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Treating Mental Illness and Behavior Disorders in Children and Adults With Mental Retardation

Anton Došen, M.D., Ph.D., and Kenneth Day, M.B., Ch.B., F.R.C.Psych., D.P.M.

  • ISBN 978-0-88048-850-1
  • Item #8850

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Since the 1970s, the development of normalization philosophy and the implementation of community care policies have highlighted the nature and treatment of psychiatric and behavior disorders in people with mental retardation and rekindled the interest of scientists, psychiatric practitioners, and service providers. With these changes has grown a substantial body of new research and information on the phenomenology, epidemiology, classification, and clinical features of mental illness and behavior disorders in mentally retarded persons.

In response to this growing interest and awareness, the editors, together with internationally renowned contributors from the United States and Europe, have compiled the first comprehensive handbook of the current theory and practice of mental health treatment and care in mentally retarded children and adults.

Both contemporary and in-depth, this multidisciplinary, multidimensional volume covers all available therapeutic methods, including psychopharmacotherapy, psychotherapy, behavior therapies, cognitive therapy, and the systems approach for all the main diagnostic disorders in people with mental retardation.

Parts I and II present an overview of epidemiology and clinical presentation, including research trends, and therapeutic methods, including psychotherapy, psychopharmacology, behavioral therapies, cognitive and social learning treatments, and working with families and caregivers.

Parts III and IV focus on psychotherapeutic interventions, such as rational emotive group treatment with dually diagnosed adults, pre-therapy for persons with mental retardation who are also psychotic, and systemic therapy, and how to apply these methods to the treatment of specific mental illnesses, such as schizophrenia, epilepsy, and mood and anxiety disorders.

Parts V and VI discuss how to treat behavior disorders such as aggression/self-aggression (pharmacotherapy and strategic behavioral interventions) and self-injurious behaviors (multimodal contextual approach), including group therapy for sex offenders and a pedagogical approach to behavior problems, and which treatment methods, such as psychodynamically oriented psychotherapy and pharmacotherapy, are most effective with children, including developmental-dynamic relationship therapy with more severely mentally retarded children.

Parts VII and VIII provide guidance on mental health services and staff training, including psychiatric treatment in community care and a model for inpatient services for mentally ill persons with mental retardation, and the editors final chapter, which draws together all the various therapeutic approaches described in previous chapters to provide a practical framework for an integrative approach.

Filling a major gap in the literature, this indispensable resource for psychiatrists, psychologists, and educators working with mentally retarded persons is also intended for general practitioners, doctors, social workers, and therapists working in the same or related fields.


  • Contributors
  • Preface
  • Part I: Introduction
  • Chapter 1. Epidemiology, etiology, and presentation of mental illness and behavior disorders in persons with mental retardation
  • Part II: Treatment Methods
  • Chapter 3. Psychotherapeutic methods
  • Chapter 3. Psychopharmacological approach
  • Chapter 4. Behavioral therapies: individualizing interventions through treatment formulation
  • Chapter 5. Cognitive and social learning treatments
  • Chapter 6. Working with families and caregivers of people with severe mental retardation
  • Part III: Psychotherapeutic Interventions
  • Chapter 7. Psychoanalytic therapies
  • Chapter 8. A rational-emotive group treatment approach with dually diagnosed adults
  • Chapter 9. Pre-therapy: a treatment method for people with mental retardation who are also psychotic
  • Chapter 10. Systemic therapy
  • Part IV: Treatment of Mental Illness
  • Chapter 11. Treatment of schizophrenia
  • Chapter 12. Treatment of mood disorders in mentally retarded persons
  • Chapter 13. Treatment of anxiety disorders in persons with mental retardation
  • Chapter 14. Treatment of epilepsy and associated disorders
  • Chapter 15. Mood and affect as determinants of psychotropic drug therapy response in mentally retarded persons with organic mental syndromes
  • Part V: Treatment of Behavior Disorders
  • Chapter 16. Pharmacotherapy in aggressive and auto-aggressive behavior
  • Chapter 17. Strategic behavioral interventions in aggression
  • Chapter 18. Self-injurious behaviors: multimodal contextual approach to treatment
  • Chapter 19. Group therapy for mentally retarded sex offenders
  • Chapter 20. Treatment and care of mentally retarded offenders
  • Chapter 21. A pedagogical approach to behavioral problems
  • Part VI: Treatment Methods With Children
  • Chapter 22. Psychodynamically oriented psychotherapy in mentally retarded children
  • Chapter 23. Developmental-dynamic relationship therapy: an approach to more severely mentally retarded children
  • Chapter 24. Pharmacotherapy in mentally retarded children
  • Chapter 25. Management of pervasive developmental disorders
  • Part VII: Mental Health Services for the Mentally Retarded and Staff Training
  • Chapter 26. Service provision and staff training: an overview
  • Chapter 27. Psychiatric treatment in community care
  • Chapter 28. A model for inpatient services for persons with mental retardation and mental illness
  • Part VIII: Integrative Treatment
  • Chapter 29. Treatment: An integrative approach
  • Index

About the Authors

Anton Došen, M.D., Ph.D., is Professor of Psychiatric Aspects of Mental Retardation at Catholic University, and Medical Director of the Clinic for Behavioral and Psychiatric Disorders in the Mentally Retarded in Nieuw Spraeland, Oostrum, The Netherlands.

Kenneth Day, M.B., Ch.B., F.R.C. Psych., D.P.M., is Medical Director and Honorary Consultant Psychiatrist at Northgate and Prudoe NHS Trust in Northumberland, and Senior Lecturer, Department of Psychiatry at the University Newcastle Upon Tyne, United Kingdom.

I was quite impressed with this book, which has an unusually broad theoretical scope. As well, the authors impress me as not just knowledgeable, but passionate about their areas of expertise, which makes the book a compelling read.—Doody Publishing, 8/1/2001

This book, edited by Drs. Dosen and Day, two prominent pioneers in the field of psychiatry of mental retardation, is the first of its kind. It fills successfully two roles. First, it is a scholarly, comprehensively referenced text, which reviews in details our current knowledge of treatment of mental disorders in persons who also have mental retardation. Second, it is also a very readable textbook, describing in practical details the treatment modalities, and as such it will be most useful to all clinicians working with this, long underserved, population. It should be an obligatory part of core library of every mental retardation-mental health professional.—Ludwik S. Szymanski, M.D., Director of Psychiatry (Emeritus), Institute for Community Inclusion, Children's Hospital, Boston, Associate Professor of Clinical Psychiatry, Harvard Medical School

Treatment issues in intellectual disability are often confined to closing paragraphs. A major textbook focusing on treatments of people with intellectual disability is timely. Dosen and Day have assembled renowned experts on aspects of therapy to produce a key book and reference source that will be a necessary addition to institutes' libraries. Issues of theory and practice from local and international perspectives are included and models for multidisciplinary approaches are clearly described. This will be a useful handbook for the desks of clinical psychologists and psychiatrists in everyday practice with this group who have a high prevalence of behavior disorders, which are often refractory.—William Fraser, M.D., Professor of Psychiatry, College of Medicine, University of Wales, Wales, United Kingdom

This handbook fills an important gap in the current knowledge base of psychiatry. It presents an up-to-date review of the treatment of mental disorders in mental retardation. This guide follows a multi-perspective approach for examining the general treatment methods and interventions as well as their application in the main psychiatric and behavior disorders. It highlights the importance of the integrative approach to the psychiatric treatment of intellectual disabilities. With that focus, current mental health services for this population group have been also explored and described here.—Luis Salvador Carulla, M.D., Professor of Psychiatry, Secretary of the Mental Retardation Section (World Psychiatric Association), Faculty of Medicine. University of Cadiz (Spain)

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