Self-control Therapy Research Articles

Therapeutic Analysis of Smoking Cessation Efforts: Literature Review

Background: Smoking is one of the most major health problems leading to the emergence of cardiovascular disease, lung disease, and cancer in the world. Smoking cessation experiences from various backgrounds of therapy types can be input to develop successful smoking cessation strategies. Objective: This literature review is to provide comprehensive information regarding types of therapies and how support and needs are encountered to successfully quit smoking. Method: This study uses the Literature review method using PRISMA Checklist guidelines and takes electronic database data sources, namely Science direct, Google Schloar, PubMed and Perpusnas with articles published from 2013 to 2022 with the keyword smoking cessation therapy. After selection and identification according to the inclusion criteria, there were 15 articles reviewed. Results: Based on the results of an analysis of 15 research articles reviewed. There are 7 types of smoking cessation therapy including Spiritual Emotional Freedom Technique (SEFT), Cognitive Restructuring, N-Acetylcystein Mucolytic Therapy, Nicotine Replacement Therapy (NRT), Varenicline Therapy, Self-Control Therapy and Hypnoterapy. Conclusion: Smoking cessation therapy is divided into 2 parts, namely Pharmacotherapy (N- Acetylcystein Mucolytic Therapy, Nicotine Replacement Therapy (NRT), Varenicline Therapy) and Non Pharmacotherapy (Spiritual Emotional Freedom Technique (SEFT), Cognitive Restructuring, Self- Control Therapy and Hypnoterapy

The role of pre-pregnancy care for women with pregestational diabetes mellitus for improving maternal and perinatal outcomes

The occurrence of diabetes mellitus in women before pregnancy (pregestational diabetes mellitus can have various adverse consequences for the mother, fetus, child, and pregnancy. Pregnancy planning in women with pregestational diabetes mellitus significantly improves the outcomes of pregnancy and childbirth. The introduction of diabetes self-control skills, the use of human insulin and insulin analogues, the use of constant subcutaneous insulin infusion and family planning allows for optimal glycemic control in early pregnancy and reduces the incidence of fetal congenital anomalies and perinatal mortality. Lifestyle optimization, weight loss, taking adequate doses of folic acid, discontinuation of teratogenic medications, and quitting smoking are essential components of preconception care. Of significant clinical value is the training of women planning pregnancy at the Diabetes school, training in self-control and insulin therapy skills, consultation with an endocrinologist, an obstetrician-gynecologist, an ophthalmologist, a nephrologist, and a nutritionist.
 The aim of this study was to present current data on pre-pregnancy care in patients with pregestational diabetes mellitus and to show its possibilities in reducing the frequency of obstetric and perinatal complications. We analyzed 74 domestic and foreign literature sources using the following databases: PubMed, PubMed Central, Google Scholar, and UpToDate.

Self-control therapy untuk mengurangi perilaku merokok pada remaja

Adolescence is a time when individuals are easily influenced by the environment. One of the environmental exposures during adolescence is the use of cigarettes. Not many teenagers are able to cope with environmental influences, thus creating a sense of conformity to smoking. The cause of adolescents not being able to overcome conformity is a lack of self-control when in situations that trigger smoking. The purpose of this study is to reduce smoking behavior in adolescents by increasing self-control when in situations that trigger smoking. Subjects consisted of four teenagers aged 16 -18 years old. The assessment method used are interview, observation, Glover-Nilsson Smoking Behavior Questionnaire (GN-SBQ) and self-report. The intervention technique used is group self-control therapy. The results of the intervention showed a gradual decrease in smoking behavior after each group member was able to apply self-control techniques when in situations that trigger smoking. The decrease in smoking behavior can occur because with self-control, each subject in the group can control the sense of conformity that triggers the subject to smoke.

Therapeutic Outcome of Self-Control and Social Interaction Interventions on Negative Body Image among in-school Adolescents with Low Health literacy in Southwest Nigeria

Low health literacy is found to be consistently associated with negative body image. This study examined the effectivenessof Self-Control Therapy (SCT) and Social Interaction Skills Training (SIST) in managing negative body image among senior secondary school students with low health literacy in Southwest Nigeria. The design is pretest-post-test, control group quasi-experimental while the factorial matrix adopted was 3×2×3. Through multi-stage sampling, three Catholic Senior Secondary Schools in Southwest Nigeria were selected. Ninety (90) students, (Males=34, Females= 56) with age range of 14 years to 16 years were randomly selected and assigned to treatment conditions. The experimental groups were exposed to ten Sessions of treatments while the control group served as a comparison group. Body Self-Image Questionnaire-Short Form (BSIQ-SF) (α=0.83), Health Literacy Scale(α=0.88), and Rosenberg Self Esteem Scale (α=0.81) were used for data collection while Analysis of Covariance (ANCOVA) and Bonferroni test were used for data analysis. Results showed a significant main effect of the treatments on the negative body image of the adolescents (F (2, 90) = 1602.50; partial η2=0.98). Participants in SCT had the least adjusted post-test mean score (34.07), followed by SIST (35.23) and control (66.13) groups. Sex of the participants had no significant interaction effect on the treatment outcome. Participants with high self-esteem had a better reduction in managing negative body image (44.27) than those with moderate self-esteem (44.51) and low self-esteem (47.30). A two-way interaction effect of treatments and self-esteem was found. This result provides support for the use of SCT and SIST to manage negative body image of senior secondary school students. These two therapies are therefore, recommended to stakeholders as viable therapies for the treatment of negative body image.

Self-Control Therapy: Daily Accounting and Focus Group Discussions Reduce Consumptive Behavior of E-Money Use in Millennials

This study aims to find out if there are differences in the level of consumptive behavior after being given treatment in the form of self-control therapy with daily accounting methods and focus group discussions. The study uses an experimental quantitative approach. The subjects of this study were 33 Mulawarman University students who were active users of e-money who were selected using purposive sampling techniques. The data collection method used is the scale of consumptive behavior. The collected data is analyzed with the Different Test method, the Wilcoxon Test with the help of SPSS software version 22. The results of this study showed that the pre-test of consumptive behavior scale with post-test consumptive behavior scale showed a P value of 0,000 0.05 which means not There’s a significant difference.

FEASIBILITY AND OUTCOMES OF AUTOGENIC RELAXATION TRAINING IN ADDITION TO USUAL PHYSIOTHERAPY FOR STROKE SURVIVORS – A PILOT STUDY

A significant percentage of stroke survivors are reported to have anxiety and depression. Autogenic Relaxation Training (ART), a psychophysiological self-control therapy which aims to induce relaxation proved to be effective in reducing the anxiety and depression in some health conditions. However, there is lack of studies which evaluated the effects of ART in the rehabilitation of stroke survivors. The aim of this experimental pilot study is to evaluate the feasibility and outcomes of ART in addition to usual physiotherapy for stroke survivors. A total of 14 sub-acute stroke survivors from a teaching hospital were enrolled in this study. All participants received 20 minutes ART followed by 40 minutes usual physiotherapy once a week and they were requested to carry out the intervention at home for twice per week, for six weeks. Intervention outcomes were assessed using Hospital Anxiety and Depression Scale (HADS-A and HADS-D), Barthel Index (BI), Timed Up and Go (TUG) and EuroQol 5-Dimension 5 Levels (EQ5D5L). Changes in all outcome measures were analysed using paired t-test and Wilcoxon signed rank test, with level of significance set at p<0.05. Post-intervention, there is statistically significant reduction of the HADS-A (p=0.04), HADS-D (p=0.02), TUG (p=0.004) and EQ5D5L (p=0.03) scores of the participants. Although not statistically significant, the mean score ± SD of BI increased from 95 ± 12.5 to 100 ± 6.25. The intervention is feasible and acceptable by the stroke survivors with no adverse events reported. In conclusion, ART in addition to usual physiotherapy is feasible and beneficial in reducing anxiety and depression, and improving functional ability, mobility and quality of life among stroke survivors.

An efficacy trial of adaptive interventions for alcohol use disorder

BackgroundAdaptive interventions, sometimes referred to as “stepped care”, are those interventions in which the type or dosage of treatment offered to patients is tailored to baseline clinical presentation and then adjusted over time in response to patient progress or lack thereof. Currently, no adaptive brief interventions exist specifically for alcohol use disorder (AUD). MethodThis study used a sequential multiple assignment randomized trial design with 160 individuals with AUD recruited both locally and nationally who had a goal to reduce or abstain from drinking. Participants received brief advice (BA) and then the study reassessed them three weeks later; the study randomized those who did not respond to BA, defined as reducing their drinking to low-risk guidelines, to two session of motivational interviewing (MI) or more BA. The study then reassessed participants at week 8. The study re-randomized nonresponders to receive either MI alone or MI plus behavioral self-control therapy (BSCT), also referred to as coping skills therapy, and evaluated participants at week 13. ResultsOverall, participants receiving any BSCT made the greatest reductions in drinking. Participants who received MI at week 4 and BSCT at week 8 outperformed all other groups. ConclusionFindings reveal that prolonged treatment, more sessions, and/or a specific combination of MI and BSCT provided optimal outcomes. Future research should determine whether such an algorithm holds across heterogenous groups of individuals with AUD.

Exorzismus und animalischer Magnetismus als Behandlungspraktiken in der Frühen Neuzeit

Alternative explanations for the cause of an illness were searched frequently if the conventional methods and medicines failed in treating diseases of which the aetiology could not beestablished. Consequently, the resulting diagnosis was often determined as bedevilment or possession. It was common practice for physicians themselves to send their patients to exorcists, if their own efforts failed to effect a cure. Those exorcists then tried to banish the evil forces from the afflicted bodies by appealing to superior opposing forces. The exorcisms ofthe sick is according to the Roman Catholic Church a sacrament. The proper practices were specified through the “Rituale Romanum” from 1614.However, not all of the healers were guided by those rules. Johann Joseph Gasner (1727–1779) fashioned his exorcisms without a single reference to the ritual guidelines of the Roman Catholic Church, and yet achieved great success with his therapies. His exorcisms can be construed as early innovative psychotherapeutic treatments when interpreting his “miraculous cures” stated in contemporary narratives. The often achieved success of the “devil banisher”, who had extraordinary suggestive and hypnotic powers, was in large parts based on the practice of a self-control therapy which could be applied afterwards by the patients in their daily life if the involuntary phenomena occurred. The lines between exorcistic doctrine and (from today’s point of view) psychotherapeutic therapy were blurred by his kind of treatment – which were unquestionably typical at that time.Fierce discussion of Gasner’s healing methods was held during the time of a criticalanalysis of iatromechanism and traditional humoral pathology in the middle of the 1770s. However, his great success rate opposed the efforts towards public enlightenment and against superstition. Notably, they were responsible for a renewed controversial discussion on witches and the devil which was believed to have ended between the 1760s and 1770s. Therefore an alternative treatment was searched for. Such a treatment was found by the physician Franz Anton Mesmer (1734–1815) with his new developed healing method, animal magnetism, with which similar results to Gasner could be achieved. The stellar ascent of Mesmer and his treatment can be ascribed to a direct response against Gasner; it also had similarities to Gasner’s therapy. Mesmer used the physical categories of matter and motion for his newly developed theses on disease and cure. He defined a concept of a global fluid as the basis for the animal magnetism. This fluid is an extremely delicate substance and can lead to a stoppage of the humours through muscle cramps. A cure could be achieved by restoring the harmony through energy transfer. Mesmer, who was also an accomplished psychologist who used methods of hypnosis and suggestion, was able to attain similar therapeutic successes as Gasner. He was seen as the suitable alternative to Gasner and his form of exorcism, and therefore worthy of support due to his scientific healing method which was incorporated into an enlightened concept and managed without the devil. The rapidly increasing interest – which declined just as quickly – was therefore not primarily based on animal magnetism itself. It was rather a result of the endeavours to proclaim alternative effective methods of treatment to exorcism.

Patterns of practice in community mental health treatment of adult depression

Objective: Community mental health therapists often endorse an eclectic orientation, but few studies reveal how therapists utilize elements of evidence-based psychotherapies. This study aimed to characterize treatment as usual patterns of practice among therapists treating depressed adults in community mental health settings. Method: Therapists (N = 165) from the USA’s largest not-for-profit provider of community-based mental health services completed surveys assessing their demographics and practice element use with depressed adult clients. Specifically, therapists indicated whether they utilized each of 45 unique practice elements from the following evidence-based psychotherapies: Acceptance and Commitment Therapy, Behavioral Activation, Brief Psychodynamic Therapy, Cognitive Behavioral Therapy (CBT), Interpersonal Therapy, Mindfulness-Based CBT, Problem-Solving Therapy, and Self-Control Therapy. Principal component analysis was employed to identify practice patterns. Results: The principal component analysis included 31 practice elements and revealed a three-factor model with distinct patterns of practice that did not align with traditional evidence-based practice approaches, including: (i) Planning, Practice, and Monitoring; (ii) Cognitive, Didactic, and Interpersonal; and (iii) Between Session Activities. Conclusions: Therapist-reported practice patterns confirmed an eclectic approach that brought together elements from theoretically distinct evidence-based psychotherapies. Future research is needed to explore how these patterns of practice relate to client outcomes to inform focused training and/or de-implementation efforts.Clinical or methodological significance of this article This study confirmed previous reports that community mental health therapists adopt an eclectic approach, combining elements from disparate theoretical orientations.

5-HTTLPR moderates naltrexone and psychosocial treatment responses in heavy drinking men who have sex with men.

A functional polymorphism (5-HTTLPR) in the promoter region of the serotonin transporter gene has been widely studied as a risk factor and moderator of treatment for a variety of psychopathologic conditions. To evaluate whether 5-HTTLPR moderates the effects of treatment to reduce heavy drinking, we studied 112 high-functioning European-American men who have sex with men (MSM). Subjects participated in a randomized clinical trial of naltrexone (NTX) and cognitive behavioral therapy (CBT) for problem drinking. Subjects were treated for 12 weeks with 100 mg/d of oral NTX or placebo (PBO). All participants received medical management with adjusted brief behavioral compliance enhancement treatment (BBCET) alone or in combination with modified behavioral self-control therapy (MBSCT; an amalgam of motivational interviewing and CBT). Participants were genotyped for the tri-allelic 5-HTTLPR polymorphism (i.e., low-activity S' or high-activity L' alleles). During treatment, the number of weekly heavy drinking days (HDD; defined as 5 or more standard drinks per day) was significantly lower in subjects with the L'L' (N = 26, p = 0.015) or L'S' (N = 52, p = 0.016) genotype than those with the S'S' (N = 34) genotype regardless of treatment type. There was a significant interaction of genotype with treatment: For subjects with the S'S' genotype, the effects of MBSCT or NTX on HDD were significantly greater than the minimal intervention (i.e., BBCET or PBO, p = 0.007 and p = 0.049, respectively). In contrast, for subjects with 1 or 2 L' alleles, the effects of the more intensive psychosocial treatment (MBSCT) or NTX did not significantly differ from BBCET or PBO. These preliminary findings support the utility of the 5-HTTLPR polymorphism for personalizing treatment selection in problem drinkers.

Unpacking Personalized Feedback: An Exploratory Study of the Impact of Its Components and the Reactions It Elicits Among Problem Drinking Men Who have Sex With Men

Personalized feedback (PF) has demonstrated effectiveness in reducing drinking. Few studies have examined its effectiveness with adult problem drinkers or its potential mediators or moderators, including developing discrepancy. This study aimed to identify potential mediators and moderators of PF provided to adult problem drinking men who have sex with men (PDMSM). Method: An exploratory analysis of PF provided to PDMSM in the context of modified behavioral self-control therapy (N = 90). The association of individual items of PF, severity of PF, and independently rated, in-session participant reactions to PF with drinking outcomes (mean drinks per drinking day, MDDD) were examined using correlations and logistic and linear regression. Results: Significant pre–post differences in MDDD emerged. Other drug risk, family risk, and having an abnormal liver enzyme test result were significantly associated with proxies for developed discrepancy in expected directions; however, no PF item or reaction to PF predicted drinking outcomes. Severity of PF was not associated with participant reactions or drinking outcome. Conclusions: PF may be an effective intervention for PDMSM. Further research is needed to identify potential mediators and moderators of PF among adults.

Variation in Mu-Opioid Receptor Gene (OPRM1) as a Moderator of Naltrexone Treatment to Reduce Heavy Drinking in a High Functioning Cohort.

It is well known that naltrexone, an FDA-approved medication for treatment of alcohol dependence, is effective for only a subset of individuals. Recent studies have examined the utility of a functional A118G single nucleotide polymorphism (SNP) of the mu-opioid receptor gene (OPRM1) as a predictor of naltrexone treatment response. Although the findings to date have generally been consistent with a moderating effect of the SNP, further evaluation of this hypothesis is warranted. To evaluate whether problem drinkers with one or two copies of the 118G allele respond better to naltrexone treatment. The treatment goal in this cohort of high functioning men who have sex with men (MSM) was to reduce heavy drinking, rather than to promote abstinence. 112 subjects of European ancestry from a randomized clinical trial of naltrexone and behavioral therapy for problem drinking MSM were included in the analysis. Subjects were treated for 12 weeks with 100 mg/day of oral naltrexone hydrochloride. All participants received medical management with a modified version of the Brief Behavioral Compliance Enhancement Treatment (BBCET), alone or in combination with Modified Behavioral Self-control Therapy (MBSCT). Naltrexone-treated subjects with one or two 118G alleles had a significantly greater percentage of non-hazardous drinking (NoH) (p < 0.01) than those treated with placebo or A118 homozygotes in either medication group. These results are consistent with a modest moderating effect of the OPRM1 118G allele on the reduction of heavy drinking by naltrexone treatment.

A randomized clinical trial of naltrexone and behavioral therapy for problem drinking men who have sex with men.

This study tested the comparative effectiveness of modified behavioral self-control therapy (MBSCT) and naltrexone (NTX), as well as the added benefit of combining the 2, in problem drinking men who have sex with men (MSM) seeking to reduce but not quit drinking. Participants (N = 200) were recruited and urn randomized to 1 of 2 medication conditions, NTX or placebo (PBO), and either MSBCT or no behavioral intervention, yielding 4 conditions: PBO, NTX, MSBCT, and NTX + MSBCT. In addition, all participants received a brief medication compliance intervention. Participants were treated for 12 weeks and assessed 1 week after treatment completion. Two primary outcomes-sum of standard drinks and number of heavy drinking days-and 1 secondary outcome-percentage of those drinking in a nonhazardous manner (NoH)-were selected a priori. There was a significant main effect for MBSCT (all ps < .01) but not NTX on all 3 outcomes. In addition, the combination of NTX and MBSCT was not more effective than either MSCBT or PBO. There was a significant interaction effect on NoH, such that NTX significantly increased the likelihood (odds ratio = 3.3) of achieving a nonhazardous drinking outcome relative to PBO. In addition, NTX was significantly more effective than PBO on a descriptive outcome: negative consequences of drinking. There was no advantage to adding NTX to MBSCT. In addition, MBSCT showed stronger evidence of efficacy than NTX. At the same time, NTX delivered in the context of a minimal medication compliance intervention was significantly more effective than PBO on an important clinical indicator. Results provide new information to guide the treatment of problem drinking, including in primary care settings.

Cognitive behavioural therapies versus other psychological therapies for depression.

This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all CBT approaches compared with all other psychological therapy approaches for acute depressionTo examine the effectiveness and acceptability of different CBT approaches (cognitive therapy, rational emotive behaviour therapy, problem-solving therapy, self-control therapy and Coping with Depression course) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all CBT approaches compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, third wave CBT) for acute depression.

Evidence-Based Psychosocial Treatments for Child and Adolescent Depression

The evidence-base of psychosocial treatment outcome studies for depressed youth conducted since 1998 is examined. All studies for depressed children meet Nathan and Gorman's (2002) criteria for Type 2 studies whereas the adolescent protocols meet criteria for both Type 1 and Type 2 studies. Based on the Task Force on the Promotion and Dissemination of Psychological Procedures guidelines, the cognitive-behavioral therapy (CBT) based specific programs of Penn Prevention Program, Self-Control Therapy, and Coping with Depression-Adolescent are probably efficacious. Interpersonal Therapy–Adolescent, which falls under the theoretical category of interpersonal therapy (IPT), also is a probably efficacious treatment. CBT provided through the modalities of child group only and child group plus parent components are well-established intervention approaches for depressed children. For adolescents, two modalities are well-established (CBT adolescent only group, IPT individual), and three are probably efficacious (CBT adolescent group plus parent component, CBT individual, CBT individual plus parent/family component). From the broad theoretical level, CBT has well-established efficacy and behavior therapy meets criteria for a probably efficacious intervention for childhood depression. For adolescent depression, both CBT and IPT have well-established efficacy. Future research directions and best practices are offered.

Practitioner’s Guide to Empirically Based Measures of Depression

Practitioner's Guide to Empirically Based Measures of Depression Arthur M. Nezu, George F. Ronan, Elizabeth A. Meadows, and Kelly S. McClure (Eds.). New York: Kluwer Academic/Plenum Publishers (www.wkap.nl). 2000, 353pp. $69.95 (spiral bound). When I am reading research on depression, or working with a depressed client here at the university, I often wonder how to obtain a particular assessment instrument that I have read about in the literature on depression. How do I go about purchasing it? How do I find it? Who designed it and who publishes it? How long does it take to administer and interpret it? Can I photocopy it or do I have to purchase it? What is the best instrument to use for a particular clientele? As part of the AABT Clinical Assessment Series, the Practitioner's Guide performs a valuable service of informing clinicians, not only of the various instruments used to assess depression, but also how to locate and obtain these instruments. Additionally, this guide offers a 10-step process to help clinicians decide on which instruments would be most beneficial to their practice. I believe this guide provides a valuable service for clinicians in the area of assessment of depression. Structure of the Practitioner's Guide The guide is divided into two major sections. Part I comprises three chapters that provide an overview of depression and its assessment. Chapter 1 is an introduction that discusses the structure of the book, the selection of the instruments included in the volume, and the format of the description of each instrument. The guide contains over 90 reviews of measures available in English that assess depression or depressive symptoms and that are relevant to cognitive behavioral therapy. Additionally, the guide provides information regarding reliability and validity of each measure. The description format for each instrument includes its title, reference, purpose, population for which it was developed, a description and overview of the instrument, research background, administration, scoring, interpretation, psychometric properties, clinical utility, research applicability, source, cost, and alternative forms. Chapter 2 provides an overview of depression, its diagnosis, assessment, and models of treatment. The first part of this chapter provides a brief overview of the DSM-IV diagnostic criteria for depression and distinguishes major depression and dysthymia. Additionally, the diagnostic overview discusses the notion of double depression. The guide distinguishes two major methods of assessment: self-report questionnaires and clinically structured interviews. The authors note the drawbacks to self-report questionnaires and inform clinicians that these types of questionnaires should not be used for purposes for which they were not designed-For example, cutoff scores shouldn't be used to determine an Axis I diagnosis. This chapter describes several models that have been developed for treating depression: Lewinsohn's Behavioral Model, Social Skills Training, Rehm's Self-Control Therapy, Nezu's Problem-Solving Therapy, Behavioral Marital Therapy, Beck's Cognitive Therapy, and the Interpersonal Model. While the authors do not provide a comparative evaluation of these models, the common thread through all these models is their empirically based development. Chapter 3 of this volume provides a 10-step guide to help clinicians select appropriate instruments for both clinical and research settings. …

Efficacy of Cognitive-Behavioral therapy in the treatment of children with adhd, with and without aggressiveness

The objectives of this study were twofold: to show the efficacy of a cognitive-behavioral self-control therapy on children with ADHD and to determine whether the combination of training in self-control with training in anger management has better outcomes on two subgroups of hyperactive children, aggressive and nonaggressive. Thirty-two children with ADHD, 16 aggressive and 16 nonaggressive, participated in the research. We applied a cognitive-behavioral self-control training, which included self-instructional training via modeling and behavioral contingencies, to 16 of the 32 hyperactive children. The other 16 hyperactive children were taught the same program, but combined with anger management training. The interventions were carried out by two therapists each taking care of four groups, one of each in the following conditions: hyperactive with the cognitive-behavioral self-control therapy, hyperactive with the combined treatment, hyperactive-aggressive with the cognitive-behavioral self-control therapy, and hyperactive-aggressive with the combined treatment. The results indicated important improvements on several measures in all treated groups. Furthermore the improvements of children with aggressiveness were slightly better, according to the parents, with the combined treatment than without it. The data provide support for including anger management training in the cognitive-behavioral interventions for hyperactive-aggressive students. © 2000 John Wiley & Sons, Inc.

Improvement of seizure control by psychological methods in patients with intractable epilepsies

Recent attempts to clarify the pathogenesis of pharmacoresistant epilepsies arrive at the conclusion that intractable epilepsies might be prevented by earlier, more effective pharmacotherapy. In this paper the problem of intractability is examined from a psychological point of view. Sixteen patients with intractable epilepsies were trained in techniques of self control (SC) in addition to ongoing pharmacological treatment. The SC training consisted of detailed self observation which aimed at identifying warning signals of a beginning seizure and seizure-provoking factors and the development of 'counter measures' (behavioural measures to interrupt a beginning seizure and to neutralize provoking factors). After SC training, all those patients who successfully managed to deal with their identified problems (strong psychic stress and/or poor intuitive SC abilities) achieved a significant improvement of seizure control: 68% obtained 80-100% reduction and 12% obtained 60-70% reduction of seizures. None changed for the worse. These findings suggested that psychological methods of seizure control can contribute to improving long-standing intractable epilepsies. Offered early in the process of epilepsy they may even help to prevent the development of intractability. A new kind of polytherapy is proposed, consisting of a combination of pharmacological and SC therapy.

Treatment of an adolescent with bowel movement phobia using self-control therapy

This report describes a self-control treatment of an adolescent with a highly unusual and severely debilitating phobia of having bowel movements in public. The treatment focused predominantly on helping the adolescent to modify his maladaptive thingking and also included role plays, graduated exposure, and homework assignments. Multimethod and multisource assessment data were collected as well as measures of social validity. Treatment gains were maintained at 3 and 6 month follow-up.

Additive Effects of Psychostimulants, Parent Training, and Self-Control Therapy with ADHD Children

Utilizing a double-blind, placebo design, the effects of a high (0.8 mg/kg) and a low (0.4 mg/kg) dose of methylphenidate alone and in combination with behavioral parent training plus child self-control instruction were evaluated with 96 attention deficit hyperactivity disorder children. No evidence of the superiority of the combined conditions relative to medication alone was found. Some limited support was found for the hypothesis that the effects of a high dose of psychostimulant medication could be achieved by combining the low dose with a behavioral intervention. The importance of the latter finding is highlighted by the fact that both the benefits and untoward effects of the psychostimulants appear to increase with the dose.