scholarly journals In support of supportive psychotherapy

2022 ◽  
Vol 21 (1) ◽  
pp. 59-60
Author(s):  
John C. Markowitz
Keyword(s):  
Supportive Psychotherapy

Three Hysterical Movement Disorders

1988 ◽  
Vol 62 (3) ◽  
pp. 979-985 ◽  
Author(s):  
Arthur S. Walters ◽  
Doris Wright ◽  
James Boudwin ◽  
Karl Jones
Keyword(s):  
Movement Disorders ◽  
Hemifacial Spasm ◽  
Older Patients ◽  
Life Experiences ◽  
Spontaneous Resolution ◽  
Older Age ◽  
Supportive Psychotherapy ◽  
Involuntary Movements ◽  
Neurological Condition ◽  
The Third

Three hysterical movement disorders are reported: a case of hysterical bilateral blepharospasm which later presented as hysterical hemifacial spasm, a case of hysterical myoclonus, and a case of hysterical parkinsonism. Two patients presented with a relative indifference to preceding life experiences that would normally have evoked considerable emotion. Two of the cases first presented at an older age and one of these older patients was a man. Two of the patients agreed to hypnotherapy and supportive psychotherapy. In both cases the “involuntary” movements disappeared during hypnosis. In the third case, there was a complete spontaneous resolution of symptoms in a neurological condition where resolution would not be expected to occur.

Listen and you will see the person through the dementia

2022 ◽  
Vol 7 (2) ◽  
pp. 88-97
Author(s):  
Rita Estrada
Keyword(s):  
Communication Skills ◽  
Psychological Assessment ◽  
Self Determination Theory ◽  
Psychological Needs ◽  
Basic Psychological Needs ◽  
Self Determination ◽  
Supportive Psychotherapy ◽  
Psychological Need ◽  
Person Centered Care ◽  
Centered Care

Dementia is an ever-increasing health and social problem, with a growing number of people being affected worldwide. As dementia progresses, dependency on others increases, requiring the presence of caregivers. Caregivers tend to focus on the diagnosis itself – dementia – which makes it difficult to see the person in their uniqueness. The person is there, and can be seen by listening, which requires time and communication skills. The voices of older adults living with several types of dementia, collected while working as a psychologist in a nursing home, are presented in the first person to bring forward the person they are. These excerpts of interactions illustrate the basic psychological need of relatedness, which is built through interaction, stories, and touch, and the needs of competence and autonomy. The framework of this paper encompasses validation therapy, person-centered care, and self-determination theory. Two conclusions emerge: Seeing the person through the dementia enables an adequate psychological assessment and a helpful supportive psychotherapy, and it also makes us acknowledge and help satisfy the three basic psychological needs of relatedness, competence, and autonomy.

scholarly journals The Diagnosis and Treatment of Borderline Schizophrenia in Adolescence

1967 ◽  
Vol 12 (3) ◽  
pp. 247-251 ◽  
Author(s):  
Philip Katz
Keyword(s):  
Treatment Program ◽  
Thought Disorder ◽  
The Other ◽  
Strengthening Effect ◽  
Supportive Psychotherapy ◽  
Environmental Manipulation ◽  
Reality Testing ◽  
Schizophrenic Reaction ◽  
Real Person ◽  
The Relationship

It is necessary to establish the presence or absence of a borderline schizophrenic reaction early, for it is of great importance in deciding on the treatment program for the patient. Its presence is suspected if there are symptoms that indicate that the patient is developing a thought disorder, and/or a disturbance of affect of schizophrenic type, and/or is beginning to detach from reality. It is also suspected if there is a persistence of such symptoms as disturbances of judgment, poor empathy and understanding of others, an absence of enjoyment, periods of seclusiveness, or sexual and philosophical preoccupations. Mixtures of the neuroses, with free-floating anxiety often indicates an underlying schizophrenic process. In the treatment of a patient with a borderline schizophrenic reaction, the prime focus should be on the prevention of a psychosis. The child should be protected against severe stresses, which may involve some environmental manipulation. Anxiety has a deteriorating effect and tranquillizers may have to be used. Supportive psychotherapy is of great value. It is essential that the relationship with the therapist be a positive one. The therapist should be a real person who offers the adolescent patient someone with whom to identify. One strengthens useful defences and lessens the need for the other defences by reducing the ego's needs for those defences, e.g. by reality testing the fantasied threats, by offering a less punitive and less rigid superego, and by manipulating the environment to reduce stress. It is often helpful to orient the patient towards pleasurable experiences which have an ego-strengthening effect. Here then, in the handling of the defences and in the management of anxiety, can be seen a major difference in the treatment of patients with a borderline schizophrenic reaction, from the treatment of patients with psycho-neuroses or personality disorders. Failure to recognize the presence of an underlying schizophrenic process may lead to the choice of the wrong treatment program for the patient, with a resultant worsening of his condition and the onset of a psychosis.

scholarly journals Cost-effectiveness of internet-delivered cognitive behaviour therapy for body dysmorphic disorder: results from a randomised controlled trial

2021 ◽  
Author(s):  
Oskar Flygare ◽  
Erik Andersson ◽  
Gjermund Glimsdal ◽  
David Mataix-Cols ◽  
Diana Djurfeldt ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Outcome Measures ◽  
Cognitive Behaviour Therapy ◽  
Body Dysmorphic Disorder ◽  
Controlled Trial ◽  
Cost Utility ◽  
Secondary Outcome ◽  
Behaviour Therapy ◽  
Supportive Psychotherapy ◽  
Cognitive Behaviour

Objectives: To evaluate the cost-effectiveness of internet-delivered cognitive behaviour therapy for body dysmorphic disorder (BDD-NET). Design: Secondary cost-effectiveness analysis from a randomised controlled trial on BDD-NET versus online supportive psychotherapy. Setting: Academic medical centre. Participants: Self-referred adult patients with a primary diagnosis of body dysmorphic disorder and a score of 20 or higher on the modified Yale-Brown obsessive compulsive scale (n = 94). Patients receiving concurrent psychotropic drug treatment were included if the dose had been stable for at least two months and remained unchanged during the trial. Interventions: Participants received either BDD-NET (n = 47) or online supportive psychotherapy (n = 47) for 12 weeks. Primary and secondary outcome measures: The primary outcome measures were cost-effectiveness and cost-utility from a societal perspective, using remission status from a diagnostic interview and quality-adjusted life years from EQ-5D, respectively. Secondary outcome measures were cost-effectiveness and cost-utility from a health care perspective and the clinics perspective. Results: Compared to supportive psychotherapy, BDD-NET produced one additional remission for an average societal cost of $4132. The cost-utility analysis showed that BDD-NET generated one additional QALY to an average cost of $14319 from a societal perspective. Conclusions: BDD-NET is a cost-effective treatment for body dysmorphic disorder, compared to online supportive psychotherapy. The efficacy and cost-effectiveness of BDD-NET should be directly compared to face-to-face cognitive behaviour therapy.

scholarly journals An audit to look at the prescribing of psychotropic medication in the general adult inpatient setting in patients with emotionally unstable personality disorder

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S31-S31
Author(s):  
Declan Hyland ◽  
Charlie Daniels ◽  
Iulian Ionescu ◽  
Christina Houghton ◽  
Katie Goodier ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Psychotropic Medication ◽  
Psychotropic Medications ◽  
Inpatient Setting ◽  
Mood Stabiliser ◽  
Supportive Psychotherapy ◽  
Psychiatric Comorbidities ◽  
Prescribing Practice ◽  
Medication Prescribing ◽  
Emotionally Unstable Personality Disorder

AimsTo assess the frequency of prescription of psychotropic medication in patients with a primary diagnosis of emotionally unstable personality disorder (EUPD) following admission to Clock View Hospital, an inpatient unit in Mersey Care NHS Foundation Trust.MethodA retrospective analysis of the electronic (RiO) record of 50 patients discharged from Clock View Hospital between 1 January 2020 and 1 November 2020 was performed to assess prescribing practice.Twenty-five patients with a diagnosis of EUPD and no associated psychiatric comorbidities were included in the sample, as well as 25 patients with a diagnosis of EUPD and associated psychiatric comorbidities.Result80% of the 25 patients with EUPD and associated psychiatric comorbidities were prescribed psychotropic medication prior to admission to hospital (56% an antidepressant, 24% a mood stabiliser, 60% an antipsychotic and 8% a benzodiazepine). 64% of patients were prescribed two or more psychotropic medications. 28% were initiated on new psychotropic medications following admission. For four of the seven prescriptions commenced on psychotropic medication, prescribing practice was as advised in Mersey Care's EUPD guidelines.Of the 25 patients with EUPD and no associated psychiatric comorbidities, 96% of the patients were prescribed psychotropic medication prior to admission to hospital (56% an antidepressant, 20% a mood stabiliser, 72% an antipsychotic and 12% a benzodiazepine). 68% of patients were prescribed two or more psychotropic medications. Following admission, 28% of patients were initiated on new regular psychotropic medications. For five of the eight prescriptions for new psychotropic medication, prescribing practice was as advised in Mersey Care's EUPD guidelines.78% of the 50 patients were prescribed as required (PRN) psychotropic medication. In 21 patients, PRN medication was prescribed for longer than one week.ConclusionThere is a higher rate of prescribing of antipsychotic prescription in those EUPD patients with no psychiatric comorbidities compared to associated psychiatric comorbidities (72% vs 60%). Surprisingly, there was a lower rate of psychotropic polypharmacy in those with psychiatric comorbidities.Use of PRN psychotropic medication for longer than a week was higher in those patients with psychiatric comorbidities compared to those without psychiatric comorbidities (58% vs 50%). Benzodiazepines were overwhelmingly the most consistently prescribed PRN medication for patients with EUPD.One action to consider would be highlighting the importance of trialling psychologically-minded interventions and supportive psychotherapy prior to initiation of psychotropic medication. There also needs to be consideration to use of the sedative antihistamine promethazine as a first-line PRN medication for acute agitation.

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