Patients In Therapy Group Research Articles

Antithrombotic therapy for prosthetic valves: routine treatment and special considerations.

The use of prosthetic heart valves has increased over the past 3 decades. Antithrombotic agents remain the mainstay of therapy to prevent thromboembolic events caused by the presence of a prosthetic heart valve. We examine the risks of thromboembolic events as well as the risks and benefits of antithrombotic therapy in patients with mechanical and bioprosthetic heart valves. We also review the data regarding the use of antithrombotic therapy in special groups of patients, such as those with intracranial bleeding, pregnant women with prosthetic heart valves, and patients with prosthetic heart valves undergoing surgery.

Trauma-Focused Group Therapy for Patients with Post-traumatic Stress

(1999). Trauma-Focused Group Therapy for Patients with Post-traumatic Stress. International Journal of Group Psychotherapy: Vol. 49, No. 4, pp. 540-543.

A Crude Way of Loving: On Surviving the Trauma of Therapeutic Change with Borderline Patients in Group Psychotherapy

This article traces the development of one patient in a psychotherapy group in which borderline pathology predominated. Dynamics specific to the therapeutic engagement of borderline patients and pressures experienced by the group analyst are illustrated. The author recommends particular adjustments in technique when conducting borderline groups.

Antitubercular activity of garlic (allium sativum) extract on combination with conventional antitubercular drugs in tubercular lymphadenitis

Based on our demonstration earlier that ethanol extract, water extract and a compound purified from garlic possessedin vitro antitubercular activity against drug resistant and susceptibleMycobacterium tuberculosis, we tried the effect of garlic extract in 30 patients of tubercular lymphadenitis. For ethical considerations, two groups of patients, 30 each, were given antitubercular therapy (ATT) consisting of isoniazid, rifampicin, ethambutol and pyrazinamide for 30 days. For the next 15 days (31 to 45 days) group 1 patients received 3-6 garlic pearls per day in addition to ATT while group 2 patients received ATT only. From 46th day onwards both the groups received ATT only for 6-8 months. Antitubercular activity of the serum samples collected on 45th day was assessed by its effect on the growth ofM. tuberculois. The serum of group 1 patients showed significantly much higher antitubercular activity than that of group 2 patients. Further, there was relief of dyspeptic symptoms caused by ATT therapy in patients of group 1 with garlic plus ATT therapy but no change in group 2 patients with ATT only. Liver function and hematological tests were normal in both the groups after 6 months of therapy. Garlic extracts or compounds have a good potential as antitubercular(s) drug if given as a supplement to ATT.

Group Psychotherapy for Patients with Coronary Heart Disease

ABSTRACTGroup therapy with cardiac patients is a relatively new specialty. The field is supported by a substantial epidemiological and experimental literature demonstrating links between heart and mind. There are several clinical trials that have demonstrated less morbidity, improved quality of life, and, to some extent, lower mortality for patients who have received psychosocial intervention, generally group therapy, compared to control patients. Different theoretical orientations and a small number of clinical techniques have been developed to help cardiac patients make an adjustment to heart-healthy living. This article provides a brief review of the literature in cardiac psychology, suggestions for developing a psychotherapy practice specialty with cardiac patients, techniques for treating these patients, and conclusions by a psychologist-cardiologist team that has been active in this area for more than a decade.

Cognitive‐Existential Group Therapy for Patients with Primary Breast Cancer — Techniques and Themes

We describe a model of cognitive-existential group therapy designed to be integrated over 6 months with regimens of adjuvant chemotherapy given as conventional medical treatment to breast cancer patients with stage 1 and 2 disease. Our broad therapy goals are for members to develop a supportive network, work through grief over losses, improve problem solving and develop cognitive strategies to maximise coping, enhance a sense of mastery over life and re-evaluate priorities for the future. Specific group themes include death anxiety, fear of recurrence, living with uncertainty, understanding treatment with chemotherapy, radiotherapy and hormone regimens, the collaborative doctor-patient relationship, body and self image, sexuality, relationships with partner, friends and family, surgical reconstruction, life style effects and future goals. Active coping skills are developed through teaching formal problem solving and cognitive restructuring of automatic negative thoughts. Technical aspects of the therapy are discussed. © 1997 John Wiley & Sons, Ltd.

“You've lost me, you've lost other people in the group”: Transference-countertransference matrix in the termination of difficult adolescent patients in group therapy

This paper, based on two year-long psychotherapy group consisting of six female adolescents, focuses on transference-countertransference reactions in group psychotherapy with difficult female adolescents who are facing the loss of their parents through AIDS. A clinical case is presented to illustrate the complications in the Termination phase with bereaved adolescent patients. The author suggests using Ferenczi's therapeutic techniques in treating adolescents.

Risk-Benefit Of Thrombol Ysis

In larger trials the relative reduction in mortality rates brought about by thrombolytic therapy is similar among various subgroups. Accordingly, the absolute mortality reduction by thrombolytic therapy is largest in patients with the greatest expected mortality in the placebo groups. Similarly, the additional benefit by accelerated tissue plasminogen activator (TPA) is proportional to the expected mortality without thrombolytic therapy. Using logistic regression analysis a table has been developed predicting the survival benefit from thrombolytic therapy in groups of patients with different baseline characteristics. A table also has been developed to predict the risk of intracranial hemorrhage from thrombolytic therapy. Using these two tables, an individual risk/benefit assessment can be made. In most patients the benefits of thrombolytic therapy far exceed the risk of intracranial hemorrhage. Similarly, the advantage of more intensive therapy (accelerated TPA) exceeds the slightly increased bleeding risk. The model presented can help to allocate different modes of reperfusion therapy to individual patients, accounting for limited resources.

The Nequipos' Collusion with the Patient's Family of Origin in Analytic Group Psychotherapy

When the analytic group is led by individuals paired for educational reasons, that is, by a supervisor and his or her student, the difficulty in conducting the group becomes magnified. Such teams are called nequipos and it is hypothesized that they will not function optimally until the latter phases of their development. The authors describe the mistakes they made as early phase nequipos in their treatment of one patient in group psychotherapy.

Myocardial perfusion imaging for evaluating interventions in coronary artery disease

Myocardial perfusion imaging provides a means for evaluating the effects of interventional therapy in several groups of patients with coronary artery disease. In patients with unstable angina, imaging during or after chest pain can be used to identify areas of jeopardized myocardium and to predict the risk of subsequent cardiac events including myocardial infarction. In patients with acute myocardial infarction, the effect of thrombolytic therapy can be monitored, and in patients with chronic ischemia and left ventricular dysfunction, thallium imaging can be used to predict whether revascularization will improve myocardial function. In patients with stable coronary artery disease, perfusion imaging has been used to evaluate efficacy of anti-anginal medications. This article reviews the use of myocardial perfusion imaging in determining the need for, and success of, various medical and surgical therapeutic interventions in patients with ischemic heart disease.

The significance of here- and-now disclosure in promoting cohesion in group psychotherapy

Here and now disclosure was compared to there- and-then disclosure to determine which type of disclosure has the most significant effect on cohesion. The subjects consisted of 45 male and 43 female patients in group therapy at a mental health clinic affiliated with a psychoanalytic training institute. A series of scales and questionnaires were administered to ascertain the subjects' feelings of cohesiveness and their typical style of disclosure in group. The significance of the type of disclosure was then determined. The most important finding was that after rigorous analysis of the two disclosure variables, only here- and- now disclosure maintained its position as a significant predictor of cohesion.

Content analysis of groups for inpatients with bipolar disorder

Group therapy for patients with bipolar disorder is recognized as beneficial but has not been studied in an inpatient population. In this study, content analysis procedures were used to describe the content and process issues in 40 short-term group psychotherapy sessions attended by 65 inpatients with bipolar disorder. Five core categories emerged from the content: understanding the disorder, relating with others, managing daily life, relating with self, and living in society. Guidance, universality, and self-understanding were described most frequently when patients identified the group event that was most personally important to them. Implications for practice include providing therapy and education to this population through a topic-oriented group model.

Content analysis of follow-up interviews with inpatient/outpatient group psychotherapy patients.

In the follow-up project of the psychosomatic clinic at the University of Heidelberg, 45 patients were interviewed who had begun group psychotherapy in a closed group over 2.5 years with an inpatient treatment period of 3 months. The follow-up interviews carried out 2-5 years after the end of the outpatient treatment period are studied by content analysis. It could be demonstrated that the content of the two main categories 'Beginning' and 'End' of the inpatient period differs very much. Two patterns of 'beginners' could be distinguished. The importance of the evaluation of the former patients' spontaneous report as involved experts for psychotherapy research is discussed.

Experiences with `Planned' Dynamic Group Psychotherapy of Patients with Anorexia Nervosa

The clinical and psychopathological symptoms of the patient with anorexic illnesses are not uniform, but are detennined by the extent of biological disturbance, especially the functional immaturity of the limbic-reticular system, and the age at which the illness was contracted, how long it has lasted, the life story of the patient and the relationship between the patient and his or her family (Ehle, 1988).

Group therapy for aphasic patients: Let's show it works

Abstract Pachalska, at the conclusion of her article, states that ‘… group treatment is one, if not the most effective means of developing communication skills and facilitating the rehabilitation process’. This relatively strong proclamation of belief was refreshing, a:; it followed several pages which cited the vague benefits associated with group treatment such as increased companionship and competition with peers. Some statements left: this reader with the impression that her overall views of group therapy see it as only adjunctive to individual therapy. Pachalska's cursory, incomplete review of the literature outlining benefits that may accrue from participation of aphasic patients in group therapy has, in this clinician's opinion, one major problem. It frequently reiterates the subjective suggestions of authors from the past several years, while failing to include some of Kearn's (1986) recommendations (from his excellent critique of group therapy) in which he stresses the need to document gains achi...

Schizophrenic group process: A comparison and replication using the HIM-G

In order to test the robustness of our model for treating schizophrenic patients in group therapy, we replicated our previous study of an inpatient schizophrenic group and also explored process in an outpatient schizophrenic group using the Hill Interaction Matrix (HIM-G). In agreement with the prior study, the results showed the groups to have a uniquely high Confrontive score, representing the highest level of group work in the Hill system, and the rank order of HIM-G scores of the groups correlated significantly with each other. This suggests that our clinical approach can be taught to different therapists and has reliability across setting.

Responses to ?tools of the trade? by Sabert Basescu

Several years ago I was able to transfer my group from a clinical setting to my private office. When the patients entered my own consultation room for the first time, they began to explore. Two individuals scanned my bookcases. One person studied the paintings on the wall. Several looked at my diplomas and certificates. For about 10 minutes no one said a word and no one sat down. They were starved for information about me. Reading Basescu's paper raises the question: What is it about me that my group therapy patients need? It so happens that of the eight patients in my group (four men and four women in their thirties), one lost her father through suicide, another lost an older brother the same way, a third individual's father was involved in an auto accident that left him in a coma for nine months, and fathers of two other patients were seriously depressed and unavailable to them for many years. The members talk about the group as the family they never had. They use the group in ways similar to how 9-14-month-old children approach their mothers for what Mahler, Pine and Bergman (1975) call refueling. Touching home-base, allows the patients to return to the real world energized for their uphill marches. For the refueling to work, the patient must feel that the therapist is reliable and makes the group a safe place to which to retreat. Needless to say most of my group patients could not be adequately refueled in childhood. A number of them were talented performing artists as children and appeared on the stage in what would have to be scary situations. While their parents arranged for them to get to the performance, none apparently

The written summary in group psychotherapy revisited

This paper addresses the use of the weekly written summary with patients in group psychotherapy. In an effort to stimulate group process and effect cotherapist communication, the authors instituted this group recording in an ongoing psychodynamically oriented mixed adult group. While the utilization of this device did, in fact, stimulate the group process and became an important part of the group's life, the therapists additionally saw significant effects upon their working alliance. These included increased focused dialogue upon group dynamics, more purposeful planning for group interventions, and heightened awareness of the significance of interventions in the group.

Psychodrama group therapy for patients with functional gastrointestinal disorders--a controlled long-term follow-up study.

Patients with gastric dyspepsia and irritable bowel syndrome at a primary health care centre were offered a special form of group psychotherapy once a week during a 3-month period. The therapy included psychodrama and relaxation training. Results were evaluated by means of self-administered questionnaires on symptoms and anxiety, comparing pretherapy levels with levels 6 months after the start of the therapy as well as 3 years later. In the studied treatment group--as well as in a control group selected in the same way but not undergoing the special treatment--the symptom levels decreased 3 months after therapy. In both groups, however, they tended to increase again after 3 years. Anxiety, on the other hand, decreased 6 months after the start of therapy in the specially treated group and no similar tendency was observed in the control group. In the treatment group subjects who reported immediately after treatment that they had learned 'a new behaviour' were more likely to report fewer symptoms of the irritable bowel syndrome 3 years later than other subjects.

Body awareness group therapy for patients with personality disorders. 1. Description of the therapeutic method.

The aim of this paper is to describe the Body Awareness Group Therapy (BAGT) designed for patients with personality disorders. The BAGT is a body-oriented small group therapy conducted by a physiotherapist and a cotherapist. The aim is to foster personal growth and development by use of individual and group exercises. The therapy is a synthesis of earlier clinical experiences, mostly based on works of Reich, on elements of encounter and of eastern body tradition.