Las dificultades que ofrecen los pacientes con difusión de identidad al tratamiento psiquiátrico / Difficulties that patients with identity diffusion offer to psychiatric treatment

En este artículo describiremos brevemente ciertos pacientes que consultan por cuadros psiquiátricos agudos y que además sufren de difusión de identidad. Estos pacientes ofrecen dificultades importantes a su propio tratamiento porque tienden a no persistir en una tarea, no cuidar de sí mismos, no confiar en las personas y a no recuperarse de las fallas de mentalización que puedan tener en sus relaciones interpersonales, produciendo graves complicaciones en el proceso terapéutico. Describiremos el Programa de Intervención Psicoeducativa y Control Farmacológico en Grupo que hemos implementado en el Instituto Psiquiátrico José Horwitz Barak para manejar de mejor forma las dificultades terapéuticas que estos pacientes ofrecen.

In this article we will briefly describe certain patients who consult for acute psychiatric symptoms and who also suffer from identity diffusion. These patients offer significant difficulties to their own treatment because they tend not to persist in a task, do not take care of themselves, do not trust people and do not recover from the mentalization failures they may have in their interpersonal relationships, producing serious complications in the therapeutic process. We will describe the Program of Psychoeducative Intervention and Pharmacological Control in Group that we have implemented in the José Horwitz Barak Psychiatric Institute to better manage the therapeutic difficulties that these patients offer.

O monstro do meio: trabalhando com casais em um tratamento grupal intensivo / The monster in between: working with couples in intensive group treatment

Neste artigo está descrito um programa de tratamento grupal intensivo para casais que sofrem de doenças psiquiátricas não psicóticas, disfunções de personalidade e/ou problemas complexos de relacionamento conjugal. Geralmente, um dos parceiros tem uma longa história de atendimento na saúde mental. Esta história de intervenções geralmente inclui ao menos algumas sessões de terapia conjugal, entretanto sem sucesso suficiente. Estes casais são parte de um grupo de pacientes da saúde mental que pode ser descrito, ou se descreve como: "tudo foi feito, mas nada realmente ajudou”. O programa de tratamento grupal intensivo iniciou em 1991 e, até fevereiro de 2004, 415 casais foram tratados em 91 grupos. Apesar do Centro para Problemas Relacionais estar situado em uma área rural do nordeste da Holanda, os casais são encaminhados de todo o país. Isso demonstra que é necessário um tratamento intensivo para casais em um setting de internação. Além disso, pelo menos no que se sabe, esse tipo de tratamento não existe em outro lugar do mundo. Nesse artigo serão apresentados detalhes do programa e a lógica que o sustenta.

In this paper we elaborate on an inpatient clinical group program for couples suffering from non-psychotic psychiatric disorders, personality disorders and/or complex partner relational problems. In general one of the partners has a long history in mental health care. The intervention history often includes at least some sessions of couple therapy, but without sufficient success. These couples are part of that group of mental health patients that can be described as, or describe themselves as: ‘everything was done but nothing really helped’. The clinical inpatient couple group program was initiated in 1991 and to date (February 2004) 415 couples have been treated in 91 groups. Although our Center for Relational Problems is situated in a rural area in the northern part of the Netherlands, these couples are referred from all over the country. This proves that there is a need for highly intensive couple treatment in an inpatient setting. Nevertheless, as far as we know, this type of treatment does not exist anywhere else in the world. In this paper we will give details of the program and the rationale behind it.

Treatment focused on myelodysplastic syndromes based on cytogenetic categories / 白血病·淋巴瘤

Myelodysplastic syndromes (MDS) are heterogeneous clonal stem cell disorders characterised not only by peripheral cytopenia and bone marrow hyperplasia but also by karyotype. The course of disease, clinical outcome and response to treatment. Cytogenetic categories is a pattern typing the intrinsical features of MDS. It is suggested here that investigating biological characters and group treatment in MDS based on cytogenetic categories may enhance the therapeutic effect and bring benefit to MDS patients.

Cognitive and Group Treatment of Internet Addiction in Adolescents

A review of the literature and the authors' recent researches on the treatment of internet addiction among adolescents based on a cognitive behavioral approach suggest that most severely addicted adolescents have various co-morbid psychiatric problems and that the cognitive behavioral approach in a group setting is effective in the improvement of not only addictive behavior but also emotional and general behavioral problems including insight, depression, anxiety, and impulsiveness. Adolescents with internet addiction, especially who are severely affected, need a comprehensive psychiatric treatment of co-morbid problems and other behavioral problems.

Psicoterapia de orientação junguiana com foco corporal para grupos de crianças vítimas de violência: avaliando habilidades da resiliência / Jungian psychotherapy with corporal focus for abused children groups: assessing resilience abilities

A Psicoterapia junguiana com foco corporal aqui estudada da ênfase aos recursos e as capacidades criativas, utilizando, portanto, o paradigma da resiliência e a perspectiva holística da psicossomática como guias. Este trabalho teve como objetivos propor e aplicar uma forma de psicoterapia de base técnica junguiana que tem o corpo simbólico como eixo. Procurou-se avaliar os efeitos dessa intervenção na ampliação de recursos promotores de resiliência. Onze crianças vítimas de violência, divididas em dois grupos selecionados por faixa etária de 8 a 10 anos e 11 a 13 anos estavam abrigadas em um mesmo lar na cidade de São Paulo e apresentavam, em seus prontuários, diferentes históricos de violência: negligência, abuso sexual ou maus tratos. Por meio de avaliação qualitativa se compararam resultados de pré-teste e pós-teste, obtidos a partir de desenho de figura humana, modelagem de figura humana em massa e cenas de areia segundo a técnica de Sandplay. Observou-se, também, o comportamento das crianças no decorrer das 16 sessões de psicoterapia. Foram analisadas duas categorias de resiliência: Percepção de Si e Percepção do Outro. Os resultados revelaram melhora em todas as crianças da amostra.

Jungian Psychotherapy with a corporal focus studied here emphasizes the resources and creative capacity of children, stressing the paradigm of resilience using the holistic and psychosomatic perspectives as guides. The objective of this work was to propose and apply a means of psychotherapy based on Jungian theory with the symbolic body as its axis. The aim was to evaluate the effects of this intervention in the amplification of the resources that promote resilience. Eleven children who had been victims of abuse, divided into two groups selected by age - 8 to 10 and 11 to 13 - were sheltered in the same home in the city of Sao Paulo with different historical records of abuse which included neglect, sexual abuse and other types of maltreatment. A comparison was made by means of a qualitative evaluation. the results before and after the tests were obtained by means of drawings and plasticine models of a human body and scenes in the sand by means of Sandplay. The children's behavior was also observed throughout the 16 sessions of psychotherapy. Two categories of resilience were analyzed. Perception of Self and Perception of the Other. The results revealed improvement in all the children in the study.

Preliminary Study on The Effect of Multicomponent Cognitive-behavioral Group Treatment Program for Fear of Flying / 항공우주의학회지

BACKGROUND: The multicomponent cognitive-behavioral group treatment program is an effective treatment for fear of flying (FOF). In Korea, the effect of this treatment has not yet been studied. This is a preliminary study to assess the program's effect for Koreans with FOF. METHODS: Among 11 patients who participated in the treatment program, 10 completed the program, and data of 9 patients were obtained. Patients participated in individual treatment phase by diagnosis and symptoms, and in the group treatment phase for 2 days, composed of education on flight and anxiety, relaxation technique, cognitive reconstruction, imaginary exposure, mock-up treatment, real flight, etc. Flying history, Visual Analogue Flight Anxiety Scale (VAFAS), Flight Anxiety Situation Questionnaire (FAS) with 3 subscales (generalized, anticipatory, in-flight), Flight anxiety Modality Questionnaire (FAM) with 2 subscale (somatic, cognitive) were assessed before treatment and at 3 months after completion of the program. RESULTS: 8 patients made flights within 3 months after treatment. VAFAS, FAS total, 3 FAS subscales, FAM, and 2 FAM subscales were all decreased significantly after treatment. CONCLUSION: This results suggest that the multicomponent cognitive-behavioral group treatment program is effective for Koreans with FOF.