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PubMed1986

The treatment of emotional disorders in general practice: psychological methods versus medication.

This paper describes three recent trials in which psychological methods were evaluated in the treatment of emotional disorders in general practice. In the first trial, brief counselling by the general practitioner was found to be as effective as anxiolytic medication, was welcomed by patients and did not increase demands on doctors' time. In the second trial (still in progress), in which treatment is aimed at emotional disorders of poor prognosis, problem solving treatment by a psychiatrist is being compared with control treatment by the G.P. The third trial evaluated an anxiety management programme provided by clinical psychologists in health centres; substantial reductions in anxiety occurred rapidly and were maintained at follow-up.

Affective Symptoms↗
PubMed1995

Confidentiality in psychological practice: a decrepit concept?

Although the principle of confidentiality in the relationship between psychologists and client has been vaunted, and is emphasised in the Australian Psychological Society's Code of Professional Conduct (the APS code; 1994), the confidentiality of this relationship is circumscribed by the absence of legal protections, the ethical beliefs of psychologists, institutional practices, and the provisions of the APS code itself. Lack of privilege in judicial proceedings, and statutory obligations to report certain types of behaviour, mandate breaches of confidentiality in some circumstances. Ethical beliefs of psychologists may support disclosure, especially where it is believed that there is danger of serious physical harm to the client or others. Multidisciplinary teams and institutional settings require the exchange of information for optimal delivery of services. Recent amendments to the APS code may require disclosure without the client's consent when a client is believed to be suicidal. Such developments, when considered at all, are typically regarded as exceptions to a general obligation of confidentiality. However, discussion of exceptions presupposes agreement on fundamental principle: the significance of, and rationale for, confidentiality in the psychologist-client relationship. It is argued in this paper that the obligation of confidentiality has been assumed rather than vigorously analysed and empirically explored. A critical examination of this obligation is the most appropriate starting point for the rehabilitation of contemporary principles of confidentiality in the psychologist-client relationship.

Attitude of Health Personnel↗
PubMed1981

[Medical psychological practice (author's transl)].

Based on the qualification regulations for medical practitioners, in most medical specialties and faculties, organizations for training in medical psychology were set up. For some years these organizations also participate increasingly with psychosocial services in the treatment of patients. Just as varied as the duties undertaken the methods applied are most strongly stamped by psychoanalysis and behavior therapy. Some prerequisites for cooperation of doctors and nurses of the "classical" medical disciplines and the medicopsychological and psychosomatic organisations are discussed.

Behavior Therapy↗
PubMed1994

Dyspepsia in general practice: psychological findings in relation to Helicobacter pylori serum antibodies.

Questionnaire data based on traditional concepts for measuring hypochondriasis and depression were related to serological data on Helicobacter pylori antibodies in 110 of 130 consecutive patients, aged 18-65 yr, consulting for dyspeptic symptoms in general practice. Of the patients thirty-seven (33.6%) and seventy-three (66.4%) were classified as H. pylori positives and H. pylori negatives, respectively, the H. pylori positive patients being significantly older than H. pylori negative patients. Factor analyses of the questionnaire data indicated the heterogeneity of each of the traditional concepts for measuring hypochondriasis and depression but succeeded in differentiating orthogonally between two hypochondriasis factors and three depression factors. Hierarchical regression analyses of factor scores, controlling for the influence of age and sex, indicated higher H. pylori antibody activity to be associated with less hypochondriacal signs of anxiety and uneasiness. It is hypothesized, that in dyspepsia without signs of H. pylori infection, somatization may account to a substantial extent for the illness.

Adolescent↗
PubMed1995

Confidentiality in psychological practice.

Confidentiality has long been a cornerstone of trust in the professional relationship between psychologists and their clients. Developments in computer technology, litigation, insurance reimbursement schemes, and changing lifestyles are forcing psychologists to reconsider and refine their approach to respecting this important ethical principle. This article review basic concepts on the matter, and discusses these in light of evolving issues in practice, technology, and the law. Some contrasts in legal and ethical aspects of confidentiality between Australia and the United States are discussed. Recommendations for enhancing attention to confidentiality in one's practice are included.

Access to Information↗
PubMed2003

Practical psychological management of old age psychosis.

Late-onset forms of psychosis have been the object of increasing interest in recent years. Despite the fact that there are still many obscure areas, significant advances in the pathophysiology, delimitation of risk factors, clinical presentation, neuropsychology and the pharmacological treatment have been made. Nevertheless, the psychological aspects of both aetiology and treatment of these late forms of psychosis have received much less attention than the rest. In contrast with that, the clinician is confronted with the need to manage patients that are reluctant to take medications and in which the outcome of pharmacological treatments is not always optimal. The elderly psychotic patient should not be excluded from the possibility of receiving any kind of psychological help. He may benefit from adaptations of different psychotherapeutic measures that can include the more classical techniques as psychodynamic oriented and behavioural-cognitive therapies or the newer forms of treatment specially designed for the aged, as reminiscence or psychomotor therapy. In any case, to obtain any result the patient needs to be managed in a way that goes well further the prescription of a neuroleptic drug. In this paper we review some of the most important psychological cues for the understanding of the elderly psychotic patient. Furthermore, we divide the therapeutic relationship over the time in three parts: The initial contact, the central phase and the termination. We offer some keys for the practical management of the patient in each of these phases, with special attention to the adherence to treatment and early identification of treatment-emergent complications like depressive symptoms or hypochondriac concerns.

Aged↗
PubMed1994

The use of consultation in psychological practice: ethical, legal, and clinical considerations.

The importance of consulting with other professionals to maintain acceptable standards of care is well documented in many health care professions. However, evidence indicates that many psychologists fail to utilize consultation when needed, and that consultation use varies along dimensions such as the education and training of the consultee, the type of setting, number of years in practice, and proximity to available consultants. In this article, we review the research on the use of consultation by psychologists as well as other health care professionals. We discuss the clinical, ethical, and legal implications of seeking consultation as a professional psychologist. Finally, a detailed and practical model for the regular use of consultation is given to improve the routine use of consultation in clinical practice.

Confidentiality↗
PubMed2006

Editing as a psychological practice.

The experience of the Jungian analyst in the role of editor of manuscripts by creative colleagues is examined. Historical precedents include Michael Fordham's editorial correspondence with Jung around the latter's synchronicity essay; Jung's handling of manuscripts submitted by Sabina Spielrein to the Jahrbuch für psychoanalytische und psychopathologische Forschungen and various authors to the Zentralblatt für Psychotherapie und ihre Grenzgebiete, and the author's close editing of a paper submitted by Andrew Samuels to the Journal of Analytical Psychology. In addition to mustering an adequate amount of generosity, erudition, and availability, the analytic editor must know how to clarify a psychological argument and to gauge the psychological impact of the written text. Notwithstanding transference/countertransference phenomena that can emerge around issues of competition, envy, and territoriality when author and editor are also fellow-authors working in the same field, the editor needs to be comfortable about serving as the author's selfobject and midwife. From an analytic perspective, although communicating decisions about the best way to put ideas into words can sometimes attract transference to the editor, the more profound transference that analysts experience in the editing situation is toward the text being edited, which helps to motivate donated time spent caring for journal manuscripts.

Creativity↗
PubMedDate not supplied

Alzheimer's disease: a practical, psychological approach.

Alzheimer's Disease affects approximately two million people. It is a crippling, organic brain disorder that causes loss of recent memory, intellectual deterioration, unpredictable behavioral changes, and personality deterioration. The fourth leading cause of death among the elderly, it also affects younger people. The disease has two victims, the Alzheimer patient and the caregiver. Caregivers often experience shame, embarrassment, denial, frustration, anger, depression, and guilt as they care for an Alzheimer patient. This paper provides information about the disease and it's manifestations, along with practical suggestions to help both the Alzheimer patient and the caregiver.

Adult↗
PubMed2006

The association between the body mass index of first-year female university students and their weight-related perceptions and practices, psychological health, physical activity and other physical health indicators.

OBJECTIVE: To investigate the association between the weight status of first-year female students (FYFS) and various weight management-related characteristics to identify possible components of a weight management programme for students. DESIGN: Cross-sectional study. SETTING: Female residences at a South African university. SUBJECTS: A total of 360 FYFS. RESULTS: Mean (+/-standard deviation (SD)) body mass index (BMI) of the FYFS was 21.8 +/- 2.6 kg m(-2), with 7.2% being underweight, 81.9% normal-weight, 10.0% overweight and 0.8% obese. Underweight, normal-weight and overweight students differed with regard to their perception of their weight (P < 0.001), weight goals (P < 0.001) and previous weight-loss practices (P < 0.001). Mean+/-SD score on the 26-item Eating Attitudes Test (EAT-26) was 8.5 +/- 9.0 with 8.4% classified as high scorers. Mean+/-SD score on the 34-item Body Shape Questionnaire (BSQ) was 87.7 +/- 32.2, with 76.1% classified as low, 11.9% as medium and 11.9% as high scorers. The self-concept questionnaire indicated that 36.7% had a high, 43.9% a medium and 19.4% a low self-concept. Higher BMI correlated with a higher BSQ score (P < 0.001), a lower self-concept (P = 0.029) and a higher EAT-26 score (P < 0.001). Smoking was prevalent amongst 13.1% of students, and 51.2% used vitamin and/or mineral supplements. Students who quitted smoking had higher (P = 0.006) BMI (22.7 +/- 2.9 kg m(-2)) than those who never smoked before (21.6 +/- 2.5 kg m(-2)). Normal-weight students were more physically active than underweight or overweight students (P = 0.038). CONCLUSIONS: The specific weight management-related needs of FYFS include information about supplement use, smoking, realistic weight goals, safe and sound weight-loss methods, weight cycling, body-shape perceptions, eating attitudes and behaviours, self-concept and physical activity. Interventions aimed at correcting these problems should target all students, regardless of their BMI.

Adolescent↗