A single intervention: a visit to the family.
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Biomedical subjects
Publications and source records attributed to I Zwerling.
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The ghetto resident's concern with immediate real and psychological survival leads to what Kluckhohn called a present-time cultural value orientation, in contrast to the middle-class time orientation, which values preparation for the future. The authors view several aspects of the psychotherapy of ghetto patients in the light of this difference: evaluating patients for long-term psychotherapy, understanding precipitating factors, and understanding the nature and urgency of patients' communications. The authors have observed behaviors as expressions of impulse rather than of culturally determined expectations that are projected onto the therapist.
Elements of a standard definition of psychotherapy are used to support the argument that the creative arts therapies should not be characterized as adjunctive therapies, or discredited as not being "real therapies." Two concepts widely acknowledged as important in the application of the creative arts therapies are discussed: first, that the nonverbal media employed by creative arts therapists tap emotional rather than cognitive processes and evoke responses more directly and immediately than traditional verbal therapies, and, second, that creative arts therapies are reality-based and provide a more immediate and real link to a patient's experience than something he can portray only verbally.
The three basic concepts of community mental health will have profound impact on many aspects of traditional psychiatric theory and practice, the author believes, and must be taken into account in psychiatric residency programs. The catchment-area concept means that psychiatrists are obligated to provide help for far larger numbers of people, including those who have problems and attitudes psychiatrists are not accustomed to dealing with. Psychiatrists must also work in partnership with communities that demand a voice in defining and labeling problems and specifying treatment modalities. The concept of promoting health as well as treating illness means that psychiatry becomes involved with broader concerns about improving the quality of life. The third concept, that behavior has family, community, social-class, and other sociocultural determinants, has already affected psychiatric practice and education, but it continues to generate friction.
The effects of Gerovital H3 (a specially stabilized form of procaine hydrochloride) on geriatric psychiatric patients were assessed in a double-blind study at Bronx State Hospital. The mean age of the subjects was 73 years and the average rating for the severity of organic symptoms was "moderate." During the first six weeks of study, the patients were each given a 5-ml injection of either Gerovital or placebo (saline) intramuscularly three times a week. This dosage was doubled to 10 ml per injection during the second six weeks. Nine Gerovital and 10 control subjects completed the first six weeks; and 6 Gerovital and 7 control subjects completed the entire 12-week study. Objective rating scales were used to evaluate patients on measures of interpersonal functioning, cognitive ability, psychiatric symptoms, and urine and blood chemical findings. All subjects were assessed before treatment and at six weeks and twelve weeks of the study. Side effects were recorded at two-week intervals. On most measures the variability between subjects was quite large, whereas differences between average scores for the two groups usually were small The few significant differences showed no systematic pattern and would be expected to occur by chance alone when so many statistical comparisons are made. The overall results of this double-blind study strongly indicated that, among these hospitalized geriatric patients with organic symptoms, Gerovital H3 had no ameliorative effect on either psychologic or physiologic functioning.
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