Full Title: A dissociative episode following stage hypnosis in a combat-injured soldier: implications, treatment and reflections

Significant data to suggest the need for more appropriate precautions for volunteers participating in stage hypnosis is presented. This paper is a case report of a soldier previously injured in battle who, due to participating in stage hypnosis one year after his injury, experienced a dissociative episode wherein post-traumatic stress symptoms were prominent. During this episode, which lasted over three hours, the service member assaulted an acquaintance, subsequently believed he was a prisoner of war, experienced amnesia for some of the events, and was eventually psychiatrically hospitalized. The diagnosis of acute psychotic reaction was rendered. Fortunately for this service member, upon his return to his treating hospital center, his primary medical team made an appropriate referral. Psychotherapeutic treatment allowed this individual to integrate his traumatic experiences, gain control and understanding of his behavior, and extinguish his pain and suffering, returning to his successful career.

Am J Clin Hypn. 2010 Jan;52(3):183-8. Wain HJ, Dailey J. Dept. of Psychiatry, Walter Reed Medical Center, 6900 Georgia Avenue NW, Washington, DC 20307-5001, USA. harold.wain@amedd.army.mil

by Lorraine Pirihi

How are you progressing with the goals you set yourself this year? Have you made a start? Or are you still procrastinating or caught the very popular "I'm too busy" epidemic?

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Full Title: The Nordic back pain subpopulation program: predicting outcome among chiropractic patients in Finland

ABSTRACT: BACKGROUND: In a previous Swedish study it was shown that it is possible to predict which chiropractic patients with persistent LBP will not report definite improvement early in the course of treatment, namely those with LBP for altogether at least 30 days in the past year, who had leg pain, and who did not report definite general improvement by the second treatment. The objectives of this study were to investigate if the predictive value of this set of variables could be reproduced among chiropractic patients in Finland, and if the model could be improved by adding some new potential predictor variables. METHODS: The study was a multi-centre prospective outcome study with internal control groups, carried out in private chiropractic practices in Finland. Chiropractors collected data at the 1st, 2nd and 4th visits using standardized questionnaires on new patients with LBP and/or radiating leg pain. Status at base-line was identified in relation to pain and disability, at the 2nd visit in relation to disability, and "definitely better" at the 4th visit in relation to a global assessment. The Swedish questionnaire was used including three new questions on general health, pain in other parts of the spine, and body mass index. RESULTS: The Swedish model was reproduced in this study sample. An alternative model including leg pain (yes/no), improvement at 2nd visit (yes/no) and BMI (underweight/normal/overweight or obese) was also identified with similar predictive values. Common throughout the testing of various models was that improvement at the 2nd visit had an odds ratio of approximately 5. Additional analyses revealed a dose-response in that 84% of those patients who fulfilled none of these (bad) criteria were classified as "definitely better" at the 4th visit, vs. 75%, 60% and 34% of those who fulfilled 1, 2 or all 3 of the criteria, respectively. CONCLUSION: When treating patients with LBP, at the first visits, the treatment strategy should be different for overweight/obese patients with leg pain as it should be for all patients who fail to improve by the 2nd visit. The number of predictors is also important.

Chiropr Osteopat. 2008 Nov 7;16:13. Malmqvist S, Leboeuf-Yde C, Ahola T, Andersson O, Ekström K, Pekkarinen H, Turpeinen M, Wedderkopp N. The Faculty of Social Sciences, University of Stavanger, and the Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway. nils.s.malmqvist@uis.no.

by Mark Gorkin, LICSW

"When It Really Is "Your Money or Your Life"

This week I was the keynote speaker at the Forty Plus annual dinner (www.40plus-dc.org/), a volunteer-based, Washington, DC, career transition/support group. In general, members are white collar types, e.g., federal employees, managers, IT professionals, academics, even some entrepreneurs, who are "in between jobs." With only 20 minutes of speaking time, my subject was definitely apt, both for the attendees and for me -- "Letting Go." From a "psycho-semantic" perspective, "letting go" involves more than just physically "dropping the rope."

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Previous work has shown that acupuncture stimulation evokes deactivation of a limbic-paralimbic-neocortical network (LPNN) as well as activation of somatosensory brain regions. This study explores the activity and functional connectivity of these regions during acupuncture vs. tactile stimulation and vs. acupuncture associated with inadvertent sharp pain. Acupuncture during 201 scans and tactile stimulation during 74 scans for comparison at acupoints LI4, ST36 and LV3 was monitored with fMRI and psychophysical response in 48 healthy subjects. Clusters of deactivated regions in the medial prefrontal, medial parietal and medial temporal lobes as well as activated regions in the sensorimotor and a few paralimbic structures can be identified during acupuncture by general linear model analysis and seed-based cross correlation analysis. Importantly, these clusters showed virtual identity with the default mode network and the anti-correlated task-positive network in response to stimulation. In addition, the amygdala and hypothalamus, structures not routinely reported in the default mode literature, were frequently involved in acupuncture. When acupuncture induced sharp pain, the deactivation was attenuated or became activated instead. Tactile stimulation induced greater activation of the somatosensory regions but less extensive deactivation of the LPNN. These results indicate that the deactivation of the LPNN during acupuncture cannot be completely explained by the demand of attention that is commonly proposed in the default mode literature. Our results suggest that acupuncture mobilizes the anti-correlated functional networks of the brain to mediate its actions, and that the effect is dependent on the psychophysical response.

Brain Res. 2009 Sep 1;1287:84-103. Epub 2009 Jun 25. Hui KK, Marina O, Claunch JD, Nixon EE, Fang J, Liu J, Li M, Napadow V, Vangel M, Makris N, Chan ST, Kwong KK, Rosen BR. Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 149 13th St., Charlestown, MA 02129, USA. hui@nmr.mgh.harvard.edu

OBJECTIVES: To assess the role of massage therapy in the cardiac surgery postoperative period. Specific aims included determining the difference in pain, anxiety, tension, and satisfaction scores of patients before and after massage compared with patients who received standard care. DESIGN: A randomized controlled trial comparing outcomes before and after intervention in and across groups. SETTING: Saint Marys Hospital, Mayo Clinic, Rochester, Minnesota. SUBJECTS: Patients undergoing cardiovascular surgical procedures (coronary artery bypass grafting and/or valvular repair or replacement) (N=58). INTERVENTIONS: Patients in the intervention group received a 20-minute session of massage therapy intervention between postoperative days 2 and 5. Patients in the control group received standard care and a 20-minute quiet time between postoperative days 2 and 5. OUTCOME MEASURES: Linear Analogue Self-assessment scores for pain, anxiety, tension, and satisfaction. RESULTS: Statistically and clinically significant decreases in pain, anxiety, and tension scores were observed for patients who received a 20-minute massage compared with those who received standard care. Patient feedback was markedly positive. CONCLUSIONS: This pilot study showed that massage can be successfully incorporated into a busy cardiac surgical practice. These results suggest that massage may be an important therapy to consider for inclusion in the management of postoperative recovery of cardiovascular surgical patients. Copyright 2009 Elsevier Ltd. All rights reserved.

Complement Ther Clin Pract. 2010 May;16(2):92-5. Epub 2009 Nov 14. Cutshall SM, Wentworth LJ, Engen D, Sundt TM, Kelly RF, Bauer BA. Department of Surgery, Mayo Clinic, Rochester, Minnesota, United States.

Deirdre Barrett, Ph.D. is author of the 2007 book, 'Waistland: The R/evolutionary Science Behind Our Weight and Fitness Crisis'. Dr. Barrett is a clinical psychologist and Assistant Professor of Psychology at Harvard Medical School. She is a Past President of the International Association for the Study of Dreams, and Editor in Chief of the journal Dreaming. She is also President of American Psychological Association's Div. 30, The Society for Psychological Hypnosis. Deirdre authored three trade books including The Committee of Sleep (Random House, 2001) and was editor of Trauma and Dreams (Harvard University Press, 1996). Dr. Barrett's commentary on dreams has been featured on Good Morning America, The Today Show, CNN, Fox, The Discovery Channel, and Voice of America.

Energy medicine modalities, also known as biofield therapies, are perhaps the most mysterious and controversial complementary alternative medicine therapies. Although many of these approaches have existed for millennia, scientific investigation of these techniques is in its early stages; much remains to be learned about mechanisms of action and efficacy. These techniques are increasingly used in clinical and hospital settings and can be incorporated into an integrative primary care practice. This article describes several energy medicine and biofield therapies and outlines key elements they hold in common. Several specific approaches are described. Research findings related to the efficacy of energy medicine are summarized, and proposed mechanisms of action and safety issues are discussed. Guidelines are offered for primary care providers wishing to advise patients about energy medicine or to integrate it into their practices, and Internet and other resources for obtaining additional information are provided. Copyright 2010 Elsevier Inc. All rights reserved.

Prim Care. 2010 Mar;37(1):165-79. Rindfleisch JA. Department of Family Medicine, Odana Atrium Family Medicine Clinic, University of Wisconsin School of Medicine and Public Health, 5618 Odana Road, Madison, WI 53719, USA. adam.rindfleisch@fammed.wisc.edu

Full Title: Pilot study of emotional freedom techniques, wholistic hybrid derived from eye movement desensitization and reprocessing and emotional freedom technique, and cognitive behavioral therapy for treatment of test anxiety in university students.

OBJECTIVE: This study explored test anxiety benefits of wholistic hybrid derived from eye movement desensitization and reprocessing and Emotional Freedom Techniques (WHEE), Emotional Freedom Techniques (EFTs), and cognitive behavioral therapy (CBT). PARTICIPANTS: Canadian university students with severe or moderate test anxiety participated. METHODS: A controlled trial of WHEE (n = 5), EFT (n = 5), and CBT (n = 5) was conducted. Standardized anxiety measures included the Test Anxiety Inventory and Hopkins Symptom Checklist-21. RESULTS: Despite small sample size, significant reductions in test anxiety were found for all three treatments. In only two sessions, WHEE and EFT achieved the same benefits as CBT did in five sessions. Participants reported high satisfaction with all treatments. Emotional freedom techniques and WHEE participants successfully transferred their self-treatment skills to other stressful areas of their lives. CONCLUSIONS: Both WHEE and EFT show promise as feasible treatments for test anxiety.

Explore (NY). 2009 Nov-Dec;5(6):338-40. Benor DJ, Ledger K, Toussaint L, Hett G, Zaccaro D. Association for Comprehensive Energy Psychology, Haverford, PA, USA.

This article describes how hypnosis can be used as an efficient technique in treating patients with anxious disorders. Hypnosis can be used to achieve a better control of the anxious symptoms through relaxation. It allows the patient to anticipate the anxiety triggering events. This technique also allows the patient to mentalise and integrate traumatic events, therefore helping him to prevent the post-traumatic anxious symptoms.

Rev Med Suisse. 2010 Feb 17;6(236):330-3. Smaga D, Cheseaux N, Forster A, Colombo S, Rentsch D, de Tonnac N. HUG, Département de psychiatrie, Avenue Krieg 15, 1208 Genève. smaga@infomaniak.ch

by Sam Slay

Our lives are made up of a series of habits that we create over time. Do you believe you intentionally adopt behavior that places you in harms way? Some harm may come in the form of decreasing health. Other harm comes in self-defeating personality traits. I am referring to the persistent habits that develop harmful behavior. For example, we fail to get healthy, get into shape, and be good to others and ourselves.

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Full Title: The influences of Chan-Chuang qi-gong therapy on complete blood cell counts in breast cancer patients treated with chemotherapy

After surgery, breast cancer patients are offered adjuvant chemotherapy to avoid cancer cell spread. During chemotherapy process, neutrophils could fall relatively, and side effects could spike to the peak. Therefore, the medical care personnel should prevent the progression of the side effects. This study aimed to examine the effects of Chan-Chuang qi-gong therapy on complete blood counts in breast cancer patients treated with chemotherapy. This study used a quasi-experimental design. The experiment group (n = 32) received a 21-day Chan-Chuang qi-gong therapy, whereas the control group (n = 35) did not. White blood cells, platelet, and hemoglobin were measured on the day before chemotherapy and on days 8, 15, and 22 during chemotherapy. According to this study, there were significant differences in white blood cells (F = 115.76, P <.001), platelets (F = 25.29, P <.001), and hemoglobin (F = 15.39, P <.001) over the 3-week therapy between the experiment and control groups. Chan-Chuang qi-gong therapy may decrease leukopenia in breast cancer patients treated with chemotherapy. It is recommended conducting more studies on qi-gong and then introducing it in clinical nursing practice at an appropriate time to promote quality of nursing care and quality of patient life.

Cancer Nurs. 2006 Mar-Apr;29(2):149-55. Yeh ML, Lee TI, Chen HH, Chao TY. Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei College of Nursing, Taipei City, Taiwan, ROC. meiling@mail1.ntcn.edu.tw

Derrick Lonsdale received his medical training in England. He emigrated to the United States in 1960 and after resident training in pediatrics at Cleveland Clinic, was invited to join the staff in the Department of Pediatrics. In 1982, Dr Lonsdale took early retirment to practice nutrition based Alternative Complementary Medicine. He is a board certified pediatrician, Fellow of the American College of Advancement in Medicine and Certified Nutrition Specialist.

The demonstration that hypnotic suggestion can inhibit word/colour Stroop highlights one of the benefits of using hypnosis to explore cognitive psychology and in particular attentional processes. The compelling results using a rigorous design have particular relevance for the presumed automaticity of some forms of information processing. Moreover the results support the potential that hypnotic suggestion offers for creating clinically informed analogues of relevant psychological and neuropsychological conditions. As with all novel research, the results of Raz and Campbell raise further operational and theoretical questions, relating in this case to the use of hypnotic, post-hypnotic and non-hypnotic suggestion and the utility of existing measures of hypnotizability. Copyright © 2010 Elsevier Inc. All rights reserved.

Conscious Cogn. 2010 Feb 24. Oakley DA, Halligan PW. Division of Psychology and Language Sciences, University College London, Gower Street, London WC1E 6BT, UK; School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff CF10 3AT, UK.

OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year-old woman presented for care with complaints of acute vertigo and dizziness. INTERVENTION AND OUTCOME: The patient was examined and diagnosed with left posterior canalolithiasis by means of the Dix-Hallpike maneuver. She was treated successfully with the Epley maneuver once and subsequently discharged without further treatment. CONCLUSION: This case demonstrates the importance of correctly identifying patients with BPPV. This case also demonstrates the successful treatment of BPPV.

J Manipulative Physiol Ther. 2009 Jun;32(5):387-90. Nørregaard AR, Lauridsen HH, Hartvigsen J. Clinical Locomotion Science, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. anorregaard@health.sdu.dk

by Joyce-Anne Locking

You can change your mind at any time you wish. Learn to walk your thought pattern through a positive process each day. It's a push and pull reaction. Push ahead as your inner vision pulls. When you examine your thoughts you may discover you are experiencing some painful emotion. The funny thing is that thought is in charge of producing emotion which in turn determines behavior. The power of pretense is recognized as reality by the mind. If you pretend to be in a state of ease and enjoyment, the body responds to the pleasing environment you suggest. Try playing a game with your mind. Tell yourself you are exactly as you wish you could be.

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Full Title: The role of acupuncture and transcutaneous-electrical nerve stimulation for postoperative pain control

PURPOSE OF REVIEW: Both patients and care providers are concerned about the adverse events associated with pharmaceutical approaches used in postoperative pain management. Acupuncture and transcutaneous-electrical nerve stimulation (TENS) are complementary treatment techniques and are very popular in the management of a variety of painful conditions. Therefore, their use might help to reduce opioid requirements and decrease the incidence of medication-related adverse events. The aim of this review is to summarize the latest findings on the use of acupuncture and TENS in postoperative pain management. RECENT FINDINGS: The number of recent high-quality trials on acupuncture and TENS in postoperative pain is limited. Evidence of efficacy in acupuncture studies is contradictory although some high-quality studies clearly found positive effects. Differences in setting and methodology might explain the variability in the results. Findings of the few recent trials using TENS are consistently positive. SUMMARY: Evidence of efficacy in recent studies on acupuncture and TENS in management of postoperative pain is limited. However, some high-quality studies clearly show positive results for both methodologies. As these techniques cause no harm, their use as adjunct to conventional pharmaceutical approaches could be considered particularly for patients in whom conventional techniques fail and/or are accompanied by severe medication-related adverse events.

Curr Opin Anaesthesiol. 2009 Oct;22(5):623-6. Meissner W. Department of Anesthesiology and Intensive Care, Friedrich Schiller University Jena, Erlanger Allee, Jena, Germany. meissner@med.uni-jena.de

by Katherine Zimmerman, PhD, CHT

We all have parts. I'm not referring to body parts here but parts of our personality. Have you ever said to someone, "a part of me really wants to take that new job but another part is afraid to make the change?" Or, "a part of me really wants to lose weight but another part says that it's just too much work." This is a normal occurrence because we all have parts of our personality that have split off and keep us struggling to make decisions. Just as with any team effort, life flows more smoothly when our parts are working together. In the following case history, Renee brings several parts into agreement creating a life that feels lighter and easier.

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Full Title: Randomized controlled trial of an Internet-delivered family cognitive-behavioral therapy intervention for children and adolescents with chronic pain

Cognitive-behavioral therapy (CBT) interventions show promise for decreasing chronic pain in youth. However, the availability of CBT is limited by many factors including distance to major treatment centers and expense. This study evaluates a more accessible treatment approach for chronic pediatric pain using an Internet-delivered family CBT intervention. Participants included 48 children, aged 11-17years, with chronic headache, abdominal, or musculoskeletal pain and associated functional disability, and their parents. Children were randomly assigned to a wait-list control group or an Internet treatment group. Primary treatment outcomes were pain intensity ratings (0-10 NRS) and activity limitations on the Child Activity Limitations Interview, both completed via an online daily diary. In addition to their medical care, the Internet treatment group completed 8weeks of online modules including relaxation training, cognitive strategies, parent operant techniques, communication strategies, and sleep and activity interventions. Youth randomized to the wait-list control group continued with the current medical care only. Findings demonstrated significantly greater reduction in activity limitations and pain intensity at post-treatment for the Internet treatment group and these effects were maintained at the three-month follow-up. Rate of clinically significant improvement in pain was also greater for the Internet treatment group than for the wait-list control group. There were no significant group differences in parental protectiveness or child depressive symptoms post-treatment. Internet treatment was rated as acceptable by all children and parents. Findings support the efficacy and acceptability of Internet delivery of family CBT for reducing pain and improving function among children and adolescents with chronic pain.

Pain. 2009 Aug 18. Palermo TM, Wilson AC, Peters M, Lewandowski A, Somhegyi H. Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA.

Secret hypnosis is done on a constant basis through advertising, as advertising is designed specifically to bypass the conscious and analytical mind and speak directly to emotions and the subconscious. Understand how hypnosis is performed with information from a certified hypnotist trainer in this free video on hypnotism.

Full Title: Social disinterest attitudes and group cognitive-behavioral social skills training for functional disability in schizophrenia

The majority of clinical trials of cognitive-behavioral therapy (CBT) for schizophrenia have used individual therapy to target positive symptoms. Promising results have been found, however, for group CBT interventions and other treatment targets like psychosocial functioning. CBT for functioning in schizophrenia is based on a cognitive model of functional outcome in schizophrenia that incorporates dysfunctional attitudes (eg, social disinterest, defeatist performance beliefs) as mediators between neurocognitive impairment and functional outcome. In this report, 18 clinical trials of CBT for schizophrenia that included measures of psychosocial functioning were reviewed, and two-thirds showed improvements in functioning in CBT. The cognitive model of functional outcome was also tested by examining the relationship between social disinterest attitudes and functional outcome in 79 people with schizophrenia randomized to either group cognitive-behavioral social skills training or a goal-focused supportive contact intervention. Consistent with the cognitive model, lower social disinterest attitudes at baseline and greater reduction in social disinterest during group therapy predicted better functional outcome at end of treatment for both groups. However, the groups did not differ significantly with regard to overall change in social disinterest attitudes during treatment, suggesting that nonspecific social interactions during group therapy can lead to changes in social disinterest, regardless of whether these attitudes are directly targeted by cognitive therapy interventions.

Schizophr Bull. 2009 Sep;35(5):874-83. Epub 2009 Jul 23. Granholm E, Ben-Zeev D, Link PC. Veterans Affairs San Diego Healthcare System (116B), 3350 La Jolla Village Drive, San Diego, CA 92161, USA. egranholm@ucsd.edu

Dr. Edgar A. Barnett began his medical career in England, practicing under the National Health Services until 1966 at which time he emigrated to Canada. He continued his medical practice in Kingston, Ontario, Canada as a certified family practitioner, Chairman of the Department of General Practice at Kingston General and Hotel Dieu Hospitals and lecturer at Queen's University.

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Certain clinical reports and researches have shown that acupuncture effects can sustain a period during the post-stimulation state, and modulate the default mode network (DMN). In this study, partial correlation approach was utilized to investigate whether or not electro-acupuncture stimulation (EAS) at the three acupoints (GB37 (Guangming), BL60 (Kunlun) and KI8 (Jiaoxin)) and one sham point on the left leg modulated the DMN and how to change the intrinsic connectivity of the DMN. The results indicated that DMN could be modulated after EAS, and there existed different modulation patterns of the four points. Meanwhile, we found that the posterior cingulate cortex and precuneus (PCC/pC) strongly interacted with other nodes during the pre- and post-stimulation states. The correlation was interrupted between the PCC/pC and anterior cingulate cortex (ACC). The orbital prefrontal cortex (OFC) negatively interacted with the left medial temporal cortex (lMTC) at the acupoints. We suggested that the distinct modulation patterns to the DMN attributed to the different effects evoked by the three acupoints and one sham point.

Neurosci Lett. 2009 Oct 25;462(3):183-7. Epub 2009 Jul 10. Liu P, Zhang Y, Zhou G, Yuan K, Qin W, Zhuo L, Liang J, Chen P, Dai J, Liu Y, Tian J. School of Sino-Dutch Biomedical and Information Engineering, Northeastern University, Shenyang, Liaoning 110004, China.

Full Title: Telephone-administered cognitive behavioral therapy: a case study of anxiety and depression in Parkinson's disease

Parkinson's disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD.

J Clin Psychol Med Settings. 2009 Sep;16(3):243-53. Epub 2009 Apr 29. Veazey C, Cook KF, Stanley M, Lai EC, Kunik ME. Department of Psychology, University of Louisiana at Lafayette, Lafayette, LA 70504-3131, USA. veazey@louisiana.edu

This article will provide an examination of Erickson's model of hypnosis and the impact hypnosis has made on the psychosocial well being of the medically ill patient. The intrinsic three stage process of a hypnotic intervention, as well as its value, practice assumptions, and its relevance to alleviating pain, distress, and anxiety with oncology patients will be discussed. We have found this approach to be particularly effective with adult oncology patients at alleviating the side effects of the arduous treatment that is often endured. Case vignettes will demonstrate the benefits of utilizing this intervention with adult patients in the hospital setting as well as provide specific insight into the creative methods in which we have woven hypnosis into our clinical work. Finally, we will explore the use and rationale of hypnosis in medical settings and the impact of using this intervention on the role of the hospital social worker.

Soc Work Health Care. 2010 Mar;49(3):245-62. Snow A, Warbet R. The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA. Alison.Snow@mountsinai.org