Need For Psychotherapeutic Interventions Research Articles

Vulnerability to depression and resolution in mothers of children with cerebral palsy

BackgroundThis study investigated associations between Self-Criticism and Dependency as factors of vulnerability to depression and maternal resolution. Resolution entails parental cognitive and emotional acceptance of the child's developmental disability. MethodsOur sample included 100 mothers whose children had a diagnosis of cerebral palsy. The Reaction to Diagnosis Interview, the Depressive Experiences Questionnaire and the Depression Scale were administered. ResultsThe results showed that unresolved mothers scored higher on the dimensions of Self-Criticism and Dependency compared to their resolved counterparts. The hierarchical cluster analysis yielded three maternal profiles based on the scores obtained on the dimensions of vulnerability to depression, regardless of maternal resolution status. The first profile was labeled Low Vulnerability and was characterized by low scores on Self-Criticism and Dependency. The second profile was labeled Dependent and it included mothers with higher scores on Dependency and lower scores on Self-Criticism. The third profile comprised mothers with higher scores on both Self-Criticism and Dependency. The smallest proportion of unresolved mothers belonged to the third, most vulnerable profile labeled Double Vulnerability. DiscussionWe discussed the implications of the obtained results in light of a need for psychotherapeutic interventions that would focus on individual differences when providing support to parental resolution.

Exploring fear from a psychodramatic perspective

The article presents an attempt to describe the phenomenon of fear from a psychodramatic perspective. The perception of fear as an innate component of the psyche and as a phenomenon shaped by learning, experience and its cognitive processing is deciphered, very briefly outlining the criteria for classifying fear. Factors that provoke fear are elucidated, namely congenital triggers, social internalization of sources of danger and personal experience, as well as fear avoidance reactions, in particular avoidance of the experience of shame. The adaptive function of fear and that of understanding the self and one`s own picture of the world are specified. Fears based on a realistic assessment of situations and imaginary ones are delimited; the difficulties in identifying the causes of illusory fears and the ways of working with this kind of fears. The need for psychotherapeutic interventions in managing this emotion and freeing oneself from its consequences is highlighted, giving a concrete example of how psychodrama explores, through roleplaying, the individual`s relationship with his/her own fear and awareness of the causes of its occurrence. All this emphasizes the need to develop internal resources, creativity and spontaneity, the ability to communicate and build relationships, the capacity for operational self-regulation, which make it possible to generate solutions in unusual and extreme situations, in order to face challenges and avoid psychological trauma caused by various fears.

Perspectives and Opportunities for Psychotherapeutic Interventions in Inpatient Psychiatric Treatment Delivered by Nurses

Psychotherapy is an essential part of treating people with mental illness. However, the implementation of psychotherapeutic interventions in the field of inpatient psychiatric treatment remains well behind demand. At the same time, the use of psychotherapeutic interventions by other professional groups - such as social workers and nursing - is not a common practice in Germany. What can we learn from the international research with regard to nursing for Germany in view of the insufficient supply of psychotherapeutic care. Based on a literature analysis, the German situation of care is related to international developments and a German training curriculum is presented. A look at the international literature shows that in other countries especially trained nurses perform psychotherapeutic Interventions. In addition, there are effective training curricula whose transferability to Germany appears to be possible after appropriate adjustments.An 18 months lasting training program for nurses is presented. In addition to disorder-specific competences, this curriculum also provides psychotherapeutic interventions with a general approach. Collaborative care in the collaboration of different health professionals has been repeatedly and stably proven to be effective and helpful in treating people with various mental disorders. In order to better meet the growing need for psychotherapeutic interventions in the population in the sense of a stepped care model, trained nurses need to be more involved in the provision of psychotherapeutic services.

Psychotherapeutic and vocational interventions among young adults with work disability due to mental disorders in Finland

Backround: Little is known about treatment and rehabilitation received and planned among young adults with work disability due to a mental disorder.Aims: To examine the implemented psychotherapeutic and vocational interventions and treatment plans among young adults with work disability due to a mental disorder.Material and methods: Data were collected from medical records of young Finnish adults aged 18–34 with a long-term work disability history due to a mental disorder (N = 1163). The participant characteristics associated with four types of interventions were analyzed using log-binomial regression analysis.Results: In total, 34% had participated in a psychotherapeutic intervention. Of the non-students, 26% had participated in vocational intervention. For 46% of the non-students, neither type of intervention was planned. Both implemented and planned psychotherapeutic interventions were associated with female sex, high education, attachment to employment, and absence of substance abuse. Low education and childhood adversity were associated with implemented vocational interventions and absence of substance abuse with planned vocational interventions.Conclusion and significance: There is an unmet need for psychotherapeutic interventions among men, among those with lower socio-economic status, and among those with poor attachment to labor market. In addition, there is a lack of vocational interventions for those with high education. People with substance abuse are largely excluded from both types of interventions.

Cognitive-Behavioral Therapy for Deliberate Self-Harm

Patients who engage in deliberate self-harm (DSH) form a heterogeneous population. There is a need for psychotherapeutic interventions that give therapists the flexibility to tailor the treatment plan to the needs of an individual patient. To detect essential ingredients for treatment, three different cognitive-behavioral theories of DSH will be reviewed: (1) the cognitive-behavioral theory of Linehan (1993a), (2) the cognitive theory of Berk, Henriques, Warman, Brown, and Beck (2004), and (3) the cognitive-behavioral theory of Rudd, Joiner, and Rajab (2001). A review of these theories makes it possible to compare the different approaches to the essential aspects in the treatment of DSH: a trusting patient-therapist relationship, building emotion regulation skills, cognitive restructuring, and behavioral pattern breaking. An overview will be given of therapeutic techniques that can be used to address the cognitive, emotional, behavioral, and interpersonal problems associated with DSH.

Clinical psychology with complex presentations in old age

Five cases are presented in detail to illustrate the role of clinical psychology with patients who have complex presentations. They are discussed with reference to the need for psychotherapeutic interventions given the limitations of pharmacotherapy; the limitations of psycho-social techniques and the consequent need for multi-disciplinary collaboration; and, the richness and complexity of psychosocial interventions and the limitations of CBT alone. These cases also illustrate the fact that interventions – whether psychosocial or psychopharmacological or both – can significantly improve life for a population often regarded as beyond help or otherwise not worth treating.

Psychosocial distress and need for psychotherapeutic treatment in cancer patients undergoing radiotherapy

Background and purpose Empirical investigations examining the need for psychotherapeutic treatment of inpatients in radiooncology departments are rare. We, therefore, assessed the degree of psychosocial distress of radiooncology inpatients and their need for psychotherapeutic interventions. Patients and methods Eighty-seven patients from two radiooncology wards underwent psychodiagnostic interviews and completed self-rating instruments to determine mental disorders, psychosocial distress, coping strategies and quality of life. Need for psychotherapeutic interventions and treatment motivation were estimated by patients and by a professional. Results Using ICD-10 criteria, mental and behavioral disorders were diagnosed in 51% of the patients, most of them adjustment disorders. The professional regarded 32.2% of patients as needing psychotherapeutic treatment, compared with 43% of the patients who were motivated to accept at least one of the psychotherapeutic treatments offered. There was a marked discrepancy between the points of view of the patient and the professional, in that, while the professional regarded anxiety as a highly significant predictor of the need for treatment, psychosocial distress played no role in the patients' estimation. Conclusions In determining the indication for psychotherapeutic treatment, both objectified psychosocial distress and a patient's subjective treatment expectations should be considered. There is a need to develop screening instruments that integrate both aspects.

Psychosomatic liaison service in neurology. Accordance between need for psychotherapeutic interventions and their realization

The study addresses the realization of psychotherapeutic interventions in the framework of an integrated psychosomatic liaison service in neurology. Eighty-four patients from one unit at the Department of Neurology of the University of Freiburg, Germany, underwent structured psychodiagnostic interviews and filled in self-rating instruments to evaluate mental disorders, psychosocial distress, ways of coping, and quality of life. Motivation and the need for treatment were estimated by both patients and a liaison psychotherapist. Using ICD-10-F criteria, mental and behavioral disorders were diagnosed in 35% of the cases. Thirty-seven percent of the patients desired psychological support. Actual intervention occurred in 27%, with a mean consultation rate of 3.7 sessions. There was only slight agreement between the estimated need for treatment and the interventions actually performed. The realization of psychotherapeutic interventions was subject to a complex interaction between patient needs, "objective" psychosocial distress, and institutional factors. Differentiation between primary medical care and psychotherapy was difficult.

Psychosomatic liaison service in hematological oncology: need for psychotherapeutic interventions and their realization.

Empirical investigations examining the psychosocial distress and need for care of inpatients with hematological malignancies are rare. Little is known about the use of psychotherapeutic interventions in routine care. To evaluate the psychosocial distress of hemato-oncological inpatients, the need for psychotherapeutic interventions and their realization in the framework of a psychosomatic liaison service has been assessed. Seventy-two patients from two hematological oncology wards underwent psychodiagnostic interviews and completed self-rating instruments, elucidating mental disorders, psychosocial distress, coping strategies, quality of life, treatment motivation and psychotherapeutic interventions. Using ICD-10 criteria, mental and behavioural disorders were diagnosed in 53% of patients. Professional assessment indicated a need for psychotherapeutic treatment in 49%, while 38% of the patients wished to receive psychological support. Actual intervention occurred for all patients in the bone marrow transplantation unit and for 23% of patients in the general hemato-oncological ward. There is considerable need for psychotherapeutic treatment which can only be handled within the framework of a liaison service in close cooperation with oncologists, nurses and mental health specialists.

Psychosomatic Liaison Service in Dermatology

Background: Empirical investigations examining the psychosocial distress and need for care of dermatology patients are rare. Little is known about the use of psychotherapeutic interventions in routine care. Objective: To evaluate the psychosocial distress of dermatological inpatients, the need for psychotherapeutic interventions and their realization in the framework of a psychosomatic liaison service. Methods: 86 patients from one unit at the University Dermatology Clinic in Freiburg underwent psychodiagnostic interviews and completed self-rating instruments, elucidating mental disorders, psychosocial distress, coping methods, quality of life, treatment motivation and psychotherapeutic interventions. Results: Using ICD-10 criteria, mental and behavioral disorders were diagnosed in 46%; most frequent were mood and anxiety disorders. Professional assessment indicated a need for psychotherapeutic treatment in 51%, while 28% of the patients wished for psychotherapy; actual intervention occurred in 38%. Conclusions: The need for psychotherapeutic treatment can only be handled within the framework of a liaison service in close collaboration with care givers.