森田疗法在神经症病人中应用分析

在对 4 2例神经症病人的治疗中 ,把森田疗法理论引入传统药物治疗中 ,按照森田疗法分期 ,结合药物治疗实施改良森田疗法。经 SCL-90 ,HAMD,SAS测试 ,取得了较满意的疗效。提示改良森田疗法对神经症病人疗效显著 ,各地应根据自身具体情况 ,灵活采用现有各种治疗手段。     

森田疗法门诊操作规则的专家意见

森田疗法已诞生100余年,住院森田疗法可操作性强、易掌握,通过4期治疗就可改善许多难治神经症,但更多神经症是在门诊治疗,无法使用住院森田疗法,因此门诊操作专家意见的制定尤为重要。本文结合国内外文献,经国内森田疗法专家多次讨论,起草了第1版门诊森田疗法操作的专家意见,制定门诊三阶段的森田疗法操作规则：病因分析阶段,通过森田疗法理论指导,分析发病因素,提高对治疗依从性,降低抵抗;作业阶段,指导患者投入建设性意义行动,实现顺其自然为所当为原则,达到治疗目的;陶冶性格、充实生活阶段,注重正面信息关注,扩大行动范围、内容,提高适应复杂生活的能力,预防因能力不足导致的复发。该规则为国内门诊森田疗法的推广,使更多神经症等心理疾病患者在门诊就可得到森田疗法治疗奠定基础。     

森田疗法治疗2例神经症

神经症病人大都有性格的缺陷,森田疗法正着眼于改善患者不良的性格,提高忍耐力、承受力、意志力以及心理素质,达到症状的缓解。森田疗法是治疗神经症尤其是难治性神经症的一种有效方法,我院自1997年11月开展森田疗法治疗神经症,获得较满意的疗效。     

住院森田疗法治疗神经症

用森田疗法的理论及住院疗法的规范对10例神经症者进行了治疗。经 CMI、SCL—90及Kraepelin 作业测定,证实森田疗法是对强迫症、疑病症、恐怖症、焦虑症卓有成效的治疗方法。     

门诊森田疗法在神经症治疗中的疗效分析

目的：探讨门诊森田疗法对神经症患者的治疗效果，为神经症的门诊治疗提供依据。方法：按CCMD-Ⅲ及森田神经质症标准诊断筛选患者，以门诊的方式实施森田疗法，并于治疗前、中、后分别施测SCL-90、SAS和SDS。结果：根据疗效判定结果，100例患者中，29例治愈，37例好转，总有效率为66．00％。SCL-90、SDS及SAS自觉症状的评分也有明显的改善。结论：门诊森田疗法是治疗神经症的有效方法，尤其是选择适当的临床类型疗效较佳。     

药物治疗无效神经症患者的门诊森田疗法

目的 :探索门诊森田疗法对药物治疗无效的神经症患者的作用。方法 :3 2例药物治疗多年无效的患者 ,停药后接受个别森田疗法治疗。结果 :疗前、治疗第 4、 8周末 SCL- 90三次得分 (总分、总均分、阳性项目总分、阳性项目数、阳性项目均分以及各因子分 )之间均有显著性差异 ( p<0 .0 5～ p<0 .0 0 1) ;第 8周末综合评定疗效有效率为78.13 %。结论 :药物治疗无效的神经症患者 ,门诊森田疗法仍然有效。     

改良森田疗法联合正念训练对广泛性焦虑障碍的随机对照试验

目的:探索在改良森田疗法基础上联合正念训练对广泛性焦虑障碍的增效作用。方法:广泛性焦虑障碍住院患者150例,随机分成改良森田疗法联合正念训练组(联合组)和改良森田疗法对照组(单一组)各75例,最终联合组65例、单一组66例完成治疗。两组均接受药物治疗和改良森田疗法治疗,联合组同时加入正念训练,共5周。采用汉密顿焦虑量表(HAMA)、中文版神经症被束缚自评量表(SSTN)、五维度正念问卷(FFMQ)评估治疗效果。结果:5周治疗后,联合组HAMA、SSTN总分低于单一组,FFMQ总分高于单一组(均P<0.05)。结论:改良森田疗法联合正念训练对广泛性焦虑障碍患者的效果优于单用改良森田疗法。     

森田疗法治疗期的新探讨

森田疗法治疗分四组，绝对卧床期，轻工作期，中度工作期，重度工作期，作者根据临床具体情况在绝对卧床期前增加了治疗准备期，主要向患者介绍森田疗法简史，理论及治疗方法，并让其阅读有关森田疗法的书籍，提高认识，消除疑虑，逐渐萌发森田疗法治疗的要求。运用此种分期方法，临床治疗６例神经症患者，取得２例治愈４例显效的显著疗效。     

住院森田疗法在治疗强迫症中的改进及疗效分析

探讨适合我国强迫症患者的有效心理疗法 ,方法 :在应用日本森田疗法基础上 ,结合临床实践 ,对治疗强迫症过程中的治疗原则、实施过程等进行了改进。对 80例强迫症患者进行了治疗 ,同时采用SCL -90 ,SDS ,SAS和EPQ在治疗前后进行评定。结果 :平均疗程 64 3± 19 7天 ,痊愈 32例 ,显著好转2 8例 ,好转 12例 ,无效 8例 ,显著好转率 75% ;量表测查结果表明 ,患者治疗后心理健康水平明显提高 ,一些人格特征得到改善。患者有无强迫行为对疗效无明显影响。结论 :改进后的住院森田疗法是治疗强迫症的有效心理疗法强     

门诊森田疗法治疗神经症16例

应用森田疗对16例神经症患者施行门诊治疗。结果提示门诊森田疗法对神经症治疗是一种较有效的方法。门诊森田疗法成功与否的关键在于选择合适的病人,他们迫切需要帮助,并决心服从医生指导,完成全部治疗过程。     

Brief Therapy and Family/Couple Therapy: An Essential Redundancy

"Brief" therapy and "family/couple" therapy are largely overlapping and redundant. Although there are almost no family/couple therapies that explicitly set time limits on treatment as a matter of course, the four central technical factors of brief therapy almost inevitably lead to therapeutic brevity in systems-oriented treatment. In this paper I emphasize that family/couple therapists tend to adhere to the dominant treatment values of brief individual therapists and set out the therapeutic values among family/couple therapists that increase the likelihood of most family/couple therapy being brief. Finally, I propose that families' and therapists' expectations about the length of treatment serve an important role in establishing the therapeutic alliance. The empirical study of the components of such expectations, and discrepancies in such expectations between therapists and families, may provide a fruitful approach for optimizing the therapeutic alliance and thus positively influencing treatment outcomes.     

How Far Have We Come in Teletherapy? Comment on “Telephone‐Administered Psychotherapy”

Telecommunication allows for therapy to be done in many formats, including telephone, computer teleconferencing, and e-mail. My comments are directed broadly at how telecommunications can be used to provide psychological services. My comments include observations on the review article, impressions following a computer search on the topic of electronic therapy, thoughts on other uses of electronic psychological services, and caveats regarding ethical and legal issues.     

Lessons Offered,Lessons Learned: Reflections on How Doing Family Therapy Can Affect Therapists

Only in working conjointly with couples and families do therapists literally witness clients struggling to improve their most intimate relationships. In writing this article, we realized that, in true systemic fashion, not only have many of our clients benefited from working with us, but also we have learned some invaluable lessons from them. Indeed, practicing couple and family therapy gives therapists many opportunities to learn about themselves, especially when it is done thoughtfully. In this article, we reflect on myriad ways in which couples and family therapy has affected each of us personally—as individuals, as partners, as parents, as adult children in our families of origin, and as educators.     

What Allows Therapy to Be Brief? Introduction to the Special Series

This article introduces the field of brief therapy and the special series on six varieties of it. The orientations covered are psychodynamic, behavioral, experiential, family/couples systems, strategic, and integrative. Most therapy conducted in the United States always has been and continues to be brief despite many clinicians' perceptions to the contrary. What allows a therapy to be time efficient, however, differs as a function of each therapy's theoretical orientation. The articles in this series focus on what features allow each therapeutic model to be short term, the techniques and theory of change it encompasses, relevant research, and likely future trends.     

In vivo molecular targeted radiotherapy

Unsealed radionuclides have been in clinical therapeutic use for well over half a century. Following the early inappropriate clinical administrations of radium salts in the early 20th century, the first real clinical benefits became evident with the use of (131)I-sodium iodide for the treatment of hypothyroidism and differentiated thyroid carcinoma and (32)P-sodium phosphate for the treatment of polycythaemia vera. In recent years the use of bone seeking agents (89)Sr, (153)Sm and (186)Re for the palliation of bone pain have become widespread and considerable progress has been evident with the use of (131)I-MIBG and (90)Y-somatostatin receptor binding agents. Although the use of monoclonal antibody based therapeutic products has been slow to evolve, the start of the 21st century has witnessed the first licensed therapeutic antibody conjugates based on (90)Y and (131)I for the treatment of non-Hodgkin's lymphoma. The future clinical utility of this form of therapy will depend upon the development of radiopharmaceutical conjugates capable of selective binding to molecular targets. The availability of some therapeutic radionuclides such as (188)Re produced from the tungsten generator system which can produce activity as required over many months, may make this type of therapy more widely available in some remote and developing countries.Future products will involve cytotoxic radionuclides with appropriate potency, but with physical characteristics that will enable the administration of therapeutic doses with the minimal need for patient isolation. Further developments are likely to involve molecular constructs such as aptamers arising from new developments in biotechnology.Patient trials are still underway and are now examining new methods of administration, dose fractionation and the clinical introduction of alpha emitting radiopharmaceutical conjugates. This review outlines the history, development and future potential of these forms of therapy.     

What Makes Brief Psychodynamic Therapy Time Efficient

To be brief and effective, psychodynamic therapy relies on six features or techniques of practice. These include (a) patient selection, especially maturity of interpersonal or object relations, (b) formulation of an individualized clinical focus stated as intrapsychic conflict, maladaptive interpersonal patterns, or negative feelings about the self, (c) a deliberate time limit that adds a sense of intensity and urgency and sets in motion therapist and patient expectancies as to when change will occur, (d) active techniques of detailed inquiry, focusing, interpretation, and, in some models, confrontation, (e) emphasis on the termination stage, especially issues of separation, loss and limitations in life, and (f) goal setting, which requires setting priorities so that time is used most efficiently. This paper reviews and evaluates relevant research and presents emerging trends for future practice of brief psychodynamic therapy.     

病毒介导的免疫治疗癌症进展

病毒主要作为基因转染载体在免疫治疗中发挥重要作用.本文详细地介绍了病毒载体类型,病毒介导的对肿瘤细胞、宿主细胞的调节,病毒疫苗等免疫治疗癌症的研究进展,可为癌症免疫治疗的基础和临床研究提供参考.     

质子治疗设备的现状和发展

为了实现质子治疗,必须有一套比常规电子直线加速器更复杂,规模更大的质子治疗设备与系统。本文首先简要地介绍质子治疗装置的系统原理,基本结构和当前国际上的质子治疗装备的商品供应概况。在此基础上进一步论述国际质子治疗装置的现状和当前的质子治疗装置研制发展。在文的最后再简要地介绍当前国际上的已有的专用质子治疗中心近况。     

Is cognitive–behavioral therapy more effective than other therapies?: A meta-analytic review

Cognitive–behavioral therapy (CBT) is effective for a range of psychiatric disorders. However, it remains unclear whether CBT is superior to other forms of psychotherapy, and previous quantitative reviews on this topic are difficult to interpret. The aim of the present quantitative review was to determine whether CBT yields superior outcomes to alternative forms of psychotherapy, and to examine the relationship between differential outcome and study-specific variables. From a computerized literature search through September 2007 and references from previous reviews, English-language articles were selected that described randomized controlled trials of CBT vs. another form of psychotherapy. Of these, only those in which the CBT and alternative therapy condition were judged to be bona fide treatments, rather than “intent-to-fail” conditions, were retained for analysis (28 articles representing 26 studies, N = 1981). Four raters identified post-treatment and follow-up effect size estimates, as well as study-specific variables including (but not limited to) type of CBT and other psychotherapy, sample diagnosis, type of outcome measure used, and age group. Studies were rated for methodological adequacy including (but not limited to) the use of reliable and valid measures and independent evaluators. Researcher allegiance was determined by contacting the principal investigators of the source articles. CBT was superior to psychodynamic therapy, although not interpersonal or supportive therapies, at post-treatment and at follow-up. Methodological strength of studies was not associated with larger or smaller differences between CBT and other therapies. Researchers' self-reported allegiance was positively correlated with the strength of CBT's superiority; however, when controlling for allegiance ratings, CBT was still associated with a significant advantage. The superiority of CBT over alternative therapies was evident only among patients with anxiety or depressive disorders. These results argue against previous claims of treatment equivalence and suggest that CBT should be considered a first-line psychosocial treatment of choice, at least for patients with anxiety and depressive disorders.     

A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: is human contact necessary for therapeutic efficacy?

Technology-based self-help and minimal contact therapies have been proposed as effective and low-cost interventions for addictive disorders, such as nicotine, alcohol, and drug abuse and addiction. The present article reviews the literature published before 2010 on computerized treatments for drug and alcohol abuse and dependence and smoking addiction. Treatment studies are examined by disorder as well as amount of therapist contact, ranging from self-administered therapy and predominantly self-help interventions to minimal contact therapy where the therapist is actively involved in treatment but to a lesser degree than traditional therapy and predominantly therapist-administered treatments involving regular contact with a therapist for a typical number of sessions. In the treatment of substance use and abuse it is concluded that self-administered and predominantly self-help computer-based cognitive and behavioral interventions are efficacious, but some therapist contact is important for greater and more sustained reductions in addictive behavior.