Relapse is common in substance use disorders (SUDs), even among treated individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for SUDs.The comprehensive search for and review of literature found over 2,000 abstracts and resulted in 25 eligible manuscripts (22 published, 3 unpublished: 8 RCTs, 7 controlled non-randomized, 6 noncontrolled prospective, 2 qualitative studies, 1 case report). When appropriate, methodological quality, absolute risk reduction, number needed to treat, and effect size (ES) were assessed.Overall, although preliminary evidence suggests MM efficacy and safety, conclusive data for MM as a treatment of SUDs are lacking. Significant methodological limitations exist in most studies. Further, it is unclear which persons with SUDs might benefit most from MM. Future trials must be of sufficient sample size to answer a specific clinical question and should target both assessment of effect size and mechanisms of action.

A total of 684 primary care physicians in Wisconsin participated in a survey designed to explore their experiences of consulting with and referring patients to mental health care professionals. The respondents indicated that they had only moderate access to mental health care professionals, and even less access when a patient was covered by Medicare or Medicaid or had no insurance. Physicians in group practices that included at least one mental health professional reported having better access to care than those in practices that did not include mental health services. Perceived access to mental health care services was not related to community size or to a managed care setting.

The death pronouncement workshop serves to prepare residents emotionally to deal with dying patients and provides them the skills to effectively and compassionately communicate with those patients' families while addressing all six ACGME core competencies.

Previous survey data reveal that patients and physicians strongly endorse the family conference, although the actual use of such meetings appears variable. Is this attributable to training experiences? The present study was conducted to explore the residents' experiences and attitudes regarding the family conference in the five University of Wisconsin family medicine programs. Methods: Five focus-groups and a brief questionnaire. Results: Four main themes emerged. Family conferences: 1) are valued as an important communication tool to disseminate medical information and reach consensus on a care plan; 2) occur primarily in inpatient settings when a crisis exists; 3) fail to occur due to significant barriers; 4) are best taught experientially with the involvement of physician role models. The survey data further supported the residents' endorsement of family conferences, the family conference as a tool to disseminate medical information to families, and the preponderance of family conferences in inpatient settings. Discussion: Results indicate that residents view family conferences as an important clinical tool and that training should emphasize supervised experiences in conducting family conferences and family physician role models.

The present study investigated the similarity between two live psychotherapy analogues and real psychotherapeutic interviews. Therapists were asked to participate in two different types of analogue situations and in initial intake sessions with real clients. In both of the analogues, a recruited subject presented a real personal problem to the therapists in helping interactions. Audiotapes of the real and analogue interviews were rated on 10 dependent variables, which were different dimensions of therapist and client behaviors. Different results were obtained for each analogue. The major findings concern mean differences between the analogue and real interviews and the linear relationships between the real and analogue interviews. Additional findings, including significant interactions between the type of interview and the experience level of the therapist, are also discussed. The results are interpreted as indicating that the generalizability of the analogues is contingent on the dependent variables in question, the type of relationship to be predicted, and the experience level of the therapists. The implications that these results have for future research involving psychotherapy analogues are discussed.