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BACKGROUND: The aim of this article is to summarize the current state of research on the effectiveness of psychotherapeutic treatment of posttraumatic stress disorder (PTSD). METHODS: The results of current meta-analyses and trend-setting individual studies are summarized and the most important forms of intervention are explained. RESULTS: The psychotherapeutic treatment methods for PTSD are very effective, the effect sizes are large and superior to those of pharmacotherapy. Trauma exposure and cognitive restructuring are most effective. Trauma-focused procedures are generally superior to other forms of psychotherapy. A range of different cognitive behavioral procedures as well as eye movement desensitization and reprocessing are recommended. The most recent initial findings confirm a very good effectiveness for imagery rescripting methods as protective interventions without a formal confrontation with trauma. Individual therapy works better than group psychotherapy. In the group setting cognitive processing therapy has proven to be the best intervention. Trauma-focused treatment should also be used when comorbid conditions such as schizophrenia, bipolar disorder or addiction are present. DISCUSSION: Trauma-focused psychotherapy in an individual setting is the treatment of choice for PTSD. A large selection of effective methods and well-reviewed manuals are available. The German language S3 guidelines are currently being updated.
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Terapia Cognitivo-Comportamental , Medicina Baseada em Evidências , Psicoterapia , Transtornos de Estresse Pós-Traumáticos , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Humanos , Psicoterapia/métodos , Terapia Cognitivo-Comportamental/métodos , Resultado do Tratamento , Dessensibilização e Reprocessamento através dos Movimentos Oculares/métodos , AlemanhaRESUMO
The purpose of this study was to determine how the 24-hour dietary recall (24HDR) is administered and how the Expanded Food and Nutrition Education Program (EFNEP) peer educators and other staff are trained on the data collection and entry process, from the EFNEP coordinators' perspectives. This cross-sectional, quantitative study utilized an online survey to collect information from EFNEP coordinators representing 61 of 76 EFNEP programs. While 56% of the programs collected the 24HDR data starting with the first thing eaten the previous day, 49% of them started collecting data at the time of class, going backwards. Most programs, i.e., 72%, reported using a multiple-pass method; however, only one-third of them reported using the standard five-pass method. Almost all programs, i.e., 97%, reported one peer educator collecting data from a group of 2-12 clients. All programs reported collecting the 24HDR data in a group setting, with about one-third of the programs also collecting data one-on-one. Most programs, i.e., 57%, reported spending ≤4 h on the initial training of staff in how to collect 24HDR data, and 54% of them reported that the peer educators entered the data themselves. This study found that the methods used to collect answers, train the staff, and enter the 24HDR data varied across EFNEP programs and that there is a need to standardize or revise the collection of 24HDR data.
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Dieta , Educação em Saúde , Humanos , Estudos Transversais , Educação em Saúde/métodos , Alimentos , Inquéritos e QuestionáriosRESUMO
Considerable effort has gone into studying bereavement in children, adults and the elderly, but few studies have investigated the effects of bereavement or grief interventions in young adults. Even fewer studies have reported on the effect of interventions for young adults with grief complications. The present study seeks to help fill this gap by describing a Danish treatment program specially developed for young adults with complicated grief reactions. The dual process model of coping with bereavement, psychodynamic theory, and a narrative approach provide the foundation for the treatment. In addition, it utilizes an eclectic use of techniques and a group treatment modality that involves providing individual therapy within a group context. The core elements of the treatment are discussed and then exemplified in two case studies.
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Luto , Psicoterapia de Grupo , Criança , Humanos , Adulto Jovem , Idoso , Pesar , Adaptação Psicológica , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Psychodrama is an experiential group psychotherapy that is used to enhance adolescents' wellbeing. The COVID-19 pandemic forced the adaptation of this method to an online setting. OBJECTIVE: This qualitative study investigated whether and how tele-psychodrama provides psychological support to adolescents, in order to better understand its strengths and weaknesses. PARTICIPANTS: 14 adolescents from Northern and Central Italy. METHOD: 14 interviews were conducted at the end of group tele-psychodrama treatment and were analysed with qualitative thematic analysis. RESULTS: Three themes were identified: (1) contribution of tele-psychodrama to adolescents' well-being; (2) implementation of psychodrama to the online setting; and (3) (the) shortcomings of tele-psychodrama. CONCLUSIONS: Despite the differences between online and in-person psychodrama, all the participants expressed their appreciation of group tele-psychodrama, which contributed to their overall psychological wellbeing and helped them process difficulties that emerged during the lockdowns.
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The Socially Evaluated Cold-Pressor Test (SECPT (Schwabe et al., 2008) [1]; reliably elicits stress responses. We refined the group-administered version of the SECPT (SECPT-G) aiming to increase its' effectiveness. In Experiment 1 (N = 39), we gathered data from 12 participants simultaneously, employing a stress confederate for each participant. In Experiment 2 (N = 69), we gathered data from six participants simultaneously, employing either six stress confederates (individual-observation) or a single one (group-observation). In Experiment 1, we found that the SECPT-G elicited cortisol responses compared to a control condition; in Experiment 2, we replicated these findings and observed that cortisol responses were similar in the individual- and the group-observation setting. The findings of Experiment 2 were corroborated by people's subjective stress experience. Importantly, both experiments show a similar magnitude of cortisol response, and a greater responder rate than in the regular SECPT or the regular Trier Social Stress Test (TSST). The presented SECPT-G template may thus serve as a reliable and efficient stress induction tool that allows standardization across research groups.
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This cluster randomized controlled trial provides evidence that focused musical instrumental practice, in comparison to traditional sensitization to music, provokes multiple transfer effects in the cognitive and sensorimotor domain. Over the last 2 years of primary school (10-12 years old), 69 children received group music instruction by professional musicians twice a week as part of the regular school curriculum. The intervention group learned to play string instruments, whereas the control group (i.e., peers in parallel classes) was sensitized to music via listening, theory and some practice. Broad benefits manifested in the intervention group as compared to the control group for working memory, attention, processing speed, cognitive flexibility, matrix reasoning, sensorimotor hand function, and bimanual coordination Apparently, learning to play a complex instrument in a dynamic group setting impacts development much stronger than classical sensitization to music. Our results therefore highlight the added value of intensive musical instrumental training in a group setting within the school curriculum. These results encourage general implementation of such training in public primary schools, thus better preparing children for secondary school and for daily living activities.
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Background: Approximately half of all asylum seekers suffer from trauma-related disorders requiring treatment, among them Posttraumatic Stress Disorder (PTSD), depression, anxiety, and somatic symptoms. There is a lack of easily accessible, low-threshold treatments taking the cultural background into account. Culturally Adapted CBT (CA CBT) is a well evaluated, transdiagnostic group intervention for refugees, using psychoeducation, meditation, and Yoga-like exercises. Objective: An uncontrolled pilot study with male Farsi-speaking refugees from Afghanistan and Iran was conducted to investigate feasibility with this ethnic group; a group for which no previous CBT trials have been reported. Method: The participants were nine Farsi-speaking, male refugees with M.I.N.I./DSM-IV diagnoses comprising PTSD, major depressive disorder, and anxiety disorders. Treatment components were adapted to the specific cultural framework of perception of symptoms, causes, ideas of healing, and local therapeutic processes. Before and after 12 weeks of treatment, the primary outcome was assessed using the General Health Questionnaire (GHQ-28). Secondary outcome measures were the Posttraumatic Checklist, Patient Health Questionnaire, Somatic Symptom Scale, World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Affective Style Questionnaire (ASQ), and Emotion Regulation Scale (ERS). Results: Seven participants completed treatment. In the completer analysis, improvements were found on almost all questionnaires. Large effect sizes were seen for the GHQ-28 (d = 2.0), WHOQOL-BREF scales (d = 1.0-2.3), ASQ tolerating subscale (d = 2.2), and ERS (d = 1.7). With respect to feasibility, cultural adaptation seemed to be a crucial means to promote effectiveness. Conclusion: CA CBT may reduce general psychopathological distress and improve quality of life. Improvement in emotion regulation strategies may mediate treatment effects. More support should be provided to enhance coping with the uncertainty of asylum status and stressful housing conditions. CA CBT appears to be a promising transdiagnostic treatment, serving as an initial low-threshold therapy in a stepped care approach.
Planteamiento: Aproximadamente la mitad de los solicitantes de asilo sufren trastornos relacionados con el trauma que requieren tratamiento, entre ellos trastorno por estrés postraumático (TEPT), depresión, ansiedad y síntomas somáticos. Hay una falta de tratamientos de fácil acceso y umbral bajo que tienen en cuenta los antecedentes culturales. La TCC adaptada culturalmente (TCC AC) es una intervención grupal transdiagnóstica bien evaluada para los refugiados, que utiliza ejercicios de psicoeducación, meditación y de Yoga. Objetivo: Se realizó un estudio piloto no controlado con hombres refugiados de habla farsi de Afganistán e Irán para investigar la viabilidad con este grupo étnico, grupo para el cual no existen informes de ensayos previos de TCC. Método: Los participantes fueron nueve refugiados varones de habla farsi, con diagnósticos M.I.N.I./DSM -IV que comprenden TEPT, trastorno depresivo mayor y trastornos de ansiedad. Los componentes del tratamiento se adaptaron al marco cultural específico de percepción de síntomas, causas, ideas de curación y procesos terapéuticos locales. Antes y después de 12 semanas de tratamiento, el resultado principal se evaluó mediante el Cuestionario de Salud General (GHQ-28, siglas en inglés de General Health Questionnaire). Las medidas de resultado secundarias fueron la Lista de Verificación Postraumática (Posttraumatic Checklist), el Cuestionario de Salud del Paciente (Patient Health Questionnaire), la Escala de Síntomas Somáticos (Somatic Symptom Scale), el Cuestionario de Calidad de Vida de la Organización Mundial de la Salud (WHOQOL-BREF, siglas en inglés de World Health Organization Quality of Life Questionnaire), el Cuestionario de Estilo Afectivo (ASQ, siglas en inglés de Affective Style Questionnaire), y la Escala de Regulación Emocional (ERS, siglas en inglés de Emotion Regulation Scale). Resultados: Siete participantes completaron el tratamiento. En el análisis más completo, se encontraron mejoras en casi todos los cuestionarios. Se observaron tamaños de efecto grandes para las escalas GHQ-28 (d = 2,0), WHOQOL-BREF (d = 1,02,3), la subescala de tolerancia ASQ (d = 2,2) y ERS (d = 1,7). Con respecto a la viabilidad, la adaptación cultural parece ser un medio crucial para promover la eficacia. Conclusión: La TCC AC puede reducir la angustia psicopatológica general y mejorar la calidad de vida. La mejora en las estrategias de regulación emocional puede mediar en los efectos del tratamiento. Debería prestarse más apoyo para mejorar la capacidad de afrontar la incertidumbre sobre el estado de asilo y condiciones de vivienda estresantes. La TCC AC parece ser un tratamiento transdiagnóstico prometedor, que sirve como una terapia de bajo umbral inicial en un abordaje de atención escalonada.
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AIMS: The purpose of this study was to evaluate differences in gross motor performance of children 3-5 years of age with motor delays when assessed individually compared to assessment in a group setting among peers with typical development (TD). METHODS: Twenty children with motor delays and 42 children with TD were recruited from a preschool program. A within-subject repeated measures design was used; each child with delay was tested both in an individual setting and in a group setting with two to four peers with TD. Testing sessions were completed 4-8 days apart. Ten different motor skills from the Peabody Developmental Motor Scales-2 were administered. Performance of each item was videotaped and scored by a blinded researcher. RESULTS: Overall gross motor performance was significantly different (p < .05) between the two settings, with 14 of 20 children demonstrating better performance in the group setting. In particular, children performed better on locomotion items (p < .05). CONCLUSIONS: The higher scores for locomotion in the group setting may be due to the influence of competition, motivation, or modeling. Assessing a child in a group setting is recommended as part of the evaluation process.
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Deficiências do Desenvolvimento/fisiopatologia , Deficiências do Desenvolvimento/psicologia , Destreza Motora , Influência dos Pares , Pré-Escolar , Comportamento Competitivo , Feminino , Humanos , Locomoção , Masculino , Motivação , Equilíbrio Postural , Método Simples-CegoRESUMO
Este trabalho insere-se no campo da psicanálise freudo-lacaniana e trata da prática analítica com grupos, a partir de uma experiência de escuta em grupo a professores, realizada no período de 2007 a 2009, e de uma revisão da literatura acerca das práticas com grupos no campo da psicanálise. Considera as contribuições de Freud, dos principais autores pós-freudianos, de Lacan, e de alguns autores de orientação lacaniana. Para acessar a produção mais recente, foram realizadas buscas no portal de periódicos e no banco de teses da Capes. Recursos de busca adicionais, tais como o Google Acadêmico e sumários de periódicos analíticos on-line, permitiram recuperar outras produções relevantes. A literatura analisada indicou, de um lado, que os efeitos imaginários inerentes à formação de grupos configurariam um obstáculo ao trabalho analítico. De outro, apontou para a possibilidade de invenção particular no contexto de uma escuta em pequenos grupos, orientada analiticamente, o que seria consequência da formação do praticante...
This work is inserted in the field of Freud and Lacans psychoanalysis and addresses the analytic practice with groups based on a listening experience with a group of teachers, held from 2007 to 2009, and a literature review about practices with groups in the field of psychoanalysis. Several theoretical contributions are considered such as, Freuds, some of the major post-Freudian authors, Lacan and some authors of his orientation. To access the latest production, searches were conducted in the Capess journals website and in the theses database. Additional search features, such as Google Scholar and summaries of analytical periodicals online, enabled the recovery of other relevant productions. On the one hand, the literature review indicated that the imaginary effects inherent in the formation of groups would stand as an obstacle to analytic work. On the other, it pointed to the possibility of particular invention in the context of listening in analytically oriented, small groups, which would be a result of the formation of the analyst...
Ce travail est inséré dans le champ de la psychanalyse freudienne et lacanienne et traite de la pratique analytique avec des groupes a partir d'une expérience d'écoute à un groupe d'enseignants, réalisée entre 2007 et 2009, et d une révision de la littérature sur les pratiques avec des groupes dans le champ de la psychanalyse, compte tenu des contributions de Freud, certains des principaux auteurs post-freudiens, Lacan et certains auteurs d'orientation lacanienne. Pour accéder à la production plus récentes, des recherches ont été faites dans les portails web de périodiques et la base de données de thèses de la Capes. D'autres outils de recherche, tels que Google Scholar et des résumés analytiques de périodiques en ligne, a permis la récupération d'autres productions pertinentes. D'une part, cette recherche a indiqué que les effets imaginaires inhérents à la formation de groupes configureraient un obstacle au travail analytique. D'autre part, elle a souligné la possibilité d'invention particulière dans le contexte de l'écoute en petits groupes, analytiquement orientée, ce qui serait un résultat de la formation du praticien...