Behavioral medicine: Practical applications in health care

Behavioral medicine: Practical applications in health care

J. Behav. Thu. & Exp. Psychiar. Vol. 12, No. 3, pp. 207-290. 1981 Printed in Great Britain. Pergamon Press Ltd. BOOK REVIEWS Behavioral Medicine: P...

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J. Behav. Thu. & Exp. Psychiar. Vol. 12, No. 3, pp. 207-290. 1981 Printed in Great Britain.


Press Ltd.

BOOK REVIEWS Behavioral Medicine: Practical Applications in Health Care by B. G. MALAMED and L. J. SIEGEL Springer Publishing Co., New York, 1980,404 pp., $22.95 The review of behavioral medicine books has taken on added significance because of the burgeoning literature in this area. I am pleased to report that, within the stated goals of the authors, this is a very good book. It is important, however, to take careful note of the qualifications. Behavioral medicine is an extremely broad topic and this book does not purport to be all things to ail people. To begin with it focuses on only a segment of the field that has come to be known as behavioral medicine. It describes the applications of behavior therapy in health care. Secondly, it is not for everyone-it is meant to be a textbook for nonbehaviorally trained members of the allied health professions-physicians, nurses, social workers, psychologists, dentists, rehabilitation specialists. The book is divided into three parts. Part I is clearly the best and in many ways the most important. Behavior therapy is defined and discussed in the health care context. The chapters on the theoretical and experimental foundations of behavior therapy are excellent, as is the chapter on behavior analysis. These chapters are important because they provide the basis on which everything else follows. They are well written and seem to be at the appropriate level for the intended audience. Part II focuses on applications of behavior therapy to health care problems and makes liberal use of case examples. Most of the major topics have been touched on including: illness behavior, adherence, life-style changes, pain, eating disorders, psychophysiologic disorders and behavioral intervention in rehabilitation. By and large the descriptions of behavior therapy are solid with a strong emphasis on the individual behavior analysis. Perhaps the major shortcoming of this section is that it is relatively uncritical.

Sufficient information is not provided to put various methods in perspective. The most glaring example of this is the coverage of obesity. In contrasting behavior therapy with traditional medical and dietary approaches the authors state “. . . behavioral programs have considerably lower dropout rates, and result in significanlty greater weight loss”. Although this statement is correct it leaves a lot unsaid. It would be much more useful for health professionals also to be told about the clinical significance of the weight losses to be expected when using these methods. Likewise, although the theoretical assumptions upon which the behavioral approach is based are accurately described, not enough attention is given to their considerable shortcomings. Part III covers psychological preparation for hospitalization and management of dental patients. The coverage of these topics is disproportionate to their significance and probably reflects the fact that the authors have been active in research on these topics. On balance, although this book is by no means comprehensive or sufficiently self-critical, the authors have succeeded in providing a very good introduction to health professionals on the topic of applying behavior therapy to health care problems. Apart from the rather poor quality of the tables, the book is nicely bound and free of production errors. PAUL LATIMER

Department of Psychiatry Temple University Medical School Henry Avenue Philadelphia, PA