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Psychotherapeutic Intervention (psychotherapeutic + intervention)
Selected AbstractsEmotional issues after kidney transplantation: a prospective psychotherapeutic studyCLINICAL TRANSPLANTATION, Issue 6 2002Lyndsay S Baines Abstract:,Background:, Negative emotional states are the single most influential factor in determining quality of life after a successful kidney transplant. We designed a prospective study using psychotherapeutic principles to understand and intervene in emotional issues in adult recipients of first cadaver kidney transplants. Methods:, Forty-nine recipients of first cadaver kidney transplants were subjected to 12 sessions (at weekly intervals) of psychotherapy within 3 months of receiving their transplant. The Beck Depression Inventory (BDI) was utilized as a measure of change in emotional state, pretherapy, at 3, 6, 9 and 12 months. A higher score on BDI was suggestive of psychological dysfunction. In the first instance, data was analysed within a quantitative framework, by virtue of the BDI. In the second instance, data was considered in terms of recurring themes described by patients during psychotherapy and was analysed qualitatively. In the third instance, both qualitative and quantitative data was considered in terms of individual patient's ability to achieve some feeling of having implemented some social, relational and vocational equilibrium into their everyday life. Recipients of live kidneys, paediatric transplants and patients who received more than one transplant were excluded, as emotional issues are different in this cohort of patients. All patients have completed 1 yr of follow up. None of the patients were on antidepressant medication before or after therapy. Results:, This is an ongoing study in which we are comparing individual vs. group therapy vs. controls (who receive no therapy). The total number of patients recruited will be 120 and the final report will be available in 2003,04. The results reported in this paper form the 49 patients in the individual arm of the study. All the patients in our study happened to be white people. There was significant improvement in the BDI scores following therapy. The mean score was 26.3 ± 7.9 before and 20.5 ± 8.8 after therapy (p = 0.001); the lowering of the scores remained sustained at 12 months. Multivariate analysis of age, gender, employment status, duration of dialysis (if in dialysis for more than 3 yrs) and psychotherapy given before transplantation did not affect the results of our study. For the qualitative aspect of the study, we grouped the emotional problems as expressed by the patients into three recurring themes (i) fear of rejection, (ii) feelings of paradoxical loss post-transplant despite having received a successful transplant and (iii) the psychological integration of the newly acquired kidney. Conclusions:, Psychotherapeutic intervention was an effective means of addressing emotional problems in recipients of kidney transplants. The recurring themes as identified above provided a baseline for psychotherapeutic exploration and resolution of these issues. Successful resolution of these issues was associated with lower BDI scores and the redefinition of normality in daily living post-transplant. [source] Profile of depression in adolescents with inflammatory bowel disease: Implications for treatmentINFLAMMATORY BOWEL DISEASES, Issue 1 2009Eva Szigethy MD Abstract Background: The purpose was to determine the utility of including neurovegetative symptoms in assessments of depression in youth with inflammatory bowel disease (IBD). Methods: Forty-one youth with IBD and concurrent depressive symptomatology were enrolled in an intervention trial and received either 9 modules of cognitive-behavioral therapy (PASCET-PI) or treatment as usual (TAU). Youth and their primary caregivers completed the Children's Depression Inventory (CDI) at pre- (T1) and posttreatment (T2). Disease severity measures and current steroid dosage were obtained at each timepoint. Change in the individual items of the CDI was compared across groups and examined in association with change in physical illness course. Results: Paired sample t -tests revealed significant changes in CDI item scores from T1 to T2 for a majority of the depressive symptoms assessed in the PASCET-PI group, but not for the TAU group. These changes did not appear to be linked to changes in disease severity and/or steroid dosage across these same timepoints. Conclusions: The inclusion of somatic items in the assessment of depression in physically ill youth is important, as these symptoms seem to respond to psychotherapeutic intervention. The present results would suggest that improvements in depressive symptomatology are not solely related to improvements in the course of IBD and that these items do reflect an important part of the profile of depressive symptoms in youth with IBD. Future research is warranted to replicate present findings and explore the generalizability of these results to other pediatric illness populations. (Inflamm Bowel Dis 2008) [source] Presenting problems among treatment-seeking gay, lesbian, and bisexual youthJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2001Trevor A. Hart Gay, lesbian, and bisexual youth are at risk for a variety of clinical problems amenable to psychotherapeutic intervention. However, many psychotherapists may be unaware of the difficulties faced by this population. The purpose of this article is to familiarize therapists with presenting complaints common to psychotherapy-seeking gay, lesbian, and bisexual youth. Some of these problems include homophobia among family, peers, and authority figures (often expressed at school or at work), depression, suicidality, social anxiety, and body image disturbance. We illustrate these important issues via four case examples. © 2001 John Wiley & Sons, Inc. J Clin Psychol/In Session 57: 615,627, 2001. [source] Adolescent life events and adult mental health 5,9 years after referral for acute psychiatric outpatient treatmentCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2004T. Skarbų Knowledge is needed of mental health in relation to life events of former acute child and adolescent outpatients at risk of suicide. The present study describes the long-term mental health outcome of young adults who as children or adolescents were referred to outpatient psychiatry for mental health problems, and identifies putative mental health statistical outcome predictors at follow-up, with focus on life events. One hundred patients referred to treatment at child and adolescent outpatient clinics in Nordland County, Norway, during 1990,1994 were interviewed face to face, 5,9 years after referral. At follow-up, life events at young age were associated with the mental health status in spite of referral and acute psychotherapeutic intervention. There was a general effect of life events at young age, affecting a large number of mental health variables. Childhood and adolescence difficulties were highly correlated, indicating a possible continuation of effects from childhood to adolescence.,Copyright © 2004 John Wiley & Sons, Ltd. [source] Is one assessment enough?CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 5 2004Patterns of helping alliance development, outcome Early therapeutic alliance is usually measured by the rating of a single session (between the third and the fifth sessions). However, there is a strong argument in favor of viewing early alliance as a developing process. This study examined the relationship between patient's rating of the helping alliance (HAq) at each session and therapy outcome. This comparison was repeated using patterns of alliance over the course of treatment. Patterns of therapeutic alliance development were detected by clustering ratings of a sample of N = 70 outpatients across four sessions of very brief psychotherapeutic intervention. Cluster analysis revealed two main patterns (shapes) of alliance development: (i) stable alliance, and (ii) linear growth pattern. These patterns are more predictive of symptom improvement and social adjustment than single ratings, whereas single ratings measuring the strength of alliance are more correlated with patient's satisfaction.,Copyright © 2004 John Wiley & Sons, Ltd. [source] Cognitive therapy integrated with life review techniques: an eclectic treatment approach for affective symptoms in older adultsJOURNAL OF CLINICAL NURSING, Issue 1 2004William J. Puentes DNSc Background., An important aspect of nursing theory development has been the adaptation of theory from other disciplines within the metaparadigm of nursing. This eclectic approach to theory development enhances the broad humanistic theory base on which effective, professional nursing practice is based. Aims and objectives., The aim of this article is to describe the process of integrating two distinct psychotherapeutic approaches into one coherent mental health nursing intervention for the treatment of affective symptoms in older adults. Guidelines for using this integration process in psychiatric mental health nursing clinical practice are presented and illustrated through the case study approach. Methods., A case study is presented describing a clinical situation in which life review techniques were used to enhance the outcomes of a cognitive therapy experience for older adults enrolled in outpatient psychotherapy treatment for acute adjustment disorder with an affective component. Conclusions and relevance to clinical practice., The advanced practice psychiatric mental health nurse who approaches psychotherapeutic interventions with older adult clients from an eclectic approach can achieve successful outcomes by having a clear understanding of (i) the dynamics of the various psychotherapeutic approaches, (i) the skill level of the practitioner, (iii) the psychosocial sophistication of the client, and (iv) the pathology being treated. In addition, active involvement by the client in a treatment process that matches his/her psychosocial skill and coping resource level will contribute to effective resolution of pathology. A cognitive therapy approach supplemented by life review techniques is an excellent example of an effective, eclectic treatment approach of affective disorders in older adults. [source] A 1.5-year follow-up of an internet-based intervention for complicated griefJOURNAL OF TRAUMATIC STRESS, Issue 4 2007Birgit Wagner Only recently have psychotherapeutic interventions for complicated grief been developed and evaluated in randomized controlled trials. These trials have reported significant reductions in complicated grief and related symptoms in response to treatment relative to control groups. However, little is known about the long-term outcomes of these treatments. The authors present an evaluation of a 1.5-year follow-up of an Internet-based cognitive,behavioral intervention for complicated grief. Treatment group patients (n = 22) were administered various assessments of complicated grief indicators, including the Impact of Event Scale, the anxiety and depression subscales of the Brief Symptom Inventory, and the SF-12. Results indicate that the reduction in symptoms of complicated grief observed at posttreatment was maintained at 1.5-year follow-up. [source] Unlicensed Residential Programs: The Next Challenge in Protecting YouthAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2006Robert M. Friedman Over the past decade in the United States, the number of private residential facilities for youth has grown exponentially, and many are neither licensed as mental health programs by states, nor accredited by respected national accrediting organizations. The Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (A START) is a multi,disciplinary group of mental health professionals and advocates that formed in response to rising concerns about reports from youth, families and journalists describing mistreatment in a number of the unregulated programs. This article summarizes the information gathered by A START regarding unregulated facilities. It provides an overview of common program features, marketing strategies and transportation options. It describes the range of mistreatment and abuse experienced by youth and families, including harsh discipline, inappropriate seclusion and restraint, substandard psychotherapeutic interventions, medical and nutritional neglect, rights violations and death. It reviews the licensing, regulatory and accrediting mechanisms associated with the protection of youth in residential programs, or the lack thereof. Finally, it outlines policy implications and provides recommendations for the protection of youth and families who pursue residential treatment. [source] | |||||||||||||