Professional Betrayal
Paul Ian Steinberg in Psychoanalysis in Medicine, 2020
One needs to determine which psychotherapeutic approach is most effective in treating abused patients. This will depend partly on variables specific to the individual patient. Although specific clinics and symptom-oriented treatments are available for survivors of abuse, physicians are probably less well acquainted with psychoanalytic treatments for abused patients. These treatments address not only symptoms related to the abuse, but the personality of the patient who experienced the abuse. That is important in not only helping a patient to recover from trauma-related symptoms, but also to understand what the trauma has meant to her, and to relate it, when appropriate, to earlier traumatic experiences of trauma and neglect predisposing her to becoming involved in a traumatic situation with her physician (Gartner, 2017).
Chapter 5 Mind-bending pain
Lawrence Goldie, Jane Desmarais in Psychotherapy and the Treatment of Cancer Patients, 2013
The psychotherapeutic approach, as I have mentioned earlier, is alien to most doctors with a scientific training, it being the antithesis of what is taught in physical medicine. The aim of psychotherapy is to enable the patient to suffer, rather than to suffer from the ails of life, whereas the proper aim of the physician seems to be the elimination of pain and disease. Whereas the physician and surgeon, with patterns of disease in mind, look for signs and symptoms of syndromes that categorise patients and their treatment, the psychotherapist conversely tries to empty his or her mind of preconceptions about the effects of the illness or the outcome of their intervention on a particular person. As with pure research, the ‘unknown’ cannot be anticipated. Instead of planning regimes and treatments that have objectives (like applied research) to which the patient is passive witness, the psychotherapist engages in a dialogue in which he or she is active. Patients, and their relatives, have their view of life transformed by the knowledge that the cancer incubus inhabits their body. Some, in their efforts to restore the status quo, try to ignore the evidence of its spread and act as if they do not know of its presence. They are then indignant and complaining. When it ‘progresses’ or ‘recurs’ their indignation and complaints seem justified.
An Agenda for Action III: Treatment, Evaluation, and Research
Barry Stimmel in Drug Abuse and Social Policy in America, 2014
The foundation of behavioral therapies is the belief that dependence upon a mood-altering drug is a learned behavior maintained and reinforced by conditioning due to the specific effect of drugs as reinforcers independent of other psychosocial conditions. Treatment includes developing new behavior incompatible with drug use, and learning to avoid situations associated with a high risk of recidivism. At times, techniques to relieve the anxiety accompanying the need or craving for the drug such as biofeedback, relaxation techniques, and meditation are also used. Types of behavior therapies can vary from contingency contracting-the setting up of a contract between patient and therapist resulting in rewards and/or punishments-to aversive conditioning, whereby the urge to use a drug or its actual use is coupled with an unpleasant reaction, to the actual extinction of the conditioning effect. Antabuse in alcoholism is an example of well-accepted averse conditioning. By causing nausea, vomiting, and cramps when alcohol is taken by a person on antabuse, the desire to drink is diminished. An example of extinction without adverse effects in narcotic dependency is the use of naltrexone (Trexan), a pure narcotic antagonist that prevents the heroin user from getting high. Unlike the classic psychotherapeutic approach, behavioral therapy is usually a time-limited process.
Psychological interventions for post stroke pain: A systematic review
Published in Neuropsychological Rehabilitation, 2023
Ian I. Kneebone, Imogene Munday, Brooke E. Van Zanden, Shirley Thomas, Toby Newton-John
Study participants were required to be adults (≥18 years) reporting chronic pain (pain persisting for at least three months) in any body site following stroke. Non-human studies and paediatric studies were excluded, as were studies published in languages other than English (owing to limitations regarding resources for accurate translation of papers). All psychological interventions following stroke that assessed pain as a primary outcome were included. Psychological interventions were defined using Eccleston and colleagues’ previous Cochrane review definition, that is: using psychotherapeutic methods specifically designed to alter psychological processes believed to contribute to pain, distress, or disability … methods underpinned by specific theories of the aetiology of human behaviour for which there is some evidence of efficacy in the broader field of clinical psychology. (Eccleston et al., 2015, p. 4)Owing to the low number of studies known to the reviewers in the area, all study designs including single-case design studies, qualitative interview and focus group studies, quasi-experimental designs, and randomized controlled trials (RCTs) were included. Both quantitative outcomes and qualitative data regarding the experience of participation in interventions were considered. In addition to measuring pain outcomes, associated changes in psychological functioning (e.g., depression, anxiety, quality of life and impact of pain on activities of daily living) were extracted.
Effects of Brief Behavioral Treatment for Insomnia on Daily Associations between Self-Reported Sleep and Objective Cognitive Performance in Older Adults
Published in Behavioral Sleep Medicine, 2020
Christina S. McCrae, Ashley F. Curtis, Jacob M. Williams, Natalie D. Dautovich, Joseph P. H. McNamara, Ashley Stripling, Joseph M. Dzierzewski, Richard B. Berry, Karin M. McCoy, Michael Marsiske
Full details of the BBTi protocol are provided in the main outcomes manuscript (McCrae et al., 2018). In summary, participants completed four weekly individually administered 60 minute in-person sessions with a trained therapist (i.e., predoctoral candidates in an American Psychological Association accredited program in Clinical Psychology). Therapists were supervised by a licensed Clinical Psychologist (C.S.M.). Sessions included instruction on four techniques shown to be efficacious in treating insomnia in older adults: sleep education and hygiene (Session 1), stimulus control (Session 1), sleep restriction (Session 2), and relaxation (Session 3). In the last session (Session 4), therapists reviewed all of the techniques taught, and discussed challenges to implementation of these techniques with participants. They also facilitated the planning of continued practice of these techniques to maximize treatment gains and ongoing maintenance of insomnia symptom management.
Psychotherapy in recurrent depression: efficacy, pitfalls, and recommendations
Published in Expert Review of Neurotherapeutics, 2020
Fiammetta Cosci, Jenny Guidi, Giovanni Mansueto, Giovanni A. Fava
The clinician could then refer the patient for a short-term (10–20 sessions) course of cognitive-behavioral therapy. This would be the psychotherapeutic approach of choice, since it has been specifically studied for its preventive effects. We would be inclined to taper antidepressant drugs during the course of psychotherapeutic treatment. Tapering should be performed at the slowest possible pace, to minimize the risk of antidepressant medication discontinuation syndromes. Slow tapering, however, may allow the detection of emerging symptoms in their prodromal phases, which may become the target of psychotherapeutic strategy, and especially withdrawal symptomatology. Interventions that bring the person out of a negative functioning are one form of success but facilitating progression toward psychological well-being is quite another. This is an emerging area for psychotherapeutic research and practice [64]. As a result, we feel that a sequential combination of CBT and WBT is the optimal choice.
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