Over the last decade, integrated care models have increased in both public and private sectors. This trend is especially apparent in primary care settings. Integrated care is designed to offer comprehensive and coordinated health services while addressing the economic realities and failures of the current health care system. Proposed integrated care models such as Accountable Care Organizations and Patient Centered Medical Homes include marked changes in health care delivery, financing, and reimbursement, which are designed to create a more cost-effective health system. This article provides an overview of integrated care to help practicing psychologists develop a better understanding of interprofessional health care and evaluate their interest in and readiness to provide professional services In health care. The advantages and challenges associated with integrated care will be provided.
Despite the presence of some literature that has addressed the characteristics of the African American female therapist, most psychotherapy training proceeds with the assumption that therapists are members of dominant groups, and most of the psychological and psychotherapy literature has been written by therapists and psychologists who come from dominant cultural perspectives. Not as much has been written about psychological paradigms or the process of psychotherapy from the perspective of the therapist who is not a dominant group member. This article explores both the common and divergent experiences that we, the authors, share as African American female therapists and the different reactions we frequently elicit in clients. We also explore how individual differences in our physical appearances, personal backgrounds, and different characteristics of our respective practices elicit distinct responses from clients that we believe are based on differences between us, despite the fact that we are both African American women. We believe that many of the stereotypes that affect perceptions of African American female clients also exist for African American female therapists. We will address how the intersection of gender, race, and sexual orientation of the client highlights the complexity of culturally competent practice.
The U.S. Centers for Disease Control and Prevention defines health disparities as "preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations." Health disparities are often the result of persistent unjust policies and discriminatory practices that increase the risk of vulnerable populations for poor health. Environmental, social, and behavioral factors-all areas of psychology's expertise-contribute to health disparities in interacting ways. This article describes health disparities, including the evidence for them, the role that psychology and the American Psychological Association (APA) can play in addressing the health disparities, and the work of the APA Presidential Task Force on Psychology and Health Equity, including the APA Resolution on Psychology and Health Equity.
Two cases of narcolepsy presenting in elderly patients are reported. Delay in diagnosis prior to presentation resulted in considerable psychosocial problems for both patients. Satisfactory responses to therapy were achieved with patients regaining independence. Difficulties associated with this diagnosis in the elderly are discussed.
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