认知暴露疗法治疗创伤后应激障碍的研究

目的 探讨认知暴露疗法治疗创伤后应激障碍(PTSD)的效果.方法 连续病例20名被随机分成两组,一组采取药物干预,另一组采用认知暴露疗法结合药物干预.疗效采用创伤后应激障碍症状清单量表(PCLS)、症状自评量表(SCL-90)、贝克抑郁问卷(BDI)、状态-特质焦虑问卷(STAI-Form Y)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)进行盲法评定.结果 药物治疗和结合治疗都在一定程度上改善了PTSD的症状,但是在再经历方面,结合治疗组下降稳定.其余各量表纵向效应明显.随访时用创伤后应激障碍症状清单量表(PCLS)进行测量,发现结合治疗组有两名被试已经不再符合PTSD诊断阶段,但是统计检验显示两治疗组之间并无差异.结论 认知暴露疗法有助于PTSD患者的心理康复.     

认识领悟疗法治疗对人恐惧症

目的 探讨认识领悟疗法对对人恐惧症的治疗作用.方法 按照钟友彬教授认识领悟疗法的原理、方法和步骤,对来访者实施认识领悟治疗.结果 来访者的恐惧症状在治疗后消失.结论 使用认识领悟疗法治疗对人恐惧症有效.     

白癜风的心理干预治疗作用评估

目的 探讨心理干预治疗在白癜风治疗中的作用.方法 对120例白癜风患者进行心理健康症状自评量表(SCL-90)问卷调查,评价受试者心理健康状况.有心理问题的66例随机分为Ⅰ、Ⅱ组,无心理问题的54例随机分为Ⅲ、Ⅳ组.Ⅰ、Ⅲ组采用心理干预+药物+光疗,Ⅱ、Ⅳ组为单纯药物+光疗治疗,疗程3个月,评价疗效同时再次进行心理测评,计算4组治疗方案的P值,评价患者心理问题的改善和皮损好转显效率的对应程度.结果 Ⅰ组与Ⅱ组对比,显效率差异有统计学意义(P＜0.05);Ⅲ与Ⅳ组对比,显效率差异无统计学意义(P＞0.05);Ⅰ组与Ⅲ组对比,显效率差异有统计学意义(P＜0.05);Ⅱ组与Ⅳ组对照,显效率差异无统计学意义(P＞0.05).结论 对白癜风患者进行心理干预治疗,有助于提高早期疗效和生活质量.     

脑梗死后抑郁相关因素的Logistic回归分析

目的了解脑梗死患者脑梗死后抑郁(PSD)患病情况及其相关因素,为脑梗死患者的心理治疗提供依据。方法调查分析脑梗死后抑郁患者的年龄、性格、受教育程度、病变部位及康复治疗状况,对调查结果采用Lo-gistic回归分析方法进行统计学分析。结果有肢体活动障碍和不良反应且未早期接受康复治疗、性格内向的患者抑郁的发生率高。病变位于皮质部位与脑梗死后抑郁有一定相关性(P<0.05)。社会因素方面,住院期间家人不够关心、住院时间延长者抑郁发生率明显增高(P<0.01)。<50岁和>65岁的患者抑郁发生率较50~65岁的高。而早期接受康复治疗、肢体功能恢复状况好可能减少PSD发生(P<0.001)。抑郁发生情况与患者的性别、婚否、经济状况及睡眠状况无关(P>0.05)。结论抑郁是脑梗死患者住院期间最常见的心理障碍,应针对其致病相关因素加强其心理治疗及护理。     

药物合并心理治疗对抑郁症的疗效分析

目的 比较药物合并心理治疗与单纯药物治疗抑郁症患者的疗效。方法 64例住院抑郁症患者随机分为研究组（药物合并心理治疗）与对照组（单纯药物治疗），治疗时间6～12周，评价指标采用HAM—D和GQOLI-74，并在治疗后6个月后进行随访以观察其疗效及复发率。结果 药物合并心理治疗和单纯药物治疗组疗效相当，但药物合并心理治疗组能改善患者的认知，6个月后随访时复发率低。结论 药物合并心理治疗对抑郁症患者是一种较好的治疗方法。     

短程精神分析治疗抑郁症

目的 探讨精神分析治疗抑郁症的机制.方法 用短程精神分析方法为抑郁症患者进行精神分析治疗,共治疗4周,8次.治疗前、治疗后分别用HAMD量表评定.不用任何药物.结果 患者抑郁症状缓解,社会功能恢复良好.治疗前HAMD27分,治疗后HAMD4分,随访2年无复发.结论 短程精神分析治疗抑郁症具有较好的疗效.     

两种方法治疗磨牙症的有效性对比研究

目的通过对两种不同方法治疗磨牙症的患者康复情况进行对比,分析并探讨治疗磨牙症的最佳方案。方法收集我校2010级学生愿意佩戴牙合垫治疗磨牙症的患者100例,分为A、B两组,各50例;A组单纯采用牙合垫治疗磨牙症,B组牙合垫联合心理疗法治疗磨牙症,治疗6个月后,对两组的康复情况进行统计学分析。结果对A、B两组患者之间的康复率进行χ2检验,P〈0.05,有统计学意义,两组之间存在差异。结论牙合垫联合心理疗法治疗磨牙症的方法优于单纯采用牙合垫治疗磨牙症。     

From the Treatment of a Compulsive Spitter: A Psychoanalytical Approach to Profound Disability

Every practicing psychotherapist will have ample experience of patients expressing rage and hatred during the course of a session. In virtually all cases, patients emit their fury in a verbal form. But what happens when an angry, traumatized patient lacks the capacity to spit out nasty words and, instead, spits saliva? While most adult psychotherapy patients have developed a well‐internalized ability to keep their bodily fluids contained inside their bodies (with the possible exception of tears), severely and profoundly learned disabled patients can drool, vomit, urinate, defecate, ejaculate, and spit in the midst of a psychotherapy session. In view of this little‐discussed, yet not infrequent, clinical phenomenon, how can a psychotherapist function when under attack from the patient and his or her actual bodily fluids? In order to explore this aspect of disability psychotherapy, the author will discuss an eight‐year treatment with a psychotic, brain‐damaged psychogeriatric patient who spat compulsively in an aggressive manner. The author will describe the way in which he endeavoured to use classical psychoanalytical approaches in order to create an environment of safety in which the patient could begin to experience greater mental containment as well as bodily containment, and eventually arrive at a state in which her spittle could be transformed into feelings and even rudimentary words.     

Advancing Telecommunication Technology and its Impact on Psychotherapy in Private Practice

This paper is a report on an informal study by a small group of psychotherapists interested in exploring the impact of recent technological innovations on their work as independent clinicians in private practice. The range of technologies studied included websites, email, mobile phones, and internet‐based banking services for payment and receipt of fees. Some of the group had experience of using internet‐based video software (or Voice Over Internet Protocol/VOIP software) for providing therapy and/or establishing supervisory and training links. The study found that these technologies have had both positive and negative impacts on professional practice and, in particular, records how practitioners have managed these changes within their clinical practice. The study notes the lack of professional training about these matters and highlights some of the issues that need to be addressed in redressing this situation.     

The Breathing Boundary

All psychotherapy is dependent on a frame, a structure. We require boundaries in order to feel and provide containment. However, when working with patient groups who have been excluded from mainstream risk‐averse treatment we learn more about the nature of professional boundaries. A boundary needs to be nurtured and thought about. It needs to breathe and to come from thought. A rigid boundary is a different matter. Where is the humble concept of not knowing? What makes flexible guidelines become rigidified into inflexible codes and barriers? In interrogating techniques that do not work with people with intellectual disabilities we learn more about shared areas of social disability. This paper focuses on questions of analytic neutrality, affect, anger, transparency, and disability psychotherapy in the external as well as internal world.