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Biomedical subjects

S W Twemlow

Publications and source records attributed to S W Twemlow.

At least 19 recordsLinked to original sources
PubMed2001

Creating a peaceful school learning environment: a controlled study of an elementary school intervention to reduce violence.

OBJECTIVE: The impact of a manual-based antiviolence program on the learning climate in an elementary school over 4 years was compared with the outcome in a control school. METHOD: The two schools were matched for demographic characteristics. The intervention in the experimental school was based on zero tolerance for bullying; the control school received only regular psychiatric consultation. Disciplinary and academic achievement data were collected in both schools. RESULTS: The experimental school showed significant reductions in discipline referrals and increases in scores on standardized academic achievement measures. CONCLUSIONS: A low-cost antiviolence intervention that does not focus on individual pathology or interfere with the educational process may improve the learning environment in elementary schools.

Achievement↗
PubMed2001

Training psychotherapists in attributes of "mind" from Zen and psychoanalytic perspectives, Part I: Core principles, emptiness, impermanence, and paradox.

This paper outlines the principles of a conceptual foundation for an innovative approach to the training of the modern psychotherapist, using certain technical and philosophical percepts found in the practice of Zen, divorced from its usual role as a form of Buddhism and/or a religious belief. A set of core principles derived from Zen and embedded in psychoanalytic theory are listed. Specific values are embodied in the day to day practice of the psychotherapist. The first of these values is the understanding of the true nature of emptiness in relation to the self and the non-Cartesian universe. Then the concept of impermanence and the centrality of paradox to the practice of Zen and psychotherapy is described. The basis of this approach to the education of the psychotherapist is grounded in the assumption that the usual training format with its focus on training in technical skills, with personal treatment being an additional requirement for many psychodynamic therapists, is insufficient for a complete educational experience. The training of the mind itself is an often forgotten and yet essential component of the training process.

Buddhism↗
PubMed2001

Training psychotherapists in attributes of "mind" from Zen and psychoanalytic perspectives, Part II: Attention, here and now, nonattachment, and compassion.

Part II of this paper enumerates four additional attributes of mind derived from Zen that could enrich the training of a psychotherapist. These include: training and modulation of the therapist's attention, the centrality of the concept of "here and now," what it is and is not, and the natural unpressured emergence of compassion as a manifestation of the therapist's nature.

Buddhism↗
PubMed2001

Interviewing violent patients.

A clinical attitude to the interview of violent patients is outlined, which enables maximum safety for the clinician and usefulness of the interview findings. This approach emphasizes careful monitoring of subjective states in the patient and clinician. The author suggests an emphasis on clinical knowledge of the DSM-IV and psychodynamic diagnoses of potentially violent psychiatric patients; self-awareness of transference and countertransference; and self-care including attention to personal physical and emotional needs, de-escalation, and self-defense skills. Finally, there is need for a safe therapeutic context within which to work.

Adult↗
PubMed2000

The roots of violence: converging psychoanalytic explanatory models for power struggles and violence in schools.

This paper demonstrates that several psychoanalytic models taken together converge to collectively explain school violence and power struggles better than each does alone. Using my own experience in doing psychoanalytically informed community intervention, I approach the problem of school violence from a combination of Adlerian, Stollerian, dialectical social systems, and Klein-Bion perspectives. This integrated model is then applied to the Columbine High School massacre in Littleton, Colorado.

Adolescent↗
PubMed1998

The application of traditional martial arts practice and theory to the treatment of violent adolescents.

Components of an effective treatment program for violent adolescents, and the complex problems posed by youth gangs, are discussed. It is proposed that traditionally taught martial arts can provide a useful alternative for such dysfunctional adolescents. The literature on the use of martial arts in the treatment of violence is reviewed, and the program philosophy is described. The program utilizes a commitment to respect and self-control, with an emphasis on leadership and community service using the traditional model of a gentle warrior. Oversight is provided by trained instructors, whose psychological and philosophical approach stresses nonviolence. The program also assists youths in coping with the complexities of an often dysfunctional family environment. Clinical examples detail the application of such a program in specialized martial arts schools, residential treatment, and public school classes.

Adolescent↗
PubMed1997

School violence reduction: a model Jamaican secondary school program.

Violence in United States' schools is epidemic. Solutions are rare. Community mental health centers are now being challenged to become part of the solution. The Montego Bay Secondary School project presents an example of how violence reduction can be achieved using almost no physical resources and the special effect, called the "Bruno Effect", created by one Jamaican police officer with the consultation of a psychodynamically-led training and intervention team. The "Bruno Effect" resulted in a dramatic reduction in the number of physical attacks from an observed 5 fights per day (3 out of the 5 involved knives and cutting) to 1 per week. The violence rate returned immediately to its former level as soon as "Bruno" left the school. The dramatic violence reduction appears related to establishing an adult protective shield. Results stem from the unique personality of the adult protector, as well as a combination of the special role of the police and the outside intervention team.

Adolescent↗
PubMed1997

Exploitation of patients: themes in the psychopathology of their therapists.

This clinical paper develops an interpersonal theory of the therapist-patient relationship when boundaries are violated. It describes a clinically useful way to define boundary transgressions. A variety of mutually created dialectical paradigms interact with the therapist's psychopathology when, for various reasons, the therapist who is fully ethically responsible cannot see what is happening. The role of burgeoning aggression, dominance/ submission interplay, envy, and erotized countertransference is explored as forces leading to sexual and nonsexual exploitation of patients. Numerous clinical vignettes are used to illustrate the theoretical issues. Two fundamental axioms of treatment are also described, which, if followed, can help avoid transgressions.

Defense Mechanisms↗
PubMed1997

Patterns of utilization of medical care and perceptions of the relationship between doctor and patient with chronic illness including chronic fatigue syndrome.

To what extent do personal constructs affect the relationship between doctor and patient when the ill patient does not readily recover with treatment? Questionnaires were returned anonymously by 609 patients with a self-reported diagnosis of chronic fatigue syndrome, who were considered chronically ill. Findings were compared with those of an earlier study of a population of 397 general medical patients. The chronically ill patients lost an average of 65 days of work per year due to illness compared to general medical patients who missed six or fewer days per year because they were ill. The chronically ill patients also reported a 66% higher frequency of iatrogenic illness, spent more money on health care, took more medication, saw more specialists, and were more litigious than the general medical population. Research suggested several patterns of relationships between doctors and patients, and attitudes to health and illness, which may alert doctors to patients' perceptions, beliefs, encoded constructs, and patterns of relating that affect responses to treatment. More attention by doctors to patients who are experiencing the stress of chronic illness is indicated.

Adolescent↗
PubMed1996

Peacekeeping and peacemaking: the conceptual foundations of a plan to reduce violence and improve the quality of life in a midsized community in Jamaica.

Thomas Jefferson noted that social ills breed economic ills and vice versa. An endless regress can occur with violence and mayhem as a chorus: Every community in the world has its own thresholds and patterns of violence, and communities experience varied levels of deterioration of safety with a reciprocal increase in violence. The United States, having undergone 200 years of social evolution as an independent nation, has a spiraling problem with violence. Jamaica, with only recent independence from British sovereignty, is an ideal crucible for the study of evolution of violence in a very young democracy and, hopefully, to identify problems and provide some solutions. Having gained independence from British rule in 1962, Jamaica immediately demonstrated a facile experimentation with forms of government that differed dramatically from what had been previously experienced under the rather rigid, autocratic British administration. In its 33 years of independence, this country has gone through some extraordinary shifts. An initial courtship with Communist theory led to a destructive liaison with Fidel Castro's version of Marxism. During this brief interlude, the intellectual ideals of equality and peace came into direct contrast with facts of a failing Communist regime. During this period, there was a steady exodus of wealthy Jamaican families for whom heavy taxation threatened financial ruin. The prime minister, the Honorable Michael Manley, a highly sophisticated left-wing intellectual liberal, soon realized the political cost of the alliance with his Caribbean neighbor, Fidel Castro, who was then and is now dedicated to old-fashioned, state-controlled Communism. He attempted to return to a free-market democracy with financial foundations that were, by then, very shaky. To succeed in a project to reduce violence and improve the quality of life, the entire community needs to be involved. From our work in countries where community projects were primarily financed by federal and state agencies, we were aware that the participation of private citizens in projects was essential for success. Commitment has an added intensity when personal time and funding is involved. Prime Minister Manley enthusiastically embraced and inspired this project, believing that it embodied the fundamental principles of democratic involvement to which he was committed. When the authors personally presented their plan to him, he accepted it immediately and with an obvious personal sense of urgency. Illness led him to resign the post of Prime Minister in 1993, but his successor, Mr. P.J. Patterson, has continued in the same committed, democratic mode.

Developing Countries↗
PubMed1996

An analysis of students' reasons for studying martial arts.

Responses to a questionnaire study of initial reasons to study martial arts by 170 students in a school of martial arts are described. Although self-defense and physical fitness motives were prominently claimed, further analyses of more subtle existential and psychological issues are warranted.

Adolescent↗
PubMed1996

A clinical and interactionist perspective on the bully-victim-bystander relationship.

The authors propose a dialectical conceptual framework for the bully-victim-bystander interaction often seen in school violence. A clinical and interactional typology is proposed for the detection of children falling into these patterns, with the goal of affording early and vigorous intervention and consultation opportunities with teachers and school administrators.

Adolescent↗
PubMed1995

Some interpersonal and attitudinal factors characterizing patients satisfied with medical care.

This research investigated the extent to which interpersonal and attitudinal factors affect the doctor-patient relationship. A questionnaire survey of people living in northeastern Kansas who had experience with medical care was conducted. Dependent measures were over-all patient satisfaction, patient's attitude toward death of self or others, causality orientation, attitude toward health and disease, and perception of the doctor-patient relationship. The majority of test subjects (92%) reported satisfaction with their medical care. A significant correlation between fear of death of significant others and scores on causality scales reflects feelings of not being in control of one's life. Other associations indicate that people who do not feel in control of their lives depend on traditional and folk remedies. Scores showing low fear of own death correlated significantly with the rated greater sense of responsibility for own health and treatment. Patients who rated themselves as more needy were unsatisfied with their care and those whose doctors called them by first name tended to be more content. Even in populations satisfied with their medical care, we suggest that the quality of care could be improved by attention to interpersonal and attitudinal factors.

Adolescent↗