Psychotherapy involves establishing a professional relationship between a trained therapist and a patient to address emotional problems. There are various approaches including psychoanalysis, humanistic, learning-based, and eclectic therapies. Techniques may include talk therapy, behavioral experiments, and group sessions. The goal is to help patients reduce symptoms, improve behaviors and relationships, and promote personal growth.
These slides contain detailed description of family therapy including : Introduction, Definition, Aims/Goals, Indication, Contraindication, Functions, Types, Nursing diagnosis and interventions, Nursing responsibilities, Research.
These slides contain detailed description of family therapy including : Introduction, Definition, Aims/Goals, Indication, Contraindication, Functions, Types, Nursing diagnosis and interventions, Nursing responsibilities, Research.
Psychotherapy or talk therapy is a way to help people with a broad variety of mental illness and emotional difficulties by talking with a mental health professional.
Group therapy is a type of psychotherapy wherein therapisr treats a group of people together. Group members meet at regular sessions to resolve their symptoms or conflicts.
Psychotherapy or talk therapy is a way to help people with a broad variety of mental illness and emotional difficulties by talking with a mental health professional.
Group therapy is a type of psychotherapy wherein therapisr treats a group of people together. Group members meet at regular sessions to resolve their symptoms or conflicts.
Five Popular Theories of Counseling PsychologyShivaniPadole
Counseling psychology could be a specialty field at intervalsin the broader discipline of psychology. The distinctiveness of the specialty is processed in terms of its five unifying themes: specialization in intact personalities; specializationon human strengths; stress on relatively brief interventions; stress on person-environment interactions; and stress on education, environments, and career development.
Psychoanalysis Sigmund Freud’s therapeutic technique. Freud believed the patient’s free associations, resistances, dreams, and transferences—and the therapist’s interpretations of them—released previously repressed feelings, allowing the patient to gain self -insight.
Psychotherapy is a therapeutic interaction contracted between trained psychotherapists and the patient based upon verbal or nonverbal communication for treatment of emotional, behavioral, personality, and psychiatric disorders.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. DEFINITION Psychotherapy is the treatment, by psychological means ,of problems, of an emotional nature, in which a trained person deliberately establishes professional relationship with the patient ,with the object of 1.removing,modifying or retarding the existing symptoms 2.mediating disturbed pattern of behaviour and 3.promoting positive personality growth and development
3. HISTORY Based on the concept of psychoanalysis Freud- Psychoanalysis,unconscious,defence mechanisms which provided the first model of understanding and subsequent treatment of neurosis. Carl Jung- analytical psychology based on interpretation of fantasy and dreams Adler-Developed a theory called Individual Psychology which concerned with how the patients life style is developed. He also emphasized the social factors in human development.
4. Melanie Klein, Winnicott, Fairbairn-Developed Psychoanalytic psychotherapy based on elaboration,modification and extension of Freudsideas.They defined that the basic drive is neither instinctual or purely social, but based on a desire to relate to others-to love and to be loved Franz Alexander- Brief psychodynamic psychotherapy
5. Based on Human potential movements(therapy and theory aim to be accessible and useful for as many people as possible) Carl Rogers- Developed Person centered therapy that based on every one is whole and good and well motivated .The task of the therapy is to draw this out. Rolo May-Existential therapy Fitz perls- Gestalt therapy Janov –Primal therapy Jacob Moreno - Psychodrama
6. Based on learning theories Skinners , Eyesenk– Behavioural therapy Wolpe – Systemic desensitization Becks – cognitive therapy Master Johnson – Sex therapy
7. Based on conceptual space between Human potential movements & learning theories Rational emotive therapy Couple therapy-Nathan Ackerman Bereavement counseling Sex therapy Behavioural modification groups
8. PSYCHOANALYTIC PSYCHOTHERAPY It based on psychoanalysis Use of insight oriented methods only. Two types of techniques-expressive and supportive. Brief treatment for selected problem or highly focused conflicts Long treatment for chronic condition or intermittent episodes
9. Psychoanalytic method involves following: Free association: A technique in which invite the patient to say whatever thought came to their minds without censoring their thoughts Transference: displacement of patients early feelings and wishes toward a person from past ,onto the therapist. Countertransference: opposite to transference in which therapist’s feeling towards the patient
10. Expressive psychotherapy One to three times a week for several sessions Patient and therapist face to face /couch can be used to gain access to fantasy or dreams Indications and contraindications: mild to moderate ego weakening including neurotic conflicts, nonpsychotic character disorders like narcissistic behavior disorder and narcissistic personality disorders,recommended for borderline personality disorder Goals : to increase the patient's self-awareness ,to improve object relations through exploration of current interpersonal events and perceptions. Major techniques: Limited free association, confrontation, clarification, and partial interpretation
11. Supportive psychotherapy Chief form used in the general practice of medicine and rehabilitation, frequently to augment extratherapeutic measures Goal: to support reality testing, to provide ego support, maintain or reestablish usual level of functioning. Selection criteria: very healthy patient faced with overwhelming crisespatient with ego deficits Duration : days, months, or years—as needed
12. Technique: Therapist predictably available. Interpretation used to strengthen defenses. Therapist maintains working reality based relationship based on support,concern and problem solving. Suggestion,reinforcement,advice,realitytesting,cognitivereconstructing,and reassurance. Psychodynamic life narrative. Medications
13. Indication For those patients for whom classic psychoanalysis or insight-oriented psychoanalytic psychotherapy is typically contraindicated ,poor ego strength, potential for decompensation is high. Amenable patients fall into the following major areas: (1) acute crisis or a temporary state of disorganization and inability to cope whose intolerable life circumstances have produced extreme anxiety (2) patients with chronic severe pathology with fragile or deficient ego functioning (3) patients whose cognitive deficits and physical symptoms make them particularly vulnerable and, thus, unsuitable for an insight-oriented approach (4) individuals who are psychologically unmotivated, although not necessarily characterologically resistant to a depth approach
14. INDICATIONS Expressive Supportive Strong motivation to understand Significant suffering Tolerance for frustration Capacity for insight Intact reality testing Meaningful object relations Good impulse control Ability to sustain work Reflective responses to trial interpretations Significant ego defects of a long-term nature Severe life crisis Poor frustration tolerance Lack of insight Poor reality testing Severely impaired object relations Poor impulse control Low intelligence Organically based cognitive dysfunction
15. BRIEF PSYCHODYNAMIC PSYCHOTHERAPY Time-limited treatment- 10 to 12 sessions. Based on psychoanalysis and psychodynamic theory. Used for Depression, anxiety, and posttraumatic stress disorder. Franz alexander and thomasfrench identified the basic characteristics
16. MALAN AND THE TAVISTOCK GROUP: BRIEF FOCAL PSYCHOTHERAPY Goal: Clarify the nature of the defense, the anxiety, and the impulseLink the present, the past, and the transference Selection criteria : Patient able to think in feeling termsHigh motivation,Good response to trial interpretation Duration: Up to one year,Mean of 20 sessions Focus: Internal conflict present since childhood Termination: Set definite date at beginning of treatment
17. MANN: TIME-LIMITED PSYCHOTHERAPY Goal: Resolution of the present and chronically endured pain and the patient's negative self-image Selection criteria: High ego strengthAble to engage and disengageTherapist quickly able to identify a central issueExcludes major depressive disorder, acute psychosis, and borderline personality disorder Duration: 12 treatment hours Focus: Present and chronically endured pain Particular image of the self Termination :Specific last session set at beginning of treatment,Termination is a major focus of the therapy work
18. DAVANLOO: SHORT-TERM DYNAMIC PSYCHOTHERAPY Goal: Resolution of oedipal conflict, loss focus, or multiple foci Selection criteria Psychological-mindednessAt least one past meaningful relationshipAble to tolerate affectGood response to trial transference interpretationHigh motivationFlexible defensesLack of projection, splitting, and denial Duration: usually 5–25, Longer durations for seriously ill Termination: No specific termination date Patient is told that treatment will be short
19. SHORT-TERM ANXIETY-PROVOKING PSYCHOTHERAPY Goal: Resolution of oedipal conflict Selection criteria: Above-average intelligenceAt least one past meaningful relationshipHigh motivationSpecific chief complaintAble to interact with evaluatorAble to express feelingsFlexible Duration: A few months Focus: Oedipal conflict Termination: No specific date given
20. GROUP PSYCHOTHERAPY Created by josephpratt The main aim is to increase personal knowledge and understanding when relating with others thus permanent change in attitudes. Duration: 6-18 months , weekly once or twice meeting last for 90 mts Organising group psychotherapy After selection of patient he should be examined individually by the conductor Patients should not meet socially outside the hospital Any significant life change should be informed to the group Repeated disruptive behavior may lead to expulsion from the group Severlypsychotic,paranoid,excessively narcissistic should not be included
21. Therapeutic phenomena common to all groups Cohesiveness-The feeling of belonging to and being accepted by the group which is essential for curiosity and self revelation Interaction- By observing their own and each others behavior their awareness and insight is increased which was motivated by interaction Universality- Members discover that others are very similar to them in feelings and actions. This counters the fear of being singled out for criticism and leads to trusting ,sharing
22. Cont…. Hope- if one person is discouraged ,others may increase the hope by encouragement Guidance- Either by example or directly members make suggestions to one another Vicarious learning- everyone has the chance to learn some idea or difficulty from others Corrective emotional experience-some person in the group may be identified as parent figure
23. Stages in the life cycle of groups Dependency- Anxiety is at its highest when the group forms ,due to expectation of who is the leader ,what are the rules. Such anxiety leads to find out some person as leader Conflict- Lateness,absence,non-cooperation, aggressive criticism, of other members are characteristic of this stage. If the stage passed successfully trust and tenderness developed. Intimacy-little by little reality creeps into groups. The surest sign of this stage is that opposites can be allowed to exist together, thus avoiding childlike extremes.
24. Types of group psychotherapy Supportive group therapy Analytically oriented group therapy Psychoanalysis of groups Transactional group therapy Behavioral group therapy
25. Group psychotherapy effective for- Relationship difficulties Problems in groups Compulsive repetition of self depriving behavior General dissatisfaction with life Family therapy Marital counseling
26. PSYCHODRAMA Method of group psychotherapy Viennese-born psychiatrist Jacob moreno Personality makeup, interpersonal relationships, conflicts, and emotional problems are explored by means of special dramatic methods. Therapeutic dramatization of emotional problems includes the Following roles: Protagonist -patient in conflict Auxiliary egos- persons who enact varying aspects of the patient,who represent some experience of pt The director- psychodramatist, or therapist, the person who guides those in the drama toward the acquisition of insight.
27. BEHAVIOUR THERAPY Based on theory of learning which Explains how behaviours are learned and unlearned. It views symptoms as a part of behavior which have maladaptive learning. Behavioral views differ from cognitive views in holding that physical, rather than mental, events control behavior. Aim : To abolish an undesirable response to a normal life stimulus and replace it with desirable behavior. Three phases of behavioural analysis Identification of nature of the problem that the trigger of the behavior ,the behavior itself,and the consequences. Intervention at a particular target point of maladaptive behavior Impact of the behaviour on life style ,relationships
28. SYSTEMATIC DESENSITIZATION Developed by Wolpe, based on the behavioral principle of counterconditioning. Relaxation Training: Most methods use so-called progressive relaxation, developed by the psychiatrist Edmund Jacobson. Suggestions to relax major muscle groups in a fixed order, beginning with the small muscle groups of the feet and working cephalad or vice versa Relaxation produces physiological effects opposite to those of anxiety Hierarchy Construction: determine all the conditions that elicit anxiety, then patients create a hierarchy list of 10 to 12 scenes in order of increasing anxiety.
29. Cont… Desensitization of the Stimulus: patients proceed systematically through the list from the least, to the most, anxiety-provoking scene while in a deeply relaxed state. Indications: Clearly identifiable anxiety provoking stimulus- Phobias, obsessions, compulsions, and certain sexual disorders
30. Therapeutic-Graded Exposure Relaxation training is not involved treatment is usually carried out in a real-life context Flooding Similar to graded exposure but no hierarchy. Based on the premise that escaping from an anxiety-provoking experience reinforces the anxiety through conditioning. Thus, clinicians can extinguish the anxiety and prevent the conditioned avoidance behavior by not allowing patients to escape the situation. No relaxation exercises are used. Contraindicated when intense anxiety would be hazardous to a patient e.x, Those with heart disease or fragile psychological adaptation. Implosion or imaginal flooding is a variant of flooding in which the feared object is confronted only in the imagination.
31. Participant Modeling In participant modeling, patients learn a new behavior by imitation, primarily by observation Useful with phobic children who are placed with other children of their own age and sex who approach the feared object or situation. Used successfully with agoraphobia Assertiveness Training Assertiveness is defined as follows: Assertive behavior enables a person to act in his or her own best interest, to stand up for herself or himself without undue anxiety, to express honest feelings comfortably, and to exercise personal rights without denying the rights of others
32. Social Skills Training: Conversation, conflict management, assertiveness, community living, friendship and dating, work and vocation, and medication management. Useful in negative symptoms in patients with schizophrenia,depression,social phobia. Aversion Therapy When a noxious stimulus (punishment) is presented immediately after a specific behavioral response, theoretically, the response is eventually inhibited and extinguished. Used for alcohol abuse, paraphilias, behaviours with impulsive and compulsive qualities, Opioid addicts
33. Positive Reinforcement When a behavioral response is followed by a generally rewarding event, such as food, avoidance of pain, or praise, it tends to be strengthened and to occur more frequently than before the reward. Combined with Social Skills Training used in schizophrenia Sex therapy Developed by William Masters and Virginia Johnson, is a behavior therapy technique used for various sexual dysfunctions, especially male erectile disorder, orgasm disorders, and premature ejaculation. It uses relaxation, desensitization, and graded exposure as the primary techniques
34. Advantages of behaviour therapy: used successfully for a variety of disorders and can be easily taught It requires less time than other therapies and is less expensive to administer Behaviour therapy –use in psychiatric disorders Anxiety disorder Agoraphobia and panic disorder Social phobia& simple phobia Obsessive- compulsive disorder Post traumatic stress disorder Mood disorder&schizophrenia Somatoform disorder Eating disorders Psychosomatic &psychosexual disorders Substance abuse Conduct disorder&ADHD
35. COGNITIVE THERAPY Cognitive therapy is a short-term, structured ,therapy that uses active collaboration between patient and therapist to achieve its therapeutic goals, which are oriented toward current problems and their resolution. It is designed to change the behaviour directly as many behaviours are maintained by consequences Abnormal thinking is due to Intrusive thoughts(automatic thoughts)-provoke an immediate emotional reaction Dysfunctional beliefs and attitudes-Determine the way of perceiving and interpreting situations. Maintained by-selective attention to unfavorable outcome,thinking illogically ,safety seeking behaviour
36. General features of CBT Pt is an active partner ,therapist only guides the pt Attention to provoking & maintaining factors by ABC approach-anticidents,behaviour,consequences.The main aim of therapy is to break this chain. Making attention to way of thinking by daily thought records Investigation itself make insight to problems and gives solutions.Even failure also have benefits Pt given with home work assignments and behavioural experiments The highly structured sessions involves-review,teaching,summarization Progress should be monitored Treatment manuals should be given to patient
37. Cognitive model of information processing Perception of an event ↓ Activation of relevant schema ↓ Altered information processing ↓ Automatic thoughts ↗ ↙ ↖ ↘ Behavioural symptoms ↔ Emotional symptoms Schemas-Relatively stable cognitive pattern that are the result of ones beliefs,attitudes and behaviour
38. Cognitive distortions Arbitrary inference - Drawing a specific conclusion without sufficient evidence Specific abstraction- Focus on a single detail while ignoring other, more important aspects of an experience Overgeneralization - Forming conclusions based on too little and too narrow experience Magnification and minimization – Over or undervaluing the significance of a particular event Personalization - Tendency to self-reference external events without basis Absolutist, dichotomous thinking - Tendency to place experience into all-or-none categories .
39. Beck’s triad Aaron Beck postulated a cognitive triad of depression that consists of (1) views about the self—a negative self-precept; (2) about the environment—a tendency to experience the world as hostile and demanding, and (3) about the future—the expectation of suffering and failure. Therapy consists of modifying these distortions
41. REEDUCATIVE PSYCHOTHERAPY CLIENT CENTRED THERAPY Developed by Carl Rojers. The therapy is based on the idea that a human being is possessed of innate goodness and actualizing tendencies ,leading to a balanced,realisticbehaviour. The guiding principle of this therapy is oriented around the fact that the client is the one responsible for his own destiny and he possesses the right choice to solve his own problems, irrespective of the choice of the therapist Therapy consist of : Attentive listening of clients feeling and contents, accepting it in a tolerant nonjudgemental way, avoiding any attempt to impose directions, Effective for: general dissatisfaction in life, difficulties due to painful past events, relationship difficulties, bereavement, adjustment to illness
42. CRISIS INTERVENTION The crisis may precipitate around any incident that overwhelms ones coping capacities. During that time the immediate response is denial ,accompanied by numbness and detachment. The mind attempt to protect itself by repressing what had happened. Goal: Main goal is rapid emotional relief but not basic personality modification. Normally six therapy is sufficient Techniques: Reassurance, confrontation, narcoanalysis, environmental manipulation, hypnotic probing, guidance ,psychotropic medications, at times brief hospitalization
43. BIOFEEDBACK Useful for those who are fearful of the labels of psychotherapy and psychiatric illness. Biofeedback involves the recording and display of small changes in the physiological levels of the feedback parameter. The display can be visual, such as a big meter or a bar of lights, or auditory. Patients are instructed to change the levels of the parameter, using the feedback from the display as a guide. Biofeedback is based on the idea that the autonomic nervous system can come under voluntary control through operant conditioning. In which the person is gradually learns to how to protect the physiological effects of distress. Neal Miller demonstrated the medical potential of biofeedback Techniques : Instrumentation, Jacobson progressive muscular relaxation ,Applied technique, Useful in : migraine, hypertension, phobia ,chronic pains, cerebral palsy, irritable bowel syndrome, asthma
44. FAMILY THERAPY Family therapy can be defined as any psychotherapeutic endeavor that explicitly focuses on altering the interactions between or among family members and seeks to improve the functioning of the family as a unit, or its subsystems, and/or the functioning of individual members of the family. Goals: To resolve or reduce pathogenic conflict and anxiety within the matrix of interpersonal relationships; To enhance the perception and fulfillment by family members of one another's emotional needs; To promote appropriate role relationships between the sexes and generations; To strengthen the capacity of individual members and the family as a whole to cope with destructive forces inside and outside the surrounding environment; To influence family identity and values so that members are oriented toward health and growth.
45. Techniques: Initial consultation to overcome the resistance due to fears by parents that they will be blamed for their child's difficulties, that the entire family will be pronounced sick, that a spouse will object, and that open discussion of one child's misbehavior will have a negative influence on siblings. Avoiding free association and careful channeling of identified problems in family between family members. Sessions held for once a week lasting for 2 hrs.
46. Indications: Problems in relationship within family-primary marital discord,communication gap. Interdependence of symptoms-wifes depression being contigent on husbands alcoholism. Emotional disorder in child resulting from conflicting parents. Failure of individual therapy Psychiatric illness requiring assessment for family therapy: Neurosis, adjustment disorders, conduct/emotional disorders of children, substance abuse, sexual dysfunction Contraindications: Major psychopathology in family. Extramarital/homosexual tendencies, Non availability of key family members
47. COUPLE THERAPY Goal: The goals of therapy for partner relational problems are to alleviate emotional distress and disability and to promote the levels of well-being of both partners together and of each as an individual. Indications: Problems in communication between partners are a prime indication for couples therapy. Unresolved conflict or stress in relationship. One partner having mental illness resulting in emergence of symptoms in healthy partner when the sick on starts resolving. Difficult or failed individual therapy. Conflicts in one or several areas, such as the partners' sexual life Contraindication: Unwillingness of one partner. Inability to control hostility in one or both partners. Paranoid partner,severe form of psychosis, When really want for divorce
48. HYPNOSIS Anton Franz Anton Mesmer first described hypnosis as a therapeutic modality Sigmund Freud used hypnosis as part of his psychoanalysis, Ernst Simmela German psychoanalyst, developed a technique for accessing repressed material that he named hypnoanalysis. Definition: Hypnosis is currently understood as a normal activity of a normal mind through which attention is more focused, critical judgment is partially suspended, and peripheral awareness is diminished. The process of hypnosis takes the hypnotizability trait and transforms it into the hypnotized state
49. Experiencing the hypnotic concentration state requires a convergence of three essential components: Absorption - is an ability to reduce peripheral awareness that results in a greater focal attention. Dissociation - is the separating out from consciousness elements of the patient's identity, perception, memory, or motor response as the hypnotic experience deepens. Suggestibility - is the tendency of the hypnotized patient to accept signals and information with a relative suspension of normal critical judgment
50. Indications Hypnosis are clinically useful in diagnosis and in treatment. Facilitating acceptance of new thoughts and feelings makes it useful in treating habitual problems and also with symptom management. Smoking, overeating, phobias, anxiety, conversion symptoms, and chronic pain are all indications for hypnosis Hypnosis can also aid in psychotherapy, notably for posttraumatic stress disorder, and it has been used for memory retrieval
51. INTERPERSONAL PSYCHOTHERAPY Interpersonal psychotherapy (ITP), a time-limited treatment for major depressive disorder tested in randomized clinical trials by Gerald L. Klerman and Myrna Weissman. The overall goal of ITP is to reduce or eliminate psychiatric symptoms by improving the quality of the patient's current interpersonal relations and social functioning. The typical course of ITP lasts 12 to 20 sessions over a 4- to 5-month period. ITP moves through three defined phases: (1) The initial phase is dedicated to identifying the problem area that will be the target for treatment (2) The intermediate phase is devoted to working on the target problem area(s) (3) The termination phase is focused on consolidating gains made during treatment and preparing the patients for future work on their own
52. Common interpersonal problem areas: Grief -Complicated bereavement after the death of a loved one Interpersonal deficits -A history of social impoverishment, inadequate or unsustaining interpersonal relationships Role transitions -Economic or family change—the beginning or end of a relationship or career, a move, promotion, retirement, graduation, diagnosis of a medical illness Interpersonal role disputes -Conflicts with a significant other—a partner, other family member, coworker, or close friend Group format of interpersonal therapy ITP delivered in a group format has many potential benefits in comparison with individual treatment. For example, a group format in which membership is based on diagnostic similarity (e.g., depression, social phobia, eating disorders) can help alleviate patients' concerns that they are the only one with a particular psychiatric disorder, while offering a social environment for patients who have become isolated, withdrawn, or disconnected from others. Group size consists of 6-9 members lasts for 20 sessions over a 5 months period.
53. GESTALT THERAPY It’s a type of reconstructive psychotherapy based on post Freudian psychoanalytic method. According to this theory ideally an object (figure)and its field(ground) should blent in harmonious assemblage(gestalt). The therapy requires a search for repressed material, the mechanism through which repression is maintained ,as well as the specific needs of the repression. To organize a mature figure-ground gestalt the dissociated aspects of an individual should be restored to his total being. Guidance in bringing these to awareness is the important step. Empty chair technique: The pt was urged to imagine a parental figure or any important figure sitting in nearly empty chair and then talk to reproach or question the imaginary occupant, followed by changing the seats and acting the part of the person known as role reversal.
54. TRANSACTIONAL ANALYSIS Suggested by Eric Berne . There are 3 different ego states in every person: Child within a person, Parent, Grownup mature reasonable adult self. Each of these aspects perceives the reality differently. The 3 are constantly operating in response to the need of a person and the kinds of past times. During therapy the 3 ego states are displayed in the relationship with the therapist, are interpreted to the patient. The function of the child and the parent within the pt and the origin of these in life history are ventilated. Ultimately the adult becomes stronger by displacing the child and parent
55. EXISTENTIAL THERAPY This is more philosophical than form of psychotherapy developed by Rollo may. Existential therapy seeks to understand how something is experienced by person himself instead of interpretation designed to fit a patients experience into a particular framework. Aim: To help the pt to discover their own response to life and to be able to accept life’s limitations and possibilities. Technique: Exploration through honest reflection ,of the attitudes, feelings, and world view of the pt Effective for- Dissatisfaction with life, interest in growing as a person, and realizing personl potential.
56. CHARACTERISTICS OF GOOD ENOUGH THERAPIST Genuine &Respectful Encouraging Understandable sensitive practical& interested relaxed and in control Confidential Able to finish the interview Common contraindications for psychotherapy Older age Low intelligence poor motivation Antisocial personality disorder
57. Conclusion: No psychotherapeutic method exists today that is acceptable to all patients or easy to operations for all therapists. The technique by which transformation comes about accord with the skill of the therapist who applies them and with the facility of the patient to accept & utilize preferred interventions .Since psychotherapy is a learning process ,it works best if the patient coordinate with his unique method of learning. References Kaplan and Sadock’s Synopsis of Psychiatry Text book of postgraduate Psychiatry-Ahuja Thorson’s principles of Psychotherapy-Brice Avery Short text book of Oxford