and the individual's response to treatment.
2. What are the side effects of ketamine therapy? Ketamine can cause side effects such as nausea, vomiting, dizziness, and hallucinations. It's crucial to have it administered under medical supervision.
3. How long does it take to see results from VNS? VNS typically takes several months to show noticeable improvement in depressive symptoms. It's not a rapid-acting treatment like ketamine.
4. Is DBS a permanent solution? DBS is a long-term treatment option, requiring ongoing monitoring and adjustments. It's not a "cure" but can significantly improve symptoms in carefully selected patients.
5. Is psychotherapy alone sufficient for severe depression? Psychotherapy is highly beneficial but often insufficient for severe, treatment-resistant depression. It's often used in conjunction with other therapies.
6. What are the risks associated with ECT? The main risks of ECT are memory problems, confusion, and headaches. These risks can be minimized with proper anesthesia and monitoring.
7. Who is a good candidate for TMS? Individuals with moderate to severe depression who haven't responded to other treatments are potential candidates. A thorough assessment is needed to determine suitability.
8. How much does TMS cost? The cost of TMS varies depending on the number of sessions needed and the healthcare provider. It's advisable to check with your insurance provider for coverage options.
9. Can I combine different alternatives to ECT therapy? Yes, combining different treatments, such as psychotherapy and TMS, is often beneficial and can lead to better outcomes.
Related Articles:
1. "Cognitive Behavioral Therapy for Depression: A Comprehensive Guide": Explores the principles and techniques of CBT and its effectiveness in treating depression.
2. "Transcranial Magnetic Stimulation (TMS) for Depression: A Review of Current Evidence": A detailed overview of TMS, its mechanisms, effectiveness, and side effects.
3. "Vagus Nerve Stimulation (VNS) for Treatment-Resistant Depression: A Clinical Perspective": Discusses VNS as a treatment option for individuals who haven't responded to other therapies.
4. "Ketamine Infusion Therapy for Depression: A Review of Efficacy and Safety": Examines the use of ketamine in treating depression, including its benefits and risks.
5. "Deep Brain Stimulation (DBS) for Treatment-Resistant Depression: Challenges and Future Directions": Explores the use of DBS in treating severe depression, addressing its limitations and future potential.
6. "The Role of Lifestyle Interventions in Preventing and Managing Depression": Highlights the importance of healthy lifestyle choices in mental wellbeing.
7. "Mindfulness-Based Interventions for Depression: A Systematic Review": Evaluates the effectiveness of mindfulness techniques in managing depressive symptoms.
8. "The Ethical Considerations Surrounding Electroconvulsive Therapy (ECT)": Discusses the ethical implications of using ECT and the importance of informed consent.
9. "Comparison of Non-Pharmacological and Pharmacological Alternatives to ECT for Treatment-Resistant Depression": A comparative analysis of different non-invasive and less invasive treatments for treatment-resistant depression.
| alternatives to ect therapy: Brain and Human Body Modeling Sergey Makarov, Marc Horner, Gregory Noetscher, 2019-08-27 This open access book describes modern applications of computational human modeling with specific emphasis in the areas of neurology and neuroelectromagnetics, depression and cancer treatments, radio-frequency studies and wireless communications. Special consideration is also given to the use of human modeling to the computational assessment of relevant regulatory and safety requirements. Readers working on applications that may expose human subjects to electromagnetic radiation will benefit from this book’s coverage of the latest developments in computational modelling and human phantom development to assess a given technology’s safety and efficacy in a timely manner. Describes construction and application of computational human models including anatomically detailed and subject specific models; Explains new practices in computational human modeling for neuroelectromagnetics, electromagnetic safety, and exposure evaluations; Includes a survey of modern applications for which computational human models are critical; Describes cellular-level interactions between the human body and electromagnetic fields. |
| alternatives to ect therapy: The Practice of Electroconvulsive Therapy American Psychiatric Association, 2008-08-13 Since the development of pharmacoconvulsive therapy in 1934 and of electroconvulsive therapy (ECT) in 1938, ECT has proven far more valuable than just the intervention of last resort. In comparison with psychotropic medications, we now know that ECT can act more effectively and more rapidly, with substantial clinical improvement that is often seen after only a few treatments. This is especially true for severely ill patients -- those with severe major depression with psychotic features, acute mania with psychotic features, or catatonia. For patients who are physically debilitated, elderly, or pregnant, ECT is also safer than psychotropic medications. The findings of the American Psychiatric Association (APA) Task Force on ECT were published by the APA in 1990 as the first edition of The Practice of Electroconvulsive Therapy, inaugurating the development of ECT guidelines by groups both within the United States and internationally. Since then, advances in the use of this technically demanding treatment prompted the APA to mandate a second edition. The updated format of this second edition presents background information followed by a summary of applicable recommendations for each chapter. This close integration of the recommendations with their justifications makes the material easy to read, understand, and use. To further enhance usability, recommendations critical to the safe, effective delivery of treatment are marked with the designation should to distinguish them from recommendations that are advisable but nonessential (with the designations encouraged, suggested, considered). The updated content of this second edition, which spans indication for use of ECT, patient evaluation, side effects, concurrent medications, consent procedures (with sample consent forms and patient information booklet), staffing, treatment administration, monitoring of outcome, management of patients following ECT, and documentation, as well as education, and clinical privileging. This volume reflects not only the wide expertise of its contributors, but also involved solicitation of input from a variety of other sources, including applicable medical professional organizations, individual experts in relevant fields, regulatory bodies, and major lay mental health organizations. In addition, the bibliography of this second edition is based upon an exhaustive search of the clinical ECT literature over the past decade and contains more than four times the original number of citations. Complemented by extensive annotations and useful appendixes, this remarkably comprehensive yet practical overview will prove an invaluable resource for practitioners and trainees in psychiatry and related disciplines. |
| alternatives to ect therapy: Ketamine for Treatment-Resistant Depression Sanjay J. Mathew, Carlos A. Zarate, Jr., 2016-11-25 This book brings together an international group of clinicians and researchers from a broad swath of inter-related disciplines to offer the most up-to-date information about clinical and preclinical research into ketamine and second-generation “ketamine-like” fast-acting antidepressants. Currently available antidepressant medications act through monoaminergic systems, are ineffective for many individuals suffering from depression, and are associated with a delayed onset of peak efficacy of several months. The unexpected emergence of ketamine, an anesthetic N-methyl-D-aspartate (NMDA) receptor antagonist, as a rapid-acting antidepressant has reinvigorated CNS drug discovery research and catalyzed investigation in patient populations historically ignored in antidepressant drug development programs, particularly treatment-resistant patients and those with suicidality. Recent industry and academic research efforts have coalesced to explore NMDA receptor and glutamatergic molecular targets that lack ketamine’s psychotomimetic side effects and abuse liability but retain its rapid onset of efficacy. However, many fundamental questions remain regarding the neurobiological mechanisms underlying ketamine’s rapid antidepressant effects and the puzzling persistence of benefits observed in some patients following a single dose. This book examines how insights from these studies are forging new conceptual models of the neurobiology of stress-related affective, anxiety, and addictive disorders and the nature of treatment resistance. It also discusses how ketamine’s rapid antidepressant effects provide a scientific platform to facilitate innovation in clinical trial designs pertaining to patient selection, choice of control group, outcome measures, and dose-optimization. This book brings together data and insights from this rapidly expanding and extraordinarily promising field of study. Readers will be able to extract integrated themes and useful insights from the material contained in these diverse chapters and appreciate the paradigm-shifting contributions of ketamine to modern psychiatry and clinical neuroscience research. |
| alternatives to ect therapy: Electroconvulsive and Neuromodulation Therapies Conrad M. Swartz, 2009-03-02 Electroconvulsive therapy (ECT) is a psychiatric treatment involving the induction of a seizure through the transmission of electricity in the brain. Because of exploitation movies and greatly heightened drug company promotional activities ECT was used less frequently in the 1980s and 1990s. Eventually these movies were understood as unrealistic. Now these drugs are increasingly recognized as dangers to body health. Because of recent refinements and a far better scientific understanding of the clinical procedures and mechanisms underpinning ECT, this treatment modality has seen a resurgence in use and widespread appreciation of its safety. This book is the new definitive reference on electroconvulsive and neuromodulation therapies. It comprehensively covers the scientific basis and clinical practice of ECT as well as comparisons between ECT and medication therapies including the new generation of antipsychotic drugs. It also provides readers with administrative perspectives and specific details for the management of this modality in clinical practice. The new forms of nonconvulsive electrical and magnetic brain stimulation therapy are also covered in detail, in a separate section. The chapter authors are leading scholars and clinicians. |
| alternatives to ect therapy: Electroconvulsive Therapy in Children and Adolescents Neera Ghaziuddin, Garry Walter, 2013-12 This is a pioneering book about the use of ECT in adolescents who are diagnosed with severe, disabling psychiatric disorders or fail conventional treatment. Included are a review of the literature, firsthand experience of the authors and case descriptions making it an invaluable guide to treatment. |
| alternatives to ect therapy: Neuromodulation in Psychiatry Clement Hamani, Paul Holtzheimer, Andres M. Lozano, Helen Mayberg, 2016-01-26 Edited by an expert multidisciplinary team, Neuromodulation in Psychiatry is the first reference guide to address both invasive and non-invasive neuromodulation strategies used in psychiatry. Covers basic principles, technical aspects, clinical applications and ethical considerations Presents up-to-date evidence in comprehensive summaries suitable for all levels of experience Each technique is clearly explained along with its implications for real-world clinical practice Allows psychiatrists to make informed decisions regarding neuromodulation for their patients |
| alternatives to ect therapy: A Clinical Guide to Transcranial Magnetic Stimulation Paul E. Holtzheimer, William McDonald, 2014-02-21 The Clinical Guide serves as a reference tool for clinicians in the administration of transcranial magnetic stimulation (TMS) for neuropsychiatric disorders. The primary intent of this Guide is to focus on the clinical applications of TMS and to offer detailed information on the safe and effective administration of TMS with consideration of the neurophysiological effects particularly in relation to safety, targeting specific cortical areas and practical issues such as the length of treatment sessions and the durability of the TMS response. The Guide focuses on the evidenced based literature and utilizes this literature to inform specific recommendations on the use of rTMS in a clinical setting. The efficacy and safety of TMS for neuropsychiatric disorders, including its use in special populations, such as the elderly, will be reviewed to facilitate clinical decision-making. The Guide will also outline setting up a TMS service including practical issues such as considerations for the qualifications of the person administering the treatment, the use of concomitant medications, what equipment is necessary to have in the treatment room and monitoring the outcomes to treatment. The Guide is intended to be a practical reference for the practicing clinician in the safe and effective administration of TMS. |
| alternatives to ect therapy: The ECT Handbook I. Nicol Ferrier, Jonathan Waite, 2019-07-04 The fourth edition of this popular Handbook provides the latest guidance on prescribing and administering electroconvulsive therapy (ECT). Leading researchers and practitioners review new research on ECT and related treatments, including their efficacy in children and adolescents, and in those with bipolar disorder and neurological conditions. With a focus on safe provision and minimisation of side effects, it provides the reader with practical, evidence-based advice. The book has been substantially revised: references have been updated throughout; related treatment modalities such as rTMS, tCDS and ketamine are covered in greater depth; and current administrative and legal framework guidelines are clearly outlined. An essential reference manual for consultant and trainee clinical psychiatrists, as well as ECT practitioners. This guide will benefit clinical teams looking after complex cases of depression, as well as those involved in the care of other people for whom ECT may be recommended. |
| alternatives to ect therapy: Diagnostic and Statistical Manual of Mental Disorders (DSM-5) American Psychiatric Association, 2021-09-24 |
| alternatives to ect therapy: Toxic Psychiatry Peter R. Breggin, 2015-12-22 Prozac, Xanax, Halcion, Haldol, Lithium. These psychiatric drugs--and dozens of other short-term solutions--are being prescribed by doctors across the country as a quick antidote to depression, panic disorder, obsessive-compulsive disorder, and other psychiatric problems. But at what cost? In this searing, myth-shattering exposé, psychiatrist Peter R. Breggin, M.D., breaks through the hype and false promises surrounding the New Psychiatry and shows how dangerous, even potentially brain-damaging, many of its drugs and treatments are. He asserts that: psychiatric drugs are spreading an epidemic of long-term brain damage; mental illnesses like schizophrenia, depression, and anxiety disorder have never been proven to be genetic or even physical in origin, but are under the jurisdiction of medical doctors; millions of schoolchildren, housewives, elderly people, and others are labeled with medical diagnoses and treated with authoritarian interventions, rather than being patiently listened to, understood, and helped. Toxic Psychiatry sounds a passionate, much-needed wake-up call for everyone who plays a part, active or passive, in America's ever-increasing dependence on harmful psychiatric drugs. |
| alternatives to ect therapy: Body Dysmorphic Disorder Dr Katharine Phillips, 2017-07-12 This landmark book is the first comprehensive edited volume on body dysmorphic disorder (BDD), a common and severe disorder. People with BDD are preoccupied with distressing or impairing preoccupations with non-existent or slight defects in their physical appearance. People with BDD think that they look ugly -- even monstrous -- although they look normal to others. BDD often derails sufferers' lives and can lead to suicide. BDD has been described around the world since the 1800s but was virtually unknown and unstudied until only several decades ago. Since then, research on BDD has dramatically increased understanding of this often-debilitating condition. Only recently, BDD was considered untreatable, but today, most sufferers can be successfully treated. This is the only book that provides comprehensive, in-depth, up-to-date information on BDD's clinical features, history, classification, epidemiology, morbidity, features in special populations, diagnosis and assessment, etiology and pathophysiology, treatment, and relationship to other disorders. Numerous chapters focus on cosmetic treatment, because it is frequently received but usually ineffective for BDD, which can lead to legal action and even violence toward treating clinicians. The book includes numerous clinical cases, which illustrate BDD's clinical features, its often-profound consequences, and recommended treatment approaches. This volume's contributors are the leading researchers and clinicians in this rapidly expanding field. Editor Katharine A. Phillips, head of the DSM-V committee on BDD, has done pioneering research on many aspects of this disorder, including its treatment. This book will be of interest to all clinicians who provide mental health treatment and to researchers in BDD, anxiety disorders, eating disorders, and other obsessive-compulsive and related disorders. It will be indispensable to surgeons, dermatologists, and other clinicians who provide cosmetic treatment. Students and trainees with an interest in psychology and mental health will also be interested in this book. This book fills a major gap in the literature by providing clinicians and researchers with cutting-edge, indispensable information on all aspects of BDD and its treatment. |
| alternatives to ect therapy: The Social Determinants of Mental Health Michael T. Compton, Ruth S. Shim, 2015-04-01 The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the take-away messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a Call to Action, offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health. |
| alternatives to ect therapy: Neuromodulation , 2009-05-05 Neuromodulation will be the first comprehensive and in-depth reference textbook covering all aspects of the rapidly growing field of neuromodulation. This book provides a complete discussion of the fundamental principles of neuromodulation and therapies applied to the brain, spinal cord, peripheral nerves, autonomic nerves and various organs. The textbook is highly structured and organized into overarching sections that cover chronic pain, movement disorders, psychiatric disorders, epilepsy, functional electrical stimulation, cardiac, gastrointestinal, genitourinary and organ neuromodulation. The fundamental principles of electricity and infusion, neural tissue interface, biomedical engineering, neuromodulation devices, basic science, neuroanatomy, neurophysiology, imaging and mechanisms are emphasized. In addition to providing details pertaining to the state-of-the-art current practice, innovative and emerging applications are discussed in specific chapters. Finally, the textbook provides specific chapters focusing on the technical aspects of the various neuromodulation procedures as well as technical specifications of various implantable devices. All of the contributors to Neuromodulation represent leading experts in the field. The editors are internationally renowned in their respective fields of neuromodulation, pain management, functional neurosurgery and biomedical engineering. Neuromodulation will be the first and foremost authoritative text on neuromodulation therapies and will establish the gold standard that defines the field for years to come.Key Features - The first comprehensive reference on the emerging field of Neuromodulation - Editors and authors include all leading figures in the field, and the leaders of the International Neuromodulation Society - Over 90 chapters on topics ranging from a layout of the fundamentals (e.g. neuroanatomy, plasticity, bioelectrical effects, infusion therapies), solutions for the biomedical engineering challenges (e.g. materials, how to preserve normal function etc.), to a rundown of the existing applications and their future promise - Over 1200 pages in splendid full color, richly illustrated - Important areas of application include: control of chronic pain delivery of drugs to the nervous system via implanted devices control of epilepsy, Parkinson, etc. functional restoration, e.g. visual, auditory, restoration after stroke, restoration of motor function after traumatic events stimulation of body organs via neural devices (incl. the heart, abdominal organs, genitourinary organs) overview over newly emerging fields - control of obesity, blood pressure, tinnitus, brain injury, neurodegenerative diseases, brain-machine interfaces |
| alternatives to ect therapy: Geriatric Psychiatry Ana Hategan, James A. Bourgeois, Calvin H. Hirsch, Caroline Giroux, 2018-04-03 This textbook presents real-world cases and discussions that introduce the various mental health syndromes found in the aging population before delving into the core concepts covered by geriatric psychiatry curricula. The text follows each case study with the vital information necessary for physicians in training, including key features of each disorder and its presentation, practical guidelines for diagnosis and treatment, clinical pearls, and other devices that are essential to students of geriatric psychiatry. With the latest DSM-5 guidelines and with rich learning tools that include key points, review questions, tables, and illustrations, this text is the only resource that is specifically designed to train both American and Canadian candidates for specialty and subspecialty certification or recertification in geriatric psychiatry. It will also appeal to audiences worldwide as a state-of-the-art resource for credentialing and/or practice guidance. The text meets the needs of the future head on with its straightforward coverage of the most frequently encountered challenges, including neuropsychiatric syndromes, psychopharmacology, eldercare and the law, substance misuse, mental health following a physical condition, medical psychiatry, and palliative care. Written by experts in the field, Geriatric Psychiatry: A Case-Based Textbook is the ultimate resource for graduate and undergraduate medical students and certificate candidates providing mental health care for aging adults, including psychiatrists, psychologists, geriatricians, primary care and family practice doctors, neurologists, social workers, nurses, and others. |
| alternatives to ect therapy: Gambling Disorder Andreas Heinz, Nina Romanczuk-Seiferth, Marc N. Potenza, 2019-01-05 This book provides an overview of the state of the art in research on and treatment of gambling disorder. As a behavioral addiction, gambling disorder is of increasing relevance to the field of mental health. Research conducted in the last decade has yielded valuable new insights into the characteristics and etiology of gambling disorder, as well as effective treatment strategies. The different chapters of this book present detailed information on the general concept of addiction as applied to gambling, the clinical characteristics, epidemiology and comorbidities of gambling disorder, as well as typical cognitive distortions found in patients with gambling disorder. In addition, the book includes chapters discussing animal models and the genetic and neurobiological underpinnings of the disorder. Further, it is examining treatment options including pharmacological and psychological intervention methods, as well as innovative new treatment approaches. The book also discusses relevant similarities to and differences with substance-related disorders and other behavioral addictions. Lastly, it examines gambling behavior from a cultural perspective, considers possible prevention strategies and outlines future perspectives in the field. |
| alternatives to ect therapy: Ethics in Electroconvulsive Therapy Jan-Otto Ottosson, Max Fink, 2012-09-10 Few mental illness treatments are more reviled in the public mind than Electroconvulsive Shock Therapy. However, in reality, ECT is a safe and effective treatment for cases of clinical depression and catatonia that are unresponsive to drug therapy. Also, unlike drugs, ECT has relatively few side effects. The authors argue that it is time for this historically stigmatized procedure to be reevaluated. The authors make a strong case for greater professional and public attention to the procedure's benefits, offering historical coverage of ECT-related movements, legislation, public and practitioner sentiment and the introduction of competing treatments. This volume will not only garner the interest of mental health professionals, but will call on policy makers and ethicists to examine its arguments. |
| alternatives to ect therapy: Encyclopedia of Gerontology and Population Aging Danan Gu, Matthew E. Dupre, 2021-11-03 This eight-volume encyclopedia brings together a comprehensive collection of work highlighting established research and emerging science in all relevant disciplines in gerontology and population aging. It covers the breadth of the field, gives readers access to all major sub-fields, and illustrates their interconnectedness with other disciplines. With more than 1300 cross-disciplinary contributors—including anthropologists, biologists, economists, psychiatrists, public policy experts, sociologists, and others—the encyclopedia delves deep into key areas of gerontology and population aging such as ageism, biodemography, disablement, longevity, long-term care, and much more. Paying careful attention to empirical research and literature from around the globe, the encyclopedia is of interest to a wide audience that includes researchers, teachers and students, policy makers, (non)governmental agencies, public health practitioners, business planners, and many other individuals and organizations. |
| alternatives to ect therapy: Treating Resistant Depression Joseph Zohar, Robert H. Belmaker, 1987 |
| alternatives to ect therapy: Shock Therapy Edward Shorter, David Healy, 2007 Shock therapy is making a comeback today in the treatment of serious mental illness. Despite its reemergence as a safe and effective psychiatric tool, however, it continues to be shrouded by a longstanding negative public image, not least due to films such as the classic One Flew over the Cuckoo's Nest, where the inmate of a psychiatric clinic (played by Jack Nicholson) is subjected to electro-shock to curb his rebellious behavior. Beyond its vilification in popular culture, the stereotype of convulsive therapy as a dangerous and inhumane practice is fuelled by professional posturing and public misinformation. Electroconvulsive therapy, or ECT, has in the last thirty years been considered a method of last resort in the treatment of debilitating depression, suicidal ideation, and other forms of mental illness. Yet, ironically, its effectiveness in treating these patients would suggest it as a frontline therapy, bringing relief from acute symptoms and saving lives. Shock therapy is making a comeback today in the treatment of serious mental illness. Despite its reemergence as a safe and effective psychiatric tool, however, it continues to be shrouded by a longstanding negative public image, not least due to films such as the classic One Flew over the Cuckoo's Nest, where the inmate of a psychiatric clinic (played by Jack Nicholson) is subjected to electro-shock to curb his rebellious behavior. Beyond its vilification in popular culture, the stereotype of convulsive therapy as a dangerous and inhumane practice is fuelled by professional posturing and public misinformation. Electroconvulsive therapy, or ECT, has in the last thirty years been considered a method of last resort in the treatment of debilitating depression, suicidal ideation, and other forms of mental illness. Yet, ironically, its effectiveness in treating these patients would suggest it as a frontline therapy, bringing relief from acute symptoms and saving lives. -- Provided by publisher. |
| alternatives to ect therapy: Essential Psychiatry Robin M. Murray, Kenneth S. Kendler, Peter McGuffin, Simon Wessely, David J. Castle, 2008-09-18 This is a major international textbook for psychiatrists and other professionals working in the field of mental healthcare. With contributions from opinion-leaders from around the globe, this book will appeal to those in training as well as to those further along the career path seeking a comprehensive and up-to-date overview of effective clinical practice backed by research evidence. The book is divided into cohesive sections moving from coverage of the tools and skills of the trade, through descriptions of the major psychiatric disorders and on to consider special topics and issues surrounding service organization. The final important section provides a comprehensive review of treatments covering all of the major modalities. Previously established as the Essentials of Postgraduate Psychiatry, this new and completely revised edition is the only book to provide this depth and breadth of coverage in an accessible, yet authoritative manner. |
| alternatives to ect therapy: Inpatient Geriatric Psychiatry Howard H. Fenn, Ana Hategan, James A. Bourgeois, 2019-06-07 This book offers mental health guidelines for all medical professionals facing the emerging challenges presented by an aging population worldwide. The text acknowledges that as the geriatric demographic grows, limited resources and infrastructures demand quality protocols to deliver inpatient geriatric psychiatric care, and that many physicians may not be trained to address these specific needs. This text fills this gap with guidelines assessing, diagnosing, and treating aging patients as they present in the emergency room and other settings. Unlike any other text, this book focuses on how to optimize the use of the inpatient setting by recommending evaluations and treatments, and offering flow-charts and figures of key points, to guide both general workup and continued evaluation and treatment. This approach aims to minimize instances of premature release or readmissions and to improve outcomes. Chapters cover the various issues that clinicians face when working with an older patient, including legal topics, limitations to treatment, prescription-related complications, patients struggling with substance abuse, and various behavioral concerns. Written by experts in the field, the text takes a multidisciplinary approach to deliver high-quality care as needs of the aging population evolve. Inpatient Geriatric Psychiatry is a vital resource for all clinicians working with an aging population, including geriatricians, psychiatrists, neurologists, primary care providers, hospitalists, psychologists, neuropsychologists, emergency room and geriatric nurses, social workers, and trainees. |
| alternatives to ect therapy: The Ketamine Papers Phil Wolfson, Glenn Hartelius, 2016-11 The Ketamine Papers opens the door to a broad understanding of this medicine's growing use in psychiatry and its decades of history providing transformative personal experiences. Now gaining increasing recognition as a promising approach to the treatment of depression, posttraumatic stress disorder (PTSD), and other psychological conditions, ketamine therapies offer new hope for patients and clinicians alike. With multiple routes of administration and practices ranging from anesthesia to psychotherapy, ketamine medicine is a diverse and rapidly growing field. The Ketamine Papers clarifies the issues and is an inspiring introduction to this powerful tool for healing and transformation--from its early use in the 1960s to its emerging role in the treatment of depression, suicidality, and other conditions. This comprehensive volume is the ideal introduction for patients and clinicians alike, and for anyone interested in the therapeutic and transformative healing power of this revolutionary medicine. |
| alternatives to ect therapy: Treatment Resistant Depression John F. Greden, Michelle B. Riba, Melvin G. McInnis, 2011 This unique book presents the treatment roadmap implemented by the University of Michigan Comprehensive Depression Center's Treatment Resistant Depression Program, step-by-step guidance that has long eluded clinicians, patients, and their families. Writing across discipline, modality, lifespan, and patient demographics, the authors have compiled the most current thinking on TRD and distilled it into a highly readable, imminently practical, and brilliantly organized source of hope. The authors believe that early intervention is critical, and they advocate strategies for renewed focus on identifying youths who are at risk or already symptomatic. Similarly, they devote chapters to special populations such as pregnant women, older people, and those with comorbidities. Perhaps most useful to patients and their families, the book has a strong self-care orientation, emphasizing the importance of exercise, nutrition, and healthy sleep guidelines. Patients who are actively engaged in managing their disease often have better outcomes. Treatment Resistant Depression is frequently a lifetime diagnosis. The book acknowledges that fact and offers a systematic course of treatment grounded in evidence-based research that is current and comprehensive. Treatment Resistant Depression: A Roadmap for Effective Care offers a new way of conceptualizing an old enemy, and should prove to be an indispensable weapon in the battle. |
| alternatives to ect therapy: Functional Neuromarkers for Psychiatry Juri D. Kropotov, 2016-05-03 Functional Neuromarkers for Psychiatry explores recent advances in neuroscience that have allowed scientists to discover functional neuromarkers of psychiatric disorders. These neuromarkers include brain activation patterns seen via fMRI, PET, qEEG, and ERPs. The book examines these neuromarkers in detail—what to look for, how to use them in clinical practice, and the promise they provide toward early detection, prevention, and personalized treatment of mental disorders. The neuromarkers identified in this book have a diagnostic sensitivity and specificity higher than 80%. They are reliable, reproducible, inexpensive to measure, noninvasive, and have been confirmed by at least two independent studies. The book focuses primarily on the analysis of EEG and ERPs. It elucidates the neuronal mechanisms that generate EEG spontaneous rhythms and explores the functional meaning of ERP components in cognitive tasks. The functional neuromarkers for ADHD, schizophrenia, and obsessive-compulsive disorder are reviewed in detail. The book highlights how to use these functional neuromarkers for diagnosis, personalized neurotherapy, and monitoring treatment results. - Identifies specific brain activation patterns that are neuromarkers for psychiatric disorders - Includes neuromarkers as seen via fMRI, PET, qEEG, and ERPs - Addresses neuromarkers for ADHD, schizophrenia, and OCD in detail - Provides information on using neuromarkers for diagnosis and/or personalized treatment |
| alternatives to ect therapy: Textbook of Disaster Psychiatry Robert J. Ursano, Carol S. Fullerton, Lars Weisaeth, Beverley Raphael, 2017-05-23 This book presents a decade of advances in the psychological, biological and social responses to disasters, helping medics and leaders prepare and react. |
| alternatives to ect therapy: This Way Madness Lies Mike Jay, 2016-09-15 Is mental illness or madness at root an illness of the body, a disease of the mind, or a sickness of the soul? Should those who suffer from it be secluded from society or integrated more fully into it? This Way Madness Lies explores the meaning of mental illness through the successive incarnations of the institution that defined it: the madhouse, designed to segregate its inmates from society; the lunatic asylum, which intended to restore the reason of sufferers by humane treatment; and the mental hospital, which reduced their conditions to diseases of the brain. Moving and sometimes provocative illustrations and photographs, sourced from the Wellcome Collection's extensive archives and the archives of mental institutions in Europe and the U.S., illuminate and reinforce the compelling narrative, while extensive gallery sections present revealing and thought-provoking artworks by asylum patients and other artists from each era of the institution and beyond. |
| alternatives to ect therapy: Clinical Manual of Electroconvulsive Therapy Mehul V. Mankad, John L. Beyer, Richard D. Weiner, Andrew Krystal, 2010-04-13 Increasingly, electroconvulsive therapy (ECT) is recognized as a proven, effective, and even life-saving intervention in certain mood and thought disorders when other treatments have had little or no effect. Despite the proven efficacy and safety of this standard treatment in psychiatry, its availability is variable. Part of this disparity in access is related to misunderstanding by laypersons regarding the treatment and its potential adverse effects. Adequate education and training of psychiatrists and their support staff are essential to ensuring patients' access to this vital treatment tool. The authors of Clinical Manual of Electroconvulsive Therapy offer this expansive yet reader-friendly volume to help psychiatrists successfully incorporate ECT into their clinical practices. It is also a valuable resource for medical students and psychiatric residents, as well as experienced clinicians and researchers. The book updates the 1985 original and 1998 second edition of Electroconvulsive Therapy: A Programmed Text, and provides readers with a scheduled approach to understanding the fundamental concepts of ECT while offering practical guidance for establishing and maintaining an ECT program. Topics include the history of ECT, indications for use, patient referral and evaluation, the basics of ECT, clinical applications, anesthetics and other medications, seizure monitoring and management, ictal motor and cardiovascular response, adverse effects, and maintenance ECT. Included are detailed descriptions of recent advances including ultra-brief pulse ECT, oxygenation, muscle relaxation, and other modifications that have made this very effective treatment much safer and more acceptable to patients. Currently, it is estimated that more than 100,000 people receive ECT treatments each year in the U.S. Indications for use of ECT are for mood disorders such as major depressive disorder and mania, and thought disorders including schizophrenia and schizoaffective disorder. Indications for use in other psychiatric disorders and general medical disorders such as Parkinson's disease, which appears to respond especially well to ECT, are reviewed as well. This highly-readable manual is a must-have for the library of any clinician interested in or currently practicing ECT: Provides background information on the origins of psychiatric treatments preceding ECT, including efforts using hydrotherapy and insulin comas Includes an algorithm for the management of ECT seizure adequacy Discusses contraindications as well as the potential adverse effects of ECT, including cognitive changes and cardiovascular complications Provides specific information about ECT device manufacturers, reprintable patient information sheets, and a written informed consent form This clinical manual comprehensively explores and explains the available knowledge regarding ECT -- based on extensive research over the past 70 years -- in order to help potential ECT clinicians make informed choices about the development and management of their ECT program. |
| alternatives to ect therapy: The Neuroscience of Depression Colin R Martin, Lan-Anh Hunter, Vinood B. Patel, Victor R Preedy, Rajkumar Rajendram, 2021-03-05 The Neuroscience of Depression: Features, Diagnosis and Treatment, is a comprehensive reference to the diagnosis and treatment of depression. This book provides readers with the mechanisms of depression reflecting on the interplay between depression and the biological and psychosocial processes. A detailed introduction to various episodes of depression, from PTSD to post-partum depression is provided, followed by a thorough discussion on biomarkers in depression and how to diagnose depression including the Hamilton Depression Rating scale. This book also includes three full sections on treatment options for depression, including pharmacological, behavioral and other novel regimes. The Neuroscience of Depression: Features, Diagnosis and Treatment is the only resource for researchers and practitioners studying, diagnosis and treating of depression. - Covers a pharmacological and behavioral treatment options - Features sections on diagnosis and biomarkers of depression - Discusses depression in children, teens and adults - Contains information on comorbidity of physical and mental conditions - Includes more than 250 illustrations and tables |
| alternatives to ect therapy: Schizophrenia Steven R. Hirsch, Daniel R. Weinberger, 2003-02-24 Schizophrenia is one of the most complex and puzzling diseases to affect mankind. It is the most common of the severe mental illnesses (psychoses) with an estimated prevalence of 0.5 - 1% in the general population and accounts for a very large portion of the day to day workload of the average psychiatrist. 50% of long-term psychiatric patients in mental hospitals are schizophrenic. There is a great deal of controversy about the causes, diagnosis and treatment of schizophrenia with the consequence that a huge amount of research is carried out in the field by psychiatrists, psychologists, neuroscientists and pharmacologists. For the average practising psychiatrist seeing schizophrenics on a regular basis, making sense of the vast body of information on the subject and filtering out what is of clinical relevance can be very difficult. There is a constant stream of new drugs emerging and the newer generation of drugs (the so-called atypicals) is very effective, but often expensive. The Editors (one American and one British) are both highly respected clinical psychiatrists who are probably the leading experts on schizophrenia from their respective countries and jointly have published almost 150 papers on the subject. They have brought together a strong group of contributors from the USA, UK and Europe to produce what will be an essential reference for the trainee and practising psychiatrist. The book consists of four sections; descriptive aspects, causative aspects, physical treatments and psychological/behavioural/social treatments. There will be discussion of the theoretical controversies over symptomatology, classification and aetiology, the relationship of schizophrenia to the other psychoses, the significance of positive and negative symptoms and pre-morbid personality. There will be chapters on organic models of schiziophrenia, neurodevelopmental, genetic and structural studies and the role of high-expressed emotion. The final section will cover social and environmental treatment, the role of the families of schizophrenics and the psychoanalytical therapies. There is a new chapter on the patient's perspective written by a former patient. |
| alternatives to ect therapy: Motivational Enhancement Therapy Manual , 1992 |
| alternatives to ect therapy: Handbook of ECT Charles H. Kellner, 2018-12-20 This book is the need-to-know guide to the practice of modern electroconvulsive therapy. |
| alternatives to ect therapy: Healing from Depression Douglas Bloch, 2009-12-01 In Healing from Depression, Douglas Bloch shares his struggle to stay alive amidst overwhelming despair and out-of-control anxiety attacks, and explains how the power of prayer and other holistic approaches ultimately led to his recovery. As one of the millions of Americans who suffer from depression, Bloch could not be helped by so-called “miracle” drugs. Therefore, he had to seek out conventional and alternative non-drug methods of healing. The result is a 12-week program that combines his inspirational story with a comprehensive manual on how to diagnose and treat depression, offering new hope and practical strategies to everyone who suffers from this debilitating condition. Complete with worksheets and goal sheets to customize individual plans, Healing from Depression is an accessible self-guided program for managing and recovering from depression. Acclaimed as a “life-line to healing,” this important book stresses the importance of social support, on going self-care activities like relaxation, nutrition, exercise, prayer, meditation, support groups, therapy and keeping a daily mood diary and gratitude journal. |
| alternatives to ect therapy: Core Psychiatry E-Book Padraig Wright, Julian Stern, Michael Phelan, 2012-01-08 A new edition of a highly successful, award winning textbook for trainee psychiatrists, covering in one volume all the subjects required for the new MRCPsych and similar exams. Written in a highly engaging manner, it will also prove invaluable to qualified psychiatrists who need to keep up-to-date with the latest developments, as well as clinical psychologists, general practitioners, psychiatric nurses and senior medical students Concise yet comprehensive, Core Psychiatry relfects the latest developments in the curriculum plus all that is new and essential in clinical practice and the sciences that underpin it. It includes new information on the new Mental Capacity Act and Mental Health Act as well as enhanced sections on psychopharmacology, old age psychiatry, child and adolescent psychiatry, forensic psychiatry and rehabilitation. The book also makes refernce to the latest NICE guidelines and includes new sections on sleep medicine and trauma psychiatry. New edition of a popular MRCPsych curriculum based text Previous edition ‘Highly Commended’ (Mental Health category) in the BMA Awards 2005 Contains useful summary boxes, lists and key points to make last minute learning easy Comprehensive and authoritative resource written by contributors to ensure complete accuracy and currency of specialist information Chapters prepared by specialists working in conjunction with trainees – content totally up-to-date and jointly written by authors who have recently been in the exam situation Contains the latest findings in sleep medicine and trauma psychiatry Expanded section on psychology – including social psychology – to reflect the latest MRCPych examination format Text updated in full to reflect the new Mental Capacity Act and Mental Health Act Relevant chapters now contain a ‘skills and competency’ section to reflect changes in MRCPsych curriculum Updating and amendments to improve coverage of old age psychiatry, child and adolescent psychiatry, forensic psychiatry and rehabilitation Contains reference to the latest NICE guidelines in boxes and tables Enhanced discussion of the use of the best current management options, both pharmacological and psychotherapeutic, the latter including CBT, DBT, EMDR and psychodynamic group, couple and family therapy. |
| alternatives to ect therapy: Struck By Living (2nd Edition) Julie Hersh, 2016-12-20 Struck by Living, originally published in 2010, is a story about me, Julie Kosnik Hersh, my experience with electroconvulsive therapy (ECT), and management of depression. This new version includes a prologue detailing the strange series of events this book spurred, as well as a wellness list in the back. On the original book tour, I decided it was too depressing to just talk about my depression, so I talked about how I stayed well too. People scribbled down these ideas like gospel, which they aren’t. They are common-sense ideas I’ve learned from years of psychotherapy, my own reading, and talking to people about this topic. I’ve included these ideas in this new edition so people don’t have to scribble. I love to read, so I wrote this book like a novel, instead of like a self-help book. I’m not a fan of self-help books as most of them claim to be “the answer.” The older I get, the more I realize how little I know. I do know there is no single answer for managing mental illness. This is a life-long task, where we all have to figure out our own quirks and how to manage them. If my story can help you figure this out—great. Each time I speak about my experience, I find people are often one step removed from the devastation of mental illness or even suicide. Stories about mothers, fathers, brothers, sisters, spouses, and children all make me wonder: Could we have stopped those deaths? If we are more aware, can we see the signs earlier and save a life? I think we can. In that belief, I offer my story. Proceeds from this book will be donated to programs and research to battle mental illness. |
| alternatives to ect therapy: Quantitative EEG, Event-Related Potentials and Neurotherapy Juri D. Kropotov, 2010-07-28 While the brain is ruled to a large extent by chemical neurotransmitters, it is also a bioelectric organ. The collective study of Quantitative ElectroEncephaloGraphs (QEEG-the conversion of brainwaves to digital form to allow for comparison between neurologically normative and dysfunctional individuals), Event Related Potentials (ERPs - electrophysiological response to stimulus) and Neurotherapy (the process of actually retraining brain processes to) offers a window into brain physiology and function via computer and statistical analyses of traditional EEG patterns, suggesting innovative approaches to the improvement of attention, anxiety, mood and behavior.The volume provides detailed description of the various EEG rhythms and ERPs, the conventional analytic methods such as spectral analysis, and the emerging method utilizing QEEG and ERPs. This research is then related back to practice and all existing approaches in the field of Neurotherapy - conventional EEG-based neurofeedback, brain-computer interface, transcranial Direct Current Stimulation, and Transcranial Magnetic Stimulation - are covered in full. While it does not offer the breadth provided by an edited work, this volume does provide a level of depth and detail that a single author can deliver, as well as giving readers insight into the personl theories of one of the preeminent leaders in the field. - Provide a holistic picture of quantitative EEG and event related potentials as a unified scientific field - Present a unified description of the methods of quantitative EEG and event related potentials - Give a scientifically based overview of existing approaches in the field of neurotherapy - Provide practical information for the better understanding and treatment of disorders, such as ADHD, Schizophrenia, Addiction, OCD, Depression, and Alzheimer's Disease |
| alternatives to ect therapy: Crossing the Quality Chasm Institute of Medicine, Committee on Quality of Health Care in America, 2001-07-19 Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change. |
| alternatives to ect therapy: Treatment-Resistant Mood Disorders Jay D. Amsterdam, Mady Hornig, Andrew A. Nierenberg, 2001-06-28 This timely book assesses all aspects of treatment-resistant depression and will be invaluable to professionals. |
| alternatives to ect therapy: Guidelines NSW Health, 2010 |
| alternatives to ect therapy: Shock Treatment is Not Good for Your Brain John Friedberg, 1976 |
| alternatives to ect therapy: Psychiatric Ethics Sidney Bloch, Paul Chodoff, 1984 Consideration of ethics has established a firm place in the affairs of psychiatrists. An increased professional commitment to accountability, together with a growing consumer movement has paved the way for a creative engagement with the ethical movement. Psychiatric Ethics has carved out a niche for itself as a major comprehensive text and core reference covering the many complex ethical dilemmas which face clinicians and researchers in their everyday practice. This new edition takes a fresh look at recent trends and developments at the interface between ethics and psychiatric practice.For this edition, Sydney Bloch and Paul Chodoff are joined by Stephen Green, a clinical professor in ethics and psychiatry at Georgetown University, in leading 29 of the finest scholars in the field from around the world. Eleven new contributors join the team of authors. They include Drs. Beauchamp, Gutheils, Sabin, McGuffin, Szmulter, Gabbard and Holmes. Since the second edition, the editors have observed several emerging aspects of psychiatric practice requiring coverage. As a result, six new chapters have been added covering the ethical aspects of community psychiatry, managed care, psychiatric genetics, resource allocation, codes of ethics and boundary violations. All others chapters have been fully revised and updated.The book will continue to be essential reading for psychiatrists and other mental health professionals, as well as of interest to ethicists, policy makers, managers and lawyers. |
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a choice among only two possibilities such that if one is chosen, the other cannot be chosen: Here are the alternatives: surrender or die. one of these choices: The alternative to riding is walking. …
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Definition of alternative noun from the Oxford Advanced Learner's Dictionary. a thing that you can choose to do or have out of two or more possibilities. The car is too expensive so we're trying …
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One of a number of possible choices or courses of action: There are plenty of alternatives to conventional advertising. b. A choice or course of action that is mutually exclusive with …
ALTERNATIVE Synonyms: 100 Similar and Opposite Words - Merriam-Webster
Some common synonyms of alternative are choice, election, option, preference, and selection. While all these words mean "the act or opportunity of choosing or the thing chosen," …
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ALTERNATIVE Definition & Meaning - Merriam-Webster
alternative implies a need to choose one and reject another possibility. preference suggests a choice guided by one's judgment or predilections. selection implies a range of choice. election …
ALTERNATIVE | English meaning - Cambridge Dictionary
Alternative (ly) means ‘something that is different and unusual and offers a possible choice’: … There must be an alternative to people sleeping on the streets. no alternative You've given me …
Alternative Definition & Meaning | Britannica Dictionary
We have alternative [= other] plans in case the weather is bad. We took an alternative route [=a different route] to avoid the traffic. Scientists are developing an alternative approach to treating …
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alternative - WordReference.com Dictionary of English
a choice among only two possibilities such that if one is chosen, the other cannot be chosen: Here are the alternatives: surrender or die. one of these choices: The alternative to riding is walking. …
alternative noun - Definition, pictures, pronunciation and usage …
Definition of alternative noun from the Oxford Advanced Learner's Dictionary. a thing that you can choose to do or have out of two or more possibilities. The car is too expensive so we're trying …
Alternative - definition of alternative by The Free Dictionary
One of a number of possible choices or courses of action: There are plenty of alternatives to conventional advertising. b. A choice or course of action that is mutually exclusive with …
ALTERNATIVE Synonyms: 100 Similar and Opposite Words - Merriam-Webster
Some common synonyms of alternative are choice, election, option, preference, and selection. While all these words mean "the act or opportunity of choosing or the thing chosen," …
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