Treatment of Stress Response Syndromes

by Mardi J. Horowitz MD

Overview

Stress is a universal condition. However, severe stress related to loss, trauma, and/or terror necessitates an integrated approach, one that was pioneered nearly 20 years ago with the publication of Treatment of Stress Response Syndromes. This classic text has been updated and revised for our times, reflecting changes in DSM-5, which introduced a new category of diagnoses called trauma- and stressor-related disorders. This new edition updates treatment recommendations for these disorders and emphasizes formulation for determining appropriate therapeutic strategies. The author's method is assessment-based and does not compartmentalize its recommendations into treatment modalities such as cognitive-behavioral therapy, prolonged exposure, or cognitive processing therapy. Instead, the book takes an integrative and transtheoretical approach that emphasizes repeated assessments, resulting in treatment plans that are individualized, flexible, and more responsive to patient changes. Clinicians plan interventions based on the current state of mind of patients as they progress through the processing of traumatic events.

The new edition reflects evolution in the field, including the following: • The cross-theoretical approach helps practitioners integrate previously acquired clinical concepts without limiting them to one treatment modality or school of thought, enhancing their ability to respond to patient needs.• Assessment can be used throughout all phases of treatment, which leads to the possibility of enhancing emotional control, advancing attachment models, and consolidating identity.• Because of the financial constraints of insurance coverage or military troop availability, many treatment guidelines for PTSD focus on brief therapy; however, this book stresses the need for therapies of the length required to provide full benefit to patients and to lead to personality growth.

In addition, the inclusion of illustrative cases anchors techniques to pragmatic actions, engaging readers and focusing them on the most critically important concepts. End-of-chapter summaries allow review of key principles, and pertinent tables and figures condense essential information for easy understanding and retrieval.

Of great practical value for psychotherapists and other mental health professionals working with patients experiencing the effects of serious life events, Treatment of Stress Response Syndromes is the definitive guide to the psychotherapy and management of acute stress and PTSD, combining clear and compelling case descriptions with the eloquent presentation of therapeutic technique.

Product Details

ISBN-13:	9781615373673
Publisher:	American Psychiatric Publishing, Incorporated
Publication date:	09/06/2020
Sold by:	Barnes & Noble
Format:	eBook
Pages:	108
File size:	2 MB
Age Range:	18 Years

About the Author

Mardi J. Horowitz, M.D., is Distinguished Professor of Psychiatry at the University of California, San Francisco. He is past president of the San Francisco Psychoanalytic Institute, the San Francisco Center for Psychoanalysis, and the Society for Psychotherapy Research.

Table of Contents

Chapter 1. Principles of Psychological Responses to Stressor EventsChapter 2. Assessment and Treatment PlanningChapter 3. Providing SupportChapter 4. Linking the Meanings of Stressor Events to the SelfChapter 5. Improving Coping SkillsChapter 6. Renarration and ReschematizationChapter 7. TerminatingChapter 8. Assessing ChangeChapter 9. ConclusionRecommended ReadingsReferences

What People are Saying About This

Selby Jacobs

For over 20 years, Dr. Mardi Horowitz has led the field in the assessment and treatment of stress response syndromes such as Acute Stress Reactions, Post-traumatic Stress Disorder, and Complicated Grief. Now, he has authored a book providing a full exposition of a brief, integrative, cognitive-dynamic treatment approach to these disorders. Bio-psychosocial in the fullest sense, his psychotherapeutic model is anchored in an elegant conception, tested in clinical research, illustrated with excellent clinical examples, and rich in clinical detail. He focuses on mental processes involving the activation of 1) emotion, 2) conscious thought and preconscious information processing, and 3) schemas of the self and relationship interactions. These processes define three domains of outcome including achievement of an adaptive emotional equilibrium, an integrated understanding of the meaning of the stressful events, and a realistic re-schematization of identity and relationships, all leading to reduced stress response symptoms. Importantly, Dr. Horowitz recommends case formulation as the best route from assessment to optimum treatment planning and predicates the formulation on a systematic method for integrating and planning treatment named Configurational Analysis. The strategies of intervention, which include providing support, exploring meanings, improving coping, working though, and terminating treatment are clearly presented. This concise, well written text is a must for the library of those interested in stress response syndromes, any mental health professional committed to well-rounded, up-to-date clinical practice and those interested in scholarly study of the treatment of these disorders.

David Spiegel

Mardi Horowitz 'wrote the book' on Stress Response Syndromes. Now he has written 'the book' on their treatment. A master therapist and noted PTSD researcher, Dr. Horowitz has given us a definitive guide to the psychotherapy and management of acute and posttraumatic stress disorder that combines crystalline case description with lucid presentation of therapeutic technique.

Bessel A. van der Kolk

In Treatment of Stress Response Syndromes, Marti Horowitz, the greatest living pioneer in the area of traumatic stress, provides us with lucid, wise and comprehensive approaches to treat the ravages of trauma. Abundant clinical examples illustrate Horowitz' systematic analyses of people's character styles, self-regulation capacities and ability for introspection necessary to assimilate traumatic memories, and to deal with the accompanying anxiety, shame, guilt and disturbances of identity and relationships. A must read for everybody dedicated to healing traumatic stress.

Lester Luborsky

I really enjoyed and profited from reading this guide. It is clear and it is well-written. It turns out to be a very useful guide in treating people with stress responses. Mardi Horowitz is world famous for his decades of research on treatment of stress responses. One of his main principles is to adhere to his concept of configurational analysis, and truly individual formulations. The whole process is made vivid by many fine case examples, such as the 19 year-old Laura, whose parents were both killed by a drunk driver. He uses process headings such as doing evaluations, giving support, and improving coping, rather than mere diagnosis.

John P. Wilson

A concise, state-of-the-art book on the successful treatment of stress, trauma, and PTSD. A must-read by a pioneer of the field. A nutshell full of wisdom and compassion.

Paul Crits-Christoph

In this volume Horowitz presents a unique integrative model for understanding and treating stress response syndromes. Drawing upon empirically-supported biological, behavioral, cognitive, and psychodynamic perspectives, the author outlines basic principles of individualized case formulation and treatment in a way that is both clinically sophisticated but highly readable. Chock full of clinical examples, this book is essential reading for any student or clinician who provides psychotherapy to victims of trauma or other stressful events.

Editorial Reviews

3 Stars from Doody

Reviewer: Chad R Percifield, DO (Michigan State University College of Medicine)
Description: This book reviews the characteristics of stress response syndromes (acute stress disorder, PTSD, and adjustment disorder); specifically, their psychological impact on individuals and how these disorders may present from a psychosocial perspective. Much of the book is used to review psychotherapeutic techniques the author has found to be useful in treating these disorders. As a second edition, first published in 2002, the book provides appropriate updates to treatment recommendations and diagnosis of stress response syndromes in accordance with the DSM-5.
Purpose: Per the author, the purpose of this book is to help clinicians who are already familiar with diagnosing and treating stress response syndromes advance their psychotherapeutic techniques. These are worthy adjectives as stress response syndromes can be difficult to treat. The book is needed as it provides a unique approach to psychotherapeutic treatment of these disorders. The book meets these objectives as it is thorough and provides detailed explanations and examples of various pertinent treatment techniques throughout.
Audience: The book is written for clinicians who are already familiar with diagnosing and treating stress response disorders. The book does meet the need of this audience as it is written at a level that is advanced enough for this group but is still easy to read. The author is credible as a recognized world leader in stress response syndrome research.
Features: The book covers typical psychological responses to stress and provides examples of how these might present clinically (i.e., maladaptive responses such as anger/aggression and isolation). Most of the text describes in detail the author's suggested approach for establishing a relationship with the patient, formulating a treatment plan, and then utilizing a variety of psychotherapeutic techniques in order to move the patient from a maladaptive response to a more adaptive response. There are many detailed discussions regarding how to appropriately provide support for the patient, improve the patient's coping skills, and work toward re-narrating the traumatic event. Useful rating scales developed by the author for patient symptoms and severity are included in the book as well.
Assessment: This book is of high quality and useful for learning to better manage stress response syndromes. The author is a highly regarded expert in the field and provides a unique "transtheoretical" approach to treatment. The author does not suggest any specific type of therapeutic modality; rather the book focuses on developing a solid biopsychosocial formulation for each patient and using that as a guide for which specific techniques to use. This approach, which focuses on flexibility of the clinician in order to better provide care for the patient, is a strength of this book. Furthermore, the book has several helpful case examples that support individual strategies or ideas discussed by the author. While the book does not have many aesthetically pleasing visuals, it does effectively use tables and flow charts when appropriate. The author's writing style tends to be more conversational, which may be off-putting for clinicians looking for a more "scientifically" written text.

Doody's Review Service

The chapters include informative and engaging case examples-clinical vignettes that capture essential points and provide useful context and detail to make the abstract more concrete and helpful.

Scott M. Monroe

What separates this book from similar texts in the field are the depth and richness of Horowitz's clinical experience. His psychopharmacologic suggestions are wise and an improvement over the advice of most authors, who either lack sophistication in the use of drugs or who lack dynamic understanding. Horowitz's advice on countertransference is particularly helpful. His balance and emphasis are in the right places, and his writing and conceptualizations are lucid.

Journal of Clinical Psychiatry - George E. Vaillant