Multisystem Therapy Research Articles

Psychotherapies Used in the Treatment of Substance Use Disorder: A Narrative Review

Drug addiction is a serious social, economic, and health issue that persists worldwide. However, the efforts and certain measures taken to curb this problem seem to be counterproductive. The high addiction relapse rates and rising number of addiction cases show the requirement for proper treatment. In general, a variety of evidencebased treatment interventions for drug addiction are available. However, the gap between the availability of evidence-based therapies and their limited implementation in practice has yet to be bridged. As recommended by previous studies, psychotherapy (‘Talk therapy’), pharmacotherapy (medication-assisted treatment), alone or in combination, can be used to treat drug addiction, with the capability of resolving the high relapse rate. This article provides an overview of the evidence for, and clinical application of, psychotherapeutic approaches used in the treatment of Substance Use Disorders (SUD). Given the scope of the literature, this review will focus on the psychotherapeutic approaches used in the treatment of illicit drug use disorders, including addictive pharmaceutics, while excluding legal drugs like alcohol and nicotine. Cognitive-Behavioural Therapy (CBT), Contingency Management interventions (CM), Community reinforcement approach, Motivational enhancement therapy, 12-step facilitation therapy, family therapy, and Multisystem Therapy (MST) are some of the most prevalent evidence-based psychotherapeutic approaches currently in practice. Evidence suggests that the combination of different psychotherapies with other treatment interventions is expected to improve treatment outcomes.

Therapeutic Effects of Mesenchymal Stromal Cell-Derived Small Extracellular Vesicles in Oxygen-Induced Multi-Organ Disease: A Developmental Perspective.

Despite major advances in neonatal intensive care, infants born at extremely low birth weight still face an increased risk for chronic illness that may persist into adulthood. Pulmonary, retinal, and neurocognitive morbidities associated with preterm birth remain widespread despite interventions designed to minimize organ dysfunction. The design of therapeutic applications for preterm pathologies sharing common underlying triggers, such as fluctuations in oxygen supply or in the inflammatory state, requires alternative strategies that promote anti-inflammatory, pro-angiogenic, and trophic activities—ideally as a unitary treatment. Mesenchymal stem/stromal cell-derived extracellular vesicles (MEx) possess such inherent advantages, and they represent a most promising treatment candidate, as they have been shown to contribute to immunomodulation, homeostasis, and tissue regeneration. Current pre-clinical studies into the MEx mechanism of action are focusing on their restorative capability in the context of preterm birth-related pathologies, albeit not always with a multisystemic focus. This perspective will discuss the pathogenic mechanisms underlying the multisystemic lesions resulting from early-life disruption of normal physiology triggered by high oxygen exposures and pro-inflammatory conditions and introduce the application of MEx as immunomodulators and growth-promoting mediators for multisystem therapy.

PT132 - Solutions towards implementing a multisystem cell therapy for improvement of urinary continence

PT132 - Solutions towards implementing a multisystem cell therapy for improvement of urinary continence

Effectiveness of a Multisystem Aquatic Therapy for Children with Autism Spectrum Disorders.

Aquatic therapy improves motor skills of persons with Autism Spectrum Disorders (ASD), but its usefulness for treating functional difficulties needs to be verified yet. We tested effectiveness of a multisystem aquatic therapy on behavioural, emotional, social and swimming skills of children with ASD. Multisystem aquatic therapy was divided in three phases (emotional adaptation, swimming adaptation and social integration) implemented in a 10-months-programme. At post-treatment, the aquatic therapy group showed significant improvements relative to controls on functional adaptation (Vineland Adaptive Behavior Scales), emotional response, adaptation to changeand on activity level (Childhood Autism Rating Scale). Swimming skills learning was also demonstrated. Multisystem aquatic therapy is useful for ameliorating functional impairments of children with ASD, going well beyond a swimming training.

Reduction of Haemorrhagic Complications during Mechanically Assisted Circulation with the Use of a Multi-System Anticoagulation Protocol

Two different anticoagulation protocols were used in 49 consecutive patients mechanically supported either for bridge to transplantation (11) or for recovery of myocardial function after cardiac surgery (35). In 46 patients a Biomedicus centrifugal pump was used and in 3 patients a Pierce-Donachy ventricles. Mechanical support was provided to the left ventricle in 14 patients, to the right ventricle in 6 and to both ventricles in 12 patients; an extra-corporeal membrane oxygenator (ECMO) support was used in 17 patients. Thirty-seven males and 12 females, aged 0.2 to 58 years, were supported for an average time of 6.3 days (range 1-43). Anticoagulation was either based on a continuous infusion of heparin in the first 27 patients (group A) or on a multi-system therapy ("La Pitié" protocol) in the other 22 patients (group B). Overall survival rate was 47%. Patients in group A had a 30% (8/27) survival rate, whereas in group B a 68% (15/22) survival rate was observed (p = 0.006). Transplantation and ventricular assist device (VAD) removal was successfully obtained in 59% (16/27) and 91% (20/22) of patients in group A and group B respectively (p = 0.05). Significant bleeding occurred in 21 patients (81%) in group A and in 2 (9%) of group B (p = 0.001). In these patients bleeding averaged 230 +/- 231 ml/kg in group A versus 55 +/- 18 ml/kg in group B (p = 0.001). Surgical revision was necessary for cardiac tamponade or persistent bleeding in 12 patients of group A (25 procedures: mean 0.9/patient) and in 3 patients of group B (one each patient: mean 0.1/patient) (p = 0.01). Infection, thrombo-embolism and brain hemorrhage were also less frequent in group A than in group B. Our data suggest that the "La Pitié" protocol provides a better control of bleeding than the conventional heparin infusion in patients receiving assist device. this reduction in thrombo-hemorrhagic complications might improve the results of mechanical circulatory support.

An Overview of Outpatient Treatment of Adolescent Substance Abuse

This paper reviews the literature on ambulatory substance abuse treatment for adolescents, including brief intervention, Twelve-Step-based outpatient treatment, family-based treatment, cognitive behavioral therapy, and pharmacologic treatment. An overview of socially and culturally specific strategies is also included. The diversity of settings and approaches and combinations of approaches in the treatment of adolescents is emphasized as are adaptations of Twelve-Step and other group based interventions. Family-based and multisystem therapy, adapted for substance using adolescents, is highlighted as a promising future direction of effective treatment.

Multisystem failure

Near-drowning represents an insult that can affect all organ systems. A common pathway for injury is hypoxemia, acidosis, and hypoperfusion. Pulmonary insufficiency and CNS dysfunction are major causes of morbidity and mortality. Variations in vascular volume, heart failure, renal failure, coagulation disorders, and electrolyte disturbances may also be present. Patients should be observed for multisystem failure and therapy tailored to the particular needs of each victim.