Diabetes treatment and acting out.
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Biomedical subjects
Publications and source records attributed to R Mester.
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The structure, functioning, and treatment concept of a psychodynamically oriented psychiatric unit for young soldiers within Israeli civilian hospital are discussed stressing: (1) the integration of the patient's military self; (2) the resolution of psychological conflicts necessary to avoid traumatic developmental arrest of the patient's personality and to foster personality growth; (3) the involvement of the patient's family in the therapeutic process. Problems in the patient-therapist relationship specifically pertaining to Israeli conditions are outlined.
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This article presents and discusses: (a) some of the diagnostic and psychotherapeutic problems which emerged when dealing with extremely religious Jewish young men; and (b) conscious ethical questions and unperceived counter-transference reactions to religion and religious patients which may overburden the therapist's helping capacity, thereby curtailing the beneficial extent of his intervention. The setting of the therapeutic process is an open intensive care unit. The possible implications and effects of carrying out institutional therapy with this particular kind of patient are also analysed.
The modern women's emancipation movement, concerned with the right of women for self-determination in the question of abortion, embraces the assumption, borne out by most recent epidemiological studies, that abortion does not produce psychological damage in most women. However, an induced abortion is a stressing experience and may for some few susceptible women, even be a traumatic one. The psychotherapist who is overly influenced by statistics and the socio-political climate and/or his own insufficiently resolved inner conflicts, may unconsciously ignore or minimize the importance of an abortion experience for a specific patient in his care. As the case illustrations show, the focusing and through elaboration of this experience may determine the final successful outcome of treatment, especially in brief psychotherapies.
The action assumptions which characterize and differentiate cultures affect the creation and functioning of their institutions. Using this analytic framework, the development of a community mental health center in Israel reflects a culture which contains both pioneering and bureaucratic action assumptions. The effects of these assumptions on staff interventions in community problems are traced. Finally, various dimensions of the emerging definition of community mental health practice in Israel are discussed and their problematic features identified.
In community psychiatry, just as in dynamic psychotherapy, aiming too high may be just as ineffective as setting too minimal goals. In this article, causes and effects of maximalistic and minimalistic attitudes in therapists, community workers and their patients are discussed. The optimum principle and the optimal preventive and therapeutic approaches are presented at a theoretical level. Three clinical examples, where therapeutic techniques based on the optimum principle were applied, are described in detail.
The area of Beit Shemesh, situated in the Jerusalem Corridor has a socioeconomic structure of the pluralistic type characteristic of modern Israel. It includes a small but quickly growing industrial city, several cooperative (moshav) and communal (kibbutz) agricultural settlements, and has a population of colourful ethnic heterogenity. The main effort in the community mental health program which was established and developed in this area was made on the levels of primary and secondary psychiatric prevention. The psychiatric community work was accomplished with a highly flexible approach and an abundance of tactics and techniques, examples of which are presented in this article.
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Behavior of patients with autistic syndrome makes delivery of oral hygiene and dental treatment a problem. In this study, the oral health and needs of two groups of patients with autism were evaluated: noninstitutionalized children with a mean age of 11 and institutionalized adults with a mean age of 22. The latter group had severe periodontal problems; almost half required periodontal surgery. Many of the children also needed periodontal treatment. Adults were found to have lower decayed, missing, and filled teeth (DMFT) scores than functionally independent Israeli persons of the same age. This finding was surprising because institutionalized adults are predisposed to development of dental caries; they frequently consume sweets, have poor oral hygiene, and do not use fluoride. Noninstitutionalized children with autism had caries rates that were similar to rates of functionally independent peers.