CAMLAW: Complementary and Alternative Medicine Law Blog

Integrative Mental Health Care - Part 1

The Textbook of Integrative Mental Health Care by James Lake, MD has just been released by Thieme Press.

The Textbook of Integrative Mental Health Care is the first book to present a comprehensive framework of conceptual information and clinical guidelines for the integrative assessment and treatment of common mental illnesses.

Complete coverage of the conceptual foundations of integrative mental health care allows the practitioner to gain a firm understanding of the philosophy and clinical methodology of integrative medicine. The textbook also describes evidence-based paradigms that enable the practitioner to develop assessment techniques and individualized treatment plans that address the unique needs of each patient.

The book highlights:

* Extensive evidence tables summarize assessment and treatment approaches;

* Easy-to-follow algorithms guide the practitioner step-by-step from initial assessment to treatment planning;

* Case vignettes describe intake, assessment and initial formulation, treatment plan, and follow-up;

This textbook will help psychiatrists, psychologists, and mental health care professionals develop safe and effective integrative approaches for the evaluation and treatment of emotional and mental problems.

The author, James Lake, MD, is a colleague and friend. His credentials in psychiatry are impeccable. He is Clinical Assistant Professor, Dept. of Psychiatry and Behavioral Sciences, Stanford University Hospital; Chairperson, American Psychiatric Association Caucus on Complementary, Alternative and Integrative Approaches in Mental Healthcare; Board-certified Psychiatrist in Private Practice, Monterey, California.

Dr. Lake took an early interest in integrating complementary and alternative medical therapies into psychiatry. On a professional level, he was the only medical doctor in the U.S. to write me a personal note following publication of my 1998 book, Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives. The following year, he invited me to California to offer grand rounds at his hospital, and subsequently, at the complementary medicine clinic created at Stanford University School of Medicine. There, he showed a keen interest in legal, regulatory, and ethical issues relating to integrative medicine approaches to psychiatry and mental health. He had already co-authored a book attempting to correlate Western, biomedical psychiatric diagnoses and treatment approaches with those in Chinese medicine (Chinese Medical Psychiatry: A Clinical Manual).

He subsequently helped found the APA (American Psychiatric Association)"Caucus on Complementary and Alternative Medicine, generating interest among his professional peers (psychiatrists) and bringing credibility to the study integrative mental health assessment and treatment.

The Textbook of Integrative Mental Health Care is, in my opinion, a tour-de-force. The book opens with a forward from Larry Dossey, MD highlighting the importance of considerations of spirituality and mind-body therapies in medicine, and in mental health care.

Part 1 of the book exposes some of the philosophical (epistemological) assumptions governing biomedicine and the way such assumptions inherently deflect biomedicine toward bias against potentially valuable CAM therapies. Relevant chapters canvass not only the "evolution of integrative medicine and implications for mental health care"--a topic not satisfactorily covered anywhere else, to date; and philosophical problems inherent in biomedicine; but also the foundations of paradigms in medicine, psychiatry and integrative medicine.

Some of the stunning propositions that Dr. Lake explores in the Textbook of Integrative Mental Health Care include, for example, the notion that biomedicine relies on assumptions of causality that are paradigm-dependent, whereas "many nonconventional systems of medicine involve nondeterministic models, including Jungian synchronicity, quantum field theory, and models of psychic functioninig (psi), in efforts to explain the observed characteristics or 'meanings' of symptoms outside of a limited classical model of linear causality" (p. 41),

The fusion of philosophy, physics, psychiatry, and a wealth of knowledge from other relevant disciplines is staggering. I write this as an admirer of Dr. Lake the psychiatrist-writer as well as from the standpoint of one who knows James Lake, the man.

In Textbook of Integrative Mental Health Care, Dr. Lake is also one of the first--if not the first--to render with any authority and clarity the core philosophical underpinnings of energy medicine in ways that are plausible, if not convincing. Drawing on complexity theory, systems approaches, proton entanglement, conceptual definitions of embodiment, paradigm-dependent interpretations of pathology, and divergent notions of human consciousness, Dr. Lake's text effortlessly weaves together multiple perspectives to create a coherent whole.

All of this then leads to a unique and possibly prophetic delineation of "foundations of clinical methodology in integrative medicine," including "history taking, assessment of formulation in integrative mental health care" and "starting and maintaining integrative treatment in mental health care." All this is replete with algorithms for assessment, treatment, and follow-up care, and comprehensive references laying out the clinical data thus far.

This masterful assimilation of disparate strands of knowledge about mental health care then forms the basis for Part 2 of the Textbook of Integrative Mental Health Care, entitled, Integrative Management of Common Mental and Emotional Symptoms. In this part, Dr. Lake first outlines "symptom-focused integrative mental health care," and then goes into each of the major categories of mental health with integrative health care approaches.

Thus, he deals with:

* integrative management of depressed mood
* integrative management of mania and cyclic mood changes
* integrative management of anxiety
* integrative management of psychosis
* integrative management of dementia and mild cognitive impairment
* integrative management of substance abuse and dependence
* integrative management of disturbances of sleep and wakefulness.

Generous appendices provide Web and other references for further study.

I highly recommend the Integrative Mental Health Care for all mental health caregivers, including (and especially) psychiatrists but also counselors of all sorts and psychiatrists.

Further, since most of us spend some time in our lives in some form of either anxiety and depression (so the experts tell us--that's the bad news), the book is very helpful and accessible even to the lay reader (that's the good news!). Buy this book for yourself--heck, buy the book for your psychiatrist or therapist, and learn how best to integrate complementary and alternative medical therapies such as acupuncture, selected herbal therapies and dietary supplements, massage therapy, aromatherapy, homeopathy, chiropractic, meditation and prayer, yoga, music therapy, and mind-body and other practices generally into conventional clinic mental health care.

In sum, this book bridges the world of conventional mental health care, with its cognitive, pharmaceutical, and other therapies, and the world of complementary medicine, with its alternative-paradigm theories, practices, assessment approaches, and treatment choices. Dr. Lake has blazed a trail for many other clinicians and researchers to follow, one which surely will be of lasting service to them and to the patients (and their families) to whom they offer care.

***

Law Offices of Michael H. Cohen offers general corporate legal services, litigation consultation, and expertise in health law, with a unique focus on alternative, complementary, and integrative medical therapies.

Michael H. Cohen is also President of the the Institute for Integrative and Energy Medicine, also known as the Institute for Health, Ethics, Law, Policy & Society. The Institute serves as a reliable forum for investigation and recommendations regarding the legal, regulatory, ethical, and health policy issues involved in the judicious integration of complementary and alternative medical therapies (such as acupuncture and traditional oriental medicine, chiropractic, massage therapy, herbal medicine) and conventional clinical care.

The most recent book written by Michael H. Cohen on health care law, regulation, ethics and policy pertaining to complementary and alternative medicine and related fields is an interdisciplinary collection of essays entitled, Healing at the Borderland of Medicine and Religion. This is the fourth book in a series, begun with Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives (1998).

Dr. James Lake informally helps advise the Institute for Integrative and Energy Medicine.

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