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PubMedDate not supplied

A social episode model of human sexual behavior.

A social episode model of sexual behavior is proposed with emphasis placed on arousal as a crucial variable. This model argues against a disease or deficiency concept of homosexuality. However, the authors also hold that it may be coercive to push clients to accept their homosexuality, and that a therapist should adequately respond to a valid sexual orientation request. The social-sexual episode is divided into two relatively independent stages, preparatory and consummatory. A mathematical analysis is included, and the model is related to Freeman and Meyer (1975) wherein changes in sexual preferences were successfully made. Other validation sources for the model are presented.

Arousal↗

PubMed2000

[Not Available].

Social requirements of shortness and efficiency influence the psychotherapeutical Situation in many ways. Based on this background the author first deals with the concept of time which showed mythic features in Sigmund Freud's writings while today we assume linear processes. This has a direct effect in dealing with therapy time where currently short-time therapies dominate. An understanding of therapy time as a setting variable enables a structuring procedure in both out-patient and in-patient therapies where the end of therapy is included early. The article ends with some remarks on how the therapist handles his time.

Experience of time↗

PubMed2000

The effects of a health educational and exercise program for older adults with osteoarthritis for the hip or knee.

OBJECTIVE: Evaluation of a self-management program for patients with osteoarthritis (OA) of the hip or knee. The program, which consisted of 6 weekly sessions of 2 hours, included health education by a peer and physical exercises taught by a physical therapist. METHODS: Randomized controlled trial. Inclusion criteria were diagnosis of OA of the hip or knee according to ACR clinical and radiographic criteria and age 55 to 75 years. EXCLUSION CRITERIA: on waiting list for joint replacement. There were pretest, posttest, and followup (6 months) assessments. The experimental group consisted of 56 patients, the control group 49. Outcome variables were pain, quality of life, activity restrictions, knowledge about OA, self-efficacy, body mass index (BMI), and mobility measures. Attention was also paid to effects on health care utilization and lifestyle behavior. RESULTS: Significant MANOVA group x time effects (p < 0.05, one-sided) were found for pain, quality of life, strength of the left M. quadriceps, knowledge, self-efficacy, BMI, physically active lifestyle, and visits to the physical therapist. Most effects were moderate at posttest assessment and smaller at followup. No effects were found for range of motion and functional tasks. CONCLUSION: The program was reasonably effective, but more attention should be paid to proactive followup interventions and to the selection of participants.

Aged↗

PubMed2002

Variations in the measurement of weaning parameters: a survey of respiratory therapists.

OBJECTIVES: Respiratory therapists differ in the methods used to obtain weaning parameters. A questionnaire survey was conducted to better characterize those differences. DESIGN: A questionnaire survey was conducted among respiratory therapists from nine hospitals in the Los Angeles area. The four-page, 32-question instrument was self-administered and anonymous. Responses were tabulated for analysis. SETTING: Respondents from nine hospitals, three hospitals with residency training programs and six community hospitals without training programs in the Los Angeles area. PARTICIPANTS: One hundred two respiratory therapists. RESULTS: There was no universally acknowledged group of weaning parameters, although four parameters were named by > 90%. There was wide variation in methods used to obtaining weaning parameters. Almost all (91%) obtained measurements with the patients breathing their current fraction of inspired oxygen, but there was great variability in the ventilator mode used to collect these parameters (T-tube, continuous positive airway pressure, pressure support), with an equally wide range of pressures added to each mode (0 to 10 cm H(2)O). There was great variation in the time (< 1 to > 15 min) before recording weaning parameters. Measurement of parameters was done either with bedside instruments or read from the ventilator display. The maximal inspiratory pressure had great variation in the duration of airway occlusion (< 1 to 20 s), with the most frequent time frame being 2 to 4 s. Differences were noted between therapists from the same hospital as well as between hospitals. CONCLUSIONS: There is great variation among respiratory therapists when obtaining weaning parameters. This calls for further standardization of the measurement of weaning parameters.

Health Care Surveys↗

PubMed1992

Psychotherapists' attitudes towards and observations of nonverbal communication in a greeting situation: II. Relationships to background variables.

An interview study of 79 Swedish psychotherapists was performed to investigate their attitudes towards and observation of nonverbal communication in a reference situation in relation to background factors such as gender, length of professional experience, and theoretical approach. The greeting situation, i.e., the first time a therapist and patient meet in a waiting-room, was chosen as the reference situation. Face communication in that greeting situation was significantly less achieved by male psychotherapists with relatively short experience than by female therapists. However, this sex difference was not significant among therapists whose psychotherapeutic experience was longer than 13 years. Attaching great importance to nonverbal communication in psychotherapy was related to an intention to be well-kept and to perform correctly in front of the patient, to establish direct communication in the greeting situation, and to background factors such as frequent work in psychotherapy and an eclectic psychotherapeutic approach.

Attitude of Health Personnel↗

PubMed2001

Being "the other therapist": the varieties of adjunctive experience with hypnosis.

Clinicians who utilize hypnosis in their practices are frequently approached with requests to participate in the care of patients who are currently in treatment with a primary therapist. Surprisingly, a review of the literature indicated that no research has been done on this common practice. This article provides a discussion of some of the important issues as well as the variables to consider in deciding whether to enter into this arrangement. It will serve as a starting point in generating further research on this crucial topic.

Adult↗

PubMed2005

A brief motivational intervention for treatment-refusing OCD patients.

Cognitive behavioral therapy involving exposure and response prevention (ERP) is the psychosocial treatment of choice for obsessive-compulsive disorder (OCD). Despite this, ERP is not widely used by mental health practitioners, and so dissemination of ERP and other empirically supported treatment (ESTs) has become a priority. Even so, utilization of ESTs such as ERP remains below 50% even among therapists who self-identify as having a cognitive behavioral orientation. Barriers to the acceptance of ERP include practical obstacles such as lack of training and the cost of treatment, but also patient variables such as treatment refusal. It has been estimated that approximately 25% of OCD patients refuse ERP. This paper describes a brief, 4-session readiness intervention (RI) designed to decrease ERP refusal among patients with OCD. In this study, 12 patients with OCD who had refused ERP were randomized to RI or wait-list (WL). 86% of participants in the RI condition and 20% of participants in WL condition agreed to begin ERP following the 4-week period. ERP following RI, but not WL, was associated with a decrease in OCD symptoms comparable to that observed in OCD patients who did not refuse ERP. However, ERP following RI was associated with a high drop-out rate (50%), a figure that exceeds that typically seen in OCD treatment studies. Techniques to reduce drop-out as well as directions for future research are discussed.

Adult↗

PubMed1992

Electrical nerve stimulation improves healing of diabetic ulcers.

A controlled study of the effects of electrical nerve stimulation (ENS) was performed in conjunction with a standard treatment for healing chronic diabetic ulcers on 64 patients divided randomly into two groups. All patients received standard treatment (paste-impregnated bandage and a self-adhesive elastic bandage) plus placebo ENS or ENS (alternating constant current; frequency, 80 Hz; pulse width, 1 msec; intensity-evoking strong paresthesias) for 20 minutes twice daily for 12 weeks. Comparison of percentages of healed ulcer area and the number of healed ulcers was made after 2, 4, 6, 8, and 12 weeks. There were significant differences (p < 0.05) in both ulcer area and healed ulcers in the ENS group compared with the placebo group after 12 weeks of treatment. The results of the present study support the use of ENS in diabetic ulcers. ENS is easy to apply and can be used by the patient at home following instructions from a medical doctor or a therapist experienced in electrical stimulation and the treatment of ulcers. Additional studies are needed to identify the mechanisms involved in the promotion of ulcer healing with electrical stimulation and to determine the stimulus variables that most efficaciously accelerate tissue repair.

Aged↗

PubMed1989

Normal adult performance on constructional praxis training tasks.

This study used a balanced factorial design to examine the performance of normal young adults on a parquetry block assembly task that occupational therapists use to treat constructional deficits in adults. Ninety-six 18- to 34-year-old right-handed college students or college graduates (48 men and 48 women) were tested. Independent variables were subjects' sex, presence or absence of color on the model design card, and amount of detail on the model design card. Dependent variables were speed and accuracy of design construction. Results of a factorial analysis of variance with the three variables showed that the subjects' total time scores were significantly related to their sex and to the presence or absence of color and the amount of detail on the design card. Interaction effects were significant for sex by amount of detail and for color by amount of detail. The results were used to generate clinical performance criteria and graded levels of difficulty for this modality. The subjects' learning and test behaviors were examined to generate ideas for treatment and for future research.

Adolescent↗

PubMed1999

[Pain and respiratory physical therapy in patients after heart surgery].

Between the months of March and June 1997, an extended observational study was carried out on 32 patients hospitalized in the intensive care unit of "Hospital General Universitario" in Alicante for postoperative care after undergoing heart surgery which included extracorporeal circulation. The variables analyzed were of a socio-demographical nature and related to the type of operation in order to homogenize the samples. The main variables under study were pain while resting and pain while carrying out these exercises: coughing, deep breathing, stimulated inspirometer, and clapping; the number of balls the patient could raise; collaboration with the physical therapist and the kind of analgesic administered. The pain measuring instrument was the visual analogous scale. The patients with the highest pain levels when performing the protocolary extubation exercises raised fewer balls in the stimulated inspirometer exercise and did not collaborate with the physical therapist. The patients who receive more doses of sedatives collaborate with the respiratory physical therapist. All those patients who receive an analgesic at a set hour raise one or two balls in the inspirometer exercise and all collaborated with the physical therapist.

Aged↗

PubMed2002

Group therapists' training: what predicts learning?

This field study represents the continuing effort to identify the determinants of learning within experiential small study groups. Thirty-seven training groups from the 1996 Institute of the American Group Psychotherapy Association were studied. Three process measures (Group Relationship Questionnaire [GRQ], Leader Adjective Measure [LAM], and Group Climate Questionnaire [GCQ]) were administered to 434 group members after the first two of four group sessions. Process variables were used to predict learning (measured by the Learning Evaluation Form [LEF]) at the end of the training groups. The factors derived from each of the measures showed good to excellent correspondence with previous studies employing the same instruments. Results suggest that perceptions of the leader and the group, rather than perceptions of one's own relationship to other group members, are more robust predictors of learning in these short-term training groups. Specifically, perceptions of an emotionally engaged group willing to confront conflict, and perceptions of a skillful leader, proved to be significant predictors of learning. Implications for the training of group therapists and group therapy research are discussed.

Factor Analysis, Statistical↗

PubMed2002

[Psychotherapy and gender: do men and women require different treatments? ].

Research has demonstrated that men and women differ considerably on a wide variety of variables. However, the effect of gender on the psychotherapy experience is little understood. This article provides a brief review of the current research literature on gender effects in psychotherapy and reports findings of gender differences in outcome for two different treatment modalities. Literature was collected using Medline and PsycLit search engines. Results from a randomized trial on supportive and interpretive short-term individual psychotherapy were used to investigate interaction effects between patient gender and form of treatment in 88 female and 56 male patients. Gender of the patient, therapist, or their interaction has minimal impact on treatment outcome. However, when gender is compared with the form of therapy, the success of the therapy differs between men and women. The findings suggest that for research on gender effects in psychotherapy to be productive, investigators need to consider how gender interacts with other conceptually meaningful variables.

Female↗

PubMed1981

Limitations of behavioral treatment of obesity: review and analysis.

Over 200 articles have been published describing behavior modification programs for weight reduction. We reviewed the group studies that reported weight data at least 1 year posttreatment. Evaluating these studies, we concluded that although changes in weight do occur, these changes are almost always clinically small, variability among patients is large, and further weight losses do not occur following the end of formal treatment. The weight lost during treatment may be explained by changes in specific eating behaviors caused by therapist contact rather than the effect of self-applied behavioral techniques on eating. Support for the effectiveness of each of the specific techniques to produce lasting weight loss or behavioral change was also lacking. Suggestions for future research in this area are given.

Adult↗

PubMed2006

Cost-effectiveness of multidisciplinary treatment in sick-listed patients with upper extremity musculoskeletal disorders: a randomized, controlled trial with one-year follow-up.

OBJECTIVE: To determine the effectiveness and cost-effectiveness of a return-to-work outpatient multidisciplinary treatment programme for sick-listed workers with non-specific upper extremity musculoskeletal complaints. METHODS: A randomized controlled trial with a 1-year follow-up was carried out. Thirty-eight subjects were allocated to multidisciplinary treatment (intervention, n=23), or to usual care provided by occupational health services (n=15). The intervention consisted of psychological and physical sessions provided by a medical specialist, a psychologist, a physiotherapist and an occupational therapist. It aims at reconditioning, "de-medicalizing", unrestrained moving and return-to-work. The intervention process was evaluated on compliance to the protocol and the effectiveness of its components. The individual outcome variable was the severity of complaints. The societal outcomes included return-to-work and costs. Measurements were performed at baseline and after 2, 6 and 12 months. Mixed model analyses were used for analysis. RESULTS: The intervention achieves its aims: physical disabilities (P=0.039), kinesiophobia (P<0.001) and physical functioning (P=0.016) improved significantly as compared to usual care. In addition, the intervention was significantly more effective in reducing the severity of complaints than usual care. The intervention was equally effective compared to usual care in terms of return-to-work (86% in the intervention group vs. 73% in the usual care group). The extra total costs and the extra gains in terms of return-to-work were not significantly higher for the intervention as compared to usual care after 12 months. CONCLUSION: Multidisciplinary treatment affects individuals positively, but shows no significant difference in (cost-) effectiveness on the societal level as compared to usual care.

Combined Modality Therapy↗

PubMed2004

Factors associated with prognosis of lateral epicondylitis after 8 weeks of physical therapy.

OBJECTIVE: To identify key factors associated with outcomes of patients who underwent 8 weeks of physical therapy (PT) for lateral epicondylitis. DESIGN: Multicenter prospective design with inception cohort of lateral epicondylitis patients commencing PT. Baseline clinical examinations were conducted by 1 physical therapist; self-report outcome measures were completed at baseline and 8 weeks later. SETTING: Nine private sports medicine clinics and 2 hospital outpatient departments in Ontario, Canada. PARTICIPANTS: Eighty-three patients with unilateral lateral epicondylitis identified by the treating physical therapists. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The final scores of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and a vertical pain visual analog scale (VAS) were used as the dependent variables. RESULTS: The final prognostic model for the 8-week DASH scores included the baseline score (95% confidence interval [CI], 0.34-0.66), sex (female) (95% CI, 3.3-14.5), and self-reported nerve symptoms (95% CI, 0.8-13.8). The model for the 8-week VAS scores included the baseline score (95% CI, 0.01-0.37), sex (female) (95% CI, 0.4-18.2), and self-reported nerve symptoms (95% CI, 4.7-25.5). A subanalysis indicated that women were more likely than men to have work-related onsets, repetitive keyboarding jobs, and cervical joint signs. Among women, these factors were associated with higher final DASH and VAS scores. CONCLUSIONS: Women and patients who report nerve symptoms are more likely to experience a poorer short-term outcome after PT management of lateral epicondylitis. Work-related onsets, repetitive keyboarding jobs, and cervical joint signs have a prognostic influence on women.

Adult↗

PubMed1999

A reattributional training program as a therapeutic strategy for fear of flying.

In this study the results for the validation of a reattributional training program applied to the fear of flying are presented. The program is made up of 13 (+/- 1) sessions and consists of three phases: Information; reattributional training; and the elaboration and application of the treatment designed by the patient with the help of the therapist. The program was applied to 24 patients while 24 other patients made up the waiting control group. The therapeutic success was evaluated by means of self-report scales, and by recording psychophysiological variables in a situation in which subjects viewed a video tape of a flight. Significant differences were obtained from the ANOVAs between experimental and control groups in all of the self-reported variables (p < 0.001) and in some of the psychophysiological variables (p < 0.05). The results support the effectiveness of the program.

Adult↗

PubMedDate not supplied

Interest in different forms of self-help in a general population sample of drinkers.

The study investigates: (1) the level of interest in self-help services for drinkers, and (2) the predictors of interest in these services. A representative sample of 1,557 Ontario respondents participated in a telephone survey. Current drinkers (n=1,247) were asked about their interest in getting: (a) a telephone call from a therapist to help them evaluate their drinking, (b) a self-help book, and (c) a computerized summary comparing their drinking to that of other Canadians. Bivariate comparisons of demographic and drinking-related variables were made between those interested and not interested in each of the offered services. Logistic regression analysis was used to find the best predictors of interest. The results revealed that 16% were interested in a telephone call, 26% in a self-help book, and 39% in computerized normative feedback. Negative consequences of drinking and indicators of lower societal resources increased interest in self-help services. Computerized feedback and self-help books serve as cheap and nonintrusive ways to provide incentive for change to early-stage problem drinkers due to the interest they raise in the intended target population.

Adult↗

PubMed1999

Utilization of psychotherapy by lesbians, gay men, and bisexuals: findings from a nationwide survey.

Based on a survey of the psychotherapy histories of 600 lesbians, gay men, and bisexuals, the number, duration, and circumstances of each therapy episode, and respondents' views of their therapists and of therapy, are reported. Findings suggest that lesbians and gay men are among the most active and satisfied--but least acknowledged--consumers of psychotherapy. Routine inclusion of sexual orientation as a demographic variable in mental health services research is proposed.

Bisexuality↗