Talking treatment in general.
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1426 to 1450 of 1,623Efficacy of psychoeducation on symptomatic and functional recovery in bipolar disorder.
Objective: To evaluate the efficacy of psychoeducation in the symptomatic and functional recovery, and quality of life (QoL) in a sample of patients with bipolar disorder (BD).
Method: The sample comprised 55 patients with BD I and II in remission (Young Mania Rating Scale ≤6 and Hamilton Depression Rating Scale ≤7). Out-patients were matched assigned to receive 16 sessions of psychoeducation [experimental group (EG)] or 16 sessions of placebo without psychoeducation [control group (CG)]. Groups were evaluated at study baseline, midpoint, endpoint, and at 6- and 12-month follow-ups.
Results: No significant differences between the groups were found for the variables evaluated (mood symptoms, functioning and QoL), except for overall clinical improvement, subjectively perceived by EG subjects. Both groups showed a trend toward improved clinical global impression and QoL (environmental). No …
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(Male) infertility: what does it mean to men? New evidence from quantitative and qualitative studies.
Scientific knowledge of the emotional repercussions of infertility on men remains limited and has only recently become the focus of social science research. Firstly, the current developments in research on the psychosocial impact of infertility on men through a search of the literature over the last 10 years are outlined in this paper. In the second section, issues raised in pretreatment counselling for men and their partner who consider donor insemination are described as this treatment typically raises many emotional issues. The results of more recent studies with sophisticated methodological design show that the emotional impact of infertility may be nearly balanced, suggesting that men do suffer as well and that they have to be addressed in infertility counselling too. The emotional and clinical aspects of donor insemination support the hypothesis that the emotional repercussions of …
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Parental HIV disclosure in Burkina Faso: experiences and challenges in the era of HAART.
Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However, limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children's role in their parents' treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex, parent's older age, parent's marital history …
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Disentangling self-stigma: are mental illness and help-seeking self-stigmas different?
Two established but disparate lines of research exist: studies examining the self-stigma associated with mental illness and studies examining the self-stigma associated with seeking psychological help. Whereas some researchers have implicitly treated these 2 constructs as synonymous, others have made the argument that they are theoretically and empirically distinct. To help clarify this debate, we examined in the present investigation the overlap and uniqueness of the self-stigmas associated with mental illness and with seeking psychological help. Data were collected from a sample of college undergraduates experiencing clinical levels of psychological distress (N = 217) and a second sample of community members with a self-reported history of mental illness (N = 324). Confirmatory factor analyses provide strong evidence for the factorial independence of the 2 types of self-stigma. Additio…
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Guydish J, Ziedonis D, Tajima B, Seward G, Passalacqua E, Chan M, Delucchi K, Zammarelli L, Levy M, Kolodziej M, Brigham G (2012)MEDLINE-indexed journal, not yet read by usDrug and alcohol dependence47 citations Addressing Tobacco Through Organizational Change (ATTOC) in residential addiction treatment settings.
Background: Smoking prevalence among persons in addiction treatment is 3-4 times higher than in the general population. However, treatment programs often report organizational barriers to providing tobacco-related services. This study assessed the effectiveness of a six month organizational change intervention, Addressing Tobacco Through Organizational Change (ATTOC), to improve how programs address tobacco dependence.
Methods: The ATTOC intervention, implemented in three residential treatment programs, included consultation, staff training, policy development, leadership support and access to nicotine replacement therapy (NRT) medication. Program staff and clients were surveyed at pre- and post-intervention, and at 6 month follow-up. The staff survey measured knowledge of the hazards of smoking, attitudes about and barriers to treating smoking, counselor self-efficacy in providing such …
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Training the brain: fact and fad in cognitive and behavioral remediation.
Putatively safe and effective for improving cognitive performance in both health and disease, products purported to train the brain appeal to consumers and healthcare practitioners. In an increasingly health-centered society, these applications constitute a burgeoning commercial market. Sparse evidence coupled with lack of scientific rigor, however, leaves claims concerning the impact and duration of such brain training largely unsubstantiated. On the other hand, at least some scientific findings seem to support the effectiveness and sustainability of training for higher brain functions such as attention and working memory. In the present paper we provide a tectonic integration and synthesis of cognitive training approaches. Specifically, we sketch the relative merits and shortcomings of these programs, which often appeal to parents who must choose between side-effect-laden medication an…
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Preferred therapist characteristics in treatment of anorexia nervosa: the patient's perspective.
Objective: Previous research in eating disorders suggests that treatment satisfaction is closely related to the manner in which care is delivered. The present research is a systematic in depth study of health professional characteristics preferred by AN-patients.
Method: Thirty-eight women with AN aged 18-51 were interviewed in depth using a phenomenological study design. Interviews were tape-recorded, transcribed, and analyzed using the QSR-NVivo7 software program.
Results: Four factors associated with patients' satisfaction with their therapists were identified: "acceptance," "vitality," "challenge," and "expertise." Patients' responses suggested that treatment of AN requires therapists who are capable of using a complex set of behaviors when interacting with their patients.
Discussion: There is accumulating evidence that across treatment modality, the manner in which treatment is deli…
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Factors affecting voluntary HIV counselling and testing among men in Ethiopia: a cross-sectional survey.
Background: Voluntary HIV counselling and testing (VCT) is one of the key strategies in the HIV/AIDS prevention and control programmes in Ethiopia. However, utilization of this service among adults is very low. The aim of the present study was to investigate factors associated with VCT utilization among adult men since men are less likely than women to be offered and accept routine HIV testing.
Methods: The study utilized data from the Ethiopian Demographic Health Survey (EDHS) 2005, which is a cross-sectional survey conducted on a nationally representative sample. Using cluster sampling, 6,778 men aged 15-59 years were selected from all the eleven administrative regions in Ethiopia. Logistic regression was used to analyze potential factors associated with VCT utilization.
Results: Overall, 21.9% of urban men and 2.6% of rural men had ever tested for HIV through VCT and most of them had …
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Holding parents so they can hold their children: grief work with surviving spouses to support parentally bereaved children.
A child's adjustment to the death of a parent is greatly influenced by the surviving parent's ability to attend to his or her own grief-related needs, to create and sustain a consistent and nurturing environment, and to encourage the child to express distressing or conflicting thoughts, feelings, and fantasies about the loss. Yet, the surviving parent's grief often compromises their ability to parent consistently and empathically. This article will illustrate how, by providing a holding environment for whole families, clinicians can help parents to facilitate children's grief reactions and, thus, mitigate long-term adverse mental health outcomes. Family Matters programs, designed and implemented in a community agency, use a holistic approach to family support and treatment in a milieu setting. Combining therapeutic work with surviving spouses and bereaved children supports children's gri…
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Women's decision making regarding choice of second trimester termination method for pregnancy complications.
Objective: To describe how women terminating a pregnancy for fetal or maternal complications decide between surgical (dilation and evacuation [D&E]) and medical abortion.
Methods: A qualitative study was conducted among women who underwent D&E or medical abortion before 24 weeks of gestation for fetal anomalies or pregnancy complications at an academic medical center where both methods are offered. Women were interviewed by phone 1 week after the procedure about their counseling experiences and reasons for choosing a particular method. Data were analyzed by 3 researchers using a grounded theory approach, and interviews were stopped upon thematic saturation.
Results: Of the 21 women, 13 (62%) chose D&E and 8 (38%) chose medical abortion. Key themes that emerged from the interviews were valuing the ability to choose the method, and the importance of religious beliefs, abortion attitudes, a…
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Smoking cessation counseling beliefs and behaviors of outpatient oncology providers.
Purpose: Many cancer patients continue to smoke after diagnosis, increasing their risk for treatment complications, reduced treatment efficacy, secondary cancers, and reduced survival. Outpatient oncology providers may not be using the "teachable moment" of cancer diagnosis to provide smoking cessation assistance. PROVIDERS AND METHODS: Physicians and midlevel providers (n = 74) who provide outpatient oncology services completed an online survey regarding smoking cessation counseling behaviors, beliefs, and perceived barriers. Outpatient medical records for 120 breast, lung, head and neck, colon, prostate, and acute leukemia cancer patients were reviewed to assess current smoking cessation assessment and intervention documentation practices.
Results: Providers reported commonly assessing smoking in new patients (82.4% frequently or always), but rates declined at subsequent visits for bot…
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"HIV isn't me…": HIV+ adolescents' experiences in a positive context of support and treatment.
We describe the experiences of a sample of Canadian HIV+ youth whose intact adolescent identities contrast sharply with the expected identity challenges of persons living with a serious, chronic disease. We first showcase the positive HIV+ identities emerging from the successful management of HIV+ status through long-term HIV-related medical care and established pharmaceutical regimes. Second, we describe the medical, familial, and broader social context of support in which these adolescents' are negotiating HIV. Finally, we highlight the youth's expectations of future, specific identity and role challenges regarding intimacy and sexuality-related to disclosure of their private HIV+ identities and their embodied HIV+ status. Continued social and medical supports will be key to their emergence into adulthood as healthy HIV+ persons; with such supports, these youths' experiences highlight …
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Struggling and enduring with God, religious support, and recovery from severe mental illness.
Objectives: People with severe mental illnesses may achieve varying degrees of recovery, including symptom reduction and community integration. Research also indicates that religiosity facilitates coping with psychological disorders. In this study, we assessed the relationship between religiosity and recovery from severe mental illnesses.
Design: Self-report data were collected from 81 participants with severe mental illnesses. We measured recovery, religious support, and participants' struggle or endurance with faith.
Results: Religious support and enduring with faith were positively associated with recovery. Struggling was negatively associated with recovery, and that relationship was mediated by religious support.
Conclusions: Religious variables, including religious support and spiritual struggle, might affect recovery from severe mental illnesses.
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Coaching for behavior change in physiatry.
Behavior modification is vital to the prevention or amelioration of lifestyle-related disease. Health and wellness coaching is emerging as a powerful intervention to help patients initiate and maintain sustainable change that can be critical to physiatry practice. The coach approach delivers a patient-centered collaborative partnership to create an engaging and realistic individualized plan. The coaching process builds the psychologic skills needed to support lasting change, including mindfulness, self-awareness, self-motivation, resilience, optimism, and self-efficacy. Preliminary studies indicate that health and wellness coaching is a useful and potentially important adjunct to usual care for managing hyperlipidemia, diabetes, cancer pain, cancer survival, asthma, weight loss, and increasing physical activity. Physiatrists can benefit from the insights of coaching to promote effective …
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Hartley MT (2011)MEDLINE-indexed journal, not yet read by usJournal of American college health : J of ACH73 citations Examining the relationships between resilience, mental health, and academic persistence in undergraduate college students.
Objective: In this study, the relationships between measures of interpersonal resilience, intrapersonal resilience, and mental health were examined with respect to academic and social integration, key determinants of academic persistence.
Participants: A sample (n = 605) of undergraduate students was recruited from 2 midwestern universities during the 2007-2008 academic year.
Methods: Hierarchal (or sequential) regression analysis examined whether the inter- and intrapersonal resilience and mental health measures contributed to explaining variance in the response variables of university cumulative grade point average (GPA) and university sense of belonging.
Results: The intrapersonal resilience factors contributed to explaining variance in cumulative GPA in addition to aptitude and achievement. Furthermore, there was a strong statistical correlation between the inter- and intrapersonal r…
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The metabolic fitness program: lifestyle modification for the metabolic syndrome using the resources of cardiac rehabilitation.
Purpose: To describe and assess the effectiveness of a lifestyle intervention program (Met Fit) designed to treat the metabolic syndrome (MetSyn) in a cardiac rehabilitation setting.
Methods: Met Fit is a physician referred and patient pay ($350) program consisting of 12 weekly sessions of 45 minutes of exercise and 45 minutes of education with target exercise recommendations of 150 to 200 minutes weekly and 5% loss in body weight using a Mediterranean-style diet. Primary outcomes are compliance with program recommendations and secondary outcomes effecting MetSyn components.
Results: Patients (N = 126) were enrolled between June 2005 and July 2009 averaging 9 per class. Mean (SD) age was 51(12) years, body mass index 38(6.9) kg/m, high density lipoprotein-cholesterol for men 37(9.4) mg/dL and women 46(10) mg/dL, glucose 121(39) mg/dL, and homeostatic model assessment of insulin resistanc…
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Quality of life measures in Islamic rectal carcinoma patients receiving counselling.
Aim: This prospective study was conducted to compare changes in the health-related quality of life (HRQoL) and religious practices of patients who underwent surgery for rectal cancer.
Method: We prospectively followed 93 Muslim patients after surgery for colorectal carcinoma: abdominoperineal excision (APE, n = 50), sphincter-saving resection (LAR, n = 22) or anterior resection including sigmoid colectomy (AR, n = 1). The HRQoL was measured pre- and postoperatively at 15-18 months with the Medical Outcomes Study Short Form 36 Health Survey (SF-36) and a modified version of the American Society of Colorectal Surgeons (ASCRS) Fecal Incontinence questionnaire. Life standards, including religious practice, were measured using the Ankara University Life Standard Questionnaire.
Results: No difference was detected in any SF-36 Health Survey HRQoL domain among the groups, although there were dif…
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Effects of adrenal sensitivity, stress- and cue-induced craving, and anxiety on subsequent alcohol relapse and treatment outcomes.
Context: Alcoholism is a chronic, relapsing illness in which stress and alcohol cues contribute significantly to relapse risk. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, increased anxiety, and high alcohol craving have been documented during early alcohol recovery, but their influence on relapse risk has not been well studied.
Objectives: To investigate these responses in treatment-engaged, 1-month-abstinent, recovering alcohol-dependent patients relative to matched controls (study 1) and to assess whether HPA axis function, anxiety, and craving responses are predictive of subsequent alcohol relapse and treatment outcome (study 2).
Design: Experimental exposure to stress, alcohol cues, and neutral, relaxing context to provoke alcohol craving, anxiety, and HPA axis responses (corticotropin and cortisol levels and cortisol to corticotropin ratio) and a prospective 90-d…
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Perinatal grief and support spans the generations: parents' and grandparents' evaluations of an intergenerational perinatal bereavement program.
Purpose: As perinatal loss, miscarriage, still birth, or neonatal death may result in signs and symptoms of grief in the entire family, perinatal bereavement programs (PBPs) should consider offering intergenerational services. The purpose of this program evaluation was to identify and evaluate siblings' and grandparents' utilization of a hospital-based PBP's intergenerational support services and education offerings with regard to the entire family's coping with the loss.
Methods: Written program evaluation surveys of parents and grandparents, with an opportunity for free response, along with parent phone follow-up, were utilized to evaluate whether a variety of inpatient/outpatient services for parents, siblings, and grandparents were useful to the entire family.
Results: Parents indicated that when siblings and grandparents were included in the PBP's services and education offerings, u…
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Neuro-chemical activation of brain reward meso-limbic circuitry is associated with relapse prevention and drug hunger: a hypothesis.
Background: It is no surprise that it has taken over four decades to confirm and extend the crucial role of dopamine and related genes and gene deficits in the etiology of risk for drug dependence. Hundreds of studies, enabled by neuroscience neuroimaging and genetic advances, have been reported. While dopamine theories have been reported, confirmed, replicated and replicated again, changes have been slow to move from the bench to the bedside. Unlike penicillin used to target certain infections, addiction requires the consent, motivation and enthusiastic participation of the patient. Clearly, current treatment has not caught up with advances in the science. In-patient and out-patient treatment still relies on detoxification, abstinence and 12 step programs. Addiction is a chronic and relapsing disease. Addiction treatment can be reported as cures at 3 or 6 weeks, only to be clearly failu…
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Mindfulness-based approaches: are they all the same?
Mindfulness-based approaches are increasingly employed as interventions for treating a variety of psychological, psychiatric and physical problems. Such approaches include ancient Buddhist mindfulness meditations such as Vipassana and Zen meditations, modern group-based standardized meditations, such as mindfulness-based stress reduction and mindfulness-based cognitive therapy, and further psychological interventions, such as dialectical behavioral therapy and acceptance and commitment therapy. We review commonalities and differences of these interventions regarding philosophical background, main techniques, aims, outcomes, neurobiology and psychological mechanisms. In sum, the currently applied mindfulness-based interventions show large differences in the way mindfulness is conceptualized and practiced. The decision to consider such practices as unitary or as distinct phenomena will pro…
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Program effectiveness of a Restorative Whole-school Approach for tackling school bullying in Hong Kong.
With bullying in schools high on policy makers' agendas, researchers are looking for effective strategies to tackle its disruptive effects. The present study sets out to address this issue. First, the prevalence of bullying is examined in Hong Kong High Schools, and second, the effectiveness of a Restorative Whole-school Approach (RWsA) in reducing bullying is examined in a quasi-experimental design. The RWsA emphasizes the setting up of restorative goals, clear instructions, team building, and good relationships among students, parents, and teachers. Over the course of 2 years, and across four schools, the effectiveness of this program was observed by comparing an intervention group with a partial intervention group (which did not receive the full treatment) and a control group (which received no treatment whatsoever). The group that received the RWsA treatment exhibited a significant r…
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Adult attachment and male aggression in couple relationships: the demand-withdraw communication pattern and relationship satisfaction as mediators.
This study examines men's domestic aggression as a function of attachment insecurities, considering the mediating roles of the demand-withdraw communication pattern and relationship satisfaction. The sample included 55 Canadian men undergoing counseling for relationship difficulties including aggression. The men completed questionnaires assessing physical and psychological aggression, the two dimensions of attachment insecurity (anxiety over abandonment and avoidance of intimacy), the demand-withdraw communication pattern, relationship satisfaction, and social desirability (a control measure). As predicted, there was an association between attachment anxiety and aggression (both physical and psychological), which was mediated by the man demands/woman withdraws (MD/WW) pattern (as reported by the men). There was no evidence of mediation by the woman demands/man withdraws pattern, as repor…
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Elliott BA (2011)MEDLINE-indexed journal, not yet read by usJournal of religion and health4 citations Forgiveness therapy: a clinical intervention for chronic disease.
Every year, chronic illnesses result in significant costs, disability and deaths. Efforts to understand the causes, treatments and management possibilities for chronic illnesses are ongoing. Some chronic conditions, including addictions, obesity, mental health circumstances, COPD and cirrhosis, have been identified as health conditions with social and interpersonal etiologies. Recent research documents that these conditions are related to adverse early life experience; treatment and prevention of these chronic conditions remains challenging. Concurrent research investigating forgiveness interventions has been reported in the counseling therapy literature, which may have enormous personal and public health impact.
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Effectiveness of a combined prenatal and postpartum smoking cessation program.
Women frequently quit smoking during pregnancy but then relapse postpartum. The BABY & ME-Tobacco Free program combines prenatal and postpartum smoking cessation counseling and biomarker feedback with monthly postpartum incentives. The settings included 22 sites (WIC offices and prenatal clinics) in upstate New York. A quasi-experimental design was used to evaluate this intervention, that included four face-to-face prenatal sessions with a counselor who did smoking cessation counseling, carbon monoxide testing and random saliva cotinine testing. For 1 year postpartum, mothers were biochemically tested every 3-4 weeks and, if negative, were issued a voucher for diapers. Three implementation models were studied: multi-tasking counselors at fixed sites (Models 1 and 2) versus itinerant smoking cessation specialists (Model 3). Outcomes included biochemically validated abstinence rates during…
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