The new edition of this concise and popular guide delivers up-to-date, hands-on guidance on the assessment and treatment of obsessive-compulsive disorder (OCD), offering a framework for understanding and helping people with this complex and challenging condition. Written by leading experts in the field, this book unpacks the intricacies of diagnosing OCD and explores models that explain the onset, development, and persistence of the disorder as well as its various manifestations.

Older adults are often underdiagnosed and undertreated for substance use disorders due to difficulty recognizing signs of substance use disorders in this population, as well as difficulty applying the DSM criteria to older adults. The current paper focuses on the prevalence of alcohol and cannabis use among older adults, as well as best practices for assessment and intervention. Through the integration of a case presentation, the current paper highlights common signs of substance use among older adults, clinical and ethical challenges in substance use disorder diagnosis and treatment among older adults, appropriate substance use assessments for older adults, and a variety of evidence-based treatment approaches that can be used with this population.

Measurement-Based Care (MBC) holds significant potential to enhance the effectiveness of the Primary Care Behavioral Health (PCBH) model, yet it remains inconsistently applied. This article positions MBC not as a procedural task, but as a core clinical competency that fosters therapeutic alliance, clarifies treatment goals, and promotes equitable care. Drawing from contrasting clinical vignettes, we demonstrate how tools inform clinical decision-making and enhance collaboration when applied skillfully by Behavioral Health Consultants. Finally, this article identifies cultural, structural, and operational barriers to implementation and offers pragmatic strategies to integrate MBC into routine care. By reframing MBC as a clinical competency, we advocate for its broader adoption as a standard of care within integrated behavioral health and PCBH specifically.

This article offers an overarching review of the literature on pregnancy loss including key terminology, standard medical treatments, patients’ reactions to pregnancy loss, and empirically supported psychological interventions for supporting loss patients. The remainder of the article delves into specific applications of therapeutic approaches for health service psychologists working with pregnancy loss patients. The vignette of a patient’s story highlights challenges that pregnancy loss patients often face and demonstrates how the health service psychologist can ultimately facilitate healing. We conclude with a list of practical “Do’s and Don’ts” for the health service psychologist working with pregnancy loss patients.

Teaching parents effective parenting strategies has several challenges for therapists, often stemming from family dynamics and ineffective discipline. Harsh punishment, inconsistency, and permissiveness can worsen behaviors, highlighting the need for structured, supportive parenting. Authoritative parenting, with warmth and consistency, fosters positive development. Therapists play a key role in helping parents regulate emotions, avoid disciplinary hypocrisy, and adapt strategies across developmental stages. By equipping parents with practical tools, therapy can strengthen parent-child relationships, reduce opposition, and promote long-term behavioral resilience.

Driven by the rapid progression of generative AI and other technological advancements, interactive virtual conversational agents are transforming the therapeutic relationship and how clients participate in behavioral health care. This article explores a case example of adopting an AI-powered conversational agent into a psychologist’s practice workflow, addressing key ethical, legal, and practical considerations. It emphasizes the importance of a client-centered approach and safety and calls for active involvement from psychologists and the broader behavioral health community in shaping the future of AI in mental health care.

Obsessive-compulsive disorder (OCD) is a chronic incapacitating mental health condition that is underrepresented in clinical treatment settings. The worldwide treatment gap for OCD is estimated at 60% (Kohn et al., 2004), a figure that reflects a shortage of specialized services, delayed help-seeking in suffers, and a mounting cost to society. The treatment of choice for OCD is a combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRIs), which has been proven efficacious in measurably reducing symptoms to below the clinical threshold (McKay et al., 2015). Nevertheless, when evaluated holistically, the success rate of the first-line treatment is limited. This study provides a literature review of the various psychodynamic models of obsessive-compulsive pathology and their attendant approaches to treatment. At present, empirical evidence for psychodynamic therapies for OCD is lacking (Leichsenring et al., 2015). To fill this gap in the research, this pragmatic case study (PCS; Fishman, 1999) aims to demonstrate the viability of short-term psychodynamic psychotherapy (STPP) as an effective treatment for OCD. Specifically, this pilot case study examines the theoretical implementation of Leichsenring and Steinert’s (2017) empirically-derived, manual-guided STPP treatment for OCD, rendered as a treatment for “Serena,” a 28-year-old female patient presenting with mild-to-moderate symptoms of OCD. Serena is a hybrid case, which is an aggregate of actual, de-identified psychotherapy cases and clinical examples from the relevant psychological literature. Through a disciplined inquiry approach, Serena’s treatment process is systematically described. Treatment outcomes are analyzed both qualitatively and quantitatively. This case study attempts to illustrate the interplay between symptom expression and the not-always-linear progress toward structural change. I conclude with a discussion of the applications and limitations of the hybrid case study and STPP for OCD, as well as implications for psychotherapy integration.

Veterans who are also first responders (V-FRs) represent a distinct, underserved population with complex and compounded mental health challenges. In addition to facing high rates of posttraumatic stress disorder, depression, anxiety, substance use, insomnia, and chronic pain, V-FRs encounter significant cultural and logistical barriers to accessing mental health services. This article aims to provide clinical guidance on addressing these issues while considering the unique cultural context of V-FRs. It outlines evidence-based treatments and assessments, offering practical strategies for clinicians to adapt these approaches to meet the specific needs of this population.

Youth Peer Support Services (YPSS)—where youth with lived experience of mental health challenges support peers—address the growing, unmet need for youth mental health services. This article emphasizes the vital role of clinicians in training, supervising, and supporting youth peer support workers (YPSWs) to ensure effective service delivery. Clinical vignettes highlight how tailored supervision, role clarity, and boundary management help YPSWs leverage their lived experience while maintaining professionalism. The vignettes demonstrate the transformative potential of YPSS on recovery and underscore the importance of clinician-led training, supervision, and organizational support. Key considerations for clinicians in YPSS implementation are discussed, offering guidance for effectively supporting the integration of YPSS into mental health systems.

Rural trans and nonbinary (TNB) youth face a paradoxical mental health challenge. They increasingly must rely on social media for support and community, but online forums pose a significant risk to young people's mental health and social well-being. The broad accessibility, user anonymity, and group dynamics on social media tend to amplify bullying and violent speech. The authors examine the clinical and ethical challenges rural mental health providers (MHPs) face, such as navigating complex, ever-increasing state and federal laws and policies affecting TNB youth; operating as specialists in service deserts; and balancing ethical obligations with client safety. We propose a therapy intervention model called Digital Literacy for Resistance (DLR) that integrates Cognitive Behavioral Therapy (CBT) tools with digital literacy strategies to empower rural TNB youth and their families.

Over the last 10–20 years, there has been a significant increase in the amount of research on nonsuicidal self-injury (NSSI). Yet it remains misunderstood, highly stigmatized, and one of the more puzzling behaviors that present in the context of health service. In this article, we aim to help clinicians to better understand and address NSSI in their clinical practice. In reference to a clinical vignette, we provide an overview of the current knowledge regarding NSSI, outline a new person-centered framework of NSSI recovery, touch on key ethical and clinical considerations regarding NSSI, and provide concrete tips for working with clients who self-injure within the person-centered framework. We also offer suggested language that can be used to support clients who self-injure, in a non-judgmental and supportive way.

Autism spectrum disorder (ASD) is associated with challenges in areas such as social skills and behavior, with 1 in 36 children diagnosed in the U.S. Annually, over 100,000 adolescents with ASD transition to adulthood, often facing a “service cliff” where support diminishes. Group therapy can help autistic adults by enhancing social skills, executive functioning, and emotional regulation while fostering belonging and reducing isolation. Telehealth-based group therapy offers additional benefits, particularly for those with social anxiety, geographic barriers, or limited transportation. While telehealth is effective for autistic adults, practical guidelines for virtual group therapy are lacking. This article provides recommendations for conducting telehealth group therapy, incorporating insights from clinicians and an autistic self-advocate.

Clinical hypnosis has applications in a wide range of psychological and health related problems. Research into clinical hypnosis has seen an improvement in scientific rigor and, in the past two decades, new research has expanded to include both randomized control trials and meta-analyses. However, the use of hypnosis in psychology, medicine, and psychotherapy lags behind its empirical support. As illustrated in the cases of Darlene (breast cancer survivor with hot flashes), Paul (smoking cessation), and Linda (irritable bowel syndrome) evidence supports clinical hypnosis for anxiety/stress, menopausal hot flashes, smoking cessation, and irritable bowel syndrome. Increasingly, hypnotherapy apps are integrated into care to provide low-cost access to self-hypnosis sessions. Clinical psychologists can expand their practice and competency with training in clinical hypnosis.

Alcohol use is common and associated with varying degrees of harm. Heavy alcohol use can lead to the development of an alcohol use disorder (AUD). The stigma and discrimination that people with AUD often face can act as barriers to seeking clinical services and may negatively impact the quality of care they receive. This article outlines best practices for working with people who use alcohol, emphasizing the importance of addressing stigma in caring for and communicating with clients. Written from a harm-reduction perspective, it highlights the significance of client-driven goal setting and autonomy, meeting clients where they are regarding their behavior change goals, and maintaining a non-judgmental, compassionate stance.

Over a decade has passed since the inclusion of internet gaming disorder (commonly known as video game addiction) in the DSM-5. The purpose of this article is to provide an up-to-date overview of internet gaming disorder. The article further reviews the challenges health service psychologists could face in identifying and evaluating internet gaming disorder, such as the ambiguity in defining “excessive gaming,” the clinical utility of DSM-5 diagnostic criteria, and the lack of an internationally standardized tool in measuring internet gaming disorder. The authors provide recommendations on these issues based on empirical research findings and interviews with clinicians working with patients diagnosed with internet gaming disorder.