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1.
Psychooncology ; 31(6): 920-928, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35001478

RESUMO

BACKGROUND: Rectal cancer (RC) patients experience unique sources of distress, including sexual dysfunction and body image concerns, which can also cause distress among partners. This preliminary study investigated patterns of psychological distress, sexual functioning, sexual distress, and relationship satisfaction among RC patient-partner couples at pivotal points during cancer treatment. METHODS: Twenty couples participated (N = 40). Patients and partners completed a series of validated measures of psychological distress (ET), sexual functioning (FSFI; IIEF), sexual distress (GMSEX; Sexual Distress Scale) and relationship satisfaction (GMREL) at time of diagnosis, 3 weeks after radiation, 4 weeks post-surgery, and after chemotherapy and surgery for ostomy closure. Descriptive statistics, t-tests, and repeated-measures ANOVA were used to analyze scores over time, first for patients and partners, and then by sex. RESULTS: Relationship satisfaction remained elevated over time. In this sample, 55% of patients and 78.9% of partners reported clinically significant rates of psychological distress at diagnosis, which decreased to 23% and 46% respectively at the last assessment. Sexual satisfaction and distress worsened for patients and partners between baseline and surgery for ostomy closure. Both male and female participants reported statistically significant declines in sexual function from baseline to end of treatment (p < 0.05). DISCUSSION: Relative to relationship satisfaction, psychological and sexual health outcomes seem more vulnerable to the effects of RC treatment during the first year after diagnosis, both for patients and partners and for men and women. Results support the need for psychosocial care and sexual education/counseling for couples coping with RC.


Assuntos
Neoplasias Retais , Disfunções Sexuais Psicogênicas , Adaptação Psicológica , Feminino , Humanos , Masculino , Orgasmo , Satisfação Pessoal , Neoplasias Retais/cirurgia , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/psicologia , Parceiros Sexuais/psicologia , Inquéritos e Questionários
2.
Psychooncology ; 27(1): 13-21, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-27943551

RESUMO

BACKGROUND: Despite the adverse effects that treatment for colorectal cancer can have on patients' quality of life and, in particular, their intimate relationships, very little research has been conducted on the psychosocial adjustment for both patients and their partners/spouses. OBJECTIVES: The aim of this systematic review was to examine dyadic studies of adjustment in couples in which one partner has been diagnosed with colorectal cancer. METHODS: Pub Med, PsychINFO, MEDLINE, Social Sciences Abstracts (EBSCO), and the Cochrane Library were systematically searched for studies reporting quality of life outcomes for colorectal cancer patients and their partners/spouses. Only studies that included dyads in the sample were eligible for inclusion. The Quality Assessment Tool for Quantitative Studies was used to evaluate each study. RESULTS: A total of 277 studies were identified, of which 9 studies met the inclusion criteria (N = 388 couples). The methodological quality of the studies was high in that they used standardized instruments validated with their samples, conducted dyadic data analyses (when appropriate), and used longitudinal designs. A synthesis of the studies revealed that (1) relationship factors (eg, support, communication, dyadic coping, and relationship satisfaction) affect adjustment to cancer; (2) cancer-related distress impacts each partner's adjustment or the relationship; and (3) gender, role (patient/caregiver), and clinical characteristics (treatment, mental health) can mediate adjustment to cancer. CONCLUSION: The quality of the relationship can influence patients' and their partners' adjustment to colorectal cancer. Psychosocial interventions that address relationship issues may be beneficial to couples facing the challenges of colorectal cancer.


Assuntos
Adaptação Psicológica , Neoplasias Colorretais/psicologia , Relações Interpessoais , Qualidade de Vida , Cônjuges/psicologia , Adulto , Idoso , Cuidadores/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Satisfação Pessoal , Parceiros Sexuais/psicologia
3.
Fam Process ; 56(2): 331-347, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-26510974

RESUMO

The current study employed a quasi-experimental design using both intent-to-treat and protocol adherence analysis of 155 moderate- to high-risk juvenile offenders to evaluate the effectiveness of Parenting with Love and Limits® (PLL), an integrative group and family therapy approach. Youth completing PLL had significantly lower rates of recidivism than the comparison group. Parents also reported statistically significant improvements in youth behavior. Lengths of service were also significantly shorter for the treatment sample than the matched comparison group by an average of 4 months. This study contributes to the literature by suggesting that intensive community-based combined family and group treatment is effective in curbing recidivism among high-risk juveniles.


Assuntos
Educação não Profissionalizante/métodos , Terapia Familiar/métodos , Delinquência Juvenil/reabilitação , Poder Familiar , Reincidência/prevenção & controle , Adolescente , Comportamento do Adolescente , Crime/prevenção & controle , Crime/estatística & dados numéricos , Feminino , Humanos , Delinquência Juvenil/legislação & jurisprudência , Masculino , Saúde Mental , Relações Pais-Filho , Cooperação do Paciente , Avaliação de Programas e Projetos de Saúde , Pontuação de Propensão , Reincidência/estatística & dados numéricos
4.
Adm Policy Ment Health ; 44(5): 716-723, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27696018

RESUMO

In this paper we argue that the therapist is a crucial change variable in psychotherapy as a whole and in couple, marital, and family therapy specifically. Therapists who work with complex systems require more skills to negotiate demanding therapy contexts. Yet, little is known about what differentiates effective couple, marital, and family therapists from those who are less effective, what innate therapy skills they possess, how they learn, and how they operationalize their knowledge in the therapy room. We discuss the need to emphasize evidence based therapists (as opposed to therapies), and implications of the importance of the role therapists for training, practice, research priorities, and policy.


Assuntos
Competência Clínica , Terapia Familiar/organização & administração , Terapia Conjugal/organização & administração , Papel Profissional , Relações Profissional-Paciente , Prática Clínica Baseada em Evidências , Terapia Familiar/educação , Terapia Familiar/normas , Humanos , Reembolso de Seguro de Saúde , Terapia Conjugal/educação , Terapia Conjugal/normas , Qualidade da Assistência à Saúde
5.
Adm Policy Ment Health ; 44(5): 792-809, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28120298

RESUMO

Many community mental health (CMH) systems contain inefficiencies, contributing to unmet need for services among youth. Using a quasi-experimental research design, we examined the implementation of an adapted structural-strategic family intervention, Parenting with Love and Limits, in a state CMH system to increase efficiency of services to youth with co-existing internalizing and externalizing functional impairments (PLL n = 296; Treatment-As-Usual n = 296; 54% male; 81% Caucasian). Youth receiving PLL experienced shorter treatment durations and returned to CMH services at significantly lower rates than youth receiving treatment-as-usual. They also demonstrated significant decreases in internalizing and externalizing symptoms over time. Findings lay the foundation for further examination of the role of an adapted structural-strategic family treatment in increasing the efficiency of CMH systems.


Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Terapia Familiar/organização & administração , Amor , Transtornos Mentais/terapia , Poder Familiar/psicologia , Adolescente , Criança , Serviços Comunitários de Saúde Mental/economia , Custos e Análise de Custo , Eficiência Organizacional , Terapia Familiar/economia , Feminino , Humanos , Masculino , Fatores de Tempo
6.
Subst Use Misuse ; 46(9): 1169-78, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21417555

RESUMO

Sex differences in opportunities to use alcohol or drugs, and transition to use, were investigated in 15 surveys, in 2001-2004 (Europe 6; Americas 3; Africa 2, Asia 3; Oceania 1). The paper focuses on 18-29 year olds (N = 9,873). The World Mental Health Survey Initiative oversaw the surveys; each country obtained its own funding. A complex picture emerged with different results for alcohol and for drugs and for opportunity to use and the transition to use. Sex differences in opportunity to use alcohol were small except in Lebanon and Nigeria, whereas for drugs, the largest differences were in Mexico and Colombia.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Internacionalidade , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Comparação Transcultural , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem
7.
Glob Implement Res Appl ; 1(1): 17-29, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36032522

RESUMO

Background: It is now widely understood that successful implementation of evidence-based treatments is facilitated by several favorable conditions (e.g., community buy-in, invested agency leadership). However, strategies for supporting agencies in promoting these conditions have been examined to a lesser extent. In this exploratory study, the implementation support procedures of Parenting with Love and Limits (PLL), an evidence-informed family treatment for child/adolescent behavior problems in which the training team follows structured procedures to help coordinate implementation support activities, are illustrated, and their preliminary effectiveness examined. Methods: PLL documents and communication records between PLL and n = 23 sites across the U.S. that initiated PLL pre-implementation activities were reviewed. In addition, implementation activities completed for each agency were entered into the Stages of Implementation Completion (SIC) dashboard. Results: The prescriptive nature of the PLL implementation support protocol was illustrated through descriptions of procedural documents and case examples. Quantitative analyses revealed that, among the 23 sites that began pre-implementation, 9 discontinued, with a trend toward sites in metropolitan areas being more likely to discontinue than those in less populous areas. In addition, the 14 sites that launched PLL demonstrated a high amount of consistency in activities, with sites in the sustainability phase completing an average of 86% of implementation behaviors. Conclusions: Training team-coordination of implementation activities may be one promising approach for supporting agencies in completing tasks to facilitate successful uptake of evidence-supported interventions. In turn, sustained implementation of evidence-supported treatments could allow communities to benefit from practice innovations to a greater extent.

8.
Psychother Res ; 19(2): 143-56, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19235092

RESUMO

This article details the development and methodological characteristics of the Systemic Therapy Inventory of Change (STIC), the first measurement system designed to assess change in family, couple, and individual therapy from a multisystemic and multidimensional perspective. The article focuses specifically on the developmental process that resulted in the five valid and reliable scales that comprise the core measure of the system, the INITIAL STIC, which is administered to clients just before beginning therapy. The scales focus on five systemic domains: individual adult, family of origin, couple, family, and individual child. This article describes the five system scales, the results of the factor analytic process that created them, as well as data on their convergent and discriminant validity.


Assuntos
Psicoterapia/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Terapia de Casal/métodos , Análise Fatorial , Terapia Familiar/métodos , Feminino , Humanos , Masculino , Psicometria
9.
J Marital Fam Ther ; 41(4): 389-400, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25382583

RESUMO

Although theory and research highlight the importance of the client-therapist relationship, marriage and family therapy (MFT) training has historically centered on specific models, consisting of proprietary language and techniques, instead of common factors like the therapeutic alliance. In this article, we begin by making an argument for explicitly focusing on the therapeutic alliance in MFT training programs. Next, we highlight common alliance threats experienced by both faculty members and student therapists. We then integrate research-informed principles with clinical wisdom to outline specific recommendations and concrete skill-building exercises for MFT educators and supervisors to use with their students to address these threats and advance training on the therapeutic alliance.


Assuntos
Terapia Familiar/educação , Terapia Conjugal/educação , Relações Profissional-Paciente , Terapia Familiar/normas , Humanos , Terapia Conjugal/normas
10.
J Marital Fam Ther ; 41(4): 401-14, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25378075

RESUMO

The expanded therapeutic alliance, consisting of multiple interpersonal alliance relationships, is a common factor inherent to the practice of all systemic therapies. The following study has three specific aims: (a) Bring an expanded, multisystemic emphasis to the study of the therapeutic alliance in individual therapy; (b) Understand better the session-by-session relationship between alliance and psychological functioning, including distinguishing within-person from between-person variability by using multilevel modeling techniques; and (c) Explore the role of early attachment relationships and family-of-origin experiences in moderating the alliance-psychological functioning relationship. Instead of taking only one or two alliance measurements throughout treatment like in the majority of previous research, we measured both alliance and psychological functioning continuously at each session for 296 subjects.


Assuntos
Apego ao Objeto , Avaliação de Processos em Cuidados de Saúde , Relações Profissional-Paciente , Psicoterapia/métodos , Adulto , Feminino , Humanos , Masculino
11.
J Marital Fam Ther ; 41(2): 136-49, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25382495

RESUMO

Specific models guide the training of marriage and family therapists (MFTs) as they offer both structure and organization for both therapists and clients. Learning models may also benefit therapists-in-training by instilling confidence and preventing atheoretical eclecticism. The moderate common factors perspective argues that models are essential, but should not be taught as "the absolute truth," given there is no evidence for relative efficacy of one empirically validated model versus another, and no single model works in all instances. The following article provides a blueprint for infusing a common factors perspective into MFT programmes by reviewing innovations in course design, outlining specific teaching strategies, and highlighting potential implementation challenges.


Assuntos
Currículo/normas , Terapia Familiar/educação , Terapia Conjugal/educação , Humanos
12.
J Marital Fam Ther ; 39(3): 346-57, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25059301

RESUMO

A federal grant was awarded to provide the Within My Reach healthy relationships curriculum to low-income, at-risk individuals involved with various social service agencies. The effectiveness of this curriculum was evaluated for 202 participants through measures of training and relationship outcomes pre-, immediately post- and 6 months posttraining. Participants experienced high levels of training satisfaction; significant increases in knowledge, communication/conflict resolution skills, and relationship quality; as well as a trend in the reduction of relationship violence. An important implication of this research is that MFTs may broaden their service delivery to at-risk individuals by collaborating with community agencies to adapt established relationship enhancement programs, evidence-based tools, and principles that complement traditional couples therapy.


Assuntos
Divórcio/prevenção & controle , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Relações Interpessoais , Pobreza/psicologia , Maus-Tratos Conjugais/prevenção & controle , Adulto , Currículo , Feminino , Educação em Saúde/normas , Humanos , Masculino
13.
Am J Health Behav ; 37(4): 458-68, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23985227

RESUMO

OBJECTIVE: To examine the relationships between 2 parenting styles and family nutrition and physical activity. METHODS: Parents of elementary/primary school children in the southeastern United States (N = 145) completed surveys regarding family relationships and health behaviors. RESULTS: Parents exhibiting a laissez-faire parenting style reported lower levels of family nutrition and physical activity. In addition, parent BMI moderated the relationship between laissez-faire parenting and these health behaviors. CONCLUSIONS: This study indicates that family-oriented nutrition and physical activity programs may benefit from including a focus on decreasing laissez-faire parenting, as well as helping overweight parents reduce their BMIs.


Assuntos
Família/psicologia , Comportamentos Relacionados com a Saúde , Poder Familiar/psicologia , Adulto , Idoso , Índice de Massa Corporal , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Inquéritos Nutricionais , Relações Pais-Filho
14.
J Marital Fam Ther ; 36(3): 307-19, 2010 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-20618578

RESUMO

The gap between clinical research and practice is a major challenge facing marriage and family therapy (MFT) training programs. Until now, the answer to bridge this gap has primarily been the Boulder Scientist-Practitioner Model. Although realistic for doctoral students, it may not be a good fit for MFT master's students who have primarily clinical career ambitions-which we believe is a legitimate and positive career choice. The following article articulates a "research informed" perspective as opposed to the scientist-practitioner framework as a research-training model for clinically oriented MFT master's programs. After articulating the similarities and differences between these two approaches, the authors outline 10 practical ideas to integrate research into programs that desire to remain clinical in focus, but also research informed.


Assuntos
Educação de Pós-Graduação/organização & administração , Terapia Familiar/educação , Terapia Conjugal/educação , Competência Profissional , Papel Profissional , Currículo , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/organização & administração , Humanos , Descrição de Cargo , Objetivos Organizacionais , Relações Profissional-Família , Avaliação de Programas e Projetos de Saúde , Pesquisa/organização & administração , Estados Unidos
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