Therapeutic Sessions Research Articles

ADVANCE integrated group intervention to address both substance use and intimate partner abuse perpetration by men in substance use treatment: a feasibility randomised controlled trial

BackgroundSubstance use is a risk factor for intimate partner abuse (IPA) perpetration. Delivering perpetrator interventions concurrently with substance use treatment shows promise.MethodsThe feasibility of conducting an efficacy and cost-effectiveness trial of the ADVANCE 16-week intervention to reduce IPA by men in substance use treatment was explored. A multicentre, parallel group individually randomised controlled feasibility trial and formative evaluation was conducted. Over three temporal cycles, 104 men who had perpetrated IPA towards a female (ex) partner in the past year were randomly allocated to receive the ADVANCE intervention + substance use treatment as usual (TAU) (n = 54) or TAU only (n = 50) and assessed 16-weeks post-randomisation. Participants’ (ex) partners were offered support and 27 provided outcome data. Thirty-one staff and 12 men who attended the intervention participated in focus groups or interviews that were analysed using the framework approach. Pre-specified criteria assessed the feasibility of progression to a definitive trial: 1) ≥ 60% of eligible male participants recruited; 2) intervention acceptable to staff and male participants; 3) ≥ 70% of participants followed-up and 4) levels of substance use and 5) IPA perpetrated by men in the intervention arm did not increase from average baseline level at 16-weeks post-randomisation.Results70.7% (104/147) of eligible men were recruited. The formative evaluation confirmed the intervention’s acceptability. Therapeutic alliance and session satisfaction were rated highly. The overall median rate of intervention session attendance (of 14 compulsory sessions) was 28.6% (range 14.3–64.3% by the third cycle). 49.0% (51/104) of men and 63.0% (17/27) of their (ex) partners were followed-up 16-weeks post-randomisation. This increased to 100% of men and women by cycle three. At follow-up, neither substance use nor IPA perpetration had worsened for men in the intervention arm.ConclusionsIt was feasible to deliver the ADVANCE intervention in substance use treatment services, although it proved difficult to collect data from female (ex)partners. While some progression criteria were met, others were not, although improvements were demonstrated by the third cycle. Lessons learned will be implemented into the study design for a definitive trial of the ADVANCE intervention.Trial registrationISRCTN79435190 prospectively registered 22nd May 2018.

Implementing solution‐focused brief therapy to facilitate hope and subjective well‐being among South African trauma survivors: A case study

AbstractPositive psychology interventions have been shown to improve well‐being in various contexts. However, few studies have explored the use of these approaches in clinical settings. Considering the high prevalence of trauma and the pressure on public mental health services in South Africa, this study implemented and described solution‐focused brief therapy (SFBT) with South African trauma survivors in order to explore their experiences of hope and subjective well‐being (SWB), during and after exposure to SFBT. Using a multiple case study design, qualitative data were collected from therapeutic sessions and semi‐structured individual interviews with seven black female participants. Following thematic analysis, results indicated that SFBT contributed towards participants’ experiences of hope and SWB. In particular, the therapeutic conversation, empathy and acceptance in therapy, visualising a better future and focusing on strengths instead of the trauma facilitated these experiences. SFBT may thus be an appropriate intervention to facilitate hope and SWB among trauma survivors.

Participation in group music therapy: A preliminary study of the experiences and perceptions of adolescents who stammer

Music therapy and music-based interventions are increasingly used in the treatment of speech, language, and communication needs, and music therapy has been extensively applied to adolescent groups. To date, however, there has been no published work examining music therapy for adolescents who stammer. The aim of the current study was to explore adolescents’ experiences and perceptions of a group music therapy intervention. Four adolescents who stammer participated in semi-structured interviews examining their experience of group music therapy intervention. The music therapy group intervention consisted of five therapeutic sessions conducted at a summer camp for children and adolescents who stammer. Analysis of in-depth, semi-structured interviews revealed four main themes and several subthemes. Recurrent themes revealed a variety of psychosocial benefits related to the experience of group music therapy, such as developing new friendships and facilitating peer support, increasing self-confidence and self-expression. There was also an emphasis on fun and enjoyment. This paper highlights a number of key benefits of music therapy for adolescents who stammer. These preliminary results highlight the potential of music therapy for adolescents who stammer, and the role of addressing psychosocial aspects of stammering within this creative arts intervention.

Virtual Delivery of Therapeutic Assessment: An Empirical Case Study

The Therapeutic Assessment (TA) model of psychological assessment has grown in use due to the demonstrated benefits to clients. However, to date, there have been no published articles on how conducting TA virtually may impact the process and experience. The COVID-19 global pandemic led to a rapid increase in virtual delivery of psychological services, including assessments. Assessors adapted procedures to ensure that clients were served ethically, the assessor-client relationship was considered, and the results were deemed valid. This empirical case study was conducted to evaluate test validity, therapeutic alliance, and the clinician’s and client’s experience of a TA conducted virtually. The validity of test administration was evaluated by experts, who reviewed video of the administration and test results; no concerns regarding integrity and interpretability of the results were identified. Therapeutic alliance, session process, and virtual presence were measured after each session. Both clinician and client reported positive experiences. The overall impact of the TA was evaluated through quantitative assessment of the client’s experience and qualitative analysis of interviews. Collectively, this research demonstrates the feasibility of conducting a TA virtually, in an efficacious manner, that leads to positive client outcomes.

A novel approach utilizing laser acupuncture teletherapy for management of elderly-onset rheumatoid arthritis: A randomized clinical trial

Introduction Rheumatoid arthritis (RA) disease is a systemic progressive inflammatory autoimmune disorder. Elderly-onset RA can be assumed as a benign form of RA. Until recently, face-to-face therapeutic sessions between health professionals and patients are usually the method of its treatment. However, during pandemics, including coronavirus disease 2019 (COVID-19), teletherapeutic sessions can extensively increase the patient safety especially in elderly patients who are more vulnerable to these infections. Thus, the aim of this randomized clinical trial was to evaluate a novel teletherapy approach for management of elderly patients suffering from RA by utilizing laser acupuncture. Methods A teletherapy system was used for management of elderly patients suffering from RA. Sixty participants were allocated randomly into two groups and the ratio was 1:1. Patients in the first group were treated with laser acupuncture and telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Patients in the second group received telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Evaluation of patients was done by using the Health Assessment questionnaire (HAQ), the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire, and the analysis of interleukin-6 (IL-6), serum C-reactive protein (CRP), plasma adenosine triphosphate (ATP) concentration and plasma malondialdehyde (MDA). Results A statistically significant difference was found in CRP, RAQoL, IL-6 and MDA between the pre- and post-treatments in the first group (p < 0.05) favouring the post-treatment group, while the HAQ showed a statistically significant difference between pre- and post-treatments (p < 0.05) in both groups. Statistically significant post-treatment differences were also observed between the two groups (p < 0.05) in RAQoL, CRP, ATP and MDA, favouring the first group. Discussion Laser acupuncture teletherapy could be suggested as a reliable treatment method for elderly patients suffering from RA, as it can provide a safe and effective therapeutic approach. Teletherapy provided safer access to health professionals and patients while giving a high patient satisfaction value with a relatively lower cost (ClinicalTrials.gov Identifier: NCT04684693).

Building skills and resilience in child abuse pediatricians: A novel program to address Secondary Traumatic Stress

BackgroundSecondary traumatic Stress (STS) is an increasingly recognized phenomenon experienced by clinicians working with patients who have experienced trauma firsthand. STS is experienced in a range of clinical settings; medical trainees and those working in Child Abuse Pediatrics (CAP) are at particular risk of experiencing STS. To date, there are no interventions described to address STS experienced by medical trainees in the context of CAP training. ObjectiveThe aim of this project was to design and pilot an innovative program to increase resilience and address STS symptoms among fellows in a CAP training program. Participants and settingThe Therapeutic Group Sessions (TGS) program was developed for CAP fellows at the Hospital for Sick Children, Toronto, Canada. MethodsThe intervention involved mandatory, monthly small group sessions facilitated by a consistent mental health professional throughout fellowship. Sessions included low intensity focusing activities, sharing impactful work-related experiences, mental health professional-led discussion of strategies and reflection on the session. Written evaluations were completed to understand the perceived impact on fellows and were analyzed for themes. ResultsFellows reported improvements in perceived STS symptoms and increased feelings of resilience. Unanticipated positive outcomes were described including, a highly bonded fellowship group and transferrable skills gained in supportive communication. Programs developed to support clinicians in other settings are reviewed and compared to the TGS program. ConclusionsThis is the first program aimed at improving resilience and addressing STS among child abuse fellows. Outcomes demonstrated numerous positive impacts that are widely applicable to the broader clinical setting.

The therapist, the group and I: how therapeutic alliance moderates the effect of group cohesion on outcomes

PurposeThis study aims to investigate whether the influence of group cohesion on the outcomes depended on the levels of the therapeutic alliance.Design/methodology/approachSixteen individuals with a substance use disorder who were undergoing treatment in a therapeutic community responded to therapeutic alliance, group cohesion, craving and outcomes measures after every therapeutic small group session for a period of six weeks. Data analysis was performed using hierarchical linear modeling.FindingsResults indicate that the effect of group cohesion is stronger when there is a high therapeutic alliance between resident and therapist.Originality/valueEven on group interventions, to enhance group cohesion effects on outcomes, therapists must foster higher therapeutic alliance levels. The findings point out the importance of studying the effect of common factors on outcomes.

Contemplating or Acting? Which Immersive Modes Should Be Favored in Virtual Reality During Physiotherapy for Breast Cancer Rehabilitation.

BackgroundEven though virtual reality (VR) is more and more considered for its power of distraction in different medical contexts, the optimal conditions for its use still have to be determined in order to design interfaces adapted to therapeutic support in oncology.ObjectiveThe objective of this study was to examine the benefits of VR using two immersion methods (i.e., one participatory, one contemplative) and comparing them with each other in a population of women with breast cancer who have undergone breast surgery, during scar massage sessions.MethodsIn a physiotherapy center, each patient participated in four experimental conditions in a random order: two sessions used virtual immersion (i.e., one participatory and one contemplative), one session proposed musical listening and the fourth one was a standard session care. The impact of the level of patient involvement in the virtual world was apprehended through the evaluation of the feeling of presence; the estimation of elapsed time of the physiotherapy sessions and particular attention was paid to the evaluation of patient emotional state.ResultsOur study showed an increase in positive emotions (i.e., joy and happiness) and a decrease in anxiety regardless which support methods were offered. Participatory VR created a feeling of more intense spatial presence.ConclusionOur results highlight the importance of the context in which VR should be offered. The presence of the practitioner and his interactions with the patient can provide a context just as favorable in reducing anxiety as the emotional regulation tools used (VR, music). The use of technological tools should be favored when the practitioner is unavailable during the treatment phase or, even, in order to reduce the monotonous nature of repetitive therapeutic sessions.

La gestion de la douleur chez les patients atteints du cancer dans un hôpital tunisien

Pain is a common symptom in cancer patients. It is subjective and difficult to communicate. It continues to be outsourced and often overlooked despite the existence of multiple recommendations. The objective of this study is to describe pain management in cancer patients in a Tunisian hospital. This is a prospective study, conducted over one month at the maternity centre of Monastir by an intern in pharmacy using a questionnaire. Of 128 patients assessed, 50 were algic. Twenty-six percent of algic patients were not treated. The neuropathic component of pain was present in 30% of cases but under treatment. Relief opioids were prescribed in 43% of cases to relieve pain. Paracetamol was prescribed in 26% of cases. Ten percent of patients use paracetamol self-medication. Sixteen percent of patients have tried non-pharmacological means, of which 62% consume plants. To optimise the management of pain at our centre, the available analgesic sheets have been developed, validated by the medical staff and disseminated in the departments of carcinology and oncohematology. Therapeutic education sessions were also scheduled to warn patients about the risks of self-medication and misuse of medicinal plants. Pain management is complex. It requires respect for international recommendations, but especially for the efforts made by all stakeholders.

Evaluation of the Use of Real-time 3D Graphics to Augment Therapeutic Music Sessions for Young People on the Autism Spectrum

The present research evaluates the effectiveness of CymaSense, a real-time 3D visualisation application developed by the authors, as a means of improving the communicative behaviours of autistic participants through the addition of a visual modality within therapeutic music sessions. Autism spectrum condition (ASC) is a lifelong neurodevelopmental disorder that can affect people in a number of ways, commonly through difficulties in communication. A multi-sensory approach within music sessions encourages people with ASC to engage more with the act of creating music, and with the therapists, increasing their level of communication and social interaction beyond the sessions. This article presents a study evaluating the use of CymaSense within a series of therapeutic music sessions, and a follow-up series of semi-structured interviews. Eight adults with ASC participated in 12 sessions using a single case experimental design approach over a total period of 19 weeks. Using qualitative and quantitative data, the results show an increase in communicative behaviour, for both verbal and non-verbal participants, resulting from the use of CymaSense. Qualitative feedback from interviews provided insight into the factors that contribute to the successful use of the application, as well as aspects that could be improved.

How did Children with Complex Care Needs Affect during the Lockdown Due to the COVID-19 Pandemic?

The COVID-19 pandemic and the lockdown imposed by most of the governments because of it have affected most of us including children with complex care needs. Because of various reasons like changed routine and social isolation, the physical and psychological health of these children has affected. With this observational study, we tried to assess new symptoms with which children with complex care needs presented during the lockdown period. We selected a cohort of children who usually attended 'Al Noor Training Centre for Persons with Disabilities' in Dubai, the United Arab Emirates where they received therapies but had to stay home and continue these therapeutic sessions through telemedicine.

Literature and Art Therapy, as an Applied Model Used by Restorative Justice - Case Study: Minors at Kavaja Minors Institution in Albania

The purpose of this paper is to analyze the restoration process of juveniles who are serving their sentences at Kavaja Minors Institution, through the therapy of literature and art. In order to understand the process, it is essential to answer the following questions: does art therapy have a transformative effect on the psychology of adolescents who have problems with the law? If so, how and to what extent does it affect and by what means do we measure the result? Methods that were used in order to process the data were the empirical, analytical, comparative and descriptive ones. The data were registered before and after sixteen therapeutic sessions that were essentially related to reading literature and dealing with other arts. If art therapy is utilized through a structured program to ensure informal education (ie, discovering oneself and others by creating and practicing process), it may help to improve adolescents' behaviors. Juveniles that are in re-education institutions may even ameliorate their psychological conditions if they are engaged to literature and art therapy. Art in itself deals with the personal dimension and consequently the interpersonal one, giving minors the opportunity to self-heal and later to self-regulate. The findings of this case study justify the importance of art therapeutic sessions in transforming and improving behaviors, learning and commitment to the creative process. This therapy was difficult to implement during the closure of institutions due to COVID-19. As a result, some of the therapeutic sessions were performed virtually and indirectly. Literature and art therapy improves young people emotionally, mentally and promotes their artistic skills. Their creativity and artistic performance (poetry, essays, debate, drama, role-play, dance and singing) remain an important proof of this restoration process.&#x0D; &#x0D; Received: 8 January 2021 / Accepted: 22 February 2021 / Published: 5 March 2021

A235 EFFECTS OF SACRAL PHOTOBIOMODULATION ON THE AUTONOMIC NERVOUS SYSTEM IN PATIENTS WITH COLONIC DYSMOTILITY

BackgroundPatients with chronic refractory constipation show colon dysmotility, including impaired coordination of descending colon-sigmoid colon-rectum-anal sphincter motor functions; this may involve slow colonic transit and colo-anal dyssynergia. Impaired neuronal communication between the sacral defecation center and the distal colon may be causative. In addition, patients with lumbosacral neurological conditions (with lower back pain) may not be able to evoke an effective defecation reflex.AimsTo evaluate if a single therapeutic session of sacral low-level laser therapy (LLLT) would affect the autonomic activity in patients with chronic constipation as revealed by changes in heart rate variability, and to report a multi-session treatment case study.MethodsIn 41 patients with chronic constipation, one session of LLLT was executed, using red LED light at a wavelength of 660 nm for 10 minutes and infrared LED light at wavelength of 840 nm for 10 minutes followed by infrared laser light with wavelength of 825 nm for 20 minutes, while measuring the electrocardiogram. One patient received this treatment 8x over 3 weeks.ResultsThe lumbar-sacral light array treatment showed a significant decrease in parasympathetic activity (RSA & RMSSD) whereas pure sacral laser light treatment showed a significant increase in parasympathetic activity (RSA & RMSSD) as well as a reduction in sympathetic activity (Baevsky’s stress index: SI) (table). A single session of LLLT was also executed during HRCM in 8 patients with some but not all showing evoked colonic motility. Before COVID-19 shutdown, one patient was successfully treated. With a history of chronic constipation without ability to have spontaneous bowel movements for 5 years, symptoms improved from 13 to 8 (on a 20 scale) and quality of life improved from 1.5 to 2.5 (on a 0–4 scale) after 8 sessions. Sympathetic reactivity from supine to standing markedly reduced, from highly elevated measured as the Baevsky index from 55 to 153 s-2 it improved from 42 to 75 s-2 upon standing after 4 sessions. Parasympathetic reactivity did not change.ConclusionsA single session of sacral LLLT markedly affected autonomic nervous activity reflected in changes in HRV. The LLLT is likely affecting the sacral defecation center through peripheral nerves entering and exiting the spinal cord including the dorsal root ganglia. LLLT treatment of a patient with inability to generate spontaneous bowel movements, resulted in ability to have complete evacuations associated with marked reduction in sympathetic reactivity during the supine-standing test, after 4 LLLT sessions. Funding AgenciesCIHRFarncombe Family Digestive Health Research Institute

Psychophysiological Therapy from a Distance: The Art of Sharing

Psychophysiological Therapy from a Distance: The Art of Sharing

ОСОБЕННОСТИ САМОСОЗНАНИЯ РЕЛИГИОЗНОЙ ЛИЧНОСТИ

The article represents person`s peculiarities of self-consciousness with different degree of religiosity and highlights the content of religious person`s self-consciousness, depending on the particular confession. It was revealed that: - religiosity draws the content basis of the religious person`s reflection (the respondents present and name themselves though God image; God appears as the central aspect of their claim to recognition); - the religious person`s self-consciousness has a special nature which is determined by reference to the divine as an ideal-image of oneself, abidance of religious precepts and tendency to spiritual development; - religious person has a special connection and dialogue with God; - religious respondents sense faith as “the live meeting and communication with God”, “the deep inner heartfelt experience of meeting with God,” “the way of salvation,” “the attaining the meaning of life,” “the inner aspiration to God and sincere faith in His Existence" etc.; - respondents of different creeds of Christianity have different meaningful content of their reflection. The results of our research can widen theoretical knowledge and ideas of religious person`s self-consciousness, key issues and features of religious person`s reflection. The results of the study can be practically applied to the educational environment, to counseling and therapeutic sessions as well as to the other human-to-human approaches.

Early post-stroke rehabilitation for upper limb motor function using virtual reality and exoskeleton: equally efficient in older patients.

To evaluate the effectiveness of virtual reality therapy (VRT) Armeo Spring® upper limb exoskeleton (Armeo), in early post-stroke rehabilitation with a focus on the elderly. Convalescence from a stroke is a complex process driven by a spontaneous recovery supported by multifactorial activation. Novel technology-based rehabilitation methods are being introduced to support brain plasticity. Using a randomised controlled study design, participants within 30 days after stroke with arm paresis were, in addition to a daily rehabilitation programme, assigned to an intervention group (45 minutes Armeo IG n = 25; mean age 66.5 years) performing VRT, or to a conventional physiotherapy (45 minutes) control group (Armeo CG, n = 25, mean age 68.1 years). Montreal Cognitive Assessment (MoCA), Functional Independence Measure (FIM) and Fugl Mayer Assessment Upper Extremity Scale (FMA-UE) were performed before and after the three-week therapy with 12 therapeutic sessions. Results of participants < 65 and ≥ 65 years old were compared. Paretic upper arm function improved significantly in both the IG and CG groups, the improvement in FMA-UE was significantly higher in the IG compared to the CG (p = 0.02), and patients ≥ 65 years old presented an equal magnitude of improvement in paretic arm function compared to younger patients. Early post-stroke rehabilitation strategies using, in addition to the daily rehabilitation programme, VRT with visual biofeedback is more effective on upper extremity motor performance than conventional physiotherapy, and the effectiveness does not diminish with patient age. This may be a promising addition to conventional physiotherapy in older stroke patients as well as in younger.

Nonverbal moments of meeting – an analysis of three psychodynamic therapy sessions

ABSTRACT The objective of this study was to empirically enrich the so far theoretically elaborated concept of Moments of Meeting (MoM), that enable processes of change in psychotherapies as described by the Boston Change Process Study Group (2018). In order to describe dyadic verbal and nonverbal patterns in those Moments of Meeting on a microanalytic level, a verbal scenic narrative microanalysis (SNMA) and a nonverbal neuropsychological gesture coding system (NEUROGES) were applied in three single psychodynamic therapeutic sessions. The verbal psychoanalytic-hermeneutic selection of moments of meeting via SNMA showed notable connections to significant nonverbal markers especially in terms of synchronic turn-taking of gestures indicating MoM. Results indicate the importance of including the communicative function of resonant nonverbal behaviour as a facilitator for mutual understanding in the psychotherapeutic setting. Furthermore, the potential of ruptures, and their repair in the dialogue, are discussed as precedents for MoM.

Embodied Imagination and Metaphor Use in Autism Spectrum Disorder.

This paper discusses different frameworks for understanding imagination and metaphor in the context of research on the imaginative skills of children with autism spectrum disorder (ASD). In contrast to a standard linguistic framework, it advances an embodied and enactive account of imagination and metaphor. The paper describes a case study from a systemic therapeutic session with a child with ASD that makes use of metaphors. It concludes by outlining some theoretical insights into the imaginative skills of children with ASD that follow from taking the embodied-enactive perspective and proposes suggestions for interactive interventions to further enhance imaginative skills and metaphor understanding in children with ASD.

Linguistic changes during EMDR sessions: A preliminary single‐case study

AbstractSeveral studies have used text analysis software such as Linguistic Inquiry and Word Count (LIWC) to study how language modification reflects improvements in individuals’ psychophysical health. The aim of this preliminary single‐case study was to evaluate the linguistic changes occurring during EMDR sessions in a patient suffering from anorexia nervosa. Each weekly session (N = 73) of an entire one‐and‐a‐half‐year treatment was divided into three different stages (pre‐stimulation, stimulation and post‐stimulation phase): the patient's speech was analysed at each phase. Results showed significant changes in the examined linguistic categories: affective processes, cognitive processes, biological processes and non‐fluency words. These changes were observed before, during and after the bilateral stimulations. These results are discussed in the light of previous studies concerning the linguistic changes occurring in traumatic event disclosure. They suggest access and reprocessing of painful events during each session, especially when the clinician uses bilateral stimulation. It is possible to suppose the patient's progressive processing of the traumatic experience, followed by its integration into more adaptive mnemonic networks at the end of the therapeutic session. In conclusion, the observed linguistic changes could be representative of an adaptive resolution of adverse life experiences, allowing the patient to create new connections between thoughts, images and bodily sensations linked to the target memories. The clinical implications and limits of this single‐case study are also discussed.

Neuropsychological Education in Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) and conduct disorders (CDs) is a prevalent condition (between 5% and 10%). It is common for symptoms to manifest for many years, sometimes continuing into adulthood, such as severe personality disorders, including alcohol and drug abuse and criminal behavior. Prevalence has shown to have increased considerably over the second half of the twentieth century (Harrison, Cowen, Burns, &amp; Fazel, 2018). The historical cultural neuropsychology allows us to think and work in a new, different way, which has shown itself to be very promising, with good results (Quintino-Aires, 2012, 2016a, 2020a). This article presents the work of our team in neuropsychological education, guided by neuropsychological rehabilitation proposed by Luria (1963, 1966b, 1970) with these children and young people. It also refers the way we use the theory of the formation of mental actions step-by-step by P. Gal’perin, both in structuring the therapeutic session with the child or adolescent ODD and CD, as well as in the pedagogical work with the parents. The case A.B., 10-year-old boy, adopted at the age of five, helps to illustrate the way these cases are usually followed in child psychiatry and clinical psychology, and what may be different within the approach of historical cultural neuropsychology. A brief review of neuroscience research is presented, particularly in neuroimaging studies, so that we can better integrate the clinical work with the boy A.B. The results of our clinical practice suggest that this may be a good working approach for the treatment of ODD and CD. More systematized and extended studies are needed with a greater number of clients.