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Sample records for psychotherapy outcome literature

  1. A Review of Psychotherapy Outcome Research: Considerations for School-Based Mental Health Providers

    Science.gov (United States)

    Zirkelback, Emily A.; Reese, Robert J.

    2010-01-01

    Evaluating psychotherapeutic outcome is an important endeavor given psychology's focus on identifying effective treatments. There is ample evidence to suggest that psychotherapy interventions for children and adolescents are effective. Unfortunately, the child and adolescent psychotherapy outcome literature lags behind the adult-focused outcome…

  2. Psychotherapy Outcome Research: Issues and Questions.

    Science.gov (United States)

    Shean, Glenn

    2016-03-01

    Emphasis on identifying evidence-based therapies (EBTs) has increased markedly. Lists of EBTs are the rationale for recommendations for how psychotherapy provider training programs should be evaluated, professional competence assessed, and licensure and reimbursement policies structured. There are however methodological concerns that limit the external validity of EBTs. Among the most salient is the circularity inherent in randomized control trials (RCTs) of psychotherapy that constrains the manner in which the psychological problems are defined, psychotherapy can be practiced, and change evaluated. RCT studies favor therapies that focus of specific symptoms and can be described in a manual, administered reliably across patients, completed in relatively few sessions, and involve short-term evaluations of outcome. The epistemological assumptions of a natural science approach to psychotherapy research limit how studies are conducted and assessed in ways that that advantage symptom-focused approaches and disadvantage those approaches that seek to bring broad recovery-based changes. Research methods that are not limited to RCTs and include methodology to minimize the effects of "therapist allegiance" are necessary for valid evaluations of therapeutic approaches that seek to facilitate changes that are broader than symptom reduction. Recent proposals to adopt policies that dictate training, credentialing, and reimbursement based on lists of EBTs unduly limit how psychotherapy can be conceptualized and practiced, and are not in the best interests of the profession or of individuals seeking psychotherapy services.

  3. Effects of Psychotherapy Training and Intervention Use on Session Outcome

    Science.gov (United States)

    Boswell, James F.; Castonguay, Louis G.; Wasserman, Rachel H.

    2010-01-01

    Objective: This study was an investigation of the relationships among therapist training variables, psychotherapy process, and session outcome in a psychotherapy training clinic. The aims were to assess the relationship between "training as usual" and intervention use in individual psychotherapy, to investigate the relationship between therapist…

  4. The outcome problem in psychotherapy: a reply.

    Science.gov (United States)

    Eysenck, H J

    2013-03-01

    This reprinted article originally appeared in Psychotherapy: Theory, Research, & Practice, 1964(MONTH), 1(3), 97-100. (The following abstract of the original article appeared in record 1966-01631-001). Comments on the original article by H. H. Strupp (see record 1965-15636-001). In his recent article in this journal, Strupp (1963) has this to say in relation to the outcome problem in psychotherapy: "A brief review of Eysenck's (1952) widely quoted survey, which capitalized upon and added considerably to the existing confusion may be instructive." In reply I would like to suggest that Strupp's review is, in the lawyer's phrase, irrelevant, incompetent and immaterial. Fortunately, the points I wish to make are so simple that they will not take up much space.

  5. Outcomes in GroupPsychotherapy: Using Persuasion Theory to Increase Treatment Efficiency

    Science.gov (United States)

    Beutler, Larry E.; And Others

    1974-01-01

    Some research suggests that improvement in psychotherapy is related to the degree that a patient adopts his therapist's evaluative attitudes. This article was designed to pursue the possibility of predicting the outcomes of group psychotherapy using attitude theory. (Author)

  6. Prediction of outcome of brief psychotherapy from therapist interpretive interventions.

    Science.gov (United States)

    Marziali, E A

    1984-03-01

    This study replicated Malan's 1976 analysis of psychodynamic interpretations and corrected the major methodological fault in his work: the use of therapist notes for rating the interpretive elements. In this study, the sessions of 25 patients treated in brief dynamic psychotherapy were audiotaped and the ratings of the interpretive interventions were made directly from the audiotapes. Malan's findings were supported. There was a positive association between more favorable outcome, measured on five psychodynamic scales, and the frequency with which therapist interpretations referred to emotions experienced in the transference relationship that were similar to those experienced in relationships with parents and other important persons. The results of this replication indicate that these therapist-offered explanations about the meanings of significant current and past interpersonal relationships contribute to the outcome of brief psychotherapy.

  7. Advanced Psychotherapy Training: Psychotherapy Scholars' Track, and the Apprenticeship Model

    Science.gov (United States)

    Feinstein, Robert E.; Yager, Joel

    2013-01-01

    Background/Objective: Guided by ACGME's requirements, psychiatric residency training in psychotherapy currently focuses on teaching school-specific forms of psychotherapy (i.e., cognitive-behavioral, supportive, and psychodynamic psychotherapy). On the basis of a literature review of common factors affecting psychotherapy outcomes and…

  8. [Defense mechanisms as outcome measure in short-term psychotherapy related to symptoms, severity and overall functioning: a preliminary study].

    Science.gov (United States)

    Coccanari de' Fornari, Maria Antonietta; Piccione, Michele; Maiello, Luca; Giampà, Alessio

    2011-01-01

    The assessment of defense mechanisms in psychotherapy is currently one of the most used ways to evaluate the effectiveness of psychotherapy. In literature there are few reports on defense mechanisms changes by short-term treatments. To determine whether the defense mechanisms are changed after twelve sessions of short-term psychotherapy related to psychopathological symptoms, severity and overall functioning. Twenty patients (12 F and 8 M; age 38.4) affected by anxiety and mood disorders were recruited to the study between November 2008 and July 2009 and were assessed with the Defense Style Questionnaire-88 (DSQ-88), scale Symptom Checklist-90-Revised (SCL-90-R), scale Clinical Global Impression (CGI) and scale Valutazione Globale del Funzionamento (VGF) at the beginning and after short-term psychotherapy. Half the sample also assumed drugs. The treatment was supportive-expressive psychotherapy of Luborsky, a short focal dynamic therapy, characterized by the integration of supportive and expressive techniques. Both patients showed a significant decrease in immature defenses and a significant-increase in mature defenses (p < 0.01). Mature defenses were significantly correlated with severity (r = -0632; p = 0.003) and overall functioning (r = 0529; p = 0.01). Immature and mature defenses seem to be a useful outcome measure in short-term psychotherapy as well as severity and overall functioning and the combined treatment may be most effective in reducing immature defenses.

  9. Outcome in psychotherapy: the past and important advances.

    Science.gov (United States)

    Lambert, Michael J

    2013-03-01

    Fifty years after the 1963 debate between Strupp and Eysenck, as recorded in their articles in Psychotherapy, it is clear that Eysenck overstated the case against psychoanalysis and dynamic psychotherapy (Bergin, 1971), while inflating the magnitude of improvement in untreated individuals (Lambert, 1976). Eysenck was probably correct about the beneficial effects of behavior therapies, but did not foresee that behavior therapy would be supplanted by cognitive behavior therapies (CBT) and eclectic mixtures of CBT that incorporate elements of eastern religion, humanistic interventions, and psychodynamic constructs. Fortunately, most of the treatments that have been tested in rigorous investigations have been found to be effective, but few have distinguished themselves as uniquely superior. Many of the problems of how to measure the effects of treatment have been solved and suggest that about two thirds of treated individuals improve or recover. This leaves a sizable portion of nonresponding individuals, but emerging methods involving in tracking treatment response are being used to decrease deterioration and enhance positive outcomes.

  10. Nonverbal Synchrony in Psychotherapy: Coordinated Body Movement Reflects Relationship Quality and Outcome

    Science.gov (United States)

    Ramseyer, Fabian; Tschacher, Wolfgang

    2011-01-01

    Objective: The authors quantified nonverbal synchrony--the coordination of patient's and therapist's movement--in a random sample of same-sex psychotherapy dyads. The authors contrasted nonverbal synchrony in these dyads with a control condition and assessed its association with session-level and overall psychotherapy outcome. Method: Using an…

  11. Post-traumatic stress disorder in older adults: a systematic review of the psychotherapy treatment literature.

    Science.gov (United States)

    Dinnen, Stephanie; Simiola, Vanessa; Cook, Joan M

    2015-01-01

    Older adults represent the fastest growing segment of the US and industrialized populations. However, older adults have generally not been included in randomized clinical trials of psychotherapy for post-traumatic stress disorder (PTSD). This review examined reports of psychological treatment for trauma-related problems, primarily PTSD, in studies with samples of at least 50% adults aged 55 and older using standardized measures. A systematic review of the literature was conducted on psychotherapy for PTSD with older adults using PubMed, Medline, PsychInfo, CINAHL, PILOTS, and Google Scholar. A total of 42 studies were retrieved for full review; 22 were excluded because they did not provide at least one outcome measure or results were not reported by age in the case of mixed-age samples. Of the 20 studies that met review criteria, there were: 13 case studies or series, three uncontrolled pilot studies, two randomized clinical trials, one non-randomized concurrent control study and one post hoc effectiveness study. Significant methodological limitations in the current older adult PTSD treatment outcome literature were found reducing its internal validity and generalizability, including non-randomized research designs, lack of comparison conditions and small sample sizes. Select evidence-based interventions validated in younger and middle-aged populations appear acceptable and efficacious with older adults. There are few treatment studies on subsets of the older adult population including cultural and ethnic minorities, women, the oldest old (over 85), and those who are cognitively impaired. Implications for clinical practice and future research directions are discussed.

  12. Does psychotherapy work with school-aged youth? A meta-analytic examination of moderator variables that influence therapeutic outcomes.

    Science.gov (United States)

    Fedewa, Alicia L; Ahn, Soyeon; Reese, Robert J; Suarez, Marietta M; Macquoid, Ahjane; Davis, Matthew C; Prout, H Thompson

    2016-06-01

    The present study is a quantitative synthesis of the available literature to investigate the efficacy of psychotherapy for children's mental health outcomes. In particular, this study focuses on potential moderating variables-study design, treatment, client, and therapist characteristics-that may influence therapeutic outcomes for youth but have not been thoroughly accounted for in prior meta-analytic studies. An electronic search of relevant databases resulted in 190 unpublished and published studies that met criteria for inclusion in the analysis. Effect sizes differed by study design. Pre-post-test designs resulted in absolute magnitudes of treatment effects ranging from |-0.02| to |-0.76| while treatment versus control group comparison designs resulted in absolute magnitudes of treatment effects ranging from |-0.14| to |-2.39|. Changes in youth outcomes larger than 20% were found, irrespective of study design, for outcomes focused on psychosomatization (29% reduction), school attendance (25% increase), and stress (48% reduction). The magnitude of changes after psychotherapy ranged from 6% (externalizing problems) to 48% (stress). Several moderator variables significantly influenced psychotherapy treatment effect sizes, including frequency and length of treatment as well as treatment format. However, results did not support the superiority of a single type of intervention for most outcomes. Implications for therapy with school-aged youth and future research are discussed.

  13. Nomothetic outcome assessment in counseling and psychotherapy: Development and preliminary psychometric analyses of the Depression/Anxiety Negative Affect Scale

    Directory of Open Access Journals (Sweden)

    Scott T. Meier

    2012-12-01

    Full Text Available Negative affect (NA plays a significant role in the initiation, persistence, and response to psychotherapy of many client problems (Moses & Barlow, 2006. This report describes the development of a brief NA measure, the Depression/Anxiety Negative Affect (DANA scale, and preliminary analyses of its psychometric properties. An initial pool of DANA items was selected on the basis of a review of relevant literature about emotion science and counseling outcomes, related tests, and feedback from psychotherapists as part of a pilot test. The DANA was evaluated in two representative clinical samples where psychotherapists produced a total of 363 session ratings with 81 clients. DANA scores evidenced adequate internal consistency, evidence of convergent and discriminant validity, and sensitivity to change over the course of psychotherapy. Effect sizes (ES of DANA scores consistently equaled or exceeded the average ES of .68 found for scales assessing the outcomes of counseling and psychotherapy in meta-analytic studies (Smith & Glass, 1977. ESs greater than 1 were found on DANA variables for clients whose therapists rated them as experiencing, rather than avoiding, NA.

  14. The Adjective Check List as an outcome measure: assessment of personality change in psychotherapy.

    Science.gov (United States)

    Itzhar-Nabarro, Zohar; Silberschatz, George; Curtis, John T

    2009-11-01

    To investigate the value of the Adjective Check List (ACL) as a psychotherapy outcome measure, the ACL and Symptom Checklist-90-Revised (SCL-90-R) were administered at four times (before therapy, immediately after therapy, and at 6-month and 1-year follow-ups) to 38 patients in brief dynamic psychotherapy. High correlations between selected ACL scales and SCL-90-R Global Severity Index scores (GSI) were found. GSI change from before to after therapy correlated with change on the ACL scales. Changes from before to after therapy were detected for ACL scales at both the mean group and the individual levels. Because the ACL provides valuable information on personality dimensions as well as concurrent levels of distress, it is a particularly promising psychotherapy outcome measure.

  15. Predicting optimal outcomes in cognitive therapy or interpersonal psychotherapy for depressed individuals using the personalized advantage index approach

    NARCIS (Netherlands)

    M.J.H. Huibers; Z.D. Cohen; L.H.J.M. Lemmens; A. Arntz; F.P.M.L. Peeters; P. Cuijpers; R.J. DeRubeis

    2015-01-01

    Introduction: Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works b

  16. Self-Disclosure and Outcome in Short-Term Group Psychotherapy.

    Science.gov (United States)

    Coche, Erich; Polikoff, Barbara

    1979-01-01

    Explores whether self-disclosure in group psychotherapy produces better group outcome. Although the expected positive relationship between the two variables was found, results also indicate a need for caution in postulating a link between self-disclosure and improvement. (BP)

  17. Interpersonal Psychotherapy-Adolescent Skills Training: Anxiety Outcomes and Impact of Comorbidity

    Science.gov (United States)

    Young, Jami F.; Makover, Heather B.; Cohen, Joseph R.; Mufson, Laura; Gallop, Robert J.; Benas, Jessica S.

    2012-01-01

    Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a…

  18. Impact of Cluster C Personality Disorders on Outcomes of Contrasting Brief Psychotherapies for Depression.

    Science.gov (United States)

    Hardy, Gillian E.; And Others

    1995-01-01

    Study compares 27 depressed clients diagnosed with Cluster C personality disorder (PD) with 87 depressed clients without the diagnosis. All clients completed cognitive-behavioral or psychodynamic-interpersonal psychotherapy. Treatment length did not influence outcome for PD clients. PD clients whose depression was also relatively severe showed…

  19. Do Patient Characteristics Predict Outcome of Psychodynamic Psychotherapy for Social Anxiety Disorder?

    Directory of Open Access Journals (Sweden)

    Jörg Wiltink

    Full Text Available Little is known about patient characteristics as predictors for outcome in manualized short term psychodynamic psychotherapy (PDT. No study has addressed which patient variables predict outcome of PDT for social anxiety disorder.In the largest multicenter trial on psychotherapy of social anxiety (SA to date comparing cognitive therapy, PDT and wait list condition N = 230 patients were assigned to receive PDT, of which N = 166 completed treatment. Treatment outcome was assessed based on diverse parameters such as endstate functioning, remission, response, and drop-out. The relationship between patient characteristics (demographic variables, mental co-morbidity, personality, interpersonal problems and outcome was analysed using logistic and linear regressions.Pre-treatment SA predicted up to 39 percent of variance of outcome. Only few additional baseline characteristics predicted better treatment outcome (namely, lower comorbidity and interpersonal problems with a limited proportion of incremental variance (5.5 to 10 percent, while, e.g., shame, self-esteem or harm avoidance did not.We argue that the central importance of pre-treatment symptom severity for predicting outcomes should advocate alternative treatment strategies (e.g. longer treatments, combination of psychotherapy and medication in those who are most disturbed. Given the relatively small amount of variance explained by the other patient characteristics, process variables and patient-therapist interaction should additionally be taken into account in future research.Controlled-trials.com/ISRCTN53517394.

  20. Supportive psychodynamic psychotherapy versus treatment as usual for first-episode psychosis: two-year outcome.

    Science.gov (United States)

    Rosenbaum, Bent; Harder, Susanne; Knudsen, Per; Køster, Anne; Lindhardt, Anne; Lajer, Matilde; Valbak, Kristian; Winther, Gerda

    2012-01-01

    During recent decades, the field of treatment of schizophrenia has lacked empirical, systematic outcome studies that support psychodynamic psychotherapy as an evidence-based intervention for patients with schizophrenia. The Danish schizophrenia project (DNS) compared psychodynamic psychotherapy for psychosis with standard treatment in patients with a first-episode schizophrenia spectrum disorder. The study was designed as a prospective, comparative, longitudinal multi-site investigation of consecutively referred patients who were included during two years. The patients were treated with either manualized individual supportive psychodynamic psychotherapy (SPP) in addition to treatment as usual or with treatment as usual alone (TaU). Symptoms and functional outcomes were measured using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning scale (GAF). The study included 269 consecutively admitted patients, age 18-35, of whom 79% remained in the study after two years. The intervention group improved significantly on measures of both PANSS and GAF scores, with large effect sizes at two years follow-up after inclusion. Further, improvement on GAF(function) (p = 0.000) and GAF(symptom) (p = 0.010) significantly favored SPP in combination with TaU over TaU alone. In spite of limitations, this study speaks in favor of including supportive psychodynamic psychotherapy in the treatment for patients with schizophrenic first-episode psychoses.

  1. Emotional Processing, Interaction Process, and Outcome in Clarification-Oriented Psychotherapy for Personality Disorders: A Process-Outcome Analysis.

    Science.gov (United States)

    Kramer, Ueli; Pascual-Leone, Antonio; Rohde, Kristina B; Sachse, Rainer

    2016-06-01

    It is important to understand the change processes involved in psychotherapies for patients with personality disorders (PDs). One patient process that promises to be useful in relation to the outcome of psychotherapy is emotional processing. In the present process-outcome analysis, we examine this question by using a sequential model of emotional processing and by additionally taking into account a therapist's appropriate responsiveness to a patient's presentation in clarification-oriented psychotherapy (COP), a humanistic-experiential form of therapy. The present study involved 39 patients with a range of PDs undergoing COP. Session 25 was assessed as part of the working phase of each therapy by external raters in terms of emotional processing using the Classification of Affective-Meaning States (CAMS) and in terms of the overall quality of therapist-patient interaction using the Process-Content-Relationship Scale (BIBS). Treatment outcome was assessed pre- and post-therapy using the Global Severity Index (GSI) of the SCL-90-R and the BDI. Results indicate that the good outcome cases showed more self-compassion, more rejecting anger, and a higher quality of therapist-patient interaction compared to poorer outcome cases. For good outcome cases, emotional processing predicted 18% of symptom change at the end of treatment, which was not found for poor outcome cases. These results are discussed within the framework of an integrative understanding of emotional processing as an underlying mechanism of change in COP, and perhaps in other effective therapy approaches for PDs.

  2. The role of self-image as a predictor of psychotherapy outcome.

    Science.gov (United States)

    Ryum, Truls; Vogel, Patrick A; Walderhaug, Eirik P; Stiles, Tore C

    2015-02-01

    The present study examined the relationship between self-image and outcome in psychotherapy. Patients (n = 170) received treatment-as-usual at a university clinic, and met diagnostic criteria for mostly anxiety and depression related disorders. Self-image was measured with the Structural Analysis of Social Behavior (SASB-I) introject pre and post-treatment. Using multiple regression analyses, higher levels of Self-ignore and Self-blame pre-treatment predicted a poorer treatment outcome in terms of symptoms (SCL-90-R) and interpersonal problems (IIP-64), respectively. Increase in Self-love and decrease in Self-blame (pre to post) predicted reduced symptoms at post-treatment, whereas decrease in Self-attack and Self-control, as well as increase in Self-affirm, predicted reduced interpersonal problems. The results suggest that self-image improvement may be important in order to achieve a good outcome in psychotherapy.

  3. Relationships among alexithymia, therapeutic alliance, and psychotherapy outcome in major depressive disorder.

    Science.gov (United States)

    Quilty, Lena C; Taylor, Graeme J; McBride, Carolina; Bagby, R Michael

    2017-08-01

    Previous studies have found that alexithymia predicts process and outcome of psychodynamic psychotherapy across a range of psychiatric disorders. There is preliminary evidence that alexithymia may exert its effects on outcome through the therapist. Other studies have found that alexithymia does not influence outcome of cognitive-behavioral therapy (CBT). The aim of the current study was to investigate the capacity of alexithymia to predict therapist- and patient-rated therapeutic alliance and response to CBT and interpersonal psychotherapy (IPT) for major depressive disorder. A total of 75 adults with major depressive disorder were randomized to receive weekly sessions of manualized individual CBT or IPT for a period of 16 weeks. Pre-treatment alexithymia exhibited a positive direct effect on depression change, and a negative indirect effect on depression change via patient-rated alliance at week 13. There was no mediating role of therapist-rated alliance. Although these findings are preliminary, they suggest that pre-treatment alexithymia has meaningful links to psychotherapy process and outcome, and that nuanced analyses incorporating intervening variables are necessary to elucidate the nature of these links. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  4. Dispositional optimism as predictor of outcome in short- and long-term psychotherapy.

    Science.gov (United States)

    Heinonen, Erkki; Heiskanen, Tiia; Lindfors, Olavi; Härkäpää, Kristiina; Knekt, Paul

    2017-09-01

    Dispositional optimism predicts various beneficial outcomes in somatic health and treatment, but has been little studied in psychotherapy. This study investigated whether an optimistic disposition differentially predicts patients' ability to benefit from short-term versus long-term psychotherapy. A total of 326 adult outpatients with mood and/or anxiety disorder were randomized into short-term (solution-focused or short-term psychodynamic) or long-term psychodynamic therapy and followed up for 3 years. Dispositional optimism was assessed by patients at baseline with the self-rated Life Orientation Test (LOT) questionnaire. Outcome was assessed at baseline and seven times during the follow-up, in terms of depressive (BDI, HDRS), anxiety (SCL-90-ANX, HARS), and general psychiatric symptoms (SCL-90-GSI), all seven follow-up points including patients' self-reports and three including interview-based measures. Lower dispositional optimism predicted faster symptom reduction in short-term than in long-term psychotherapy. Higher optimism predicted equally rapid and eventually greater benefits in long-term, as compared to short-term, psychotherapy. Weaker optimism appeared to predict sustenance of problems early in long-term therapy. Stronger optimism seems to best facilitate engaging in and benefiting from a long-term therapy process. Closer research might clarify the psychological processes responsible for these effects and help fine-tune both briefer and longer interventions to optimize treatment effectiveness for particular patients and their psychological qualities. Weaker dispositional optimism does not appear to inhibit brief therapy from effecting symptomatic recovery. Patients with weaker optimism do not seem to gain added benefits from long-term therapy, but instead may be susceptible to prolonged psychiatric symptoms in the early stages of long-term therapy. © 2016 The British Psychological Society.

  5. Therapeutic alliance and cohesion variables as predictors of outcome in short-term group psychotherapy.

    Science.gov (United States)

    Joyce, Anthony S; Piper, William E; Ogrodniczuk, John S

    2007-07-01

    The current study explored the relative ability of aggregate therapeutic alliance and cohesion variables to predict short-term group therapy outcome. Data were collected from a comparative trial of two forms of time-limited group psychotherapy for complicated grief (Piper, McCallum, Joyce, Rosie, & Ogrodniczuk, 2001). The therapeutic alliance and elements of the cohesion construct were measured from the perspectives of each patient and the group therapist at intervals during the groups; scores were aggregated across assessments. Hierarchical multiple regression analyses, adjusting for the effects of treatment approach (interpretive vs. supportive) and specific group membership, demonstrated that the patient-rated alliance was a consistent predictor of outcome. Two cohesion measures, reflecting other participants' (therapist, other members) views of the patient's "fit" with the group, also accounted for variation in outcome. Implications of the findings for research and clinical practice, and the limitations of the measurement approach taken in this study, are considered.

  6. The association between retrospective outcome evaluations and pre-post-treatment changes in psychodynamic group-psychotherapy

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2008-01-01

    In the present study of 203 patients in psychodynamic group psychotherapy, we explore associations between patient and therapist global retrospective outcome evaluations (ROE), and pre-post-treatment changes on the Symptom Check List 90 Revised (SCL-90-R) and non-symptomatic focus of therapy. The...

  7. Attachment as Moderator of Treatment Outcome in Major Depression: A Randomized Control Trial of Interpersonal Psychotherapy versus Cognitive Behavior Therapy

    Science.gov (United States)

    McBride, Carolina; Atkinson, Leslie; Quilty, Lena C.; Bagby, R. Michael

    2006-01-01

    Anxiety and avoidance dimensions of adult attachment insecurity were tested as moderators of treatment outcome for interpersonal psychotherapy (IPT) and cognitive-behavioral therapy (CBT). Fifty-six participants with major depression were randomly assigned to these treatment conditions. Beck Depression Inventory-II, Six-Item Hamilton Rating Scale…

  8. A meta-analysis of multicultural competencies and psychotherapy process and outcome.

    Science.gov (United States)

    Tao, Karen W; Owen, Jesse; Pace, Brian T; Imel, Zac E

    2015-07-01

    For decades, psychologists have emphasized the provision of multiculturally competent psychotherapy to reduce racial and ethnic disparities in mental health treatment. However, the relationship between multicultural competencies (MC) and other measures of clinical process and treatment outcome has shown heterogeneity in effect sizes. This meta-analysis tested the association of client ratings of therapist MC with measures of therapeutic processes and outcome, including: (a) working alliance, (b) client satisfaction, (c) general counseling competence, (d) session impact, and (e) symptom improvement. Among 18 studies (20 independent samples) included in the analysis, the correlation between therapist MC and outcome (r = .29) was much smaller than the association with process measures (r = .75), but there were no significant differences in correlations across different types of MC or clinical process measures. Providing some evidence of publication bias, effect sizes from published studies (r = .67) were larger than those from unpublished dissertations (r = .28). Moderator analyses indicated that client age, gender, the representation of racial-ethnic minority (R-EM) clients, and clinical setting were not associated with effect size variability. Based on these findings, we discuss implications and recommendations for future research that might lead to a better understanding of the effects of therapist MC on treatment process and outcome. Primary needs in future research include the development and evaluation of observer ratings of therapist MC and the implementation of longitudinal research designs.

  9. Nonverbal synchrony of head- and body-movement in psychotherapy: different signals have different associations with outcome

    Directory of Open Access Journals (Sweden)

    Fabian eRamseyer

    2014-09-01

    Full Text Available Objective: The coordination of patient’s and therapist’s bodily movement – nonverbal synchrony – has been empirically shown to be associated with psychotherapy outcome. This finding was based on dynamic movement patterns of the whole body. The present paper is a new analysis of an existing dataset (Ramseyer & Tschacher, 2011, which extends previous findings by differentiating movements pertaining to head and upper-body regions. Method: In a sample of 70 patients (37 female, 33 male treated at an outpatient psychotherapy clinic, we quantified nonverbal synchrony with an automated objective video-analysis algorithm (Motion Energy Analysis, MEA. Head- and body-synchrony was quantified during the initial 15 minutes of video-recorded therapy sessions. Micro-outcome was assessed with self-report post-session questionnaires provided by patients and their therapists. Macro-outcome was measured with questionnaires that quantified attainment of treatment goals and changes in experiencing and behavior at the end of therapy. Results: The differentiation of head- and body-synchrony showed that these two facets of motor coordination were differentially associated with outcome. Head-synchrony predicted global outcome of therapy, while body-synchrony did not, and body-synchrony predicted session outcome, while head-synchrony did not. Conclusions: The results pose an important amendment to previous findings, which showed that nonverbal synchrony embodied both outcome and interpersonal variables of psychotherapy dyads. The separation of head- and body-synchrony suggested that distinct mechanisms may operate in these two regions: Head-synchrony embodied phenomena with a long temporal extension (overall therapy success, while body-synchrony embodied phenomena of a more immediate nature (session-level success. More explorations with fine-grained analyses of synchronized phenomena in nonverbal behavior may shed additional light on the embodiment of

  10. Intensive short-term dynamic psychotherapy for severe music performance anxiety: assessment, process, and outcome of psychotherapy with a professional orchestral musician.

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    Kenny, Dianna T; Arthey, Stephen; Abbass, Allan

    2014-03-01

    This paper reports on the process and outcome of therapy using intensive short-term dynamic psychotherapy (ISTDP) with a professional musician who had suffered severe music performance anxiety over the course of his entire 30-year career. In this paper, we describe the nature of the therapy, the case history of the musician, the first assessment and trial therapy session, and the course and successful outcome of therapy. The patient underwent 10 sessions of ISTDP over a period of 4 months. This paper reports on the first 6 sessions, which were most relevant to the understanding and treatment of the patient's severe music performance anxiety. This case study is the first reported application of ISTDP to a professional musician. We believe that this case study provides initial support that moderate to severe performance anxiety, in at least some cases, has its origins in unresolved complex emotions and defences arising from ruptures to early attachment relationships.

  11. Movement Coordination in Psychotherapy: Synchrony of Hand Movements is Associated with Session Outcome. A Single-Case Study.

    Science.gov (United States)

    Ramseyer, Fabian; Tschacher, Wolfgang

    2016-04-01

    Previous work has shown that nonverbal behavior was associated with both session-level outcome and global outcome in psychotherapy. Nonverbal synchrony--here the coordination between patient's and psychotherapist's movement behavior--is a facet of nonverbal behavior that has recently been studied with video-based motion energy analysis (MEA). The present study aimed to replicate and extend these findings by using direct acquisition of movement data. In a single-case analysis, we monitored patient's and therapist's hand movements with a high-resolution accelerometric measurement system (Vitaport (r)). In addition to these behavioral data, both patient and therapist provided session-level ratings of various factors relevant to the psychotherapy process, which were assessed with post-session questionnaires. The patient-therapist coordination of hand movements, i.e. nonverbal synchrony, in (N = 27) sessions of this dyadic psychotherapy was positively associated with progress reported in post-session questionnaires. Sessions with good evaluations concerning the quality of therapeutic alliance were characterized by high movement coordination. Thus, accelerometric data of this therapy dyad confirmed previous findings gained through video analyses: The coordination of nonverbal behavior shown by patient and therapist was an indicator of beneficial processes occurring within sessions. This replication study showed that nonverbal synchrony embodies important aspects of the alliance. Its assessment and quantification may provide therapists important additional information on processes that usually occur outside conscious awareness, but that nevertheless influence core aspects of the therapy.

  12. Psychotherapy for Delinquents?

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    Richards, Ian; Sullivan, Ann

    1996-01-01

    Presents the results of a psychotherapy consultation service for delinquents (n=47). Based on data obtained from this program and a review of relevant literature, a working model of individual psychotherapy related to attachment theory as it applies to this population is presented. Discusses difficulties that warrant resolution. (JPS)

  13. Determining the pertinence of psychotherapy outcome research findings for clinical practice: comment on Westen and Morrison (2001).

    Science.gov (United States)

    Derubeis, R J; Stirman, S W

    2001-12-01

    D. Westen and K. Morrison's (2001) article is a challenge to advocates of empirically supported therapies (ESTs) and to the research enterprise that has determined which therapies are given the EST designation. Their concern that the long-term effects of ESTs are understudied and, apparently, weak is valid. However, their pessimistic conclusions about the generalizability of the results from outcome studies of ESTs are based on a serious logical error. The authors of the present article described an alternative research method that can address important and appropriate questions about the generalizability of ESTs. Continued dialogue between proponents and opponents of contemporary trends in psychotherapy outcome research is encouraged.

  14. Davanloo’s Intensive Short-Term Dynamic Psychotherapy in a tertiary psychotherapy service: overall effectiveness and association between unlocking the unconscious and outcome

    Directory of Open Access Journals (Sweden)

    Robert Johansson

    2014-08-01

    Full Text Available Background. Intensive Short-Term Dynamic Psychotherapy (ISTDP, as developed by Habib Davanloo, is an intensive emotion-focused psychodynamic therapy with an explicit focus on handling resistance in treatment. A core assumption in ISTDP is that psychotherapeutic effects are dependent on in-session emotional processing in the form of rise in complex transference feelings that occurs when treatment resistance is challenged. Recent research indicates that an unlocking of the unconscious, a powerful emotional breakthrough achieved at a high rise in complex transference feelings, can potentially enhance ISTDP’s effectiveness. While ISTDP has a growing evidence base, most of the research conducted has used small samples and has tested therapy delivered by expert therapists. The aims of this study were to evaluate the overall effectiveness of ISTDP when delivered in a tertiary psychotherapy service, and to investigate if having an unlocking of the unconscious during therapy predicted enhanced treatment effectiveness. Methods. A total of 412 patients were included in the analyses. The average length of treatment was 10.2 sessions (SD 13.3. Multilevel growth curve modeling was used to evaluate treatment effectiveness and the association between unlocking the unconscious and outcome. A number of control predictors including type of treatment resistance were selected and included in the analyses. Outcome measures were the Brief Symptom Inventory (BSI and the Inventory of Interpersonal Problems (IIP. About half of the patients in the study were treated by therapists in training and the other half by more experienced therapists. Results. Growth curve analyses using the full intention-to-treat sample revealed significant within-group effects of ISTDP on both the BSI and the IIP. Effect sizes were large (>0.80. Unlocking the unconscious during therapy was associated with significantly larger treatment outcome. The relationship was further moderated by type of

  15. Social support as a predictor of the outcome of depressive and anxiety disorder in short-term and long-term psychotherapy.

    Science.gov (United States)

    Lindfors, Olavi; Ojanen, Sakari; Jääskeläinen, Tuija; Knekt, Paul

    2014-04-30

    Social support is known to be important for well-being of individuals, but it is not clear how it predicts psychotherapy outcome in patients suffering from depressive or anxiety disorders. The aim of the present study was to study the prediction of social support on the outcome of short-term and long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term psychotherapy (short-term psychodynamic or solution-focused) or long-term psychodynamic psychotherapy. The level of social support at baseline was assessed using the Brief Inventory of Social Support and Integration (BISSI). Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and four times during a 3-year follow-up. Patients with a high level of social support before treatment benefitted more from long-term than short-term therapy at the 3-year follow-up, whereas patients with a low level of social support experienced no such benefit. Pretreatment social support seems to predict differentially short- and long-term psychotherapy and thus needs to be acknowledged when evaluating patient's resources and treatment options. More research is needed to verify these findings.

  16. Intelligence as a predictor of outcome in short- and long-term psychotherapy.

    Science.gov (United States)

    Knekt, Paul; Saari, Taru; Lindfors, Olavi

    2014-12-30

    Intelligence has been suggested as a suitability factor for short-term therapy whereas its possible effect on short-term versus long-term therapy still is unknown. The aim of this study was to compare the prediction of intelligence on the level of psychiatric symptoms and psychosocial functioning in psychotherapies of different lengths. A total of 251 outpatients from the Helsinki Psychotherapy Study, aged 20–46 years, and suffering from mood or anxiety disorders were allocated to two long-term and two short-term therapies. Intelligence was assessed at baseline with the Wechsler Adult Intelligence Scale (WAIS-R). Psychiatric symptoms and psychosocial functioning were assessed 5–10 times during a 5-year follow-up using two primary symptom measures (HDRS and HARS) and one primary measure of psychosocial functioning (GAF). Short-term therapy was more effective than long-term therapy during the first year of follow-up. During the second to fourth follow-up year no differences between short- and long-term therapies or the intelligence groups were found. At the fifth follow-up year, however, long-term psychotherapy showed a statistically significantly larger change in all three primary measures compared to short-term therapy among those with higher intelligence. No differences between therapy groups were noted in those with lower intelligence. People with higher intelligence may benefit more from long-term than from short-term psychotherapy. These findings should be confirmed.

  17. Subclinical psychotic experiences and bipolar spectrum features in depression : association with outcome of psychotherapy

    NARCIS (Netherlands)

    Wigman, J. T. W.; van Os, J.; Abidi, L.; Huibers, M. J. H.; Roelofs, J.; Arntz, A.; Kelleher, I.; Peeters, F. P. M. L.

    2014-01-01

    Background Subthreshold psychotic and bipolar experiences are common in major depressive disorder (MDD). However, it is unknown if effectiveness of psychotherapy is altered in depressed patients who display such features compared with those without. The current paper aimed to investigate the impact

  18. Pretreatment and Process Predictors of Outcome in Interpersonal and Cognitive Behavioral Psychotherapy for Binge Eating Disorder

    Science.gov (United States)

    Hilbert, Anja; Saelens, Brian E.; Stein, Richard I.; Mockus, Danyte S.; Welch, R. Robinson; Matt, Georg E.; Wilfley, Denise E.

    2007-01-01

    The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined…

  19. Psychotherapy for Depression in Adults: A Meta-Analysis of Comparative Outcome Studies

    Science.gov (United States)

    Cuijpers, Pim; van Straten, Annemieke; Andersson, Gerhard; van Oppen, Patricia

    2008-01-01

    Although the subject has been debated and examined for more than 3 decades, it is still not clear whether all psychotherapies are equally efficacious. The authors conducted 7 meta-analyses (with a total of 53 studies) in which 7 major types of psychological treatment for mild to moderate adult depression (cognitive-behavior therapy, nondirective…

  20. Enhancing Treatment Outcome of Patients at Risk of Treatment Failure: Meta-Analytic and Mega-Analytic Review of a Psychotherapy Quality Assurance System

    Science.gov (United States)

    Shimokawa, Kenichi; Lambert, Michael J.; Smart, David W.

    2010-01-01

    Objective: Outcome research has documented worsening among a minority of the patient population (5% to 10%). In this study, we conducted a meta-analytic and mega-analytic review of a psychotherapy quality assurance system intended to enhance outcomes in patients at risk of treatment failure. Method: Original data from six major studies conducted…

  1. The effects of training in time-limited dynamic psychotherapy: changes in therapeutic outcome.

    Science.gov (United States)

    Bein, E; Anderson, T; Strupp, H; Henry, W; Schacht, T; Binder, J; Butler, S

    2000-02-01

    The present study explored the effects on therapeutic outcomes of training therapists in brief manualized therapy. As part of the Vanderbilt II project, each of 16 therapists (8 psychiatrists and 8 clinical psychologists) treated 2 moderately disturbed adult patients using his or her customary short-term treatment methods; they then received a year of training in a manualized form of brief dynamic therapy, Time-Limited Dynamic Psychotherapy (TLDP); finally, they administered TLDP to 2 additional patients. It was hypothesized that training would result in improved outcomes generally and that differentially greater improvement would be seen in patients commonly considered less suitable for brief dynamic therapy. Outcome data obtained at termination failed to support either hypothesis. Measurements of interpersonal dependency obtained at a one-year follow-up were consistent with the first hypothesis, but the follow-up data were inconsistent with the second. A systematic review of the 32 posttraining cases suggested that the majority of the therapists had not achieved basic competence at TLDP. Die hier beschriebene Studie untersucht die Wirkungen eines Trainings in manualisierter Kurzzeitherapie auf das Therapierergebnis. Als Teil des Vanderbilt II Projektes behandelten jeweils 16 Therapeuten (8 Psychiater und 8 klinische Psychologen) zwei mittelgradig beeinrächtigte erwachsene Patienten mit den ihnen vertrauten Kurzzeitbehandlungsmethoden. Danach wurden sie über ein Jahr in einer manualisierten Form psychodynamischer Kurzzeittherapie ausgebildet und wandten diese Therapie auf zwei weitere Patienten an. Es wurde angenommen, dass die Ausbildung in besseren Ergebnisdaten, die bei Ende der Therapie erhoben wurden, konnten diese Hypothese nicht bestätigen. Maße für die interpersonale Abhängigkeit zu einem Einjahreskatamnesezeitpunkt waren mit der ersten Hypothese konform, aber inkonsistent mit der zweiten. Eine systematische Untersuchung der 32 nach der Ausbildung

  2. Spiritually and religiously integrated group psychotherapy

    DEFF Research Database (Denmark)

    Viftrup, Dorte Toudal; Hvidt, Niels Christian; Buus, Niels

    2013-01-01

    WE SYSTEMATICALLY REVIEWED THE RESEARCH LITERATURE ON SPIRITUALLY AND RELIGIOUSLY INTEGRATED GROUP PSYCHOTHERAPY TO ANSWER THE FOLLOWING THREE QUESTIONS: first, how are spirituality and religiosity defined; second, how are spiritual and religious factors characterized and integrated into group......, 8 articles were considered eligible for the review. Findings from the evaluation suggested that the concepts of spirituality and religiosity were poorly conceptualized and the way in which spiritual and religious factors were integrated into such group psychotherapies, which distinguished it from...... other types of group psychotherapies, was not fully conceptualized or understood either. However, clear and delimited conceptualization of spiritual and religious factors is crucial in order to be able to conclude the direct influences of spiritual or religious factors on outcomes. Implications...

  3. 从认知行为治疗的发展看心理治疗的疗效评估%Evaluation of psychotherapy outcome: A perspective from cognitive behavioral therapy development

    Institute of Scientific and Technical Information of China (English)

    王建平; 王晓菁; 唐苏勤

    2011-01-01

    Whether the outcome of psychological counseling and psychotherapy can be evaluated or not has always been a controversial debate among psychological scholars. Being able to evaluate the outcome is also the aim of different psychotherapy schools. In all schools of psychological counseling and therapy, cognitive behavioral therapy (CBT) is considered to be the only evidence-based psychotherapy. The author, being a CBT therapist herself, combined with her many years of practical experience of psychotherapy, as well as a lot of literature review, put forward her opinions on the origin, development and characteristics of CBT. The author believed that CBT follows the real " scientist-practitioner" model, and the effect of CBT can be evaluated with evidence support.%心理咨询与治疗的效果能否评估以及如何评估一直是学者们争议的话题,也是各心理咨询治疗流派努力的方向.在心理咨询与治疗各流派中,认知行为治疗(CBT)被认为是唯一循证的心理咨询治疗方法.本文作者是CBT治疗师,结合自己多年心理咨询治疗的实践经验和回顾相关文献,从CBT的起源、发展和特点,提出了自己的观点和看法,认为CBT是真正遵循和体现了“科学家-实践家”的模式,其效果是可以评价的,是有证据支持的.

  4. Videoconferencing psychotherapy: a systematic review.

    Science.gov (United States)

    Backhaus, Autumn; Agha, Zia; Maglione, Melissa L; Repp, Andrea; Ross, Bridgett; Zuest, Danielle; Rice-Thorp, Natalie M; Lohr, James; Thorp, Steven R

    2012-05-01

    Individuals with mental health problems may face barriers to accessing effective psychotherapies. Videoconferencing technology, which allows audio and video information to be shared concurrently across geographical distances, offers an alternative that may improve access. We conducted a systematic literature review of the use of videoconferencing psychotherapy (VCP), designed to address 10 specific questions, including therapeutic types/formats that have been implemented, the populations with which VCP is being used, the number and types of publications related to VCP, and available satisfaction, feasibility, and outcome data related to VCP. After electronic searches and reviews of reference lists, 821 potential articles were identified, and 65 were selected for inclusion. The results indicate that VCP is feasible, has been used in a variety of therapeutic formats and with diverse populations, is generally associated with good user satisfaction, and is found to have similar clinical outcomes to traditional face-to-face psychotherapy. Although the number of articles being published on VCP has increased in recent years, there remains a need for additional large-scale clinical trials to further assess the efficacy and effectiveness of VCP.

  5. Feedback versus no feedback to improve patient outcome in group psychotherapy for eating disorders (F-EAT): A randomized clinical trial

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Waaddegaard, Mette; Poulsen, Stig Bernt

    of continuous feedback on adherence and outcome in group psychotherapy. Methods/design: The trial is set up in a randomized design for outpatients diagnosed with bulimia nervosa, binge eating disorder, or eating disorder not otherwise specified (DSM-IV). They are allocated 1:1 to the experimental group...

  6. Values in psychotherapy.

    Science.gov (United States)

    Holmes, J

    1996-01-01

    There is a tension between those who hold that psychotherapy is a scientific discipline and therefore "value-free," and those who believe that values are inherent in the nature of psychotherapy. Psychoanalysis has moved from a science-based ideology, through the ethical concerns of Melanie Klein, to a recognition of the "aesthetic" dimension--the creation of suitable forms that can contain psychological distress. From this latter perspective, the antagonism between religion and psychotherapy, initiated by Freud, becomes less acute. Action-based ethical systems, which ignore the inner world, are critically scrutinized. The evidence suggesting there is a relationship between good outcome in psychotherapy and shared values between therapist and client is reviewed. It is posited that through examination of the "ethical countertransference," therapists should become aware of their own value systems and how they influence practice.

  7. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change.

    Science.gov (United States)

    Styła, Rafał

    2015-01-01

    Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and "V" shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a "V" shape or fluctuations is optimal for more disturbed patients. Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and "V" shape of SCC change. The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis.

  8. Predicting Optimal Outcomes in Cognitive Therapy or Interpersonal Psychotherapy for Depressed Individuals Using the Personalized Advantage Index Approach.

    Directory of Open Access Journals (Sweden)

    Marcus J H Huibers

    Full Text Available Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works best for the depressed individual. In this paper, we aim to replicate a recently developed treatment selection method, using data from an RCT comparing the effects of cognitive therapy (CT and interpersonal psychotherapy (IPT.134 depressed patients completed the pre- and post-treatment BDI-II assessment. First, we identified baseline predictors and moderators. Second, individual treatment recommendations were generated by combining the identified predictors and moderators in an algorithm that produces the Personalized Advantage Index (PAI, a measure of the predicted advantage in one therapy compared to the other, using standard regression analyses and the leave-one-out cross-validation approach.We found five predictors (gender, employment status, anxiety, personality disorder and quality of life and six moderators (somatic complaints, cognitive problems, paranoid symptoms, interpersonal self-sacrificing, attributional style and number of life events of treatment outcome. The mean average PAI value was 8.9 BDI points, and 63% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Those who were randomized to their predicted optimal treatment (either CT or IPT had an observed mean end-BDI of 11.8, while those who received their predicted non-optimal treatment had an end-BDI of 17.8 (effect size for the difference = 0.51.Depressed patients who were randomized to their predicted optimal treatment fared much better than those randomized to their predicted non-optimal treatment. The PAI provides a great opportunity for formal decision-making to improve individual patient outcomes in depression. Although the utility of the PAI

  9. Predicting Optimal Outcomes in Cognitive Therapy or Interpersonal Psychotherapy for Depressed Individuals Using the Personalized Advantage Index Approach

    Science.gov (United States)

    Huibers, Marcus J. H.; Cohen, Zachary D.; Lemmens, Lotte H. J. M.; Arntz, Arnoud; Peeters, Frenk P. M. L.; Cuijpers, Pim; DeRubeis, Robert J.

    2015-01-01

    Introduction Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works best for the depressed individual. In this paper, we aim to replicate a recently developed treatment selection method, using data from an RCT comparing the effects of cognitive therapy (CT) and interpersonal psychotherapy (IPT). Methods 134 depressed patients completed the pre- and post-treatment BDI-II assessment. First, we identified baseline predictors and moderators. Second, individual treatment recommendations were generated by combining the identified predictors and moderators in an algorithm that produces the Personalized Advantage Index (PAI), a measure of the predicted advantage in one therapy compared to the other, using standard regression analyses and the leave-one-out cross-validation approach. Results We found five predictors (gender, employment status, anxiety, personality disorder and quality of life) and six moderators (somatic complaints, cognitive problems, paranoid symptoms, interpersonal self-sacrificing, attributional style and number of life events) of treatment outcome. The mean average PAI value was 8.9 BDI points, and 63% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Those who were randomized to their predicted optimal treatment (either CT or IPT) had an observed mean end-BDI of 11.8, while those who received their predicted non-optimal treatment had an end-BDI of 17.8 (effect size for the difference = 0.51). Discussion Depressed patients who were randomized to their predicted optimal treatment fared much better than those randomized to their predicted non-optimal treatment. The PAI provides a great opportunity for formal decision-making to improve individual patient outcomes in depression. Although

  10. Therapist and relationship factors influencing dropout from individual psychotherapy: a literature review.

    Science.gov (United States)

    Roos, Johanna; Werbart, Andrzej

    2013-01-01

    Among potential predictors of dropout, client variables are most thoroughly examined. This qualitative literature review examines the current state of knowledge about therapist, relationship and process factors influencing dropout. Databases searches identified 44 relevant studies published January 2000-June 2011. Dropout rates varied widely with a weighted rate of 35%. Fewer than half of the studies directly addressed questions of dropout rates in relation to therapist, relationship or process factors. Therapists' experience, training and skills, together with providing concrete support and being emotionally supportive, had an impact on dropout rates. Furthermore, the quality of therapeutic alliance, client dissatisfaction and pre-therapy preparation influenced dropout. To reduce dropout rates, therapists need enhanced skills in building and repairing the therapeutic relationship.

  11. Forensic psychotherapy.

    Science.gov (United States)

    Riordan, Daniel

    2017-06-01

    This paper describes the role forensic psychotherapy has in the assessment and treatment of mentally disordered offender patients, and its role in the supervision of individual therapists, staff groups or whole organisations which contain and manage this patient population. Forensic psychotherapy has a valuable role to play in the management of mentally disordered forensic patients. As forensic services continue to develop in Australia and New Zealand and interest in this field continues to grow, then the future of forensic psychotherapy looks bright.

  12. Neuroimaging for psychotherapy research: current trends.

    Science.gov (United States)

    Weingarten, Carol P; Strauman, Timothy J

    2015-01-01

    This article reviews neuroimaging studies that inform psychotherapy research. An introduction to neuroimaging methods is provided as background for the increasingly sophisticated breadth of methods and findings appearing in psychotherapy research. We compiled and assessed a comprehensive list of neuroimaging studies of psychotherapy outcome, along with selected examples of other types of studies that also are relevant to psychotherapy research. We emphasized magnetic resonance imaging (MRI) since it is the dominant neuroimaging modality in psychological research. We summarize findings from neuroimaging studies of psychotherapy outcome, including treatment for depression, obsessive compulsive disorder (OCD), and schizophrenia. The increasing use of neuroimaging methods in the study of psychotherapy continues to refine our understanding of both outcome and process. We suggest possible directions for future neuroimaging studies in psychotherapy research.

  13. Hypnotic Psychotherapy with Sex Offenders

    Science.gov (United States)

    Moseley, Sullivan; Briggs, Wanda P.; Magnus, Virginia

    2005-01-01

    The authors review the literature on the prevalence of sex offenders; multiple treatment modalities; and implications of the use of hypnotic psychotherapy, coupled with cognitive behavioral treatment programs, for treating sex offenders. (Contains 2 tables.)

  14. Narrative Processes in Psychotherapy: differences between Good and Poor Outcome Clients

    Directory of Open Access Journals (Sweden)

    Luis Botella

    2015-12-01

    Full Text Available This paper compares 30 patients with good therapeutic outcome to 30 with poor therapeutic outcome in terms of the differential distribution of (1 Intake Variables (2 Outcome and Process Variables, and (3 Narrative Variables. Results indicated that psychosocial functioning, motivation, pre-therapy symptoms, Working Alliance, total number of therapy sessions, total pre-post symptom reduction, and mean scoring for total working alliance in sessions 3, 4, and 8 discriminated between both groups. Results also showed that almost all narrative variables except some of them discriminated good outcome clients from poor outcome ones from the beginning, midpoint and final stage of their therapeutic process. These results are discussed according to their relevance for clinical practice.

  15. Is investigator background related to outcome in head to head trials of psychotherapy and pharmacotherapy for adult depression? A systematic review and meta-analysis

    Science.gov (United States)

    Gentili, Claudio; Pietrini, Pietro; Cuijpers, Pim

    2017-01-01

    Background The influence of factors related to the background of investigators conducting trials comparing psychotherapy and pharmacotherapy has remained largely unstudied. Specializations emphasizing biological determinants of mental disorders, like psychiatry, might favor pharmacotherapy, while others stressing psychosocial factors, like psychology, could promote psychotherapy. Yet financial conflict of interest (COI) could be a confounding factor as authors with a medical specialization might receive more sponsoring from the pharmaceutical industry. Method We conducted a meta-analysis with subgroup and meta-regression analysis examining whether the specialization and affiliation of trial authors were associated to outcomes in the direct comparison of psychotherapy and pharmacotherapy for the acute treatment of depression. Meta-regression analysis also included trial risk of bias and author conflict of interest in relationship to the pharmaceutical industry. Results We included 45 trials. In half, the first author was psychologist. The last author was psychiatrist/MD in half of the trials, and a psychologist or statistician/other technical in the rest. Most lead authors had medical affiliations. Subgroup analysis indicated that studies with last authors statisticians favored pharmacotherapy. Univariate analysis showed a negative relationship between the presence of statisticians and outcomes favoring psychotherapy. Multivariate analysis showed that trials including authors with financial COI reported findings more favorable to pharmacotherapy. Discussion We report the first detailed overview of the background of authors conducting head to head trials for depression. Trials co-authored by statisticians appear to subtly favor pharmacotherapy. Receiving funding from the industry is more closely related to finding better outcomes for the industry’s elective treatment than are factors related to authors’ background. Limitations For a minority of authors we could

  16. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: An empirical validation of the theoretical model of the self-concept change

    Directory of Open Access Journals (Sweden)

    Rafał eStyła

    2015-10-01

    Full Text Available Background: Self-concept clarity describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of self-concept clarity change (especially stable increase and V shape observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable self-concept clarity increase is needed for the participants with a rather healthy personality structure, while self-concept clarity change characterized by a V shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M=5.8 was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale, Symptoms’ Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The Self-Concept Clarity Scale was also administered every two weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable self-concept clarity increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and V shape of self-concept clarity change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of self-concept clarity is a sign of a good treatment prognosis.

  17. The role of therapists' treatment adherence, professional experience, therapeutic alliance, and clients' severity of psychological problems: Prediction of treatment outcome in eight different psychotherapy approaches. Preliminary results of a naturalistic study.

    Science.gov (United States)

    Tschuschke, Volker; Crameri, Aureliano; Koehler, Miriam; Berglar, Jessica; Muth, Katharina; Staczan, Pia; Von Wyl, Agnes; Schulthess, Peter; Koemeda-Lutz, Margit

    2015-01-01

    In this naturalistic study, 262 audiotaped psychotherapy sessions--randomly drawn from 81 individual therapies from eight different psychotherapy approaches--were rated completely on treatment adherence using a newly developed rating manual. In the therapy sessions, a relatively low percentage of treatment specific interventions (ranging from 4.2% to 27.8%) was found for all eight approaches, 50% to 73% of the interventions were nonspecific or common, and approximately 18% to 27% were intervention techniques from other approaches. Different types of psychotherapy differed highly significantly in levels of treatment adherence. There was no statistically significant association between the type of psychotherapy and its outcome, or between the degree of therapists' treatment fidelity and the treatment outcome. However, there were significant associations between therapists' degree of professional experience, clients' initial psychological burden, and treatment response. Clients' severity of psychological problems prior to treatment predicted quality of therapeutic alliance while therapists' treatment adherence was predicted by therapists' professional experience and by the quality of the therapeutic alliance. We discuss the seemingly indirect importance of treatment adherence for psychotherapy outcome that we found in this study in relation to findings from other studies and in the context of the role of schools within psychotherapy.

  18. An intensive case analysis of client metacognition in a good-outcome psychotherapy: Lisa's case.

    Science.gov (United States)

    Carcione, Antonino; Dimaggio, Giancarlo; Fiore, Donatella; Nicolo, Giuseppe; Procacci, Michele; Semerari, Antonio; Pedone, Roberto

    2008-11-01

    The authors analyzed the successful case of Lisa, a client with major depression, using the Metacognitive Assessment Scale (MAS). Consistently with the literature on depression, the authors hypothesize that Lisa's ability to reflect on mental states--here metacognition--is marginally affected. The authors found that Lisa was better at describing her own mind rather than understanding the mind of the others. Furthermore, the most severe impairment was in using metacognition to cope with mental state source of distress and to enact strategies to solve interpersonal problems. During the therapy such difficulties improved progressively. Limitations and implications of these findings are discussed.

  19. Placebo psychotherapy: synonym or oxymoron?

    Science.gov (United States)

    Kirsch, Irving

    2005-07-01

    Contrary to some recent claims, the placebo effect is real and in some cases very substantial. Placebo effects can be produced or enhanced by classical conditioning, but consistent with virtually all contemporary conditioning theories, these effects are generally mediated by expectancy. Expectancy can also produce placebo effects that are inconsistent with conditioning history. Although expectancy also plays an important role in psychotherapy outcome, the logic of placebo-controlled trials does not map well onto psychotherapy research. The idea of evaluating the efficacy of psychotherapy by controlling for nonspecific or placebo factors is based on a flawed analogy and should be abandoned.

  20. Therapist variation within randomised trials of psychotherapy: implications for precision, internal and external validity.

    Science.gov (United States)

    Walwyn, Rebecca; Roberts, Chris

    2010-06-01

    Nesting of patients within therapists in psychotherapy trials creates an additional level within the design. The multilevel nature of this design has implications for the precision, internal and external validity of estimates of the treatment effect. Prior to or during a trial, psychotherapies are allocated to therapists and therapists are assigned to patients such that the therapist becomes part of the causal pathway from the intervention to the patient. It is therefore important to consider not only the relationship between interventions and patients but also relationships between interventions and therapists and between therapists and patients. Research designs comparing the effects of therapeutic approaches, therapist characteristics and packages of the two can be unified by viewing therapists as an important source of variability within psychotherapy outcome studies. Methodological considerations arising from therapist variation will be discussed, drawing together and building upon the associated psychotherapy and statistical literatures. Parallels will also be made with related designs and methods of analysis.

  1. Feedback versus no feedback in improving patient outcome in group psychotherapy for eating disorders (F-EAT)

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Poulsen, Stig Bernt; Waaddegaard, Mette

    2014-01-01

    or control group at a ratio of 1:1. The experimental group will receive standard treatment (systemic and narrative group psychotherapy) with feedback intervention, whereas the control group will receive standard treatment only. The participants are diagnosed with bulimia nervosa binge eating disorder...

  2. Transpersonal psychotherapy.

    Science.gov (United States)

    Boorstein, S

    2000-01-01

    The history, theory, and practice of Transpersonal (or Spiritual) Psychotherapy are presented. The author describes his own evolution from a traditional psychoanalyst to a psychotherapist who uses the tools and wisdom from spiritual traditions to enhance traditional psychotherapy while, at the same time, improving the self system of the therapist. Dangers as well as benefits of the spiritual approach are outlined. The creation and holding of a spiritual or transpersonal context is described and ways to ascertain, in the clinical situation, the appropriateness of such an approach are explained. The use of bibliotherapy to help transform and expand the worldview of the patient is outlined. Prayer and meditational systems also have a healing role in this approach. To illustrate the uses of Transpersonal Psychotherapy in practice, four cases are presented: 1) a paranoid schizophrenic man, 2) a well-functioning borderline person, 3) a very poorly functioning borderline person, and 4) a high-functioning neurotic man who had been in psychoanalysis.

  3. [General psychotherapy].

    Science.gov (United States)

    Vymetal, J

    2003-01-01

    Nowadays a theoretical psychotherapeutical thinking develops from the eclectic practice and uses particularly the research of the effective factors of the therapy. Best they can be characterized as differentiate, synthetic, integrative and exceeding other approaches. The development in question goes on with attempts of creating a general model of the psychotherapy that could be a basis for models of special psychotherapies. The aim of such a model is to describe all that is present as important factor for inducing a desirable change of a human in all psychotherapeutical approaches. Among general models we can mention the generic model of D. E. Orlinski and K. I. Howard, Grawe's cube (the author is K. Grawe) and the equation of the psychotherapy.

  4. The Dodo-Bird Debate, Empirically Supported Relationships and Functional Analytic Psychotherapy

    Science.gov (United States)

    Vandenberghe, Luc; de Sousa, Ana Carolina Aquino

    2005-01-01

    The dodo-bird verdict has haunted the literature on psychotherapy outcome since its early beginnings. It is based on the counter-intuitive finding that often highly diverging treatments do not differ much in effectiveness. There is evidence that much of the common effect of different treatments can be related to unspecific factors as opposed to…

  5. Mind, brain and psychotherapy

    Directory of Open Access Journals (Sweden)

    Sheth Hitesh

    2009-01-01

    Full Text Available There is long-standing debate about superiority of mind over brain, in other words about superiority of mind over matter. And outcome of this debate is going to decide future of psychiatry. The psychiatrists believing in materialism may say that brain is all and by changing neurotransmitters level with new molecules of drugs would cure all illnesses. On the other hand, antipsychiatry activists and some psychotherapists oppose all types of treatment despite of convincing evidence that drug therapy is effective (although sometimes it is not as effective as it claims to be. However, truth lies somewhere in between. Pharmacotherapy and psychotherapy are like two legs of psychiatry and psychiatry cannot walk into a future on one leg. The studies have shown that judicious use of pharmacotherapy along with psychotherapy gives better outcome than any one of them used alone. We must heal dichotomy between mind and brain before we heal the patients.

  6. Engagement with Young Adult Literature: Outcomes and Processes

    Science.gov (United States)

    Ivey, Gay; Johnston, Peter H.

    2013-01-01

    This study examines students' perceptions of the outcomes and processes of engaged reading in classrooms prioritizing engagement through self-selected, self-paced reading of compelling young adult literature. The primary data were 71 end-of-year student interviews, supported by end-of-year teacher interviews, biweekly observational data,…

  7. Psychotherapy for Personality Disorders in a Natural Setting: A Pilot Study over Two Years of Treatment.

    Science.gov (United States)

    Kolly, Stéphane; Kramer, Ueli; Maillard, Pauline; Charbon, Patrick; Droz, Jessica; Frésard, Emmanuelle; Berney, Sylvie; Despland, Jean-Nicolas

    2015-09-01

    Long-term assessment of the effects of psychotherapy for personality disorders (PDs) in a natural environment is an important task. Such research contributes to enlarge the practice-based evidence, embedded in broad collaborations between clinicians and researchers in psychotherapy for PDs. The present pilot study used rigorous assessment procedures and incorporated feedback loops of outcome information to the therapists in demonstrating the effects of psychotherapy for PD in a natural setting. The number of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for any PD was the primary outcome (along with psychological distress, depression, impulsiveness, and quality of life as secondary measures), assessed at intake, 6, 12, 18, and 24 months of psychotherapy for N = 13 patients with PD. Data were analyzed using hierarchical linear modeling. Results demonstrated a large pre-post effect (d = 2.22) for the observer-rated measure (primary outcome), and small to medium effects for the secondary outcomes; these results were corroborated by a steady decrease of symptoms over all five time points, which was significant for several outcomes. These results add a piece to the literature by demonstrating the effects of long-term psychotherapy for PDs in increasingly diverse contexts and suggest that practice-oriented research can be carried out in a collaborative and systematic manner.

  8. Positive Psychotherapy

    Science.gov (United States)

    Seligman, Martin E. P.; Rashid, Tayyab; Parks, Acacia C.

    2006-01-01

    Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported…

  9. Big ideas for psychotherapy training.

    Science.gov (United States)

    Fauth, James; Gates, Sarah; Vinca, Maria Ann; Boles, Shawna; Hayes, Jeffrey A

    2007-12-01

    Research indicates that traditional psychotherapy training practices are ineffective in durably improving the effectiveness of psychotherapists. In addition, the quantity and quality of psychotherapy training research has also been limited in several ways. Thus, based on extant scholarship and personal experience, we offer several suggestions for improving on this state of affairs. Specifically, we propose that future psychotherapy trainings focus on a few "big ideas," target psychotherapist meta-cognitive skills, and attend more closely to the organizational/treatment context in which the training takes place. In terms of future training research, we recommend that researchers include a wider range of intermediate outcomes in their studies, examine the nature of trainee skill development, and investigate the role that organizational/treatment culture plays in terms of the retention of changes elicited by psychotherapy training. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  10. Promoting Efficacy Research on Functional Analytic Psychotherapy

    Science.gov (United States)

    Maitland, Daniel W. M.; Gaynor, Scott T.

    2012-01-01

    Functional Analytic Psychotherapy (FAP) is a form of therapy grounded in behavioral principles that utilizes therapist reactions to shape target behavior. Despite a growing literature base, there is a paucity of research to establish the efficacy of FAP. As a general approach to psychotherapy, and how the therapeutic relationship produces change,…

  11. Outcome of systemic and analytic group psychotherapy for adult women with history of intrafamilial childhood sexual abuse: a randomized controlled study

    DEFF Research Database (Denmark)

    Lau, M; Kristensen, Ellids

    2007-01-01

    Research suggests that group psychotherapy for adults with a history of child sexual abuse (CSA) is generally beneficial. Only few studies have included random assignment. This study compared the effects of analytic (A) and systemic group psychotherapy (S) on CSA.......Research suggests that group psychotherapy for adults with a history of child sexual abuse (CSA) is generally beneficial. Only few studies have included random assignment. This study compared the effects of analytic (A) and systemic group psychotherapy (S) on CSA....

  12. Baseline training in cognitive and psychodynamic psychotherapy during a psychologist training program. Exploring client outcomes in therapies of one or two semesters.

    Science.gov (United States)

    Dennhag, Inga; Armelius, Bengt-Åke

    2012-01-01

    This effectiveness study explored the outcomes of 187 clients seen by 187 students undergoing baseline training in psychotherapy. Clients reduced their symptoms (SCL-90) and increased their positive self-image (SASB introject) during the therapy. Multiple regression analyses showed no differences between the cognitive and the psychodynamic training approaches and no differences between one and two semesters duration of the therapies. However, 2-3% of variance in end states was accounted for by the interaction between the variables, indicating a moderating effect of duration in the two approaches. Outcomes for clients in the cognitive training approach were significantly better with two semesters than with one semester, while there was no such difference in the psychodynamic approach. Consequences for baseline training are discussed.

  13. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available Search About Us Borderline Personality Disorder (BPD) Treatment Resources For Professionals Contact Us NYP.org Borderline Personality Disorder Resource Center Treatment Psychotherapy Psychotherapy Treatment Psychotherapy ...

  14. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available Search About Us Borderline Personality Disorder (BPD) Treatment Resources For Professionals Contact Us NYP.org Borderline Personality Disorder Resource Center Treatment Psychotherapy Psychotherapy Treatment Psychotherapy Taking Care of Yourself Questions About ...

  15. Learning outcomes for interprofessional education (IPE): Literature review and synthesis.

    Science.gov (United States)

    Thistlethwaite, Jill; Moran, Monica

    2010-09-01

    As part of a World Health Organization (WHO) initiative we searched the literature to explore defined learning outcomes for interprofessional education between 1988, when the last WHO technical report on interprofessional education was published, and 2009. We describe and synthesize findings from 88 citations over this 21 year period. There is a variety in the way learning outcomes are presented but there are many similarities between specific outcomes and/or objectives. Papers describing educational interventions do not always include specific outcomes or objectives. Our findings have been integrated into a list of learning outcomes with six categories for further debate and discussion. This project is part of a wider initiative initiated by the WHO in 2007 to review the current position of interprofessional education worldwide. It is also a sub-project of a learning and teaching grant funded by the Carrick Institute for Learning and Teaching within Australia. In this paper we use the CAIPE definition of interprofessional education: "Occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care" (Barr, 2002 ).

  16. [Outpatient Psychotherapy Under Naturalistic Conditions: A Selective Review of Results from German Speaking Countries].

    Science.gov (United States)

    Altmann, Uwe; Thielemann, Désirée; Strauß, Bernhard

    2016-10-01

    There is a growing body of literature recognizing the importance of outpatient psychotherapy. Several studies investigated the efficacy of outpatient psychotherapy and aspects of the health care system under natural conditions. This paper gives an overview of studies from German speaking countries (TRANS-OP-, TK-, PAP-S- and QS-PSY-BAY-study).The results of the different studies indicate both, positive outcome of the therapies (e. g., reduction of symptoms with an average ES of 1,03; improvement of symptoms despite premature termination) as well as an economic benefit (end of treatment depending on treatment outcome and not limited by therapy sessions; extensions of psychotherapy only if patient is highly impaired and therapeutic alliance is positive; high reduction of supply costs and sick leave). However, the low health care density in rural areas and the waiting periods before starting therapy are indicators of structural problems of the health care system with respect to outpatient psychotherapy.The efficacy of outpatient psychotherapies under natural conditions is sufficiently supported. Future studies should investigate structural aspects of the health care system, for example by focussing on the establishment of inter-sectoral connections between different professional groups and a reduction of bureaucratic actions. © Georg Thieme Verlag KG Stuttgart · New York.

  17. The Bullying Literature Project: Using Children's Literature to Promote Prosocial Behavior and Social-Emotional Outcomes among Elementary School Students

    Science.gov (United States)

    Wang, Cixin; Couch, Lauren; Rodriguez, Geovanna Rosas; Lee, Catherine

    2015-01-01

    The current study evaluated the effectiveness of the Bullying Literature Project on social-emotional and behavioral outcomes among elementary school students. The Bullying Literature Project is a five-session classroom-wide intervention that uses children's literature as a springboard to promote adaptive social-cognitive process, teach social…

  18. The Bullying Literature Project: Using Children's Literature to Promote Prosocial Behavior and Social-Emotional Outcomes among Elementary School Students

    Science.gov (United States)

    Wang, Cixin; Couch, Lauren; Rodriguez, Geovanna Rosas; Lee, Catherine

    2015-01-01

    The current study evaluated the effectiveness of the Bullying Literature Project on social-emotional and behavioral outcomes among elementary school students. The Bullying Literature Project is a five-session classroom-wide intervention that uses children's literature as a springboard to promote adaptive social-cognitive process, teach social…

  19. Client attachment in a randomized clinical trial of psychoanalytic and cognitive-behavioral psychotherapy for bulimia nervosa: Outcome moderation and change.

    Science.gov (United States)

    Daniel, Sarah Ingrid Franksdatter; Poulsen, Stig; Lunn, Susanne

    2016-06-01

    In the context of a randomized clinical trial of psychoanalytic psychotherapy (PPT) versus cognitive behavior therapy (CBT) for bulimia nervosa (BN), this study performed secondary analyses of (a) the relation between attachment and pretreatment symptom levels, (b) whether client pretreatment attachment moderated treatment outcome, (c) whether change in client attachment was associated with symptomatic change, and (d) whether client attachment changed differently in the 2 treatments. Sixty-nine women and 1 man of a mean age of 25.8 years diagnosed with BN were randomly assigned to either 2 years of weekly PPT or 5 months of CBT. Assessments at intake, after 5 months, and after 2 years included the Eating Disorder Examination to assess eating disorder symptoms, the Adult Attachment Interview to assess client attachment, and the Symptom Checklist 90-R to assess general psychiatric distress. Repeated measures were analyzed using multilevel analysis. Higher scores on attachment insecurity and attachment preoccupation were associated with more frequent binging pretreatment. Pretreatment attachment did not predict treatment outcome. In PPT, but not in CBT, reduction of binging was associated with an increase in attachment security. The 2 treatment types were not associated with significantly different patterns of attachment-related change. Degree and type of attachment insecurity is related to the frequency of binging in BN. Increase in attachment security may be a treatment-specific mechanism of change in PPT for BN. (PsycINFO Database Record

  20. Overcoming treatment resistance in chronic depression: a pilot study on outcome and feasibility of the cognitive behavioral analysis system of psychotherapy as an inpatient treatment program.

    Science.gov (United States)

    Brakemeier, Eva-Lotta; Radtke, Martina; Engel, Vera; Zimmermann, Johannes; Tuschen-Caffier, Brunna; Hautzinger, Martin; Schramm, Elisabeth; Berger, Mathias; Normann, Claus

    2015-01-01

    The Cognitive Behavioral Analysis System of Psychotherapy (CBASP), initially developed as an outpatient treatment for chronic depression (CD), has been adapted as a multidisciplinary 12-week inpatient program for CD. Seventy inpatients with CD and treatment resistance were included in a noncontrolled trial. The Hamilton Depression Rating Scale served as the primary outcome measure. Prospective naturalistic follow-up assessments were conducted 6 and 12 months after discharge. Dropout rate was 7.1%; 90.4% perceived the program as helpful. Pre-post comparisons yielded strong effect sizes; 75.7% of the intention-to-treat sample responded, and 40.0% remitted. Nonremission was associated with experiencing temporary deterioration of symptoms during treatment. After 6 months 75.0% and after 12 months 48.0% of patients sustained response. The CBASP program appears as a feasible acute treatment for treatment-resistant CD inpatients with promising outcome. However, the continuation of treatment after discharge should be optimized especially for patients with subjective deterioration during treatment.

  1. Breastfeeding and language outcomes: A review of the literature.

    Science.gov (United States)

    Smith, Jamie Mahurin

    2015-01-01

    Many researchers have investigated the potential impact of breastfeeding in infancy on a child's subsequent development, but only a small subset of these studies considers language development and impairment. This paper reviews that literature, discussing postnatal neurodevelopment, potential mechanisms for dietary influences on communication outcomes, studies of typically developing children, and studies of children with communication concerns. For population based studies of language development, a modest but statistically robust relationship is seen across large samples that account for breastfeeding exclusivity. A similar protective relationship is seen in studies that evaluate the relationship between breastfeeding and language disorders; effect sizes are typically larger in these papers. Implications for researchers and service providers are reviewed. Readers will be able to describe possible mechanisms by which early diet might influence neurodevelopment. They will be able to describe the relationships observed between diet in infancy and language outcomes in large population-based studies, as well as the trends observed in studies of the relationship between infant diet and communication impairment. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Culturally Adapted Psychotherapy and the Legitimacy of Myth: A Multilevel Model, Direct Comparison Meta-Analysis

    Science.gov (United States)

    Benish, Steven G.

    2010-01-01

    Culturally adapted psychotherapy has potential to improve psychotherapy outcomes for ethnic and racial minorities and solve a decades-long conundrum that alteration of specific ingredients does not improve psychotherapy outcomes. Adaptation of the cultural explanation of illness, known as the anthropological Myth in universal healing practices…

  3. The Psychotherapy Research Project of the Menninger Foundation: An Overview.

    Science.gov (United States)

    Wallerstein, Robert S.

    1989-01-01

    Studied processes and outcomes of psychoanalysis and psychoanalytic psychotherapy. Followed 42 subjects over natural course of treatment, with 100 percent follow-up 2-3 years posttermination. Some follow-ups extended over 30-year study. Psychoanalysis achieved more limited outcomes than predicted; psychotherapies often achieved more than…

  4. The Virtues of Cultural Resonance, Competence, and Relational Collaboration with Native American Indian Communities: A Synthesis of the Counseling and Psychotherapy Literature

    Science.gov (United States)

    Trimble, Joseph E.

    2010-01-01

    The article extends the scholarship, observations, and recommendations provided in Joseph Gone's article, "Psychotherapy and Traditional Healing for American Indians: Prospects for Therapeutic Integration" (2010 [this issue]). The overarching thesis is that for many Indian and Native clients, interpersonal and interethnic problems can emerge when…

  5. Interpretive psychotherapy with chronic pain patients.

    Science.gov (United States)

    Lakoff, R

    1983-12-01

    Patients for whom medical and surgical management has failed to relieve chronic pain were treated in a multimodal programme which included interpretive psychotherapy. Dynamic conflicts were identified in all cases and utilized in the psychotherapy and programme design. Examined in the light of ego functioning, pain that was previously considered intractible, yielded to psychological treatment. Further research is planned to identify the parts played by the different modalities and to study outcome.

  6. [Problems of bilinguism in psychotherapy].

    Science.gov (United States)

    Fadda, S; Müller, C

    1978-01-01

    The authors have attempted an introductory study of problems which are inherent to psychoanalytically oriented psychotherapy and psychoanalysis conducted in the second language of a bilingual therapist. This situation seems to be more complex than is usually admitted in current literature. The main problem encountered by the authors in their personal practice stems from the fact that the process of identification becomes complex when the therapist is confronted with regressive and/or progressive shifts in the course of the treatment.

  7. Ethics and aims in psychotherapy: a contribution from Kant.

    Science.gov (United States)

    Callender, J S

    1998-08-01

    Psychotherapy is an activity which takes many forms and which has many aims. The present paper argues that it can be viewed as a form of moral suasion. Kant's concepts of free will and ethics are described and these are then applied to the processes and outcome of psychotherapy. It is argued that his ideas, by linking rationality, free will and ethics into a single philosophical system, offer a valuable theoretical framework for thinking about aims and ethical issues in psychotherapy.

  8. Therapy 101: A Psychotherapy Curriculum for Medical Students

    Science.gov (United States)

    Aboul-Fotouh, Frieda; Asghar-Ali, Ali Abbas

    2010-01-01

    Objective: This pilot project, designed and taught by a resident, created a curriculum to introduce medical students to the practice of psychotherapy. Medical students who are knowledgeable about psychotherapy can become physicians who are able to refer patients to psychotherapeutic treatments. A search of the literature did not identify a…

  9. Holism in Psychotherapy and Spiritual Direction: A Course Correction

    Science.gov (United States)

    Sperry, Len; Mansager, Erik

    2004-01-01

    The authors offer a course correction for understanding the term holism as used in spiritually oriented psychotherapy literature. This is done to allow the relationship between psychotherapy and spirituality to expand beyond limited dualistic conceptualizations, They first address numerous sources from which spiritually oriented psychotherapy…

  10. Alliance in individual psychotherapy.

    Science.gov (United States)

    Horvath, Adam O; Del Re, A C; Flückiger, Christoph; Symonds, Dianne

    2011-03-01

    This article reports on a research synthesis of the relation between alliance and the outcomes of individual psychotherapy. Included were over 200 research reports based on 190 independent data sources, covering more than 14,000 treatments. Research involving 5 or more adult participants receiving genuine (as opposed to analogue) treatments, where the author(s) referred to one of the independent variables as "alliance," "therapeutic alliance," "helping alliance," or "working alliance" were the inclusion criteria. All analyses were done using the assumptions of a random model. The overall aggregate relation between the alliance and treatment outcome (adjusted for sample size and non independence of outcome measures) was r = .275 (k = 190); the 95% confidence interval for this value was .25-.30. The statistical probability associated with the aggregated relation between alliance and outcome is p < .0001. The data collected for this meta-analysis were quite variable (heterogeneous). Potential variables such as assessment perspectives (client, therapist, observer), publication source, types of assessment methods and time of assessment were explored.

  11. Feedback versus no feedback in improving patient outcome in group psychotherapy for eating disorders (F-EAT)

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Poulsen, Stig Bernt; Waaddegaard, Mette

    2014-01-01

    , or an eating disorder not otherwise specified, according to the DSM-IV. In the experimental group feedback to the participants, based on the Outcome Rating Scale (ORS) and the Group Session Rating Scale (GSRS), is actively added to standard treatment. The ORS assesses areas of life functioning known to change...... If the results will confirm the hypothesis, this trial will support feedback as a way to improve group treatment attendance for outpatients with eating disorders. Trial registration: ClinicalTrials.gov identifier: NCT01693237...

  12. Mobile technology boosts the effectiveness of psychotherapy and behavioral interventions: a meta-analysis.

    Science.gov (United States)

    Lindhiem, Oliver; Bennett, Charles B; Rosen, Dana; Silk, Jennifer

    2015-11-01

    We conducted a meta-analysis on the effects of mobile technology on treatment outcome for psychotherapy and other behavioral interventions. Our search of the literature resulted in 26 empirical articles describing 25 clinical trials testing the benefits of smartphone applications, personal digital assistants (PDAs), or text messaging systems either to supplement treatment or substitute for direct contact with a clinician. Overall, mobile technology use was associated with superior treatment outcome across all study designs and control conditions, effect size (ES) = .34, p mobile technology using a rigorous "Treatment" versus "Treatment + Mobile" design, effect sizes were only slightly more modest (ES = .27) and still significant (p mobile technology for the delivery of psychotherapy and other behavioral interventions.

  13. Therapists' professional and personal characteristics as predictors of outcome in long-term psychodynamic psychotherapy and psychoanalysis.

    Science.gov (United States)

    Heinonen, E; Knekt, P; Jääskeläinen, T; Lindfors, O

    2014-06-01

    Whether long-term psychodynamic therapy (LPP) and psychoanalysis (PA) differ from each other and require different therapist qualities has been debated extensively, but rarely investigated empirically. In a quasi-experimental design, LPP was provided for 128 and PA for 41 outpatients, aged 20-46 years and suffering from mood or anxiety disorder, with a 5-year follow-up from start of treatment. Therapies were provided by 58 experienced therapists. Therapist characteristics, measured pre-treatment, were assessed with the Development of Psychotherapists Common Core Questionnaire (DPCCQ). General psychiatric symptoms were assessed as the main outcome measure at baseline and yearly after start of treatment with the Symptom Check List, Global Severity Index (SCL-90-GSI). Professionally less affirming and personally more forceful and less aloof therapists predicted less symptoms in PA than in LPP at the end of the follow-up. A faster symptom reduction in LPP was predicted by a more moderate relational style and work experiences of both skillfulness and difficulties, indicating differences between PA and LPP in the therapy process. Results challenge the benefit of a classically "neutral" psychoanalyst in PA. They also indicate closer examinations of therapy processes within and between the two treatments, which may benefit training and supervision of therapists. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Helicopter EMS Transport Outcomes Literature: Annotated Review of Articles Published 2007-2011.

    Science.gov (United States)

    Brown, Brandon S; Pogue, Korby A; Williams, Emily; Hatfield, Jesse; Thomas, Matthew; Arthur, Annette; Thomas, Stephen H

    2012-01-01

    Helicopter EMS (HEMS) and its possible association with outcomes improvement continues to be a subject of discussion. As is the case with other scientific discourse, debate over HEMS usefulness should be framed around an evidence-based assessment of the relevant literature. In an effort to facilitate the academic pursuit of assessment of HEMS utility, in late 2000 the National Association of EMS Physicians' (NAEMSP) Air Medical Task Force prepared annotated bibliographies of the HEMS-related outcomes literature. As a result of that work, two review articles, one covering HEMS use in nontrauma and the other in trauma, published in 2002 in Prehospital Emergency Care surveyed HEMS outcomes-related literature published between 1980 and mid-2000. The project was extended with two subsequent reviews covering the literature through 2006. This review continues the series, outlining outcomes-associated HEMS literature for the three-year period 2007 through the first half of 2011.

  15. Helicopter EMS transport outcomes literature: annotated review of articles published 2004-2006.

    Science.gov (United States)

    Thomas, Stephen H

    2007-01-01

    Helicopter EMS (HEMS) and its possible association with outcomes improvement continues to be a subject of debate. As is the case with other scientific endeavors, debate over HEMS usefulness should be framed around an evidence-based assessment of the relevant literature. In an effort to facilitate the academic pursuit of assessment of HEMS utility, in late 2000 the National Association of EMS Physicians' (NAEMSP) Air Medical Task Force prepared annotated bibliographies of the HEMS-related outcomes literature. As a result of that work, two review articles, one covering HEMS use in nontrauma and the other in trauma, published in 2002 in Prehospital Emergency Care surveyed HEMS outcomes-related literature published between 1980 and mid-2000. The project was extended with a 2004 review that covered the literature published between 2000 and 2003. The current review continues the series, outlining outcomes-associated HEMS literature from 2004 through 2006.

  16. The Play of Psychotherapy

    Science.gov (United States)

    Marks-Tarlow, Terry

    2012-01-01

    The author reviews the role of play within psychotherapy. She does not discuss the formal play therapy especially popular for young children, nor play from the Jungian perspective that encourages the use of the sand tray with adults. Instead, she focuses on the informal use of play during psychotherapy as it is orchestrated intuitively. Because…

  17. Effects of mobile gaming patterns on learning outcomes: a literature review

    NARCIS (Netherlands)

    Schmitz, Birgit; Klemke, Roland; Specht, Marcus

    2013-01-01

    Schmitz, B., Klemke, R., & Specht, M. (2012). Effects of mobile gaming patterns on learning outcomes: A literature review. International Journal of Technology Enhanced Learning, 4(5-6), 345-358. doi:10.1504/IJTEL.2012.051817

  18. Measuring the Outcome of Biomedical Research: A Systematic Literature Review

    OpenAIRE

    Frédérique Thonon; Rym Boulkedid; Tristan Delory; Sophie Rousseau; Mahasti Saghatchian; Wim van Harten; Claire O'Neill; Corinne Alberti

    2015-01-01

    Background There is an increasing need to evaluate the production and impact of medical research produced by institutions. Many indicators exist, yet we do not have enough information about their relevance. The objective of this systematic review was (1) to identify all the indicators that could be used to measure the output and outcome of medical research carried out in institutions and (2) enlist their methodology, use, positive and negative points. Methodology We have searched 3 databases ...

  19. Attrition in Psychotherapy: A Survival Analysis

    Science.gov (United States)

    Roseborough, David John; McLeod, Jeffrey T.; Wright, Florence I.

    2016-01-01

    Purpose: Attrition is a common problem in psychotherapy and can be defined as clients ending treatment before achieving an optimal response. Method: This longitudinal, archival study utilized data for 3,728 clients, using the Outcome Questionnaire 45.2. A Cox regression proportional hazards (hazard ratios) model was used in order to better…

  20. Teaching focus in psychotherapy: a training essential.

    Science.gov (United States)

    Summers, Richard F; Xuan, Yan; Tavakoli, Donald N

    2013-03-01

    Practical application of psychodynamic therapy technique requires that the therapist focus the treatment. The authors review the current evidence about focus in psychotherapy, which suggests that it has a beneficial impact on outcome and patient satisfaction. The core psychodynamic problem is proposed as a valuable conceptual model for providing focus for patient, psychotherapist, and supervisor. The authors narrate a case history from the perspective of both the psychotherapist and the supervisor to demonstrate the opportunities and challenges in using this concept. Finally, the authors suggest that a focus on focus is desirable in residency psychotherapy training programs, and they make suggestions for educational methods that enhance resident training in this area.

  1. The real relationship in psychotherapy supervision.

    Science.gov (United States)

    Watkins, C Edward

    2011-01-01

    While the real relationship has long been addressed in psychoanalysis and psychotherapy, the matter of the real relationship in psychotherapy supervision has yet to receive any attention. Ample supervisory focus has indeed been given to the working alliance and transference-countertransference configuration (including parallel processes), but after a century of psychotherapy supervision, any mention whatsoever of real relationship phenomena is absent. In this paper, the following hypotheses are proposed: The real relationship (1) is a crucial component of the supervision relationship that has transtheoretical implications; (2) exists from the moment supervision begins until its end; (3) is the forever silent yet forever substantive contributor to supervisory process and outcome; (4) exerts a significant impact on (a) the development and establishment of the supervisory working alliance and (b) the unfolding and eventual utilization of the transference-countertransference experience in the supervisory situation; (5) consists of at least two dimensions in supervision--realism and genuineness--that vary along valence and magnitude continua (building on the works of Greenson and Gelso), and (6) deserves a place of eminence equal to the working alliance and transference-countertransference configuration if supervision theory, practice, and research are to be most fully informed. The possibility of using recent real relationship research in psychotherapy as a prototype to inform future research in supervision is presented, and two case examples are provided to illustrate the seeming power of real relationship phenomena in psychotherapy supervision.

  2. Measuring the outcome of biomedical research: a systematic literature review.

    Directory of Open Access Journals (Sweden)

    Frédérique Thonon

    Full Text Available There is an increasing need to evaluate the production and impact of medical research produced by institutions. Many indicators exist, yet we do not have enough information about their relevance. The objective of this systematic review was (1 to identify all the indicators that could be used to measure the output and outcome of medical research carried out in institutions and (2 enlist their methodology, use, positive and negative points.We have searched 3 databases (Pubmed, Scopus, Web of Science using the following keywords: [Research outcome* OR research output* OR bibliometric* OR scientometric* OR scientific production] AND [indicator* OR index* OR evaluation OR metrics]. We included articles presenting, discussing or evaluating indicators measuring the scientific production of an institution. The search was conducted by two independent authors using a standardised data extraction form. For each indicator we extracted its definition, calculation, its rationale and its positive and negative points. In order to reduce bias, data extraction and analysis was performed by two independent authors.We included 76 articles. A total of 57 indicators were identified. We have classified those indicators into 6 categories: 9 indicators of research activity, 24 indicators of scientific production and impact, 5 indicators of collaboration, 7 indicators of industrial production, 4 indicators of dissemination, 8 indicators of health service impact. The most widely discussed and described is the h-index with 31 articles discussing it.The majority of indicators found are bibliometric indicators of scientific production and impact. Several indicators have been developed to improve the h-index. This indicator has also inspired the creation of two indicators to measure industrial production and collaboration. Several articles propose indicators measuring research impact without detailing a methodology for calculating them. Many bibliometric indicators identified

  3. Applicationof Qualitative Research on the Process-outcome Research of Psychotherapy%质化研究在心理治疗过程-效果研究中的应用

    Institute of Scientific and Technical Information of China (English)

    张延妍; 张亚林; 曾洁

    2015-01-01

    The effectiveness of psychotherapy has been confirmed and beyond doubt .Process‐outcome study is trying to describe the influence on the treatment effect caused by the process variables when exploring how can psychotherapy be effective .Moreover ,the application of qualitative research in the process‐outcome study can deepen the understanding of the overall treatment .This paper mainly illustrated the development and modifications of process‐outcome study as well as qualitative research ,and the characteristics ,advantages and inadequacies with examples when qualitative research applies to process‐outcome study .Finally ,it described the opportunities and challenges determined by the features of this research method when making further explorations .%心理治疗的有效性已被证实并毋庸置疑,在针对解答心理治疗如何有效这个问题上,过程-效果研究可以做到考察过程变量对治疗效果造成的影响;而进一步将质化研究应用于过程-效果研究之中,更能加深对治疗整体的认识和理解。主要介绍了过程-效果研究的相关研究方式和质化研究的发展变化、主要方法,并简要描述质化研究运用于过程-效果研究中的相关特点、方式、优势及不足并举例说明,以及因质化研究应用的特点所决定其将要面临的机遇与挑战。

  4. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... options exist. Transference-Focused Psychotherapy (TFP) Dialectical Behavior Therapy (DBT) Other forms of therapy for BPD include: ... than acting out these emotions impulsively. Schema-Focused Therapy (SFT) This type of therapy focuses on reframing “ ...

  5. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... Psychotherapy (TFP) This form of therapy is rooted in the patient’s confused and contradictory sense of identity ... person to another person, such as the therapist. In that moment, the therapist talks with the patient ...

  6. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... treatment options exist. Transference-Focused Psychotherapy (TFP) Dialectical Behavior Therapy (DBT) Other forms of therapy for BPD ... STEPPS can help reduce symptoms and problem BPD behaviors, relieve symptoms of depression, and improve quality of ...

  7. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... people learn tools, exercises, and concrete things they can do to manage their emotions when certain challenging ... treatment (such as medications or individual psychotherapy), STEPPS can help reduce symptoms and problem BPD behaviors, relieve ...

  8. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... identify and verbally express their emotions, describe their interactions with other people, and talk about themselves and ... stress (particularly the stress of rejection or disappointing interactions with other people). Supportive Psychotherapy A form of ...

  9. Introduction: Psychotherapy for Psychosis.

    Science.gov (United States)

    Garrett, Michael

    2016-01-01

    Beginning with Paul Federn--a contemporary of Sigmund Freud--every generation of psychotherapists for the past hundred years has included a small number of determined clinicians who have worked psychotherapeutically with psychotic patients, and written about their work. This special issue of the American Journal of Psychotherapy contains seven papers by clinicians in this generation who are using psychotherapy in the treatment of psychosis.

  10. PSYCHOTHERAPY SUPPORT ON SCIZOPHRENIA

    OpenAIRE

    Widyawati Suhendro

    2013-01-01

    Schizophrenia is a disease that causes varying descriptions. The symptoms of schizophrenia are divided into two groups, the primary and secondary symptoms. Treatment should be done as soon as possible, because a state of psychotic periods raises the possibility to suffer mental decline. The treatment is carried out must be comprehensive, multimodal, empirically and can be applied to the patient. One therapy that is given is psychotherapy. Psychotherapy is usually combined with pharmacologica...

  11. Core Outcomes and Common Data Elements in Chronic Subdural Hematoma: A Systematic Review of the Literature Focusing on Reported Outcomes.

    Science.gov (United States)

    Chari, Aswin; Hocking, Katie C; Broughton, Ellie; Turner, Carole; Santarius, Thomas; Hutchinson, Peter J; Kolias, Angelos G

    2016-07-01

    The plethora of studies in chronic subdural hematoma (CSDH) has not resulted in the development of an evidence-based treatment strategy, largely due to heterogeneous outcome measures that preclude cross-study comparisons and guideline development. This study aimed to identify and quantify the heterogeneity of outcome measures reported in the CSDH literature and to build a case for the development of a consensus-based core outcome set. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with the PROSPERO international prospective register of systematic reviews (CRD42014007266). All full-text English language studies with >10 patients (prospective) or >100 patients (retrospective) published after 1990 examining clinical outcomes in CSDH were eligible for inclusion. One hundred two eligible studies were found. There were 14 (13.7%) randomized controlled trials, one single arm trial (1.0%), 25 (24.5%) cohort comparison studies, and 62 (60.8%) prospective or retrospective cohort studies. Outcome domains reported by the studies included mortality (63.8% of included studies), recurrence (94.1%), complications (48.0%), functional outcomes (40.2%), and radiological (38.2%) outcomes. There was significant heterogeneity in the definitions of the outcome measures, as evidenced by the seven different definitions of the term "recurrence," with no definition given in 19 studies. The time-points of assessment for all the outcome domains varied greatly from inpatient/hospital discharge to 18 months. This study establishes and quantifies the heterogeneity of outcome measure reporting in CSDH and builds the case for the development of a robust consensus-based core outcome set for future studies to adhere to as part of the Core Outcomes and Common Data Elements in CSDH (CODE-CSDH) project.

  12. Serious Games for Psychotherapy: A Systematic Review.

    Science.gov (United States)

    Eichenberg, Christiane; Schott, Markus

    2017-06-01

    In the evolving digital age, media applications are increasingly playing a greater role in the field of psychotherapy. While the Internet is already in the phase of being established when it comes to the care of mental disorders, experimentation is going on with other modern media such as serious games. A serious game is a game in which education and behavior change is the goal, alongside with entertainment. The objective of the present article was to provide a first empirical overview of serious games applied to psychotherapy and psychosomatic rehabilitation. Therefore, a systematic literature search, including the terms "serious game" or "computer game" and "psychotherapy" or "rehabilitation" or "intervention" or "mental disorders" in the databases Medline and PsycINFO, was performed. Subsequently, an Internet search was conducted to identify studies not published in journals. Publications not providing empirical data about effectiveness were excluded. On the basis of this systematic literature review, the results of N = 15 studies met inclusion criteria. They utilized primarily cognitive behavioral techniques and can be useful for treating a range of mental disorders. Serious games are effective both as a stand-alone intervention or part of psychotherapy and appeal to patients independent of age and sex. Included serious games proved to be an effective therapeutic component. Nonetheless, findings are not conclusive and more research is needed to further investigate the effectiveness of serious games for psychotherapeutic purposes.

  13. Psychotherapies for Children and Adolescents

    Science.gov (United States)

    ... Facts for Families Guide Psychotherapy for Children and Adolescents: Different Types No. 86; updated February 2017 Psychotherapy ... Therapy (DBT) can be used to treat older adolescents who have chronic suicidal feelings/thoughts, engage in ...

  14. Ethical reflection and psychotherapy.

    Science.gov (United States)

    Vyskocilová, Jana; Prasko, Jan

    2013-01-01

    Theories of ethics and ethical reflection may be applied to both theory and practice in psychotherapy. There is a natural affinity between ethics and psychotherapy. Psychotherapy practice is concerned with human problems, dilemmas and emotions related to both one's own and other people's values. Ethics is also concerned with dilemmas in human thinking and with how these dilemmas reflect other individuals' values. Philosophical reflection itself is not a sufficient basis for the ethics of psychotherapy but it may aid in exploring attitudes related to psychotherapy, psychiatry and health care. PubMed, Web of Science and Scopus databases were searched for articles containing the keywords "psychotherapy", "ethics", "therapeutic relationship" and "supervision". The search was conducted by repeating the terms in various combinations without language or time restrictions. Also included were data from monographs cited in reviews. The resulting text is a review with conclusions concerning ethical aspects of psychotherapy. The ability to behave altruistically, sense for justice and reciprocity and mutual help are likely to be genetically determined as dispositions to be later developed by upbringing or to be formed or deformed by upbringing. Early experiences lead to formation of ethical attitudes which are internalized and then applied to both one's own and other people's behavior. Altruistic behavior has a strong impact on an individual's health and its acceptance may positively influence the pathophysiological mechanisms underlying numerous diseases. Ethical theory and reflection, however, may be applied to both theory and practice of psychotherapy in a conscious, targeted and thoughtful manner. In everyday practice, psychotherapists and organizations must necessarily deal with conscious conflicts between therapeutic possibilities, clients' wishes, their own as well as clients' ideas and the real world. Understanding one's own motives in therapy is one of the aims of a

  15. Student Evaluations, Outcomes, and National Licensure Examinations in Radiology Education: A Narrative Review of the Literature

    OpenAIRE

    Linaker, Kathleen L.

    2015-01-01

    Objective The purpose of this study was to examine literature on radiological student evaluation and outcome assessments including national board examinations. Methods A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references. Results Of the 4716 unique abstracts reviewed by the author, 54 were found to be relevant to the purpose of thi...

  16. Group Psychotherapy in Italy.

    Science.gov (United States)

    Giannone, Francesca; Giordano, Cecilia; Di Blasi, Maria

    2015-10-01

    This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.

  17. Psychotherapy: A 40-Year Appraisal.

    Science.gov (United States)

    Garfield, Sol L.

    1981-01-01

    Appraises selected issues and developments in the field of psychotherapy since 1940. Discusses increased participation of clinical psychologists in the area of psychotherapy, increased popularity of psychotherapy, declining influence of psychoanalysis and related views, emergence of behavioral and cognitive therapies, and recent emphasis on…

  18. Group Psychotherapy in Iceland.

    Science.gov (United States)

    Ívarsson, Ómar

    2015-10-01

    In this overview of group psychotherapy in Iceland, an attempt will be made to describe how it is practiced today, give some glimpses into its earlier history, and clarify seven issues: (1) the standing of group psychotherapy in Iceland, its previous history, and the theoretical orientation of dynamic group therapy in the country; (2) the role of group therapy in the health care system; (3) how training in group therapy is organized; (4) the relationship between group psychotherapy research and clinical practice; (5) which issues/processes can be identified as unique to therapy groups in Iceland; and (6) how important are group-related issues within the social background of the country; and (7) what group work holds for the future.

  19. Case sampling for psychotherapy practice, theory, and policy guidance: Qualities and quantities.

    Science.gov (United States)

    Krause, Merton S

    2016-09-01

    Random sampling of cases is usually infeasible for psychotherapy research, so opportunistic and purposive sampling must be used instead. Such sampling does not justify generalizations from sample to population-distribution statistics, but does justify reporting what independent-variable value configurations are associated with what dependent-variable value configurations. This allows only the generalization that these associations occur at least that frequently in the population sampled from, which is enough for suggesting and testing some psychotherapy theories and informing some psychotherapy practice. Although psychotherapy practice is a longitudinal process, formal psychotherapy outcome research is so far most feasible and most widely done in the form of two-phase cross-sectional input-outcome studies. Thus, the analysis of sampling for psychotherapy research here will be in terms of the independent- and dependent-variable value configurations produced in such two-phase studies.

  20. Gratitude in cognitive psychotherapy

    Directory of Open Access Journals (Sweden)

    Natalia C. Moyano

    2015-08-01

    Full Text Available Gratitude is a cognitive-affective state caused by the recognition that one has received a benefit from an external agent, due to the good intentions of this agent. Despite the evidence that associate gratitude with subjective well being, psychological well being, physical health and copping with stressful events, it is not enough taken in consideration in an academic level and in its interaction with psychotherapy instruments as well. In this article, the central concepts and information provided by the research are revised, intending to analyze possible ways to include gratitude into Cognitive Psychotherapy

  1. USING BACH FLOWER IN HOLISTIC PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Vagner Ferreira do Nascimento

    2017-05-01

    Full Text Available This is a narrative review from scientific literature that aimed to describe concepts and approaches for indications of the therapeutic use of Bach flower remedies in holistic psychotherapy. The review was developed in February 2016 from books, official documents and articles indexed in Lilacs and Scielo databases. Bach flower remedies is a therapeutic method that aims to restore the balance of human being, restoring its vital energy through holistic care. Because the flower essences act on psychic and emotional dimension of individual, when employed in holistic psychotherapy can provide greater autonomy, self-care and effectiveness compared to other alternative methods. The literature indicated that flower essence therapy is a safe practice and can be used in a complementary to health care, but should be performed by qualified professionals. It has also shown to be a promising and important area for nursing professional, but it still requires greater investment in research in the area to support the practice.

  2. Psychodynamic psychotherapy for the depressive syndrome.

    Science.gov (United States)

    Cameron, P M

    1989-06-01

    Historical approaches of psychotherapy for depression are contrasted with current psychotherapeutic strategies. Now more strategies are focused, structured, time-limited, observable, testable, researchable and data based. The following depressive syndromes are reviewed in terms of the literature that demonstrates the effectiveness of psychotherapy: major depressive disorder, bipolar depressive disorder, depression associated with medical illness such as cancer, myocardial infarction and stroke, resistant depression post-traumatic stress disorder, grief reactions and depression during adolescence, mid-life and the geriatric period of the life cycle. A conceptual model favoring tripartite focus of intervention is recommended. Psychodynamic psychotherapy for depression must consider intrapsychic, interpersonal and family dynamics as well as social supports. A model for each population needs to be studied and developed further. Recommendations for current research are suggested. In the individual modification of psychotherapeutic approaches we must consider the varying maturity of ego defenses and the ego strength of the individual patient. Forty well-designed studies that demonstrate the effectiveness of psychotherapy in the depressive syndromes are quoted in this paper.

  3. PubMed数据库中(1979~2008)飞行员与心理疗法文献计量学分析%Bibliometric Analysis of Literatures of Pilot and Psychotherapy in PubMed during 1979-2008

    Institute of Scientific and Technical Information of China (English)

    孙涵雪; 刘旭峰; 许昌泰

    2011-01-01

    目的 对飞行员与心理学、心理疗法、行为疗法、精神分析疗法、认知疗法和森田疗法文献进行计量分析,以确定其文献增长规律和发展趋势.方法 登录www.ncbi.nlm.nih.gov/Pubmed(PubMed数据库)后用"pilot+psychology,pilot+psychotherapy,psychology,psychotherapy,behavior therapy,psychoanalytic therapy,cognitive therapy和Morita therapy"检索"从1979/01/01到 2008/12/31"文献量.根据科学文献增长规律的理论,对数据进行分析.结果 1979 ~2008年,PubMed数据库收录飞行员+心理学文献10 568篇,飞行员+心理疗法文献2038篇,心理学文献689 144篇,心理疗法文献92 086篇,行为疗法78 407篇,精神分析疗法9777篇,认知疗法33 775篇和森田疗法3547篇.对1979 ~2008年逐年累积文献量进行回归分析表明,心理学和心理疗法文献呈缓慢递增,其方程近似直线(Y=a+bX);而飞行员+心理学(心理疗法)文献上升缓慢,其方程近似于以e为底的指数方程:Y=43.996e0.1083x (10.434e0.0943x ).心理疗法文献以英语为主导(89.50%).结论 飞行员与心理学及心理疗法的研究仍是一个热点,影响心理学文献增长的主要因素是学科自身固有的规律和科所处的环境条件.%Objective We carried out a bibliometric analysis of pilot and psychotherapy literatures in aiming to determine its growth ruling and growth tendenc and to providing the basis for research problems in relation with psychotherapy.Methods We selected( PubMed databases,www.ncbi.nlm.nih.gov/Pubmed) literatures that contained key descriptors, including pilot and psychology, pilot and psychotherapy, behavior therapy, psychoanalytic therapy, cognitive therapy and Morita therapy, in their titles or papers from 1979 to 2008.As bibliometric indicators of psychotherapy we calculated the biomedical journals referring to psychotherapy.We applied the principal bibliometric indicators;Price's and Bradford's laws on the increase or dispersion of scientific

  4. Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes : A Systematic Literature Review

    NARCIS (Netherlands)

    Sidorenkov, Grigory; Haaijer-Ruskamp, Flora M.; de Zeeuw, Dick; Bilo, Henk; Denig, Petra

    The authors conducted a systematic literature review to assess whether quality indicators for diabetes care are related to patient outcomes. Twenty-four studies were included that formally tested this relationship. Quality indicators focusing on structure or processes of care were included.

  5. Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes : A Systematic Literature Review

    NARCIS (Netherlands)

    Sidorenkov, Grigory; Haaijer-Ruskamp, Flora M.; de Zeeuw, Dick; Bilo, Henk; Denig, Petra

    2011-01-01

    The authors conducted a systematic literature review to assess whether quality indicators for diabetes care are related to patient outcomes. Twenty-four studies were included that formally tested this relationship. Quality indicators focusing on structure or processes of care were included. Descript

  6. Outcome of pregnancy in women with congenital heart disease - A literature review

    NARCIS (Netherlands)

    Drenthen, Willem; Pieper, Petronella G.; Roos-Hesselink, Jolien W.; van Lottum, Willem A.; Voors, Adriaan A.; Mulder, Barbara J. M.; van Dijk, Arie P. J.; Vliegen, Hubert W.; Yap, Sing C.; Moons, Philip; Ebels, Tjark; van Veldhuisen, Dirk J.

    2007-01-01

    A search of peer-reviewed literature was conducted to identify reports that provide data on complications associated with pregnancy in women with structural congenital heart disease (CHD). This review describes the outcome of 2,491 pregnancies, including 377 miscarriages (15%) and 114 elective abort

  7. The Effect of Peer Review on Information Literacy Outcomes in a Chemical Literature Course

    Science.gov (United States)

    Zwicky, David A.; Hands, Michael D.

    2016-01-01

    This article describes the use of peer review in a writing project involving upper-level chemistry students in a chemical literature course, with the goal of improving student performance in meeting information literacy outcomes. Students were asked to find articles on a topic of their choice over the course of a semester and assemble the results…

  8. Mobile gaming patterns and their impact on learning outcomes: A literature review

    NARCIS (Netherlands)

    Schmitz, Birgit; Klemke, Roland; Specht, Marcus

    2012-01-01

    Schmitz, B., Klemke, R., & Specht, M. (2012). Mobile gaming patterns and their impact on learning outcomes: A literature review. In A. Ravenscroft, S. Lindstaedt, C. D. Kloos, & D. Hérnandez-Leo (Eds.), Proceedings of 7th European Conference on Technology Enhanced Learning (EC-TEL 2012) (pp. 419-424

  9. Avaliação de processo e resultado em psicoterapias: uma revisão Evaluación del proceso y resultado en psicoterapias: una revisión Assessment of psychotherapy process and outcome: a review

    Directory of Open Access Journals (Sweden)

    Ana Carolina Peuker

    2009-09-01

    psychotherapy is a challenge to both researchers and clinical psychologists. This critical review about assessment of process and outcomes in psychotherapy stimulates the debate on how evidence-based clinical practice can provide scientific information about the relationship between therapeutic intervention and clinical outcome. This allows to identify therapeutic mechanisms and strategies to enhance the process of change in psychotherapy. This debate might narrow the gap between research and clinical practice. The improvement on clinical psychology training and the choice of cost-effective interventions might depend on the identification of variables that influence efficacy and effectiveness of psychotherapy.

  10. Qualitative psychotherapy research: the journey so far and future directions.

    Science.gov (United States)

    Levitt, Heidi M

    2015-03-01

    This article documents the evolution of qualitative psychotherapy research over the past 3 decades. Clients' and therapists' accounts of their experiences in psychotherapy provide a window into the psychotherapy relationship and its mechanisms of change. A sizable body of literature has been generated that uses qualitative methods to collect and analyze these accounts and to shed light on the psychotherapy process. It notes changes in the field such as growing numbers of dissertations and publications using qualitative methods as well as a strengthening emphasis on qualitative research within graduate education and research funding bodies. Future recommendations include developing principles for practice from qualitative methods and conducting qualitative meta-analyses. Other recommendations include forming journal review policies that support the publication of qualitative research and that focus on coherence in adapting methods to meet research goals, in light of a study's characteristics and epistemological framework, rather than focusing on sets of procedures.

  11. Psychotherapy for Suicidal Clients.

    Science.gov (United States)

    Lester, David

    1994-01-01

    Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

  12. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... when people with BPD realize others understand their experience and treatment options exist. Transference-Focused Psychotherapy (TFP) ... self-image – possibly brought on by negative childhood experiences – that affects how people react to their environment, ...

  13. Personality Theory and Psychotherapy

    Science.gov (United States)

    Fagan, Joen; And Others

    1974-01-01

    This group of articles discusses various aspects of Gestalt Therapy including its major contributions, role in psychotherapy, and contributions of Gestalt psychology in general. There is some discussion of the philosophical background of Gestalt therapy along with Gestalt theory of emotion. A case study and an annotated bibliography are included…

  14. Art Therapy Verses Psychotherapy

    Science.gov (United States)

    Del Giacco, Maureen

    2009-01-01

    The purpose of my paper is to identify the difference between psychotherapy and art therapy. Then to introduce a technique within the field of art therapy that is relevant to neuro-plasticity Del Giacco Neuro Art Therapy. The paper identifies the importance of the amygdala and the hippocampus within the role of art therapy. Supporting…

  15. Psychotherapy, Postmodernism, and Morality.

    Science.gov (United States)

    Kitwood, Tom

    1990-01-01

    Proposes a postmodern ethics based on mutual respect and trust, derived from psychotherapy, and recognizing the primacy of individual subjectivity. Develops the concept of free attention to one another creating moral space. Stresses affect over reason and practice over theory. Sees moral space as fundamental to the social fabric. (CH)

  16. Piaget and psychotherapy.

    Science.gov (United States)

    Friedman, T L

    1978-04-01

    It is difficult to apply Piaget's theory to psychotherapy because the place of affect in it is ambiguous. When the alternatives are considered, it seems most consistent with Piaget's ideas to regard both cognitive and affective phenomena as problem-solving organizations. Piaget's remarkable discoveries in the cognitive sphere are a consequence of the easy access in that sphere to the kind of problems that need solving, and the phasic development of solutions. But the nature of the problems to be solved or the values to be guarded by a patient in psychotherapy are not knowable independently of the patient's actual behavior. In one respect all that is left from Piaget's approach for psychotherapy generally is the truism that therapy fosters differentiation and integration. However, even if we cannot frame a peculiarly Piagetian paradigm of psychotherapy, Piaget is valuable in posing a subsidiary question, namely, what in therapy fosters problem-solving activity. A reading of Piaget suggests that a patient learns by acting on his therapist and tacitly interpreting the results of his actions, that difficulties in therapy are the material from which therapy proceeds, and that in order to grasp the situation of the patient, the therapist himself may need to act on him and not just think about him. An implied lesson for training would be that supervision should instill a professional identity that is reinforced rather than challenged by therapy difficulties, and does not rely solely on theoretical categorizing.

  17. Medikamentengabe und Psychotherapie

    OpenAIRE

    2013-01-01

    Psychopharmakotherapie ist ein möglicher Baustein in der multimodalen Behandlung kinder- und jugendpsychiatrischer Störungsbilder. Diese simple Aussage ist unumstritten. Dennoch haben im klinischen Alltag sowohl Eltern als auch Psychotherapeuten häufig erhebliche Bedenken, einem Kind ein Psychopharmakon zu verabreichen. Neben angemessenen Bedenken zu potenziellen Wechselwirkungen zwischen psychopharmakotherapie und Psychotherapie oder Unsicherheiten zu Wirkungen und Nebenwirkungen eines Psych...

  18. Analytic and Systemic Specialized Incest Group Psychotherapy

    DEFF Research Database (Denmark)

    Elkjaer, Henriette Kiilsholm; Mortensen, Erik Lykke; Poulsen, Stig Bernt

    PURPOSE: Women with long-term sequalae of child sexual abuse (CSA) were randomly assigned to analytic (Group A) or systemic group psychotherapy (Group S). Pre-post-analysis indicated that both therapies led to significant improvement, but overall Group S had significantly better outcome than Group...... and the four time points as repeated measures. Intention to treat analysis demonstrated that improvement were significant on all measures (P treated with Group A or Group S treatment...

  19. The Underlying Structure of Diverse Work Groups: A Literature Review on Faultlines and Diversity Outcomes

    Directory of Open Access Journals (Sweden)

    Stanciu, A.

    2015-12-01

    Full Text Available Diversity can be seen everywhere, as either a readily observable trait of people, such as gender and ethnicity, or as a hidden set of abilities, such work skills and personality traits. Organizations consider that work-teams with a diverse composition outperform homogeneous work-teams. Although this is often the case, there can be specific types of diversity composition that are detrimental for organizational outcomes. Usually this occurs in situations where members of a team align on more than one diversity attribute, thus creating a diversity faultline. As of yet, however, the literature is lacking a systematic overview as to whether diversity faultlines are always associated with poor organizational outcomes. To address this issue we conducted a literature review in which we sought to unravel the different underlying structures of diversity faultlines and their association with organizational outcomes. We distinguished between affective outcomes and productive outcomes. The findings indicate that faultlines can be categorized as based on social category aspects, information/ decision-making aspects, or a combination of the two attributes. Furthermore, the results suggest that there is no straightforward relationship between the various faultlines and outcomes. We argue that this is potentially due to the fact that these studies have not addressed the normative fit of faultlines. Our review also hints at the necessity of researchers to reach a consensus on how to operationalize some diversity traits.

  20. Psychotherapy Participants Show Increased Physiological Responsiveness to a Lab Stressor Relative to Matched Controls

    Directory of Open Access Journals (Sweden)

    Patrick R Steffen

    2014-07-01

    Full Text Available Accumulating evidence indicates that psychotherapy participants show increased physiological responsiveness to stress. The purpose of the present study was to examine differences between individuals participating in outpatient psychotherapy and matched controls using an experimental design. Forty-two psychotherapy participants and forty-eight matched controls were assessed on cardiovascular and cortisol functioning at baseline, during the Trier Social Stress Test (TSST, and during a twenty-minute recovery period. Psychotherapy participants and matched controls did not differ at baseline or during the TSST on the physiological measures but psychotherapy participants had higher cortisol and heart rate during the recovery period. In regards to reactivity, cortisol increased during the recovery period for the psychotherapy participants but decreased for those in the matched control group. Psychotherapy participants experiencing clinically significant levels of distress displayed elevated systolic and diastolic blood pressure and heart rate during the TSST when compared to psychotherapy participants not experiencing clinically significant levels of distress. Overall, physiological reactivity to stress appears to be an important issue for those in psychotherapy and directly addressing this issue may help improve psychotherapy outcomes.

  1. Ethical Considerations for Cognitive-Behavioral Therapists in Psychotherapy Research Trials

    Science.gov (United States)

    Haman, Kirsten L.; Hollon, Steven D.

    2009-01-01

    Psychotherapy research studies, which balance the pursuit of knowledge with the provision of treatment, can place unique demands on clinicians, patients, and research staff. However, the literature on ethical considerations in psychotherapy trials is minimal. The current paper depicts CBT community standards of practice in the context of two…

  2. Weighing the Evidence for Psychotherapy Equivalence: Implications for Research and Practice

    Science.gov (United States)

    Westmacott, Robin; Hunsley, John

    2007-01-01

    In the past two decades, numerous meta-analyses have been published that examine the question of psychotherapy equivalence. Hunsley and Di Giulio (2002) critically reviewed this literature and concluded that there was abundant evidence that the Dodo bird verdict of equivalence across psychotherapies is false. In this article, we summarize and…

  3. Social CRM Adoption and its Impact on Performance Outcomes: a Literature Review

    Directory of Open Access Journals (Sweden)

    Marolt Marjeta

    2015-12-01

    Full Text Available Background and Purpose: Social customer relationship management (social CRM is an emerging concept that integrates traditional CRM and social media in order to provide benefits for organizations and customers. Despite the benefits that social CRM can bring, many organizations are still at the early stage of adoption. To move beyond social marketing and to exploit opportunities offered by sales and customer service, organizations need to be aware of factors that drive social CRM adoption and different implications of social CRM adoption for performance outcomes. This paper aims to provide a review of scholarly literature on social CRM adoption with the focus on factors and performance outcomes.

  4. Narcissistic grandiosity and narcissistic vulnerability in psychotherapy.

    Science.gov (United States)

    Pincus, Aaron L; Cain, Nicole M; Wright, Aidan G C

    2014-10-01

    This article briefly summarizes the empirical and clinical literature underlying a contemporary clinical model of pathological narcissism. Unlike the DSM Narcissistic Personality Disorder (NPD), this clinical model identifies and differentiates between two phenotypic themes of dysfunction-narcissistic grandiosity and narcissistic vulnerability-that can be expressed both overtly and covertly in patients' ways of thinking, feeling, behaving, and participating in treatment. Clinical recognition that narcissistic patients can and often do present for psychotherapy in vulnerable states of depression, anxiety, shame, and even suicidality increases the likelihood of accurate diagnosis and effective treatment planning. This article provides case examples derived from psychotherapies with narcissistic patients to demonstrate how narcissistic grandiosity and narcissistic vulnerability concurrently present in patients who seek treatment.

  5. The role of emotional intelligence in symptom reduction after psychotherapy in a heterogeneous psychiatric sample

    NARCIS (Netherlands)

    Nyklicek, I.; Schalken, P.; Meertens, S.

    2015-01-01

    Background Emotional intelligence of the patient has been claimed to potentially be an important factor in psychotherapy. Empirical studies are largely lacking. The purpose of this study was to examine if (i) pre-intervention emotional intelligence predicts outcome of psychotherapy and (ii) change i

  6. The role of emotional intelligence in symptom reduction after psychotherapy in a heterogeneous psychiatric sample

    NARCIS (Netherlands)

    Nyklicek, I.; Schalken, P.; Meertens, S.

    2015-01-01

    Background Emotional intelligence of the patient has been claimed to potentially be an important factor in psychotherapy. Empirical studies are largely lacking. The purpose of this study was to examine if (i) pre-intervention emotional intelligence predicts outcome of psychotherapy and (ii) change

  7. História recente e perspectivas atuais da pesquisa de resultados em psicoterapia psicanalítica de longa duração Recent history and current perspectives of outcome studies on long-term psychoanalytic psychotherapy

    Directory of Open Access Journals (Sweden)

    Simone Isabel Jung

    2006-12-01

    Full Text Available Este artigo apresenta a história recente - dos anos 90 a janeiro de 2006 - e as perspectivas atuais da pesquisa de resultados em psicoterapia psicanalítica de longa duração com pacientes adultos em ambulatório. São analisadas e citadas 21 investigações, das quais quatro foram desenvolvidas na América Latina e apenas uma no Brasil. Isso demonstra que, apesar da evolução nas investigações psicanalíticas de resultado, nos países latinos, o número de pesquisas ainda é escasso. A efetividade da psicoterapia psicanalítica é demonstrada de maneira significativa, com diversos delineamentos de pesquisa. Percebe-se uma evolução na metodologia de pesquisa utilizada nas investigações no decorrer dos anos. A preocupação em colocar a investigação psicanalítica consoante com princípios científicos, sem desconsiderar a subjetividade característica dessa abordagem, é marcante. Ressalta-se a importância da investigação psicanalítica para confirmar os pressupostos do corpo teórico e a eficácia/efetividade do tratamento e possibilitar a refutação e modificação da teoria psicanalítica.This article shows the recent history (from the 1990's to January 2006 and current perspectives of outcome studies on long-term psychoanalytic psychotherapy in adult outpatients. Twenty-one inquiries are cited and analyzed, of which four were developed in Latin America and only one in Brazil. This shows that research is still scarce in Latin-American countries, despite the advances on outcome psychoanalytical investigations. The effectiveness of psychoanalytic psychotherapy was evidenced in a significant manner by several different research outlines. An evolution in research methodology used over the past years could be observed. The concern about placing the psychoanalytical investigation in association with scientific principles, without disregarding the subjectivity characteristic of this approach, is remarkable. The importance of

  8. The Arts, Crafts, and Sciences of Psychotherapy.

    Science.gov (United States)

    Benjamin, Lorna Smith

    2015-11-01

    Contemporary training and practice of psychotherapy and the research that supports it is the subject of this review. I discuss it in the light of what I value most from my own professional training, which was, in my opinion, highly privileged by comparison with what is offered today. A minimal hoped-for outcome is that younger readers will find valuable tidbits here and there that will be useful in their own versions of psychotherapy. A maximal hope is that a few individuals who choose to maintain clinical skills as well as emphasize psychotherapy research might be encouraged to follow their instincts toward excellence. They would allow their curiosity to bloom and their work to be creative and more adherent to the rules of natural science than time allows in these days of dashboards that count funding associated with numbers of publications, grants, teaching, and service hours. Admittedly, that path less well traveled would be risky, because what truly is new takes time to develop and implement and the outcomes when research truly can disconfirm hypotheses (as distinct from fail to confirm them) are, well, uncertain.

  9. Quantum change and psychotherapy.

    Science.gov (United States)

    Bien, Thomas H

    2004-05-01

    Deep change in psychotherapy more typically comes slowly rather than suddenly, but this difference between therapeutic change and quantum change may be one of perspective rather than substance. Psychotherapy may be understood as a kind of mindfulness practice similar to working with koans in that the client presents a life dilemma incapable of rational solution. While quantum change cannot be engineered, the psychotherapist can create an environment conducive to such transformation by producing true presence and modeling calm, concerned, sustained attention to the dilemma that precipitated treatment. Psychotherapists who also maintain a sense of their work as a high art and a way of being, and who in consequence cultivate their own emotional and spiritual development, may be more likely to create such an environment.

  10. Constructivism and psychotherapy.

    Science.gov (United States)

    Mahoney, Michael J; Granvold, Donald K

    2005-06-01

    Constructivism is a metatheoretical perspective that embraces diverse traditions in medicine, philosophy, psychology, and spiritual wisdom. Constructive psychotherapy emphasizes complex cycles in the natural ordering and reorganizing processes that characterize all development in living systems. Individuals are encouraged to view themselves as active participants in their lives. Within rich contexts of human relationship and symbol systems, people make new meanings as they develop. Techniques from many different traditions can help people find and refine their sense of balance as they develop.

  11. Psychotherapy and pharmacotherapy: a contemporary perspective.

    Science.gov (United States)

    Sandberg, Larry S; Busch, Fredric N

    2012-09-01

    A contemporary perspective on psychotherapy and pharmacotherapy views both treatments as somatic in nature. Abandoning Cartesian dualism frees the clinician to consider therapeutic options based on the best available evidence rather than falsely dichotomizing approaches as biological or psychological. Evidence-based medicine is a helpful though limited paradigm upon which to base treatment decisions. Instead, clinicians should strive for an evidence-informed approach that is patient centered. This approach is illustrated in relation to depressive illness where moderators of outcome are examined (illness severity, history of trauma, personality disorders, patient preference) that will influence clinical recommendations on combining treatment. Psychotherapy is increasingly proving to be a valuable therapeutic modality across the severity spectrum, a finding at odds with current treatment practices.

  12. DFP: Psychotherapie der Angststörungen

    Directory of Open Access Journals (Sweden)

    Doering S

    2011-01-01

    Full Text Available Die Psychotherapie stellt eine wirksame Behandlung für alle Angststörungen dar. Die Kombination mit einer (antidepressiven Pharmakotherapie dürfte oft sinnvoll sein, ist jedoch nur bei der Panikstörung empirisch untermauert. Bei allen Angststörungen sind verhaltenstherapeutische Ansätze am besten in ihrer Wirksamkeit belegt. Inzwischen sind – außer für die spezifischen Phobien – auch psychodynamische Ansätze manualisiert und empirisch evaluiert. Entspannungsverfahren werden bei der sozialen Phobie und der Panikstörung empfohlen und sind oft Bestandteil umfassender Behandlungsprogramme. Komorbide Störungen – insbesondere Persönlichkeitsstörungen – verschlechtern den Outcome der Angstbehandlung. Für die Zukunft sind weitere Untersuchungen zur langfristigen Wirksamkeit der Psychotherapie sowie zur Behandlung von Angstpatienten mit komorbiden Störungen notwendig.

  13. Hypoglycemic encephalopathy: a case series and literature review on outcome determination.

    Science.gov (United States)

    Witsch, Jens; Neugebauer, Hermann; Flechsenhar, Julia; Jüttler, Eric

    2012-10-01

    Data on clinical long-term outcome after the acute phase of hypoglycemic encephalopathy (HE) using validated outcome scales is currently unavailable. Here we report the results of a systematic literature search for studies on HE and data on long-term outcome in patients with HE admitted to three Charité hospitals between January 2005 and July 2010. HE was defined as coma/stupor and blood glucose levels GOS), and Barthel index (BI). Fifteen patients were included, with a mean age of 60 years (range 29-79). Two were lost to follow-up. Of the remaining 13 patients, six had died (46 %). In the seven survivors, the median mRS score was 0 (range 0-5), median GOS score was 5 (range 2-5), and median BI was 100 (range 0-100). MRIs made in the acute phase were available for three patients and revealed no obvious relation between lesion size or pattern and clinical outcome. To our knowledge, this is the first case series using validated clinical scoring systems to determine clinical long-term outcome after HE. The results suggest that mortality is high, but long-term survival with little or no disability is possible and can be observed in the majority of survivors. Risk of death or poor outcome does not seem to be related to MRI features in the acute phase but rather to other presumably medical factors.

  14. Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

    Science.gov (United States)

    Berger, Andre; Fergany, Amr

    2009-01-01

    Introduction. Laparoscopic radical nephroureterectomy (LNU) is being increasingly performed at several centers across the world. We review oncologic outcomes after LNU procedure and the techniques for the management of distal ureter. Materials and Methods. A comprehensive review of the literature was performed on the oncological outcomes and management of distal ureter associated with LNU for upper tract transitional cell carcinoma (TCC). Results and Discussion. LNU for upper tract TCC is performed pure laparoscopically (LNU) or hand-assisted (HALNU). The management of the distal ureter is still debated. LNU appears to have superior perioperative outcomes when compared to open surgery. Intermediate term oncologic outcomes after LNU are comparable to open nephroureterectomy (ONU). Conclusions. Excision of the distal ureter and bladder cuff during nephroureterectomy remains controversial. Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context. PMID:19020656

  15. Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

    Directory of Open Access Journals (Sweden)

    Andre Berger

    2009-01-01

    Full Text Available Introduction. Laparoscopic radical nephroureterectomy (LNU is being increasingly performed at several centers across the world. We review oncologic outcomes after LNU procedure and the techniques for the management of distal ureter. Materials and Methods. A comprehensive review of the literature was performed on the oncological outcomes and management of distal ureter associated with LNU for upper tract transitional cell carcinoma (TCC. Results and Discussion. LNU for upper tract TCC is performed pure laparoscopically (LNU or hand-assisted (HALNU. The management of the distal ureter is still debated. LNU appears to have superior perioperative outcomes when compared to open surgery. Intermediate term oncologic outcomes after LNU are comparable to open nephroureterectomy (ONU. Conclusions. Excision of the distal ureter and bladder cuff during nephroureterectomy remains controversial. Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context.

  16. Mechanical thrombectomy in pediatric acute ischemic stroke: Clinical outcomes and literature review.

    Science.gov (United States)

    Madaelil, Thomas P; Kansagra, Akash P; Cross, DeWitte T; Moran, Christopher J; Derdeyn, Colin P

    2016-08-01

    There are limited data on outcomes of mechanical thrombectomy for pediatric stroke using modern devices. In this study, we report two cases of pediatric acute ischemic stroke treated with mechanical thrombectomy, both with good angiographic result (TICI 3) and clinical outcome (no neurological deficits at 90 days). In addition, we conducted a literature review of all previously reported cases describing the use of modern thrombectomy devices. Including our two cases, the aggregate rate of partial or complete vessel recanalization was 100% (22/22), and the aggregate rate of favorable clinical outcome was 91% (20/22). This preliminary evidence suggests that mechanical thrombectomy with modern devices may be a safe and effective treatment option in pediatric patients with acute ischemic stroke. © The Author(s) 2016.

  17. [Psychotherapy as cultural discourse].

    Science.gov (United States)

    Józefik, Barbara

    2011-01-01

    It is impossible to think about psychotherapy without reference to the cultural context. In order to understand the development of this domain it is helpful to apply the concept of cultural discourse. When we think about the over one hundred years' history of psychotherapy it becomes clear that understanding of a person, his/her difficulties, psychopathology, the role of a psychotherapist, psychotherapy and its limitations have been changing. It depended on the acknowledged epistemological horizon. Therefore it is important to observe the process of creating discourses related to psychotherapeutic "reality". These discourses are not simply descriptive but they participate in creation of reality. They are not neutral, on the contrary, their application has broad practical, theoretical, ethical and legal consequences. An attempt to describe the culture, or better cultures, we are immersed in, is an attempt to describe the identity of contemporary psychotherapists. This article, referring to the constructionists' perspective and works of Michael Foucault, presents how cultural changes influence psychotherapists' ways of thinking, their practice and presence in social space.

  18. A systematic review of depression psychotherapies among Latinos.

    Science.gov (United States)

    Collado, Anahí; Lim, Aaron C; MacPherson, Laura

    2016-04-01

    For decades, the literature has reported persistent treatment disparities among depressed Latinos. Fortunately, treatment development and evaluation in this underserved population has expanded in recent years. This review summarizes outcomes across 36 unique depression treatment studies that reported treatment outcomes for Latinos. Results indicated that there was significant variability in the quality of RCT and type/number of cultural adaptations. The review suggested that there might a relation between cultural adaptations with treatment outcomes; future studies are warranted to confirm this association. Cognitive Behavioral Therapy was the most evaluated treatment (CBT; n=18, 50% of all evaluations), followed by Problem Solving Therapy (PST; n=4), Interpersonal Therapy (IPT; n=4), and Behavioral Activation (BA; n=3). CBT seems to fare better when compared to usual care, but not when compared to a contact-time matched control condition or active treatment. There is growing support for PST and IPT as efficacious depression interventions among Latinos. IPT shows particularly positive results for perinatal depression. BA warrants additional examination in RCT. Although scarce, telephone and in-home counseling have shown efficacy in reducing depression and increasing retention. Promotora-assisted trials require formal assessment. Limitations and future directions of the depression psychotherapy research among Latinos are discussed.

  19. Power Politics of Family Psychotherapy.

    Science.gov (United States)

    Whitaker, Carl A.

    It is postulated that the standard framework for psychotherapy, a cooperative transference neurosis, does not validly carry over to the successful psychotherapy of a two-generation family group. In many disturbed families, the necessary and sufficient dynamics for change must be initiated, controlled, and augmented by a group dynamic power-play,…

  20. History, Contemporary Outcomes, and Future of Penile Prostheses: A Review of the Literature.

    Science.gov (United States)

    Trost, Landon; Hellstrom, Wayne J G

    2013-10-01

    Since their introduction, penile prostheses have consistently remained a superior treatment option for men with erectile dysfunction (ED) refractory to conservative measures. Ongoing enhancements to prosthetic design, materials, and surgical techniques have resulted in improved outcomes. To review available literature on notable historical advancements and improvements of the penile prosthesis, summarize contemporary outcomes of recent devices, and discuss possible future directions of the penile prosthesis. A PubMed search was performed of all articles published from 1960 to present relating to penile prosthesis. Priority was given to series with 12 months of follow-up or greater, larger series, and studies reporting on outcomes of more recent prosthetic models. Main outcomes included historical review of improvements leading to, and contemporary series reporting on rates of mechanical failures, infections, and satisfaction with penile prostheses. Penile prostheses have undergone numerous enhancements since initial reports of synthetic materials utilized in the 1950s. Among others, recent notable device enhancements include Parylene coating, Bioflex® material, Inhibizone(TM) antibacterial impregnation, hydrophilic coating, lockout valves, and easy release pump mechanisms, all of which have improved mechanical reliability, reduced infection rates, and/or improved patient satisfaction with penile prostheses. Contemporary series of 3-piece penile prostheses report mechanical survival of 81-94%, 68-89%, and 57-76% at 5, 10, and 15 years, respectively. Infection rates of current devices are 1-2% in first-time, low-risk populations, and 2-3% for higher risk groups, with patient and partner satisfaction at 92-100% and 91-95%, respectively. Two-piece and malleable devices are associated with slightly higher mechanical reliability and decreased patient satisfaction. Minimal data currently exist on the outcomes of selected patient populations, including Peyronie's disease

  1. Predictors of discharge in child psychoanalytic psychotherapy

    OpenAIRE

    Izabel Cristina Paez; Maria Lucia Tiellet Nunes; Vânia Naomi Hirakata

    2015-01-01

    Introduction: This empirical study was based on the analysis of the results of a study about dropout predictors among in child psychoanalytic psychotherapy. The objectives were to characterize the sample of children discharged from psychoanalytic psychotherapy, examine the association between sociodemographic/ clinical variables and child psychoanalytic psychotherapy discharge, and determine predictors of discharge in child psychoanalytic psychotherapy.Method: This quantitative, descriptive a...

  2. Social Psychotherapy in Brazil.

    Science.gov (United States)

    Fleury, Heloisa J; Marra, Marlene M; Knobel, Anna M

    2015-10-01

    This paper describes the practice of sociodrama, a method created by J. L. Moreno in the 1930s, and the Brazilian contemporary socio-psychodrama. In 1970, after the Fifth International Congress of Psychodrama was held in Brazil, group psychotherapy began to flourish both in private practice and hospital clinical settings. Twenty years later, the Brazilian health care system added group work as a reimbursable mental health procedure to improve social health policies. In this context, socio-psychodrama became a key resource for social health promotion within groups. Some specific conceptual contributions by Brazilians on sociodrama are also noteworthy.

  3. Health outcomes during the 2008 financial crisis in Europe: systematic literature review.

    Science.gov (United States)

    Parmar, Divya; Stavropoulou, Charitini; Ioannidis, John P A

    2016-09-06

     To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes.  Systematic literature review.  Structural searches of key databases, healthcare journals, and organisation based websites.  Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis.  41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed.  Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

  4. Health outcomes during the 2008 financial crisis in Europe: systematic literature review

    Science.gov (United States)

    Parmar, Divya; Ioannidis, John P A

    2016-01-01

    Objective To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes. Design Systematic literature review. Data sources Structural searches of key databases, healthcare journals, and organisation based websites. Review methods Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis. Results 41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed. Conclusions Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis. PMID:27601477

  5. Literature review and analysis of the development of health outcomes assessment instruments in Chinese medicine

    Institute of Scientific and Technical Information of China (English)

    Feng-bin Liu; Zheng-kun Hou; Yun-ying Yang; Zheng-zheng Zhang; Di Xie; Nelson Xie; Hong Thach Nguyen

    2013-01-01

    OBJECTIVE:To evaluate the development of health outcomes assessment instruments in Chinese medicine.METHODS:A comprehensive literature search for all published articles in China National Knowledge Infrastructure Database,Chongqing VIP Database and WANFANG Data was conducted.The studies that met the inclusion and exclusion criteria were used to extract information according to a predesigned assessment instrument.RESULTS:A total of 97 instruments for health outcome assessment in Chinese medicine were identified.Of these questionnaires,7 were generic,12 were condition-specific and 78 were disease-specific.All instruments were suitable for adults,children,and both men and women.These instruments aimed to evaluate the health-related quality of life,signs and symptoms as well as patient satisfaction and doctor-reported outcome.However,the descriptions were poorly constructed for some of the most basic parameters,such as the domains and items,administrative mode,response options,memory recall periods,burden evaluation,format,copyright,content validity,and other properties.CONCLUSION:The instrument development for health outcomes assessment in Chinese medicine is increasing rapidly; however,there are many limitations in current methodologies and standards,and further studies are needed.

  6. A closer look at the discrimination outcomes in the IAT literature.

    Science.gov (United States)

    Carlsson, Rickard; Agerström, Jens

    2016-08-01

    To what extent the IAT (Implicit Association Test, Greenwald et al., 1998) predicts racial and ethnic discrimination is a heavily debated issue. The latest meta-analysis by Oswald et al. (2013) suggests a very weak association. In the present meta-analysis, we switched the focus from the predictor to the criterion, by taking a closer look at the discrimination outcomes. We discovered that many of these outcomes were not actually operationalizations of discrimination, but rather of other related, but distinct, concepts, such as brain activity and voting preferences. When we meta-analyzed the main effects of discrimination among the remaining discrimination outcomes, the overall effect was close to zero and highly inconsistent across studies. Taken together, it is doubtful whether the amalgamation of these outcomes is relevant criteria for assessing the IAT's predictive validity of discrimination. Accordingly, there is also little evidence that the IAT can meaningfully predict discrimination, and we thus strongly caution against any practical applications of the IAT that rest on this assumption. However, provided that the application is thoroughly informed by the current state of the literature, we believe the IAT can still be a useful tool for researchers, educators, managers, and students who are interested in attitudes, prejudices, stereotypes, and discrimination. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  7. The roles of funding source, clinical trial outcome, and quality of reporting in orthopedic surgery literature.

    Science.gov (United States)

    Khan, Safdar N; Mermer, Matthew J; Myers, Elizabeth; Sandhu, Harvinder S

    2008-12-01

    Compared with nonfunded or peer-reviewed funded projects, industry-sponsored clinical trials have traditionally been associated with more positive results. This relationship has been extensively studied in the nonsurgical literature. Although a few authors have addressed specialties, little has been reported on orthopedic clinical trials and their association with funding, study outcome, and efforts to reduce bias after randomization across journals of multiple subspecialties. For the study reported here, we selected 5 major orthopedic subspecialty journals: Journal of Bone and Joint Surgery (American Volume), Spine, Journal of Arthroplasty, Journal of Orthopaedic Trauma, and American Journal of Sports Medicine. We chose a 2-year limit for investigation (2002-2004); included all original randomized clinical trials reported in these 5 journals; and examined these trials for their study design, funding source, outcome, bias potential, and conclusion reached. Support for the 100 eligible orthopedic clinical trials was stated as coming from industry (26 trials, 26%), nonprofit sources (19 trials, 19%), and mixed sources (5 trials, 5%); no support was stated in 46 trials (46%), and support was not reported in 4 trials (4%). Of the 26 trials reporting industry support, 22 (85%) were graded as indicating an outcome favorable to the new treatment. The association between industry funding and favorable outcome was strong and significant (PJournal of Bone and Joint Surgery and Spine, measures taken to reduce bias were not documented.

  8. Of God and Psychotherapy.

    Science.gov (United States)

    Karasu, T Byram

    2015-01-01

    Psychotherapy is an instrument for remediation of psychological deficits and conflict resolution, as well as an instrument for growth and self-cultivation. In fact, psychotherapy is the finest form of life education. All of this is done without psychotherapists' playing a teacher, a minister, a priest, a rabbi, an imam, or a Buddhist monk, but by being familiar with what they know and more. That "more" is about understanding "the attributes" of gods and religions as they serve the all-too-human needs of believing and belonging. It is about the distillation of common psychological, sociological, moral, and philosophical attributes of religions, and the recognition that the attributes themselves are faith and God. Attributes that serve the affiliative needs define faith, for example, belonging is faith; attributes that serve the divine needs define God, for example, compassion is God. Those who have recovered from their primitive innocence need to formulate their ideas of God and religion, regardless of their affiliation with a religious community. One may need to resonate emotionally with the God of his or her religion, but intellectually need to transcend all its dogma and cultivate a personal concept of divinity free from any theological structure. Such an enlightened person achieves enduring equanimity by striving to own the attributes of Gods--to be godly. This is equally true for psychotherapists as it is for their patients.

  9. Prevention, management, and outcomes of macrosomia: a systematic review of literature and meta-analysis.

    Science.gov (United States)

    Rossi, A Cristina; Mullin, Patrick; Prefumo, Federico

    2013-10-01

    Macrosomia represents an obstetric challenge, and when suspected, there is no general consensus as to whether expectant management, induction of labor, or elective cesarean delivery are the best option. This review article was aimed to discuss literature published in the last decade about the identification, management, and outcomes of macrosomia. The identification of macrosomia remains uncertain, mainly because of the high heterogeneity across studies because of different definitions of macrosomia, gestational age at time of assessment, and fetal weight formulas. With regard to management and outcomes of macrosomia, 12,212 macrosomic neonates can be pooled from 17 articles. Compared with neonates with normal birth weight, the odds ratio of emergency cesarean delivery increases from 1.92 (1.53-2.42) to 2.24 (1.42-3.56) and 5.20 (3.47-7.79) for macrosomia 4000 g or greater, 4500 g or greater, and 5000 g or greater, respectively. The odds ratios of shoulder dystocia are 7.18 (2.06-25.00), 7.33 (5.13-10.48), and 16.16 (7.62-34.26) for macrosomia 4000 g or greater, 4500 g or greater, and 5000 g or greater, respectively. Three birth traumas were reported after cesarean delivery. Perinatal mortality is similar between macrosomic and neonates with normal birth weight at each cutoff of macrosomia. Nonetheless, limitations of current literature, which are also discussed in this review, do not allow to drive definitive conclusion about the management of macrosomia.

  10. A Systematic Review of the Combined Use of Electroconvulsive Therapy and Psychotherapy for Depression

    Science.gov (United States)

    McClintock, Shawn M.; Brandon, Anna R.; Husain, Mustafa M.; Jarrett, Robin B.

    2011-01-01

    Objective Electroconvulsive therapy (ECT) is one of the most effective treatments for severe Major Depressive Disorder (MDD). However, after acute phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe MDD and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation. Methods The authors performed two independent searches in PsychInfo (1806 – 2009) and MEDLINE (1948 – 2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of six articles (English language) that mentioned ECT and psychotherapy in the abstract, and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome. Results Although research over the past seven decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes. Conclusions Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special

  11. Effectiveness of Child Psychoanalytic Psychotherapy in a Clinical Outpatient Setting

    Science.gov (United States)

    Deakin, Elisabeth Kuhn; Tiellet Nunes, Maria Lucia

    2009-01-01

    The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6-11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All…

  12. Benchmarks for Psychotherapy Efficacy in Adult Major Depression

    Science.gov (United States)

    Minami, Takuya; Wampold, Bruce E.; Serlin, Ronald C.; Kircher, John C.; Brown, George S.

    2007-01-01

    This study estimates pretreatment-posttreatment effect size benchmarks for the treatment of major depression in adults that may be useful in evaluating psychotherapy effectiveness in clinical practice. Treatment efficacy benchmarks for major depression were derived for 3 different types of outcome measures: the Hamilton Rating Scale for Depression…

  13. Parent-Infant Psychotherapy and Postpartum Depression: The Fathers Participation

    Directory of Open Access Journals (Sweden)

    Milena da Rosa Silva

    2013-05-01

    Full Text Available Given the specificities of postpartum maternal depression, the literature recommends that fathers become involved in psychological interventions within this context. This study presents an investigation of the participation of fathers in parent-infant psychotherapy in the context of maternal postpartum depression. Two families participated in this study, both with a child aged between 7 and 8 months old, whose mothers showed depressive symptoms. These families participated in parent-infant psychotherapy lasting approximately 12 sessions. Analysis of the fathers’ participation in psychotherapy showed that their presence during sessions enables the therapy to address aspects of parenthood, and also reduce the feeling of mothers as being the only ones responsible for the family’s process of change. In regard to the technique, the presence of fathers during sessions allows the therapist to see and address the issues concerning mother-father-infant during sessions.

  14. Class barriers to psychotherapy and counselling.

    Science.gov (United States)

    Ollerton, I

    1995-01-01

    This paper focuses on the barriers to the uptake of counselling and psychotherapy from a social class perspective. It begins with a definition of class before discussing particular aspects that inhibit uptake. Barriers focused upon are those regarding travel, costs, child care, appointment times and location of actual therapists. Likewise barriers to the effective outcome, for example cognitive and verbal abilities of clients, are addressed and the way in which these barriers inhibit the referral rate from particular social groups. Finally the self-imposed barriers of certain social groups are explored regarding self exile from the counselling arena.

  15. Psychotherapy change process research: realizing the promise.

    Science.gov (United States)

    Elliott, Robert

    2010-03-01

    Change process research (CPR) is the study of the processes by which change occurs in psychotherapy and is a necessary complement to randomized clinical trials and other forms of efficacy research. In this article the author describes and evaluates four types of CPR. The first three are basic designs and include quantitative process-outcome, qualitative helpful factors, and microanalytic sequential process; the fourth, the significant events approach, refers to methods such as task analysis and comprehensive process analysis that integrate the first three. The strengths and weaknesses of each design are described and summarized using both causal and practical criteria as part of an overall argument for systematic methodological pluralism.

  16. Mental health outcomes during colorectal cancer survivorship: a review of the literature.

    Science.gov (United States)

    Mosher, Catherine E; Winger, Joseph G; Given, Barbara A; Helft, Paul R; O'Neil, Bert H

    2016-11-01

    This article reviews literature on adults' mental health outcomes during acute and long-term colorectal cancer (CRC) survivorship. We identified articles that included at least one measure of psychological symptoms or mental quality of life or well-being through a search of databases (CINAHL, MEDLINE, PsycINFO, and PsycARTICLES). Articles were published between January 2004 and April 2015. A significant proportion of CRC survivors experience clinically meaningful levels of anxiety and depressive symptoms or reduced mental well-being across the trajectory of the illness. Demographic, medical, and psychosocial predictors of mental health outcomes were identified. However, few studies were theory-driven, and gaps remain in our understanding of risk and protective factors with respect to mental health outcomes, especially during long-term CRC survivorship. Theory-driven longitudinal research with larger samples is required to identify subgroups of CRC survivors with different trajectories of psychological adjustment. Such research would assess adjustment as a function of internal resources (e.g., personality and coping) and external resources (e.g., finances and social support) to inform future interventions for CRC survivors. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  17. The role of hope in psychotherapy with older adults.

    Science.gov (United States)

    Bergin, L; Walsh, S

    2005-01-01

    The positive impact of psychotherapy upon the mental health problems of older people is increasingly accepted. However little attention has been paid to the role of hope in working therapeutically with older adults. Three relevant bodies of literature, namely adult psychotherapy, hope in older adulthood, and coping with chronic and terminal illness, provide a starting point for examining the therapeutic uses of hope. However, it is argued that these literatures cannot provide a sufficiently comprehensive conceptualisation of hope in psychotherapy with elders. Firstly, it is considered that hope in therapy is directly affected by key experiences of ageing, namely: facing physical and/or cognitive deterioration and facing death. Also, these three bodies of literature have tended to dichotomise hope as either beneficial and adaptive or dysfunctional and maladaptive. A developmental perspective is used to critique this dichotomy and a clinical framework is provided which examines the role and utility of hope in older adult psychotherapy from a more integrated viewpoint embedded in the client's life history. The framework is comprised of three types of 'hope work': 'facilitating realistic hope,' 'the work of despair' and 'surviving not thriving'. Suggestions are made about how this work may be carried out and with whom.

  18. Learning how to ask in ethnography and psychotherapy.

    Science.gov (United States)

    Krause, Inga-Britt

    2003-01-01

    To social anthropologists an affinity with psychotherapy lies in the view that this discipline is a social science. Increasingly, social anthropologists offer comments and analyse their own data using psychotherapeutic or psychoanalytic frames of reference. At the same time, a methodological crisis has developed in ethnography. This is a crisis of how to carry out an ethnographic enquiry in a disciplined manner without either claiming to be a detached observer on the one hand or explaining away the subjective experiences of informants or clients with too much interpretation on the other. The aim of this paper is to address this crisis and to suggest ways in which ethnographers can use techniques from one type of psychotherapy, namely systemic or family psychotherapy in order to access social and psychological aspects of the lives of their informants. The paper achieves this by describing systemic psychotherapy and its theoretical foundations in the ethnographic work of Gregory Bateson. It then reviews the mainly medical anthropology literature in which the connection between psychotherapy and anthro pology has been discussed. While this literature has suggested a narrative and a performative approach to ethnographic data and, therefore, to informants, it has not extended the analytic frame to include the ethnographer him/herself within these frames. Clinical case material is presented to demonstrate how such an inclusion is central to the practice of systemic psychotherapy and to show that this type of material is ethnographic. The techniques of double description, hypothesising and circular questioning are described and demonstrated, and it is argued that adapting these to an ethnographic enquiry will enhance the validity of the anthropological project.

  19. Problems of process-efficiency studies in psychotherapy.

    Science.gov (United States)

    Meyer, A E

    1996-01-01

    Three areas of psychotherapy research can be delimited of which differential efficiency research promises to be the most fruitful, because it will eventually inform us which interventions with what kind of patient and what kind of problem will be the most constructive. One problem it can solve is the so-called equivalence paradox. This epitheton designates the fact, that in spite of the enormous differences in theory and interventions between the different kinds of psychotherapies, their results are not remarkably divergent. One quite popular hypothesis is that this is due to common factors, commun to any and every kind of psychotherapy. Our results indicate that this explanation is too simplistic because it uses a monosubstance-doses-effect-relationship model and disregards interaction. One other avenue is the relevant events approach. Our examples yield equivocal results. Nevertheless this remains a promising field of investigation. Finally there are time series analyses which are probably most germane to the field of psychotherapies. One illustration with a case of negative psychotherapy outcome is presented. Time series analysis is able to show that the patient changed to a negativistic attitude in the middle of session, whereas the psychoanalyst only changed at the beginning of session 10 respectively in its middle.

  20. Grundprinzipien der existenziellen Psychotherapie

    Directory of Open Access Journals (Sweden)

    Längle A

    2015-01-01

    Full Text Available Die existenzielle Psychotherapie hat mit der humanistischen Psychotherapie zentrale Themen gemeinsam: personale Freiheit, Verantwortung, Sinnsuche, Authentizität. Die therapeutische Vorgangsweise ist primär phänomenologisch, d. h. auf den Einzelnen und die Einmaligkeit der Situation ausgerichtet. Begegnung der Person und Interesse an dem, was sie bewegt, steht vor der Anwendung von allgemeinen Techniken. Damit kommt die Person mit ihrer zentralen Fähigkeit, das für sie Wesentliche zu erfassen und der Entscheidung zuzuführen, in den Mittelpunkt des Geschehens. Das Auffinden der inneren Zustimmung zu dem, was man tut oder unterlässt, gilt als zentral in der Vorgangsweise der existenziellen Psychotherapie. So liegt das Interesse weniger in der Symptomfreiheit als im Erreichen persönlicher Erfüllung im Leben. Die Therapie beginnt darum meist mit der Arbeit an der Annahme, am Verstehen und an der Stellungnahme zu den Problemen und Erfahrungen, die das Leid verursachen. Diese dialogische Haltung ist auch bei chronischen Krankheiten von grundlegender Bedeutung. Psychische Störungen bzw. Krankheiten wirken sich hemmend auf den Vollzug dieser Fähigkeiten der authentischen Person aus, mit Auswirkungen vor allem auf die Qualität des (inneren und äußeren Dialogs. Dadurch entsteht neben dem spezifischen Leiden, das Bezug auf die jeweils gestörte existenzielle Struktur nimmt, ein Mangel an innerer Erfüllung im Leben, der als existenzielles Hauptsymptom gilt. Dem erfüllenden Dialog geht eine Offenheit des Menschen voraus, in der er sich vom Leben und von der Lebenssituation befragen lässt hinsichtlich dessen, was seine geeignete Antwort auf die Situation wäre. Nicht ausreichend gelebte Pflege und Sorge um die Grundstrukturen der Existenz wirken sich hemmend auf die Voraussetzungen für erfüllendes Leben aus: auf die personalen Fähigkeiten der Wahrnehmung, des Fühlens, Entscheidens und sich mit den Kontexten Abstimmens. Ein verminderter

  1. Psychotherapy training: Suggestions for core ingredients and future research.

    Science.gov (United States)

    Boswell, James F; Castonguay, Louis G

    2007-12-01

    Despite our considerable depth and breadth of empirical knowledge on psychotherapy process and outcome, research on psychotherapy training is somewhat lacking. We would argue, however, that the scientist-practitioner model should not only guide practice, but also the way our field approaches training. In this paper we outline our perspective on the crucial elements of psychotherapy training based on available evidence, theory, and clinical experience, focusing specifically on the structure, key components, and important skills to be learned in a successful training program. In addition, we derive specific research directions based on the crucial elements of our proposed training perspective, and offer general considerations for research on training, including method and measurement issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  2. Disappointed Love and Suicide: A Randomized Controlled Trial of "Abandonment Psychotherapy" Among Borderline Patients.

    Science.gov (United States)

    Andreoli, A; Burnand, Y; Cochennec, M-F; Ohlendorf, P; Frambati, L; Gaudry-Maire, D; Di Clemente, Th; Hourton, G; Lorillard, S; Canuto, A; Frances, A

    2016-04-01

    To determine whether ambulatory psychotherapy targeted to abandonment experiences and fears can reduce suicidality and improve outcome in borderline patients referred to the emergency room with major depressive disorder and self-destructive behavior severe enough to require medical/surgical treatment and a brief psychiatric hospitalization. A total of 170 subjects were randomized at hospital discharge into three treatment groups: treatment as usual (TAU), abandonment psychotherapy delivered by certified psychotherapists, and abandonment psychotherapy delivered by nurses. Assessments were performed before randomization and at 3-month follow-up. Continued suicidality and other outcome measures were significantly worse in the treatment-as-usual as compared to both abandonment psychotherapy groups, but there were no differences between the two psychotherapy groups. These results suggest the efficacy of manualized psychotherapy that specifically targets the abandonment fears and experiences that are so common as precipitants to suicidal and self-destructive acts in borderline patients. It does not appear that formal psychotherapy training is associated with better outcomes.

  3. Uses of humor in psychotherapy.

    Science.gov (United States)

    Dimmer, S A; Carroll, J L; Wyatt, G K

    1990-06-01

    Given demonstrated usefulness in facilitating learning, aiding healing, and reducing stress, humor has gained recognition as a clinical tool. This article reviews some uses and potential misuses of humor in psychotherapy and suggests directions for practice and research.

  4. Humor and creativity in psychotherapy

    Directory of Open Access Journals (Sweden)

    Javier Martín Camacho

    2015-09-01

    Full Text Available In the current article principal theories on humor are analyzed, relating them to different conceptions of creativity. Finally, some indications for the use of humor in psychotherapy are introduced, highlighting their positive and negative aspects. 

  5. Trends in Counseling and Psychotherapy.

    Science.gov (United States)

    Smith, Darrell

    1982-01-01

    Surveyed the views of both clinical and counseling psychologists regarding current trends in counseling and psychotherapy. Found psychoanalysis to be declining in popularity, while cognitive-behavioral options represented one of the strongest theoretical emphases today. (Author/GC)

  6. Trends in Counseling and Psychotherapy.

    Science.gov (United States)

    Smith, Darrell

    1982-01-01

    Surveyed the views of both clinical and counseling psychologists regarding current trends in counseling and psychotherapy. Found psychoanalysis to be declining in popularity, while cognitive-behavioral options represented one of the strongest theoretical emphases today. (Author/GC)

  7. Nonverbal communication in psychotherapy.

    Science.gov (United States)

    Foley, Gretchen N; Gentile, Julie P

    2010-06-01

    The mental status examination is the objective portion of any comprehensive psychiatric assessment and has key diagnostic and treatment implications. This includes elements such as a patient's baseline general appearance and behavior, affect, eye contact, and psychomotor functioning. Changes in these parameters from session to session allow the psychiatrist to gather important information about the patient. In psychiatry, much emphasis is placed on not only listening to what patients communicate verbally but also observing their interactions with the environment and the psychiatrist. In a complimentary fashion, psychiatrists must be aware of their own nonverbal behaviors and communication, as these can serve to either facilitate or hinder the patient-physician interaction. In this article, clinical vignettes will be used to illustrate various aspects of nonverbal communication that may occur within the setting of psychotherapy. Being aware of these unspoken subtleties can offer a psychiatrist valuable information that a patient may be unwilling or unable to put into words.

  8. Should psychotherapy consider reincarnation?

    Science.gov (United States)

    Peres, Julio F P

    2012-02-01

    There is increasing recognition of the need to take into account the cultural environment and belief systems of psychotherapy patients because these values reflect basic assumptions about man's nature and the cognitive references used to cope with psychological difficulties. Currently accepted psychotherapeutic approaches take no account of the belief in life after death held by most of the world's population. The World Values Survey (http://www.worldvaluessurvey.org) showed that there are large numbers of reincarnationists around the world, and whatever the reasons for believing in reincarnation, psychotherapeutic approaches should not ignore this significant group of people. Respect for patient opinions and subjective realities is a therapeutic need and an ethical duty, even though therapists may not share the same beliefs. Guidelines are suggested for professionals to develop collaborative models that help patients mobilize their intrinsic intelligence to find solutions to their complaints.

  9. A critical synopsis of the diagnostic and screening radiology outcomes literature.

    Science.gov (United States)

    Blackmore, C C; Black, W C; Jarvik, J G; Langlotz, C P

    1999-01-01

    In summary, the radiology outcomes research literature is both extensive and broad. The methodologic quality, however, is quite variable. Overall, this quality could be improved by intervention in two areas: methodologic dissemination and development. The number of researchers investigating radiology-related outcomes is high, and presently there are over 20 journals devoted exclusively to radiology research. Even with a relatively narrow definition of "outcomes," we identified over 200 radiology outcomes studies, most from the past few years. However, the methodologic quality of most of these articles was relatively low, with important design flaws and biases. Nonetheless, a substantial number of radiology publications do employ state-of-the-art research methods and innovative approaches to methodologic challenges. The quality of radiology outcomes research overall would benefit tremendously from dissemination of such research methods. Instruction in outcomes research methods is accessible to radiologists. For example, there have been several recent articles and series of articles on outcomes research methods in JAMA, including guidelines for the performance and reporting of cost-effectiveness analyses (38-40) and for developing clinical prediction rules (57). Within radiology, several recent articles have appeared on, among other things, cost-effectiveness analysis (34,59,60), assessing quality of life (43), screening for disease (53), and defining the study population (61). The research compendium compiled for the GERRAF (General Electric-Association of University Radiologists Radiology Research Academic Fellowships) program remains a comprehensive methodologic source for many of the issues in radiology outcomes research, and outcomes research methods courses are offered every year at the Society for Health Services Research in Radiology and Society for Medical Decision Making meetings, as well as at the meeting of the Radiological Society of North America. Even

  10. PSYCHOTHERAPY SUPPORT ON SCIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Widyawati Suhendro

    2013-12-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Schizophrenia is a disease that causes varying descriptions. The symptoms of schizophrenia are divided into two groups, the primary and secondary symptoms. Treatment should be done as soon as possible, because a state of psychotic periods raises the possibility to suffer mental decline. The treatment is carried out must be comprehensive, multimodal, empirically and can be applied to the patient. One therapy that is given is psychotherapy. Psychotherapy is usually combined with pharmacological actions in order to increase the level of maximum healing. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  11. [The various facets of psychotherapy].

    Science.gov (United States)

    Berger, Mathias

    2013-01-01

    In the last decades, psychotherapy has gained increasing importance in the field of psychiatric treatment. Notably, disorder-specific and evidence-based psychotherapeutic strategies now dominate the field as compared to traditional schools of psychotherapy. It should not be neglected that patients, besides being offered a specifically tailored psychological therapy for their disorder, are also in need of reliable moral support and help. Therapeutic creativity frequently is an important skill to gain access to patients.

  12. The (dramatic) process of psychotherapy.

    Science.gov (United States)

    Zeig, Jeffrey K

    2008-07-01

    Psychotherapy can be conceived as a symbolic drama in which patients can experientially realize their capacity to change. Methods derived from hypnosis can empower therapy without the use of formal trance. A case conducted by Milton Erickson is presented and deconstructed in order to illuminate Erickson's therapeutic patterns. A model is offered for adding drama to therapy, and the model is placed into a larger model of choice points in psychotherapy.

  13. Daily hassles, their antecedents and outcomes among professional first responders: A systematic literature review.

    Science.gov (United States)

    Larsson, Gerry; Berglund, Anna Karin; Ohlsson, Alicia

    2016-08-01

    Occupational groups such as firefighters, military officers, paramedics and police officers are exposed to a combination of acute, severe and accumulated everyday stress. Drawing on the daily hassles perspective on stress, the aim was to synthesize existing research on daily hassles in professional first responder settings into a theoretical model. A systematic mixed studies review with an integrated design was undertaken. The selection process resulted in 40 articles meeting the inclusion criteria. The selected papers represented two literature reviews, one qualitative study, eight longitudinal studies and 29 cross-sectional studies. Five superior categories emerged in the analysis: Individual antecedent and continuously framing factors, Environmental antecedent and continuously framing factors, Appraisal and coping processes, Daily hassles and Outcome. Suggestions for future research are presented.

  14. Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study Psicoterapia psicodramática combinada ao tratamento medicamentoso no transtorno depressivo maior: um estudo aberto e naturalístico

    OpenAIRE

    Elisabeth Maria Sene Costa; Rosilda Antonio; Márcia Britto de Macedo Soares; Ricardo Alberto Moreno

    2006-01-01

    OBJETIVE: Recent literature has highlighted the role of psychotherapy in the treatment of major depressive disorder. Combined therapies comprising both psychotherapy and pharmacotherapy have presented the best results. Although several kinds of psychotherapies have been studied in the treatment of depressive disorders, there remains a lack of data on psychodramatic psychotherapy in the treatment of major depressive disorder. The objective of this study was to evaluate the impact of psychodram...

  15. Neighborhood safety factors associated with older adults' health-related outcomes: A systematic literature review.

    Science.gov (United States)

    Won, Jaewoong; Lee, Chanam; Forjuoh, Samuel N; Ory, Marcia G

    2016-09-01

    Neighborhood safety is important for older adults' health and wellbeing, but there has not been a synthesis in the literature of what is currently known about this construct. This systematic literature review, following the PRISMA guidelines, focuses on identifying neighborhood safety factors associated with health-related outcomes and behaviors of older adults in the U.S. A search was conducted in 2014 via Academic Search Complete, CINAHL, Embase, MEDLINE, SportDis, and Transportation Databases. Based on our inclusion and exclusion criteria, we identified thirty-two articles for review. Sixteen studies examined health outcomes such as health status, mental health, physical function, morbidity/mortality, and obesity; the other sixteen studies focused on health behaviors, such as physical activity and walking. Four domains of neighborhood safety were identified: overall/general neighborhood safety; crime-related safety; traffic-related safety; and proxies for safety (e.g., vandalism, graffiti). Overall/general neighborhood safety appeared most relevant to mental health and physical function. Traffic-related safety was most pertinent to physical activity, while crime-related safety was more consistently associated with mental health and walking. While all safety variables were significantly associated with mental health, no significant associations were found for obesity. We also found that specific measures or constructs of safety were not applied consistently across the examined studies, making it difficult to compare the results. This review identified several important gaps in the existing studies dealing with neighborhood safety-health relationships among older adults. Further studies are needed that examine the different roles of multidimensional neighborhood safety in promoting the community health, not only in the U.S., but globally. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Literature review and analysis of the application of health outcome assessment instruments in Chinese medicine

    Institute of Scientific and Technical Information of China (English)

    Feng-bin Liu; Zheng-kun Hou; Yun-ying Yang; Pei-wu Li; Qian-wen Li; Nelson Xie; Jing-wei Li

    2013-01-01

    OBJECITVE:To evaluate the application of health assessment instruments in Chinese medicine.METHODS:According to a pre-defined search strategy,a comprehensive literature search for all articles published in China National Knowledge Infrastructure databases was conducted.The resulting articles that met the defined inclusion and exclusion criteria were used for analysis.RESULTS:A total of 97 instruments for health outcome assessment in Chinese medicine have been used in fundamental and theoretical research,and 14 of these were also used in 29 clinical trials that were randomized controlled trials,or descriptive or cross-sectional studies.In 2 152 Chinese medicine-based studies that used instruments in their methodology,more than 150 questionnaires were identified.Among the identified questionnaires,51 were used in more than 10 articles (0.5%).Most of these instruments were developed in Western countries and few studies (4%) used the instrument as the primary evidence for their conclusions.CONCLUSION:Usage of instruments for health outcome assessment in Chinese medicine is increasing rapidly; however,current limitations include selection rationale,result interpretation and standardization,which must be addressed accordingly.

  17. Mental health outcomes in times of economic recession: a systematic literature review.

    Science.gov (United States)

    Frasquilho, Diana; Matos, Margarida Gaspar; Salonna, Ferdinand; Guerreiro, Diogo; Storti, Cláudia C; Gaspar, Tânia; Caldas-de-Almeida, José M

    2016-02-03

    Countries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations' health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes. Literature review of records identified through Medline, PsycINFO, SciELO, and EBSCO Host. Only original research papers, published between 2004 and 2014, peer-reviewed, non-qualitative research, and reporting on associations between economic factors and proxies of mental health were considered. One-hundred-one papers met the inclusion criteria. The evidence was consistent that economic recessions and mediators such as unemployment, income decline, and unmanageable debts are significantly associated with poor mental wellbeing, increased rates of common mental disorders, substance-related disorders, and suicidal behaviours. On the basis of a thorough analysis of the selected investigations, we conclude that periods of economic recession are possibly associated with a higher prevalence of mental health problems, including common mental disorders, substance disorders, and ultimately suicidal behaviour. Most of the research is based on cross-sectional studies, which seriously limits causality inferences. Conclusions are summarised, taking into account international policy recommendations concerning the cost-effective measures that can possibly reduce the occurrence of negative mental health outcomes in populations during periods of economic recession.

  18. Prophylactic efficacy of fluoxetine, escitalopram, sertraline, paroxetine, and concomitant psychotherapy in major depressive disorder: outcome after long-term follow-up.

    Science.gov (United States)

    Peselow, Eric D; Tobia, Gabriel; Karamians, Reneh; Pizano, Demetria; IsHak, Waguih William

    2015-02-28

    The acute efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder (MDD) is well established; however their role in longer-term prevention of recurrence remains unconfirmed. This study aims at examining: the prophylactic efficacy of four commonly used SSRIs in MDD in a naturalistic setting with long-term follow-up, the effect of concomitant cognitive behavioral therapy (CBT), and the predictors of outcome. In a prospective cohort study, 387 patients who either remitted or responded following treatment with four different SSRIs-fluoxetine, escitalopram, sertraline and paroxetine-were followed up over several years. During an average follow-up period of 34.5 months, 76.5% of patients experienced MDD recurrence. Escitalopram and fluoxetine showed a numerically higher prophylactic efficacy than paroxetine and sertraline but the difference was statistically insignificant. The prophylactic efficacy for SSRI-only treatment was limited, with a recurrence rate of 82.0%, compared to 59.0% of patient recurrence rate in concomitant Cognitive Behavioral Therapy (CBT). The relatively small size of the CBT group and the lack of randomization may undermine the extrapolation of its findings to clinical practice. Nevertheless, the study preliminary data may help in defining the clinical utility of antidepressants and CBT in the prophylaxis from MDD recurrence.

  19. Patterns and outcomes of breast reconstruction in older women - A systematic review of the literature.

    Science.gov (United States)

    Oh, D D; Flitcroft, K; Brennan, M E; Spillane, A J

    2016-05-01

    Older age is associated with lower rates of breast reconstruction (BR) for women requiring mastectomy. The purpose was to assess the available evidence on uptake, outcome and quality of life (QoL) after BR in older women. A systematic literature review was performed via Medline, Embase and Cochrane databases using the search terms breast reconstruction, breast cancer, and mastectomy. Eligible studies reported rates of BR, rates of different reconstructive techniques, complication rates, and/or patient reported outcome measures (PROMs) of BR in women aged 60 years or older undergoing mastectomy for ductal carcinoma in situ or invasive carcinoma. A total of 42 eligible studies were included, with 32 of these reporting BR rates, 10 reporting rates of different reconstructive techniques, 10 reporting rates of complications, and four reporting PROMs. The studies reported 24,746 cases of BR in 407,570 mastectomy patients aged 60 years or older from 1987 to 2012. Implant based BR was more common than autologous techniques. Mostly, complication rates were not higher in older women, and QoL outcomes were similar to younger women. This review confirms that BR rates are lower in older women despite recent studies demonstrating its efficacy. The perception among some surgeons and women requiring mastectomy that the potential risks of BR in older women outweigh the benefits needs to be revisited. Education of consumers and surgeons along with public advocacy for offering BR to all clinically eligible women are the most promising means of changing practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Optimizing Outcomes following Total and Subtotal Tongue Reconstruction: A Systematic Review of the Contemporary Literature.

    Science.gov (United States)

    Manrique, Oscar J; Leland, Hyuma A; Langevin, Claude-Jean; Wong, Alex; Carey, Joseph N; Ciudad, Pedro; Chen, Hung-Chi; Patel, Ketan M

    2017-02-01

    Background More than 45,000 Americans are diagnosed with oropharyngeal cancer annually and multimodal treatment often requires wide excision, lymphadenectomy, chemotherapy, and radiation. Total and subtotal lingual resection severely impairs speech, swallow, and quality of life (QoL). This study investigates functional outcomes and QoL following subtotal and total tongue resection with free tissue transfer reconstruction. Materials and Methods A systematic review of the English language literature was performed using PubMed, Ovid, Embase, and Cochrane databases based on predetermined inclusion/exclusion criteria. Included studies were reviewed for surgical technique, adjuvant treatment, surgical and functional outcomes, and QoL. Results From an initial search yield of 1,467 articles, 22 studies were included for final analysis. Speech intelligibility was correlated with the volume and degree of protuberance of the neotongue. Adjuvant therapy (radiation) and large tumor size were associated with worse speech and swallow recovery. At 1 year follow-up, despite 14 to 20% rates of silent aspiration, 82 to 97% of patients resumed oral feeding. Neurotized flaps have been demonstrated to improve flap sensation but have not yet demonstrated any significant impact on speech or swallow recovery. Finally, many patients continue to experience pain after surgery, but patient motivation, family support with physician, and speech therapist follow-up are associated with improved QoL scores. Conclusion Tongue reconstruction is dictated by the amount of soft tissue resection. Taking into consideration the most common factors involved after tongue resection and reconstruction, further studies should focus on more objective measurements to offer solutions and maximize final outcomes.

  1. Fasting, Diabetes, and Optimizing Health Outcomes for Ramadan Observers: A Literature Review.

    Science.gov (United States)

    Almansour, Hadi A; Chaar, Betty; Saini, Bandana

    2017-04-01

    Globally, and in Australia, diabetes has become a common chronic health condition. Diabetes is also quite prevalent in culturally and linguistically diverse pockets of the Australian population, including Muslims. There are over 90 million Muslims with diabetes worldwide. Diabetes management and medication use can be affected by religious practices such as fasting during Ramadan. During Ramadan, Muslims refrain from oral or intravenous substances from sunrise to sunset. This may lead to many potential health or medication-related risks for patients with diabetes who observe this religious practice. This literature review aimed to explore (1) health care-related interventions and (2) intentions, perspectives, or needs of health care professionals (HCPs) to provide clinical services to patients with diabetes while fasting during Ramadan with a view to improve health outcomes for those patients. Using a scoping review approach, a comprehensive search was conducted. Databases searched systematically included PubMed, Medline, Embase, and International Pharmaceutical Abstracts. Studies published in English that described interventions or intentions to provide interventions regarding diabetes and Ramadan fasting were included. Fourteen published articles that met the inclusion criteria were retrieved and content analyzed. Of those, nine intervention studies regarded diabetes management education. Five studies described professional service intention, four of which were related to the role of pharmacists in diabetes management in Qatar, Australia, and Egypt, and one French study examined the general practitioners' (GPs) experiences in diabetes management for Ramadan observers. The intervention studies had promising outcomes for diabetes management during Ramadan. Effect sizes for improvement in HbA1c post intervention ranged widely from -1.14 to 1.7. Pharmacists appeared to be willing to participate in programs to help fasting patients with diabetes achieve a safe

  2. [Psychotherapy: Legally recognized in Quebec].

    Science.gov (United States)

    Trudeau, Jean-Bernard; Desjardins, Pierre; Dion, Alain

    2015-01-01

    Until recently, Quebec was the first to have regulated the practice of psychotherapy through law adopted in 2009. The law emerged following 30 years of efforts and inter-professional discussions that led to a consensus by an expert committee presided by Dr Jean-Bernard Trudeau in 2005. In this essay, Dr Jean-Bernard Trudeau, general practitioner, and two psychiatrist and psychologist colleagues, who have participated to the expert committee or have been involved more recently in the implementation of law no 21 in Quebec, relate the main landmarks and moments in the regulation of the practice in psychotherapy following this inter-professional consensus that was translated in the law 21. They relate particularly the last ten years that have led to the adoption of law 21 in 2009, following two parliamentary commission after the Trudeau report. They underline how the practice of psychotherapy is integrated in the professional system and submitted to strict regulation. It includes regulations for obtaining the license of psychotherapist and for maintaining competence. Guidelines emerging from continuous inter-professional discussions for the application of the law and of its regulation in the public and private sectors are produced by the Quebec Professions Office. The definition of psychotherapy that was reached by consensus is not limited to the treatment of mental disorders and is distinguished from other intervention in the area of human relations. Continuous training is mandatory and is implemented on one hand by the Order of the psychologists for the psychologists and other professionals practicing psychotherapy and on the other hand the College of physicians for physician practicing psychotherapy. The authors finally described the interdisciplinary advisory council for the practice of psychotherapy that the legislator has foreseen as an external mechanism to insure the conformity of regulation with the spirit of the law and to give opinions to the various

  3. Effects of sex and gender in ten types of psychotherapy.

    Science.gov (United States)

    Staczan, Pia; Schmuecker, Roswitha; Koehler, Miriam; Berglar, Jessica; Crameri, Aureliano; von Wyl, Agnes; Koemeda-Lutz, Margit; Schulthess, Peter; Tschuschke, Volker

    2017-01-01

    This paper addresses the results of two samples of a large naturalistic (effectiveness study) outpatient process-outcome study in Switzerland (Practice-Oriented Outpatient Psychotherapy Study). Ten different types of psychotherapy were investigated by looking at the role of the sex or gender of therapists and patients with regard to treatment outcome by including several nonspecific therapeutic factors. Ten different types of psychotherapy, 237 patients, and 68 therapists were included in the study. A subsample of 116 cases was analyzed with regard to therapists' technical interventions. Sex and gender issues of both therapists and patients did not play a crucial role in any type of psychotherapy investigated. Gender issues appeared to play an indirect role. Female therapists intervene more empathically, whereas male therapists tend to use more confrontational techniques. Since the results show that therapists differ substantially with regard to their intervention techniques due to their sex, they should become more conscious of their interventions by considering patients' severity of psychological problems and patients' level of psychological functioning so as to not over or underchallenge them.

  4. Tales from the edge : sufferers’ perspectives of the role of psychotherapy in recovery from anorexia nervosa

    OpenAIRE

    2013-01-01

    As a psychotherapist working in the field of eating disorders, I have a long-standing interest in accessing the subjective expertise of a wider group of sufferers, including what it is like and what it means to suffer from anorexia, the factors that help to support recovery and the role psychotherapy plays in contributing towards the recovery process. This study provides a timely addition to the literature on the nature and role of psychotherapy as a treatment for anorexia. Stu...

  5. Child Psychotherapy Dropout: An Empirical Research Review

    Science.gov (United States)

    Deakin, Elisabeth; Gastaud, Marina; Nunes, Maria Lucia Tiellet

    2012-01-01

    This study aims to discuss the most recent data about child psychotherapy dropout, especially child psychoanalytical psychotherapy. The authors also try to offer some possible alternatives to prevent such a phenomenon. The definition of "child psychotherapy dropout" is extensively discussed. The goal has been to attempt to create a standardised…

  6. Trends in Psychotherapy Process Research: Samples, Measures, Researchers, and Classic Publications.

    Science.gov (United States)

    Hill, Clara E.; And Others

    1994-01-01

    Examined psychotherapy studies published in "Journal of Counseling Psychology" (JCP) and "Journal of Consulting and Clinical Psychology" (JCCP) between 1978 and 1992. Found that JCP published mostly process, outcome, and analogue research, whereas JCCP published mostly outcome research. Most process and process-outcome studies across journals were…

  7. Introduction to the special section "Big'er' Data": Scaling up psychotherapy research in counseling psychology.

    Science.gov (United States)

    Owen, Jesse; Imel, Zac E

    2016-04-01

    This article introduces the special section on utilizing large data sets to explore psychotherapy processes and outcomes. The increased use of technology has provided new opportunities for psychotherapy researchers. In particular, there is a rise in large databases of tens of thousands clients. Additionally, there are new ways to pool valuable resources for meta-analytic processes. At the same time, these tools also come with limitations. These issues are introduced as well as brief overview of the articles.

  8. [New Developments in Video Games for Psychotherapy].

    Science.gov (United States)

    Brezinka, Veronika

    2016-01-01

    A literature survey on new developments in the area of video games and psychotherapy of children and adolescents was conducted. Despite the omnipresence of computers and the internet, development of therapeutic games seems rather slow. The video game Treasure Hunt was introduced in 2008 to support treatment of children with internalizing and externalizing disorders. Camp Cope-A-Lot was developed for treatment of anxious children, whereas the self-help game SPARX is directed at depressed adolescents. Rage-Control is a biofeedback game for children with anger problems. The game Zoo U aims to assess and train social skills of primary school children. Ricky and the Spider for young children with obsessive compulsive disorder is meant to support the cognitive-behavioural treatment of these patients. Clash- Back is a French game for adolescents with externalizing problems. Possible reasons for the relatively slow development of therapeutic games are the high methodological demands concerning an evaluation as well as the high costs of game development. Nonetheless, computers and the internet are bound to influence psychotherapy with children and adolescents in the long run.

  9. Safety and outcomes of cochlear implantation in the elderly:A review of recent literature

    Institute of Scientific and Technical Information of China (English)

    Zao Yang; Maura Cosetti

    2016-01-01

    Global demographic changes related to longevity are leading to increasing numbers of the elderly, for whom hearing loss is a significant cause of morbidity and disability. Once met with reticence, severely hearing impaired older adults are increasingly being considered for cochlear implantation (CI). Significant data indicate that CI in the elderly population is safe, well-tolerated, and effective. Risks from CI surgery and anesthesia are low and generally comparable to rates in other age groups. Outcomes studies regarding CI in older adults have shown excellent improvements to speech perception, quality of life, and even cognition. Overall, currently available data suggests that advanced age should not, in itself, be considered a barrier to implantation. This review paper will highlight selected articles from recent medical literature regarding the safety and efficacy of CI in the elderly population. Copyright © 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  10. Transvenous permanent pacemaker implantation in dextrocardia: technique, challenges, outcome, and a brief review of literature.

    Science.gov (United States)

    Shenthar, Jayaprakash; Rai, Maneesh K; Walia, Rohit; Ghanta, Somasekhar; Sreekumar, Praveen; Reddy, Satish S

    2014-09-01

    Dextrocardia is a rare congenital anomaly. Pacemaker implantation in dextrocardia can be challenging because of the distorted anatomy and associated anomalies. The literature regarding implantation of pacemaker in dextrocardia is scarce. The study involved retrospective analysis of records of patients with dextrocardia who had undergone pacemaker implantation between January 2006 and July 2013 from a single centre. Six patients with dextrocardia (five males and one female) underwent permanent pacemaker implantation (PPI) between January 2006 and July 2013. Of them, three had situs solitus dextrocardia and three situs inversus dextrocardia. All three patients with situs solitus dextrocardia had associated corrected transposition of great arteries. The indication for pacemaker implantation was symptomatic complete atrioventricular (AV) block in four, high-grade AV block in one, and sinus node dysfunction in one patient. A favourable outcome was noted during a mean follow-up of 3.9 years (4 months to 7 years) with one patient needing a pulse generator replacement. Permanent pacemaker implantation in dextrocardia can be challenging because of the distorted anatomy. Use of a technique employing angiography to delineate chamber anatomy and relationship can assist the operator during such difficult PPIs. The medium- and long-term survival after a successful pacemaker implantation in dextrocardia is favourable. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  11. [Method of existence analytic psychotherapy].

    Science.gov (United States)

    Längle, A

    1990-01-01

    Introducing questions of individual purpose and meaning into psychotherapy was an important contribution of Viktor Frankl and a necessary supplement to traditional psychotherapy. V. Frankls "Logotherapy" (logos = meaning) however has found its main application in counselling (especially bereavement and grief processes) and prophylactic endeavours (e.g. pedagogics). Suffering from meaninglessness, on the other hand, showed up to be a respectively rare indication for psychotherapeutic interventions in its proper sense. Thus the question was arising how to apply Frankl's valuable meaning-centered concept of man (which he called "Existential Analysis") in a genuine way to other neurosis and to personality disorders, so far "unspecific indications" to Logotherapy. This paper gives an outline and methodological foundation of "Existential Analysis Psychotherapy". A case study finally is illustrating its phenomenological proceeding.

  12. Neurobiological factors as predictors of cognitive-behavioral therapy outcome in individuals with antisocial behavior: a review of the literature.

    Science.gov (United States)

    Cornet, Liza J M; de Kogel, Catharina H; Nijman, Henk L I; Raine, Adrian; van der Laan, Peter H

    2014-11-01

    This review focuses on the predictive value of neurobiological factors in relation to cognitive-behavioral therapy outcome among individuals with antisocial behavior. Ten relevant studies were found. Although the literature on this topic is scarce and diverse, it appears that specific neurobiological characteristics, such as physiological arousal levels, can predict treatment outcome. The predictive value of neurobiological factors is important as it could give more insight into the causes of variability in treatment outcome among individuals with antisocial behavior. Furthermore, results can contribute to improvement in current treatment selection procedures and to the development of alternative treatment options.

  13. Impact of Peer Nutrition Education on Dietary Behaviors and Health Outcomes among Latinos: A Systematic Literature Review

    Science.gov (United States)

    Perez-Escamilla, Rafael; Hromi-Fiedler, Amber; Vega-Lopez, Sonia; Bermudez-Millan, Angela; Segura-Perez, Sofia

    2008-01-01

    Objective: This systematic review assesses the impact of peer education/counseling on nutrition and health outcomes among Latinos and identifies future research needs. Design: A systematic literature search was conducted by: (1) searching Internet databases; (2) conducting backward searches from reference lists of articles of interest; (3)…

  14. Impact of Peer Nutrition Education on Dietary Behaviors and Health Outcomes among Latinos: A Systematic Literature Review

    Science.gov (United States)

    Perez-Escamilla, Rafael; Hromi-Fiedler, Amber; Vega-Lopez, Sonia; Bermudez-Millan, Angela; Segura-Perez, Sofia

    2008-01-01

    Objective: This systematic review assesses the impact of peer education/counseling on nutrition and health outcomes among Latinos and identifies future research needs. Design: A systematic literature search was conducted by: (1) searching Internet databases; (2) conducting backward searches from reference lists of articles of interest; (3)…

  15. Psychotherapy patient transfer: secondhand rose.

    Science.gov (United States)

    Sederer, L

    1975-10-01

    The author uses the analogy of the marketplace to examine the dynamics of the transfer of psychotherapy patients in university clinic settings. The outgoing therapist is the seller, the prospective therapist the buyer, and the patient the commodity--the secondhand Rose. Marketing techniques that are used in this buyers' market allow no active patient participation and are therefore antithetical to the tenets of psychotherapy. The author suggests early clarification of therapeutic goals, assignment of therapists on the basis of patient choice, and explanation of time frames and limits as means for ameliorating the problems he describes.

  16. Humanism as a common factor in psychotherapy.

    Science.gov (United States)

    Wampold, Bruce E

    2012-12-01

    There are many forms of psychotherapies, each distinctive in its own way. From the origins of psychotherapy, it has been suggested that psychotherapy is effective through factors that are common to all therapies. In this article, I suggest that the commonalities that are at the core of psychotherapy are related to evolved human characteristics, which include (a) making sense of the world, (b) influencing through social means, and (c) connectedness, expectation, and mastery. In this way, all psychotherapies are humanistic. (c) 2012 APA, all rights reserved.

  17. The Sequential Integration of Pharmacotherapy and Psychotherapy in the Treatment of Major Depressive Disorder: A Meta-Analysis of the Sequential Model and a Critical Review of the Literature.

    Science.gov (United States)

    Guidi, Jenny; Tomba, Elena; Fava, Giovanni A

    2016-02-01

    A number of randomized controlled trials in major depressive disorder have employed a sequential model, which consists of the use of pharmacotherapy in the acute phase and of psychotherapy in its residual phase. The aim of this review was to provide an updated meta-analysis of the efficacy of this approach in reducing the risk of relapse in major depressive disorder and to place these findings in the larger context of treatment selection. Keyword searches were conducted in MEDLINE, EMBASE, PsycINFO, and Cochrane Library from inception of each database through October 2014. Randomized controlled trials examining the efficacy of the administration of psychotherapy after successful response to acute-phase pharmacotherapy in the treatment of adults with major depressive disorder were considered for inclusion in the meta-analysis. Thirteen high-quality studies with 728 patients in a sequential treatment arm and 682 in a control treatment arm were included. All studies involved cognitive-behavioral therapy (CBT). The pooled risk ratio for relapse/recurrence was 0.781 (95% confidence interval [CI]=0.671-0.909; number needed to treat=8), according to the random-effects model, suggesting a relative advantage in preventing relapse/recurrence compared with control conditions. A significant effect of CBT during continuation of antidepressant drugs compared with antidepressants alone or treatment as usual (risk ratio: 0.811; 95% CI=0.685-0.961; number needed to treat=10) was found. Patients randomly assigned to CBT who had antidepressants tapered and discontinued were significantly less likely to experience relapse/recurrence compared with those assigned to either clinical management or continuation of antidepressant medication (risk ratio: 0.674; 95% CI=0.482-0.943; number needed to treat=5). The sequential integration of CBT and pharmacotherapy is a viable strategy for preventing relapse in major depressive disorder. The current indications for the application of

  18. [Real-time monitoring in psychotherapy - methodology and casuistics].

    Science.gov (United States)

    Maurer, Gabriele; Aichhorn, Wolfgang; Leeb, Wilfried; Matschi, Brigitte; Schiepek, Günter

    2011-01-01

    Real-Time Monitoring in psychotherapy is a new method to increase quality and efficacy in psychotherapy. This internet-based information technology offers an online collection of psychotherapy-related data and allows insights into therapeutic patterns of change without any time-delay. The classical pre-post-evaluation is completed by an assessment of therapeutic processes. Besides an internet-based data collection the Synergetic Navigation System (SNS) integrates different methods of nonlinear time series analysis and provides a visualization of results. SNS is a new internet-based technology of data collection and data analysis. For illustration we present a single case study (avoidant personality disorder (DSM IV 301.82) with recurrent major depressive episodes) where SNS was applied in clinical practice (in-patient treatment). SNS results are used for therapy planning by repeated feedback interviews with the patients. Critical phases and nonlinearities of the ongoing self-organization processes can be identified. In addition to the practical impact of real-time monitoring SNS allows for continuous process-outcome-research in naturalistic settings. Models of change processes (e.g. sudden gains) can be tested but also used as a interpretation frame of idiographic results. In every day practice SNS enhances transparency, self-efficacy of patients, and supports the motivation to change. Compliance of patients is high, and the data show high validity. Therefore as a future perspective SNS should become routine in clinical practice and be integrated in professional psychotherapy training.

  19. [Attitudes toward psychotherapy in the general population].

    Science.gov (United States)

    Petrowski, Katja; Hessel, Aike; Körner, Annett; Weidner, Kerstin; Brähler, Elmar; Hinz, Andreas

    2014-02-01

    Attitudes towards psychotherapy are important predictors for the acceptance and usage of psychotherapy. A survey examined attitudes towards psychotherapy in a sample representative of the German population including 2089 persons between 14 to 92 years of age. Two thirds of the sample indicated a positive attitude towards psychotherapy. Men as well as individuals with lower education reported a more negative attitude towards psychotherapy than women and persons with higher educational level. Education had a medium effect size (d=0.44). Individuals with somatoform symptoms did not indicate a more negative attitude towards psychotherapy than the general population. Even though the majority of the population has a more positive attitude towards psychotherapy, this positive attitude does not apply for all groups of the -population.

  20. Clinical outcome of pediatric collagenous gastritis: case series and review of literature.

    Science.gov (United States)

    Hijaz, Nadia Mazen; Septer, Seth Steven; Degaetano, James; Attard, Thomas Mario

    2013-03-07

    Collagenous gastritis (CG) is characterized by patchy subepithelial collagen bands. Effective treatment and the clinical and histological outcome of CG in children are poorly defined. The aim of this study is to summarize the published literature on the clinical outcome and response to therapy of pediatric CG including two new cases. We performed a search in Pubmed, OVID for related terms; articles including management and clinical and/or endo-histologic follow up information were included and abstracted. Reported findings were pooled in a dedicated database including the corresponding data extracted from chart review in our patients with CG. Twenty-four patients were included (17 females) with a mean age of 11.7 years. The clinical presentation included iron deficiency anemia and dyspepsia. The reported duration of follow up (in 18 patients) ranged between 0.2-14 years. Despite most subjects presenting with anemia including one requiring blood transfusion, oral iron therapy was only documented in 12 patients. Other treatment modalities were antisecretory measures in 13 patients; proton pump inhibitors (12), or histamine-2 blockers (3), sucralfate (5), prednisolone (6), oral budesonide in 3 patients where one received it in fish oil and triple therapy (3). Three (13%) patients showed no clinical improvement despite therapy; conversely 19 out of 22 were reported with improved symptoms including 8 with complete symptom resolution. Spontaneous clinical resolution without antisecretory, anti-inflammatory or gastroprotective agents was noted in 5 patients (4 received only supplemental iron). Follow up endo-histopathologic data (17 patients) included persistent collagen band and stable Mononuclear cell infiltrate in 12 patients with histopathologic improvement in 5 patients. Neither collagen band thickness nor mononuclear cell infiltrate correlated with clinical course. Intestinal metaplasia and endocrine cell hyperplasia were reported (1) raising the concern of long

  1. Psychotherapy via Videoconferencing: A Review

    Science.gov (United States)

    Simpson, Susan

    2009-01-01

    Research into the use of videoconferencing for clinical purposes, in particular psychotherapy, is gradually expanding. A number of case studies and case series have suggested that videoconferencing can be clinically effective and acceptable to patients. Nevertheless, there is a lack of methodologically rigorous studies with adequate sample sizes…

  2. Palmistry, tarot cards, and psychotherapy.

    Science.gov (United States)

    Pejic, Nicholas G

    2008-01-01

    The author summarizes his experience with palm and Tarot card readers in New Orleans. The history, practice, and psychodynamics of palmistry and Tarot are explored. It's postulated that these practices are forms of archaic psychotherapy, which employ supportive treatment and placebo. These tactics are used to elicit hope for its clients.

  3. Beyond Psychobabble: Careers in Psychotherapy.

    Science.gov (United States)

    Mariani, Matthew

    1995-01-01

    Describes the five largest psychotherapy occupations (psychiatrist, clinical/counseling psychologist, clinical social worker, marriage and family therapist, clinical mental health counselor) and looks at training requirements, types of practices, trends, and related occupations. Lists professional associations and references for further…

  4. The current status of psychotherapy

    African Journals Online (AJOL)

    is as old as human culture'. However, the latter is now ... evolved to three main types as a result of these influ- .... tive by demonstrating a mean effect size for psychotherapy of 0.85 (that ... therapy that makes a difference changes brain function.

  5. Supervisor trainees' and their supervisors' perceptions of attainment of knowledge and skills: an empirical evaluation of a psychotherapy supervisor training programme.

    Science.gov (United States)

    Sundin, Eva C; Ogren, Marie-Louise; Boëthius, Siv Boalt

    2008-11-01

    This study aimed to evaluate the success of a 2-year, part-time training programme for psychotherapy supervisors. A second aim was to examine factors that might contribute to perceived knowledge and skills attainment during the training course. This is a naturalistic, longitudinal study where several measures are used to examine group process and outcome. Supervisor trainees' (N=21) and their facilitators' (N=6) ratings of learning (knowledge and skills), relations to the supervisor and supervision group, usage of the group, and supervisor style were completed at three time points. The findings suggested that both trainees and their supervisors perceived that the trainees attained a substantial amount of knowledge and skills during the course. In accordance with the literature and expectations, the regression analysis suggested a strong negative association between a strong focus on group processes in the initial and middle phases of the training and perceived knowledge and skills attainment in the final phase of the training. The expected, positive role of relations among trainees in the supervision group in the first half of the training and perceived knowledge and skills attainment in the final part of the training was obtained, whilst the hypothesized significance of the relationship between trainee and supervisor did not receive support. The supervisory course seemed to provide a training that allowed trainees to attain knowledge and skills that are necessary for psychotherapy supervisors. The results of this pilot study also emphasize the need of more research on learning in the context of group supervision in psychotherapy.

  6. Coming out of the sex therapy closet: using experiential psychotherapy with sexual problems and concerns.

    Science.gov (United States)

    Kleinplatz, Peggy J

    2007-01-01

    Mahrer's Experiential Psychotherapy provides a valuable alternative to conventional sex therapy with individuals and couples. Experiential Psychotherapy uses the sexual complaint as it would any situation or scene described at the outset of therapy, as an entry point to the client's deeper experiencing. Several of the advantages of the methods employed are listed. Specifically, the ways in which Experiential Psychotherapy is ideally suited to dealing with forbidden, haunting, and disturbing sexual feelings, fantasies, and urges are highlighted. Clinical illustrations are presented of experiential dream work with a sexual assault survivor and of a couple referred for treatment of his erectile dysfunction and her low sexual desire. Experiential Psychotherapy effects profound changes in the person(s), connections within and with others, and in bodily phenomena. These outcomes, including freer choices, heightened pleasure and embodiment, extend beyond the predominant treatment paradigm's amelioration of sexual symptoms and disorder.

  7. Culture and demoralization in psychotherapy.

    Science.gov (United States)

    de Figueiredo, John M; Gostoli, Sara

    2013-01-01

    In most societies, members of a culture have attempted to help each other in times of trouble with various types of healing methods. Demoralization - an individual experience related to a group phenomenon - responds to certain elements shared by all psychotherapies. This article has three objectives: (1) to review the theoretical background leading to our current views on culture and demoralization in psychotherapy, (2) to discuss the methodological challenges faced in the cross-cultural study of demoralization and psychotherapy, and (3) to describe the clinical applications and research prospects of this area of inquiry. Demoralization follows a shattering of the individual's assumptive world and it is different from homeostatic responses to a stressful situation or from depressive disorders. Only a few comparative studies of this construct across cultures have been undertaken. The presentation of distress may vary widely from culture to culture and even within the same culture. To avoid 'category fallacy', it is important to understand the idioms of distress peculiar to a cultural group. A cultural psychiatrist or psychotherapist would have to identify patient's values and sentiments, reconstruct his/her personal and collective ambient worlds, and only then study demoralization. The limitations of our current diagnostic systems have resulted in methodological challenges. Cultural clinicians should consider using a combination of both 'clinimetric' and 'perspectivistic' approaches in order to arrive at a diagnosis and identify the appropriate intervention. The presenting problem has to be understood in the context of the patient's individual, social and cultural background, and patients unfamiliar with Western-type psychotherapies have to be prepared to guide their own expectations before the former are used. Future research should identify the gaps in knowledge on the effectiveness of cultural psychotherapy at reversing or preventing demoralization. Copyright

  8. Ayurvedic concepts related to psychotherapy.

    Science.gov (United States)

    Behere, Prakash B; Das, Anweshak; Yadav, Richa; Behere, Aniruddh P

    2013-01-01

    The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.

  9. Combination of psychotherapy and benzodiazepines versus either therapy alone for panic disorder: a systematic review

    Directory of Open Access Journals (Sweden)

    Furukawa Toshi A

    2007-05-01

    Full Text Available Abstract Background: The efficacy of combined psychotherapy and benzodiazepine treatment for panic disorder is still unclear despite its widespread use. The present systematic review aims to examine its efficacy compared with either monotherapy alone. Methods: All randomised trials comparing combined psychotherapy and benzodiazepine for panic disorder with either therapy alone were identified by comprehensive electronic search on the Cochrane Registers, by checking references of relevant studies and of other reviews, and by contacting experts in the field. Two reviewers independently checked eligibility of trials, assessed quality of trials and extracted data from eligible trials using a standardized data extraction form. Our primary outcome was "response" defined by global judgement. Authors of the original trials were contacted for further unpublished data. Meta-analyses were undertaken synthesizing data from all relevant trials. Results: Only two studies, which compared the combination with behaviour (exposure therapy, met our eligibility criteria. Both studies had a 16-week intervention. Unpublished data were retrieved for one study. The relative risk for response for the combination was 1.25 (95%CI: 0.78 to 2.03 during acute phase treatment, 0.78 (0.45 to 1.35 at the end of treatment, and 0.62 (0.36 to 1.07 at 6–12 months follow-up. Some secondary outcomes hinted at superiority of the combination during acute phase treatment. One study was identified comparing the combination to benzodiazepine. The relative risk for response was 1.57 (0.83 to 2.98, 3.39 (1.03 to 11.21, statistically significant and 2.31 (0.79 to 6.74 respectively. The superiority of the combination was observed on secondary outcomes at all the time points. No sub-group analyses were conducted due to the limited number of included trials. Conclusion: Unlike some narrative reviews in the literature, our systematic search established the paucity of high quality evidence for

  10. [Psychotherapies for the Treatment of Phantom Limb Pain].

    Science.gov (United States)

    Cárdenas, Katherine; Aranda, Mariana

    The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed. To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitization and reprocessing eye movements and hypnosis. The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitization and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomized trials are required. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  11. Sign-language interpretation in psychotherapy with deaf patients.

    Science.gov (United States)

    Porter, A

    1999-01-01

    Sporadic encounters with deaf patients seeking psychotherapy present a challenge to general clinicians outside of specialized services for the deaf. Skills for working with people who do not share one's own language mode and culture are not routinely taught in most training programs, so clinicians may be unprepared when they first encounter a deaf patient. While it would be ideal to be able to match deaf patients with therapists fluent in their preferred language mode, this is often not feasible in smaller centers. Working with a trained professional sign-language interpreter can be a productive alternative, as long as patient, therapist, and interpreter understand and are comfortable with the process. Peer-reviewed literature on sign language interpretation in psychotherapy is sparse, but some practical guidelines can be gleaned from it and supplemented by information provided by the deaf community through the Internet. This paper arose from one psychiatric resident's first experience of psychotherapy working with a sign-language interpreter, and summarizes the literature search that resulted from a quest for understanding of deaf culture and experience, of the unique characteristics of sign language, and of the effects on the therapeutic relationship of the presence of the interpreter.

  12. Can the use of humor in psychotherapy be taught?

    Science.gov (United States)

    Valentine, Lisa; Gabbard, Glen O

    2014-02-01

    Despite an abundance of literature detailing the potential benefits of the use of humor in therapy, humor is rarely taught to psychiatric residents as a method of therapeutic intervention. This communication attempts to explain how current understanding of attachment theory and neuroscience may assist psychiatric faculty and supervisors in their teaching of humorous therapeutic interventions. This article reviews and synthesizes the extant literature on the use of humor, as well as recent work in neuroscience, attachment theory, and mentalization. Humor can be conceptualized as an instance of implicit relational knowing and may thus contribute significantly to the therapeutic action of psychotherapy as a subcategory of "moments of meeting" between therapist and patient. However, training residents to use humor in psychotherapy requires more individualized attention in supervision and classroom seminars. Factors such as individual proclivities for humorous repartee, mentalizing capacity, and an authentic interest in adding humor to the session may be necessary to incorporate spontaneous humor into one's technique. New findings from the areas of attachment theory, neuroscience, and right-hemisphere learning are providing potential opportunities for sophisticated teaching of the use of humor in psychotherapy.

  13. Methods of Intracanal Reinforcement in Primary Anterior Teeth–Assessing the Outcomes through a Systematic Literature Review

    OpenAIRE

    Mittal, Neeti; Bhatia, Hind Pal; Haider, Khushtar

    2015-01-01

    ABSTRACT Aim: To assess how the various methods of intracanal reinforcement (short root canal posts) performed in their clinical and radiographic outcomes for restoring grossly broken down primary anterior teeth after pulpectomy for 1 year or longer follow-up period. Materials and methods: Literature search of electronic databases (Sept 2013) and various journals (1980-Sept 2013) using medical subject headings and free text terms was conducted. For inclusion in quality assessment, prespecifie...

  14. Advances in Psychotherapy for Depressed Older Adults.

    Science.gov (United States)

    Raue, Patrick J; McGovern, Amanda R; Kiosses, Dimitris N; Sirey, Jo Anne

    2017-09-01

    We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk. Growing evidence supports the feasibility, acceptability, and effectiveness of psychotherapy modified for a variety of health care and social service settings. Research supports the benefits of selecting the type of psychotherapy based on a comprehensive assessment of the older adult's psychiatric, medical, functional, and cognitive status, and tailoring psychotherapy to the settings in which older depressed adults are most likely to present.

  15. Evaluation in Residential Environmental Education: An Applied Literature Review of Intermediary Outcomes

    Science.gov (United States)

    Ardoin, Nicole M.; Biedenweg, Kelly; O'Connor, Kathleen

    2015-01-01

    Residential environmental education aims to enhance proenvironmental attitudes, knowledge, and behaviors, as well as attain outcomes related to personal and interpersonal skills. Although these outcomes may not be evident for months or even years afterward, few program evaluations investigate how the experience and context affect intended outcomes…

  16. Evaluation in Residential Environmental Education: An Applied Literature Review of Intermediary Outcomes

    Science.gov (United States)

    Ardoin, Nicole M.; Biedenweg, Kelly; O'Connor, Kathleen

    2015-01-01

    Residential environmental education aims to enhance proenvironmental attitudes, knowledge, and behaviors, as well as attain outcomes related to personal and interpersonal skills. Although these outcomes may not be evident for months or even years afterward, few program evaluations investigate how the experience and context affect intended outcomes…

  17. Psychotherapy research at the start of the 21st century: the persistence of the art versus science controversy.

    Science.gov (United States)

    Joyce, Anthony S; Wolfaardt, Ulrich; Sribney, Christine; Aylwin, A Scott

    2006-11-01

    This article offers an overview of prominent general trends in the field of psychotherapy research. We consider 3 areas of the literature: metaanalytic reviews addressing the effectiveness of psychotherapy, the movement to identify empirically supported treatments (EST), and research on the "common factor" or "contextual" models of psychotherapy. We present narrative reviews of selected literature associated with each area. The reviews highlight several issues currently confronting the field. Metaanalytic reviews underscore 2 conclusions: psychotherapy is superior to the absence of treatment, and different approaches to psychotherapy yield equivalent effects. In counterpoint to these findings, the EST movement emphasizes the empirical demonstration that specific psychotherapies have efficacy for specific disorders. Misinterpretation of EST findings has led to considerable controversy. Although EST research can identify causal effects of therapy, it has less capacity to explain how these effects come about. We suggest an appropriate perspective on EST findings. Considerable evidence supports the importance of common factors as mechanisms of change; at present, however, this evidence is predominantly correlational. We conclude that a blending of EST studies and research on the common factors represents the greatest potential for advancing the field. Studies to identify specific ESTs are key to validating the efficacy of psychotherapy approaches and need to be undertaken with the psychodynamic and experiential therapies. Greater emphasis on common factors in research, training, and practice can advance understanding about change processes in efficacious therapies, facilitate the development of sensitive clinicians, and increase the effectiveness of mental health services.

  18. Brain tissue oxygen-based therapy and outcome after severe traumatic brain injury: a systematic literature review.

    Science.gov (United States)

    Nangunoori, Raj; Maloney-Wilensky, Eileen; Stiefel, Michael; Park, Soojin; Andrew Kofke, W; Levine, Joshua M; Yang, Wei; Le Roux, Peter D

    2012-08-01

    Observational clinical studies demonstrate that brain hypoxia is associated with poor outcome after severe traumatic brain injury (TBI). In this study, available medical literature was reviewed to examine whether brain tissue oxygen (PbtO2)-based therapy is associated with improved patient outcome after severe TBI. Clinical studies published between 1993 and 2010 that compared PbtO2-based therapy combined with intracranial and cerebral perfusion pressure (ICP/CPP)-based therapy to ICP/CPP-based therapy alone were identified from electronic databases, Index Medicus, bibliographies of pertinent articles, and expert consultation. For analysis, each selected paper had to have adequate data to determine odds ratios (ORs) and confidence intervals (CIs) of outcome described by the Glasgow outcome score (GOS). Seven studies that compared ICP/CPP and PbtO2- to ICP/CPP-based therapy were identified. There were no randomized studies and no comparison studies in children. Four studies, published in 2003, 2009, and 2010 that included 491 evaluable patients were used in the final analysis. Among patients who received PbtO2-based therapy, 121(38.8%) had unfavorable and 191 (61.2%) had a favorable outcome. Among the patients who received ICP/CPP-based therapy 104 (58.1%) had unfavorable and 75 (41.9%) had a favorable outcome. Overall PbtO2-based therapy was associated with favorable outcome (OR 2.1; 95% CI 1.4-3.1). Summary results suggest that combined ICP/CPP- and PbtO2-based therapy is associated with better outcome after severe TBI than ICP/CPP-based therapy alone. Cross-organizational practice variances cannot be controlled for in this type of review and so we cannot answer whether PbtO2-based therapy improves outcome. However, the potentially large incremental value of PbtO2-based therapy provides justification for a randomized clinical trial.

  19. Integrating self-help books into psychotherapy.

    Science.gov (United States)

    Campbell, Linda F; Smith, Thomas P

    2003-02-01

    This article describes a systematic and integral method of incorporating self-help books into psychotherapy as a collaborative function. We address the distinctions between self-help and bibliotherapy, consider bibliotherapy as adjunctive or integrative to psychotherapy, and outline the multiple uses of bibliotherapy for clinical purposes. How to apply self-help books in psychotherapy and ways to select books are illustrated by a case example. Indications and contraindications for bibliotherapy in therapy are outlined.

  20. Psychotherapy of the dying patient.

    Science.gov (United States)

    Stedeford, A

    1979-07-01

    The psychotherapeutic aspects of the care of the 49 terminally ill patients described in the preceeding paper are discussed. Their differing ways of coping with the stress of dying and the range of psychotherapeutic strategies used in treatment are described. The work suggests that the therapist's use of psychological insights can improve his understanding of the emotional pain of terminal illness, and well-aimed psychotherapy can contribute to its relief.

  1. Emotional Control in Psychotherapy Discourse.

    Science.gov (United States)

    Horowitz, Mardi

    2016-01-01

    Emotional control may be observed to be (1) too excessive as in avoidant behaviors during psychotherapy, (2) suitable to a frank expression of feelings, or (3) lacking in regulation causing too intense affective experiences. This article offers a theory that may help clinicians make observations about this range of possible states, formulate the patient's defensive processes, and choose if, how, and when to act. The observations and formulations presented focus on specific and present moment situations rather than habitual defense mechanisms.

  2. Open access meta-analysis for psychotherapy research.

    Science.gov (United States)

    Baldwin, Scott A; Del Re, A C

    2016-04-01

    Meta-analysis has played a key role in psychotherapy research for nearly 40 years. There is now an opportunity for technology to assist with transparent and open meta-analyses. The authors describe an open-access database of effect sizes and a corresponding web application for performing meta-analyses, viewing the database, and downloading effect sizes. The initial databases provide effect sizes for family therapy for delinquency studies and for alliance-outcome correlations in individual psychotherapy. Disciplinary norms about data sharing and openness are shifting. Furthermore, meta-analyses of behavioral interventions have been criticized for lacking transparency and openness. The database and web application are aimed at facilitating data sharing and improving the transparency of meta-analyses. The authors conclude with a discussion of future directions for the database.

  3. PSYCHOPATHOLOGY AND PSYCHOTHERAPY IN ISLAM

    Directory of Open Access Journals (Sweden)

    Amiruddin

    2015-12-01

    Full Text Available Psychopathology is mental illness that has often suffered by human being. There are several factors that causes this illness, some of which are modern life characterized by materialistic, hedonistic and egoistic lives. In Islam, psychopathology which is described as a form of deviation from norms or moral values, spiritual and religion. Psychopathology is divided into three parts, namely those associated with faith, humanity and psychopathology which is associated with combination of faith and human being.Meanwhile psychotherapy is an effort to cure mental and psychiatric disorders suffered by individuals. Psychotherapy is a solution to cure various problems of mental disorders. Al-Qur’an, as the principles of Islamic teachings, contain information about psychotherapy for those who suffer from mental disorders. Religious approach is completely needed for therapy and it helps the psychopath recover from his/her mental disorders.TheQur’an could be used as a treatment as well as a preventive step, so that all human being will not suffer from mental disorders, and religious approach can bring the psychopaths closer to God, theAlmighty.

  4. [Psychotherapy with the unwilling patient].

    Science.gov (United States)

    Madert, K K

    1984-05-01

    By means of the residential motivation therapy of addicts we discuss ways of dealing with the specific problems, that arise in psychotherapy of character disordered, who are not suffering psychically. The - in the view of the addict patient - often unvoluntary referral to the hospital provokes the patient's refusal of cooperation. The greatest therapeutic challenge is the ego-syntonicity of the character disorder and the rigid defense structure of overcompensation, projection and denial, covered up by rationalizations. This defense system serves to avoid closeness and contact with the original emotions. In our group setting we use mini-contracts, reality-oriented confrontation of behavioral issues in order to make the addict aware of his desperation and lack of fullfilment in life, and offer attractive models of living and the experience of warmth and bondedness in the group. Our main techniques are non-verbal. Body experience and full-body-expression of emotions mediate self-experience which is then integrated verbally. The goal of this psychoanalytically based psychotherapy is to bring about by working through resistances, the attitudes which are a precondition for continuing with a personality-changing psychotherapy.

  5. [On the present situation in psychotherapy and its implications - A critical analysis of the facts].

    Science.gov (United States)

    Tschuschke, Volker; Freyberger, Harald J

    2015-01-01

    The currently dominating research paradigm in evidence-based medicine is expounded and discussed regarding the problems deduced from so-called empirically supported treatments (EST) in psychology and psychotherapy. Prevalent political and economic as well as ideological backgrounds influence the present dominance of the medical model in psychotherapy by implementing the randomized-controlled research design as the standard in the field. It has been demonstrated that randomized controlled trials (RCTs) are inadequate in psychotherapy research, not the least because of the high complexity of the psychotherapy and the relatively weak role of the treatment concept in the change process itself. All major meta-analyses show that the Dodo bird verdict is still alive, thereby demonstrating that the medical model in psychotherapy with its RCT paradigm cannot explain the equivalence paradox. The medical model is inappropriate, so that the contextual model is proposed as an alternative. Extensive process-outcome research is suggested as the only viable and reasonable way to identify highly complex interactions between the many factors regularly involved in change processes in psychotherapy.

  6. Cognitive Behavioral Analysis System of Psychotherapy and Brief Supportive Psychotherapy for Augmentation of Antidepressant Nonresponse in Chronic Depression

    Science.gov (United States)

    Kocsis, James H.; Gelenberg, Alan J.; Rothbaum, Barbara O.; Klein, Daniel N.; Trivedi, Madhukar H.; Manber, Rachel; Keller, Martin B.; Leon, Andrew C.; Wisniewski, Steven R.; Arnow, Bruce A.; Markowitz, John C.; Thase, Michael E.

    2012-01-01

    Context Previous studies have found that few chronically depressed patients remit with antidepressant medications alone. Objective To determine the role of adjunctive psychotherapy in the treatment of chronically depressed patients with less than complete response to an initial medication trial. Design This trial compared 12 weeks of (1) continued pharmacotherapy and augmentation with cognitive behavioral analysis system of psychotherapy (CBASP), (2) continued pharmacotherapy and augmentation with brief supportive psychotherapy (BSP), and (3) continued optimized pharmacotherapy (MEDS) alone. We hypothesized that adding CBASP would produce higher rates of response and remission than adding BSP or continuing MEDS alone. Setting Eight academic sites. Participants Chronically depressed patients with a current DSM-IV–defined major depressive episode and persistent depressive symptoms for more than 2 years. Interventions Phase 1 consisted of open-label, algorithm-guided treatment for 12 weeks based on a history of antidepressant response. Patients not achieving remission received next-step pharmacotherapy options with or without adjunctive psychotherapy (phase 2). Individuals undergoing psychotherapy were randomized to receive either CBASP or BSP stratified by phase 1 response, ie, as nonresponders (NRs) or partial responders (PRs). Main Outcome Measures Proportions of remitters, PRs, and NRs and change on Hamilton Scale for Depression (HAM-D) scores. Results In all, 808 participants entered phase 1, of which 491 were classified as NRs or PRs and entered phase 2 (200 received CBASP and MEDS, 195 received BSP and MEDS, and 96 received MEDS only). Mean HAM-D scores dropped from 25.9 to 17.7 in NRs and from 15.2 to 9.9 in PRs. No statistically significant differences emerged among the 3 treatment groups in the proportions of phase 2 remission (15.0%), partial response (22.5%), and non-response (62.5%) or in changes on HAM-D scores. Conclusions Although 37.5% of the

  7. What impact does nursing care left undone have on patient outcomes? Review of the literature.

    Science.gov (United States)

    Recio-Saucedo, Alejandra; Dall'Ora, Chiara; Maruotti, Antonello; Ball, Jane; Briggs, Jim; Meredith, Paul; Redfern, Oliver C; Kovacs, Caroline; Prytherch, David; Smith, Gary B; Griffiths, Peter

    2017-08-31

    Systematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes. A considerable body of evidence support the hypothesis that lower levels of registered nurses on duty increases the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear. Systematic review. We searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses' aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review. Fourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary-tract infections (UTIs), patient falls, pressure ulcers, critical incidents, quality of care, and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged. The review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self-reported data. In order to support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care. More research that uses objective staffing and outcome measures is required

  8. 中国心理咨询/治疗中有关保密研究的文献回顾%Literature Review of Confidentiality Research in Counseling and Psychotherapy Field of China

    Institute of Scientific and Technical Information of China (English)

    周司丽; 侯志瑾; 姚莹颖

    2012-01-01

    Confidentiality is a significant precondition to counseling and psychotherapy. As one of ethical codes, it means counselors and psychotherapist should keep clients' information disclosed confidentially. Confidentiality is a complex ethical behavior of the profession. The present study aimed to review all quantitative studies and argumentary papers published on confidentiality in China, and to conclude the status quo and future direction of research and practice of confidentiality. The refinement of the first edition of "Ethical Codes for Clinical and Counseling Professionals of Chinese Psychological Society" was also proposed through review.%保密是进行心理咨询与治疗的一项重要基本前提,其作为伦理守则是指为来访者在咨询与治疗中所表达的信息保守秘密.然而,保密原则在实施中是一个复杂的专业伦理行为.本文试图通过回顾我国心理咨询与治疗领域有关保密的量化研究与各种评述,总结我国心理咨询与治疗领域有关保密问题的研究和实践现状与不足,并在此基础上为《中国心理学会临床与咨询心理学工作伦理守则(第一版)》提出完善建议.

  9. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review.

    Directory of Open Access Journals (Sweden)

    Leire Santisteban

    Full Text Available Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians.In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time.Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included.In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMTwas the most commonly used measure (in 36% of studies. Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72% combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL, the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus.The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke.

  10. Patient reported outcomes measures in neurogenic bladder and bowel: A systematic review of the current literature.

    Science.gov (United States)

    Patel, Darshan P; Elliott, Sean P; Stoffel, John T; Brant, William O; Hotaling, James M; Myers, Jeremy B

    2016-01-01

    To describe existing bladder and bowel specific quality of life (QoL) measurement tools, QoL in patients with multiple sclerosis (MS), spinal cord injury (SCI), Parkinson's Disease (PD), stroke, or spina bifida (SB) affected by bladder or bowel dysfunction, and the impact of specific bladder and bowel management on QoL. We performed a systematic review in PubMed/Medline databases in accordance with the PRISMA statement for English publications between January 1, 2000 and January 1, 2014. Articles were first screened based on their abstract and select full-text articles were then reviewed for eligibility. Articles with no QoL or PROM assessing urinary or bowel dysfunction were excluded. Risk of bias assessment included randomization, incomplete outcomes data, selective outcomes reporting, and other biases. All articles were graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system as per the Cochrane Handbook for Systematic Reviews of Interventions. The most common QoL measurement tool for urinary and bowel dysfunction was the Medical Outcomes Study SF-36. Twelve (24%) studies used only non-validated QoL questionnaires. Only three urinary or bowel specific QoL measures were found: the Qualiveen questionnaire, the FICQoL, and the QoL-BM. Several studies identified instances were clinical and patient-reported outcomes were inconsistent particularly with indwelling urinary catheter usage and reconstructive surgery. Additionally, certain clinical outcomes surrogates commonly used as primary outcomes measures may not correlate with the patient reported outcomes (PRO). Current PRO measures (PROM) and QoL assessments are heterogeneous and several inconsistencies in clinical and PRO for various management options exist. Standardized PROM will help identify optimal bladder and bowel management for patients with neurologic conditions. © 2014 Wiley Periodicals, Inc.

  11. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

    Science.gov (United States)

    Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

    2016-01-01

    Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

  12. Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis.

    Science.gov (United States)

    Denniston, Charlotte; Molloy, Elizabeth; Nestel, Debra; Woodward-Kron, Robyn; Keating, Jennifer L

    2017-04-07

    The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Systematic review and qualitative synthesis. A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Outcome of hyperleukocytic adult acute myeloid leukaemia: a single-center retrospective study and review of literature.

    Science.gov (United States)

    Marbello, Laura; Ricci, Francesca; Nosari, Anna Maria; Turrini, Mauro; Nador, Guido; Nichelatti, Michele; Tedeschi, Alessandra; Vismara, Eleonora; Morra, Enrica

    2008-08-01

    Hyperleukocytic acute myeloid leukaemia is considered to have a poor prognosis due to high early death rate secondary to leukostasis. Supportive treatments do not seem to have reduced early exitus in this subset of patients. Prognostic impact of hyperleukocytosis on outcome has been the object of few studies. Clinical characteristics and outcome of 45 consecutive adult patients with newly diagnosed acute myeloid leukaemia presenting to our institution with a white cell count (WBC) above 100 x 10(9)L(-1) were reviewed. The outcome of this subset of patients was compared with 200 patients with a leukocyte count lower than 100 x 10(9)L(-1) similarly treated in the same period. Eight hyperleukocytic patients (17%) died of intracranial haemorrhage or pulmonary failure due to leukostasis within the first 7 days of treatment. A significant association was found between complete response (CR) and absence of hyperleukocytosis, but if early deaths were removed from analysis the difference was no longer significant. Hyperleukocytosis also significantly reduces the overall survival (OS) but does not significantly influence the disease-free survival (DFS). We reviewed in literature studies in which the outcome of series of at least 10 patients with hyperleukocytosis were compared with that of patients with a leukocyte count lower than 100 x 10(9)L(-1). Our data were consistent with those of the literature regarding the rate of early mortality and causes of death. In most of the reviewed series hyperleukocytosis does not seem to influence the outcome of patients. Avoiding early death seems to be an important step in this subset of patients. New data about pathophysiology of leukostasis are needed.

  14. Impact of appetitive and aversive outcomes on brain responses: linking the animal and human literatures

    Science.gov (United States)

    Bissonette, Gregory B.; Gentry, Ronny N.; Padmala, Srikanth; Pessoa, Luiz; Roesch, Matthew R.

    2014-01-01

    Decision-making is motivated by the possibility of obtaining reward and/or avoiding punishment. Though many have investigated behavior associated with appetitive or aversive outcomes, few have examined behaviors that rely on both. Fewer still have addressed questions related to how anticipated appetitive and aversive outcomes interact to alter neural signals related to expected value, motivation, and salience. Here we review recent rodent, monkey, and human research that address these issues. Further development of this area will be fundamental to understanding the etiology behind human psychiatric diseases and cultivating more effective treatments. PMID:24624062

  15. Impact of appetitive and aversive outcomes on brain responses: Linking the animal and human literatures

    Directory of Open Access Journals (Sweden)

    Gregory B Bissonette

    2014-03-01

    Full Text Available Decision-making is motivated by the possibility of obtaining reward and/or avoiding punishment. Though many have investigated behavior associated with appetitive or aversive outcomes, few have examined behaviors that rely on both. Fewer still have addressed questions related to how anticipated appetitive and aversive outcomes interact to alter neural signals related to expected value, motivation, and salience. Here we review recent rodent, monkey, and human research that address these issues. Further development of this area will be fundamental to understanding the etiology behind human psychiatric diseases and cultivating more effective treatments.

  16. Impact of appetitive and aversive outcomes on brain responses: linking the animal and human literatures.

    Science.gov (United States)

    Bissonette, Gregory B; Gentry, Ronny N; Padmala, Srikanth; Pessoa, Luiz; Roesch, Matthew R

    2014-01-01

    Decision-making is motivated by the possibility of obtaining reward and/or avoiding punishment. Though many have investigated behavior associated with appetitive or aversive outcomes, few have examined behaviors that rely on both. Fewer still have addressed questions related to how anticipated appetitive and aversive outcomes interact to alter neural signals related to expected value, motivation, and salience. Here we review recent rodent, monkey, and human research that address these issues. Further development of this area will be fundamental to understanding the etiology behind human psychiatric diseases and cultivating more effective treatments.

  17. Individual psychotherapy as an adjunct to group psychotherapy.

    Science.gov (United States)

    Amaranto, E A; Bender, S S

    1990-01-01

    This paper describes a form of combined psychotherapy in which the individual sessions are used as an adjunct to group therapy. Each group member is seen regularly in individual sessions to focus primarily on the member's ongoing group work. The individual sessions are scheduled on a rotating basis. Typically, each group member is seen in an individual session once every four weeks. Additional individual sessions are available only when immediate attention is appropriate and necessary. The group is viewed as the primary therapeutic component. A cost-effective therapeutic approach that uses both individual and group methods, this modality lends itself well to a clinic and to a private practice setting.

  18. A Functional Analytic Approach to Group Psychotherapy

    Science.gov (United States)

    Vandenberghe, Luc

    2009-01-01

    This article provides a particular view on the use of Functional Analytical Psychotherapy (FAP) in a group therapy format. This view is based on the author's experiences as a supervisor of Functional Analytical Psychotherapy Groups, including groups for women with depression and groups for chronic pain patients. The contexts in which this approach…

  19. Consequences of Psychotherapy Clients' Mental Health Ideology.

    Science.gov (United States)

    Milling, Len; Kirsch, Irving

    Current theoretical approaches to understanding emotional difficulties are dominated by the medical model of mental illness, which assumes that emotional dysfunction can be viewed the same way as physical dysfunction. To examine the relationship between psychotherapy clients' beliefs about the medical model of psychotherapy and their behavior…

  20. Patterns of Symptomatic Recovery in Psychotherapy.

    Science.gov (United States)

    Kopta, Stephen Mark; And Others

    1994-01-01

    Used psychotherapy dosage model in which effect was probability of recovery to compare treatment response rates for psychological symptoms. Administered symptom checklists to 854 psychotherapy outpatients at intake and during treatment. Chronic distress symptoms demonstrated fastest average response rate, whereas characterological symptoms…

  1. Practice Parameter for Psychodynamic Psychotherapy with Children

    Science.gov (United States)

    Medicus, Jennifer

    2012-01-01

    This Practice Parameter describes the principles of psychodynamic psychotherapy with children and is based on clinical consensus and available research evidence. It presents guidelines for the practice of child psychodynamic psychotherapy, including indications and contraindications, the setting, verbal and interactive (play) techniques, work with…

  2. Psychological treatments for posttraumatic stress disorder: recommendations for the clinician based on a review of the literature.

    Science.gov (United States)

    Robertson, Michael; Humphreys, Leanne; Ray, Rebecca

    2004-03-01

    This article reviews available research data supporting the use of psychotherapy in the treatment of posttraumatic stress disorder (PTSD). The authors highlight how this evidence might inform clinical choices in treating PTSD, as well as demonstrating how assumptions based on gaps in the available literature may be misleading. The authors first discuss findings concerning a number of interventions that are commonly used in the treatment of trauma victims or patients with PTSD: critical incident stress debriefing, psychoeducation, exposure therapy, eye movement desensitization reprocessing, stress inoculation therapy, trauma management therapy, cognitive therapy, psychodynamic psychotherapy, and hypnotherapy. They also discuss a number of treatment strategies that have recently been studied in PTSD, including imagery rehearsal, memory structure intervention, interpersonal psychotherapy, and dialectical behavior therapy. PTSD is associated with significant symptomatic morbidity, although desired outcomes in clinical practice are typically related more to reduction in social, interpersonal, and occupational impairment. The most methodologically robust studies, which have typically examined cognitive or behavioral treatments, indicate that psychotherapy helps to relieve symptom severity; however, there is no consistent information about whether these interventions are helpful in improving other domains of impairment and associated disability, even though these problems are often the greatest concern to patients. Nor does the available evidence indicate when, and for whom, various psychotherapeutic interventions should be provided, or whether different modalities of treatment can and should be combined, or sequentially offered, as is often done in specialized treatment programs. Clinicians should keep these issues in mind in reviewing the literature on current (and future) clinical research. Unfortunately, the current evidence base on psychotherapy for PTSD gives only

  3. School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature

    Science.gov (United States)

    Wheaton, Anne G.; Chapman, Daniel P.; Croft, Janet B.

    2016-01-01

    Background: Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy…

  4. Systemic lupus erythematosus and pregnancy outcomes: an update and review of the literature.

    Science.gov (United States)

    Peart, Erica; Clowse, Megan E B

    2014-03-01

    This review synthesizes new data from the studies published between 2011 and 2013, with particular focus on the different information gleaned by various study types. Population-based cohorts have demonstrated that women with systemic lupus erythematosus (SLE) have fewer live births and more pregnancy complications, but can have successful live births after having a poor outcome. A retrospective study suggests that only 4 months, not the traditional 6 months of disease quiescent SLE prior to pregnancy improves outcomes. Prospective studies identified several novel predictors of poor pregnancy outcomes, including uterine Doppler and laboratory findings. A prospective study found great success in transitioning to azathioprine from mycophenolate mofetil prior to pregnancy in patients with quiet lupus nephritis. Two retrospective analyses suggest that hydroxychloroquine may prevent congenital heart block in pregnancies exposed to SSA/Ro antibodies. Finally, the initial pregnancy data for belimumab suggest a high degree of transplacental transfer, but thus far no definitive link between belimumab and congenital abnormalities. Recent studies suggest both novel markers of poor pregnancy outcomes and new approaches to the management of lupus during pregnancy.

  5. Education Abroad in China: Literature Review of Study Abroad Program Types, Outcomes and Benefits

    Science.gov (United States)

    Dixon, Brett

    2013-01-01

    While there has been an increase in students studying abroad in China, this increase has not been seen in the respective number of articles published in scholarly journals on education abroad in China. This paper summarizes articles from journals on the types of education abroad programs in China, organized by topic, and by the outcomes and…

  6. Shame, guilt, and posttraumatic stress disorder in adult survivors of childhood sexual abuse at risk for human immunodeficiency virus: outcomes of a randomized clinical trial of group psychotherapy treatment.

    Science.gov (United States)

    Ginzburg, Karni; Butler, Lisa D; Giese-Davis, Janine; Cavanaugh, Courtenay E; Neri, Eric; Koopman, Cheryl; Classen, Catherine C; Spiegel, David

    2009-07-01

    This study evaluated the effectiveness of group psychotherapy in reducing levels of shame and guilt in adult survivors of childhood sexual abuse at risk for HIV, and whether such reductions would mediate the effects of treatment on posttraumatic stress disorder (PTSD) symptoms. One hundred sixty-six women were randomized into 3 conditions: a trauma-focused group, a present-focused group, and a waitlist group. Women received 6 months of treatment and were assessed at pretreatment (T1), immediately posttreatment (T2), and 6 months posttreatment (T3). Both treatment conditions resulted in reduced shame and guilt. The treatment effect on PTSD symptoms was mediated by changes in shame, but it was not associated with changes in guilt. These findings suggest that, when treating childhood sexual abuse survivors' PTSD, it is important to address the negative self-appraisals, such as shame, that commonly accompany such symptoms.

  7. Form and structure and their function in psychotherapy.

    Science.gov (United States)

    Rothenberg, A

    1992-07-01

    Psychotherapy is a creative process with the same types of effects and determinants as other creative activities in fields such as literature, visual arts, and science. In all of these activities, a focus on form and structure serves to generate new and valuable resultants or creations. As shown in the example of the poet Richard Wilbur's creation of a poem, his focus on rhyme and other formal features generated a new and valuable emotional tension in the poem. In psychotherapy, the creation consists of new and valuable aspects or structural features of personality. This creative result in therapy is produced in part by therapists' focus on form in terms of sequences, style of verbal and non-verbal presentation, and the phases of encounter, growth, and separation. As shown in the psychotherapy session excerpted, the therapist's lack of attention to the critical theme initiated by the patient at the beginning of the session (encounter) as well as to the meanings of connections between sequences in the following interactions (growth) led to a non-creative or destructive suicidal threat at the end (separation). The overall creative result arises also from therapists' attention to patients' approaches to the overall structure of psychotherapy as a regularly occurring timed experience in which the therapist does not directly intervene in the patient's life. This structural organization provides a trial domain for the patient in which creative growth and personal welfare can be facilitated. Both patient and therapist need to focus on any attempts to undermine the structural organization and its meaning. Similarly, in creative activities in other fields, writers, artists, and scientists characteristically focus on form, in a detailed as well as general way, in order to facilitate both aesthetic and social growth and welfare.

  8. Prediction of treatment discontinuation and recovery from Borderline Personality Disorder: Results from an RCT comparing Schema Therapy and Transference Focused Psychotherapy

    NARCIS (Netherlands)

    A. Arntz; S. Stupar-Rutenfrans; J. Bloo; R. van Dyck; P. Spinhoven

    2015-01-01

    Knowing what predicts discontinuation or success of psychotherapies for Borderline Personality Disorder (BPD) is important to improve treatments. Many variables have been reported in the literature, but replication is needed and investigating what therapy process underlies the findings is necessary

  9. Learning through the lens: ethical considerations in videotaping psychotherapy.

    Science.gov (United States)

    Funkenstein, Amy B; Kessler, Katherine Ann; Schen, Cathy R

    2014-01-01

    Psychiatry training programs have begun to use technology to enhance psychotherapy teaching. Videotaped interviews provide a window into the psychotherapeutic exchange, demystifying the process and capturing verbal and nonverbal interactions, facial expression, and tone of voice-which can illustrate therapeutic elements such as the alliance and resistance. The process of videotaping psychotherapeutic interviews, however, introduces issues related to consent, ethics, and the dynamics of therapy. By examining two cases in which residents asked their patients to videotape a session for didactic purposes and encountered divergent outcomes, we explore the ethical issues unique to providing informed consent for videotaping psychotherapy. Informed consent must be given verbally and in writing. Verbal consent must include discussion of the risks and benefits of therapy. The discussion must also include the risks inherent in memorializing sensitive material on an external device, with disclosure of the logistics of how data will be stored, who will view the recorded material, and when it will be destroyed. Therapists should be aware of the coercive power inherent in the physician-patient relationship and should individualize each informed consent procedure with this knowledge in mind. Despite these potential pitfalls, videotaping sessions provides a wealth of information about both patients and therapists that can improve psychotherapy teaching and supervision, and indirectly improve patient care.

  10. Quality of Life: Literature Review and Recommendations for Measurement of Military Outcomes

    Science.gov (United States)

    1994-01-01

    extensively scrutinized in the literature (Andrews & Withey, 1976; Michalos, 1986; Zedeck, Maslach , Mosier, & Skitka, 1988). Schuessler and Fisher (1985, p...perceived costs associated with leaving the company), Meyer, Paunonen, Gellatly, Goffin, and Jackson (1989) found that affective commitment was...D., & Jackson , D. N. (1989). Organizational commitment and job performance: It’s the nature of the commitment that counts. Journal ofApplied

  11. Psychotherapy with a 3-Year-Old Child: The Role of Play in the Unfolding Process

    Science.gov (United States)

    Salcuni, Silvia; Di Riso, Daniela; Mabilia, Diana; Lis, Adriana

    2017-01-01

    Few studies have investigated the outcomes and process of psychodynamic psychotherapies with children. Among the limited number of studies, some only paid attention to play and verbal production, as they are fundamental aspects in assessing the psychotherapy process. This paper focuses on an empirical investigation of a 3-year, once-a-week psychodynamic psychotherapy carried out with a 3-year-old girl. A process-outcome design was implemented to evaluate play and verbal discourse in in the initial, middle, and final parts of 30 psychotherapy sessions. Repeated measurements of standardized play categories (the Play Category System and the Affect in Play Scale—Preschool version) and verbal discourse (Verbal Production) were analyzed. To increase the clinical validity of the study, data from the assessment phase and vignettes from the sessions were reported to deepen the patient’s picture during the unfolding therapy process. Parent reports before and after the therapy were also included. Empirically measured changes in play and verbal production were fundamental in evaluating the young patient’s psychotherapy process. Verbal production and discourse ability progressively increased and took the place of play, which instead became more symbolic. Developmental issues as well as psychotherapy’s influence on the patient’s change, were discussed in relation to the role of play in enhancing the development of verbal dialog and the expression of the child’s emotions, needs, and desires. PMID:28101070

  12. Treatment patterns and survival outcomes in patients with cervical cancer complicated by complete uterine prolapse: a systematic review of literature.

    Science.gov (United States)

    Matsuo, Koji; Fullerton, Morgan E; Moeini, Aida

    2016-01-01

    Cervical cancer complicated by complete uterine prolapse is a rare clinical entity and uniform management recommendations have yet to be determined. The aim of the current review was to examine the effects of management patterns on survival outcomes in cervical cancer patients with complete uterine prolapse. A systematic review of the literature was conducted using three public search engines. This included case reports with detailed descriptions of tumor characteristics, cancer management, and survival outcomes. Treatment patterns and tumor characteristics were correlated to survival outcomes. There were 78 patients with cervical cancer with complete uterine prolapse. Their mean age was 63.7 years. The median duration of prolapse was 147.9 months and 22.2% of the patients experienced persistent/recurrent prolapse after cancer treatment. The mean tumor size was 8.9 cm and squamous cell carcinoma (83.9%) was the most common histologic type. The majority of patients (56.2%) had stage I cancer. Tumor characteristics were similar across the treatment patterns. Survival outcomes were more favorable with surgery-based treatment (48 patients) than with radiation-based treatment (30 patients): 5-year recurrence-free survival rate 72.0% vs. 62.9% (p = 0.057), and 5-year disease-specific overall survival rate 77.0% vs. 68.2% (p = 0.017). After controlling for age and stage, surgery-based therapy remained an independent prognostic factor for better disease-specific overall survival outcome (hazard ratio 0.32, 95% confidence interval 0.11 - 0.94, adjusted p = 0.039). Although limited in study size, our results at least suggest that surgery-based treatment may have a positive effect on survival outcome in cervical cancer patients with complete uterine prolapse.

  13. Pulmonary sporotrichosis: case series and systematic analysis of literature on clinico-radiological patterns and management outcomes.

    Science.gov (United States)

    Aung, Ar Kar; Teh, Bing Mei; McGrath, Christopher; Thompson, Philip J

    2013-07-01

    Pulmonary infections by Sporothrix spp. manifest radiologically as cavitary or non-cavitary disease depending on whether the infection is primary pulmonary or multifocal sporotrichosis. Despite current guidelines, the optimal management for pulmonary sporotrichosis remains unclear. In order to clarify this, we present two cases of pulmonary sporotrichosis, as well as the results of a comprehensive literature review of treatment outcomes based on clinico-radiological presentation patterns of the disease. A literature search of all case reports in English language over the last 50 years (1960-2010) was conducted. Data on patient characteristics, risk factors, clinico-radiological patterns, treatment modalities and outcomes were collected and analyzed. A total of 86 cases were identified, i.e., 64 (74.4%) primary pulmonary and 22 (25.6%) multifocal sporotrichosis. Radiologically, primary pulmonary disease was commonly characterized by cavity formation which was lacking in multifocal infections (P = 0.0001). Immunosuppressant use was more common in multifocal sporotrichosis (P = 0.0001), while hemoptysis was more common in primary pulmonary form (P = 0.01). No other differences in patient characteristics or risk factors were noted. Extra-pulmonary multifocal sporotrichosis most commonly involved skin (81.8%) and joints (45.4%). For patients with cavitary primary pulmonary sporotrichosis, outcomes from medical therapy alone were inferior to surgical intervention (P = 0.02). However, for both primary pulmonary and multifocal sporotrichosis with non-cavitary disease, medical therapy alone provided good outcomes. Only 12 (16.7%) cases were treated with itraconazole. Treatment of pulmonary sporotrichosis should be guided by the clinico-radiological patterns of presentation. Medical therapy alone is likely sufficient for non-cavitary disease while early surgery should be considered for cavitary primary pulmonary sporotrichosis. The experience in treating cavitary disease

  14. Sterbenlassen. Vom Ende einer Psychotherapie

    OpenAIRE

    Ranefeld, Johannes

    2001-01-01

    Reflexionen zum Ende einer psychoanalytischen Psychotherapie; ein Ende, an das es sich nur zögernd und ausweichend annähern läßt. Sterben ist letztendlich ein einsames Geschäft, wir halten den Tod für ansteckend und verfahren nach der Regel: "Man darf nicht zulassen, daß er einem ins Gesicht atmet" (Michael Connelly 1996, The Poet). Dennoch wird ver­sucht, beschreibend ein Konzept der Annäherungen zu skizzieren.

  15. Prevention of sexually transmitted HIV infection: A meta-analytic review of teh behavioral outcome literature.

    Science.gov (United States)

    Kalichman, S C; Carey, M P; Johnson, B T

    1996-03-01

    Social learning theory-based models have recently provided the foundation for a series of twelve controlled human immunodeficiency virus (HIV) risk reduction intervention studies that have examined sexual behavior change. These interventions have been tested with adolescents, gay and bisexual men, inner-city women, college students, and seriously mentally ill adults. We report the first meta-analysis of these intervention studies. We found that, as expected, the mean weighted effect of HIV-risk reduction interventions on behavioral outcomes was positive and strongly significant (d+=0.25). Moreover, the studies' effect sizes were consistently positive, ranging from 0.11 to 0.53, and were largest when the outcomes were measured close in time to the intervention. We discuss other methodological challenges that, if solved, should enhance the success of future HIV-risk reduction interventions.

  16. Reproductive outcome in 3 families with a satellited chromosome 4 with review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Arn, P.H.; Younie, L.; Russo, S. [Nemours Children`s Clinic, Jacksonville, FL (United States)] [and others

    1995-07-03

    We describe 3 families segregating for a translocation of the nucleolus organizer region (NOR) onto chromosome 4. Review of previously reported cases of translocations involving NOR and chromosome 4 shows that these translocations may be associated with variable reproductive outcomes. We provide evidence that imprinting is not the mechanism responsible for the variable reproductive outcomes in the case of satellited 4p chromosomes; this may offer indirect support for a ribosomal gene position effect. Translocated ribosomal genes may influence the expression of neighboring genes and could explain the variable phenotypes in individuals with satellited nonacrocentric chromosomes. We recommend that prenatal counseling of individuals with satellited nonacrocentric chromosomes should be cautious. 23 refs., 2 figs., 1 tab.

  17. A literature review of record linkage procedures focusing on infant health outcomes

    Directory of Open Access Journals (Sweden)

    Carla Jorge Machado

    Full Text Available Record linkage is a powerful tool in assembling information from different data sources and has been used by a number of public health researchers. In this review, we provide an overview of the record linkage methodologies, focusing particularly on probabilistic record linkage. We then stress the purposes and research applications of linking records by focusing on studies of infant health outcomes based on large data sets, and provide a critical review of the studies in Brazil.

  18. Reproductive Outcomes Associated with Noise Exposure — A Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    Gordana Ristovska

    2014-08-01

    Full Text Available Introduction: High noise exposure during critical periods in gestation is a potential stressor that may result in increased risk of implantation failure, dysregulation of placentation or decrease of uterine blood flow. This paper systematically reviews published evidence on associations between reproductive outcomes and occupational and environmental noise exposure. Methods: The Web of Science, PubMed and Embase electronic databases were searched for papers published between 1970 to June 2014 and via colleagues. We included 14 epidemiological studies related to occupational noise exposure and nine epidemiological studies related to environmental noise exposure. There was some evidence for associations between occupational noise exposure and low birthweight, preterm birth and small for gestational age, either independently or together with other occupational risk factors. Five of six epidemiologic studies, including the two largest studies, found significant associations between lower birthweight and higher noise exposure. There were few studies on other outcomes and study design issues may have led to bias in assessments in some studies. Conclusions: There is evidence for associations between noise exposure and adverse reproductive outcomes from animal studies. Few studies in have been conducted in humans but there is some suggestive evidence of adverse associations with environmental noise from both occupational and epidemiological studies, especially for low birthweight.

  19. "Many Secrets Are Told around Horses": An Ethnographic Study of Equine-Assisted Psychotherapy

    Science.gov (United States)

    Van Tiem, Jennifer

    2014-01-01

    This dissertation presents an ethnography of equine-assisted psychotherapy (EAP) based on nine months of fieldwork at "Equine Healers," a non-profit organization in central Colorado that specialized in various therapeutic modalities associated with EAP. In bridging scholarly work around animals, a literature suffused with the notion of…

  20. Methods of Intracanal Reinforcement in Primary Anterior Teeth–Assessing the Outcomes through a Systematic Literature Review

    Science.gov (United States)

    Bhatia, Hind Pal; Haider, Khushtar

    2015-01-01

    ABSTRACT Aim: To assess how the various methods of intracanal reinforcement (short root canal posts) performed in their clinical and radiographic outcomes for restoring grossly broken down primary anterior teeth after pulpectomy for 1 year or longer follow-up period. Materials and methods: Literature search of electronic databases (Sept 2013) and various journals (1980-Sept 2013) using medical subject headings and free text terms was conducted. For inclusion in quality assessment, prespecified inclusion criteria were applied. Quality assessment was performed by using ‘The Cochrane collaboration’s tool for assessing risk of bias’. Results: Seven relevant papers were selected for full text evaluation. After applying the inclusion criteria, only two trials could be considered for quality assessment. Both of these were classified as having high risk of bias. Conclusion: The evidence to support any method of intracanal reinforcement for restoring grossly broken down anterior teeth is presently lacking. Further trials with well-defined methodology are needed. How to cite this article: Mittal N, Bhatia HP, Haider K. Methods of Intracanal Reinforcement in Primary Anterior Teeth– Assessing the Outcomes through a Systematic Literature Review. Int J Clin Pediatr Dent 2015;8(1):48-54. PMID:26124581

  1. The Genesis II in primary total knee replacement: a systematic literature review of clinical outcomes.

    Science.gov (United States)

    Bhandari, Mohit; Pascale, Walter; Sprague, Sheila; Pascale, Valerio

    2012-01-01

    Since its introduction in 1996, the Genesis II Total Knee System has produced good clinical results in patients undergoing primary total knee replacement. A systematic review of the literature-the first of its kind for this device-was undertaken to collect data on the Genesis II in order to provide a better understanding of its medium- to long-term performance. Of 124 Genesis II-related studies published in the literature, 11 met the eligibility criteria and were included in the final analysis. The included studies had a mean follow-up length of 38.1 months. Data from 1201 knees were available for review. Patients were an average of 70.5 years of age and predominantly female (63%). Findings indicated that the revision rate with this implant is low with up to 11.9 years of follow-up, with 14 revisions in total. The survival rate ranged from 100% at 1 and 2 years to 96.0% at 11.9 years. The mean Knee Society knee score improved 51.0 points from preoperative to postoperative evaluation. In conclusion, the Genesis II exhibited good clinical performance with up to 11 years follow-up, with an encouraging rate of survival and improvement in function. Additional studies with larger sample sizes and longer follow-up periods are needed to better understand the long-term performance of this implant.

  2. The use of mobile apps to improve nutrition outcomes: A systematic literature review.

    Science.gov (United States)

    DiFilippo, Kristen N; Huang, Wen-Hao; Andrade, Juan E; Chapman-Novakofski, Karen M

    2015-07-01

    We conducted a systematic review to determine if the use of nutrition apps resulted in improved outcomes, including knowledge and behavior, among healthy adults. Using app(s), cellular phone, iPads, mobile phone, mobile telephone, smart phone, mobile and mHealth as search terms with diet, food and nutrition as qualifiers we searched PubMed, CINAHL (January 2008-October 2013) and Web of Science (January 2008-January 2014). Inclusion criteria were peer-reviewed randomized controlled trials, non-controlled trials, and cohort studies published in English that used apps to increase nutrition knowledge or improve behavior related to nutrition. Studies that were descriptive, did not include apps, focused on app development, app satisfaction app feasibility, text messaging, or digital photography were excluded. We evaluated article quality using the Academy of Nutrition and Dietetics Evidence Analysis Manual. Data was extracted for knowledge, behavior and weight change. Our initial search identified 12,010 titles from PubMed, 260 from CINAHL and 4762 from Web of Science; of these, only four articles met all search criteria. Positive quality ratings were given to three articles; only one reported knowledge outcomes (non-significant). All four articles evaluated weight loss and suggested an advantage to using nutrition apps. Behavioral changes in reviewed studies included increased adherence to diet monitoring (p app (p = 0.024). Few studies, however, have explored the use of nutrition apps as supportive educational interventions. Most apps focus on weight loss with inconsistent outcomes. We conclude that using apps for education needs additional research which includes behavior theory within the app and improved study design.

  3. [Inpatient treatment of depression. Should one combine psychotherapy and drugs?].

    Science.gov (United States)

    Huber, T J

    2005-03-01

    Antidepressants as well as different psychotherapeutic strategies have been proven efficacious in the treatment of unipolar depression. In the clinical setting both are often combined using psychotherapeutic methods varying from psychoeducation to formal psychotherapy. The present article provides a critical overview of the evidence base for this combination in the inpatient treatment of depression. The current literature is contradictory and difficult to compare. However, combination therapy appears advantageous in therapy-resistant, chronic and severe forms of depressive disorders. Much further research is needed to facilitate well-founded guidelines.

  4. Synchrony in Dyadic Psychotherapy Sessions

    Science.gov (United States)

    Ramseyer, Fabian; Tschacher, Wolfgang

    Synchrony is a multi-faceted concept used in diverse domains such as physics, biology, and the social sciences. This chapter reviews some of the evidence of nonverbal synchrony in human communication, with a main focus on the role of synchrony in the psychotherapeutic setting. Nonverbal synchrony describes coordinated behavior of patient and therapist. Its association with empathy, rapport and the therapeutic relationship has been pointed out repeatedly, yet close evaluation of empirical studies suggests that the evidence remains inconclusive. Particularly in naturalistic studies, research with quantitative measures of synchrony is still lacking. We introduce a new empirical approach for the study of synchrony in psychotherapies under field conditions: Motion Energy Analysis (MEA). This is a video-based algorithm that quantifies the amount of movement in freely definable regions of interest. Our statistical analysis detects synchrony on a global level, irrespective of the specific body parts moving. Synchrony thus defined can be considered as a general measure of movement coordination between interacting individuals. Data from a sequence of N = 21 therapy sessions taken from one psychotherapy dyad shows a high positive relationship between synchrony and the therapeutic bond. Nonverbal synchrony can thus be considered a promising concept for research on the therapeutic alliance. Further areas of application are discussed.

  5. The Subject in Cognitive Psychotherapy

    Directory of Open Access Journals (Sweden)

    Isabel Caro-Gabalda

    2015-05-01

    Full Text Available This paper discusses the various subjects embedded in cognitive psychotherapy. The cognitive model developed by Beck, considered as a rationalist and modernist model, will exemplify these subjects. Cognitive therapy should be placed in the modernist historical context and related to a subject characterized as having rationality and the ability to observe and detect cognitions, emotions and behaviors. The paper develops this background introducing three main subject types. The first is the introspective and conscious subject, who is able to observe what is within oneself, has free access, and is conscious of one's cognitive world. The second is the cognitive miser that describes the subject who enters into therapy. The final subject identified, is the trained scientist who is able to develop a more objective knowledge, changing faulty schemas and cognitive distortions. This subject is the one most looked for in cognitive therapy. We could connect these subjects to some of the main elements of cognitive therapy such as the concept of ABC, assessment procedures, cognitive techniques or the relevance of schemas. Finally, the paper suggests some issues for study that could contribute to the theoretical and clinical evolution of cognitive psychotherapy.

  6. [Body-centered psychotherapy IKP (Institute of Body-Centered Psychotherapy): holistic psychotherapy].

    Science.gov (United States)

    Maurer-Groeli, Y

    1996-03-01

    Body centered Psychotherapy IKP is treated in this article under the aspect of a holistic approach. First the theory and the system of science are summarised and shown as to which amount they are changing concerning knowledge of details and wholeness. It is pointed out that the actual paradigma "to the depth" has to be completed by that of "wideness". The way of holistic-multirelational thinking, stating a diagnosis and doing therapy is demonstrated along a case study going on at the background of a therapeutic encounter-relationship which is emotionally warm (Gestalt-approach).

  7. Cultural competence dimensions and outcomes: a systematic review of the literature.

    Science.gov (United States)

    Alizadeh, Somayeh; Chavan, Meena

    2016-11-01

    It has been widely suggested that cultural competence is an individual's core requirement for working effectively with culturally diverse people. However, there is no consensus regarding the definition or the components of this concept and there is a dearth of empirical proof indicating the benefits of cultural competence. Therefore, a systematic review was conducted to identify the most common cultural competence dimensions proposed in recent publications and to identify whether sufficient evidence exists regarding the efficacy of cultural competence in the healthcare context. A total of 1204 citations were identified through an electronic search of databases, of which 18 publications included cultural competence frameworks, and 13 studies contained empirical data on cultural competence outcomes. The overarching themes of the review were centred around the challenges faced by the healthcare sector in many countries due to growing cultural diversity, but lack of cultural competence, leading to predicaments that arise during intercultural interactions between patients and clinicians. This review will benefit researchers exploring cultural competence as one of the research variables impacting research outcomes. © 2015 John Wiley & Sons Ltd.

  8. School-based diabetes interventions and their outcomes: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Bénédicte Pansier

    2015-04-01

    Full Text Available Type 1 diabetes is one of the most common chronic childhood diseases, while type 2 diabetes in children is increasing at alarming rates globally. Against this backdrop, the school is a critical environment for children with diabetes. They continue to face barriers to education that may lead to depression, poor academic performance, and poor quality of life. To address these challenges, diabetes interventions have been implemented in school and the goal was to systematically review these interventions and their outcomes between 2000 and 2013. Fifteen studies were included in the narrative synthesis. Education of school personnel was the main focus before 2006. Studies reported gains in knowledge and perceived confidence of school staff. Since 2006, more comprehensive interventions have been developed to promote better care coordination and create a safe school environment. These studies reported improved diabetes management and quality of life of students. Assessment tools varied and study design included randomized controlled trials, quantitative and qualitative methods. Although many of the studies reported a significant difference in the parameters measured, it was not possible to determine optimal ways to improve the health, quality of life and academic performance of children with diabetes, given the disparity in scope, assessment tools and measured outcomes. Experimental designs, longer follow-up studies, larger sample sizes, and a higher number of participating schools are critical issues to consider in future studies. Most of the research was conducted in North America and further research is needed in other parts of the world.

  9. Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, Alysa, E-mail: alysa.fairchild@albertahealthservices.ca [Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Straube, William [Advanced Technology Consortium, Imaged-Guided Therapy QA Center, St. Louis, Missouri (United States); Laurie, Fran [Quality Assurance Review Center, Lincoln, Rhode Island (United States); Followill, David [Radiological Physics Center, University of Texas MD Anderson Cancer Centre, Houston, Texas (United States)

    2013-10-01

    Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Disease sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question.

  10. Outcome following Resection of Biliary Cystadenoma: A Single Centre Experience and Literature Review

    Directory of Open Access Journals (Sweden)

    M. Pitchaimuthu

    2015-01-01

    Full Text Available Background. Biliary cystadenomas (BCAs are rare, benign, potentially malignant cystic lesions of the liver, accounting for less than 5% of cystic liver tumours. We report the outcome following resection of biliary cystadenoma from a single tertiary centre. Methods. Data of patients who had resection of BCA between January 1993 and July 2014 were obtained from liver surgical database. Patient demographics, clinicopathological characteristics, operative data, and postoperative outcome were analysed. Results. 29 patients had surgery for BCA. Male : female ratio was 1 : 28. Clinical presentation was abdominal pain (74%, jaundice (20%, abdominal mass (14%, and deranged liver function tests (3%. Cyst characteristics included septations (48%, wall thickening (31%, wall irregularity (38%, papillary projections (10%, and mural nodule (3%. Surgical procedures included atypical liver resection (52%, left hemihepatectomy (34%, right hemihepatectomy (10%, and left lateral segmentectomy (3%. Median length of stay was 7 (IQ 6.5–8.5 days. Two patients developed postoperative bile leak. No patients had malignancy on final histology. Median follow-up was 13 (IQ 6.5–15.7 years. One patient developed delayed biliary stricture and one died of cholangiocarcinoma 11 years later. Conclusion. Biliary cystadenomas can be resected safely with significantly low morbidity. Malignant transformation and recurrence are rare. Complete surgical resection provides a cure.

  11. Improving Patient Outcomes: Effectively Training Healthcare Staff in Psychological Practice Skills: A Mixed Systematic Literature Review.

    Science.gov (United States)

    Garzonis, Katherine; Mann, Eryn; Wyrzykowska, Aleksandra; Kanellakis, Pavlo

    2015-08-01

    Training is an important part of modern European healthcare services and is often cited as a way to improve care quality. To date, various training methods have been used to impart skills relevant to psychological practice in a variety of mental health professionals. However, patient outcomes are rarely used in evaluating the effectiveness of the different training methods used, making it difficult to assess true utility. In the present review, we consider methods of training that can effectively impact trainee and patient outcomes. To do so, PubMed, PsycNET, Scopus, CENTRAL and ERIC were searched for studies on training of healthcare staff in psychological practice approaches. In total, 24 studies were identified (16 quantitative and 8 qualitative). For the most part, group, individual, and web-based training was used. A variety of health professionals were trained in skills including 'communication', 'diagnosis', and 'referral' to name but a few. In the majority of studies staff skill level improved. These findings hold implications for the design, implementation, and evaluation of training for mental healthcare staff.

  12. Effects of smoking on the outcome of implant treatment: A literature review

    Directory of Open Access Journals (Sweden)

    Baig Mirza

    2007-01-01

    Full Text Available Statement of Problem: The use of osseointegrated implants as a foundation for the prosthetic replacement of missing teeth has become widespread in the last decade. Owing to the remarkable success of dental implants, there has been growing interest in identifying the factors associated with implant failure. Given the well-documented deleterious effect of smoking on wound healing after tooth extraction and its association with poor quality bone and periodontal disease, a negative effect of tobacco use on implant success is to be expected. Purpose: To establish the relationship between smoking and implant-related surgical procedures (i.e, sinus lift procedures, bone grafts and dental implants, including the incidence of complications related to these procedures and the long-term survival and success rates of dental implants among smokers and nonsmokers based on relevant literature. Materials and Methods: Relevant clinical studies published in English between 1990 and 2006 were reviewed. The articles were located through Medline and, manually, through the references of peer-reviewed literature. This was supplemented with a hand search of selected dental journals and text books. Results: The majority of the past and current literature implicates smoking as one of the prominent risk factors affecting the success rate of dental implants with only a handful of studies failing to establish a connection. Most of the studies report the failure rate of implants in smokers as being more than twice that in nonsmokers. These findings are difficult to ignore. There is a statistically significant difference between smokers and nonsmokers in the failure rates of dental implants. Smoking also has a strong influence on the complication rates of implants: it causes significantly more marginal bone loss after implant placement, it increases the incidence of peri-implantitis and affects the success rates of bone grafts. The failure rate of implants placed in grafted

  13. Prediction of treatment discontinuation and recovery from Borderline Personality Disorder: Results from an RCT comparing Schema Therapy and Transference Focused Psychotherapy.

    Science.gov (United States)

    Arntz, Arnoud; Stupar-Rutenfrans, Snežana; Bloo, Josephine; van Dyck, Richard; Spinhoven, Philip

    2015-11-01

    Knowing what predicts discontinuation or success of psychotherapies for Borderline Personality Disorder (BPD) is important to improve treatments. Many variables have been reported in the literature, but replication is needed and investigating what therapy process underlies the findings is necessary to understand why variables predict outcome. Using data of an RCT comparing Schema Therapy and Transference Focused Psychotherapy as treatments for BPD, variables derived from the literature were tested as predictors of discontinuation and treatment success. Participants were 86 adult outpatients (80 women, mean age 30.5 years) with a primary diagnosis of BPD who had on average received 3 previous treatment modalities. First, single predictors were tested with logistic regression, controlling for treatment type (and medication use in case of treatment success). Next, with multivariate backward logistic regression essential predictors were detected. Baseline hostility and childhood physical abuse predicted treatment discontinuation. Baseline subjective burden of dissociation predicted a smaller chance of recovery. A second study demonstrated that in-session dissociation, assessed from session audiotapes, mediated the observed effects of baseline dissociation on recovery, indicating that dissociation during sessions interferes with treatment effectiveness. The results suggest that specifically addressing high hostility, childhood abuse, and in-session dissociation might reduce dropout and lack of effectiveness of treatment.

  14. Case Management as a Significant Component of Usual Care Psychotherapy for Youth with Disruptive Behavior Problems

    Science.gov (United States)

    Zoffness, Rachel; Garland, Ann; Brookman-Frazee, Lauren; Roesch, Scott

    2009-01-01

    Youth with disruptive behavior problems (DBPs) represent the majority of youth served in usual care (UC) psychotherapy, and are at high risk for maladaptive outcomes. Little is known about UC psychotherapeutic strategies utilized with this population. Researchers and clinicians suggest that case management (CM) is a major activity occurring in…

  15. Are Psychotherapeutic Changes Predictable? Comparison of a Chicago Counseling Center Project with a Penn Psychotherapy Project.

    Science.gov (United States)

    Luborsky, Lester; And Others

    1979-01-01

    Compared studies predicting outcomes of psychotherapy. Level of prediction success in both projects was modest. Particularly for the rated benefits score, the profile of variables showed similar levels of success between the projects. Successful predictions were based on adequacy of personality functioning, match on marital status, and length of…

  16. Case Management as a Significant Component of Usual Care Psychotherapy for Youth with Disruptive Behavior Problems

    Science.gov (United States)

    Zoffness, Rachel; Garland, Ann; Brookman-Frazee, Lauren; Roesch, Scott

    2009-01-01

    Youth with disruptive behavior problems (DBPs) represent the majority of youth served in usual care (UC) psychotherapy, and are at high risk for maladaptive outcomes. Little is known about UC psychotherapeutic strategies utilized with this population. Researchers and clinicians suggest that case management (CM) is a major activity occurring in…

  17. Group Psychotherapy for Women with a History of Incest: The Research Base.

    Science.gov (United States)

    Marotta, Sylvia A.; Asner, Kimberly K.

    1999-01-01

    Demonstrates the wide range of adequacy of current studies on group psychotherapy for women with incest histories. Because the studies differed in methodology and reporting, they were categorized and assessed by six criteria: design, sample, inclusion criteria, replicability, analysis, and outcome. Implications for both researchers and…

  18. Psychotherapy Training for Residents: Reconciling Requirements with Evidence-Based, Competency-Focused Practice

    Science.gov (United States)

    Weerasekera, Priyanthy; Manring, John; Lynn, David John

    2010-01-01

    Objective: The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies…

  19. The effects of kinesiotape on athletic-based performance outcomes in healthy, active individuals: a literature synthesis

    Science.gov (United States)

    Drouin, Jillian L.; McAlpine, Caitlin T.; Primak, Kari A.; Kissel, Jaclyn

    2013-01-01

    Context: The effect of the application of kinesiotape to skin overlying musculature on measurable athletic-based performance outcomes in healthy individuals has not been well established. Objective: To systematically search and assess the quality of the literature on the effect of kinesiotape on athletic-based performance outcomes in healthy, active individuals. Methods: An electronic search strategy was conducted in MANTIS, Cochrane Library and EBSCO databases. Retrieved articles that met the eligibility criteria were rated for methodological quality by using an adaption of the critical appraisal criteria in Clinical Epidemiology by Sackett et al. Results: Ten articles met the inclusion criteria. Seven articles had positive results in at least one athletic-based performance measure compared to controls. Conclusion: Evidence is lacking to support the use of kinesiotape as a successful measure for improving athletic-based performance outcomes in healthy individuals. However, there is no evidence to show that kinesiotape has a negative effect on any of the performace measures. PMID:24302784

  20. Psychotherapy is an ethical endeavor: Balancing science and humanism in clinical practice.

    Science.gov (United States)

    Allen, Jon G

    2013-01-01

    The author proposes that psychotherapy is best grounded in scienceinformed humanism and, more specifically, that psychotherapists at least implicitly promote ethical, moral--and indeed, virtuous--behavior. In doing so, therapists are challenged continually to engage in making evaluative moral judgments without being judgmental. He contends that psychotherapists, and psychologists especially, are overly reliant on science and might benefit from being more explicit in their ethical endeavors by being better informed about the illuminating philosophical literature on ethics. He highlights the concept of mentalizing, that is, attentiveness to mental states in self and others, such as needs, feelings, and thoughts. He proposes that mentalizing in the context of attachment relationships is common to all psychotherapies, and that this common process is best understood conjointly from the perspectives of developmental psychology and ethics. The author defends the thesis that employing psychotherapy to promote ethical, moral, and virtuous functioning can be justified on scientific grounds insofar as this functioning is conducive to health.

  1. Effectiveness of group body psychotherapy for negative symptoms of schizophrenia: multicentre randomised controlled trial †

    OpenAIRE

    Priebe, S.; Savill, M.; Wykes, T.; Bentall, R P; Reininghaus, U; Lauber, C; Bremner, S; Eldridge, S; Röhricht, F.

    2016-01-01

    Background\\ud Negative symptoms of schizophrenia have a severe impact\\ud on functional outcomes and treatment options are limited.\\ud Arts therapies are currently recommended but more\\ud evidence is required.\\ud \\ud Aims\\ud To assess body psychotherapy as a treatment for negative\\ud symptoms compared with an active control (trial registration:ISRCTN84216587).\\ud \\ud Method\\ud Schizophrenia out-patients were randomised into a\\ud 20-session body psychotherapy or Pilates group. The primary\\ud ou...

  2. Improving medical literature sourcing by first-year medical students in problem-based learning: outcomes of early interventions.

    Science.gov (United States)

    Krasne, Sally; Stevens, Carl D; Wilkerson, LuAnn

    2014-07-01

    To describe and report outcomes of interventions implemented in the preclerkship curriculum at the David Geffen School of Medicine at UCLA to guide students toward use of high-quality information sources and build a foundation for developing fluency in applying primary medical literature to answer clinical questions. The authors introduced three phases of change to instruction in literature searching and sourcing for beginning medical students writing learning issue essays: in phase 1 (2003-2006), students were introduced to online resources during orientation week and received a lecture on high-yield literature searching midway through their first curricular block; in phase 2 (2007-2008), the high-yield lecture shifted to orientation week, and a resource matrix and librarian-guided workshop on locating authoritative sources were added; and in phase 3 (2009), peer evaluation and collaboration were implemented. To track changes in sourcing skills, the authors analyzed 3,199 references from 665 essays written by 465 first-year students for two problem-based learning (PBL) cases during the first block of one representative year per phase (2006, 2008, 2009). Over the study period, the authors found significantly increased citations to peer-reviewed journal articles and guidelines and decreased citations to general public Web sites and highly abstracted resources. Peer feedback and collaboration in phase 3 were associated with maintenance of these gains. Early introduction of instruction on medical literature searching and sourcing, a librarian-guided workshop, and peer collaboration and feedback improved the quality of references cited by students in PBL essays during their first curricular block.

  3. Cyberbullying, Race/Ethnicity and Mental Health Outcomes: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Lynne Edwards

    2016-06-01

    Full Text Available Cyberbullying is a relatively new phenomenon associated with the widespread adoption of various digital communication technologies, including the internet and mobile phones. As of 2013, nearly 20% of youths in grades 9–12 in the US reported being traditionally bullied in face-to-face encounters while almost 15% reported being cyberbullied (Kann et al., 2014. Bullying victimization is associated with a variety of behavioral and psychological effects, from becoming bullies themselves (i.e., bully-victims, to poor academic performance, depression and suicidal ideation (Nansel et al., 2001; Wang, Nansel, & Iannotti, 2011; Willard, 2007. Research on these phenomena has focused primarily on white youth, leaving a void in our understanding of how cyberbullying has affected youth of color. This narrative literature review addresses this oversight by providing an overview of recent cyberbullying research that focuses on Hispanic, Asian and black adolescents (k=15. We found that youth of color appear to be less likely to experience cyberbullying than white youth but they experience suicidal ideation and attempts at about the same rates when they do experience cyberbullying.

  4. Cyberbullying, Race/Ethnicity and Mental Health Outcomes: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Lynne Edwards

    2016-06-01

    Full Text Available Cyberbullying is a relatively new phenomenon associated with the widespread adoption of various digital communication technologies, including the internet and mobile phones. As of 2013, nearly 20% of youths in grades 9–12 in the US reported being traditionally bullied in face-to-face encounters while almost 15% reported being cyberbullied (Kann et al., 2014. Bullying victimization is associated with a variety of behavioral and psychological effects, from becoming bullies themselves (i.e., bully-victims, to poor academic performance, depression and suicidal ideation (Nansel et al., 2001; Wang, Nansel, & Iannotti, 2011; Willard, 2007. Research on these phenomena has focused primarily on white youth, leaving a void in our understanding of how cyberbullying has affected youth of color. This narrative literature review addresses this oversight by providing an overview of recent cyberbullying research that focuses on Hispanic, Asian and black adolescents (k=15. We found that youth of color appear to be less likely to experience cyberbullying than white youth but they experience suicidal ideation and attempts at about the same rates when they do experience cyberbullying.

  5. Population Knowledge, Attitude, and Practice Regarding Helicobacter pylori Transmission and Outcomes: A Literature Review.

    Science.gov (United States)

    Driscoll, Lisa J; Brown, Heidi E; Harris, Robin B; Oren, Eyal

    2017-01-01

    Helicobacter pylori infection is associated with the development of chronic gastritis, peptic ulcer disease, and gastric cancer. Current clinical recommendations are that H. pylori test-and-treat should be individualized based on comorbidities and patient preferences among populations at increased risk for certain morbidities. However, knowledge, attitudes and practices regarding H. pylori among potential patient populations are largely unknown. We conducted a literature review to assess knowledge, attitudes, and practices of patients or community populations around H. pylori transmission, prevention, and associated morbidity. Nine studies met the inclusion criteria, all published between 1997 and 2014. Eight studies evaluated perception of H. pylori among at-risk populations, while one study evaluated perception among a general population. The studies suggest inconsistencies between the perceptions of these populations and the established understanding of knowledge, attitude, and preventive practices for H. pylori among even at-risk populations. To adequately respond to current test-and-treat recommendations for treatment of H. pylori, general population education must be implemented, especially among at-risk populations. Further work is needed within at-risk populations in the United States to determine prevalence of H. pylori and their current knowledge if adequate prevention strategies are to be designed.

  6. Looking back, looking forward: A historical reflection on psychotherapy process research.

    Science.gov (United States)

    Knobloch-Fedders, Lynne M; Elkin, Irene; Kiesler, Donald J

    2015-01-01

    In 1983, a group of 14 prominent psychotherapy process researchers attended a workshop sponsored by the US National Institute of Mental Health. Although the previous decade had seen a marked emphasis on psychotherapy outcome research, there had also been several major advances in the field of process research. The goals of the workshop were to review the current state of the field, address methodological and conceptual issues, and provide recommendations to advance scholarship in this area. In this paper, we summarize the major themes of the workshop and consider the degree to which its recommendations have come to fruition via subsequent developments in the field. Although 30 years have passed since the workshop was held, its insights remain highly relevant to psychotherapy process research today.

  7. Review of neuropsychotherapy: how the neurosciences inform effective psychotherapy and neuropsychotherapie (neuropsychotherapy).

    Science.gov (United States)

    Draguns, Juris G

    2007-03-01

    Reviews the book, Neuropsychotherapie (Neuropsychotherapy) and its English translation, Neuropsychotherapy: How the Neurosciences Inform Effective Psychotherapy, by Klaus Grawe (2004). In the last two decades, momentous advances have occurred in neuroscientific knowledge of complex human behavior and experience. At the same time, there has been a steady accretion of research-based information on the technique, process, and outcome of psychotherapy. In Neuropsychotherapie, Klaus Grawe has undertaken the integration of these two trends. He proceeds from the expectation that the breakthroughs in neuroscience are crucial both for the understanding of psychotherapy and for the further enhancement of its effectiveness. Grawe's book is a landmark and a breakthrough, and its impact will be felt for a great many years. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  8. Rape treatment outcome research: empirical findings and state of the literature.

    Science.gov (United States)

    Vickerman, Katrina A; Margolin, Gayla

    2009-07-01

    This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery.

  9. Treatment and outcome of severe intraventricular extension in patients with subarachnoid or intracerebral hemorrhage: a systematic review of the literature.

    Science.gov (United States)

    Nieuwkamp, D J; de Gans, K; Rinkel, G J; Algra, A

    2000-02-01

    Severe intraventricular hemorrhage caused by extension from subarachnoid hemorrhage or intracerebral hemorrhage leads to hydrocephalus and often to poor outcome. We conducted a systematic review to compare conservative treatment, extraventricular drainage, and extraventricular drainage combined with fibrinolysis. We carried out a search in Medline of the literature between January 1966 and December 1998 and an additional hand-search from January 1990 to December 1998. Pharmaceutical companies were contacted to gather unpublished data. We reviewed the reference lists of all relevant articles. Two authors independently assessed eligibility of the studies and extracted data on characteristics of study design, patients, and treatment. Patients with primary intraventricular hemorrhage were excluded. Main outcome measures were death and poor outcome (defined as death or dependency) at the end of follow-up. No randomized clinical trial has yet been conducted so far, and we therefore reviewed only observational studies. The case fatality rate for conservative treatment (ten studies) was 78%. For extraventricular drainage (seven studies) it was 58% [relative risk versus conservative treatment (RR) 0.74; 95% confidence interval (CI) 0.55-0.99]. For extraventricular drainage with fibrinolytic agents (five studies) the case fatality rate was 6% (RR 0.08; 95% CI 0.02-0.24). The poor outcome rate for conservative treatment was 90%, that for extraventricular drainage 89% (RR 0.98; 95% CI 0.75-1.30) and that for extraventricular drainage with fibrinolytic agents 34% (RR 0.38; 95% CI 0.21-0.68). All RR values remained essentially the same after adjusting for age, sex, World Federation of Neurological Surgeons scale, study design, and year of publication for the studies that provided these data. Outcome is thus poor in patients with intraventricular extension of subarachnoid or intracerebral hemorrhage. This meta-analysis suggests that treatment with ventricular drainage combined

  10. Green areas and health outcomes: a systematic review of the scientific literature

    Directory of Open Access Journals (Sweden)

    Francesco Di Nardo

    2010-12-01

    Full Text Available

    Background: Growing medical evidence shows that access to the natural environment improves health and wellbeing, prevents disease and helps people recover from illness. Experiencing nature in the outdoors can help tackle obesity and coronary heart disease. Green areas exert their benefits on both physical and mental health, promoting physical activity and strengthening the sense of community thus positively influencing social interaction. Urbanization poses problems through effects such as environmental pollution, accidents, heat island effects, climate change and a consequent demand for urban green areas.

    Material and methods: We performed literature searches of electronic journal databases for studies and reviews that focused on the relationship between green spaces and health. We looked at the effects on physical health, mental health, social health, physical activity and well-being in its broadest sense and then we categorically organized our findings.

    Results: We found many contradictory and unexpected results. However, the reported findings were generally consistent and supported the current view that urban design and the availability of urban green spaces are key elements of prosperity and individual/collective comfort, so as to influence both the perceived health and the objective physical conditions in a measurable way. A weak relationship between physical activity levels and green space availability is observed.

    Conclusions: The occasionally contradictory results that emerged in this study suggest that a opulation’s esponse to urban design interventions is often unpredictable. Further research is needed to quantify the trength of relation between green spaces and urban health, but also to investigate the social and behavioural spects which are more difficult to measure and understand.

  11. Psychotherapy: from exorcism to cognitive theories

    Directory of Open Access Journals (Sweden)

    Durval Mazzei Nogueira Filho

    Full Text Available The author discusses aspects of psychotherapeutic action. He defends the rationality of the procedure, comments on the splintering of the field of psychotherapy and discusses the usefulness of applying the scientific methodology to this field of knowledge.

  12. Psychotherapy and distributive justice: a Rawlsian analysis.

    Science.gov (United States)

    Wilmot, Stephen

    2009-03-01

    In this paper I outline an approach to the distribution of resources between psychotherapy modalities in the context of the UK's health care system, using recent discussions of Cognitive Behavioural Psychotherapy as a way of highlighting resourcing issues. My main goal is to offer an approach that is just, and that accommodates the diversity of different schools of psychotherapy. In order to do this I draw extensively on the theories of Justice and of Political Liberalism developed by the late John Rawls, and adapt these to the particular requirements of psychotherapy resourcing. I explore some of the implications of this particular analysis, and consider how the principles of Rawlsian justice might translate into ground rules for deliberation and decision-making.

  13. PSYCHOTHERAPY WITH THE PARENT EGO STATE

    Directory of Open Access Journals (Sweden)

    Maruša Zaletel

    2012-06-01

    Full Text Available In their article, the authors present the findings of the study in which they conceptualized the method of psychotherapy with the Parent ego state. Their aim was to explore whether this method could be divided into individual, content-wise separate chronological phases which can be observed with the majority of clients. By using a modified method of content analysis of five psychotherapy transcripts and a video recording of a psychotherapy session, nine chronological phases were identified. In order to illustrate the individual phases, excerpts from the transcripts and the video recording of psychotherapy have been included. The article proposes under what conditions can this method be used, and presents some of its limitations.

  14. John Bowlby and couple psychotherapy.

    Science.gov (United States)

    Clulow, Christopher

    2007-12-01

    The centenary of John Bowlby's birth provides a context for considering the policy, research and practice legacies that he left for practitioners working in many different fields supporting couples and families. Part historical, and part forwardlooking, this paper considers the links between attachment in the infant-parent dyad that was at the heart of Bowlby's concern and the nature of the affective ties that bind couples together in adult romantic relationships. An overview of the influence of his theory on family policy and adult attachment research is followed by an appreciation of its significance for the practice of couple psychotherapy. The paper concludes with a comment on the implications of current neuroscience knowledge for therapeutic technique.

  15. Psychotherapy - insights from bhagavad gita.

    Science.gov (United States)

    Reddy, M S

    2012-01-01

    Spoken and written commentary on Bhagavad Gita, the distilled spiritual essence of Vedas and Upanishads, is aplenty. Mahatma Gandhi was quoted as saying that whenever he had a problem Bhagavad Gita offered an answer and the solution. For a student of psychology Bhagavad Gita offers a valuable case study for lessons in psychotherapy - resolution of conflict and successful resumption of action from a state of acute anxiety and guilt laden depression that precipitated inaction. This presentation makes a humble attempt to discuss the therapy process involved in Bhagavad Gita in which Lord Krishna helped the grief-stricken Arjuna through dialogue and discussion. The focus would be on the conflict and diagnosis of patient, the background setting of the situation, personality of patient, technique of therapy, underlying psychological concepts/ principles/theories, the Guru - Sishya concept, etc.

  16. Monoamniotic twins discordant for anencephaly managed conservatively with good outcomes: two case reports and a review of the literature.

    Science.gov (United States)

    Lim, K I; Dy, C; Pugash, D; Williams, K P

    2005-08-01

    Monoamniotic twin pregnancy discordant for anencephaly (MATDA) is a rare occurrence with only seven prior reported cases. Selective termination has been advocated in managing discordant monoamniotic twins. We report two cases managed expectantly with good outcomes and review other previously reported cases. The first case was a primigravid woman diagnosed with MATDA at 18 weeks. She was managed expectantly until 32 + 5 weeks when a Cesarean section was performed for preterm labor. The surviving female infant weighed 1610 g. The second case was a multigravid woman who was diagnosed with MATDA at 17 + 5 weeks and was managed as an outpatient. An emergency Cesarean section was performed at 31 weeks for non-reassuring monitoring and the surviving male infant weighed 1790 g. In both cases, the survivors were discharged home in good condition. A review of these two cases and those in the literature suggests that expectant management should be considered among management options for this rare condition.

  17. Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy - a systematic literature review.

    Science.gov (United States)

    Pareja, René; Rendón, Gabriel J; Sanz-Lomana, Carlos Millán; Monzón, Otto; Ramirez, Pedro T

    2013-10-01

    Radical trachelectomy is a standard treatment for selected patients with early-stage cervical cancer. Outcomes are well established for vaginal radical trachelectomy (VRT), but not for abdominal radical trachelectomy (ART). We searched MEDLINE, EMBASE, and CINAHL (October 1997 through October 2012) using the terms: uterine cervix neoplasms, cervical cancer, abdominal radical trachelectomy, vaginal radical trachelectomy, fertility sparing, and fertility preservation. We included original articles, case series, and case reports. Excluded were review articles, articles with duplicate patient information, and articles not in English. We identified 485 patients. Ages ranged from 6 to 44 years. The most common stage was IB1 (331/464; 71%), and the most common histologic subtype was squamous cell carcinoma (330/470; 70%). Operative times ranged from 110 to 586 min. Blood loss ranged from 50 to 5568 mL. Three intraoperative complications were reported. Forty-seven patients (10%) had conversion to radical hysterectomy. One hundred fifty-five patients (35%) had a postoperative complication. The most frequent postoperative complication was cervical stenosis (n=42; 9.5%). The median follow-up time was 31.6 months (range, 1-124). Sixteen patients (3.8%) had disease recurrence. Two patients (0.4%) died of disease. A total of 413 patients (85%) were able to maintain their fertility. A total of 113 patients (38%) attempted to get pregnant, and 67 of them (59.3%) were able to conceive. ART is a safe treatment option in patients with early-stage cervical cancer interested in preserving fertility. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Psychotherapies

    Science.gov (United States)

    ... persistent irritability, or a sense of discouragement or hopelessness that won’t go away. A health professional may suspect or have diagnosed a condition such as depression, bipolar disorder, post-traumatic stress or other disorder ...

  19. Psychotherapy with physically disabled patients.

    Science.gov (United States)

    Oliveira, Rui Aragao; Milliner, Eric K; Page, Richard

    2004-01-01

    With the last decades, health care interventions have been more productively attuned to actualizing the potential for optimal recuperation of every patient. Unique and important contributions of psychotherapy to this effort include: 1) A formulation which synthesizes an understanding of clinical behaviors, reality-based physical limitations and risks with an appreciation of the patient's mechanisms of defense, ego strengths and weaknesses, and transference expectations which impact the treatment process; 2) The utilization of individual psychotherapy (focused on "insight") in combination with supportive individual and group experiences. For children and adolescents struggling with age-appropriate physical-developmental and social issues or learning disabilities, psychoeducational approach for disabled youngsters has proven very beneficial. 3) Occasional crises occur which involve the spouse or relatives more than the index patient. Working to provide supportive Couple or Family System intervention is sometimes as essential as caring for the disabled individual. 4) Numerous Group Therapy approaches have proven efficacious. Treatment in a group setting is attractive to those who are concerned about cost-containment. Unfortunately, groups for disabled are often "didactic" and utilize a format that provides factual information about disabilities, medical procedures, and sometimes an intellectual discussion of "emotional answers" for certain types of problems or conditions. Groups that facilitate self-disclosure and emotional interactions among the members accomplish more meaningful results. In conclusion, we wish to emphasize the importance of developing rigorous scientific research in the area of disabilities which will match the excellence of clinical work already being done in the field. Gaining an accurate and more thorough understanding of the psychological reality of a disabled person's internal world may be a key to facilitating his or her self-esteem and

  20. Psychotherapy and pharmacotherapy: toward an integrative model.

    Science.gov (United States)

    Karasu, T B

    1982-09-01

    The author reviews historical trends, hypotheses, and problems in the application of pharmacotherapy and psychotherapy and uses research findings to develop an integrative model. He portrays a chronology of models over three decades; an "additive" relationship represents the decade of 1970 to 1980. He presents factors that must be considered in determining the effects of pharmacotherapy plus psychotherapy and recommends refinement of these variables in future research.

  1. Cognitive Behavioral Psychotherapy with Older Adults

    OpenAIRE

    Knight, Bob G.; Satre, Derek

    1999-01-01

    Cognitive behavioral psychotherapy is readily adaptable to use with older adults. This review integrates discussion of cognitive and behavioral intervention techniques with recent research and clinical observations in the field of gerontology. Cognitive changes with aging, personality and emotional development, cohort effects, and the social environment of older adults are discussed in relation to psychotherapy. Applications of cognitive behaivor therapy to specific late life problems such as...

  2. NONVERBAL STORIES: THE BODY IN PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine

    2014-11-01

    Full Text Available Emotional experience is stored within the amygdala and the limbic system of the brain as affect, visceral, and physiological sensation without symbolization and language. These significant memories are expressed in affect and through our bodily movements and gestures. Such body memories are unconscious non-symbolized patterns of self-in-relationship. Several methods of a body centered psychotherapy are described and clinical case examples illustrate the use of expressive methods within a relational psychotherapy.

  3. CyberKnife radiosurgery for brainstem metastases: Management and outcomes and a review of the literature.

    Science.gov (United States)

    Liu, Szu-Hao; Murovic, Judith; Wallach, Jonathan; Cui, Guosheng; Soltys, Scott G; Gibbs, Iris C; Chang, Steven D

    2016-03-01

    To our knowledge this paper is the first to use recursive partitioning analysis (RPA) for brainstem metastasis (BSM) patient outcomes, after CyberKnife radiosurgery (CKRS; Accuray, Sunnyvale, CA, USA); nine similar previous publications used mainly Gamma Knife radiosurgery (Elekta AB, Stockholm, Sweden). Retrospective chart reviews from 2006-2013 of 949 CKRS-treated brain metastasis patients showed 54 BSM patients (5.7%): 35 RPA Class II (65%) and 19 Class III (35%). There were 30 women (56%) and 24 men (44%). The median age was 59 years (range 36-80) and median follow-up was 5 months (range 1-52). Twenty-three patients (43%) had lung carcinoma BSM and 12 (22%) had breast cancer BSM. Fifty-four RPA Class II and III BSM patients had a median overall survival (OS) of 5 months, and for each Class 8 and 2 months, respectively. Of 36 RPA Class II and III patients with available symptoms (n=31) and findings (n=33), improvement/stability occurred in the majority for symptoms (86%) and findings (92%). Of 35 cases, 28 (80%) achieved BSM local control (LC); 13/14 with breast histology (93%) and 10/13 with lung histology (77%). All six RPA Class II and III patients with controlled extracranial systemic disease (ESD) experienced LC. Median tumor volume was 0.14 cm(3); of 34 RPA Class II and III cases, 26 LC patients had a 0,13 cm(3) median tumor volume while it was 0.27 cm(3) in the eight local failures. Of 35 cases, single session equivalent dosages less than the median (n=13), at the 17.9 Gy median (n=5) and greater than the median (n=17) had BSM LC in 10 (77%), four (80%) and 14 cases (82%), respectively. Univariate analysis showed Karnofsky Performance Score, RPA Class and ESD-control predicted OS. CKRS is useful for RPA Class II and III BSM patients with effective clinical and local BSM control.

  4. Feto-maternal outcomes of pregnancy complicated by Krukenberg tumor: a systematic review of literature.

    Science.gov (United States)

    Kodama, Michiko; Moeini, Aida; Machida, Hiroko; Blake, Erin A; Grubbs, Brendan H; Matsuo, Koji

    2016-09-01

    Krukenberg tumor is a rare type of ovarian cancer with a poor prognosis, and little is known about its behavior during pregnancy. A systematic review was conducted to identify pregnancies complicated by Krukenberg tumor, correlated to oncologic and neonatal outcomes (n = 35). Mean age of cases was 30.4 years, and the most common origin of primary cancer was the stomach (68.6 %) followed by the colon (14.3 %). The two most common presenting symptoms were abdominal/pelvic pain (51.4 %) and nausea/vomiting (48.6 %). Two-thirds of tumors were bilateral (65.7 %) and the average size was 16.7 cm. Ascites (45.7 %), carcinomatosis (25.7 %) and non-ovarian distant metastases (14.3 %) were found at the time of surgery. Chemotherapy was administered in 20 cases, with fetal exposure in two of these. The ovarian tumor was identified prior to the primary cancer diagnosis in all 28 cases. The overall number of live births was 27 (81.8 %). The median survival was 6 months after Krukenberg tumor diagnosis. In univariate analysis, decreased overall survival was associated with dyspnea, ascites, carcinomatosis, non-radical surgery for the primary cancer, and residual disease at surgery (all, p < 0.05). On multivariate analysis, dyspnea and carcinomatosis remained independent prognostic factors for decreased overall survival after Krukenberg tumor diagnosis (2-year overall survival rates, dyspnea 0 vs. 56.6 %, adjusted-hazard ratio [HR] 9.74, 95 % confidence interval [CI] 2.04-46.2, p < 0.01; and carcinomatosis, 0 vs. 58.1 %, adjusted-HR 7.95, 95 % CI 1.76-36.0, p < 0.01). Our results showed that prognosis of Krukenberg tumor complicated pregnancies is extremely poor, however it may be improved if radical surgery is achievable.

  5. Management and outcome of high-grade multicentric gliomas: a contemporary single-institution series and review of the literature.

    Science.gov (United States)

    di Russo, Paolo; Perrini, Paolo; Pasqualetti, Francesco; Meola, Antonio; Vannozzi, Riccardo

    2013-12-01

    Multicentric malignant gliomas are well-separated tumours in different lobes or hemispheres, without anatomical continuity between lesions. The purpose of this study was to explore the clinical features, the pathology and the outcome according to the management strategies in a consecutive series of patients treated at a single institution. In addition, an analysis of the existing literature is presented. For the institutional analysis, a retrospective review of all patients who underwent treatment for multicentric gliomas in the last 7 years was performed. For the analysis of the literature, a MEDLINE search with no date limitations was accomplished for surgical treatment of multicentric malignant gliomas. Two hundred and thirty-nine patients with glioma were treated in our department. Eighteen patients (7.5 %) with a mean age of 64 years (age range, 37-78 years) presented multicentric malignant gliomas. Thirteen patients (72 %) underwent surgical resection of at least one lesion that was followed by adjuvant treatment in all but one case. Five patients (28 %) underwent stereotactic biopsy and thereafter received chemotherapy. A survival advantage was associated with resection of at least one lesion followed by adjuvant treatment (median overall survival 12 months) compared with 4 months for stereotactic biopsy followed by chemotherapy. Similar results were obtained from the review of the literature. Resection of at least one lesion seems to play a significant role in the management of selected patients with multicentric malignant gliomas. Multi-institutional studies on larger series are warranted to define how aggressively the patients with malignant multicentric gliomas should be treated.

  6. Health outcomes and related effects of using social media in chronic disease management: a literature review and analysis of affordances.

    Science.gov (United States)

    Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando

    2013-12-01

    Whilst the future for social media in chronic disease management appears to be optimistic, there is limited concrete evidence indicating whether and how social media use significantly improves patient outcomes. This review examines the health outcomes and related effects of using social media, while also exploring the unique affordances underpinning these effects. Few studies have investigated social media's potential in chronic disease, but those we found indicate impact on health status and other effects are positive, with none indicating adverse events. Benefits have been reported for psychosocial management via the ability to foster support and share information; however, there is less evidence of benefits for physical condition management. We found that studies covered a very limited range of social media platforms and that there is an ongoing propensity towards reporting investigations of earlier social platforms, such as online support groups (OSG), discussion forums and message boards. Finally, it is hypothesized that for social media to form a more meaningful part of effective chronic disease management, interventions need to be tailored to the individualized needs of sufferers. The particular affordances of social media that appear salient in this regard from analysis of the literature include: identity, flexibility, structure, narration and adaptation. This review suggests further research of high methodological quality is required to investigate the affordances of social media and how these can best serve chronic disease sufferers. Evidence-based practice (EBP) using social media may then be considered.

  7. Role of nutritional status in predicting quality of life outcomes in cancer--a systematic review of the epidemiological literature.

    Science.gov (United States)

    Lis, Christopher G; Gupta, Digant; Lammersfeld, Carolyn A; Markman, Maurie; Vashi, Pankaj G

    2012-04-24

    Malnutrition is a significant factor in predicting cancer patients' quality of life (QoL). We systematically reviewed the literature on the role of nutritional status in predicting QoL in cancer. We searched MEDLINE database using the terms "nutritional status" in combination with "quality of life" together with "cancer". Human studies published in English, having nutritional status as one of the predictor variables, and QoL as one of the outcome measures were included. Of the 26 included studies, 6 investigated head and neck cancer, 8 gastrointestinal, 1 lung, 1 gynecologic and 10 heterogeneous cancers. 24 studies concluded that better nutritional status was associated with better QoL, 1 study showed that better nutritional status was associated with better QoL only in high-risk patients, while 1 study concluded that there was no association between nutritional status and QoL. Nutritional status is a strong predictor of QoL in cancer patients. We recommend that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, which includes nutritional screening, nutritional assessment and intervention as appropriate. Correcting malnutrition may improve QoL in cancer patients, an important outcome of interest to cancer patients, their caregivers, and families.

  8. Role of nutritional status in predicting quality of life outcomes in cancer – a systematic review of the epidemiological literature

    Science.gov (United States)

    2012-01-01

    Malnutrition is a significant factor in predicting cancer patients’ quality of life (QoL). We systematically reviewed the literature on the role of nutritional status in predicting QoL in cancer. We searched MEDLINE database using the terms “nutritional status” in combination with “quality of life” together with “cancer”. Human studies published in English, having nutritional status as one of the predictor variables, and QoL as one of the outcome measures were included. Of the 26 included studies, 6 investigated head and neck cancer, 8 gastrointestinal, 1 lung, 1 gynecologic and 10 heterogeneous cancers. 24 studies concluded that better nutritional status was associated with better QoL, 1 study showed that better nutritional status was associated with better QoL only in high-risk patients, while 1 study concluded that there was no association between nutritional status and QoL. Nutritional status is a strong predictor of QoL in cancer patients. We recommend that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, which includes nutritional screening, nutritional assessment and intervention as appropriate. Correcting malnutrition may improve QoL in cancer patients, an important outcome of interest to cancer patients, their caregivers, and families. PMID:22531478

  9. Lumbar Endoscopic Microdiscectomy: Where Are We Now? An Updated Literature Review Focused on Clinical Outcome, Complications, and Rate of Recurrence

    Directory of Open Access Journals (Sweden)

    Giulio Anichini

    2015-01-01

    Full Text Available Endoscopic disc surgery (EDS for lumbar spine disc herniation is a well-known but developing field, which is increasingly spreading in the last few years. Rate of recurrence/residual, complications, and outcomes, in comparison with standard microdiscectomy (MD, is still debated and need further data. We performed an extensive review based on the last 6 years of surgical series, systematic reviews, and meta-analyses reported in international, English-written literature. Articles regarding patients treated through endoscopic transforaminal or interlaminar approaches for microdiscectomy (MD were included in the present review. Papers focused on endoscopic surgery for other spinal diseases were not included. From July 2009 to July 2015, we identified 51 surgical series, 5 systematic reviews, and one meta-analysis reported. In lumbar EDS, rate of complications, length of hospital staying, return to daily activities, and overall patients’ satisfaction seem comparable to standard MD. Rate of recurrence/residual seems higher in EDS, although data are nonhomogeneous among different series. Surgical indication and experience of the performing surgeon are crucial factors affecting the outcome. There is growing but still weak evidence that lumbar EDS is a valid and safe alternative to standard open microdiscectomy. Statistically reliable data obtained from randomized controlled trials (better if multicentric are desirable to further confirm these results.

  10. Lumbar Endoscopic Microdiscectomy: Where Are We Now? An Updated Literature Review Focused on Clinical Outcome, Complications, and Rate of Recurrence

    Science.gov (United States)

    Anichini, Giulio; Landi, Alessandro; Caporlingua, Federico; Beer-Furlan, André; Brogna, Christian; Delfini, Roberto; Passacantilli, Emiliano

    2015-01-01

    Endoscopic disc surgery (EDS) for lumbar spine disc herniation is a well-known but developing field, which is increasingly spreading in the last few years. Rate of recurrence/residual, complications, and outcomes, in comparison with standard microdiscectomy (MD), is still debated and need further data. We performed an extensive review based on the last 6 years of surgical series, systematic reviews, and meta-analyses reported in international, English-written literature. Articles regarding patients treated through endoscopic transforaminal or interlaminar approaches for microdiscectomy (MD) were included in the present review. Papers focused on endoscopic surgery for other spinal diseases were not included. From July 2009 to July 2015, we identified 51 surgical series, 5 systematic reviews, and one meta-analysis reported. In lumbar EDS, rate of complications, length of hospital staying, return to daily activities, and overall patients' satisfaction seem comparable to standard MD. Rate of recurrence/residual seems higher in EDS, although data are nonhomogeneous among different series. Surgical indication and experience of the performing surgeon are crucial factors affecting the outcome. There is growing but still weak evidence that lumbar EDS is a valid and safe alternative to standard open microdiscectomy. Statistically reliable data obtained from randomized controlled trials (better if multicentric) are desirable to further confirm these results. PMID:26688809

  11. Use of the Yitzhaki Index as a test of relative deprivation for health outcomes: a review of recent literature.

    Science.gov (United States)

    Adjaye-Gbewonyo, Kafui; Kawachi, Ichiro

    2012-07-01

    We reviewed the empirical studies published between 2000 and 2010 that test the relative deprivation (RD) hypothesis in relation to population health. Our review focuses primarily on 14 studies using the Yitzhaki Index and related relative income measures. We summarize their main findings by health outcome, address methodological challenges in measuring RD, and identify several gaps in the literature as well as future directions for research in this area. Gaps in the evidence include the need for longitudinal studies with stronger causal designs - for example, examining changes in RD in relation to changes in health outcomes, with careful control for confounding by individual income and other indicators of socioeconomic position. Defining the appropriate reference group (from which people make social comparisons) poses a major empirical challenge, as evidenced by the fact that the measurement of RD has not materially advanced since Yitzhaki's original formulation in 1979. More innovative approaches to operationalizing RD are needed - including the measurement of RD in dimensions other than income, incorporating inter-generational comparisons; and attempting exogenous manipulation of RD, e.g. through laboratory-based experiments. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Linking governance mechanisms to health outcomes: a review of the literature in low- and middle-income countries.

    Science.gov (United States)

    Ciccone, Dana Karen; Vian, Taryn; Maurer, Lydia; Bradley, Elizabeth H

    2014-09-01

    We conducted a synthesis of peer-reviewed literature to shed light on links between governance mechanisms and health outcomes in low- and middle-income countries. Our review yielded 30 studies, highlighting four key governance mechanisms by which governance may influence health outcomes in these settings: Health system decentralization that enables responsiveness to local needs and values; health policymaking that aligns and empowers diverse stakeholders; enhanced community engagement; and strengthened social capital. Most, but not all, studies found a positive association between governance and health. Additionally, the nature of the association between governance mechanisms and health differed across studies. In some studies (N = 9), the governance effect was direct and positive, while in others (N = 5), the effect was indirect or modified by contextual factors. In still other studies (N = 4), governance was found to have a moderating effect, indicating that governance mechanisms influenced other system processes or structures that improved health. The remaining studies reported mixed findings about the association between governance and health (N = 6), no association between governance and health (N = 4), or had inconclusive results (N = 2). Further exploration is needed to fully understand the relationship between governance and health and to inform the design and delivery of evidence-based, effective governance interventions around the world.

  13. Cognitive behavioral analysis system of psychotherapy versus interpersonal psychotherapy for early-onset chronic depression: a randomized pilot study.

    Science.gov (United States)

    Schramm, Elisabeth; Zobel, Ingo; Dykierek, Petra; Kech, Sabine; Brakemeier, Eva-Lotta; Külz, Anne; Berger, Mathias

    2011-03-01

    The only psychotherapy specifically designed and evaluated for the treatment of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), has never been directly compared to another depression-specific psychological method. Thirty patients with early-onset chronic depression were randomized to 22 sessions of CBASP or Interpersonal Psychotherapy (IPT) provided in 16 weeks. Primary outcome was the score on the 24-item Hamilton Rating Scale for Depression (HRSD) assessed posttreatment by an independent blinded evaluator. Secondary endpoints were, among others, remission (HRSD≤8) rates and the Beck Depression Inventory (BDI). The study included a prospective naturalistic 12-month follow-up. Intent-to-treat analyses of covariance (ANCOVA) revealed that there was no significant difference in posttreatment HRSD scores between the CBASP and the IPT condition, but in self-rated BDI scores. We found significantly higher remission rates in the CBASP (57%) as compared to the IPT (20%) group. One year posttreatment, no significant differences were found in the self-reported symptom level (BDI) using ANCOVA. The study used only a small sample size and no placebo control. The generalizability of the results may be limited to patients with a preference for psychological treatment. While the primary outcome was not significant, secondary measures showed relevant benefits of CBASP over IPT. We found preliminary evidence that in early-onset chronic depression, an approach specifically designed for this patient population was superior to a method originally developed for the treatment of acute depressive episodes. Long-term results suggest that chronically depressed patients may need extended treatment courses. Copyright © 2010 Elsevier B.V. All rights reserved.

  14. Telomere Length Assessment for Prediction of Organ Transplantation Outcome. Future or Failure: A Review of the Literature

    Science.gov (United States)

    Kłoda, Karolina; Domański, Leszek; Mierzecki, Artur

    2017-01-01

    Telomeres are located at each end of eukaryotic chromosomes. Their functional role is genomic stability maintenance. The protective role of telomeres depends on various factors, including number of nucleotides repeats, telomere-binding proteins, and telomerase activity. Organ transplantation is the preferred replacement therapy in the case of chronic kidney disease and the only possibility of sustaining recipients’ life in the case of advanced liver failure. While the prevalence of acute rejection is constantly decreasing, prevention of transplanted organ long-term function loss is still challenging. It has been demonstrated that post-transplant stressors accelerate aging of the allografts manifested through telomere shortening. The aim of this paper was to evaluate the importance of telomere length assessment for prediction of organ transplantation outcome. Literature review included the 10 most important studies regarding linkage between allograft function and telomere erosion, including 2 of our own reports. Telomere length assessment is useful to predict organ transplantation outcome. The importance of telomere length as a prediction marker depends on the analyzed material. To obtain reliable results, both graft cells (donor material) and lymphocytes (recipient material) should be examined. In the case of kidney transplantation, assessment of telomere length in the early post-transplant period allows prediction of the long-term function of the transplanted organ. To increase the accuracy of transplantation outcome prediction, telomere length assessment should be combined with evaluation of other aging biomarkers, like CDKN2A (p16). Large-scale clinical studies regarding telomere length measurement, including genome wide association analysis introducing relevant genetic factors, are needed for the future. PMID:28076340

  15. Efficacy of group psychotherapy for social anxiety disorder: A meta-analysis of randomized-controlled trials.

    Science.gov (United States)

    Barkowski, Sarah; Schwartze, Dominique; Strauss, Bernhard; Burlingame, Gary M; Barth, Jürgen; Rosendahl, Jenny

    2016-04-01

    Group psychotherapy for social anxiety disorder (SAD) is an established treatment supported by findings from primary studies and earlier meta-analyses. However, a comprehensive summary of the recent evidence is still pending. This meta-analysis investigates the efficacy of group psychotherapy for adult patients with SAD. A literature search identified 36 randomized-controlled trials examining 2171 patients. Available studies used mainly cognitive-behavioral group therapies (CBGT); therefore, quantitative analyses were done for CBGT. Medium to large positive effects emerged for wait list-controlled trials for specific symptomatology: g=0.84, 95% CI [0.72; 0.97] and general psychopathology: g=0.62, 95% CI [0.36; 0.89]. Group psychotherapy was also superior to common factor control conditions in alleviating symptoms of SAD, but not in improving general psychopathology. No differences appeared for direct comparisons of group psychotherapy and individual psychotherapy or pharmacotherapy. Hence, group psychotherapy for SAD is an efficacious treatment, equivalent to other treatment formats.

  16. [Integrated psychotherapy for eating disorders].

    Science.gov (United States)

    Tomizawa, O

    1995-01-01

    The various psychotherapeutic strategies for eating disorders (EDs) include psychoanalytic, cognitive-behavioral, family oriented, arts therapy and others. In this paper, the psychodynamism of EDs and their therapy are reexamined and considered holistically from "the separate aspects of eating" point of view. That is the separation of eating regulated by biological appetite and the eating or not eating deriving from the patient's mind, unrelated to appetite. A new therapeutic technique called "formalization", which clarifies the separation of aspects of eating are invented. For integrated psychotherapy of EDs, it is necessary to combine the formalization technique of which clarifies and promotes patients' conflicts, and the integrated psychodynamic therapies that treat the promoted conflicts. The psychodynamism of EDs is the subject of much argument by many therapist. Although these arguments differ, they are similar in two points. Firstly, all of them consider EDs as distinctly separate from biological appetites. Secondly, the behavior of patients with EDs are taken as "false solution" or "substitution" of their essential problem. It is impossible to completely separate the physical action of eating mentally, however there may be a second meaning of eating separate from appetite. Seen in this light, psychotherapies are classified into two groups. One supports and sympathizes with these conflicts and the other is an educational one, telling the patients that a false solution is invalid. The former approach is employed by almost all psychodynamic therapies, such as psychoanalysis, family oriented therapy, arts therapy, self-help groups and the like. These therapies treat patients' conflicts with a non-judgemental approach, transform the psychodynamism, and consequently improve the eating behavior. The latter is applied by behavior therapy. Under strict operant conditioning, adequate behavior is reinforced by reward and inadequate behavior is eliminated by punishment

  17. Some limitations on the external validity of psychotherapy efficacy studies and suggestions for future research.

    Science.gov (United States)

    Shean, Glenn D

    2012-01-01

    Increased emphasis on identifying empirically supported treatments (ESTs) has enhanced the scientific basis for psychotherapy practice, but uncritical acceptance of ESTs as the basis for credentialing and policy decisions risks stifling innovation and creativity in the field. There are limitations inherent in efficacy studies of psychotherapy that can constrain external validity. This article discusses several limitations on the external validity of efficacy studies, as well as other issues related to evaluating psychotherapy outcome research. These limitations and concerns include: 1) the practice of maximizing homogeneity by selecting participants diagnosed with a single Axis I disorder; 2) the practice of requiring manualized therapies for efficacy research; 3) the assumption that lasting and meaningful changes occur and can be assessed within a relatively short time frame; 4) the assumption that valid assessments of outcome can be conducted in randomized control trials studies without concern for researcher allegiance; and 5) the view that evidence of effectiveness from non-RCT design studies can be ignored. Finally, alternative research approaches for studying psychotherapy that can potentially supplement knowledge gained from efficacy studies and foster continued innovation and creativity in the field are discussed.

  18. PERSONALITY THEORY IN INTEGRATIVE PERSONALITY-ORIENTED RECONSTRUCTIVE PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    V I Kurpatov

    2010-01-01

    approaches. V.N. Myasishchev's theory of personality relations in association with its universality, as well as pathogenetic psychotherapy may be the basis for the integration of other methods of psychotherapy

  19. Use of Psychotherapy for Depression in Older Adults

    National Research Council Canada - National Science Library

    Wei, Wenhui; Sambamoorthi, Usha; Olfson, Mark; Walkup, James T; Crystal, Stephen

    2005-01-01

    OBJECTIVE: The authors examine national patterns in psychotherapy for older adults with a diagnosis of depression and analyze correlates of psychotherapy use that is consistent with Agency for Health Care...

  20. Change mechanisms of schema-centered group psychotherapy with personality disorder patients.

    Directory of Open Access Journals (Sweden)

    Wolfgang Tschacher

    Full Text Available BACKGROUND: This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain. METHODOLOGY AND FINDINGS: 69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome. CONCLUSIONS/SIGNIFICANCE: The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders.

  1. Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide

    Science.gov (United States)

    Heisel, Marnin J.; Talbot, Nancy L.; King, Deborah A.; Tu, Xin M.; Duberstein, Paul R.

    2014-01-01

    Objective To pilot a psychological intervention adapted for older adults at-risk for suicide. Design A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Setting Outpatient mental healthcare provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Participants Seventeen English-speaking adults 60 years or older, at- risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. Intervention A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at-risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Measurements Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation), and secondary study outcomes (depressive symptom severity; social adjustment and support; psychological well-being), and psychotherapy process measures. Results Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Conclusions Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at-risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. PMID:24840611

  2. A comparison between phone-based psychotherapy with and without text messaging support in between sessions for crisis patients.

    Science.gov (United States)

    Furber, Gareth; Jones, Gabrielle Margaret; Healey, David; Bidargaddi, Niranjan

    2014-10-08

    Few studies have tested whether individually tailored text messaging interventions have an effect on clinical outcomes when used to supplement traditional psychotherapy. This is despite the potential to improve outcomes through symptom monitoring, prompts for between-session activities, and psychoeducation. The intent of the study was to explore the use of individually tailored between-session text messaging, or short message service (SMS), as an adjunct to telephone-based psychotherapy for consumers who present to the Emergency Department (ED) in situational and/or emotional crises. Over a 4-month period, two therapists offered 68 prospective consumers of a telephone-based psychotherapy service individually tailored between-session text messaging alongside their telephone-based psychotherapy. Attendance and clinical outcomes (depression, anxiety, functional impairment) of those receiving messages were compared against a historical control group (n=157) who received telephone psychotherapy only. A total of 66% (45/68) of the consumers offered SMS accepted the intervention. A total of 432 messages were sent over the course of the trial, the majority involving some kind of psychoeducation or reminders to engage in therapy goals. There were no significant differences in clinical outcomes between consumers who received the SMS and those in the control group. There was a trend for participants in the intervention group to attend fewer sessions than those in the control group (mean 3.7, SD 1.9 vs mean 4.4, SD 2.3). Both groups showed significant improvement over time. Individually tailored SMS were not found to improve clinical outcomes in consumers receiving telephone-based psychotherapy, but the study was underpowered, given the effect sizes noted and the significance level chosen. Given the ease of implementation and positive feedback from therapists and clients, individually tailored text messages should be explored further in future trials with a focus on enhancing

  3. Making the business case for enhanced depression care: the National Institute of Mental Health-harvard Work Outcomes Research and Cost-effectiveness Study.

    Science.gov (United States)

    Wang, Philip S; Simon, Gregory E; Kessler, Ronald C

    2008-04-01

    Explore the business case for enhanced depression care and establish a return on investment rationale for increased organizational involvement by employer-purchasers. Literature review, focused on the National Institute of Mental Health-sponsored Work Outcomes Research and Cost-effectiveness Study. This randomized controlled trial compared telephone outreach, care management, and optional psychotherapy to usual care among depressed workers in large national corporations. By 12 months, the intervention significantly improved depression outcomes, work retention, and hours worked among the employed. Results of the Work Outcomes Research and Cost-effectiveness Study trial and other studies suggest that enhanced depression care programs represent a human capital investment opportunity for employers.

  4. Psychotherapies for adult depression: recent developments.

    Science.gov (United States)

    Cuijpers, Pim

    2015-01-01

    Much has been learned from the 400 randomized trials on psychotherapies for adult depression that have been conducted, but much is also still unknown. In this study some recent attempts to further reduce the disease burden of depression through psychotherapies are reviewed. In the past, many new psychotherapies have promised to be more effective than existing treatments, usually without success. We describe recent research on two new therapies, acceptance and commitment therapy and cognitive bias modification, and conclude that both have also not shown to be more effective than existing therapies. A growing number of studies have also focused on therapies that may be successful in further reducing the disease burden, such as treatments for chronic depression and relapse prevention. Other studies are aimed at scaling up psychological services, such as the training of lay health counselors in low-income and middle-income countries, telephone-based, and internet-based therapies. Psychotherapies are essential tools in the treatment of adult depression. Randomized trials have shown that these treatments are effective, and by focusing on key issues, such as chronic depression, relapse, and scaling them up, psychotherapies contribute more and more to the reduction of the disease burden of depression.

  5. [Summary: Scientific evaluation of EMDR psychotherapy].

    Science.gov (United States)

    Haour, F; de Beaurepaire, C

    2016-06-01

    The evaluation of psychotherapy methods is made difficult by their practical and theoretical diversities as well as the increasing number of available therapies. Evaluation based on scientific criteria in randomized control trials is providing the highest level of proof and recognition by Health Agencies. A recently described integrative psychotherapy, eye movement desensitization and reprocessing (EMDR), developed by F. Shapiro since 1989, has been confronted with the validation procedure used in pharmacological treatment. It was of interest to review the scientific validation steps carried out for this EMDR psychotherapy and for its mechanisms of action. The practical and methodological protocol of the EMDR psychotherapy for trauma integration is reviewed as well as clinical results and mechanisms. This EMDR therapy, focused on the resolutions of traumas, was started by treating patients with post-traumatic stress disorders (PTSD). The integrative EMDR protocol obtained the highest level of efficiency, for PTSD treatment, twenty years after its first publication. The efficiency of the protocol is now under study and scientific evaluation for troubles in which the trauma experiences are triggers or factors of maintenance of the troubles: anxiety, depression, phobia, sexual troubles, schizophrenia, etc. This new integrative psychotherapy follows the pathways and the timing observed for the evaluation and the validation of other therapies. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  6. Obstacles to early career psychiatrists practicing psychotherapy.

    Science.gov (United States)

    Clemens, Norman A; Plakun, Eric M; Lazar, Susan G; Mellman, Lisa

    2014-09-01

    Though psychiatric residents are expected to be competent psychotherapists on graduation, further growth in skill and versatility requires continued experience in their ongoing career. Maturity as a psychotherapist is essential because a psychiatrist is the only mental health provider who, as a physician, can assume full responsibility for biopsychosocial patient care and roles as supervisor, consultant, and team leader. Graduating residents face an environment in which surveys show a steady and alarming decline in practice of psychotherapy by psychiatrists, along with a decline in job satisfaction. High educational debts, practice structures, intrusive management, and reimbursement policies that devalue psychotherapy discourage early career psychiatrists from a practice style that enables providing it. For the early-career psychiatrist there is thus the serious risk of being unable to develop a critical mass of experience or a secure identity as a psychiatric psychotherapist. Implementation of parity laws and the Affordable Care Act (ACA) will affect the situation in unpredictable ways that call for vigilance and active response. Additional service and administrative demands may result from the ACA, creating ethical dilemmas about meeting urgent patient needs versus biopsychosocial standards of care. The authors recommend 1) vigorous advocacy for better payment levels for psychotherapy and freedom from disruptive management; 2) aggressive action against violations of the parity act, 3) active preparation of psychiatric residents for dealing with career choices and the environment for providing psychotherapy in their practice, and 4) post-graduate training in psychotherapy through supervision/consultation, continuing education courses, computer instruction, and distance learning.

  7. From medicine to psychotherapy: the placebo effect.

    Science.gov (United States)

    Justman, Stewart

    2011-01-01

    If placebos have been squeezed out of medicine to the point where their official place in in clinical trials designed to identify their own confounding effect, the placebo effect nevertheless thrives in psychotherapy. Not only does psychotherapy dispose of placebo effects that are less available to medicine as it becomes increasingly technological and preoccupied with body parts, but factors of the sort inhibiting the use of placebos in medicine have no equivalent in psychology. Medicine today is disturbed by the placebo effect in a way psychotherapy is not. Psychotherapy does not have to grapple with such a disconcerting paradox as successful sham surgery, and unlike those physicians who once pretended to treat the patient's body while actually attempting to treat the mind, the psychotherapist can treat the mind in all frankness. Perhaps it is because psychotherapy is less burdened by doubts about the placebo effect that it was able to come to its aid when it was orphaned by medicine. It is vain to expect something with so long a history as the placebo effect to disappear from the practices of healing.

  8. Treatment adherence and other patient-reported outcomes as cost determinants in multiple sclerosis: a review of the literature

    Directory of Open Access Journals (Sweden)

    Lizán L

    2014-12-01

    Full Text Available Luis Lizán,1 Marta Comellas,1 Silvia Paz,1 José Luis Poveda,2 Dennis M Meletiche,3 Carlos Polanco4 1Outcomes’10, Castellón, Spain; 2Hospital Universitario La Fe, Valencia, Spain; 3EMD Serono Inc., Rockland, MA, USA; 4Merck S.L., Madrid, SpainBackground: Treatment adherence is one of the key factors for achieving optimal clinical outcomes. In order to assess costs related to adherence to, and persistence and compliance with, disease-modifying therapies (DMTs in patients with multiple sclerosis (MS, a narrative review of the literature was performed. Satisfaction with and preference for DMTs and their delivery devices were also assessed, as both can have an influence on patients’ adherence and persistence. Methods: Electronic databases (MEDLINE, PubMed, Google Scholar, congress proceedings were searched to identify publications analyzing MS costs related to adherence, persistence, satisfaction, and preferences for MS treatments. Bibliographic references were hand searched. English or Spanish studies published between January 2007 and January 2013 were selected. Results: A total of 398 titles were identified, of which 12 met the inclusion criteria. Six studies evaluated the impact of adherence, persistence, and compliance on treatment costs; four publications analyzed satisfaction with DMTs; and two assessed treatment preferences based on attributes of the delivery device. Increased adherence and persistence were associated with better clinical outcomes, leading to lower relapse risk (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.59–0.85 and a decrease in health care resource use, such as MS-related hospitalizations (OR: 0.63; 95% CI: 0.47–0.83 and emergency department visits (OR: 0.80; 95% CI: 0.60–1.07. This reduction in resource use led to a patient/year total cost reduction (excluding DMT costs of up to 22%. Conclusion: This review highlights the importance of ensuring adequate adherence in MS patients through treatments

  9. How to Accomplish the Assistive Technology Service Delivery Process for Adults in Order to Obtain the Best Outcomes - A Literature Review

    DEFF Research Database (Denmark)

    Brandt, Åse; Christensen, Anne; Grünberger, Pernille

    2015-01-01

    and training in assistive device use had a positive impact on outcomes. Also professionals' higher assistive device expertise seems to result in better outcomes. More research within the field is needed, especially studies that compare the effectiveness and cost-effectiveness of specific methods applying......In order to gain knowledge about which methods in the assistive technology service delivery process or parts hereof that result in positive outcomes, a literature review was accomplished. 20 publications were included. Some evidence was found that user involvement in the service delivery process...

  10. WELLFOCUS PPT: Modifying positive psychotherapy for psychosis.

    Science.gov (United States)

    Riches, Simon; Schrank, Beate; Rashid, Tayyab; Slade, Mike

    2016-03-01

    Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline that has developed somewhat separately from psychotherapy and focuses on amplifying well-being rather than ameliorating deficit. The processes targeted in PPT (e.g., strengths, forgiveness, gratitude, savoring) are not emphasized in traditional psychotherapy approaches to psychosis. The goal in modifying PPT is to develop a new clinical approach to helping people experiencing psychosis. An evidence-based theoretical framework was therefore used to modify 14-session standard PPT into a manualized intervention, called WELLFOCUS PPT, which aims to improve well-being for people with psychosis. Informed by a systematic review and qualitative research, modification was undertaken in 4 stages: qualitative study, expert consultation, manualization, and stake-holder review. The resulting WELLFOCUS PPT is a theory-based 11-session manualized group therapy. (c) 2016 APA, all rights reserved).

  11. The influence of psychotherapy on marriage typology

    Directory of Open Access Journals (Sweden)

    Staniszewski Mirosław

    2016-07-01

    Full Text Available The article analyses the influence of psychotherapeutic group work on matrimonial relations. Such questions are put up in the research as if participating of one of the married couples in a group psychotherapy could indirectly influence the other partner, and also if the type of matrimony could change under the influence of psychotherapy, for example from hierarchical to the partner’s. The article generalizes the classification of marriage types and pays special attention on the types that can be subject to the positive changes as a result of psychotherapeutic influence. Actuality and value of this research lay in estimation of the ability of psychotherapy to influence the matrimony on the whole in case when only one of the partners takes part in the therapy.

  12. Ancient Greek psychotherapy for contemporary nurses.

    Science.gov (United States)

    Kourkouta, Lambrini

    2002-08-01

    Ancient Greek physicians as well as philosophers were fully cognizant of a human being's psychological function and used their particular art to influence individual or social behavior in accordance with their pursuit. This art or technique favorably compares with several of the methods currently called supportive psychotherapy. This psychotherapy was the first form of care for people with mental health problems. Nurses who base their practice on ancient Greek psychotherapy see the patient as a whole, a person who creates meaning in life. Applying the philosophical principles of ancient Greeks helps nurses understand the behavior of people with mental health problems and recognize and facilitate adaptive satisfaction of these psychological needs. In addition, psychiatric nurses are able to help distressed individuals understand their fears and anxieties, so they are freed from the causes of their symptoms that led them to seek therapy in the first place. Consequently, this understanding can make psychiatric nurses' work a living experience and add meaning to their work.

  13. New parity, same old attitude towards psychotherapy?

    Science.gov (United States)

    Clemens, Norman A

    2010-03-01

    Full parity of health insurance benefits for treatment of mental illness, including substance use disorders, is a major achievement. However, the newly-published regulations implementing the legislation strongly endorse aggressive managed care as a way of containing costs for the new equality of coverage. Reductions in "very long episodes of out-patient care," hospitalization, and provider fees, along with increased utilization, are singled out as achievements of managed care. Medical appropriateness as defined by expert medical panels is to be the basis of authorizing care, though clinicians are familiar with a history of insurance companies' application of "medical necessity" to their own advantage. The regulations do not single out psychotherapy for attention, but long-term psychotherapy geared to the needs of each patient appears to be at risk. The author recommends that the mental health professions strongly advocate for the growing evidence base for psychotherapy including long-term therapy for complex mental disorders; respect for the structure and process of psychotherapy individualized to patients' needs; awareness of the costs of aggressive managed care in terms of money, time, administrative burden, and interference with the therapy; and recognition of the extensive training and experience required to provide psychotherapy as well as the stresses and demands of the work. Parity in out-of-network benefits could lead to aggressive management of care given by non-network practitioners. Since a large percentage of psychiatrists and other mental health professionals stay out of networks, implementation of parity for out-of-network providers will have to be done in a way that respects the conditions under which they would be willing and able to provide services, especially psychotherapy, to insured patients. The shortage of psychiatrists makes this an important access issue for the insured population in need of care.

  14. Development of a core outcome set for clinical trials in squamous cell carcinoma: study protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

    Science.gov (United States)

    Schlessinger, Daniel I; Iyengar, Sanjana; Yanes, Arianna F; Chiren, Sarah G; Godinez-Puig, Victoria; Chen, Brian R; Kurta, Anastasia O; Schmitt, Jochen; Deckert, Stefanie; Furlan, Karina C; Poon, Emily; Cartee, Todd V; Maher, Ian A; Alam, Murad; Sobanko, Joseph F

    2017-07-12

    Squamous cell carcinoma (SCC) is a common skin cancer that poses a risk of metastasis. Clinical investigations into SCC treatment are common, but the outcomes reported are highly variable, omitted, or clinically irrelevant. The outcome heterogeneity and reporting bias of these studies leave clinicians unable to accurately compare studies. Core outcome sets (COSs) are an agreed minimum set of outcomes recommended to be measured and reported in all clinical trials of a given condition or disease. Although COSs are under development for several dermatologic conditions, work has yet to be done to identify core outcomes specific for SCC. Outcome extraction for COS generation will occur via four methods: (1) systematic literature review; (2) patient interviews; (3) other published sources; and (4) input from stakeholders in medicine, pharmacy, and other relevant industries. The list of outcomes will be revaluated by the Measuring PRiority Outcome Variables via Excellence in Dermatologic surgery (IMPROVED) Steering Committee. Delphi processes will be performed separately by expert clinicians and patients to condense the list of outcomes generated. A consensus meeting with relevant stakeholders will be conducted after the Delphi exercise to further select outcomes, taking into account participant scores. At the end of the meeting, members will vote and decide on a final recommended set of core outcomes. The Core Outcome Measures in Effectiveness Trials (COMET) organization and the Cochrane Skin Group - Core Outcome Set Initiative (CSG-COUSIN) will serve as advisers throughout the COS generation process. Comparison of clinical trials via systematic reviews and meta-analyses is facilitated when investigators study outcomes that are relevant and similar. The aim of this project is to develop a COS to guide use for future clinical trials.

  15. Psychotherapies in Acute and Transient Psychoses

    Directory of Open Access Journals (Sweden)

    Manuel González de Chávez

    2014-10-01

    Full Text Available From a comprehensive and global view -psychological, biological and social - acute and transient psychoses could be considered identity breakdowns with fragmentation of its structure, paranoid mechanism and cognitive regression. Psychotherapies favour evolution of psychotic identity through disorder awareness and knowledge of aspects of patients that make them more vulnerable to psychotic experiences. We underline the key role of group psychotherapy to improve therapeutic relationships and best use of patient’s coping strategies in the chronology of therapeutic interventions and recovery process of these patients.

  16. Intensive psychotherapy for the psychiatrist's family.

    Science.gov (United States)

    Chessick, R D

    1977-10-01

    A series of intensive psychotherapy cases of wives and children of psychiatrists reveals that the special problems they present may be divided into those at the onset of treatment, those in the process of the treatment, and special countertransference problems. Paradoxically, early recognition and acceptance of psychotherapy are a foremost problem involving the psychiatrist as father or spouse. During therapy, narcissistic injuries to the psychiatrist father or spouse and loyalty problems in the patient emerge as special problems. Countertransference revolves around peer relationships and "psychopolitics," as well as referrals of other patients.

  17. Systematic review of research investigating psychotherapy and information and communication technologies.

    Science.gov (United States)

    Hallberg, Sílvia Cristina Marceliano; Lisboa, Carolina Saraiva de Macedo; de Souza, Déborah Brandão; Mester, Ariela; Braga, Andréia Zambon; Strey, Artur Marques; da Silva, Camila Sartori

    2015-01-01

    Information and communication technologies (ICTs) are devices, services and knowledge that reproduce, process and distribute information. Psychotherapy has been influenced by these technologies, and there is a tendency for their role to expand. To describe the current panorama of the scientific literature on psychotherapy and ICTs. This is a systematic and descriptive review. Searches were run on the electronic databases Biblioteca Virtual em Saude (BVS), PsycINFO, Scopus, PePSIC, ScienceDirect and Index Psi, using the Boolean operator AND and the descriptors psychotherapy, computers, Internet, cell phones and social networks. A considerable volume of empirical research was found, published recently in many different parts of the world, especially in the United States. There is very little Brazilian research on the subject. The majority of the studies identified assess the efficacy or describe the development of techniques and psychotherapies, via ICTs, for prevention, diagnosis or treatment of mental and behavioral disorders. The psychopathology most investigated in this area is depression and it was not possible to draw conclusions on a possible trend for research into the subject to increase. The technology most investigated was the Internet and cognitive-behavioral therapy was the most common theoretical approach in these studies. Systematic reviews of published studies can detect gaps in the research agenda within a specific field of knowledge.

  18. Health outcomes of children born after IVF/ICSI: a review of current expert opinion and literature.

    Science.gov (United States)

    Fauser, B C J M; Devroey, P; Diedrich, K; Balaban, B; Bonduelle, M; Delemarre-van de Waal, H A; Estella, C; Ezcurra, D; Geraedts, J P M; Howles, C M; Lerner-Geva, L; Serna, J; Wells, D

    2014-02-01

    The Sixth Evian Annual Reproduction (EVAR) Workshop Group Meeting was held to evaluate the impact of IVF/intracytoplasmic sperm injection on the health of assisted-conception children. Epidemiologists, reproductive endocrinologists, embryologists and geneticists presented data from published literature and ongoing research on the incidence of genetic and epigenetic abnormalities and congenital malformations in assisted-conception versus naturally conceived children to reach a consensus on the reasons for potential differences in outcomes between these two groups. IVF-conceived children have lower birthweights and higher peripheral fat, blood pressure and fasting glucose concentrations than controls. Growth, development and cognitive function in assisted-conception children are similar to controls. The absolute risk of imprinting disorders after assisted reproduction is less than 1%. A direct link between assisted reproduction and health-related outcomes in assisted-conception children could not be established. Women undergoing assisted reproduction are often older, increasing the chances of obtaining abnormal gametes that may cause deviations in outcomes between assisted-conception and naturally conceived children. However, after taking into account these factors, it is not clear to what extent poorer outcomes are due to the assisted reproduction procedures themselves. Large-scale, multicentre, prospective epidemiological studies are needed to investigate this further and to confirm long-term health consequences in assisted-conception children. Assisted reproduction treatment is a general term used to describe methods of achieving pregnancy by artificial means and includes IVF and sperm implantation. The effect of assisted reproduction treatment on the health of children born using these artificial methods is not fully understood. In April 2011, fertility research experts met to give presentations based on research in this area and to look carefully at the evidence

  19. Parent-infant psychotherapy and postpartum depression : the father’s participation

    OpenAIRE

    2013-01-01

    Given the specifi cities of postpartum maternal depression, the literature recommends that fathers become involved in psychological interventions within this context. This study presents an investigation of the participation of fathers in parentinfant psychotherapy in the context of maternal postpartum depression. Two families participated in this study, both with a child aged between 7 and 8 months old, whose mothers showed depressive symptoms. These families participated in parentinfant psy...

  20. Metacognitive disturbances in persons with severe mental illness: theory, correlates with psychopathology and models of psychotherapy.

    Science.gov (United States)

    Lysaker, Paul H; Gumley, Andrew; Dimaggio, Giancarlo

    2011-03-01

    Metacognition refers to the ability to think about thinking, both one's own and that of others. In this introduction to the special issue on this subject, the editors summarize preceding literature on the nature and extent of metacognitive disturbances in severe mental illness. They then summarize the proceeding seven pieces that explore models of metacognitive disturbance in severe mental illness, its correlates with psychopathology, and emerging models of psychotherapy.

  1. Meaning-centered psychotherapy: a form of psychotherapy for patients with cancer.

    Science.gov (United States)

    Thomas, Lori P Montross; Meier, Emily A; Irwin, Scott A

    2014-10-01

    Caring for patients with cancer involves addressing their myriad physical, psychological, social, and spiritual needs. Although many cancer treatments focus on physical or psychological needs, few treatments specifically target the basic need for meaning and spiritual well-being in this population. This article describes the creation and evolution of a new psychotherapy devoted to these needs, a therapy termed "meaning-centered psychotherapy." In this article, a detailed description of meaning-centered psychotherapy is provided. An explanation of the current research findings related to this treatment are also offered, with information about the various group and individual treatments as well as the new expansions for use with cancer survivors or nursing staff. Overall, meaning-centered psychotherapy shows promise for enhancing meaning and spiritual well-being among patients with cancer and offers exciting possibilities for future research in other areas.

  2. Implications of RDoC for the research and practice of psychotherapy.

    Science.gov (United States)

    Hershenberg, Rachel; Goldfried, Marvin R

    2015-03-01

    The field of psychotherapy is at an important juncture. Recent changes in the field include (a) the skeptical reception of the fifth edition of the Diagnostic and Statistical Manual and (b) NIMH's prioritization of an alternative classification system to guide translational and intervention research. Moreover, (c) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis. Thus, psychological research as it relates to the practice of psychotherapy is at a crossroads. In this article, we provide a brief overview of several generations of psychotherapy outcome research, including the consequences that followed in the 1980s as psychotherapy research moved toward randomized controlled trials for clinical disorders. We delineate the inherent strengths and limitations of this movement and address how the NIMH has recently responded with the Research Domain Criteria (RDoC). We then address philosophical and practical implications of the emphasis on a neuroscientific conceptualization of psychological problems. Finally, we discuss opportunities for a next generation of convergent science that incorporates, rather than replaces, psychosocial variables across stages of translational research and treatment development.

  3. Update on best available options in obstetrics anaesthesia: perinatal outcomes, side effects and maternal satisfaction. Fifteen years systematic literature review.

    Science.gov (United States)

    Gizzo, Salvatore; Noventa, Marco; Fagherazzi, Simone; Lamparelli, Laura; Ancona, Emanuele; Di Gangi, Stefania; Saccardi, Carlo; D'Antona, Donato; Nardelli, Giovanni Battista

    2014-07-01

    In modern obstetrics, different pharmacological and non-pharmacological options allow to obtain pain relief during labour, one of the most important goals in women satisfaction about medical care. The aim of this review is to compare all the analgesia administration schemes in terms of effectiveness in pain relief, length of labour, mode of delivery, side effects and neonatal outcomes. A systematic literature search was conducted in electronic databases in the interval time between January 1999 and March 2013. Key search terms included: “labour analgesia”, “epidural anaesthesia during labour” (excluding anaesthesia for Caesarean section), “epidural analgesia and labour outcome” and “intra-thecal analgesia”. 10,331 patients were analysed: 5,578 patients underwent Epidural-Analgesia, 259 patients spinal analgesia, 2,724 combined spinal epidural analgesia, 322 continuous epidural infusion (CEI), 168 intermittent epidural bolus, 684 patient-controlled infusion epidural analgesia and 152 intra-venous patient-controlled epidural analgesia. We also considered 341 women who underwent patient-controlled infusion epidural analgesia in association with CEI and 103 patients who underwent patient-controlled infusion epidural analgesia in association with automatic mandatory bolus. No significant differences occurred among all the available administration schemes of neuraxial analgesia. In absence of obstetrical contraindication, neuraxial analgesia has to be considered as the gold standard in obtaining maternal pain relief during labour. The options available in the administration of analgesia should be known and evaluated together by both gynaecologists and anaesthesiologists to choose the best personalized scheme and obtain the best women satisfaction. Since it is difficult to identify comparable circumstances during labour, it is complicate to standardize drugs schemes and their combinations.

  4. Facts and values in psychotherapy-A critique of the empirical reduction of psychotherapy within evidence-based practice.

    Science.gov (United States)

    Berg, Henrik; Slaattelid, Rasmus

    2017-10-01

    This paper addresses an implicit presupposition in research-supported psychological treatments and evidence-based practice in psychology. It argues that the notion of research-supported psychological treatments is based on a reductive conceptualisation of psychotherapy. Research-supported psychological treatments hinge upon an empirical reduction where psychotherapy schools become conceptualized as mere collections of empirical propositions. However, this paper argues that the different psychotherapy schools have distinct ethoses that are constituted by normative claims. Consequently, the evaluation of the different psychotherapy schools and the practice of psychotherapy should include the underlying normative claims of these ethoses. © 2017 John Wiley & Sons, Ltd.

  5. The Ghent Psychotherapy Study (GPS) on the differential efficacy of supportive-expressive and cognitive behavioral interventions in dependent and self-critical depressive patients : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Meganck, Reitske; Desmet, Mattias; Bockting, Claudi; Inslegers, Ruth; Truijens, Femke; De Smet, Melissa; De Geest, Rosa; Van Nieuwenhove, Kimberly; Hennissen, Vicky; Hermans, Goedele; Loeys, Tom; Norman, Ufuoma Angelica; Baeken, Chris; Vanheule, Stijn

    2017-01-01

    Background: Major depressive disorder is a leading cause of disease burden worldwide, indicating the importance of effective therapies. Outcome studies have shown overall efficacy of different types of psychotherapy across groups, yet large variability within groups. Although patient characteristics

  6. The effects of psychotherapy for adult depression on suicidality and hopelessness: a systematic review and meta-analysis.

    Science.gov (United States)

    Cuijpers, Pim; de Beurs, Derek P; van Spijker, Bregje A J; Berking, Matthias; Andersson, Gerhard; Kerkhof, Ad J F M

    2013-01-25

    Although treatment guidelines suggest that suicidal patients with depression should be treated for depression with psychotherapy, it is not clear whether these psychological treatments actually reduce suicidal ideation or suicide risk. We conducted a systematic review and meta-analysis of studies on psychotherapy for depression in which outcomes on suicidality were reported. We also focused on outcomes on hopelessness because this is strongly associated with suicidal behavior in depression. Thirteen studies (with 616 patients) were included, three of which examined the effects of psychotherapy for depression on suicidal ideation and suicide risk, and eleven on hopelessness. No studies were found with suicide attempts or completed suicides as the outcome variables. The effects on suicidal ideation and suicide risk were small (g=0.12; 95% CI: -0.20-0.44) and not statistically significant. A power calculation showed that these studies only had sufficient power to find an effect size of g=0.47. The effects on hopelessness were large (g=1.10; 95% CI: 0.72-1.48) and significant, although heterogeneity was very high. Furthermore, significant publication bias was found. After adjustment of publication bias the effect size was reduced to g=0.60. At this point, there is insufficient evidence for the assumption that suicidality in depressed patients can be reduced with psychotherapy for depression. Although psychotherapy of depression may have small positive effects on suicidality, available data suggest that psychotherapy for depression cannot be considered to be a sufficient treatment. The effects on hopelessness are probably higher. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. A dynamic systems approach to psychotherapy: A meta-theoretical framework for explaining psychotherapy change processes.

    Science.gov (United States)

    Gelo, Omar Carlo Gioacchino; Salvatore, Sergio

    2016-07-01

    Notwithstanding the many methodological advances made in the field of psychotherapy research, at present a metatheoretical, school-independent framework to explain psychotherapy change processes taking into account their dynamic and complex nature is still lacking. Over the last years, several authors have suggested that a dynamic systems (DS) approach might provide such a framework. In the present paper, we review the main characteristics of a DS approach to psychotherapy. After an overview of the general principles of the DS approach, we describe the extent to which psychotherapy can be considered as a self-organizing open complex system, whose developmental change processes are described in terms of a dialectic dynamics between stability and change over time. Empirical evidence in support of this conceptualization is provided and discussed. Finally, we propose a research design strategy for the empirical investigation of psychotherapy from a DS approach, together with a research case example. We conclude that a DS approach may provide a metatheoretical, school-independent framework allowing us to constructively rethink and enhance the way we conceptualize and empirically investigate psychotherapy. (PsycINFO Database Record

  8. The spirit of Jungian group psychotherapy: from taboo to totem.

    Science.gov (United States)

    Ettin, M F

    1995-10-01

    Practitioners of analytical psychology were late in coming to the practice of group psychotherapy because Carl Jung effectively forbade the treatment of individuals in stranger groups. This article explores Jung's objections to group therapy and, by way of a conceptual review of the literature, expands on the practice that grew up proximate to his death. It is argued that Jungian theory is especially conducive to collective treatment because it is concerned with the relationship between oppositions (whether in persons or between people) and uses synthetic and symbolic processes to bring about an integration of the one with the many. For Jungians who espouse a theory of symbolic transformation, archetype, and myth, the group is embodied in individuals and can be accessed by working with individuals in groups.

  9. [Are there specific factors in the psychotherapy of anorexia nervosa?].

    Science.gov (United States)

    Zipfel, Stephan; Resmark, Gaby

    2015-01-01

    The present literature review examines the question of how general and specific factors can be differentiated in the psychotherapy of anorexia nervosa. Over the past 10 years different research trends have appeared. On the one hand subclassifications of new therapy approaches from several schools of therapy have been propagated (e.g. CBT-E, FPT), on the other hand generic treatment manuals have been published that are rather adapted to patients needs (e.g. SSCM, TTM). On a third way, currently therapy manuals for special subgroups have been developed, e.g. for chronic patients with anorexia nervosa or family-based manuals for adolescents. A completely different direction follows those approaches that are based on neuropsychological models and deficits in anorexia nervosa. Overall, the results of current studies have been promising, however, there has not been a winner yet, the race is still open!

  10. Pitfalls of the psychotherapy of twins with eating disorders.

    Science.gov (United States)

    Túry, F; Szentes, A; Varga, M

    2012-06-01

    Scientific literature is limited on problems related to the psychotherapy of twins, especially eating disorders. This paper discusses the therapeutic difficulties encountered with two anorexic and one bulimic sets of twins. The three case reports show that the symbiotic tendency of twins is a frequent phenomenon, which may be a special resistance against change, and can serve as a factor maintaining the pathological state. In many cases, the parental behaviour strengthens the symbiosis of the twins, instead of helping the individuation. The integration of individual and family therapeutic interventions is proposed. The separation-individuation process of the twins can be stimulated by individual sessions with each of the twins, or separate sessions during family therapy (i.e., sessions with the parents and with one of the twins). In this case, the best strategy would be to have the individual and family therapies conducted by the same therapist.

  11. Do Comorbid Anxiety Disorders Moderate the Effects of Psychotherapy for Bipolar Disorder? Results From STEP-BD

    Science.gov (United States)

    Deckersbach, Thilo; Peters, Amy T.; Sylvia, Louisa; Urdahl, Anna; Magalhães, Pedro V.S.; Otto, Michael W.; Frank, Ellen; Miklowitz, David J.; Berk, Michael; Kinrys, Gustavo; Nierenberg, Andrew

    2013-01-01

    Objective At least 50% of individuals with bipolar disorder have a lifetime anxiety disorder. Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration, greater illness severity, and poorer treatment response. The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome. Method In the Systematic Treatment Enhancement Program randomized controlled trial of psychotherapy for bipolar depression, participants received up to 30 sessions of intensive psychotherapy (family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) or collaborative care, a three-session comparison treatment, plus pharmacotherapy. Using the number needed to treat, we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year. Results A total of 269 patients (113 women) with a comorbid lifetime anxiety disorder (N=177) or without a comorbid lifetime anxiety disorder (N=92) were included in the analysis. Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care (66% compared with 49% recovered over 1 year; number needed to treat=5.88, small to medium effect). For patients without a lifetime anxiety disorder, there was no difference between rates of recovery in psychotherapy compared with collaborative care (64% compared with 62% recovered; number needed to treat=50, small effect). Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care (84% compared with 53% recovered; number needed to treat=3.22, medium to large effect), whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments (54% compared with 46% recovered; number needed to treat=12.5, small effect). Conclusions Depressed patients

  12. The Effect of School-Based Health Clinics on Teenage Pregnancy and Parenting Outcomes: An Integrated Literature Review

    Science.gov (United States)

    Strunk, Julie A.

    2008-01-01

    Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy…

  13. The Effect of School-Based Health Clinics on Teenage Pregnancy and Parenting Outcomes: An Integrated Literature Review

    Science.gov (United States)

    Strunk, Julie A.

    2008-01-01

    Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy…

  14. Innovative uses of psychodynamic group psychotherapy.

    Science.gov (United States)

    Buchele, B J

    1994-01-01

    Psychodynamic group psychotherapy is gaining renewed attention as an effective form of treatment, due in part to increasing economic constraints that make other forms of treatment less accessible. The author highlights some innovative applications of both extended and time-limited groups. She also describes specific issues that can be addressed effectively in homogeneous time-limited group therapy.

  15. Premature conclusions about psychotherapy for dysthymia

    NARCIS (Netherlands)

    Cuijpers, P.

    2009-01-01

    3.0.CO;2-F 5. McCullough JP. Psychotherapy for dysthymia: a naturalistic study of ten patients. J Nerv Ment Dis. 1991;179(12):734–740. PubMed doi:10.1097/00005053-199112000-00004 6. Keller MB, McCullough JP, Klein DN, et al. A comparison of nefazodone, the cognitive behavioral-analysis system of

  16. Toward a Neurobiology of Child Psychotherapy

    Science.gov (United States)

    Kay, Jerald

    2009-01-01

    Brain imaging studies have demonstrated that psychotherapy alters brain structure and function. Learning and memory, both implicit and explicit, play central roles in this process through the creation of new genetic material that leads to increased synaptic efficiency through the creation of new neuronal connections. Although there is substantial…

  17. Play and the Art of Psychotherapy

    Science.gov (United States)

    American Journal of Play, 2014

    2014-01-01

    Terry Marks-Tarlow is a clinical and consulting psychologist and psychotherapist and a member of the teaching faculty at the Reiss Davis Child Study Center in Los Angeles. She is the author of "Awakening Clinical Intuition: An Experiential Workbook for Psychotherapists"; "Psyche's Veil: Psychotherapy, Fractals, and…

  18. Recent Studies in Functional Analytic Psychotherapy

    Science.gov (United States)

    Garcia, Rafael Ferro

    2008-01-01

    Functional Analytic Psychotherapy (FAP), based on the principles of radical behaviorism, emphasizes the impact of eventualities that occur during therapeutic sessions, the therapist-client interaction context, functional equivalence between environments, natural reinforcement and shaping by the therapist. This paper reviews recent studies of FAP…

  19. Existential psychotherapy of students as learning strategy

    DEFF Research Database (Denmark)

    Dræby, Anders

    According to parts of the existential psychology and psychotherapy the individual's exploration and compliance of his or her life project is central to the experience of living a meaningful life. In many ways, becoming a fully adult individual is about identifying and taking responsibility for th...

  20. Psychotherapy: The Listening Voice. Rogers and Erickson.

    Science.gov (United States)

    Leva, Richard A.

    The views of Carl Rogers and Milton H. Erickson are combined in this book on psychotherapy. The first section focuses on belief systems, views of man, new views of the unconscious, and a philosophy for change. Erickson and his relationship to myth, the nature of man and the goal of counseling, trance, and a radical view of the unconscious are…

  1. Interventions and Strategies in Counseling and Psychotherapy.

    Science.gov (United States)

    Watts, Richard E., Ed.; Carlson, Jon, Ed.

    This book acknowledges the contributions of Alfred Adler and illustrates the many ways in which Adlerian ideas underpin and influence contemporary therapeutic approaches. It brings together today's leading thinkers to address the practice of counseling and psychotherapy from a social-cognitive perspective. Contributors apply the basic ideas of…

  2. Premature conclusions about psychotherapy for dysthymia

    NARCIS (Netherlands)

    Cuijpers, P.

    2009-01-01

    3.0.CO;2-F 5. McCullough JP. Psychotherapy for dysthymia: a naturalistic study of ten patients. J Nerv Ment Dis. 1991;179(12):734–740. PubMed doi:10.1097/00005053-199112000-00004 6. Keller MB, McCullough JP, Klein DN, et al. A comparison of nefazodone, the cognitive behavioral-analysis system of psy

  3. Interventions and Strategies in Counseling and Psychotherapy.

    Science.gov (United States)

    Watts, Richard E., Ed.; Carlson, Jon, Ed.

    This book acknowledges the contributions of Alfred Adler and illustrates the many ways in which Adlerian ideas underpin and influence contemporary therapeutic approaches. It brings together today's leading thinkers to address the practice of counseling and psychotherapy from a social-cognitive perspective. Contributors apply the basic ideas of…

  4. Psychotherapy: The Listening Voice. Rogers and Erickson.

    Science.gov (United States)

    Leva, Richard A.

    The views of Carl Rogers and Milton H. Erickson are combined in this book on psychotherapy. The first section focuses on belief systems, views of man, new views of the unconscious, and a philosophy for change. Erickson and his relationship to myth, the nature of man and the goal of counseling, trance, and a radical view of the unconscious are…

  5. Multicultural Approaches in Psychotherapy: A Rejoinder

    Science.gov (United States)

    Owen, Jesse; Leach, Mark M.; Wampold, Bruce; Rodolfa, Emil

    2011-01-01

    In this rejoinder, the authors address several issues raised by R. L. Worthington and F. R. Dillon (2011) and C. R. Ridley and M. Shaw-Ridley (2011) regarding (a) the measurement of multicultural competencies (MCCs), (b) sampling considerations in multicultural research, and (c) the conceptual frame of multicultural psychotherapy research. The…

  6. Development of a core outcome set for clinical trials in facial aging: study protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

    Science.gov (United States)

    Schlessinger, Daniel I; Iyengar, Sanjana; Yanes, Arianna F; Henley, Jill K; Ashchyan, Hovik J; Kurta, Anastasia O; Patel, Payal M; Sheikh, Umar A; Franklin, Matthew J; Hanna, Courtney C; Chen, Brian R; Chiren, Sarah G; Schmitt, Jochen; Deckert, Stefanie; Furlan, Karina C; Poon, Emily; Maher, Ian A; Cartee, Todd V; Sobanko, Joseph F; Alam, Murad

    2017-08-01

    Facial aging is a concern for many patients. Wrinkles, loss of volume, and discoloration are common physical manifestations of aging skin. Genetic heritage, prior ultraviolet light exposure, and Fitzpatrick skin type may be associated with the rate and type of facial aging. Although many clinical trials assess the correlates of skin aging, there is heterogeneity in the outcomes assessed, which limits the quality of evaluation and comparison of treatment modalities. To address the inconsistency in outcomes, in this project we will develop a core set of outcomes that are to be evaluated in all clinical trials relevant to facial aging. A long list of measureable outcomes will be created from four sources: (1) systematic medical literature review, (2) patient interviews, (3) other published sources, and (4) stakeholder involvement. Two rounds of Delphi processes with homogeneous groups of physicians and patients will be performed to prioritize and condense the list. At a consensus meeting attended by physicians, patients, and stakeholders, outcomes will be further condensed on the basis of participant scores. By the end of the meeting, members will vote and decide on a final recommended set of core outcomes. Subsequent to this, specific measures will be selected or created to assess these outcomes. The aim of this study is to develop a core outcome set and relevant measures for clinical trials relevant to facial aging. We hope to improve the reliability and consistency of outcome reporting of skin aging, thereby enabling improved evaluation of treatment efficacy and patient satisfaction. Core Outcome Measures in Effectiveness Trials (COMET) Initiative, accessible at http://www.comet-initiative.org/studies/details/737 . Core Outcomes Set Initiative, (CSG-COUSIN) accessible at https://www.uniklinikum-dresden.de/de/das-klinikum/universitaetscentren/zegv/cousin/meet-the-teams/project-groups/core-outcome-set-for-the-appearance-of-facial-aging . Protocol version date is 28

  7. Psychotherapy, a concept for the nonpsychiatric physician.

    Science.gov (United States)

    KAHN, J P

    1962-05-01

    Patients tend to repeat with their physician, as with other significant people in their lives, their earlier previous patterns of behavior. The physician as well as the patient is involved in the physician-patient relationship. He will tend to respond to his patients in accordance with his earlier life experiences and his characteristic repetitive behavioral pattern. For both physician and patient, the relationship between them extends beyond the immediate reality situation. Psychotherapy is the utilization of psychological measures in the treatment of sick persons and the deliberate utilization by the physician of the physician-patient relationship for the benefit of the patient. The kind of psychotherapy that is practical and utilizable by the nonpsychiatric physician is that which uses education, reassurance, support and the management of the patient's problems either directly or indirectly or through the intermediary of other people or agencies. The symbolic aspect of the physician-patient relationship is based essentially on the fact that a sick person, because of his anxiety and because of the threat to his physical and psychic integrity, is more dependent and more anxious than he would be if he were well, and therefore he has a correspondingly greater need for the authoritative and protective figure he finds in the physician. Psychotherapy is not directed exclusively to the treatment of flagrantly or obviously neurotic or psychotic patients. It should be and is directed to all sick persons. Limitations in psychotherapy are set by various determinants, among which are the nature of the precipitating factor in the illness, the nature of the sick person, the skill, knowledge and abilities of the physician, and the nature of the physician-patient relationship. In psychotherapy, as in all medicine, the physician should not do anything which may disturb the patient if the disturbance is of no value or if it cannot be followed through with special skills.

  8. Using Animal-assisted Therapy to Enrich Psychotherapy.

    Science.gov (United States)

    Amerine, Jeanne Louise; Hubbard, Grace B

    2016-01-01

    Animal-assisted therapy (AAT) has been shown to be effective in the treatment of many psychological disorders, including autism spectrum disorders, depression, anxiety, and posttraumatic stress disorder (PTSD). AAT can be used as an adjunct to other forms of psychotherapy. With AAT, the animal becomes a part of the treatment plan. Outcomes for clients that are associated with the use of AAT include (1) increased sense of comfort and safety, (2) increased motivation, (3) enhanced self-esteem, (4) increased prosocial behaviors, and (5) decreased behavioral problems. AAT provides a bridge for the therapist to develop a therapeutic relationship with a client, and the animal can provide supportive reassurance for the therapist. The amount of data that supports the benefits of AAT for the treatment of those with mental illnesses is growing, but evidence-based research that supports its use is lacking. Further research is needed.

  9. The mind-body relationship in psychotherapy: Grounded cognition as an explanatory framework

    Directory of Open Access Journals (Sweden)

    Nuwan Dominic Leitan

    2014-05-01

    Full Text Available As a discipline, psychology is defined by its location in the ambiguous space between mind and body, but theories underpinning the application of psychology in psychotherapy are largely silent on this fundamental metaphysical issue. This is a remarkable state of affairs, given that psychotherapy is typically a real-time meeting between two embodied agents, with the goal of facilitating behavior change in one party. The overarching aim of this paper is to problematize the mind-body relationship in psychotherapy in the service of encouraging advances in theory and practice. The paper briefly explores various psychotherapeutic approaches to help explicate relationships between mind and body from these perspectives. Themes arising from this analysis include a tendency toward dualism (separation of mind and body from the conceptualization of human functioning, exclusivism (elimination of either mind or body from the conceptualization of human functioning, or mind-body monism (conceptualization of mind and body as a single, holistic system. We conclude that the literature, as a whole, does not demonstrate consensus, regarding the relationship between mind and body in psychotherapy. We then introduce a contemporary, holistic, psychological conceptualization of the relationship between mind and body, and argue for its potential utility as an organizing framework for psychotherapeutic theory and practice. The holistic approach we explore, grounded cognition, arises from a long philosophical tradition, is influential in current cognitive science, and presents a coherent empirically testable framework integrating subjective and objective perspectives. Finally, we demonstrate how this grounded cognition perspective might lead to advances in the theory and practice of psychotherapy.

  10. The mind-body relationship in psychotherapy: grounded cognition as an explanatory framework.

    Science.gov (United States)

    Leitan, Nuwan D; Murray, Greg

    2014-01-01

    As a discipline, psychology is defined by its location in the ambiguous space between mind and body, but theories underpinning the application of psychology in psychotherapy are largely silent on this fundamental metaphysical issue. This is a remarkable state of affairs, given that psychotherapy is typically a real-time meeting between two embodied agents, with the goal of facilitating behavior change in one party. The overarching aim of this paper is to problematize the mind-body relationship in psychotherapy in the service of encouraging advances in theory and practice. The paper briefly explores various psychotherapeutic approaches to help explicate relationships between mind and body from these perspectives. Themes arising from this analysis include a tendency toward dualism (separation of mind and body from the conceptualization of human functioning), exclusivism (elimination of either mind or body from the conceptualization of human functioning), or mind-body monism (conceptualization of mind and body as a single, holistic system). We conclude that the literature, as a whole, does not demonstrate consensus, regarding the relationship between mind and body in psychotherapy. We then introduce a contemporary, holistic, psychological conceptualization of the relationship between mind and body, and argue for its potential utility as an organizing framework for psychotherapeutic theory and practice. The holistic approach we explore, "grounded cognition," arises from a long philosophical tradition, is influential in current cognitive science, and presents a coherent empirically testable framework integrating subjective and objective perspectives. Finally, we demonstrate how this "grounded cognition" perspective might lead to advances in the theory and practice of psychotherapy.

  11. [Diagnosis and psychoanalytic psychotherapy for personality disordered persons].

    Science.gov (United States)

    Minakawa, Kuninao

    2011-01-01

    The author uses PubMed searches on clinical studies on personality disorders and finds that the borderline personality disorder is most extensively researched. Mary Zanarini summeries there are four kinds of psychotherapies that are proved to be effective in the treatment of BPD patients, including mentalization based treatment, transference focused therapy, dialectic behavior therapy and schema focused therapy. They are all effective to improve the severity of impulsivity and self-destructiveness. The author then reviews McGlashan's series of extensive follow-up studies on BPD and other mental disorders at Chestnut Lodge back in 1980's. The data tells us that both symptomatic stability and level of social adaptation in the long term outcome of BPDs varied to be very poor to recovered. The outcome seem to be heavily relied on the intimate relationship BPDs could enjoy or not. This finding was also noted in a five year Tokyo BPDs follow-up studies by Moriya, Ikuta and Minakawa in 1990's. Both impulsivity and self-destructiveness get always worse along with loss or threatened loss of love object. Therefore all psychotherapies for BPDs should be directed to improve their pathological object relations although it would be extremely difficult to attain. The author finally points it out that the primary prevention of BPDs should be designed and begin a program on a trial basis in a community soon because there are many empirical studies to show the mothers with BPD tend to be frightened by her baby and/or frighten her baby and this pattern of communication is the first epigenetic expression of BPDs.

  12. How treatment affects the brain: meta-analysis evidence of neural substrates underpinning drug therapy and psychotherapy in major depression.

    Science.gov (United States)

    Boccia, Maddalena; Piccardi, Laura; Guariglia, Paola

    2016-06-01

    The idea that modifications of affect, behavior and cognition produced by psychotherapy are mediated by biological underpinnings predates the advent of the modern neurosciences. Recently, several studies demonstrated that psychotherapy outcomes are linked to modifications in specific brain regions. This opened the debate over the similarities and dissimilarities between psychotherapy and pharmacotherapy. In this study, we used activation likelihood estimation meta-analysis to investigate the effects of psychotherapy (PsyTh) and pharmacotherapy (DrugTh) on brain functioning in Major Depression (MD). Our results demonstrate that the two therapies modify different neural circuits. Specifically, PsyTh induces selective modifications in the left inferior and superior frontal gyri, middle temporal gyrus, lingual gyrus and middle cingulate cortex, as well as in the right middle frontal gyrus and precentral gyrus. Otherwise, DrugTh selectively affected brain activation in the right insula in MD patients. These results are in line with previous evidence of the synergy between psychotherapy and pharmacotherapy but they also demonstrate that the two therapies have different neural underpinnings.

  13. Cognitive behavioral analysis system of psychotherapy and brief supportive psychotherapy for augmentation of antidepressant nonresponse in chronic depression: the REVAMP Trial.

    Science.gov (United States)

    Kocsis, James H; Gelenberg, Alan J; Rothbaum, Barbara O; Klein, Daniel N; Trivedi, Madhukar H; Manber, Rachel; Keller, Martin B; Leon, Andrew C; Wisniewski, Steven R; Arnow, Bruce A; Markowitz, John C; Thase, Michael E

    2009-11-01

    Previous studies have found that few chronically depressed patients remit with antidepressant medications alone. To determine the role of adjunctive psychotherapy in the treatment of chronically depressed patients with less than complete response to an initial medication trial. This trial compared 12 weeks of (1) continued pharmacotherapy and augmentation with cognitive behavioral analysis system of psychotherapy (CBASP), (2) continued pharmacotherapy and augmentation with brief supportive psychotherapy (BSP), and (3) continued optimized pharmacotherapy (MEDS) alone. We hypothesized that adding CBASP would produce higher rates of response and remission than adding BSP or continuing MEDS alone. Eight academic sites. Chronically depressed patients with a current DSM-IV-defined major depressive episode and persistent depressive symptoms for more than 2 years. Phase 1 consisted of open-label, algorithm-guided treatment for 12 weeks based on a history of antidepressant response. Patients not achieving remission received next-step pharmacotherapy options with or without adjunctive psychotherapy (phase 2). Individuals undergoing psychotherapy were randomized to receive either CBASP or BSP stratified by phase 1 response, ie, as nonresponders (NRs) or partial responders (PRs). Proportions of remitters, PRs, and NRs and change on Hamilton Scale for Depression (HAM-D) scores. In all, 808 participants entered phase 1, of which 491 were classified as NRs or PRs and entered phase 2 (200 received CBASP and MEDS, 195 received BSP and MEDS, and 96 received MEDS only). Mean HAM-D scores dropped from 25.9 to 17.7 in NRs and from 15.2 to 9.9 in PRs. No statistically significant differences emerged among the 3 treatment groups in the proportions of phase 2 remission (15.0%), partial response (22.5%), and nonresponse (62.5%) or in changes on HAM-D scores. Although 37.5% of the participants experienced partial response or remitted in phase 2, neither form of adjunctive psychotherapy

  14. Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Flood, Karen, E-mail: karenrogers@doctors.org.uk; Nicholson, Anthony A. [Leeds Teaching Hospitals, Department of Radiology (United Kingdom)

    2013-06-15

    Purpose. To describe the presentation, treatment, and outcomes for 14 patients with aneurysms of the inferior pancreaticoduodenal arteries associated with occlusive lesions of the celiac axis, and to review the literature for similar cases. Methods, Over a period of 12 years, 14 patients (10 women and 4 men) ranging in age from 26 to 50 (mean 46) years were demonstrated to have aneurysms of the inferior pancreaticoduodenal artery origin associated with stenosis or occlusion of the celiac axis. All patients were treated by a combination of surgery and interventional radiology. Results. Outcome data collected between 3 months and 4 years (mean 2 years) demonstrated that all aneurysms remained excluded, and all 14 patients were well. The 49 case reports in the literature confirm the findings of this cohort. Conclusion. In inferior pancreaticoduodenal artery aneurysm resulting from celiac occlusive disease, endovascular treatment is best achieved by stenting the celiac axis and/or embolizing the aneurysm when necessary.

  15. Iatrogenic symptoms associated with a therapy cult: examination of an extinct "new psychotherapy" with respect to psychiatric deterioration and "brainwashing".

    Science.gov (United States)

    Hochman, J

    1984-11-01

    In 1982, the first and only discussion of psychotherapy cults appeared in the literature. Temerlin and Temerlin (1982) studied five "bizarre" groups which were formed when five practitioners of psychotherapy simultaneously served as friends, lovers, relatives, employers, colleagues, and teachers, all to patients who were themselves mental health professionals. In choosing the term "psychotherapy cult," the authors have noted similarities of the groups they reviewed to some religious cults, citing the three definitions of the "cult" in Webster's 1966 Third New International Dictionary: (1) a system for the cure of disease based on the dogma, tenets or principles set forth by its promulgator to the exclusion of scientific experience or demonstration, (2) great or excessive dedication to some person, idea or organization, (3) a religion or mystic regarded as mysterious or unorthodox. The psychotherapy cults studied by Temerlin and Temerlin varied from 15 to 75 mental health professionals held together by their idealization of a shared therapist and the activities which they conducted jointly: workshops, seminars, courses, businesses, professional ventures, and social life. As patients became more involved in the social and personal life of their therapists, they gradually withdrew from all friends and family, becoming increasingly dependent on the therapist and their new "siblings." Upon joining the group, many patients felt a sense of being loved and belongingness. The authors described the "cognitive pathology" of idiosyncratic group jargon which served to maintain an illusion of knowledge, sophistication, and personal growth, while removing all ambivalence and uncertainty. The authors concluded that psychotherapy cult membership is an iatrogenically determined negative effect of psychotherapy. Of the former cult members they interviewed, most had perceived themselves as deteriorating or at an impasse, or had experienced disillusionment with their therapists

  16. Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

    NARCIS (Netherlands)

    Staats, H

    2005-01-01

    Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

  17. Neural Implications of Psychotherapy, Pharmacotherapy, and Combined Treatment in Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Thomas L Schwartz

    2016-01-01

    Full Text Available Numerous clinical trials have been conducted to determine the utility of antidepressant treatment (ADT, psychotherapy, and combined psycho-pharmaco-psychotherapy (PPPT in treating major depressive disorder (MDD. While all approaches have shown benefit over placebo to varying degrees, the parallel neurophysiological mechanisms that underlie their efficacy have received little attention. The authors will review and discuss a growing body of literature that relates the factors of treatment selection and response to the principles of neuromodulation, with emphasis regarding how neuroimaging and other experimental data reinforce the need for personalized MDD treatment. This manuscript and its theoretical approaches were supported by conducting relevant literature searches of MEDLINE and PubMed electronic databases, prioritizing systemic reviews, and randomized clinical trials using selected MeSH terms. The authors conclude that ADT, psychotherapy, and PPPT all create potentially observable neurofunctional changes and argue that additive and synergistic potentiation of these effects in PPPT may produce more sustained symptom relief than with monotherapy alone.

  18. INTEGRATIVE PSYCHOTHERAPY AND MINDFULNESS: THE CASE OF SARA

    Directory of Open Access Journals (Sweden)

    Mihael Černetič

    2015-02-01

    Full Text Available The article explores the relationship between Integrative Psychotherapy and mindfulness on a theoretical as well as practical level. Although mindfulness is not an explicit constituent of Integrative Psychotherapy, the two are arguably a natural fit. Mindfulness has the potential to enhance internal and external contact, a central concept in Integrative Psychotherapy, as well as strengthen a client’s Adult ego state. This article presents a case study whereby Integrative Psychotherapy is analysed from the perspective of mindfulness. Within the course of therapy, parallels were observed between the client's increased mindfulness, improved internal and external contact, strengthened Adult ego state, mastery of introjections, as well as diminished feelings of guilt, improved mood, self care and ability to engage in appropriate separation and individuation. These gains support the conclusion that Integrative Psychotherapy and mindfulness are inherently related and that explicit incorporation of mindfulness may enhance the therapeutic process of Integrative Psychotherapy.

  19. Teaching psychodynamic psychotherapy to psychiatric residents: an integrated approach.

    Science.gov (United States)

    Gastelum, Emily; Douglas, Carolyn J; Cabaniss, Deborah L

    2013-03-01

    There is enduring controversy in our field regarding the place for supportive interventions in psychodynamic psychotherapy. This controversy is reflected in the differing ways in which psychodynamic psychotherapy has been conceptualized and taught in psychiatric residency training programs. The authors propose an "integrated" approach for teaching psychodynamic psychotherapy to trainees. In the integrated model, psychodynamic psychotherapy is conceptualized as a form of therapy designed to (a) uncover unconscious elements that influence thoughts, feelings, and behavior, and (b) support weakened psychological function. Using this model, residents learning psychodynamic psychotherapy are taught both uncovering and supporting techniques side by side in one course with specific guidelines for assessing when to use one set of interventions or the other. Teaching psychodynamic psychotherapy to residents in this integrated way prepares them to become skilled clinicians who are able to move fluidly from supporting to uncovering in a pragmatic and flexible manner, matched to the particular moment-to-moment needs of the individual patient.

  20. Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Berger Mathias

    2011-08-01

    Full Text Available Abstract Background Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP, faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. Methods/Design The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD. Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. Discussion The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically

  1. Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus supportive psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial.

    Science.gov (United States)

    Schramm, Elisabeth; Hautzinger, Martin; Zobel, Ingo; Kriston, Levente; Berger, Mathias; Härter, Martin

    2011-08-17

    Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD). Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA) controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically depressed patients. ClinicalTrials.gov (NCT00970437).

  2. A developmental approach to gifts in long-term group psychotherapy extending from an anniversary ritual.

    Science.gov (United States)

    Smolar, Andrew I; Eichen, Ann E

    2013-01-01

    Therapists have been quietly receiving gifts from patients for many years, but only recently have they been acknowledging and reporting such transactions. Most of the literature on the subject, which has been sparse, has been limited to the individual psychotherapy setting. In this article, we take up the issue within the group psychotherapeutic setting, surveying the literature, and describing our own experience with what became a gift-giving ritual in our long-term open-ended therapy group. We offer a group developmental perspective for informing therapeutic responses to gifts, and suggestions for the technical management of this kind of transaction.

  3. Psychotherapy and Psychosocial Treatment: Recent Advances and Future Directions.

    Science.gov (United States)

    Plakun, Eric M

    2015-09-01

    Psychotherapy and psychosocial treatment have been shown to be effective forms of treatment of a range of individual and complex comorbid disorders. The future role of psychotherapy and psychosocial treatment depends on several factors, including full implementation of mental health parity, correction of underlying false assumptions that shape treatment, payment priorities and research, identification and teaching of common factors or elements shared by effective psychosocial therapies, and adequate teaching of psychotherapy and psychosocial treatment.

  4. The Dodo Bird and Common Factors in Psychotherapy

    Directory of Open Access Journals (Sweden)

    Bruno Trancas

    2014-06-01

    Full Text Available Since its inception, the theoretical exploration of psychotherapy has originated diverse ideas on the mechanisms underlying its effectiveness. The authors focus on one of the founding moments of the theory of common factors in psychotherapy and subsequently explore its theoretical grounds and conceptual evolution. Criticism to the construct and exposure of its fragilities are also approached. Some consequences of this knowledge relating to the practice and training of psychotherapy are put forward.

  5. Controversies in psychotherapy research: epistemic differences in assumptions about human psychology.

    Science.gov (United States)

    Shean, Glenn D

    2013-01-01

    It is the thesis of this paper that differences in philosophical assumptions about the subject matter and treatment methods of psychotherapy have contributed to disagreements about the external validity of empirically supported therapies (ESTs). These differences are evident in the theories that are the basis for both the design and interpretation of recent psychotherapy efficacy studies. The natural science model, as applied to psychotherapy outcome research, transforms the constitutive features of the study subject in a reciprocal manner so that problems, treatments, and indicators of effectiveness are limited to what can be directly observed. Meaning-based approaches to therapy emphasize processes and changes that do not lend themselves to experimental study. Hermeneutic philosophy provides a supplemental model to establishing validity in those instances where outcome indicators do not lend themselves to direct observation and measurement and require "deep" interpretation. Hermeneutics allows for a broadening of psychological study that allows one to establish a form of validity that is applicable when constructs do not refer to things that literally "exist" in nature. From a hermeneutic perspective the changes that occur in meaning-based therapies must be understood and evaluated on the manner in which they are applied to new situations, the logical ordering and harmony of the parts with the theoretical whole, and the capability of convincing experts and patients that the interpretation can stand up against other ways of understanding. Adoption of this approach often is necessary to competently evaluate the effectiveness of meaning-based therapies.

  6. Remote psychotherapy for terminally ill cancer patients.

    Science.gov (United States)

    Cluver, Jeffrey S; Schuyler, Dean; Frueh, B Christopher; Brescia, Frank; Arana, George W

    2005-01-01

    We conducted a feasibility study of remote psychotherapy in 10 terminally ill cancer patients with diagnoses of adjustment disorder or major depression. Subjects received six sessions of individual cognitive therapy with the same therapist. Sessions alternated between face-to-face sessions and remote sessions delivered by analogue videophone. After each therapy session, a brief questionnaire was used to evaluate the subjects' level of satisfaction with the session, sense of connectedness to the therapist and overall progress being made in the therapy. Nine patients completed the study. Of 53 completed therapy sessions, 21 were by videophone and 32 were conducted face to face. Participants reported strong positive perceptions and acceptance after almost all therapy sessions, regardless of service delivery mode. The study suggests that there may be a role for the delivery of psychotherapy using low-bandwidth videophones.

  7. Attachment theory: a biological basis for psychotherapy?

    Science.gov (United States)

    Holmes, J

    1993-10-01

    John Bowlby bemoaned the separation between the biological and psychological approaches in psychiatry, and hoped that attachment theory, which brings together psychoanalysis and the science of ethology, would help bridge the rift between them. Recent findings in developmental psychology have delineated features of parent-infant interaction, especially responsiveness, attunement, and modulation of affect, which lead to either secure or insecure attachment. Similar principles can be applied to the relationship between psychotherapist and patient--the provision of a secure base, the emergence of a shared narrative ('autobiographical competence'), the processing of affect, coping with loss--these are common to most effective psychotherapies and provide the basis for a new interpersonal paradigm within psychotherapy. Attachment theory suggests they rest on a sound ethological and hence biological foundation.

  8. A semiotic approach to suitability for psychotherapy.

    Science.gov (United States)

    Meltzer, J D

    1978-11-01

    At the beginning of my career as a psychotherapist I interviewed a number of patients in an effort to find one who seemed to be a good prospect for long-term psychotherapy. While interviewing with this purpose in mind, I was struck by the fact that a number of the people I spoke with gave me a sense of being extremely suitable for this sort of therapy, but that others seemed quite unsuitable. An informal survey among my peers as well as among more senior therapists revealed that they were not unfamiliar with the phenomenon. The present empirical study of the semiotic aspects of suitability for psychotherapy grew out of this early experience.

  9. Some neurobiological aspects of psychotherapy. A review.

    Science.gov (United States)

    Liggan, D Y; Kay, J

    1999-01-01

    Ever since the idea was accepted that memory is associated with alterations in synaptic strength, studies on the cellular and molecular mechanisms responsible for the plastic changes in neurons have attracted wide interest in the scientific community. This article explores the process of memory consolidation leading to persistent modifications in synaptic plasticity as a mechanism by which psychotherapy facilitates changes in the permanent storage of information acquired throughout the individual's life. The psychobiological interrelationships of affect, attachment, and memory offer a perspective regarding the etiology and treatment of clinical disturbances of affect. Analogies between brain physiology and modes of psychotherapy provide the foundation for a review of psychiatric disorders involving the inability to control fear, obsessions, compulsions, and delusions, all of which respond to psychotherapeutic interventions.

  10. Self and its anxieties in existential psychotherapy

    Directory of Open Access Journals (Sweden)

    Marica Mircea Adrian

    2017-05-01

    Full Text Available The existence of a self and the imperative of knowing it have gone through philosophy from its beginning until today. Existentialism, starting with Kierkegaard and continuing with Heidegger, relate the scope of the authentic self to that of anxiety. Once the scope of the anxiety of self has been formulated, it entered the sphere of psychological theories. The prolific encounter between existentialism and psychology materializes into the influent contemporary psychological school, named existential psychotherapy. Our analysis wishes to describe the nodal points of this encounter, having as reference points the scope of self and its anxieties. In the first part of the analysis we look into the philosophical premises, referring to the two above mentioned names, while in the second part we present the taking-ups and the applicative adjustments brought up by existential psychotherapy.

  11. Applied philosophy and psychotherapy: Heraclitus as case study

    Directory of Open Access Journals (Sweden)

    Johann Beukes

    2002-11-01

    Full Text Available This article investigates a recent attempt to apply philosophy within the discipline of psychotherapy and to investigate the somewhat undefined realm of philosophical counselling. After introducing the claims of this interdisciplinary exercise and after addressing the problems involved in crossing the boundaries between philosophy and psychotherapy, the article elaborates on  Alex Howard’s (2000 [Philosophy for counselling and psychotherapy: Pythagoras to post-modernism. London: Macmillan] attempt to make explicit use of philosophy in psychotherapy, using his interpretation and application of Heraclitus’ philosophy as case study.

  12. NONVERBAL STORIES: THE BODY IN PSYCHOTHERAPY

    OpenAIRE

    Richard G. Erskine

    2014-01-01

    Emotional experience is stored within the amygdala and the limbic system of the brain as affect, visceral, and physiological sensation without symbolization and language. These significant memories are expressed in affect and through our bodily movements and gestures. Such body memories are unconscious non-symbolized patterns of self-in-relationship. Several methods of a body centered psychotherapy are described and clinical case examples illustrate the use of expressive methods within a re...

  13. Recognition of psychotherapy effectiveness: the APA resolution.

    Science.gov (United States)

    Campbell, Linda F; Norcross, John C; Vasquez, Melba J T; Kaslow, Nadine J

    2013-03-01

    In August 2012, the American Psychological Association (APA) Council of Representatives voted overwhelmingly to adopt as APA policy a Resolution on the Recognition of Psychotherapy Effectiveness. This invited article traces the origins and intentions of that resolution and its protracted journey through the APA governance labyrinth. We summarize the planned dissemination and projected results of the resolution and identify several lessons learned through the entire process.

  14. Individual patient data meta-analysis of combined treatments versus psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for adult depression: a protocol

    Science.gov (United States)

    Weitz, Erica; Kleiboer, Annet; van Straten, Annemieke; Hollon, Steven D; Cuijpers, Pim

    2017-01-01

    Introduction There are many proven treatments (psychotherapy, pharmacotherapy or their combination) for the treatment of depression. Although there is growing evidence for the effectiveness of combination treatment (psychotherapy + pharmacotherapy) over pharmacotherapy alone, psychotherapy alone or psychotherapy plus pill placebo, for depression, little is known about which specific groups of patients may respond best to combined treatment versus monotherapy. Conventional meta-analyses techniques have limitations when tasked with examining whether specific individual characteristics moderate the effect of treatment on depression. Therefore, this protocol outlines an individual patient data (IPD) meta-analysis to explore which patients, with which clinical characteristics, have better outcomes in combined treatment compared with psychotherapy (alone or with pill placebo), pharmacotherapy and pill placebo. Methods and Analysis Study searches are completed using an established database of randomised controlled trials (RCTs) on the psychological treatment of adult depression that has previously been reported. Searches were conducted in PubMed, PsycInfo, Embase and the Cochrane Central Register of Controlled Trials. RCTs comparing combination treatment (psychotherapy + pharmacotherapy) with psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for the treatment of adult depression will be included. Study authors of eligible trials will be contacted and asked to contribute IPD. Conventional meta-analysis techniques will be used to examine differences between studies that have contributed data and those that did not. Then, IPD will be harmonised and analysis using multilevel regression will be conducted to examine effect moderators of treatment outcomes. Dissemination Study results outlined above will be published in peer-reviewed journals. Study results will contribute to better understanding whether certain patients respond best to combined

  15. Removing pathogenic memories: a neurobiology of psychotherapy.

    Science.gov (United States)

    Centonze, Diego; Siracusano, Alberto; Calabresi, Paolo; Bernardi, Giorgio

    2005-10-01

    Experimental research examining the neural bases of nondeclarative memory has offered intriguing insight into how functional and dysfunctional implicit learning affects the brain. Long-term modifications of synaptic transmission, in particular, are currently considered the most plausible mechanism underlying memory trace encoding and compulsions, addiction, anxiety, and phobias. Therefore, an effective psychotherapy must be directed to erase maladaptive implicit memories and aberrant synaptic plasticity. This article describes the neurobiological bases of pathogenic memory disruption to provide some insight into how psychotherapy works. At least two mechanisms of unwanted memory erasing appear to be implicated in the effects of psychotherapy: inhibition of memory consolidation/reconsolidation and extinction. Behavioral evidence demonstrated that these two ways to forget are profoundly distinct in nature, and it is increasingly clear that their cellular, synaptic, and molecular underpinnings are different. Accordingly, the blockade of consolidation/reconsolidation erases memories by reversing the plasticity associated with memory maintenance, whereas extinction is a totally new form of plasticity that, similar to the plasticity underlying the old memory, requires protein synthesis-dependent synaptic remodeling.

  16. Interpersonal psychotherapy (IPT) in major depressive disorder.

    Science.gov (United States)

    Brakemeier, Eva-Lotta; Frase, Lukas

    2012-11-01

    In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.

  17. [Accepted Manuscript] Mechanisms and effects of public reporting of surgeon outcomes: A systematic review of the literature.

    OpenAIRE

    Behrendt, K; Groene, O.

    2016-01-01

    Public reporting of surgeon outcomes has become a key strategy in the English NHS to ensure accountability and improve the quality of care. Much of the evidence that supported the design of the strategy originates from the USA. This report aims to assess how the evidence on public reporting could be harnessed for cross-country translation of this health system strategy; in particular, to gauge the expected results of the UK surgeon outcome initiative and to propose criteria that elucidate tha...

  18. Response to psychotherapy for posttraumatic stress disorder: the role of pretreatment verbal memory performance.

    Science.gov (United States)

    Nijdam, Mirjam J; de Vries, Giel-Jan; Gersons, Berthold P R; Olff, Miranda

    2015-08-01

    Neuropsychological studies have consistently demonstrated impaired verbal memory in posttraumatic stress disorder (PTSD). Trauma-focused treatment for PTSD is thought to rely on memory, but it is largely unknown whether treatment outcome is influenced by memory performance. The aim of the study, therefore, was to examine the relationship between verbal memory performance and treatment response to trauma-focused psychotherapy. Participants were referred to our outpatient clinic and recruited between December 2003 and January 2009 upon diagnosis of PTSD according to DSM-IV. Secondary analyses of a randomized controlled trial comparing eye movement desensitization and reprocessing therapy (n = 70) and brief eclectic psychotherapy (n = 70), a cognitive-behavioral intervention, are reported. Response to treatment was measured by self-reported PTSD symptom severity (Impact of Event Scale-Revised) over 17 weeks. Pretreatment verbal memory measures (California Verbal Learning Test, Rivermead Behavioral Memory Test) were included in the mixed linear model analyses in order to investigate the influence of memory on treatment outcome. Pretreatment encoding, short-term retrieval, long-term retrieval, and recognition performance were significantly associated with treatment response in terms of self-reported PTSD symptom severity for both treatments (P ≤ .013). Receiver operating characteristic curves predicting treatment response with pretreatment memory indices showed that 75.6% of the patients could be correctly classified as responder. Poor verbal memory performance represents a risk factor for worse treatment response to trauma-focused psychotherapy. Memory measures can be helpful in determining which patients are unable to benefit from trauma-focused psychotherapy. Future research should explore how treatment perspectives of patients with poor verbal memory can be improved. ISRCTN.com identifier: ISRCTN64872147. © Copyright 2015 Physicians Postgraduate Press, Inc.

  19. The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Lau Rick L

    2012-12-01

    Full Text Available Abstract Background A number of factors have been identified as influencing total knee arthroplasty outcomes, including patient factors such as gender and medical comorbidity, technical factors such as alignment of the prosthesis, and provider factors such as hospital and surgeon procedure volumes. Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of total joint arthroplasty to higher volume centers, and adoption of volume standards. To contribute to the discussions concerning the optimization of provider factors and proposals to regionalize total knee arthroplasty practices, we undertook a systematic review to investigate the association between surgeon volume and primary total knee arthroplasty outcomes. Methods We performed a systematic review examining the association between surgeon volume and primary knee arthroplasty outcomes. To be included in the review, the study population had to include patients undergoing primary total knee arthroplasty. Studies had to report on the association between surgeon volume and primary total knee arthroplasty outcomes, including perioperative mortality and morbidity, patient-reported outcomes, or total knee arthroplasty implant survivorship. There were no restrictions placed on study design or language. Results Studies were variable in defining surgeon volume (‘low’: 5 to >70 total knee arthroplasty per year. Mortality rate, survivorship and thromboembolic events were not found to be associated with surgeon volume. We found a significant association between low surgeon volume and higher rate of infection (0.26% - 2.8% higher, procedure time (165 min versus 135 min, longer length of stay (0.4 - 2.13 days longer, transfusion rate (13% versus 4%, and worse patient reported outcomes. Conclusions Findings suggest a trend towards better outcomes for higher volume surgeons, but results must be interpreted with caution.

  20. Change in self-esteem predicts depressive symptoms at follow-up after intensive multimodal psychotherapy for major depression.

    Science.gov (United States)

    Dinger, Ulrike; Ehrenthal, Johannes C; Nikendei, Christoph; Schauenburg, Henning

    2017-01-08

    Reduced self-esteem is a core symptom of depression, but few studies have investigated within-treatment change of self-esteem as a predictor of long-term outcome in depression. This study investigated change in self-esteem during 8 weeks of multimodal, psychodynamically oriented psychotherapy for 40 depressed patients and tested whether it would predict outcome 6 months after termination. Data was drawn from a randomized clinical pilot trial on day-clinic versus inpatient psychotherapy for depression. Findings supported the association between change in self-esteem and follow-up depression severity, even when controlling for within-treatment symptom change. Change in self-esteem was not related to overall symptoms and interpersonal problems at follow-up. Thus, change in self-esteem may be an important variable in preventing relapse for depression. Self-esteem is related to depressive symptoms and interpersonal problems. Improvement of self-esteem during psychotherapy correlates with improvements of symptoms and interpersonal problems. Change of self-esteem during psychotherapy predicts depressive symptoms 6 months after termination of therapy. When treating depressed patients, psychotherapists should work towards an improvement of self-esteem in order to prevent relapse. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Treatment outcome in breast cancer patients with ipsilateral supraclavicular lymph node metastasis at time of diagnosis: a review of the literature.

    Science.gov (United States)

    Grotenhuis, B A; Klem, T M A L; Vrijland, W W

    2013-03-01

    In the revised 6th edition of the AJCC-TNM staging system for breast cancer, metastasis in ipsilateral supraclavicular lymph node(s) is considered as a locoregional disease and classified as N3c rather than M1 distant disease. The aim of this review was to search the recent literature in order to investigate whether the reported treatment outcome of patients with ipsilateral supraclavicular metastases in breast cancer patients justifies this revision. A review of the recent English-language literature (January 2001-June 2012) concerning breast cancer with supraclavicular involvement was performed. A total number of six studies were included in the current review. All reported comparable data with regard to treatment outcome after multimodality treatment, despite considerable heterogeneity in study populations. Patients with ipsilateral supraclavicular lymph node involvement showed outcomes more similar to locally advanced breast cancer patients rather than patients with distant tumor spread. It seems that the 2002 revision of the AJCC-TNM staging system for breast cancer has appropriately reclassified patients with supraclavicular disease to a new category (N3c). Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Demographics of extra-articular calcaneal fractures: Including a review of the literature on treatment and outcome

    NARCIS (Netherlands)

    T. Schepers (Tim); A.Z. Ginai (Abida); E.M.M. van Lieshout (Esther); P. Patka (Peter)

    2008-01-01

    textabstractIntroduction: Extra-articular calcaneal fractures represent 25-40% of all calcaneal fractures and an even higher percentage of up to 60% is seen in children. A disproportionately small part of the literature on calcaneal fractures involves the extra-articular type. The aim of this study

  3. Exploring Psychotherapy Clients' Independent Strategies for Change While in Therapy

    Science.gov (United States)

    Mackrill, Thomas

    2008-01-01

    Psychotherapy research usually describes how client change is caused by therapist interventions. This article describes how clients change by continuing to use and revising the strategies for change that they bring with them when they first enter therapy. This article presents data from a qualitative diary study of psychotherapy. Three cases…

  4. Solicited diary studies of psychotherapy in qualitative research

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward

    2008-01-01

    Diary studies are scarce within the field of qualitative psychotherapy research. In this article arguments for and against the employment of solicited diaries studies in qualitative psychotherapy research are investigated. The strengths of diary studies are presented along with arguments concerning...

  5. Characteristics of Patients Involved in Psychotherapy in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Sabina Alispahić

    2014-04-01

    Full Text Available Introduction: The aim of this study was to determine the demographic and clinical characteristics of Bosnian and Herzegovinian patients involved in psychotherapeutic treatments in order to explore the current situation of psychotherapy in Bosnia and Herzegovina.Methods: The study included 213 patients (154 women and 47 men undergoing diverse psychotherapeutic treatments. Data about demographic and clinical characteristics were collected by questionnaire. Following characteristics were documented: age, sex, education, employment status, marital status, specific problem that got the client involved in psychotherapy, type of psychotherapy, and use of psychopharmacology.Results: Majority of the patients undergoing psychotherapy are age up to 40 and female. They are by vast majority holding a university degree and are employed. Nearly equal number of patients is living in partnership or marriage compared to single or never been married. Most frequent reasons for getting involved in the psychotherapy treatment are of the intrapersonal nature (depression, anxiety and panic attacks. Majority of the patients were involved in gestalt and cognitive behavioral psychotherapy, and at the same time majority of those were not prescribed medicaments.Conclusions: We point out and overview some of the most prominent socio-demographic traits of patients undergoing psychotherapy, the ones that could be important in the future research with the higher degree of control. In the terms of personal initiative, psychotherapy stops being a taboo in Bosnia and Herzegovina. However, there is still a long path until it reaches integration in daily life of the people.

  6. Is There Room for Criticism of Studies of Psychodynamic Psychotherapy?

    Science.gov (United States)

    Thombs, Brett D.; Jewett, Lisa R.; Bassel, Marielle

    2011-01-01

    Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler. Shedler declared unequivocally that "empirical evidence supports the efficacy of psychodynamic therapy" (p. 98). He did not mention any specific criticisms that have been made of evidence on psychodynamic psychotherapies or address possible distinctions…

  7. Using Media to Teach How Not to Do Psychotherapy

    Science.gov (United States)

    Gabbard, Glen; Horowitz, Mardi

    2010-01-01

    Objective: This article describes how using media depictions of psychotherapy may help in teaching psychiatric residents. Methods: Using the HBO series "In Treatment" as a model, the authors suggest how boundary transgressions and technical errors may inform residents about optimal psychotherapeutic approaches. Results: The psychotherapy vignettes…

  8. Use of Psychotherapy by Rural and Urban Veterans

    Science.gov (United States)

    Cully, Jeffrey A.; Jameson, John P.; Phillips, Laura L.; Kunik, Mark E.; Fortney, John C.

    2010-01-01

    Purpose: To examine whether differences exist between rural and urban veterans in terms of initiation of psychotherapy, delay in time from diagnosis to treatment, and dose of psychotherapy sessions. Methods: Using a longitudinal cohort of veterans obtained from national Veterans Affairs databases (October 2003 through September 2004), we extracted…

  9. The Grandmaternal Transference in Parent-Infant/Child Psychotherapy

    Science.gov (United States)

    Dugmore, Nicola

    2013-01-01

    The psychic significance of the figure of the grandmother in psychodynamic psychotherapy has received scant attention. This paper develops the concept of the "grandmaternal transference" in parent-infant psychotherapy and explores its identification, its possible functions and its therapeutic significance. The grandmaternal transference has…

  10. Rorschach and MMPI-2 Indices of Early Psychotherapy Termination.

    Science.gov (United States)

    Hilsenroth, Mark J.; And Others

    1995-01-01

    Investigates the differences between 97 patients who had prematurely terminated psychotherapy and 81 who had participated in individual psychotherapy for at least 6 months and 24 sessions on selected Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Rorschach variables. Theoretical implications of interpersonal variables are discussed in…

  11. Psychotherapy for chronic major depression and dysthymia: A meta analysis.

    NARCIS (Netherlands)

    Cuijpers, P.; Straten, van A.; Schuurmans, J.; Oppen, van P.C.; Hollon, S.D.; Andersson, G.

    2009-01-01

    Abstract Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic depressi

  12. Psychiatric Residents' Views of Quality of Psychotherapy Training and Psychotherapy Competencies: A Multisite Survey

    Science.gov (United States)

    Calabrese, Christina; Sciolla, Andres; Zisook, Sidney; Bitner, Robin; Tuttle, Jeffrey; Dunn, Laura B.

    2010-01-01

    Objective: Few studies of residents' attitudes toward psychotherapy training exist. The authors examined residents' perceptions of the quality of their training, support for training, their own competence levels, and associations between self-perceived competence and perceptions of the training environment. Methods: An anonymous, web-based…

  13. Developing an "evidence-based medicine and use of the biomedical literature" component as a longitudinal theme of an outcomes-based medical school curriculum: year 1.

    Science.gov (United States)

    Burrows, Suzetta; Moore, Kelly; Arriaga, Joaquin; Paulaitis, Gediminas; Lemkau, Henry L

    2003-01-01

    This paper describes the new outcomes-based curriculum at the University of Miami School of Medicine, a model curriculum for the first decade of the twenty-first century. The new curriculum has a strong emphasis on evidence-based medicine (EBM), implemented throughout its four years as a component of one of its longitudinal themes. The "EBM and Use of the Biomedical Literature" component, which begins at orientation, was developed and is implemented by the Louis Calder Memorial Library, the center of EBM focus and activity for the curriculum and other initiatives at the University of Miami/Jackson Memorial Medical Center. The authors are unaware of any published reports of library-centric EBM initiatives as part of a longitudinal theme of a four-year outcomes-based curriculum. Other innovations of the EBM component in the new curriculum to date include use of Blackboard and CATmaker software programs for self-paced, interactive educational opportunities.

  14. Impact of pain on the outcome of group psychotherapy

    OpenAIRE

    Ogrodniczuk, John S.; Piper, William E.; Joyce, Anthony S.

    2008-01-01

    Este estudio ex post facto investigó la influencia del dolor físico en el resultado de la psicoterapia grupal en pacientes con depresión mayor, después de controlar tipo de psicoterapia recibida, uso de medicación antidepresiva y alexitimia (para tener en cuenta la tendencia a somatizar sensaciones desagradables o negativas). Los datos provienen de 48 pacientes psiquiátricos externos con depresión mayor comórbida y duelo complicado que participaron en un estudio aleatorizado de dos tipos de p...

  15. Impact of pain on the outcome of group psychotherapy

    Directory of Open Access Journals (Sweden)

    John S. Ogrodniczuk

    2008-01-01

    Full Text Available Este estudio ex post facto investigó la influencia del dolor físico en el resultado de la psicoterapia grupal en pacientes con depresión mayor, después de controlar tipo de psicoterapia recibida, uso de medicación antidepresiva y alexitimia (para tener en cuenta la tendencia a somatizar sensaciones desagradables o negativas. Los datos provienen de 48 pacientes psiquiátricos externos con depresión mayor comórbida y duelo complicado que participaron en un estudio aleatorizado de dos tipos de psicoterapia grupal para duelo complicado. Los pacientes evaluaron su propio dolor usando la subescala SF-36 de Dolor Físico. Para medir los resultados de la psicoterapia se utilizaron el Inventario de Depresión de Beck, el Inventario Breve de Síntomas-53 y la Escala de Ajuste Social. La alexitimia fue evaluada utilizando la Escala de Alexitimia de Toronto. Mayores niveles de dolor físico al comienzo del estudio estuvieron asociados, después de 12 semanas de psicoterapia grupal, con menores mejoras en síntomas depresivos, malestar psiquiátrico general y menor funcionamiento social. La variable dolor explicó entre el 13 y el 21% de la variabilidad en el resultado del tratamiento. El efecto negativo del dolor fue consistente en ambos tipos de psicoterapia grupal. El efecto del uso de medicación antidepresiva sobre el impacto del dolor en el resultado del tratamiento fue similar para ambos tipos de psicoterapia grupal. Reconocer y tratar el dolor comórbido podría mejorar el resultado del tratamiento psicoterapéutico en pacientes deprimidos.

  16. Personality, Psychopathology, and Psychotherapy: A Pre-specified Analysis Protocol for Confirmatory Research on Personality–Psychopathology Associations in Psychotherapy Outpatients

    Science.gov (United States)

    Hengartner, Michael P.; Yamanaka-Altenstein, Misa

    2017-01-01

    The role of personality trait variation in psychopathology and its influence on the outcome of psychotherapy is a burgeoning field. However, thus far most findings were based on controlled clinical trials that may only poorly represent real-world clinical settings due to highly selective samples mostly restricted to patients with major depression undergoing antidepressive medication. Focusing on personality and psychopathology in a representative naturalistic sample of psychotherapy patients is therefore worthwhile. Moreover, up to date hardly any confirmatory research has been conducted in this field. Strictly confirmatory research implies two major requirements: firstly, specific hypotheses, including expected effect sizes and statistical approaches to data analysis, must be detailed prior to inspection of the data, and secondly, corresponding protocols have to be published online and freely available. Here, we introduce a longitudinal naturalistic study aimed at examining, firstly, the prospective impact of baseline personality traits on the outcome of psychotherapy over a 6-month observation period; secondly, the stability and change in personality traits over time; thirdly, the association between longitudinal change in psychopathology and personality; fourthly, the agreement between self-reports and informant rating of personality; and fifthly, the predictive validity of personality self-reports compared to corresponding informant ratings. For it, we comprehensively state a priori hypotheses, predict the expected effect sizes and detail the statistical analyses that we intend to conduct to test these predictions. Such a stringent confirmatory design increases the transparency and objectivity of psychopathological research, which is necessary to reduce the rate of false-positive findings and to increase the yield of scientific research. PMID:28203209

  17. Effect of Increased Intensity of Physiotherapy on Patient Outcomes After Stroke: An Economic Literature Review and Cost-Effectiveness Analysis.

    Science.gov (United States)

    Chan, B

    2015-01-01

    Functional improvements have been seen in stroke patients who have received an increased intensity of physiotherapy. This requires additional costs in the form of increased physiotherapist time. The objective of this economic analysis is to determine the cost-effectiveness of increasing the intensity of physiotherapy (duration and/or frequency) during inpatient rehabilitation after stroke, from the perspective of the Ontario Ministry of Health and Long-term Care. The inputs for our economic evaluation were extracted from articles published in peer-reviewed journals and from reports from government sources or the Canadian Stroke Network. Where published data were not available, we sought expert opinion and used inputs based on the experts' estimates. The primary outcome we considered was cost per quality-adjusted life-year (QALY). We also evaluated functional strength training because of its similarities to physiotherapy. We used a 2-state Markov model to evaluate the cost-effectiveness of functional strength training and increased physiotherapy intensity for stroke inpatient rehabilitation. The model had a lifetime timeframe with a 5% annual discount rate. We then used sensitivity analyses to evaluate uncertainty in the model inputs. We found that functional strength training and higher-intensity physiotherapy resulted in lower costs and improved outcomes over a lifetime. However, our sensitivity analyses revealed high levels of uncertainty in the model inputs, and therefore in the results. There is a high level of uncertainty in this analysis due to the uncertainty in model inputs, with some of the major inputs based on expert panel consensus or expert opinion. In addition, the utility outcomes were based on a clinical study conducted in the United Kingdom (i.e., 1 study only, and not in an Ontario or Canadian setting). Functional strength training and higher-intensity physiotherapy may result in lower costs and improved health outcomes. However, these results

  18. Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature

    Directory of Open Access Journals (Sweden)

    Najmeh Akhlaghi

    2015-01-01

    Full Text Available Vital pulp therapy (VPT is a biologic and conservative treatment modality to preserve the vitality and function of the coronal or remaining radicular pulp tissue in vital permanent teeth. A search was conducted via the Cochrane database, PubMed, MEDLINE, and Ovid for any articles with the criteria for "pulp-capping," or "pulp-capping materials" and "VPT outcomes" from 1978 to mid 2014. All articles were evaluated and the valid papers were selected. The outcomes of various VPT techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and complete pulpotomy in vital permanent teeth were extracted. Although various studies have different research approach, most studies noted a favorable treatment outcome. Mineral trioxide aggregate (MTA appears to be more effective than calcium hydroxide (Ca(OH 2 for maintaining long-term pulp vitality after indirect and direct pulp-capping. However, it seems that the success rate for partial pulpotomy and pulpotomy with Ca(OH 2 is similar to MTA.

  19. Predicting Psychotherapy Dropouts: A Multilevel Approach.

    Science.gov (United States)

    Kegel, Alexander F; Flückiger, Christoph

    2015-01-01

    The role of therapeutic processes in predicting premature termination of psychotherapy has been a particular focus of recent research. The purpose of this study was to contrast outpatients who completed therapy and those who dropped out with respect to their self-reported in-session experiences of self-esteem, mastery, clarification and the therapeutic alliance. The 296 patients with mixed disorders were treated with an integrative form of cognitive-behavioural therapy without pre-determined time limit (M = 20.2 sessions). Multilevel analyses indicated that patients who did not completetreatment reported, on average, lower levels of self-esteem, mastery and clarification and lower ratings of their therapeutic alliance in treatment in contrast to patients who completed therapy. Patient-reported change in self-esteem experiences over the course of treatment turned out to be the strongest predictor of dropout from psychotherapy or successful completion. When dropout occurred before the average treatment length was reached, patients reported fewer clarifying experiences as early as the first session and their ratings of the therapeutic alliance were characterized by an absence of positive development. Both of these aspects seem to be involved in patients' decisions to leave treatment early. The findings underscore the importance of the therapeutic process in understanding the mechanisms behind treatment dropout. Analyses data from 296 patients at a private outpatient clinic in a routine practice setting (CBT). Completer/dropout definition: presence or absence of measurement battery at post-assessment. Focuses on change in therapy processes by investigating post-session reports. Finds that positive changes in self-esteem experiences is the most robust predictor of dropout, followed by ratings of clarification experiences and the global alliance. In line with recent dropout research, these process indicators might help to detect therapeutic situations that are

  20. Psychodrama: group psychotherapy through role playing.

    Science.gov (United States)

    Kipper, D A

    1992-10-01

    The theory and the therapeutic procedure of classical psychodrama are described along with brief illustrations. Classical psychodrama and sociodrama stemmed from role theory, enactments, "tele," the reciprocity of choices, and the theory of spontaneity-robopathy and creativity. The discussion focuses on key concepts such as the therapeutic team, the structure of the session, transference and reality, countertransference, the here-and-now and the encounter, the group-as-a-whole, resistance and difficult clients, and affect and cognition. Also described are the neoclassical approaches of psychodrama, action methods, and clinical role playing, and the significance of the concept of behavioral simulation in group psychotherapy.

  1. The supervisory needs of neophyte psychotherapy trainees.

    Science.gov (United States)

    Duryee, J; Brymer, M; Gold, K

    1996-11-01

    This article focuses on the difficulties facing the neophyte trainee in the field of psychotherapy. Three areas of such difficulties are identified, defined, and discussed: feelings of inadequacy and incompetence, anxieties concerning supervisors, and confusion concerning multiple theoretical views of clinical work. Two vignettes from the early training of the paper's junior authors illustrate and discuss these problems and their resolution in applied contexts. A conclusion is offered which emphasizes the value of supervisory recognition of these dimensions of trainees' experience, as well as their potential for modeling processes of growth that are likely to help supervisees' patients as well.

  2. An Integrative Psychotherapy of Postpartum Adjustment

    Directory of Open Access Journals (Sweden)

    Carol Merle-Fishman

    2010-12-01

    Full Text Available Becoming a mother is a time of transition, transformation and sometimes trauma. The immediacy of meeting the needs of an infant, combined with the immediacy of becoming a mother, often collide to produce depression, anxiety and stress. Shame, confusion, isolation and cultural expectations often prevent women from seeking the postpartum support they need, which may result in long lasting depression, anxiety and unresolved trauma. Integrative Psychotherapy, Transactional Analysis and Attachment Theory offer ways to understand postpartum adjustment as well as methodologies for addressing this unique developmental event in the life of women.

  3. Review of Psychotherapy as a human science.

    Science.gov (United States)

    Langan, Robert

    2008-12-01

    Reviews the book, Psychotherapy as a human science by Daniel Burston and Roger Frie (see record 2006-12980-000). In this book, the authors show how philosophical assumptions pervade therapeutic praxis. "In our view, philosophy is inherent to the very practice of psychotherapy" (p. 2). There is a "common ground that unites the therapists of today with the philosophers of the past" (p. 17). Their effort succeeds brilliantly in reconnecting psychology and philosophy and, by that homecoming, to ground psychotherapy (including contemporary psychoanalysis) as a "human science." The book begins by sketching ideas about truth we inherit from the Greeks, then shows how Descartes and Pascal helped launch the Enlightenment with their thinking about truth and the limits of reason. Kant, Hegel, and Marx broaden the scope to include reason, the unconscious, and the course of history. Kierkegaard and Nietzsche interject angst and authenticity. Dilthey proposes a human science neither scientistic nor irrational. Husserl launches phenomenology as the proper study of experience; Scheler, Jaspers and Heidegger react in their particular ways. Freud and Jung come to loggerheads over the unconscious. Buber, Binswanger, and Boss further develop existential-phenomenological perspectives in terms of human interrelatedness. Confrontation with the other and the limits of reciprocity engage Sartre, Lacan, and Laing. Psychoanalysis grows intersubjectively through the work of Sullivan, Fromm, Merleau-Ponty, Benjamin, and Stolorow. Postmodernism's excess, Frie and Burston conclude, requires acknowledgment of an authentic self answerable for choices in life: '...[W]e are both determined by, and exercise our agency in determining, the communicative contexts in which we exist" (p. 262). Psychotherapy from this existential-phenomenological perspective becomes "a rigorous exploration of our ways of making meaning--both consciously and unconsciously" (p. 263). The book ends, then, with an affirmation

  4. Use of a horror film in psychotherapy.

    Science.gov (United States)

    Turley, J M; Derdeyn, A P

    1990-11-01

    Modern improvements in the technology of cinematic special effects have ushered in a new genre of vivid and graphic horror film. The numerous sequels of these films attest to their popularity among adolescents and young adults. Considerable concern has arisen on the part of parents, professionals, and policymakers regarding adverse effects of these films upon children. The authors discuss the meaning of a horror film to a troubled 13-year-old boy and describe the use of the film in his psychotherapy. The modern horror film serves many of the same functions for the adolescent that the traditional fairy tale serves for the younger child.

  5. Near-death experiences and psychotherapy.

    Science.gov (United States)

    Griffith, Linda J

    2009-10-01

    Psychiatrists are likely to come into contact with patients who have had near-death experiences, who may have a variety of reactions to the experience, and who may benefit from psychotherapy. We may also have opportunities to work with individuals who are reacting to others who have had such experiences. There is much a psychiatrist can offer to these people, including listening respectfully, being nonjudgemental, normalizing the experience, providing education, and assisting with integrating the experience into their lives to develop or maintain the best possible functioning.

  6. Rates and predictors of referral for individual psychotherapy, group psychotherapy, and medications among Iraq and Afghanistan veterans with PTSD.

    Science.gov (United States)

    Mott, Juliette M; Barrera, Terri L; Hernandez, Caitlin; Graham, David P; Teng, Ellen J

    2014-04-01

    This study examined rates of referral for medication, individual psychotherapy, and group psychotherapy within a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty mental health clinic. Participants were 388 Iraq and Afghanistan veterans who were referred for PTSD treatment following a mental health evaluation required for all new VA enrollees. The majority of the sample was referred for medication (79 %), with comparatively fewer referrals for individual (39 %) or group psychotherapy (24 %). Forty percent of participants were referred for combined medication and psychotherapy. Patient demographic and clinical characteristics were examined to determine whether these variables predicted referral type. Female veterans and those with lower clinician ratings of overall functioning were more likely to be referred for individual therapy. Group psychotherapy referrals were more common in veterans who were older, unemployed, identified as an ethnic minority, and had a comorbid anxiety disorder. There were no significant predictors of medication referral.

  7. Human otoacariasis:Demographic and clinical outcomes in patients with ear-canal ticks and a review of literature

    Institute of Scientific and Technical Information of China (English)

    Taliye Cakabay; Ozan Gokdogan; Murat Kocyigit

    2016-01-01

    Introduction:Otoacariasis is a rare infestation of the ear canal, which affects the quality of life especially in rural areas. Different types of ticks and mites may cause otoacariasis. Although treatment of otoacariasis is simple, diseases transmitted through ticks and mites should be considered during diagnosis and treatment. Both local and systemic signs and symptoms of such diseases should be followed up. A literature review was conducted in PubMed using the following terms:“otoacariasis,”“ticks,”“mites,”and“outer ear canal infestations.”Demographic, radiologic, and treatment options were discussed. Treatment hints and pitfalls were also discussed with the literature review. Conclusion:In this paper, we describe otoacariasis in humans and discuss the appropriate interventions. Copyright © 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  8. Maternal satisfaction as an outcome criterion in research on labor analgesia: data analysis from the recent literature.

    Science.gov (United States)

    Dualé, Christian; Nicolas-Courbon, Aurélie; Gerbaud, Laurent; Lemery, Didier; Bonnin, Martine; Pereira, Bruno

    2015-03-01

    To investigate whether maternal satisfaction (MS) is taken into consideration as an outcome criterion in clinical research on analgesia for labor. A systematic review of articles reporting analgesia for labor from a panel of 17 influential journals was undertaken. A total of 116 articles were analyzed, including 282 within-study groups. The scope of MS, the type of outcome measure used, and the time of measurement were noted. Each available observation was assigned an ordinal value of MS (ordMS), according to data distribution. The factors influencing ordMS were identified by multivariable analysis. The methods used to assess MS were very variable, even within the different measurement tools reported. The weighted distribution of ordMS was 17.8%, 21.8%, 31.2%, and 29.3% for levels "poor," "fair," "good," and "excellent," respectively. In comparative studies, statistical differences for analgesia were related to statistical differences for MS (Pvalue was high (0.87). Power to detect a difference in MS between treatment groups was low in general, but it influenced reporting of a significant difference for MS (P<0.0001). The obstetrical factors influencing ordMS were: the body mass index, the initial cervical dilatation, and the within-study percentage of nulliparous women. The techniques alternative to epidural analgesia negatively influenced ordMS. A standard and validated tool to assess MS in clinical research on analgesia for labor is still to be developed. Power should be improved by acting on sample sizes or sensitivity of the outcome.

  9. Outcome of pregnancy in women treated with all-trans retinoic acid; a case report and review of literature.

    Science.gov (United States)

    Valappil, Saudabi; Kurkar, Micheal; Howell, Rosemary

    2007-10-01

    All-trans-retinoic acid (ATRA) has been proved to be an effective treatment for acute promyelocytic leukemia (APL), inducing remission in more than 90% of cases. Treatment of APL in pregnancy is controversial as the use of ATRA has been questioned due to the teratogenic effect of retinoids. We report a case of pregnancy in a woman exposed to ATRA during the first trimester. The baby was born healthy, without any anomalies. Review of all reported cases of the use of ATRA in pregnancy revealed no serious adverse outcomes or congenital anomalies although only very few cases had exposure in the first trimester.

  10. Severe Aplastic Anemia following Acute Hepatitis from Toxic Liver Injury: Literature Review and Case Report of a Successful Outcome

    Directory of Open Access Journals (Sweden)

    Kamran Qureshi

    2014-01-01

    Full Text Available Hepatitis associated aplastic anemia (HAAA is a rare syndrome in which severe aplastic anemia (SAA complicates the recovery of acute hepatitis (AH. HAAA is described to occur with AH caused by viral infections and also with idiopathic cases of AH and no clear etiology of liver injury. Clinically, AH can be mild to fulminant and transient to persistent and precedes the onset SAA. It is assumed that immunologic dysregulation following AH leads to the development of SAA. Several observations have been made to elucidate the immune mediated injury mechanisms, ensuing from liver injury and progressing to trigger bone marrow failure with the involvement of activated lymphocytes and severe T-cell imbalance. HAAA has a very poor outcome and often requires bone marrow transplant (BMT. The findings of immune related myeloid injury implied the use of immunosuppressive therapy (IST and led to improved survival from HAAA. We report a case of young male who presented with AH resulting from the intake of muscle building protein supplements and anabolic steroids. The liver injury slowly resolved with supportive care and after 4 months of attack of AH, he developed SAA. He was treated with IST with successful outcome without the need for a BMT.

  11. Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature

    Science.gov (United States)

    Akhlaghi, Najmeh; Khademi, Abbasali

    2015-01-01

    Vital pulp therapy (VPT) is a biologic and conservative treatment modality to preserve the vitality and function of the coronal or remaining radicular pulp tissue in vital permanent teeth. A search was conducted via the Cochrane database, PubMed, MEDLINE, and Ovid for any articles with the criteria for “pulp-capping,” or “pulp-capping materials” and “VPT outcomes” from 1978 to mid 2014. All articles were evaluated and the valid papers were selected. The outcomes of various VPT techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and complete pulpotomy in vital permanent teeth were extracted. Although various studies have different research approach, most studies noted a favorable treatment outcome. Mineral trioxide aggregate (MTA) appears to be more effective than calcium hydroxide (Ca(OH)2) for maintaining long-term pulp vitality after indirect and direct pulp-capping. However, it seems that the success rate for partial pulpotomy and pulpotomy with Ca(OH)2 is similar to MTA. PMID:26604953

  12. Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. II. Psychotherapy alone or in combination with antidepressant medication.

    Science.gov (United States)

    Parikh, Sagar V; Segal, Zindel V; Grigoriadis, Sophie; Ravindran, Arun V; Kennedy, Sidney H; Lam, Raymond W; Patten, Scott B

    2009-10-01

    In 2001, the Canadian Psychiatric Association and the Canadian Network for Mood and Anxiety Treatments (CANMAT) partnered to produce evidence-based clinical guidelines for the treatment of depressive disorders. A revision of these guidelines was undertaken by CANMAT in 2008-2009 to reflect advances in the field. This article, one of five in the series, reviews new studies of psychotherapy in the acute and maintenance phase of MDD, including computer-based and telephone-delivered psychotherapy. The CANMAT guidelines are based on a question-answer format to enhance accessibility to clinicians. Evidence-based responses are based on updated systematic reviews of the literature and recommendations are graded according to the Level of Evidence, using pre-defined criteria. Lines of Treatment are identified based on criteria that included evidence and expert clinical support. Cognitive-Behavioural Therapy (CBT) and Interpersonal Therapy (IPT) continue to have the most evidence for efficacy, both in acute and maintenance phases of MDD, and have been studied in combination with antidepressants. CBT is well studied in conjunction with computer-delivered methods and bibliotherapy. Behavioural Activation and Cognitive-Behavioural Analysis System of Psychotherapy have significant evidence, but need replication. Newer psychotherapies including Acceptance and Commitment Therapy, Motivational Interviewing, and Mindfulness-Based Cognitive Therapy do not yet have significant evidence as acute treatments; nor does psychodynamic therapy. Although many forms of psychotherapy have been studied, relatively few types have been evaluated for MDD in randomized controlled trials. Evidence about the combination of different types of psychotherapy and antidepressant medication is also limited despite widespread use of these therapies concomitantly. CBT and IPT are the only first-line treatment recommendations for acute MDD and remain highly recommended for maintenance. Both computer-based and

  13. A Register-Based Study of Occupational Functioning in Non-Psychotic Patients Before and After Psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Poulsen, Stig Bernt; Mortensen, Erik Lykke;

    2013-01-01

    . Patients who completed treatment (completer patients) had, on average, 15.7 days on sick leave two years before treatment and 23.1 days on sick leave two years after treatment, while the control group had 5.4 and 7.5 days, respectively. Regarding disability pension, completer patients had 7.6 days before...... higher number of days on sick leave (pp=0.010) compared to the control group, while the change in days with unemployment was insignificant (p=0.501). Conclusion: Occupational outcome of psychotherapy may be less advantageous than shown in previous studies. Differences can...... perhaps be explained by the length and symmetry of the observation period before and after intervention. Other possible reasons for the outcome are: disorder chronicity; a labor market that excludes individuals with mental disorders; and that psychotherapy does not address occupational functioning....

  14. Optimal duration of combined psychotherapy and pharmacotherapy for patients with moderate and severe depression: A meta-analysis

    DEFF Research Database (Denmark)

    Møldrup, Claus; Østergaard, Svetlana

    2011-01-01

    Background: To investigate the most effective duration of combined psychotherapy and pharmacotherapy for achieving remission and preventing relapse in depressive patients compared to pharmacotherapy alone. Methods: A systematic review of English articles using PubMed, EMBASE, Web of Science...... of the studies, clinical binary outcomes such as response, remission or relapse were extracted. Result: All pooled analyses were based on random-effects models. Twenty-one articles describing the influence of additional psychotherapy on remission and 15 articles reporting the influence on relapse in depression......, the Cochrane Library, and PsychINFO was performed in September 2009. Clinical studies comparing pharmacotherapy alone with pharmacotherapy in combination with a psychological intervention for depression treatment that reported response, remission or relapse as outcomes were included in the analysis. For each...

  15. Psychotherapy, psychoanalysis and urban poverty in Argentina.

    Science.gov (United States)

    Epele, Maria Esther

    2016-12-01

    Based on ethnographic research carried out in the Buenos Aires Metropolitan Area, this paper examines the views of social actors on the psychoanalytically-oriented psychotherapy focused on marginalized populations. From Foucault's perspective on the forms of truth-telling, the aim of this paper is to analyze, as a preliminary research report, treatments according to the native ways of speaking and listening, which dominate the description of therapeutic experiences of patients who come to the treatment without any professional intermediation. The neoliberal transformations of the past decades in Argentina changed both the landscape of the public health system and the daily lives of marginalized people. Considering such changes, this paper examines the ways in which verbal actions (speaking and listening) take place in psychotherapy and mark the course not only of treatments but also the temporal rhythms of their development, and their various levels of efficacy. Finally, the discussion focuses on how ways of speaking and listening in treatments are modeled not only by institutional dynamics but also by the characteristics these verbal activities take in everyday life under the logics of power that prevail over them.

  16. Metacognitive mastery dysfunctions in personality disorder psychotherapy.

    Science.gov (United States)

    Carcione, Antonino; Nicolò, Giuseppe; Pedone, Roberto; Popolo, Raffaele; Conti, Laura; Fiore, Donatella; Procacci, Michele; Semerari, Antonio; Dimaggio, Giancarlo

    2011-11-30

    Individuals with personality disorders (PDs) have difficulties in modulating mental states and in coping with interpersonal problems according to a mentalistic formulation of the problem. In this article we analyzed the first 16 psychotherapy sessions of 14 PD patients in order to explore whether their abilities to master distress and interpersonal problems were actually impaired and how they changed during the early therapy phase. We used the Mastery Section of the Metacognition Assessment Scale, which assesses the use of mentalistic knowledge to solve problems and promote adaptation. We explored the hypotheses that a) PD patients had problems in using their mentalistic knowledge to master distress and solve social problems; b) the impairments were partially stable and only a minimal improvement could be observed during the analyzed period; c) patients' mastery preferences differed from one another; d) at the beginning of treatment the more effective strategies were those involving minimal knowledge about mental states. Results seemed to support the hypotheses; the patients examined had significant difficulties in mastery abilities, and these difficulties persisted after 16 sessions. Moreover, the attitudes towards problem-solving were not homogenous across the patients. Lastly, we discuss implications for assessment and treatment of metacognitive disorders in psychotherapy.

  17. Religious Cognitive-Emotional Therapy :A New Form of Psychotherapy

    Directory of Open Access Journals (Sweden)

    Ali Reza Rajaei

    2010-08-01

    Full Text Available "nFrom the ancient times up to this date, it has been thought that religion and spirituality have important effects on human being's mental life. However, some psychologists and psychotherapists have ignored this role ,and thus neglected to study the effects of applying religion and spirituality in psychotherapy. However, many psychologists and psychotherapists have recently studied the relationship between religion or spirituality and mental health ; or used religious interventions in psychotherapies . Although different kinds of religious psychotherapies have been proposed, no comprehensive theory has been presented in this area. In this article a scientific ,comprehensive and applied spiritual method of psychotherapy is suggested . Religious Cognitive- Emotional Therapy (RCET is a new form of cognitive therapy that uses the basic religious beliefs and insights in psychotherapy. RCET is a new integration of cognitive, humanistic, and existential psychotherapies that takes into account religious beliefs and insights of the clients. RCET is an effective method of psychotherapy for the treatment of those who suffer from identity crisis , depression , and anxiety ; and it can be developed to address other psychological disorders as well . Because RCET is a new approach, practically is needed to do further theoretical research in this area.

  18. Religious cognitive-emotional therapy: a new form of psychotherapy.

    Science.gov (United States)

    Rajaei, Ali Reza

    2010-01-01

    From the ancient times up to this date, it has been thought that religion and spirituality have important effects on human being's mental life. However, some psychologists and psychotherapists have ignored this role, and thus neglected to study the effects of applying religion and spirituality in psychotherapy. However, many psychologists and psychotherapists have recently studied the relationship between religion or spirituality and mental health; or used religious interventions in psychotherapies. Although different kinds of religious psychotherapies have been proposed, no comprehensive theory has been presented in this area. In this article a scientific, comprehensive and applied spiritual method of psychotherapy is suggested. Religious Cognitive- Emotional Therapy (RCET) is a new form of cognitive therapy that uses the basic religious beliefs and insights in psychotherapy. RCET is a new integration of cognitive, humanistic, and existential psychotherapies that takes into account religious beliefs and insights of the clients. RCET is an effective method of psychotherapy for the treatment of those who suffer from identity crisis, depression, and anxiety; and it can be developed to address other psychological disorders as well. Because RCET is a new approach, practically is needed to do further theoretical research in this area.

  19. Religious Cognitive–Emotional Therapy: A New Form of Psychotherapy

    Science.gov (United States)

    2010-01-01

    From the ancient times up to this date, it has been thought that religion and spirituality have important effects on human being's mental life. However, some psychologists and psychotherapists have ignored this role, and thus neglected to study the effects of applying religion and spirituality in psychotherapy. However, many psychologists and psychotherapists have recently studied the relationship between religion or spirituality and mental health; or used religious interventions in psychotherapies. Although different kinds of religious psychotherapies have been proposed, no comprehensive theory has been presented in this area. In this article a scientific, comprehensive and applied spiritual method of psychotherapy is suggested. Religious Cognitive- Emotional Therapy (RCET) is a new form of cognitive therapy that uses the basic religious beliefs and insights in psychotherapy. RCET is a new integration of cognitive, humanistic, and existential psychotherapies that takes into account religious beliefs and insights of the clients. RCET is an effective method of psychotherapy for the treatment of those who suffer from identity crisis, depression, and anxiety; and it can be developed to address other psychological disorders as well. Because RCET is a new approach, practically is needed to do further theoretical research in this area. PMID:22952497

  20. The impact of maxillary osteotomy on speech outcomes in cleft lip and palate: an evidence-based approach to evaluating the literature.

    Science.gov (United States)

    Pereira, Valerie; Sell, Debbie; Tuomainen, Jyrki

    2013-01-01

    Objective : To undertake a critical and systematic review of the literature on the impact of maxillary advancement on speech outcomes in order to identify current best evidence. Design and Main Outcome Measures : The following databases were searched: PubMed, CINAHL, and The Cochrane Controlled Trials Register. In addition, reference lists were hand searched for additional articles. Using a predefined framework and set criteria, evidence was evaluated using the assignment of levels of evidence (at least Level III on the evidence hierarchy), calculation of post-hoc power (≥ 0.8), effect size (Cohen's d ≥ 0.5), and adaptation of the parameters as set out by The Cochrane Collaboration. Results : Of the 40 studies identified, the majority (68%) fell within Level III.ii, representing cohort-type studies and a fifth (20%) within Level IV, the weakest form of evidence. Power and effect size calculations were only possible in 9 studies for different speech outcomes, and only seven studies met the set criteria for best evidence. Accordingly, current best evidence for articulation exists only for a noncleft population, is conflicting for resonance and nasalance, and is mixed for velopharyngeal function depending on which instrumental measure is used. Conclusions : There is an obvious need for further prospective research in the field with strong speech methodology such as the undertaking of interrater and intrarater reliability, adequate follow-up, and sufficient sample sizes based on a priori power analyses. Methodologic issues are discussed and recommendations made.

  1. Feto-maternal outcomes of pregnancy complicated by ovarian malignant germ cell tumor: a systematic review of literature.

    Science.gov (United States)

    Kodama, Michiko; Grubbs, Brendan H; Blake, Erin A; Cahoon, Sigita S; Murakami, Ryusuke; Kimura, Tadashi; Matsuo, Koji

    2014-10-01

    Malignant germ cell tumors (MGCT) are a rare type of ovarian cancer with poorly understood behavior during pregnancy. This systematic review evaluated feto-maternal outcomes and management patterns of 102 ovarian MGCT-complicated pregnancies identified in PubMed/MEDLINE. Mean age was 25.8. The most common histology type was dysgerminoma (38.2%) followed by yolk sac tumor (30.4%). Abdomino-pelvic pain (35.3%) was the most common symptom. The majority were stage I disease (76.4%) with a mean tumor size of 17.9cm. Most cases had live births (77.5%) at term (56.6%). Tumor surgery without fetal conservation took place in 22 (21.6%) cases (Group 1). This group was characterized by the first trimester tumor detection and intervention, non-viable pregnancy, and frequent concurrent hysterectomy. There were 59 (57.8%) cases which underwent expectant management of pregnancy: mean delay 16.4 weeks for 46 (45.1%) cases with tumor surgery and fetal conservation (Group 2); and 7.8 weeks for 13 (12.7%) cases with tumor surgery after delivery (Group 3). The live birth rate in Groups 2 and 3 was 98.3%. There were 21 (20.6%) cases in which the tumor was incidentally found intra/postpartum (Group 4). Group 2 showed the highest 5-year overall survival rate (92.8%) followed by Group 4 (79.5%), Group 3 (71.4%), and Group 1 (56.2%, p=0.028). Group 1 had more advanced-stage disease when compared to Group 2 (proportion of stages II-IV disease, 36.4% versus 11.4%, p=0.023). In multivariate analysis, age ≤20 (p=0.032) and stages II-IV (p=0.02) remained independent prognosticators for decreased overall survival in all cases. Expectant management of pregnancy was not associated with poor survival outcome in multivariate analysis (p=0.43). In conclusion, our analysis demonstrated that timing of tumor intervention and delivery significantly impacted feto-maternal outcome of ovarian MGCT-complicated pregnancies. It is suggested that early detection and tumor intervention with expectant

  2. Mediators and Moderators in Meta-Analysis: There's a Reason We Don't Let Dodo Birds Tell Us Which Psychotherapies Should Have Prizes.

    Science.gov (United States)

    Shadish, William R., Jr.; Sweeney, Rebecca B.

    1991-01-01

    Focusing on psychotherapy research, illustrates methods for studying mediator and moderator variables in meta-analysis, discusses their advantages and disadvantages, and shows how inclusion of these variables can change interpretation of meta-analytic results. Notes that therapeutic orientation may make significant difference to outcome but only…

  3. Evidence showing the relationship between sagittal balance and clinical outcomes in surgical treatment of degenerative spinal diseases: a literature review.

    Science.gov (United States)

    Le Huec, Jean-Charles; Faundez, Antonio; Dominguez, Dennis; Hoffmeyer, Pierre; Aunoble, Stéphane

    2015-01-01

    The measure of radiographic pelvic and spinal parameters for sagittal balance analysis has gained importance in reconstructive surgery of the spine and particularly in degenerative spinal diseases (DSD). Fusion in the lumbar spine may result in loss of lumbar lordosis (LL), with possible compensatory mechanisms: decreased sacral slope (SS), increased pelvic tilt (PT) and decreased thoracic kyphosis (TK). An increase in PT after surgery is correlated with postoperative back pain. A decreased SS and/or abnormal sagittal vertical axis (SVA) after fusion have a higher risk of adjacent segment degeneration. High pelvic incidence (PI) increases the risk of sagittal imbalance after spine fusion and is a predictive factor for degenerative spondylolisthesis. Restoration of a normal PT after surgery is correlated with good clinical outcome. Therefore, there is a need for comparative prospective studies that include pre- and postoperative spinopelvic parameters and compare complication rate, degree of disability, pain and quality of life.

  4. An Overview of Cancer Rehabilitation and Exercise in the Literature: Promoting Increased Referrals to Improve Oncology Outcomes

    Directory of Open Access Journals (Sweden)

    Leslie J. Waltke

    2014-08-01

    Full Text Available Medical management for malignant neoplastic diseases includes surgery, chemotherapy, radiation, and hormonal and biological therapies. Each of these antineoplastic interventions has unique impacts on physiological, musculoskeletal and functional performance. Cancer rehabilitation is the area of physical medicine responsible for addressing impairments associated with cancer treatment and survivorship, advanced disease and end of life. Although it is expected that more than one-half of persons being treated for cancer will suffer moderate pain and physical and functional decline, and that most will describe fatigue, referrals to rehabilitation are traditionally low. Evidence suggests that referrals to rehabilitation before, during and after treatment for neoplastic disease may improve physiological and functional performance, quality of life and survival outcomes. Oncology practitioners are encouraged to refer patients undergoing cancer treatment to a rehabilitation professional at the peridiagnosis period.

  5. Prenatal diagnosis and outcome of absent pulmonary valve syndrome: contemporary single-center experience and review of the literature.

    Science.gov (United States)

    Wertaschnigg, D; Jaeggi, M; Chitayat, D; Shannon, P; Ryan, G; Thompson, M; Yoo, S J; Jaeggi, E

    2013-02-01

    To review the anomaly spectrum of prenatally detected absent pulmonary valve syndrome (APVS) and the outcome after diagnosis. Previous fetal studies reported survival rates of ≤ 25% for patients with intended postnatal care. Clinical data and echocardiograms of 12 cases with a fetal diagnosis of APVS between 2000 and 2010 were analyzed in this retrospective single-center study. Collected parameters included: gestational age at referral, associated fetal abnormalities, cardiothoracic ratio, maximum diameters of pulmonary annulus and main and branch pulmonary arteries, ventricular dimensions and function as well as ventricular Doppler flows. Karyotyping included fluorescence in-situ hybridization (FISH) analysis for microdeletion 22q11.2. Median gestational age at diagnosis was 24 weeks. Three subtypes of APVS were observed: (1) with tetralogy of Fallot (TOF) and no arterial duct (n = 10; 83%); (2) isolated, with a large arterial duct (n = 1; 8%); and (3) with tricuspid atresia, right ventricular dysplasia and a restricted duct (n = 1; 8%). The cardiothoracic ratio and pulmonary artery dimensions were increased in all cases. The karyotype was abnormal in 70% of fetuses with TOF and their mortality rate was significantly higher due to pregnancy termination (n = 3) or perinatal demise (n = 2) (hazard ratio, 5; 95% CI, 0.87-28.9; P = 0.015). Of seven live births with active postnatal care, six children (86%) were alive without residual respiratory symptoms at a median follow-up of 4.7 (range, 2.1-10.6) years. Outcome after fetal diagnosis of APVS was significantly better in this study compared with those of previous fetal series, with a low mortality rate for actively managed patients. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  6. Psicoterapia psicodinâmica e o tratamento do jogo patológico Psychodynamic psychotherapy and the treatment of pathological gambling

    Directory of Open Access Journals (Sweden)

    Richard J. Rosenthal

    2008-05-01

    ão evitativo de comportamento e defesas psicodinâmicas.OBJECTIVE: The search for empirically based treatments for pathological gambling is in its infancy, with relatively few clinical trials and an absence of naturalistic studies. Treatment retention of gamblers has been a problem; cognitive-behavioral treatment and pharmacotherapy studies report especially high dropout rates. Psychodynamic approaches, with their emphasis on the therapeutic relationship, and the meaning of the patient's self-destructive and seemingly irrational behaviors, and on obstacles to self-forgiveness, might improve outcome. METHOD: After a description of psychodynamic psychotherapy, the literature on both short-term and longer therapies is reviewed regarding their efficacy for a variety of disorders. With regard to pathological gambling, the author summarizes the early (1914-1970 psychoanalytic literature then reviews the more recent psychodynamic psychotherapy literature on pathological gambling. RESULTS: A review of the recent psychodynamic psychotherapy literature on pathological gambling failed to disclose a single randomized controlled study of treatment efficacy or effectiveness. However, there are eight positive outcome studies described as multi-modal eclectic; half of those seem to utilize psychodynamic approaches. Two of the more successful programs are described. CONCLUSIONS: A review of the outcomes literature for psychodynamic psychotherapy demonstrates efficacy for a variety of disorders sufficient to justify a clinical trial for pathological gambling. Short-term psychodynamic psychotherapy, with its focus on core issues, may be particularly applicable to the pathological gambler's need to avoid or escape intolerable affects and problems. Longer therapies may be needed to modify an avoidant coping style and defenses.

  7. Maintaining boundaries in psychotherapy: Covert narcissistic personality characteristics and psychotherapists.

    Science.gov (United States)

    Luchner, Andrew F; Mirsalimi, Hamid; Moser, Casey J; Jones, Rebecca A

    2008-03-01

    The psychological literature to date has identified more than one form of narcissism: the more well-known grandiose form, and the less familiar and recognized covert form. Although the distinction between these two narcissistic types has been identified with regard to better conceptualizing client dynamics, there has been much less written about how covert narcissistic tendencies and traits may affect psychotherapists and psychotherapy. This paper uses psychodynamic theory to highlight the role that covert narcissistic characteristics may have on the psychotherapists' ability to maintain boundaries, potentially leading to boundary transgressions (existing along a continuum from therapeutically useful to maladaptive and anti-therapeutic). Specific therapeutic situations have been delineated to increase therapists' recognition and awareness of themes that may emerge and compromise the boundaries between themselves and their clients. Areas of focus include narcissism and its forms, the possible connection between covert narcissism in psychotherapists and the impact on managing boundaries, the potential therapeutic implications of covert narcissistic tendencies in psychotherapists, and the implications of covert narcissistic personality characteristics on treatment, supervision, and training. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  8. Sensitivity analysis in multiple imputation in effectiveness studies of psychotherapy

    Science.gov (United States)

    Crameri, Aureliano; von Wyl, Agnes; Koemeda, Margit; Schulthess, Peter; Tschuschke, Volker

    2015-01-01

    The importance of preventing and treating incomplete data in effectiveness studies is nowadays emphasized. However, most of the publications focus on randomized clinical trials (RCT). One flexible technique for statistical inference with missing data is multiple imputation (MI). Since methods such as MI rely on the assumption of missing data being at random (MAR), a sensitivity analysis for testing the robustness against departures from this assumption is required. In this paper we present a sensitivity analysis technique based on posterior predictive checking, which takes into consideration the concept of clinical significance used in the evaluation of intra-individual changes. We demonstrate the possibilities this technique can offer with the example of irregular longitudinal data collected with the Outcome Questionnaire-45 (OQ-45) and the Helping Alliance Questionnaire (HAQ) in a sample of 260 outpatients. The sensitivity analysis can be used to (1) quantify the degree of bias introduced by missing not at random data (MNAR) in a worst reasonable case scenario, (2) compare the performance of different analysis methods for dealing with missing data, or (3) detect the influence of possible violations to the model assumptions (e.g., lack of normality). Moreover, our analysis showed that ratings from the patient's and therapist's version of the HAQ could significantly improve the predictive value of the routine outcome monitoring based on the OQ-45. Since analysis dropouts always occur, repeated measurements with the OQ-45 and the HAQ analyzed with MI are useful to improve the accuracy of outcome estimates in quality assurance assessments and non-randomized effectiveness studies in the field of outpatient psychotherapy. PMID:26283989

  9. Neuropsychologically informed strategic psychotherapy in teenagers and adults with ADHD.

    Science.gov (United States)

    Seidman, Larry J

    2014-10-01

    Stimulants are the primary treatment for ADHD. Psychotherapy may augment pharmacologic treatment. In this article, we discuss strategies psychotherapists may use in working with teenagers and adults, including individuals who reject medications or take them suboptimally. Individuals with ADHD often have other psychiatric issues, including affective or cognitive comorbidities. Having ADHD does not protect people from the difficulties of life, and psychotherapy can help to disentangle "ADHD" from other issues. A psychotherapist knowledgeable about ADHD assessment can improve diagnostic precision. Psychotherapy can integrate forms of treatment in which the central goal is increasing mastery and competence of the individual.

  10. The application of Peplau's theory to group psychotherapy.

    Science.gov (United States)

    Lego, S

    1998-06-01

    This paper illustrates the application of Hildegard Peplau's Interpersonal Theory of Nursing to group psychotherapy. The phases of the nurse-patient relationship, including orientation, identification, exploitation and resolution, are described as they relate to group psychotherapy, and clinical examples are presented. The clinical examples also demonstrate the patient's movement in group therapy through the steps of the learning process: observation, description, analysis, formulation, validation, testing, integration and utilization. Finally, the roles of the nurse including stranger, resource person, teacher, leader, surrogate and counsellor are described as they occur in group psychotherapy.

  11. Using interpersonal psychotherapy (IPT) to treat depression in older primary care patients.

    Science.gov (United States)

    Post, Edward P; Miller, Mark D; Schulberg, Herbert C

    2008-03-01

    Depression in older adults is associated with substantial morbidity as well as mortality related to both suicide and nonsuicide causes. Lessening the burden of untreated depression in the elderly requires a flexible approach to treatment that incorporates the patient's life circumstances and treatment preferences. Interpersonal psychotherapy (IPT) is a time-limited, evidence-based psychosocial intervention used to treat depression either alone or in combination with medication. Familiarity with its features and use can assist geriatric clinicians in optimizing outcomes for their patients with depression.

  12. Clinical features and outcome of typhoid fever and invasive non-typhoidal salmonellosis in a tertiary hospital in Belgium: analysis and review of the literature.

    Science.gov (United States)

    Yombi, J C; Martins, L; Vandercam, B; Rodriguez-Villalobos, H; Robert, A

    2015-08-01

    Typhoid fever (TF) occurs rarely in industrialized countries because of advances in health care and improvement of drinking water. Conversely, non-typhoid salmonellosis (NTS) remains widespread, because of food contamination or asymptomatic carriage. Non-typhoid salmonellosis can be severe when becoming invasive non-typhoid salmonellosis (iNTS). Although established prognostic indicators of the two pathologies are different, direct comparisons between iNTS and TF in the literature remain scarce. The purpose of this study was to analyse and compare demographic, clinical features and outcome of hospitalized patients with TF and iNTS. Demographic, clinical features and outcome were retrospectively analysed in a series of patients hospitalized between 2007 and 2012. A total of 33 patients were enrolled, including 13 with established TF and 20 with iNTS. No differences between TF and iNTS patients were observed in incidence of fever, abdominal cramps, diarrhoea, headache, nausea and vomiting and duration of antibiotic therapy (≤ 7 days in both groups). Although the clinical outcome of TF patients was identical to that of iNTS patients, including incidence of complications, length of hospitalization and mortality (1/13 (7.7%) vs 2/20 (10%), P = 0.43), comorbidities were less frequent in the TF group than in the iNTS group (2/13 vs 15/20, P = 0.003). The clinical profile and outcome of TF patients are similar to those with iNTS. Although comorbidities are more often associated with iNTS, the results of our study suggest that clinical management of these two diseases should remain similar.

  13. Combination of pharmacotherapy and psychotherapy in the treatment of chronic depression: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    von Wolff Alessa

    2012-06-01

    Full Text Available Abstract Background Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences. This review examined whether the combination of pharmacological treatments and psychotherapy is associated with higher effectiveness than pharmacotherapy alone via meta-analysis; and identified possible treatment effect modifiers via meta-regression-analysis. Methods A systematic search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL, MEDLINE, EMBASE, ISI Web of Science, BIOSIS, PsycINFO, and CINAHL. Primary efficacy outcome was a response to treatment; primary acceptance outcome was dropping out of the study. Only randomized controlled trials were considered. Results We identified 8 studies with a total of 9 relevant comparisons. Our analysis revealed small, but statistically not significant effects of combined therapies on outcomes directly related to depression (BR = 1.20 with substantial heterogeneity between studies (I² = 67%. Three treatment effect modifiers were identified: target disorders, the type of psychotherapy and the type of pharmacotherapy. Small but statistically significant effects of combined therapies on quality of life (SMD = 0.18 were revealed. No differences in acceptance rates and the long-term effects between combined treatments and pure pharmacological interventions were observed. Conclusions This systematic review could not provide clear evidence for the combination of pharmacotherapy and psychotherapy. However, due to the small amount of primary studies further research is needed for a conclusive decision.

  14. Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zwerenz Rüdiger

    2012-12-01

    Full Text Available Abstract Background There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. Our study determines the efficacy of a manualized short-term psychodynamic psychotherapy and predictors of outcome by personality and quality of the therapeutic relationship. Methods/design Eligible breast cancer patients with comorbid depression are assigned to short-term psychodynamic psychotherapy (up to 20 + 5 sessions or to treatment as usual (augmented by recommendation for counseling center and physician information. We plan to recruit a total of 180 patients (90 per arm in two centers. Assessments are conducted pretreatment, after 6 (treatment termination and 12 months (follow-up. The primary outcome measures are reduction of the depression score in the Hospital Anxiety and Depression Scale and remission of depression as assessed by means of the Structured Clinical Interview for DSM IV Disorders by independent, blinded assessors at treatment termination. Secondary outcomes refer to quality of life. Discussion We investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment. Trial registration ISRCTN96793588

  15. Initial and last manifest dream reports of patients in psychodynamic psychotherapy and combined psychotherapy/pharmacotherapy.

    Science.gov (United States)

    Glucksman, Myron L; Kramer, Milton

    2012-12-01

    The initial and last manifest dream reports (MDRs) of 30 patients who had either successfully terminated, or continued to make satisfactory progress at an advanced stage of psychodynamic psychotherapy and combined psychotherapy/pharmacotherapy, were rated according to the following variables: Affect and Affect Valence; Affect Valence of Associations and Direction of Association Themes; Dream Narrative; Psychodynamic Formulation; Transference; and Dream Theme. Similar to previous studies, the initial MDRs contained more negative than positive affect. Conversely, the last MDRs contained more positive than negative affect. Associations to initial MDRs contained more negative affect; on the other hand, associations to last MDRs contained more positive affect. Direction of association themes were more negative in initial MDRs and more positive in last MDRs. Dream narratives were more negative in initial MDRs and more positive in last MDRs. Psychodynamic formulations were more negative in initial MDRs and more positive in last MDRs. Transference was more negative in initial MDRs and more positive in last MDRs. Relational and injury dream themes occurred more frequently than others in both initial and last MDRs. Initial MDRs contained more injury dream themes than last MDRs. The findings of this study demonstrate that there is a correlation between MDR variables and clinical improvement during treatment. The patients in this study were selected by MG, the treating therapist, on the basis of satisfactory progress. The MDRs of patients who failed to progress or did poorly were not discussed in this report. The findings, therefore, must be taken as preliminary and indicate the need for further research on manifest dreams during psychotherapy and combined psychotherapy/pharmacotherapy.

  16. Resting-state connectivity predictors of response to psychotherapy in major depressive disorder.

    Science.gov (United States)

    Crowther, Andrew; Smoski, Moria J; Minkel, Jared; Moore, Tyler; Gibbs, Devin; Petty, Chris; Bizzell, Josh; Schiller, Crystal Edler; Sideris, John; Carl, Hannah; Dichter, Gabriel S

    2015-06-01

    connectivity of the right insula with the right middle temporal gyrus and the left intraparietal sulcus with the orbital frontal cortex. These results add to the nascent body of literature investigating pretreatment rs-fcMRI predictors of antidepressant treatment response and is the first study to examine rs-fcMRI predictors of response to psychotherapy.

  17. Lipid levels in dissociative disorders: effects of psychodynamic psychotherapy.

    Science.gov (United States)

    Damsa, Cristian; Lazignac, Coralie; Miller, Nick; Maris, Susanne; Adam, Eric; Rossignon, Kevin

    2014-09-01

    Although there are several data suggesting a link between lower lipids levels and the risk of suicide, there are few data concerning lower lipids levels in patients with dissociative disorders (DD). This is the first longitudinal study investigating the evolution of the lipids levels during a specific 8 weeks of psychodynamic psychotherapy (PP) for patients with DD. 32 patients diagnosed with DD (SCID for DSMIVR) were assessed with Dissociative Experiences Scale (DES), Clinical Global Impression and Improvement Scale and their lipids levels (total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein and very low density lipoprotein) were measured at inclusion and after 3 and 8 weeks of PP. 30 patients finished the study. There is a significant positive (p dissociation (DES scores) at the beginning and at the end of the study. Interestingly, we found a significant (p = 0.018) positive link between the reduction of the dissociation (DES) and the increase of the triglycerides levels after 8 weeks of treatment. While lower lipids seems related to a higher level of dissociation before and after the treatment, an increasing triglycerides level was observed after 8 weeks of PP in patients with a better outcome. Further studies are needed with larger samples and control groups, in order to confirm these preliminary data. These findings could open the way for hypothesis about the role of lipids in the pathophysiology of DD and raise the question of the patients with DD receiving antilipidemiants agents.

  18. Obesity and Its Potential Effects on Antidepressant Treatment Outcomes in Patients with Depressive Disorders: A Literature Review.

    Science.gov (United States)

    Woo, Young Sup; Seo, Hye-Jin; McIntyre, Roger S; Bahk, Won-Myong

    2016-01-12

    Accumulating evidence regarding clinical, neurobiological, genetic, and environmental factors suggests a bidirectional link between obesity and depressive disorders. Although a few studies have investigated the link between obesity/excess body weight and the response to antidepressants in depressive disorders, the effect of weight on treatment response remains poorly understood. In this review, we summarized recent data regarding the relationship between the response to antidepressants and obesity/excess body weight in clinical studies of patients with depressive disorders. Although several studies indicated an association between obesity/excess body weight and poor antidepressant responses, it is difficult to draw definitive conclusions due to the variability of subject composition and methodological differences among studies. Especially, differences in sex, age and menopausal status, depressive symptom subtypes, and antidepressants administered may have caused inconsistencies in the results among studies. The relationship between obesity/excess body weight and antidepressant responses should be investigated further in high-powered studies addressing the differential effects on subject characteristics and treatment. Moreover, future research should focus on the roles of mediating factors, such as inflammatory markers and neurocognitive performance, which may alter the antidepressant treatment outcome in patients with comorbid obesity and depressive disorder.

  19. Course and outcome of bipolar spectrum disorder in children and adolescents: a review of the existing literature.

    Science.gov (United States)

    Birmaher, Boris; Axelson, David

    2006-01-01

    The longitudinal course of children and adolescents with bipolar disorder (BP) is manifested by frequent changes in symptom polarity with a fluctuating course showing a dimensional continuum of bipolar symptom severity from subsyndromal to mood syndromes meeting full Diagnostic and Statistical Manual of Mental Disorders criteria. These rapid fluctuations in mood appear to be more accentuated than in adults with BP, and combined with the high rate of comorbid disorders and the child's cognitive and emotional developmental stage, may explain the difficulties encountered diagnosing and treating BP youth. Children and adolescents with early-onset, low socioeconomic status, subsyndromal mood symptoms, long duration of illness, rapid mood fluctuation, mixed presentations, psychosis, comorbid disorders, and family psychopathology appear to have worse longitudinal outcome. BP in children and adolescents is associated with high rates of hospitalizations, psychosis, suicidal behaviors, substance abuse, family and legal problems, as well as poor psychosocial functioning. These factors, in addition to the enduring and rapid changeability of symptoms of this illness from very early in life, and at crucial stages in their lives, deprive BP children of the opportunity for normal psychosocial development. Thus, early recognition and treatment of BP in children and adolescents is of utmost importance.

  20. Cryptogenic organizing pneumonia: clinical and radiological features, treatment outcomes of 17 patients, and review of the literature.

    Science.gov (United States)

    Niksarlıoğlu, Elif Yelda; Özkan, Gülcihan Zehra; Bakan, Nur Dilek; Yurt, Sibel; Kılıç, Lütfiye; Çamsarı, Güngör

    2016-12-20

    We evaluated patients with cryptogenic organizing pneumonia (COP) who attended our clinic. We retrospectively investigated the clinical and radiological findings, diagnostic methods, treatment, and follow-up outcomes of 17 patients who had been histopathologically diagnosed with COP. The mean age of the patients was 49.8 ± 10.4 years. The most common symptom was cough (n = 15; 88.2%) and the most common radiological finding (n = 10) was consolidation in the inferior lobes on thoracic computed tomography. The diagnosis of COP was made by open lung biopsy in 11 (64.7%) patients, transbronchial biopsy in 5 (29.4%), and video-assisted thoracoscopic surgery biopsy in 1 (5.9%). The mean follow-up period was 28.7 ± 25.0 (range: 3-85) months. Twelve patients received oral corticosteroid therapy and seven of them improved without any fibrotic changes. One patient refused treatment; a chest radiography of that patient was found to be normal at the end of the 20-month follow-up period. Three patients received no other therapy, as the lesion had been completely excised. Common symptoms included cough and dyspnea, while the main radiological presentation of COP was consolidation. Corticosteroids are a good treatment option in general, but relapse may occur.

  1. Outcome of endodontic surgery: a meta-analysis of the literature--part 1: Comparison of traditional root-end surgery and endodontic microsurgery.

    Science.gov (United States)

    Setzer, Frank C; Shah, Sweta B; Kohli, Meetu R; Karabucak, Bekir; Kim, Syngcuk

    2010-11-01

    The aim of this study was to investigate the outcome of root-end surgery. The specific outcome of traditional root-end surgery (TRS) versus endodontic microsurgery (EMS) and the probability of success for comparison of the 2 techniques were determined by means of meta-analysis and systematic review of the literature. An intensive search of the literature was conducted to identify longitudinal studies evaluating the outcome of root-end surgery. Three electronic databases (Medline, Embase, and PubMed) were searched to identify human studies from 1966 to October 2009 in 5 different languages (English, French, German, Italian, and Spanish). Relevant articles and review papers were searched for cross-references. Five pertinent journals (Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxillofacial Surgery) were individually searched back to 1975. Three independent reviewers (S.S., M.K., and F.S.) assessed the abstracts of all articles that were found according to predefined inclusion and exclusion criteria. Relevant articles were acquired in full-text form, and raw data were extracted independently by each reviewer. Qualifying papers were assigned to group TRS or group EMS. Weighted pooled success rates and relative risk assessment between TRS and EMS were calculated. A comparison between the groups was made by using a random effects model. Ninety-eight articles were identified and obtained for final analysis. In total, 21 studies qualified (12 for TRS [n = 925] and 9 for EMS [n = 699]) according to the inclusion and exclusion criteria. Weighted pooled success rates calculated from extracted raw data showed 59% positive outcome for TRS (95% confidence interval, 0.55-0.6308) and 94% for EMS (95% confidence interval, 0.8889-0.9816). This difference was statistically significant (P < .0005). The relative risk ratio

  2. Bifocal Intracranial Germinoma: A Retrospective Analysis of Treatment Outcomes in 20 Patients and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Weksberg, David C. [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Shibamoto, Yuta [Department of Radiology, Nagoya City University, Graduate School of Medical Sciences, Nagoya (Japan); Paulino, Arnold C., E-mail: apaulino@tmhs.org [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States)

    2012-03-15

    Purpose: Bifocal germinoma (BFG) is a rare intracranial neoplasm for which the choice of radiation therapy (RT) field is controversial. Some believe that BFG represents disseminated disease requiring craniospinal irradiation (CSI), whereas others believe that BFG represents localized disease and advocate for more limited fields. Methods and Materials: We analyzed 20 BFG patients at our institutions with classic bifocal lesions (pineal gland and suprasellar region). In addition, we identified 60 BFG patients from the literature. The RT fields, use of chemotherapy and extent of disease were recorded and analyzed for each patient. Results: There were 55 patients with bifocal lesions only (Group I), and 25 with bifocal lesions plus ventricular and/or CSF positive disease (Group II). The 5-year progression-free survival was 95% for Group I and 80% for Group II. In Group I, there were no failures in patients receiving CSI (n = 11), two spinal failures in those treated with more limited RT fields without chemotherapy (n = 17), and one spinal failure with chemotherapy (n = 23). In Group II, there were no failures in patients receiving CSI (n = 11), but four spinal failures were observed in patients receiving more limited RT fields with chemotherapy (n = 13); 1 patient who received whole-brain RT without chemotherapy experienced failure in the spine and brain. Conclusions: CSI is associated with excellent PFS in BFG. In Group I BFG patients, omission of spinal irradiation appears to be a reasonable approach, especially when chemotherapy is used. Patients with Group II BFG are best treated with CSI.

  3. Psychotherapy mediated by remote communication technologies: a meta-analytic review

    Directory of Open Access Journals (Sweden)

    Richards David

    2008-07-01

    Full Text Available Abstract Background Access to psychotherapy is limited by psychopathology (e.g. agoraphobia, physical disability, occupational or social constraints and/or residency in under-served areas. For these populations, interventions delivered via remote communication technologies (e.g. telephone, internet may be more appropriate. However, there are concerns that such delivery may influence the therapeutic relationship and thus reduce therapy effectiveness. This review aimed to determine the clinical effectiveness of remotely communicated, therapist-delivered psychotherapy. Methods Systematic review (including electronic database searching and correspondence with authors of randomised trials of individual remote psychotherapy. Electronic databases searched included MEDLINE (1966–2006, PsycInfo (1967–2006, EMBASE (1980–2006 and CINAHL databases (1982–2006. The Cochrane Central Register of Controlled Trials (CENTRAL and the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDAN-CTR. All searches were conducted to include studies with a publication date to July 2006. Results Thirteen studies were identified, ten assessing psychotherapy by telephone, two by internet and one by videoconference. Pooled effect sizes for remote therapy versus control conditions were 0.44 for depression (95%CI 0.29 to 0.59, 7 comparisons, n = 726 and 1.15 for anxiety-related disorders (95%CI 0.81 to 1.49, 3 comparisons, n = 168. There were few comparisons of remote versus face-to-face psychotherapy. Conclusion Remote therapy has the potential to overcome some of the barriers to conventional psychological therapy services. Telephone-based interventions are a particularly popular research focus and as a means of therapeutic communication may confer specific advantages in terms of their widespread availability and ease of operation. However, the available evidence is limited in quantity and quality. More rigorous trials are required to

  4. The influence of obesity and body mass index on the outcome of laparoscopic colorectal surgery: a systematic literature review.

    Science.gov (United States)

    Hotouras, A; Ribas, Y; Zakeri, S A; Nunes, Q M; Murphy, J; Bhan, C; Wexner, S D

    2016-10-01

    The relationship between obesity, body mass index (BMI) and laparoscopic colorectal resection is unclear. Our object was to assess systematically the available evidence to establish the influence of obesity and BMI on the outcome of laparoscopic colorectal resection. A search of PubMed/Medline databases was performed in May 2015 to identify all studies investigating the impact of BMI and obesity on elective laparoscopic colorectal resection performed for benign or malignant bowel disease. Clinical end-points examined included operation time, conversion rate to open surgery, postoperative complications including anastomotic leakage, length of hospital stay, readmission rate, reoperation rate and mortality. For patients who underwent an operation for cancer, the harvested number of lymph nodes and long-term oncological data were also examined. Forty-five studies were analysed, the majority of which were level IV with only four level III (Oxford Centre for Evidence-based Medicine 2011) case-controlled studies. Thirty comparative studies containing 23 649 patients including 17 895 non-obese and 5754 obese showed no significant differences between the two groups with respect to intra-operative blood loss, overall postoperative morbidity, anastomotic leakage, reoperation rate, mortality and the number of retrieved lymph nodes in patients operated on for malignancy. Most studies, including 15 non-comparative studies, reported a longer operation time in patients who underwent a laparoscopic procedure with the BMI being an independent predictor in multivariate analyses for the operation time. Laparoscopic colorectal resection is safe and technically and oncologically feasible in obese patients. These results, however, may vary outside of high volume centres of expertise. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  5. The Psychotherapy Process with Adolescents: A First Pilot Study and Preliminary Comparisons between Different Therapeutic Modalities Using the "Adolescent Psychotherapy Q-Set"

    Science.gov (United States)

    Bychkova, Tetyana; Hillman, Saul; Midgley, Nick; Schneider, Celeste

    2011-01-01

    An innovative methodology is presented for describing the therapeutic processes involved in five types of adolescent treatments: psychoanalysis, psychodynamic psychotherapy, cognitive-behavioural therapy, mentalisation-based treatment and interpersonal psychotherapy. Using the "Adolescent Psychotherapy Q-Set" (APQ), 18 experienced clinicians…

  6. Examining the Therapeutic Relationship and Confronting Resistances in Psychodynamic Psychotherapy

    Science.gov (United States)

    Gentile, Julie P.; Gillig, Paulette Marie

    2011-01-01

    Psychodynamic psychotherapy is effective for a variety of mental health symptoms. This form of psychotherapy uses patient self reflection and self examination, as well as the therapeutic relationship between the patient and psychiatrist, to explore maladaptive coping strategies and relationship patterns of the patient. A thorough understanding of resistance and the core conflictual relationship theme afford the psychiatrist the ability to facilitate this work. In this article, the composite case illustrates some of the psychodynamic psychotherapy techniques that can be employed in a psychotherapy case. In this example, the case is about a certified public accountant that came to treatment because of an acute stressor that put her career goals at risk. An acute episode or event can bring to light chronic and ongoing symptoms, which have had a remitting and relapsing course, and leave the patient unable to compensate on his or her own. PMID:21686147

  7. Verbal Response Mode Use by Clients in Psychotherapy.

    Science.gov (United States)

    Stiles, William B.; Sultan, Faye E.

    1979-01-01

    Verbal behavior in transcripts of psychotherapy was coded according to Stile's taxonomy of verbal response modes. Therapists of different theoretical persuasions used different mixtures of verbal techniques. Common elements that make verbal interaction psychologically therapeutic lie in client behavior. (Author)

  8. Gestalt psychotherapy in the outpatient treatment of borderline ...

    African Journals Online (AJOL)

    the use of Gestalt psychotherapy in the treatment of BPD patients. The authors ... psychological tests showed difficulties in social communication and adjustment, as .... impairments in reasoning, personality, movement, speech, social graces ...

  9. New medical psychotherapy CPT coding: the tail wagging the dog?

    Science.gov (United States)

    Clemens, Norman A

    2013-03-01

    The implications of the 2013 revised current procedural terminology (CPT) system for coding psychotherapy with medical evaluation and management (E&M) are discussed. The author expresses concern about a potential devaluing of psychotherapy because of the required order of reporting combined codes, with E&M the primary code. Procedural and documentation requirements for using the standard medical E&M codes challenge psychiatrists to be systematic and efficient in order not to interfere with time and attention essential to an effective psychotherapy process. Insensitive use of computers when working with patients can damage rapport and progress. The trend toward sharing personal health information in large systems calls for heightened discretion. Using the psychotherapy notes protected under the Health Insurance Portability and Accountability Act (HIPAA) for highly sensitive personal information is essential to preserve patient privacy.

  10. College Psychotherapy at a Hong Kong Counseling Center

    Science.gov (United States)

    Leung, Eugenie Y.

    2013-01-01

    This article presents an online interview about college psychotherapy at a Hong Kong counseling center. The interview discusses how students generally feel about going for counseling or therapy and how common it is in Hong Kong.

  11. Forgiveness in psychotherapy: the key to healing.

    Science.gov (United States)

    Menahem, Sam; Love, Melanie

    2013-08-01

    The process of forgiveness in psychotherapy involves both letting go of resentment toward the offender and replacing the resentment with mindful awareness and empathy. By reconceptualizing past transgressions with a kinder, more equivocal outlook, clients attain a shift in perspective that is spiritual and cognitive in nature, thereby reducing symptomology and enhancing their quality of life. Such insights bring clients toward their inner Buddha nature, which transcends the suffering associated with clinging to past hurts and resentment. This process is facilitated by techniques such as concentrative meditation and identifying with transgressors through perspective taking. Forgiveness therapy improves clients' sense of well-being by promoting feelings of peacefullness toward oneself as well as others.

  12. Analysis of transference in Gestalt group psychotherapy.

    Science.gov (United States)

    Frew, J E

    1990-04-01

    In Gestalt therapy, transference is viewed as a contact boundary disturbance which impairs the patient's ability to accurately perceive the present therapy situation. The boundary disturbances in Gestalt therapy most closely related to the analytic notion of transference are projection, introjection, and confluence. In Gestalt group psychotherapy, group members interfere with the process of need identification and satisfaction by distorting their contact with each other through projecting, introjecting, and being confluent. The Gestalt group therapist uses interventions directed to individuals and to the group to increase participants' awareness of these boundary disturbances and of the present contact opportunities available to them when these disturbances are resolved. In formulating interventions, the leader is mindful of the function of boundary disturbances to the group-as-a-whole as well as to individuals.

  13. Preferences for behavioural, analytic and gestalt psychotherapy.

    Science.gov (United States)

    Sobel, H J

    1979-09-01

    This study investigated preferences for behavioural, analytic and gestalt psychotherapy among a sample of 40 SES class III and IV adult females and 67 college freshmen who had never been actual therapy patients. A scaled survey assessed general preference, preference given an imagined long-standing depressive disorder, preference given an imagined specific phobia, and preference for the therapist-patient relationship. Three audio tapes were designed, each describing one of the modalities. High inter-rater reliability and agreement were determined by three independent judges. Results showed that young females had a general preference for gestalt therapy. Young and old females, but not young males, significantly preferred behavioural therapy for a specific phobia. Under forced-choice conditions the group as a whole significantly preferred gestalt therapy. No differences were found for the relationship or preference given a depressive disorder. Preference was hypothesized as a cognitive structure with potential use in therapist-client matching.

  14. Introduction: Science, Sexuality, and Psychotherapy: Shifting Paradigms.

    Science.gov (United States)

    Cerbone, Armand R

    2017-08-01

    This introduction presents an overview of the current issue (73, 8) of Journal of Clinical Psychology: In Session. This issue features a series of articles, with clinical cases, each presented to illustrate the challenges faced by individuals and couples whose sexual and gender identities and expressions do not comport with traditional and cultural norms. These articles also document the challenges to the therapists who treat them. Considered individually, each article underscores the need to recognize the importance of evidence in guiding psychotherapy in cases involving sexuality. The discussions in each article offer recommendations meant to help and guide psychotherapists. Considered collectively, they raise important questions and considerations about shifting paradigms of human sexuality. Implications for assessment and treatment of cases involving sexuality and gender identity are discussed and recommended. © 2017 Wiley Periodicals, Inc.

  15. The Use of Dreams in Psychotherapy

    Science.gov (United States)

    Schredl, Michael; Bohusch, Claudia; Kahl, Johanna; Mader, Andrea; Somesan, Alexandra

    2000-01-01

    Since the publication of Sigmund Freud's The Interpretation of Dreams, dream interpretation has been a standard technique often used in psychotherapy. However, empirical studies about the frequency of working on dreams in therapy are lacking. The present study elicited, via a self-developed questionnaire, various aspects of work on dreams applied by psychotherapists in private practice. The findings indicate that dreams were often used in therapy, especially in psychoanalysis. In addition, a significant relationship was found between the frequency of the therapists' working on their own dreams and frequency of work on dreams in therapy. Because work on dreams was rated as beneficial for the clients, further studies investigating the effectiveness and the process of working on dreams will be of interest. PMID:10793127

  16. The right brain is dominant in psychotherapy.

    Science.gov (United States)

    Schore, Allan N

    2014-09-01

    This article discusses how recent studies of the right brain, which is dominant for the implicit, nonverbal, intuitive, holistic processing of emotional information and social interactions, can elucidate the neurobiological mechanisms that underlie the relational foundations of psychotherapy. Utilizing the interpersonal neurobiological perspective of regulation theory, I describe the fundamental role of the early developing right brain in relational processes, throughout the life span. I present interdisciplinary evidence documenting right brain functions in early attachment processes, in emotional communications within the therapeutic alliance, in mutual therapeutic enactments, and in therapeutic change processes. This work highlights the fact that the current emphasis on relational processes is shared by, cross-fertilizing, and indeed transforming both psychology and neuroscience, with important consequences for clinical psychological models of psychotherapeutic change.

  17. Psychotherapy as a rite of passage.

    Science.gov (United States)

    Beels, C Christian

    2007-12-01

    Some psychotherapies may work because they resemble rites of passage. To explore this idea, this article describes an "individual" case of depression in which drug, cognitive, and narrative approaches fell short of effectiveness, and change occurred in a series of experiences that resemble a rite of passage. This resemblance is illuminated by examining two apparently quite different healing processes--Alcoholics Anonymous and multifamily group therapy in schizophrenia--to explore the elements they have in common with the case described: the acceptance of what Victor Turner called a liminal experience, and the importance of witnesses to the ritual support for that acceptance. The discussion contributes to a loosening of the distinctions between the processes of individual, family, group, and other social therapies and leads to questions about the expert knowledge the therapist provides.

  18. Safety and outcome of treatment of metastatic melanoma using 3-bromopyruvate: a concise literature review and case study.

    Science.gov (United States)

    El Sayed, Salah Mohamed; Mohamed, Walaa Gamal; Seddik, Minnat-Allah Hassan; Ahmed, Al-Shimaa Ahmed; Mahmoud, Asmaa Gamal; Amer, Wael Hassan; Helmy Nabo, Manal Mohamed; Hamed, Ahmed Roshdi; Ahmed, Nagwa Sayed; Abd-Allah, Ali Abdel-Rahman

    2014-07-01

    3-Bromopyruvate (3BP) is a new, promising anticancer alkylating agent with several notable functions. In addition to inhibiting key glycolysis enzymes including hexokinase II and lactate dehydrogenase (LDH), 3BP also selectively inhibits mitochondrial oxidative phosphorylation, angiogenesis, and energy production in cancer cells. Moreover, 3BP induces hydrogen peroxide generation in cancer cells (oxidative stress effect) and competes with the LDH substrates pyruvate and lactate. There is only one published human clinical study showing that 3BP was effective in treating fibrolamellar hepatocellular carcinoma. LDH is a good measure for tumor evaluation and predicts the outcome of treatment better than the presence of a residual tumor mass. According to the Warburg effect, LDH is responsible for lactate synthesis, which facilitates cancer cell survival, progression, aggressiveness, metastasis, and angiogenesis. Lactate produced through LDH activity fuels aerobic cell populations inside tumors via metabolic symbiosis. In melanoma, the most deadly skin cancer, 3BP induced necrotic cell death in sensitive cells, whereas high glutathione (GSH) content made other melanoma cells resistant to 3BP. Concurrent use of a GSH depletor with 3BP killed resistant melanoma cells. Survival of melanoma patients was inversely associated with high serum LDH levels, which was reported to be highly predictive of melanoma treatment in randomized clinical trials. Here, we report a 28-year-old man presented with stage IV metastatic melanoma affecting the back, left pleura, and lung. The disease caused total destruction of the left lung and a high serum LDH level (4,283 U/L). After ethics committee approval and written patient consent, the patient received 3BP intravenous infusions (1-2.2 mg/kg), but the anticancer effect was minimal as indicated by a high serum LDH level. This may have been due to high tumor GSH content. On combining oral paracetamol, which depletes tumor GSH, with 3BP

  19. Safety and outcome of treatment of metastatic melanoma using 3-bromopyruvate:a concise literature review and case study

    Institute of Scientific and Technical Information of China (English)

    Salah Mohamed El Sayed; Ali Abdel-Rahman Abd-Allah; Walaa Gamal Mohamed; Minnat-Allah Hassan Seddik; Al-Shimaa Ahmed Ahmed; Asmaa Gamal Mahmoud; Wael Hassan Amer; Manal Mohamed Helmy Nabo; Ahmed Roshdi Hamed; Nagwa Sayed Ahmed

    2014-01-01

    3-Bromopyruvate (3BP) is a new, promising anticancer alkylating agent with several notable functions. In addition to inhibiting key glycolysis enzymes including hexokinase II and lactate dehydrogenase (LDH), 3BP also selectively inhibits mitochondrial oxidative phosphorylation, angiogenesis, and energy production in cancer cells. Moreover, 3BP induces hydrogen peroxide generation in cancer cells (oxidative stress effect) and competes with the LDH substrates pyruvate and lactate. There is only one published human clinical study showing that 3BP was effective in treating fibrolamellar hepatocellular carcinoma. LDH is a good measure for tumor evaluation and predicts the outcome of treatment better than the presence of a residual tumor mass. According to the Warburg effect, LDH is responsible for lactate synthesis, which facilitates cancer cell survival, progression, aggressiveness, metastasis, and angiogenesis. Lactate produced through LDH activity fuels aerobic cell populations inside tumors via metabolic symbiosis. In melanoma, the most deadly skin cancer, 3BP induced necrotic celldeath in sensitive cels, whereas high glutathione (GSH) content made other melanoma cels resistant to 3BP. Concurrent use of a GSH depletor with 3BP killed resistant melanoma cells. Survival of melanoma patients was inversely associated with high serum LDH levels, which was reported to be highly predictive of melanoma treatment in randomized clinical trials. Here, we report a 28-year-old man presented with stage IV metastatic melanoma affecting the back, left pleura, and lung. The disease caused total destruction of the left lung and a high serum LDH level (4,283 U/L). After ethics committee approval and written patient consent, the patient received 3BP intravenous infusions (1-2.2 mg/kg), but the anticancer effect was minimal as indicated by a high serum LDH level. This may have been due to high tumor GSH content. On combining oral paracetamol, which depletes tumor GSH, with 3BP treatment

  20. Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

    Science.gov (United States)

    2014-01-01

    Objective To identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts. Design This is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts. Results This review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme. Conclusion Through a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts. PMID:24521004