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1.
J Psychiatr Pract ; 27(3): 152-163, 2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33939369

RESUMO

Crisis intervention psychotherapy (CIP) is an underutilized form of therapy that can be offered as a treatment during psychiatric disasters and emergencies, and it may be especially useful during the age of Coronavirus Disease 2019 (COVID-19). CIP is a problem-solving, solution-focused, trauma-informed treatment, utilizing an individual or systemic/family-centered approach. CIP is a brief form of psychotherapy delivered as a companion or follow-up to psychological first aid. Crisis psychotherapy is designed to resolve a crisis and restore daily functioning. CIP can be adapted as a single session for a COVID-19 mental health emergency or for a hotline or as 2 to 20 sessions of treatment with COVID-19 patients and families offered virtually on a psychiatric inpatient unit, through a consultation-liaison service, or in outpatient settings. This article reviews the history of critical incident stress management and the use of its replacement, psychological first aid. The history and core principles of crisis psychotherapy and 8 core elements of treatment are described. The use of digital and virtual technology has enabled the delivery of crisis psychotherapy during the COVID-19 pandemic. A case study of a family impacted by COVID-19 is reported as an illustration. The use of a 6-week timeline, an ecological map, and a problem-solving wheel-and-spoke treatment plan are demonstrated.


Assuntos
/psicologia , Intervenção na Crise , Terapia Familiar , Psicoterapia Breve , Telemedicina , Intervenção na Crise/métodos , Intervenção na Crise/normas , Terapia Familiar/métodos , Terapia Familiar/normas , Humanos , Psicoterapia Breve/métodos , Psicoterapia Breve/normas , Telemedicina/métodos , Telemedicina/normas
2.
Trials ; 22(1): 243, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33794971

RESUMO

BACKGROUND: Parental mental illness is common and can lead to dependent children incurring a high risk of developing mental disorders, physical illness, and impaired educational and occupational outcomes. Family Talk is one of the better known interventions designed to prevent the intergenerational transmission of mental illness. However, its evidence base is small, with few robust independent randomised controlled trials, and no associated process or cost evaluations. The PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children) research programme involves a mixed method evaluation of Family Talk which is being delivered in mental health settings in Ireland to improve child and family psychosocial functioning in families with parental mental illness. METHODS: The study comprises a multi-centre, randomised controlled trial (RCT), with nested economic and process evaluations, to assess the clinical and cost-effectiveness and implementation mechanisms of Family Talk compared to usual services. The study is being conducted in 15 adult and child mental health settings in Ireland. Families with a parent with mental illness, and children aged 5-18 years (n = 144 families) will be randomised to either the 7-session Family Talk programme (n = 96) or to standard care (n = 48) using a 2:1 allocation ratio. The primary outcomes are child psychosocial functioning and family functioning. Secondary outcomes are as follows: understanding and experience of parental mental illness, parental mental health, child and parental resilience, partner wellbeing and service utilisation. Blind assessments will take place at pre-intervention and at 6- and 12-month follow-up. DISCUSSION: Given the prevalence and burden of intergenerational mental illness, it is imperative that prevention through evidence-based interventions becomes a public health priority. The current study will provide an important contribution to the international evidence base for Family Talk whilst also helping to identify key implementation lessons in the scaling up of Family Talk, and other similar interventions, within routine mental health settings. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN13365858 . Registered 5th February 2019.


Assuntos
Filho de Pais Incapacitados , Relações Familiares , Terapia Familiar/métodos , Transtornos Mentais , Serviços de Saúde Mental , Ensaios Clínicos Controlados Aleatórios como Assunto , Adolescente , Criança , Análise Custo-Benefício , Humanos , Irlanda , Avaliação de Processos em Cuidados de Saúde , Resultado do Tratamento
3.
J Marital Fam Ther ; 47(2): 304-319, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33721348

RESUMO

The novel Coronavirus pandemic (COVID-19) and subsequent social distancing practices have altered the way we move through the world and access physical and mental healthcare. While researchers and clinicians have begun to explore the impact of telehealth delivery on psychotherapy and treatment outcomes, the purpose of this study was to explore the lived experiences of individuals in teletherapy, specifically those engaging in teletherapy with a romantic partner or family member. Using a thematic analysis of open-ended online survey questions, we explored the experiences of 25 individuals who engaged in couple or family teletherapy after social distancing began. The resulting themes included "making do," safe therapeutic space, convenience, logistical challenges, and therapist accommodation. We discuss the clinical implications of these themes to support effective couple and family teletherapy and offer suggestions and considerations for remote clinical interventions and practices. [Correction added on 22 March 2021, after first online publication: The term '19' has been changed to '(COVID-19)' in the first line of the Abstract section, in this version.].


Assuntos
Terapia de Casal/métodos , Terapia Familiar/métodos , Satisfação do Paciente/estatística & dados numéricos , Fisioterapeutas/estatística & dados numéricos , Relações Profissional-Paciente , Telemedicina/estatística & dados numéricos , /epidemiologia , Feminino , Humanos , Masculino , Fisioterapeutas/psicologia , Inquéritos e Questionários
4.
J Marital Fam Ther ; 47(2): 440-454, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33749898

RESUMO

The COVID-19 pandemic has transformed so many aspects of our lives. For psychotherapists, telehealth is likely a permanent part of the future mental health landscape. For family therapists using a manualized treatment, this brings unique challenges and creative opportunities. In this article, we describe the adaptation of attachment-based family therapy (ABFT) in the context of telehealth and COVID-19. ABFT is an empirically supported treatment model designed for adolescents and young adults struggling with depression, anxiety, trauma, and suicide. ABFT is a semi-structured, process-oriented, and trauma-informed family therapy model which presents its own unique challenges and benefits in telehealth environments. We present our adaptations based on years of telehealth clinical experience and address how this model supports the impact of COVID-19 on families.


Assuntos
Terapia de Casal/métodos , Terapia Familiar/métodos , Apego ao Objeto , Telerreabilitação/métodos , Adolescente , Feminino , Humanos , Masculino , Modelos Psicológicos , Relações Profissional-Família , Adulto Jovem
5.
Inf. psiquiátr ; (241): 63-83, jul.-sept. 2020.
Artigo em Espanhol | IBECS | ID: ibc-197444

RESUMO

La psicoterapia multifamiliar es un modelo de terapia grupal compleja, rica e integradora, que permite incluir en un mismo lugar a pacientes, familias y equipo terapéutico. Las primeras experiencias en grupos multifamiliares se inician en Estados Unidos durante los años cincuenta, en entornos hospitalarios, para el tratamiento de los trastornos psicóticos como la esquizofrenia. Con el tiempo, el modelo multifamiliar se expande por el mundo y se ha venido implementando en distintos dispositivos asistenciales como hospitales de día o programas comunitarios, así como en una gran diversidad de poblaciones clínicas. En febrero de 2018, en el Equipo de Intervención Precoz en Psicosis (EIPP) del área del Baix Empordà, de la red de salud mental pública de la provincia de Girona, se crea un Grupo Multifamiliar (GMF) para jóvenes que han sufrido un Primer Episodio Psicótico (PEP) o bien tienen riesgo de padecerlo, los llamados Estados Mentales de Alto Riesgo (EMAR). En el equipo se construye un escenario terapéutico grupal con el objetivo de vincular, contener y dar continuidad de tratamiento al paciente y a su familia. Nuestro enfoque multifamiliar se ha inspirado en las ideas de Jaakko Seikkula y su modelo psicoterapéutico de Diálogo Abierto (Open Dialogue), y en las aportaciones de Irvin Yalom sobre la eficacia de los Factores Terapéuticos Grupales. Hemos hecho especial hincapié en los elementos a tener en cuenta en la gestión del clima emocional del grupo, que como sabemos es una de las variables de cambio psíquico más importantes. Nuestro GMF tiene como característica particular, la conducción terapéutica interdisciplinar. El presente artículo muestra el proceso de implementación e integración del GMF en un programa comunitario de intervención precoz de los trastornos psicóticos incipientes


Multifamily psychotherapy is a complex, rich and inclusive group therapy model that allows patients, families and a therapeutic team to be included in the same place. The first experiences in multi-family groups began in the United States during the 1950s, in hospital settings, for the treatment of psychotic disorders such as schizophrenia. Over time, the multi-family model has been spread throughout the world and has been implemented in different healthcare services such as day hospitals or community programs as well as in a wide variety of clinical populations. In February 2018, in the Early Intervention Team in Psychosis (EIPP) of the Baix Empordà area, of the public mental health network of the province of Girona, a Multifamily Group (MFG) is created for young people who have suffered from a First Psychotic Episode (FPE) or they are at risk of suffering it, the so-called High Risk Mental States (HRMS). The team builds a group therapeutic scenario with the aim of linking, controlling and giving continuity of treatment to the patient and their family. Our multifamily approach has been inspired by Jaakko Seikkula's ideas and his Open Dialogue psychotherapeutic model, and by the contributions of Irvin Yalom on the efficacy of Group Therapeutic Factors. We have placed special emphasis on the elements to be taken into account when managing the emotional climate of the group, which is known as one of the most important variables of psychic change. Our GMF has as its particular characteristic, Interdisciplinary Therapeutic Management. This article shows the process of implementation and integration of the GMF in an incipient psychotic disorders early intervention community program


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Transtornos Psicóticos/terapia , Intervenção Médica Precoce/organização & administração , Psicoterapia de Grupo/métodos , Equipe de Assistência ao Paciente , Psicoterapia de Grupo/instrumentação , Transtornos Mentais/terapia , Relações Mãe-Filho/psicologia , Terapia Familiar/métodos
6.
Fam Process ; 59(3): 989-996, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32743795

RESUMO

This paper addresses the need for a swift transition from in-person clinical supervision to telesupervision during the time of the COVID-19 global pandemic. Five specific areas will be discussed in the effort to enhance the quality of clinical supervision provided to couple and family therapists in training at this time including the following: (1) COVID-19 and the structural changes and technological adaptation of supervision; (2) culturally and contextually sensitive guidelines for clinical supervision during COVID-19; (3) the supervisee's competence and the clinical supervisory process; (4) the new set of boundaries and the supervisory role; (5) and the supervisory alliance and supervisees' vulnerabilities in the face of COVID-19.


Assuntos
Infecções por Coronavirus/psicologia , Terapia de Casal/organização & administração , Terapia Familiar/organização & administração , Pneumonia Viral/psicologia , Psicoterapia/organização & administração , Telemedicina/organização & administração , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Terapia de Casal/métodos , Terapia Familiar/métodos , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Telemedicina/métodos
7.
Fam Process ; 59(3): 865-882, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32663315

RESUMO

The novel coronavirus has added new anxieties and forms of grieving to the myriad practical and emotional burdens already present in the lives of underserved and uninsured immigrant families and communities. In this article, we relate our experiences since the COVID-19 crisis to the lessons we have learned over time as mental health professionals working with families in no-cost, student-managed community comprehensive health clinics in academic-community partnerships. We compare and contrast the learnings of flexibility of time, space, procedures, or attendance we acquired in this clinical community setting during regular times, with the new challenges families and therapists face, and the adaptations needed to continue to work with our clients in culturally responsive and empowering ways during the COVID-19 pandemic. We describe families, students, professionals, promotoras (community links), and IT support staff joining together in solidarity as the creative problem solvers of new possibilities when families do not have access to Wi-Fi, smartphones, or computers, or suffer overcrowding and lack of privacy. We describe many anxieties related to economic insecurity or fear of facing death alone, but also how to visualize expanding possibilities in styles of parenting or types of emotional support among family members as elements of hope that may endure beyond these unprecedented tragic times of loss and uncertainty.


Assuntos
Serviços Comunitários de Saúde Mental/métodos , Infecções por Coronavirus/psicologia , Emigrantes e Imigrantes/psicologia , Terapia Familiar/métodos , Pneumonia Viral/psicologia , Quarentena/psicologia , Adolescente , Adulto , Idoso , Betacoronavirus , Criança , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/prevenção & controle , Feminino , Pessoal de Saúde/psicologia , Disparidades em Assistência à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/etnologia , Pneumonia Viral/prevenção & controle , Populações Vulneráveis/etnologia , Populações Vulneráveis/psicologia , Adulto Jovem
8.
Fam Process ; 59(3): 1045-1059, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32621755

RESUMO

This report introduces the COVID-19 Family Environment Scale (CHES), which aims to measure the impact of social distancing due to COVID-19 on household conflict and cohesion. Existing measures do not capture household experiences relevant to the pandemic, in which families are largely confined to their homes while sharing a life-threatening situation. Using best practice guidelines, we developed a pool of items and revised them with review by a panel of experts, and cognitive interviewing with community respondents. We administered the CHES by online survey to 3,965 adults. The CHES consists of 15 items for each of two subscales, household conflict (α = .847) and household cohesion (α = .887). Exploratory factor analysis yielded two factors, corresponding to the intended conflict and cohesion items, which accounted for 29% of variance. Confirmatory factor analysis partially supported the 2-factor model (RMSEA = .057; CFI = .729, TLI = .708, and SRMR = .098). The CHES also contains 25 optional items to describe respondent and household characteristics, and household-level COVID-19 exposure. The CHES, publicly available at https://elcentro.sonhs.miami.edu/research/measures-library/covid-19/index.html, provides a tool for measuring the impact of the COVID-19 pandemic on important determinants of resilience in the face of major stressful events. Further work is needed to address the factor structure and establish validity of the CHES.


Assuntos
Infecções por Coronavirus/psicologia , Conflito Familiar/psicologia , Relações Familiares/psicologia , Pneumonia Viral/psicologia , Escalas de Graduação Psiquiátrica/normas , Quarentena/psicologia , Adolescente , Adulto , Betacoronavirus , Criança , Infecções por Coronavirus/prevenção & controle , Análise Fatorial , Características da Família , Terapia Familiar/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Reprodutibilidade dos Testes , Adulto Jovem
9.
Fam Process ; 59(3): 974-988, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32692867

RESUMO

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship-based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context's constraints and exploiting its strengths is key to providing high-quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add-on to a face-to-face practice.


Assuntos
Infecções por Coronavirus/psicologia , Terapia de Casal/métodos , Terapia Familiar/métodos , Pneumonia Viral/psicologia , Quarentena/psicologia , Telemedicina/métodos , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
10.
Fam Process ; 59(3): 898-911, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32678915

RESUMO

This article addresses the many complex and traumatic losses wrought by the COVID-19 pandemic. In contrast to individually based, symptom-focused grief work, a resilience-oriented, systemic approach with complex losses contextualizes the distress and mobilizes relational resources to support positive adaptation. Applying a family resilience framework to pandemic-related losses, discussion focuses on the importance of shared belief systems in (1) meaning-making processes; (2) a positive, hopeful outlook and active agency; and (3) transcendent values and spiritual moorings for inspiration, transformation, and positive growth. Practice guidelines are offered to facilitate adaptation and resilience.


Assuntos
Adaptação Psicológica , Infecções por Coronavirus/psicologia , Terapia Familiar/métodos , Pesar , Pneumonia Viral/psicologia , Resiliência Psicológica , Betacoronavirus , Esperança , Humanos , Pandemias , Guias de Prática Clínica como Assunto , Terapias Espirituais/métodos
11.
Fam Process ; 59(3): 967-973, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32594521

RESUMO

COVID-19 and the accompanying procedures of shelter-in-place have had a powerful effect on all families but have additional special meanings in the context of families contemplating divorce, divorcing, or carrying out postdivorce arrangements. This paper explores those special meanings for these families. It also offers suggestions for couple and family therapists involved in helping these families during the time of COVID-19.


Assuntos
Infecções por Coronavirus/psicologia , Divórcio/psicologia , Terapia Familiar/métodos , Pneumonia Viral/psicologia , Quarentena/psicologia , Adolescente , Adulto , Betacoronavirus , Criança , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto Jovem
12.
Fam Process ; 59(3): 997-1006, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32594527

RESUMO

Online therapy and supervision, a rapidly rising practice in couple and family therapy, has been the subject of a growing body of literature. From its early days, family therapy training has included live supervision, which has typically been conducted by a supervisor and a team of trainees situated on the other side of a one-way mirror. With the outbreak of the COVID-19 global pandemic, we-the staff of supervisors at the Barcai Institute in Tel Aviv, Israel-were compelled to find solutions to continue meeting with clients and to provide supervision for family therapy trainees. To this end, we have shifted our live supervision courses ("practicums") to the virtual arena, adapting the popular application "Zoom" into what we call "PractiZoom." Based on over 100 PractiZoom sessions conducted between March and May 2020, involving 14 supervisors and 28 therapists-in-training and their clients, the article reflects on this pioneering online practicum for the online live supervision of therapists with geographically distributed participants. In this article, we outline our operational methods and adaptations for conducting live behind-the-mirror supervision online. Following a short theoretical background, we outline the process of online live supervision, discuss our reflections and those of our trainees on the challenges and possibilities it poses, and offer a number of preliminary conclusions and recommendations.


Assuntos
Infecções por Coronavirus/psicologia , Terapia de Casal/organização & administração , Terapia Familiar/organização & administração , Pneumonia Viral/psicologia , Psicoterapia/organização & administração , Telemedicina/organização & administração , Adulto , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Terapia de Casal/educação , Terapia de Casal/métodos , Terapia Familiar/educação , Terapia Familiar/métodos , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Psicoterapia/educação , Quarentena/psicologia , Telemedicina/métodos , Adulto Jovem
13.
Fam Process ; 59(3): 847-864, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32589265

RESUMO

The worldwide coronavirus (COVID-19) has had profound effects on all aspects of life: physical health, the ability to travel locally or to more distant destinations, material and financial resources, and psychosocial wellbeing. Couples, families, and communities and individual persons in those relationships have struggled to cope with emerging depression, anxiety, and trauma, and the rise of relational conflict. In this article, we suggest that the existential nature of the pandemic's challenges requires more than just the usual psychosocial interventions. We propose a taxonomy of responses to foster coping and resilience-"Reaching Up, Down, In, and Around." "Reaching Up" includes accessing spiritual, religious, and ethical values. "Reaching Down" includes ideas and practices that foster a revised relationship with the Earth and its resources, and that engage families to participate in activities that aid the Earth's recovery from decades of human-caused damage. "Reaching In" represents a turn towards experiences available in the mind and in shared minds in relationships that provide pleasure, excitement, joy, and peace, given that external sources of these emotions are of limited availability due to quarantine. "Reaching Around" involves reframing the mandate for "social distancing" as fostering social connection and support while maintaining physical distancing. The challenges for family therapists, whose practices are confined largely to online therapy, and who are struggling with the same fears and constraints as those persons they are attempting to help, are also discussed.


Assuntos
Infecções por Coronavirus/psicologia , Terapia Familiar/métodos , Pneumonia Viral/psicologia , Quarentena/psicologia , Adaptação Psicológica , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Resiliência Psicológica
14.
Int J Eat Disord ; 53(7): 1142-1154, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32533799

RESUMO

The necessity to employ distance-based methods to deliver on-going eating disorder care due to the novel coronavirus (COVID-19) pandemic represents a dramatic and urgent shift in treatment delivery. Yet, TeleHealth treatments for eating disorders in youth have not been adequately researched or rigorously tested. Based on clinical experience within our clinic and research programs, we aim to highlight the common challenges clinicians may encounter in providing family-based treatment (FBT) via TeleHealth for children and adolescents with anorexia nervosa and bulimia nervosa. We also discuss possible solutions and offer practical considerations for providers delivering FBT in this format. Additional research in TeleHealth treatment for eating disorders in youth may lead to improved access, efficiency, and effectiveness of FBT delivered via videoconferencing.


Assuntos
Anorexia Nervosa/terapia , Bulimia Nervosa/terapia , Infecções por Coronavirus/prevenção & controle , Terapia Familiar/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Adolescente , Betacoronavirus , Criança , Feminino , Humanos , Comunicação por Videoconferência
15.
Inf. psiquiátr ; (240): 43-52, abr.-jun. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-194757

RESUMO

Se describe el grupo multifamiliar que está en marcha desde Septiembre de 2012 en L'Hospitalet de Llobregat. Un grupo que atiende a personas diagnosticadas de trastorno mental severo y sus familiares, con el objetivo general de mejorar su salud y calidad de vida. Se trata de facilitar la comunicación para trabajar aspectos relacionales y vinculares. Se pretende ofrecer un espacio donde poder pensar conjuntamente las experiencias vividas en la propia familia. El SCORE-15 es un cuestionario que se ha demostrado útil para analizar los cambios en terapia de familia. Estudiamos su aplicabilidad en el contexto de terapia de grupo multifamiliar. Se investiga si los asistentes y los terapeutas observan cambios en el funcionamiento de la familia a lo largo de varias sesiones del grupo multifamiliar. Es un estudio observacional en un contexto asistencial público. Se invita a participar en el estudio a los nuevos participantes del grupo multifamiliar entre Enero y Julio de 2017, se les aplica el cuestionario SCORE en 3 ocasiones: antes de comenzar su vinculación al grupo, al cabo de 3 sesiones y en la última sesión. En base a los resultados obtenidos, valoramos el SCORE-15 como una herramienta útil a incluir en el proceso terapéutico de las personas que participan en el grupo multifamiliar que nos permite disponer de un registro de los cambios que se producen a nivel de funcionamiento familiar


It is described a multifamily group that has been ongoing in L'Hospitalet Llobregat since 2012. A group that handles both persons diagnosed with severe mental disorders and their families, with a general goal to improve their health and quality of their lives. It is about facilitating the communication in order to work on the rational and bonding aspects. It is intended to offer a space where it is possible to reflect together the experiences lived within their own family. SCORE is a tool which turned out to be useful for analysis of the changes in family therapy. We are studying its applicability in the context of multifamily group therapy. It is being researched if the assistants and therapists observe the changes in the family function over the series of sessions in the multifamily group. It is an observational study in the context of public assistance. New participants of a multifamily group are invited to participate between January and July 2017. SCORE is applied on 3 occasions: before starting their introduction to the group, after 3 sessions and in the last session. Based on the obtained results, we evaluate SCORE- 15 as a useful tool to include persons who participate a multifamily group in a therapeutic process which further permits us have at our disposal a register of the produced changes at the level of family function


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Projetos Piloto , Família/psicologia , Testes Psicológicos/normas , Transtornos Mentais/psicologia , Terapia Familiar/normas , Relações Familiares/psicologia , Terapia Familiar/métodos , Psicometria , Saúde Mental/normas
16.
Lancet Psychiatry ; 7(5): 420-430, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32353277

RESUMO

BACKGROUND: Multisystemic therapy is a manualised treatment programme for young people aged 11-17 years who exhibit antisocial behaviour. To our knowledge, the Systemic Therapy for At Risk Teens (START) trial is the first large-scale randomised controlled trial of multisystemic therapy in the UK. Previous findings reported to 18 months after baseline (START-I study) did not indicate superiority of multisystemic therapy compared with management as usual. Here, we report outcomes of the trial to 60 months (START-II study). METHODS: In this pragmatic, randomised, controlled, superiority trial, young people (aged 11-17 years) with moderate-to-severe antisocial behaviour were recruited from social services, youth offending teams, schools, child and adolescent mental health services, and voluntary services across England, UK. Participants were eligible if they had at least three severity criteria indicating past difficulties across several settings and one of five general inclusion criteria for antisocial behaviour. Eligible families were randomly assigned (1:1), using stochastic minimisation and stratifying for treatment centre, sex, age at enrolment, and age at onset of antisocial behaviour, to management as usual or 3-5 months of multisystemic therapy followed by management as usual. Research assistants and investigators were masked to treatment allocation; the participants could not be masked. For this extension study, the primary outcome was the proportion of participants with offences with convictions in each group at 60 months after randomisation. This study is registered with ISRCTN, ISRCTN77132214, and is closed to accrual. FINDINGS: Between Feb 4, 2010, and Sept 1, 2012, 1076 young people and families were assessed for eligibility and 684 were randomly assigned to management as usual (n=342) or multisystemic therapy (n=342). By 60 months' of follow-up, 188 (55%) of 342 people in the multisystemic therapy group had at least one offence with a criminal conviction, compared with 180 (53%) of 341 in the management-as-usual group (odds ratio 1·13, 95% CI 0·82-1·56; p=0·44). INTERPRETATION: The results of the 5-year follow-up show no evidence of longer-term superiority for multisystemic therapy compared with management as usual. FUNDING: National Institute for Health Research Health Services and Delivery Research programme.


Assuntos
Comportamento do Adolescente , Comunicação , Transtorno da Conduta/reabilitação , Crime/estatística & dados numéricos , Terapia Familiar/métodos , Delinquência Juvenil/reabilitação , Poder Familiar , Apoio Social , Adaptação Psicológica , Adolescente , Terapia de Controle da Ira , Transtorno da Personalidade Antissocial , Criança , Inglaterra , Feminino , Visita Domiciliar , Humanos , Masculino , Relações Pais-Filho , Rede Social , Resultado do Tratamento
17.
Infant Ment Health J ; 41(3): 313-326, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32242949

RESUMO

Parenting very young children in the context of military service, deployment separations, and war-related trauma can be challenging for many families. Female active duty personnel represent one of the fastest growing segments of the military, and recent policy changes have led women to pursue serving in combat positions at much higher rates. While not much is known about service member mothers, some studies have shown that they experience significant symptoms of distress, depression, and anxiety during the deployment cycle, feelings of disconnection from family during reintegration, and higher rates of childhood trauma histories than their male counterparts. Service member mothers who experience the combined stressors of deployment separation, combat exposure, and adverse childhood experiences-a triple threat-may be at serious risk of posttraumatic stress and depressive symptomatology, which can negatively influence the quality and nature of their parenting and parent-child relationships. This case report describes the participation of a young single service member mother and her preschool-aged daughter in a home-based, reintegration program designed for military families with very young children (ages 0-5). The paper illustrates how this relationship-based, reflective parenting intervention was effective in increasing the mother's sense of competence in her parenting and strengthening the parent-child relationship.


Assuntos
Terapia Familiar/métodos , Comportamento Materno/psicologia , Militares/psicologia , Relações Mãe-Filho/psicologia , Poder Familiar/psicologia , Lesões Relacionadas à Guerra/psicologia , Adulto , Ansiedade/etiologia , Pré-Escolar , Relações Familiares , Feminino , Serviços de Assistência Domiciliar , Humanos , Família Militar/psicologia , Mães , Desenvolvimento de Programas , Autoimagem
18.
Enferm. clín. (Ed. impr.) ; 30(supl.3): 155-159, mar. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-196133

RESUMO

OBJECTIVE: This study aims to determine the effect of paranoid schizophrenia family psychoeducation therapy on family stress levels in treating paranoid schizophrenia patients. METHOD: It was a quantitative research with quasi experimental methods with Pre-post test with control group. The stress questionnaire was taken from the Depression Anxiety Stress Scale 42 was used in data collection after it was tested for validity (r-count between 0.372 and 0.792) and reliability (Cronbach alpha 0.91). The intervention of this study was in the form of family psychoeducation therapy given to the families of paranoid schizophrenia patients. The study was conducted at the Dr. Amino Gondhohutomo, Central Java province in August 2015-March 2016. The number of samples was 84 people consisting of 42 people in the control group, 42 intervention groups. The sampling technique uses purpose sampling until the number of samples is met. Data were bivariate analysis using the Wilcoxon test, Mann-Whitney test. RESULT: The results showed there was an effect of schizophrenia family psychoeducation therapy on family stress levels in treating schizophrenia patients (p value=0.001). CONCLUSION: An atmosphere of minimal friction and reduced stress conditions will make family health tasks work well in patient care


No disponible


Assuntos
Humanos , Pessoa de Meia-Idade , Esquizofrenia/terapia , Cuidadores/educação , Terapia Familiar/métodos , Psicologia do Esquizofrênico , Relações Familiares , Família/psicologia
19.
NeuroRehabilitation ; 46(2): 143-155, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083598

RESUMO

BACKGROUND: Brain injury is considered a chronic condition and the medical model has long been the traditional paradigm underlying rehabilitation programs for people after acquired brain injury (ABI). In recent years, strengths-based approaches have been increasingly proposed, but little has been written about specific psychotherapeutic application in ABI rehabilitation. OBJECTIVE: To describe a strengths-based model, Solution-Focused Brief Therapy (SFBT) and its clinical application to individuals with ABI and their families. METHODS: The author describes the assumptions, tenets, and principles of SFBT, a competency-based and resource-based model that orients to the future and focuses on strengths and successes. A direct comparison is made between the traditional medical paradigm and the solution-focused paradigm. RESULTS: Key ingredients of SFBT are described, including specific strategies, techniques, and its clinical application with individuals with ABI and their families. Limitations around using SFBT and the need for further research with ABI populations are reported. CONCLUSIONS: SFBT is a welcome shift away from the problem-saturated stories that underlie traditional rehabilitation approaches. The strengths-based underpinning of SFBT is a promising psychotherapeutic intervention that merits further investigation with ABI populations.


Assuntos
Lesões Encefálicas/psicologia , Lesões Encefálicas/terapia , Terapia Familiar/métodos , Psicoterapia Breve/métodos , Humanos , Redação
20.
Int J Eat Disord ; 53(4): 606-610, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32092177

RESUMO

OBJECTIVE: Improved treatment outcome in family-based treatment (FBT) for anorexia nervosa (AN) is predicted by weight gain occurring early in the course of treatment (i.e., about 4 lbs by week 4). Although prior work suggests that early weight gain in higher levels of care (e.g., partial hospitalization programs [PHP]) predicts weight restoration at discharge, no study has examined the specific rate of gain within FBT-informed PHP programs that best predicts treatment response. METHOD: This study examined rate of weight gain in pounds and percent expected body weight (EBW) that predicts positive outcome in 70 patients (M age = 15.49 years, SD = 2.56) with AN who were enrolled in a family-based PHP. RESULTS: Receiver operator characteristic analyses demonstrated that changes in %EBW during weeks 2-5 were more useful than changes in weight in predicting positive outcome. Gaining at least 8.9 pounds or over 8% of EBW in the first 4 weeks of treatment significantly predicted positive outcome. DISCUSSION: Findings suggest that positive outcome in an FBT-informed PHP is predicted by rapid weight gain in the initial weeks of treatment. Research is needed to identify specific family and patient characteristics that facilitate weight gain and to develop corresponding interventions to improve outcome.


Assuntos
Anorexia Nervosa/terapia , Hospital Dia/métodos , Terapia Familiar/métodos , Ganho de Peso/efeitos da radiação , Adolescente , Feminino , Hospitalização , Humanos , Masculino , Resultado do Tratamento , Ganho de Peso/fisiologia
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