A Clinician's Guide to Using Light Therapy

Light therapy is an effective, evidence-based, non-pharmacological treatment for seasonal affective disorder (SAD) and other depressive and circadian sleep conditions. This step-by-step guide helps busy mental health clinicians and other health professionals to better diagnose SAD and incorporate light therapy into their everyday clinical practice. The authors summarize the diagnostic process, describe a simplified method for light therapy and provide practical information on how to evaluate and obtain light devices. Invaluable clinician resources such as educational handouts, lists of frequently asked questions, instruction sheets, rating scales and suggestions for additional sources of information are also included. Case studies are used throughout to illustrate the processes and techniques in their clinical context.

Preface	p. ix
Light as therapy	p. xi
How to use this book	p. xii
Abbreviations used	p. xiii
Seasonal Affective Disorder: Diagnostic Issues	p. 1
Definition and diagnostic criteria	p. 3
Prevalence and burden	p. 11
Screening	p. 12
Clinical features	p. 13
Differential diagnosis	p. 18
Variants of SAD	p. 20
Further reading	p. 23
Light Treatment	p. 25
Incorporate light therapy into clinical practice	p. 27
Encourage self-care	p. 27
Who should not use light therapy?	p. 29
Use the simplified light treatment method	p. 29
Monitor clinical response	p. 31
Manage side effects	p. 33
Enhance adherence	p. 38
Customize treatment	p. 39
Review treatment parameters	p. 40
Trouble-shoot poor or limited response	p. 43
How long to continue light therapy	p. 47
When to restart light treatment in a subsequent season	p. 48
Using light therapy in the summer	p. 48
Further reading	p. 50
Light Devices	p. 51
What to look for in a light device	p. 53
Light boxes	p. 54
LED devices	p. 59
Light visors and caps	p. 60
Dawn simulators	p. 60
Unproven devices and false claims	p. 62
Practical aspects	p. 63
Further reading	p. 65
Other Treatments, Alone and Combined with Light	p. 67
Antidepressants	p. 69
How to choose between antidepressants and light therapy	p. 73
Combining antidepressants and light therapy	p. 75
Cognitive behavioural therapy	p. 75
Herbal and nutriceutical treatments	p. 76
Other treatments (negative ions, exercise)	p. 78
Further reading	p. 79
Effectiveness and Mechanism of Action	p. 81
How to measure effectiveness of treatments	p. 83
The placebo effect: myths and realities	p. 84
The evidence for light therapy in SAD	p. 86
How does light therapy work?	p. 89
Circadian rhythms: a primer	p. 90
Phase-shifting effects of light	p. 92
Photoperiod theory	p. 95
Phase-shift theory	p. 95
Neurotransmitter theory	p. 96
The dual vulnerability hypothesis	p. 98
Further reading	p. 98
Light Treatment for Other Condition	p. 101
Nonseasonal depression	p. 103
Bipolar disorder	p. 104
Other depressive and psychiatric conditions	p. 107
Circadian sleep-wake disorders	p. 109
Further reading	p. 111
Clinician Resources	p. 113
Internet and print resources	p. 115
Audit Form-chart review	p. 116
Frequently Asked Questions (FAQ) about SAD	p. 118
Instructions for Light Therapy handout	p. 123
Patient Self-Care handout	p. 125
MEQ	p. 127
SPAQ	p. 133
SIGH-SAD Summary	p. 136
PHQ-9	p. 140
QIDS-SR	p. 143
Adverse Events Scale	p. 146
Sample insurance reimbursement letter	p. 149
Index	p. 151
Table of Contents provided by Ingram. All Rights Reserved.

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A Clinician's Guide to Using Light Therapy

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