ABSTRACT
This paper describes a day treatment program that provides predominantly cognitive-behavioral therapy for a heterogeneous group of patients. Preliminary results of the program are also presented. Assessment tools included the Beck Depression Inventory, the Symptom Checklist, and a questionnaire on changes in social life. Instruments were administered at admission, at discharge, and six months after discharge. The patients showed significant improvement in scores on all instruments at discharge. Improvements were stable after six months for all diagnostic categories-depression, eating disorders, and personality disorders. The program shows promise as an effective treatment approach for patients with various psychiatric diagnoses.
Subject(s)
Cognitive Behavioral Therapy/methods , Day Care, Medical/organization & administration , Depression , Hospitals, Psychiatric/trends , Mental Disorders/therapy , Outcome Assessment, Health Care , Social Adjustment , Adult , Female , Follow-Up Studies , Hospitals, Psychiatric/organization & administration , Humans , Male , Program Evaluation , Psychiatric Status Rating Scales , SwitzerlandABSTRACT
2-Azanorbornyl-derived amino alcohols were prepared and evaluated as ligands in the Ru(II)-catalyzed asymmetric transfer hydrogenation of aromatic ketones. To improve selectivity and rate, the structure of the ligand was optimized. Acetophenone was reduced using 0.5 mol % catalyst in 40 min in 94% ee. This system was also able to reduce a wide range of aromatic ketones to the corresponding alcohols, while maintaining high enantioselectivities and yields. The effects of catalyst loading and the presence of cosolvents in the reaction vessel were examined, and a linearity study was also done.
ABSTRACT
The objective of this prospective study is to assess curriculum-related factors which might influence both concepts of health and illness and health behaviour. A representative sample of 546 freshmen enrolled at the University of Berne, entering medical students and a control group of freshmen in other faculties, were surveyed on their subjective concepts of illness and health. The questionnaire described as "Health and illness concept Scales" (HICS) was mailed out shortly before the beginning of school, and was returned by 70%. The prospective medical view of health and illness before entering professional training, contrary to the hypothesis of "anticipatory socialisation". Their general concept of illness and health was found to be distinctly naturalistic rather than psychosocial in nature. While psychosocial factors were considered to be rather irrelevant by both cohort of students, individual health behaviour and the ability to recognize warning signs of impending hazard to one's health were given high priority.
Subject(s)
Curriculum , Disease , Health , Students, Medical/psychology , Cohort Studies , Concept Formation , Demography , Education, Medical, Undergraduate , Female , Health Behavior , Humans , Male , Prospective Studies , Surveys and Questionnaires , SwitzerlandABSTRACT
Historical and pragmatic reasons justify short term practice of psychotherapy. Some of the better known methods are discussed in respect to their concept, indication and setting: Malan and the Tavistock-group; Mann: Time limited psychotherapy; Sifneos: STAP, Short term anxiety provoking psychotherapy; Davenloo: Broad focus short term dynamic psychotherapy; Strupp: TLDP, Time limited dynamic psychotherapy; Luborksy: Supportive-expressive psychoanalytic psychotherapy; Klerman: Interpersonal psychotherapy; Beck: Cognitive therapy. After a cross-comparison arguments are given why there is still a need for a more problem- and patient-oriented, eclectic and limited psychotherapy. Besides theoretical reasons there are practical and didactic aspects in favour of such a method.
Subject(s)
Adaptation, Psychological , Problem Solving , Psychotherapy, Brief/methods , Cognitive Behavioral Therapy/methods , Humans , Psychoanalytic Therapy/methodsABSTRACT
Problem Oriented Therapy (POT) is a short-term therapy concept that is characterized by the following essentials: Problem orientation, patient orientation, eclecticism and process-structuring. These essentials will be explained and their therapeutic and didactic implications shown. POT is not committed to a certain psychotherapeutic school but uses selectively reliable methods from different therapeutic approaches. The indication to specific therapeutic strategies is made from a pragmatic point of view on the level of problem definition and takes account of the patient's own comprehension of the problem. Transparency and flexibility of therapeutic thinking and acting are essential in POT. This will be illustrated by a case report. The training-settings of POT will also be briefly described.
Subject(s)
Anxiety Disorders/therapy , Problem Solving , Psychotherapy, Brief/methods , Self Concept , Adaptation, Psychological , HumansABSTRACT
Subjective illness concepts mean the more or less comprehensive psychological explanations about causes and functions of actual psychosocial problems by the patient. These concepts historically arise from interactions with the social environment. In respect to the actual situation they are constructed in a new way. They aim at monitoring the individuals' experience of being ill or healthy. Often they don't accomplish this aim because they are deficient for many reasons. In the therapeutic situation the patient is confronted with the scientific theories of his therapist. Both concepts represent different perspectives of the same problem. However, both have to be discussed in a cooperative manner and ultimately result in a complementary view which we denote as an important issue for our problemoriented therapy.
Subject(s)
Anxiety Disorders/psychology , Problem Solving , Psychotherapy, Brief/methods , Adult , Anxiety Disorders/therapy , Female , HumansABSTRACT
The therapeutic concept is problem- and patient-oriented. In analogy to it the didactic concept is problem- and therapist-oriented. The essential point is learning in groups from practical cases. Problem-oriented in this context means that the problems-solving process in which the patient and the therapist are engaged is supported by the observer group. Therapist-oriented means that the learning process should take account of the different preferences and experiences of the therapists. That can only be accomplished by problem-oriented learning. Each psychotherapy training group consists of 4 assistant doctors and a supervisor and stays together about 1 year. The strongly structured concept of problem-oriented therapy (POT) [Blaser et al., 1988] offers the beginner a framework by which he can guide the dialogue with the patient. The eclecticism of POT allows the more experienced therapist to try out new methods without losing track of the problem. The constantly changing role of being observer or therapist supports the group coherence, and furthermore it promotes an important element of therapeutic competence, the ability to get into a close relation with the patient and at the same time being able to observe oneself, the patient and the therapeutic process from a more distant view. In addition to the POT training group tutorials in special psychotherapy methods and single supervision sessions are offered.
Subject(s)
Problem Solving , Psychiatry/education , Psychotherapy, Brief/education , Clinical Competence , Curriculum , Humans , Physician-Patient RelationsABSTRACT
Problem-oriented therapy (POT) features the following essentials: problem orientation, eclecticism, patient orientation and brevity. These ingredients, above all the eclecticism, are detailed: diverse psychotherapeutic interventions are administered to foster awareness, modification of thought patterns, modification of behavior, emotionality, awareness of the body, ability to relax, and support. The required abilities of the therapist are mainly flexibility and transparency of his therapeutic actions. The definition of the problem which is negotiated together with the patient is decisive for the selection of the intervention strategy. An example illustrates the use of POT especially as in contrast to school-consistent traditional therapies.
Subject(s)
Problem Solving , Psychotherapy/methods , Combined Modality Therapy , Humans , Physician-Patient Relations , Psychotherapy, Brief/methods , Therapeutics/psychologyABSTRACT
Subjective illness concepts mean the comprehensive psychological explanations about causes and functions of actual problems by the patient. These concepts are related to basic needs and they historically arise from interactions with the social environment. In respect to the actual situation they are constructed in a new way. They aim at reorganizing the needs of the sick individual as well as monitoring his experience of being ill. Often they do not accomplish this aim because they appear to be deficient for many reasons. In the therapeutic situation the patient is confronted with the scientific theories of his therapist. Both concepts represent different perspectives of the same problem. However, both have to be discussed in a cooperative manner and ultimately result in a complementary view which we denote as 'problem definition'.
