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5150: On Unethical Privacy is an autobiographical piece where Matthew Reynolds recounts the situation wherein he was involuntarily committed shortly before his 21st birthday. He describes the situation that led to his psychotic break, and the problems his parents had, who he is very close to and have had a large place in his treatment. He was incapable of informed consent and, after being tranquilized, due to his manic depression, he slept for 36 hours wherein neither his parents, physician, psychiatrist, or anybody else were contacted. Finally, his main moral dilemma is discussed. He highlights just what went wrong ethically based on his own memory of events, which he learned of during and after his involuntary committal. His main argument is: “what use is a psychotic patient’s undeniable rights to privacy, if he is incapable of helping himself?” He notes how these systems backfired throughout.

Dementia caregiving is associated with negative physical and psychological health consequences. Multicomponent, behavioural, and psychotherapeutic interventions for reducing caregivers’ distress, particularly the cognitive-behavioural ones, present the greatest effect sizes, but nevertheless these effects are only moderate. The third wave of behavioural therapies and, specifically acceptance and commitment therapy (ACT), offers interesting therapeutic tools aimed at fostering the acceptance of aversive internal experiences and the commitment to personal values. Given the chronic nature of the caregiving situation and the unchangeability of many of its elements (e.g. feeling sadness or grief), ACT represents a promising and potentially helpful therapeutic approach to help dementia caregivers to decrease their emotional distress. Very few studies have so far analysed the efficacy of ACT or some of its components (e.g. mindfulness) in this population, but these provide some preliminary support for the utility of this approach in improving caregivers’ psychological well-being. Assuming the need for further research in order to consider ACT as an empirically validated therapy for dementia caregivers, in this chapter we analyse, in the context of caregiving, the psychological processes highlighted in the ACT model of psychopathology, such as experiential avoidance, describing examples of them in cases of caregivers we have assisted in our clinical work, and outlining ACT-based therapeutic strategies that we have found useful on a clinical basis for modifying them.

The autobiographical story of Dieter is sketched here to portray his struggle to fit in the worlds of others while living in a world that is created from his luscious and profound imagination, but that is hardly possible, and mostly impossible, for others to grasp or even imagine. In spite of his reading a lot, much intellectual ability and ability with words, Dieter’s inabilities are both subtle and like walking into a brick wall. He is not defined by these limitations, however, even though his identity has been a burden. Instead, he believes, among many other things, in creating endless possibilities through the powers of thought, and heroically wants to share his world through poetry and writings that have not been heard or read before.

This chapter discusses the current understanding of relations between attention deficit hyperactivity disorder (ADHD) and substance use. Children with ADHD are at risk for problems in substance use; evidence suggests that the relations between ADHD and substance use may differ across age groups, gender, and comorbid conditions. Important issues regarding appropriate assessment and developmental trajectories may play a role in how these differences are understood. In comorbid substance use and ADHD, significant overlap in genetic, neurobiological, and trait factors suggests that ADHD and substance use share a common etiology, although factors influencing the phenotypic expression of these factors continue to play an important role in how comorbidity is expressed. Finally, treatment of these comorbid conditions is discussed, both in terms of the issues surrounding medication for ADHD in the context of substance abuse and potential nonmedication treatments that address both substance use and ADHD symptoms through cognitive behavioral strategies.

Resilience refers to positive adjustment among youth who have been exposed to one or more risk factor(s). In this chapter, we review articles published within the past two decades that have included a focus on resilience processes among adolescents at risk of using substances. The review is organized by the level of promotive factor investigated (individual, family, and community), followed by a review of studies that have focused on exposure to cumulative risk and promotive factors. Prior to reviewing these studies, we provide a brief overview of resilience theory, including key terms and models of resilience. The chapter concludes by addressing the limitations of the research on resilience and adolescent substance use and makes recommendations for future research.

This chapter discusses mental health advocacy in the UK and how the history of mental health care has influenced current practice, as well as how the advocacy sector in general has shaped government policy and legislation. The emphasis is on England and Wales, although advocacy delivery in Scotland and Northern Ireland is also considered. The chapter first defines advocacy and outlines its history in the UK before analyzing recent developments in the country. It then examines the principles of advocacy (independence; empowerment; representation, information, support; accountability; confidentiality), together with different forms of advocacy in the UK and key legislation, including the Mental Capacity Act 2005 and the Mental Health Act 1983 in England and Wales. Finally, it looks at issues and challenges faced by mental health advocates with regard to ethics and values, such as conflicts of interest and duty, the nature of professional obligations and neutrality, and social justice.

This chapter discusses mental health advocacy in the UK and how the history of mental health care has influenced current practice, as well as how the advocacy sector in general has shaped government policy and legislation. The emphasis is on England and Wales, although advocacy delivery in Scotland and Northern Ireland is also considered. The chapter first defines advocacy and outlines its history in the UK before analyzing recent developments in the country. It then examines the principles of advocacy (independence; empowerment; representation, information, support; accountability; confidentiality), together with different forms of advocacy in the UK and key legislation, including the Mental Capacity Act 2005 and the Mental Health Act 1983 in England and Wales. Finally, it looks at issues and challenges faced by mental health advocates with regard to ethics and values, such as conflicts of interest and duty, the nature of professional obligations and neutrality, and social justice.

This chapter examines alcohol and drug use as risk factors for delinquency during adolescence. There is strong evidence for comorbidity between substance use and delinquency for individuals. Users, compared to nonusers, are more likely to be delinquent; and delinquents, compared to nondelinquents, are more likely to use substances. Conversely, substance use and delinquency follow different developmental patterns from adolescence into young adulthood, and trends in adolescent substance use and delinquency from 1980 through 2009 do not converge well. Alcohol, compared to drugs, has a stronger acute effect on adolescent aggression/violence. Developmentally, there appears to be a reciprocal association between substance use and delinquency, although findings differ across samples and time frames. There are several alternative models that explain why alcohol and drug use are risk factors for adolescent delinquency.

An increasing understanding of the etiology, course, prevention, and treatment of substance use disorders and their related harms continues apace, aided by multidisciplinary research efforts and new discoveries and technologies in a range of allied scientific disciplines. In this concluding chapter of The Oxford Handbook of Substance Use and Substance Use Disorders, the authors highlight a range of opportunities and challenges facing those interested in gaining a basic understanding of the nature of these phenomena and the novel approaches emerging to assess, prevent, and treat these conditions with the goal of reducing the enormous burden these problems place on individuals, families, communities, and our global society as a whole.

An increasing understanding of the etiology, course, prevention, and treatment of substance use disorders and their related harms continues apace, aided by multidisciplinary research efforts and new discoveries and technologies in a range of allied scientific disciplines. In this concluding chapter of The Oxford Handbook of Substance Use and Substance Use Disorders, the authors highlight a range of opportunities and challenges facing those interested in gaining a basic understanding of the nature of these phenomena and the novel approaches emerging to assess, prevent, and treat these conditions with the goal of reducing the enormous burden these problems place on individuals, families, communities, and our global society as a whole.

This chapter provides an introduction to, and overview of, substance use expectancy theory, which offers one framework to explain why individuals approach and engage in substance use behaviors. We begin with an overview of basic behavioral science models of expectancy, noting that the capacity to anticipate outcomes of behaviors, and hence choose to engage in behaviors from which one expects benefits or rewards, is central to adaptive functioning. We note the importance of the insight that this anticipation/expectancy principle can be applied to substance use. We then review models of the development of learned anticipations or expectancies of reward from substance use and consider factors that influence substance use expectancy development. We observe that longitudinal data, documenting expectancies’ prediction of subsequent addictive behaviors, and experimental data, documenting reductions in both drinking and eating disorder symptoms following expectancy reduction, speak to the functional role of expectancies in addictive behaviors.

Applied behavior analysis (ABA) is the applied science and professional practice devoted to understanding and changing human behavior. The characteristics of applied behavior analysis include (a) a focus on socially important behavior; (b) demonstration of functional relationships between environmental events and behavior; (c) clear description of procedures; (d) connection to basic behavioral principles; and (e) production of meaningful, generalizable, and long-lasting changes in behavior. This chapter provides an overview of the field of ABA starting with issues in assessment and research design, followed by a review of basic behavioral principles that form the foundation of ABA procedures. Next, procedures to establish new behaviors are reviewed and the functional approach to assessing and changing problem behavior is described.

In modern psychiatry, professionals claim to speak to patients as equals, to take them seriously as a person. In this article, the author shares his personal experience, in which he—like other former psychiatric inmates—is reduced to the role of a former patient who is expected only to speak about his personal patient narrative. This happens despite the fact that he received international awards in acknowledgement of exceptional scientific and humanitarian contributions about how to minimize risks of withdrawal from psychiatric drugs, build alternatives beyond psychiatry and develop possibilities for self-help for individuals experiencing madness and strategies toward implementing humane and ethical treatment. Can psychiatry solve its intrinsic ethical problems when professionals do not leave behind their roles as “experts” (and users and survivors of psychiatry their roles as “patients”) and their associations continue to refuse even discussion about psychiatric human rights violations?

This chapter reviews John Bowlby’s attachment theory and examines how client attachments influence individual, couple, and group therapy treatments. Bowlby (1988) specifically emphasized how the individual counseling relationship provides a new secure attachment experience for clients that offers them the opportunity to internalize more positive working models of themselves and others. Similarly, in couple counseling, therapy challenges automatic negative expectations that hinder intimacy, and it facilitates each partner in becoming a secure base for the other. Group therapy, like the other modalities, encourages members to examine their internal representations of themselves and others in the group, and the group becomes a secure base from which to examine automatic thoughts and emotions that often hinder intimacy. The chapter includes an extensive review of the empirical work applying attachment theory to these three therapeutic modalities, and it concludes by addressing future research and clinical implications.

Considered a third-wave behavior therapy, behavioral activation is a therapeutic process emphasizing structured attempts to increase overt behaviors likely to bring patients into contact with reinforcing environmental contingencies and corresponding improvements in thoughts, mood, and quality of life. In the past two decades, behavioral activation has emerged as an empirically supported treatment for depression that has effectively been provided to patients with diverse clinical presentations and in multiple therapeutic contexts. This chapter focuses on providing a brief historical context of behavioral activation, a description of the principles and procedures underlying contemporary behavioral activation therapies, a review of assessment strategies particularly relevant to this approach, a comprehensive analysis of treatment outcome studies, and a presentation of limitations and future directions that need to be addressed to further solidify the status of behavioral activation as an effective and feasible approach to treating clinical depression and other mental health problems.

This article examines the ethical issues associated with explaining, understanding, and treating disorderly eating behaviors (DEB) in young women. It argues that the kind of gender-related, self-destructive behavior observed in disordered eating seems to be incongruent with individualistic analysis and explanation, instead pointing to evidence indicating that it is better to view such disorders as group phenomena. After reviewing recent studies that looked into the prevalence and causes of “group” disorders using the particular example of bulimia, the article describes the new category of “belonging bulimia” that may be used to understand, and hence prevent, such epidemics. It discusses the theoretical assumptions pertinent to belonging bulimia, with emphasis on relationality, causal explanation, and social behavior. It stresses the need to study social factors in the etiology of belonging bulimia with the neuroscience of groups, rather than just individuals. It also calls for a greater focus on virtue ethics to address belonging bulimia.

Body image disturbances are common among women in the general population. Less is known about their prevalence and impact during pregnancy. This chapter examines the history of body image theory and research. Next, we examine issues related to body image during pregnancy, such as pregravid weight, gestational weight gain, and the unique ways women think about the changes to their body during pregnancy. The role of physical activity, mood, and eating disorders in relation to peripartum body image disturbance is also discussed. Finally, assessment of body image disturbance and existing treatments are presented. Future research is needed to develop peripartum-specific body image assessment tools and to assess the impact of psychosocial interventions during and after pregnancy on body image dissatisfaction.

Many psychiatric disorders involve problems with the recognition and preservation of personal boundaries. Philosophy can help to clarify what is at stake, both socially and phenomenologically, in drawing such boundaries. In particular, assignments of responsibility and determinations of loss are deeply implicated in the determination of personal boundaries. Understanding these implications can help make sense of the volatile emotions of borderline personality disorder, for example, and it can clarify what is missing from DSM descriptions more generally.

Brief groups are defined as being time-limited, with a preset termination, with a process orientation, and being professionally led. Membership is closed, and members are screened for fit, consistent goals, and similar ego strength. A brief history of the precursors of brief group treatments is explored. The process stages, or group trajectory, are described and related to the nature and timing of interventions. Brief group process and outcome research, the vast majority of extant studies, is explored; and recommendations are made for more carefully designed studies. Finally, a combination of predictions and a wish list for future research, practice, and training is offered.

This chapter surveys an interface of growing interest to clinicians and patients, from four points of view. First, it explores the growing dialogue between Buddhism and modern psychology, tracing it to a surprising complementarity in ideas and methods. Second, it shines light on the distinctiveness between Buddhist and modern psychology, exploring the religious and ethical aspects of Buddhism neglected by many proponents of dialogue. Third, it reviews key areas of potential conflict, where clinicians may helpfully challenge Buddhist patients to reconsider their understanding and practice of Buddhism. Fourth, it surveys key areas of potential contribution, where mental health researchers, clinicians, and patients may benefit from studying Buddhist theories or applying Buddhist methods.