RESUMO
This article introduces the therapeutic contracting program as a comprehensive treatment system for persons with serious mental illness. Therapeutic contracting offers a promising framework for integrating medical, psychological, and social therapies in a manner that fosters clients' active involvement in treatment. This article outlines a multistage therapy program that mobilizes clients' adaptational resources through experimental interventions, structured goal-setting exercises, and skills-building experiences. Data illustrate the effectiveness of therapeutic contracting for (a) securing clients' treatment compliance, (b) promoting positive clinical outcomes, (c) reducing overall treatment costs. The therapeutic contracting model is discussed as a potential vehicle for expanding the professional role of psychologists in psychiatric settings, particularly in areas of clinical and administrative decision making.
Assuntos
Relações Profissional-Paciente , Doença Crônica , Tomada de Decisões , Humanos , Transtornos Mentais/reabilitação , Cooperação do Paciente , Resultado do TratamentoRESUMO
Agoraphobia is a complex disorder characterized by substantial personal, social, and occupational disability. This paper presents a cognitive-behavioral model of group psychotherapy for agoraphobia treatment wherein group members are taught active coping skills to reduce anxiety and behavioral avoidance. Therapy occurs in the context of a supportive group, which aids in reducing the social isolation and alienation attendant on this severe anxiety disorder. The model of treatment is amenable to both time-limited and open-ended group therapy formats.
Assuntos
Agorafobia/terapia , Terapia Cognitivo-Comportamental/métodos , Transtorno de Pânico/terapia , Psicoterapia de Grupo/métodos , Agorafobia/psicologia , Dessensibilização Psicológica/métodos , Processos Grupais , Humanos , Transtorno de Pânico/psicologia , Cooperação do Paciente/psicologia , Apoio SocialAssuntos
Continuidade da Assistência ao Paciente/organização & administração , Serviços de Saúde Mental/organização & administração , Terapia Cognitivo-Comportamental , Hospitais Psiquiátricos/organização & administração , Humanos , Massachusetts , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Modelos Organizacionais , Cooperação do Paciente , Ajustamento SocialRESUMO
The cases of three self-injurious patients suffering with borderline personality disorder are briefly presented. From this clinical base, the consultant describes a cognitive-behavioral psychotherapeutic model and how it might be applied to the treatment of these and similar patients. A dialectical behavioral approach is used to describe three major dichotomies and their application. The consultant also illustrates how cognitive-behavioral therapy may be integrated with more dynamic-analytic approaches, and proposes a strategy and methodology that establish and reinforce the treatment alliance in developing a treatment plan.
Assuntos
Transtorno da Personalidade Borderline/terapia , Terapia Cognitivo-Comportamental/métodos , Automutilação/terapia , Adulto , Transtorno da Personalidade Borderline/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Automutilação/psicologiaRESUMO
The performance of 60 elderly volunteers (mean age = 74.5 years) on two cancellation tasks was examined under one of three experimental conditions: social praise, social reproof, or no comment. When compared with the no-comment group, subjects in the reproof condition showed response increments over baseline performance (p less than .05). Praise, when compared with no comment, failed to reach statistical significance. Results are interpreted in terms of the possible negative reinforcement, challenge, or informational properties of reproof. The clear implications from these data are that social incentives may well facilitate behavioral change in the aged and that there is a need for further examination of the effects of this variable.
