Hasil untuk "Therapeutics. Psychotherapy"

A. Horvath, A. D. Del Re, C. Flückiger et al.

S. Garfield, A. Bergin, W. Dryden

Acileide Cristiane Fernandes Coelho, Maria Inês Gandolfo Conceição

Este artículo propone una reflexión sobre los aspectos teóricos y prácticos de las intervenciones psicosociales en comunidades, con énfasis en la trayectoria profesional y las transformaciones producidas por la movilización e interacción comunitaria, entendidas como elementos centrales del proceso de intervención. A partir de experiencias en contextos comunitarios brasileños, se destaca el poder de los vínculos y la participación que se construyen en el encuentro entre profesionales y actores locales. Los caminos recorridos en estas experiencias dieron lugar a una guía metodológica para la acción psicosocial en la comunidad, que incluye etapas como la preparación del profesional en el diagnóstico territorial, la identificación de la demanda, la movilización, la intervención misma, el intercambio y la desconexión de las acciones. A lo largo de este recorrido, se discuten las acciones fundamentales y el cuidado ético involucrados en el desarrollo de las intervenciones comunitarias, entendidas como prácticas sustentadas por la escucha sensible, el respeto mutuo y la construcción colectiva.

Dr. Hiba Saeed, Dr. Sana Akram, Dr Hussain Ahmad Saeed et al.

Background: Hamstring strain injuries commonly affect athletes particularly those engaging in activities that involve frequent high velocity and quick changes in direction. Such injuries cause severe pain, limitation of motion, and reduction in trunk muscular endurance and thus require longer time to rehabilitation. Objective: To determine the effects of multimodal intervention on pain, range of motion and trunk endurance in patients with hamstring strain injury. Methodology: A randomized controlled trial (RCT) was conducted with 60 participants (aged 18-30) divided into two groups: a control group receiving conventional physical therapy (CPT) and an intervention group receiving a multimodal intervention over six weeks. Data was collected using visual analogue scale, goniometer and trunk endurance test. Data was analyzed using SPSS 25. Results: Both groups showed significant improvements (p < 0.001). By the 6th week, Group B achieved superior outcomes, with knee flexion increasing from 90.08° to 127.31° (p = 0.002), hip extension rising from 4.28° to 10.17° (p < 0.001), pain levels decreasing from 9.06 to 4.67 (p < 0.001), and trunk endurance improving from 2.17 to 3.72 (p = 0.045). In comparison, Group A showed improvements in knee flexion (89.89° to 118.31°), hip extension (3.81° to 7.78°), pain (8.31 to 5.78), and trunk endurance (1.78 to 3.22), but with less significant differences. Conclusion: Multimodal intervention significantly improves pain levels, ROM, and trunk endurance in patients with hamstring strain injury, offering a comprehensive approach to rehabilitation. Keywords: Hamstring muscles, muscle stretching exercises, pain management, ROM

Jefryadi Jefryadi, Lilis Setiawati, Lusi Fatmita AS et al.

This research explores the impact of parenting, online game usage, and peer interaction on elementary school (SD) student’s academic achievement. Various factors often affect academic achievement, including environment, family, digital habits, and social relationships. With the development of technology and the changing dynamics of family, it is vital to understand how these factors mutually interact and affect the student’s academic development. Type research descriptive associative explaining​ the extent of the impact of parenting, online game usage, and peer interaction on elementary school student’s academic achievement in Lubuk Linggau. This research uses a sample of 150 respondents from 3000 elementary school students in Lubuk Linggau. Path analysis uses the SPSS program to process data. The research results show that parenting, online game usage, and peer interaction significantly affect elementary school students' academic achievement. However,​ there are research findings that parents do not affect academic achievement, as mediated by peer interactions. These results show that parents must implement pattern-supportive care​ for student development​, limit excessive online game usage, and monitor interaction with their students' social lives to ensure positive academic achievement

Jacob B. Nienhuis, Jesse Owen, J. Valentine et al.

Mayelin Rey

Behnood Behmanesh, Khadijeh Abolmaali Alhosseini, Mehran Azadi

Separation anxiety disorder is one of the issues and problems that lead to academic failure and huge losses for the parents and society. This is a qualitative research on separation anxiety disorder in preschool children. The present research method was qualitative with a grounded theory approach based on Charmaz constructivist model. The population included mothers of children with separation anxiety disorder in Tehran in 2020, from whom 10 mothers were selected by homogeneous purposeful sampling until saturation. The semi-structured interview method was used to collect data and the data were analyzed with the MAXQDA software 2020 version. 370 primary codes, 4 themes including the position of strategic management application, the position of the determining father-affected mother, the effective position of the underlying factors, and the position of the child's sensitivity in infancy and childhood and showed a central category of early sensitivity to interactions and environment. It can be concluded that inadequate understanding of interactions and dysfunctional parenting strategies are effective in separation anxiety, and therefore to prevent this disorder, parental educational interventions and the involvement of fathers in parenting are recommended.

Ana Casas Dorado

F. Falkenström, N. Solomonov, Julian A. Rubel

The introduction of novel methodologies in the past decade has advanced research on mechanisms of change in observational studies. Time-lagged panel models allow to track session-by-session changes and focus on within-patient associations between predictors and outcomes. This shift is crucial, as change in mechanisms inherently takes place at a within-patient level. These models also enable preliminary casual inferences, which can guide the development of effective personalized interventions that target mechanisms of change, used at specific treatment phases for optimal effect. Given their complexity, panel models need to be implemented with caution, as different modeling choices can significantly affect results and reduce replicability. We outline three central methodological recommendations for use of time-lagged panel analysis to study mechanisms of change: a) Taking patient-specific effects into account, separating out stable between-person differences from within-person fluctuations over time; b) properly controlling for autoregressive effects; c) considering long-term time-trends. We demonstrate these recommendations in an applied example examining the session-by-session alliance-outcome association in a naturalistic psychotherapy study. We present limitations of time-lagged panel analysis and future directions.

Matt Blanchard, B. Farber

Abstract Objective: To identify psychotherapy clients’ motives for concealing suicidal ideation from their therapist, and their perceptions of how their therapists could better elicit honest disclosure. Method: A sample of 66 psychotherapy clients who reported concealing suicidal ideation from their therapist provided short essay responses explaining their motives for doing so and what their therapist could do to help them be more honest. Content analysis was used to identify major motives and themes in these responses. Results: Seventy percent of suicidal ideation concealers cited fear of unwanted practical impacts outside therapy as the reason they did not disclose. Chief among these unwanted impacts was involuntary hospitalization, a perceived outcome of disclosing even mild suicidal thoughts. Less concrete motives for concealment, such as shame or embarrassment, were significant but secondary concerns. Nearly half of suicide-concealing clients said they would be more honest only if the threat of hospitalization was somehow reduced or controlled. Conclusion: Fostering disclosure of suicidal ideation in therapy may require renewed attention to providing transparent, comprehensive, and easy-to-understand psychoeducation about the triggers for hospitalization and other interventions. Clients make risk-benefit calculations about whether to disclose suicidal ideation, but may operate with exaggerated or inaccurate ideas about the consequences of disclosure.

Genevieve Marais, Alistair McBeath

The impact and challenges of therapist self-disclosure on the disclosing therapist was explored using Reflexive Thematic Analysis of five interviews with integrative psychotherapists. Three main themes were created: ‘Ambivalent understandings’, ‘Risking rupture and transgression?’ and ‘Regrets, risks and rewards’. Therapist self-disclosure was revealed as a complex and multi-faceted phenomenon which evokes a range of feelings in therapists including regret, anxiety, vulnerability, guilt but also a driving belief that it can enhance client well-being. Therapist self-disclosure is seen as best used sparingly, appropriately, and in alignment with client well-being. A discussion draws out some implications for appropriate clinical practice.

Tamara S. Yatsenko

Benjamin Kraus, G. Dammann, M. Rudaz et al.

Abstract Background: The model of Operationalized Psychodynamic Diagnosis and the model of Personality Organization influenced the concept of the Level of Personality Functioning (LPF) in DSM-V. The LPF is becoming a key variable for diagnostics, treatment and outcome measurement, but there are few studies which integrate the LPF in the study design. This study pursues to expand this body of knowledge by investigating the research question: would an inpatient psychotherapy lead to significant improvements in the LPF? Methods: The study included 156 inpatients at the Psychiatric Hospital Münsterlingen, Switzerland. Exclusion criteria were aggression, psychosis, mental retardation, and participation in another study. The LPF was measured with the Operationalized Psychodynamic Diagnosis—Structure Questionnaire (OPD-SQ) and the short version of the Inventory of Personality Organization (IPO-16) at admission and termination of treatment about eleven weeks later. A repeated-measures ANOVA controlled for age, symptom load, treatment duration and gender was conducted. Results: Data revealed significant, medium improvements for OPD-SQ (F(2,88) = 8.24, p < .01,  = 0.09) and IPO-16 (F(2,91) = 6.09, p < .05,  = 0.06) between admission and termination of psychotherapy and a different change pattern for OPD-SQ and IPO-16. Conclusion: Inpatient psychotherapy is associated with improvements in LPF.

Magnus Nordmo, Jon T Monsen, P. Høglend et al.

Abstract Findings from previous psychotherapy research suggest that the majority of improvement takes place in the initial phase of treatment with the relative effectiveness dropping at a negatively accelerating rate. However, the evidence for this pattern of change comes from investigations of short-term treatments and it is unclear whether this also holds for more flexible and long-term psychotherapy. We provided open-ended treatments under routine-care conditions for a representative sample of 362 patients, including a large proportion characterized by severe psychopathology. Patients attended 52 sessions on average (SD = 59, range = 1-364, Mdn = 36). Our results indicated that the degree of improvement was linearly associated with time spent in psychotherapy and contingent upon the severity of psychological problems at intake. The least severely afflicted received the shortest treatments, experienced the most rapid change but demonstrated smaller overall magnitudes of improvement. More severely suffering patients received longer treatments, had slower rates of change but in general received greater overall benefits. We argue that previous suggestions of psychotherapy dosage have been less appropriate for patients suffering from moderate to severe psychopathology.

Christina S. Soma, Brian R. Baucom, Bo Xiao et al.

Abstract Objective: Close interpersonal relationships are fundamental to emotion regulation. Clinical theory suggests that one role of therapists in psychotherapy is to help clients regulate emotions, however, if and how clients and therapists serve to regulate each other’s emotions has not been empirically tested. Emotion coregulation – the bidirectional emotional linkage of two people that promotes emotional stability – is a specific, temporal process that provides a framework for testing the way in which therapists’ and clients’ emotions may be related on a moment to moment basis in clinically relevant ways. Method: Utilizing 227 audio recordings from a relationally oriented treatment (Motivational Interviewing), we estimated continuous values of vocally encoded emotional arousal via mean fundamental frequency. We used dynamic systems models to examine emotional coregulation, and tested the hypothesis that each individual’s emotional arousal would be significantly associated with fluctuations in the other’s emotional state over the course of a psychotherapy session. Results: Results indicated that when clients became more emotionally labile over the course of the session, therapists became less so. When changes in therapist arousal increased, the client’s tendency to become more aroused during session slowed. Alternatively, when changes in client arousal increased, the therapist’s tendency to become less aroused slowed.

T. Furukawa, O. Efthimiou, Erica S. Weitz et al.

R. Kumsta

Many mental health difficulties have developmental origins. Understanding the mechanisms for how psychosocial experiences are biologically embedded and influence lifelong development is a key challenge for the mental health disciplines. In recent years, epigenetic processes have emerged as a potential mechanism mediating the long-lasting vulnerability following the experience of adversity. Animal models provide evidence that early-life adversity can produce enduring epigenetic modifications in the brain, which mediate disorder-like behaviours, and there is emerging evidence to support that environmental factors influence epigenetic processes in humans. The investigation of DNA methylation, a chemical modification of the DNA with a role in gene regulatory processes, is becoming increasingly popular in psychological studies. A particular interest for the psychotherapy field lies in the potential for psychological interventions to influence epigenetic processes. Hence, the focus of this review will be on studies that have investigated intervention-associated changes in DNA methylation. Results of the first few studies will be critically reviewed, and a model of how therapy-associated changes of DNA methylation in peripheral, non-brain tissue might be useful as epigenetic biomarkers of treatment outcome will be presented. PRACTITIONER POINTS: Many mental health difficulties have substantial developmental origin. Epigenetic processes have emerged as a potential mechanism mediating the long-term effects of early adversity Epigenetic refers to cellular mechanisms that control gene expression states, independent of changes to the underlying DNA sequence. The epigenome can be highly dynamic and potentially influenced by external factors A particular interest for the psychotherapy field lies in the potential for psychological interventions to influence epigenetic processes.

D. Fosha, Nathan C. Thoma

Psychotherapy has primarily focused on ameliorating symptoms and psychopathology. This is in contrast to positive psychology, which has focused on bringing about what Keyes (2002) has called "flourishing." Accelerated experiential dynamic psychotherapy (AEDP) seeks to bridge the two traditions by both relieving suffering through processing painful negative emotions to completion and then going on to foster flourishing, in session and beyond, through a technique called metatherapeutic processing. After a brief summary of the AEDP approach, the aim of this article is to elaborate specifically on metatherapeutic processing, where a focus on savoring and exploring the positive affects that accompany the change process itself can set into motion an upward spiral of positive affect that broadens and builds the treatment's effectiveness. We provide a how-to primer on metatherapeutic processing as well as annotated transcript material from three cases to illustrate the application of the technique. We describe how metatherapeutic processing can organically foster, from the bottom-up, positive feeling states labeled transformational affects, such as gratitude, love, hope, curiosity, and zest, freeing up these vital energies that were latent within the client. We go on to propose that although metatherapeutic processing was conceived of within the framework of AEDP, it is a technique that can be integrated into a wide variety of psychotherapies, to activate flourishing in session and beyond. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

A. McAleavey, S. Youn, Henry Xiao et al.

ABSTRACT Objective: Though many studies have shown that psychotherapy can be effective, psychotherapy available in routine practice may not be adequate. Several methods have been proposed to evaluate routine psychological treatments. The aim of this paper is to demonstrate the combined utility of complementary methods, change-based benchmarking, and end-state normative comparisons, across a range of self-reported psychological symptoms. Method: Benchmarks derived from randomized controlled trials (RCTs) and normative comparisons were used to evaluate the effectiveness of psychotherapy in a large (N = 9895) sample of clients in university counseling centers (UCCs). Results: Overall, routine psychotherapy was associated with significant improvement across all symptoms examined. For clients whose initial severity was similar to RCT participants, the observed pre–post effect sizes were equivalent to those in RCTs. However, treatment tended to lead to normative end-state functioning only for those clients who were moderately, but not severely, distressed at the start of psychotherapy. Conclusions: This suggests that although psychotherapy is associated with an effective magnitude of symptom improvement in routine practice, additional services for highly distressed individuals may be necessary. The methods described here comprise a comprehensive analysis of the quality of routine care, and we recommend using both methods in concert. Clinical or methodological significance of this article: This study examines the effectiveness of routine psychotherapy provided in a large network of counseling centers. By comparing multiple established methods to define outcomes in this sample we provide a detailed understanding of typical outcomes. The findings show that, across several different problem areas, routine psychotherapy provided substantial benefit, particularly to clients in the most distress. However, there is room to improve, especially by increasing the number of clients who return to normal functioning by the end of treatment. Using distinct methods provides complementary answers to the question: How effective is routine psychotherapy?