Effectiveness of a 6-month home-based training program in Prader-Willi patients

In addition to hypotonia and relative sarcopenia, patients with Prader-Willi syndrome (PWS) show reduced spontaneous physical activity and gait disorders. Scant evidence exists that daily muscle training increases their lean mass and physical activity levels. Whether adequate long-term physical training is feasible and effective in improving muscle function and gait in PWS is still unknown.Eleven adult PWS patients (mean age: 33.8 ± 4.3 years; mean BMI: 43.3 ± 5.9 kg/m²) admitted to our hospital were enrolled in this study. During their hospital stay they attended a 2-week rehabilitation program which included supervised exercise sessions. At discharge, Group 1 (6 patients) continued the same exercises at home for 6 months, while Group 2 (5 patients) did not continue home-based training. They were assessed at admission (PRE), at 2 weeks (POST1) and at 6 months (POST2). The assessment consisted of a clinical examination, 3D gait analysis and muscle strength measurement with an isokinetic dynamometer.After 2 weeks of supervised training (POST1), no significant changes in spatial-temporal gait parameters were observed, although significant improvements in ankle dorsal flexion during stance and swing and knee flexor strength were evidenced by 3D gait analysis and dynamometry in all patients.Following 6 months of home training (POST2), Group 1 had showed significant improvements in cadence and reduced knee hyperextension in mid-stance. Ankle plantar and dorsal flexors isokinetic strength had improved significantly at 120° s^?1, whereas Group 2 showed no changes in their spatial-temporal and kinematic parameters.The present study reinforces the idea that even in participants with PWS who present with a distinctive psychological profile, long-term group interventions are feasible and effective in improving their overall physical functioning. Providing an effective and simple home-based training program represents a continuum of the rehabilitation process outside the hospital, which is a crucial issue in chronic conditions.     

Behavioural psychotherapy training for nurses in Australia: a pilot program

This paper describes a pilot program that examined the feasibility of training for qualified mental health nurses in behavioural psychotherapy in response to the perceived need for improved client access to services. A 6-month course was conducted with four nurses from the in-patient mental health unit at Flinders Medical Centre, South Australia. They received a combination of workshop training and supervised practice by qualified and experienced nurse behavioural psychotherapists and were assessed throughout the period for clinical competency and level of knowledge in the subject. All four nurses completed the training satisfactorily. Each trainee treated four clients who presented with a range of anxiety disorders. The implications for further training of suitably qualified mental health professionals in the area are discussed.     

程式训练对提高酒精依赖患者生活质量的影响

目的探讨程式训练对提高酒精依赖患者生活质量的影响。方法对80例酒精依赖患者随机分成研究组和对照组各40例,在药物治疗的同时,对研究组患者进行程式训练,对照组患者予以传统的精神康复干预,对两组患者随访1年,采用世界卫生组织生活质量量表（WHO-QOL-100）、焦虑自评量表（SAS）及抑郁自评量表（SDS）进行评定。结果程式训练之前两组患者的生活质量总评及生理领域、心理领域、独立性领域、社会关系领域、环境领域、精神支柱、宗教、个人信仰6个领域均无显著性差异。程式训练1年后,研究组患者的生活质量总评及生理领域、心理领域、独立性领域、社会关系领域、环境领域、精神支柱、宗教、个人信仰均明显高于对照组,SAS）及SDS评分明显低于对照组,差异有统计学意义。结论程式训练能明显减轻酒精依赖患者的焦虑、抑郁情绪,全面提高其生活质量。     

Implementing program-wide awareness about recovery in a large mental health and addictions program

St. Joseph's Healthcare Hamilton conceptualized a multi-step plan for implementing a recovery oriented service delivery approach within their Mental Health and Addictions Program. This brief report discusses the first phase of this plan which included building awareness of recovery utilizing Anthony's (2000) system standards to develop a needs assessment for managers and senior team members. The survey had three purposes: to increase managers' awareness about recovery; to allow managers to express concerns that they had with this paradigm; and to afford managers an opportunity to explore the ways in which their service was and was not operating in a recovery oriented way. Initiatives designed to build awareness throughout the program are discussed.     

Effectiveness of a social skills training program using self/other perspective-taking: a nine-month follow-up

Using a pre/posttest design, with a nine-month follow-up, a new, "modified" social skills training program, which incorporates the concept of self/other perspective-taking, was evaluated and compared to a traditional social skills program in a sample of 36 children. Students in the modified group showed more short- and long-term improvement in behavior than did those in the traditional social skills training group. Implications for practice and research are discussed.     

Effectiveness of a parent training program in (pre)adolescence: evidence from a randomized controlled trial

The present randomized controlled trial examined the effectiveness of the parent training program Parents and Children Talking Together (PCTT) for parents with children in the preadolescent period who experience parenting difficulties. The program is focused on reducing child problem behavior by improving parents' communication and problem solving skills, and disciplining behavior. Largest effects were expected for families with higher SES, and with children in mid-adolescence. Multi-informant and multi-method data were used from 78 self-referred families with children aged 9-16 (M=13.09, SD=1.75). Intention-to-treat analysis (retention rate 95%; immediate posttest only) showed that participation in PCTT significantly improved parents' communication and problem solving skills (F(1,70)=11.77, p<0.01 and F(1,70)=12.87, p<0.01), and reduced their dysfunctional disciplining behavior in conflict situations (F(1,70)=5.25, p<.0.05). The PCTT intervention was most effective for parents with higher SES and for parents with children between the ages of 14 and 16. No consistent gender effects were found.     

Effectiveness of a case management program

Legislation of a case management service provided an opportunity to conduct a natural experiment exploring questions about implementation and effectiveness of case management services. A sample of 21 case managed and 21 comparison clients was interviewed using a protocol adapted from the Quality of Life Questionnaire (Fixed Response Alternative version). Results indicate that case managed clients received more services and had fewer unmet service needs. Quality of life was greater for case managed clients, hospital utilization was reduced, and a possible relationship among services, quality of life, and hospital utilization was identified.     

A collaborative effort to establish a comprehensive epilepsy program in Peru

We report the achievements obtained, over a period of 4 years, by the collaborative partnering effort of the Epilepsy Program at Western University in Canada and the Instituto of Ciencias Neurologicas in Lima, Peru, building an epilepsy program in Peru.     

Applicants' choice of a residency training program

The authors present results from a survey of senior medical students in the class of 1981 concerning their selection of residency training programs in psychiatry. Generally, students were more influenced by clinical training opportunities and quality of life factors and not much influenced by the philosophy of the program. The implications of the findings are discussed from the perspectives of both advising and recruiting medical students.     

Effectiveness of a psychoeducational skill training DVD program to reduce stress in Chinese American dementia caregivers: Results of a preliminary study

Prior research (Gallagher-Thompson, D., Gray, H., Tang, P., Pu, C.-Y., Tse, C., Hsu, S., et al. (2007). Impact of in-home intervention versus telephone support in reducing depression and stress of Chinese caregivers: Results of a pilot study. American Journal of Geriatric Psychiatry, 15, 425–434.) found that an in-home behavioral management program, derived conceptually from cognitive behavioral theories (CBT), was effective in reducing caregiver related stress and depressive symptoms in Chinese American dementia caregivers (CGs). Results were promising, but a more cost-effective intervention is needed to serve this growing population. Past work also found that a psychoeducational videotaped training program based on CBT was effective in reducing stress due to caregiving in Caucasian and African American dementia family CGs (Steffen, 2000 Steffen, AM. 2000. Anger management for dementia caregivers: A preliminary study using video and telephone interventions. Behavior Therapy, 31: 281–299. [Crossref], [Web of Science ®] [Google Scholar], Anger management for dementia caregivers: A preliminary study using video and telephone interventions. Behavior Therapy, 31, 281–299.). To date no research has been conducted using a technological medium to deliver a similar kind of intervention to Chinese American caregivers. The present study evaluated the effectiveness of a similar but culturally “tailored” program in which 70 CGs were randomly assigned to a 12-week CBT skill training program delivered on a DVD, or to a general educational DVD program on dementia. Both were available in Mandarin Chinese or English as preferred. Pre post change analyses indicated that CGs did not differ on change in level of negative depressive symptoms, but positive affect was higher, and patient behaviors were appraised as less stressful and bothersome, for CGs in the CBT skill training program. They were also more satisfied with the program overall and reported that they believed they were able to give care more effectively. Results encourage further development of theoretically based interventions, delivered using modern technology, for this ever increasing group of CGs.     

Effects of social-skills training in a community-based program.

The effects of social-skills training upon the behavior of 8 previously institutionalized mentally retarded adults, residing in community group homes were evaluated. In comparison to a control group, the subjects who received training showed substantial changes in the desirable direction for each behavior. Generalization to unfamiliar situations was also noted. The problems in placing retarded clients in the community without social-skills training and the potential disadvantages of inadequate training were discussed.     

Effectiveness of an attention-training program

Attention Process Training (APT), a hierarchical, multilevel treatment program, was designed to remediate attention deficits in brain-injured persons. The program incorporates current theories in the experimental attention literature. Four brain-injured subjects, varying widely in both etiology of injury and time post onset, underwent intensive cognitive remediation including 5 to 10 weeks of specific attention training. Results are displayed using a single subject multiple baseline across behaviors design. All four subjects demonstrated significant gains in attention following the initiation of attention training. Remediation of another cognitive function (visual processing) was not associated with alterations in attention behavior. The merits of a process-specific approach to cognitive rehabilitation are discussed.     

Pathways to recovery: promoting change within a developmental-systemic framework

This article describes a format for the process of achieving therapeutic change through structured individual sessions with adolescents or adults with eating disorders. It is a model for change based on three separate existing theoretical or conceptual strands: Developmental theory; the application of systems theory and cybernetics to clinical practice; and feminist ideology. It was developed as a pragmatic, clinician-friendly model that could be successfully used by therapists from different disciplines, and is referred to here as developmental-systemic-feminist therapy or individual developmental-systemic therapy. Change in this context is defined as the overt and measurable alteration in feelings, thoughts and behaviours of the participant(s) over the course of treatment. The article provides an overview of the treatment model and outlines the five steps used to achieve change (explore; understand; accept; challenge; change). Essential components of the therapist's stance, skills and knowledge are described, followed by a discussion of the structure and content of sessions in different stages of the therapy. Finally, clinical examples are given to illustrate the clinical use of this model in young patients with eating disorders.     

A review of the constructs, curriculum and training data from a workforce development program for recovery support specialists

The theoretical underpinnings, training content and initial training data of a workforce development program are described. The program was designed for people with psychiatric and/or substance use disorders, and provides skills to improve their employability in the behavioral health system. Trainees rated their knowledge, skills and attitudes as improved after training. Supervisor ratings of participants after three months of employment are consistent with the participant's self-ratings.     

Psychiatry--family practice liaison: a collaborative approach to clinical training

In view of the growing need for effective liaison between psychiatry and family practice programs, some of the models for educational and clinical liaison are discussed, and a clinical training program is described in which psychiatry and family practice educators work collaboratively in the training of both family practice and psychiatry residents and medical students. The program is offered as a model for providing comprehensive clinical training to residents and students and comprehensive clinical care to patients.