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At least 217 records · Page 12Linked to original sources
PubMed1976

The continuing care clinic: outpatient treatment of the chronically ill.

The need for continuing care of chronic psychiatric patients within the community is a pressing problem that calls for development and testing of new treatment methods. This paper describes one such method, the Continuing Care Clinic, an outpatient program for chronic patients who have not responded well to other outpatient treatment approaches. The clinic's structure, treatment rationale and procedures, and clinical results over a 31/2-year period are described. Among specific treatment features discussed are the use of multiple therapists, focus on available personality strengths and on reality issues, and patient-staff group interaction as an adjunct to individual psychotherapy.

Adaptation, Psychological↗
PubMed2003

Long-term maintenance ECT: a retrospective review of efficacy and cognitive outcome.

Continuation and maintenance electroconvulsive therapy (ECT) are used to prevent relapse of depression after a successful course of index ECT. Such a course of treatment is typically extended for as long as a year. However, some patients seem to require longer courses of maintenance ECT. Little is known about the outcomes of long-term use (> 1 year) of maintenance ECT. We reviewed our maintenance ECT practice for the year 2000 and found that 43 patients had been receiving maintenance ECT for more than a year. This retrospective study reviews the outcomes of these patients. All patients had depression associated with either unipolar or bipolar disorder or schizoaffective disorder. These patients had multiple medication or psychotherapy trials or both and multiple hospitalizations before receiving maintenance ECT. Effects on depressive symptoms, level of functioning, health care use, frequency of hospitalizations, and cognition are discussed. We conclude that extended maintenance ECT is efficacious and well tolerated and reduces hospital use for a population of chronically depressed patients refractory to medication.

Adult↗
PubMed1991

Psychotherapy and case management for multiple personality disorder. Synthesis for continuity of care.

Patients with MPD are often difficult to manage in the community. These patients have a chaotic lifestyle with acting out behaviors and traumatic relationships. They have difficulty in managing time, maintaining good function, and being safe. The prognosis is good, however, with intensive psychotherapy. Still, containment of the treatment, which is often stormy, is a difficult task. Clinical case management is a treatment modality that strives to bring order out of chaos, stabilize the patient in the community, and encourage the highest level of function during treatment. It is useful to conceptualize case management as a framework for MPD psychotherapy, both to contain the therapy and to be drawn on for strength and resources. The stages of MPD therapy can be intertwined with the core case management functions of assessing, planning, linking to resources, monitoring, and advocacy to facilitate continuity of care for the patient. The synthesis of psychotherapy and case management can decrease chaos for both the patient and therapist, facilitate the patient's function on a daily basis, and increase connectedness for the patient and needed services. There is an art and a subtlety to the synthesis that grows with awareness and experience of the therapist/case manager. It is a synthesis worthy of development and implementation.

Abreaction↗
PubMed2001

Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis.

This study compared the efficacy of 3 16-week treatments for depression in 63 patients with multiple sclerosis (MS) and major depressive disorder (MDD): individual cognitive-behavioral therapy (CBT), supportive-expressive group therapy (SEG). and the antidepressant sertraline. Significant reductions were seen from pre- to posttreatment in all measures of depression. Intent-to-treat and completers analyses using the Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward. M. Medelson. J. Mock, & J. Erbaugh, 1961) and MDD diagnosis found that CBT and sertraline were more effective than SEG at reducing depression. These results were largely supported by the BDI-18, which eliminates BDI items confounded with MS. However, the Hamilton Rating Scale for Depression (M. Hamilton, 1960) did not show consistent differences between treatments. Reasons for this inconsistency are discussed. These findings suggest that CBT or sertraline is more likely to be effective in treating MDD in MS compared with supportive group treatments.

Cognitive Behavioral Therapy↗
PubMed1996

Resistances in a hospital setting: issues in resolution.

This article describes multiple forms of resistances--patients toward reality, staff toward patients, staff toward staff, and my own counterresistances--in a hospital setting. Examples derive from within the psychiatric system itself, group work with a chronically ill population, a multiple family therapy group, and a case conference setting.

Adult↗
PubMed1983

Multiple versus individual therapy: are two better than one?

Individual and cotherapy sessions were compared via questionnaires and tape recordings to assess differences in attitudes and therapy process. Results showed that therapists view multiple therapy more positively, do not observe differences in process in the counseling situations, and offer lower levels of facilitative conditions on Carkhuff scales in the multiple than the individual situation.

Adolescent↗