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Hosp Community Psychiatry ; 40(4): 402-6, Apr 1989.
Artigo em Inglês | MedCarib | ID: med-14428


Sociodrama, a synthesis of group psychotherapy and theatrical presentation, was used from 1978 to 1981 to promote rehabilitation of chronic mentally ill patients at Bellevue Mental Hospital in Jamaica. Staff and patients collectively analyzed their recollections of the hospital's history, then wrote and staged dramatic productions based on the insights derived from those analyses. Changes in the major themes that emerged from the process reflected improvement in therepuetic attitudes and practices and in patient-staff communication over the four-year period. Patients who participated in the sociodramas had greater decreases in medication doseage and psychosocial disability scores and higher rates of improvement and discharge than a matched group of patients who did not participate (AU)

Humanos , Transtornos Mentais/reabilitação , Psicodrama , Doença Crônica , Jamaica , Transtornos Mentais/terapia , Psicoterapia de Grupo , Relações Raciais , Fatores Socioeconômicos
Br J Psychiatry ; 113(499): 643-58, June 1976.
Artigo em Inglês | MedCarib | ID: med-9931


An alcoholism treatment programme has been in operation at the St. Ann's Hospital, Port of Spain, Trinidad since March, 1956, combining emetine aversion treatment in groups with milieu therapy and group psychotherapy. In January, 1961, the treatment programme was moved to a separate unit with 20 beds, and the group therapy was handed over to an occupational therapist. An Alcoholism Rehabilitation Officer was appointed who was himself an alcoholic, and A.A. meetings were held on the ward. Patients were followed up at weekly out-patient clinics. The closest collaboration has been maintained throughout with Alcoholics Anonymous, the first group of which begun in March, 1956. A significant role has been played in Community Education by the Alcoholism Sub-committee of the Mental Health Association. This collaboration produced a remarkable growth in the number of A.A. groups, which by 1966 numbered 31 in a population of 950,000. The growth of A.A. groups, especially in small rural villages, created a change in the social environment which gave the recovered alcoholic a sense of personal worth. Calypso singers treated at the unit wrote calypsoes about their experience and played a part in promoting community acceptance of the disease concept of alcoholism. A follow-up study was carried out in 1963 and 1964 on 370 patients, 57 of whom had been treated in 1956 and 313 in 1961. The differences in the characteristics of these two groups indicated an improvement in the community attitude to alcoholism and a greater willingness to seek treatment. The overall outcome was defined in terms of a seven-point scale of abstinence and social functioning with total abstinence of two years or better at one end, and death at the other. The overall success rates were calculated as percentages of the whole, counting those lost to follow-up as failures. Group I (seven-year follow-up of 57 patients) showed 52.6 per cent. success with 36.8 per cent. totally abstinent for more than two years, 3.5 per cent.(2 patients) having returned to social drinking, and 10.5 per cent. dead, half of them by suicide. These results compared favourably with the follow-up studies by Davies, Shepard and Myers and by Wing at the Maudsley Hospital over four years. A further comparison was made with the follow-up study of untreated alcoholics by Kendall and Staton over a period of similar to that of Group I of the Trinidad study. Group II (two-year follow-up of 313 patients) showed 42.49 percent. success with a total abstinence of 35.14 per cent. These rates are only apparently lower than those of Group I because of the large group (40.8 per cent.) lost to follow-up. The group lost to trace, was, however not significantly different from the sample as a whole, and there were reasons to believe that in fact Group II had done rather better than Group I. The ratio of success to known failures improved from 2:1 to 2.5:1. An attempt was made to break down the number treated in terms of type of treatment. As this was not a planned study no claims were made for the significance of the figures, but the group who elected to have emetine and who went to A.A. on discharge emerged with strikingly better results. The importance to therapy of obtaning cultural acceptance of the disease concept of alcoholism is stressed. Reasons are sought for the large proportion of East Indians among those coming for treatment. Negroes and East Indians in Trinidad form subcultures of comparable size, yet highest rates of alcoholism seem to come from the Indians with stable family units and male role models, while the matrifocal Negro group seems less vulnerable. This finding is at variance with the expectations of psychoanalytic theory, and sociocultural deprivation seems the likely explanation. (AU)

Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Alcoolismo/tratamento farmacológico , Alcoolismo/epidemiologia , Alcoolismo/terapia , Programas Médicos Regionais , Serviços de Saúde Comunitária , Emetina/uso terapêutico , Seguimentos , Terapia Ocupacional , Psicologia Social , Psicoterapia de Grupo , Fatores Socioeconômicos , Trinidad e Tobago , Índias Ocidentais
In. Anon. Family relationships: fourth Caribbean Conference for Mental Health. Curacao, s.n, 1963. p.169-176.
Monografia em Inglês | MedCarib | ID: med-10152
In. Carter, Samuel E. The adolescent in the changing Caribbean: proceedings of the Third Caribbean Conference for Mental Health. Kingston, The Herald, 1963. p.158-160.
Monografia em Inglês | MedCarib | ID: med-10098