scholarly journals Organising and evaluating a Balint group for trainees in psychiatry

2003 ◽  
Vol 27 (11) ◽  
pp. 434-436 ◽  
Author(s):  
Gearoid Fitzgerald ◽  
Michael D. Hunter
Keyword(s):  
Clinical Practice ◽  
Discussion Group ◽  
Case Vignette ◽  
Group Method ◽  
Clinical Implications ◽  
Case Discussion ◽  
Written Responses ◽  
Before And After ◽  
One Year ◽  
Balint Group

Aims and MethodWe describe the Balint case discussion group method and how it can be applied to training psychiatrists. In a group that we ran, the performance of members on a clinical task before and after a year in the group was investigated. Written responses to a case vignette were appraised blindly by psychotherapists who were also examiners for the Royal College of Psychiatrists.ResultsThere were eight members in the Balint group, which met weekly for one year. We found that members' performance on the clinical task improved significantly following the year spent in the Balint group.Clinical ImplicationsA Balint group, as part of an introduction to psychotherapy for psychiatrists, may represent a step towards achieving comprehensive training that is relevant to ordinary clinical practice.

scholarly journals Trainees' experiences of a Balint group

2003 ◽  
Vol 27 (7) ◽  
pp. 274-275 ◽  
Author(s):  
Arthita Das ◽  
Paul Egleston ◽  
Hany El-Sayeh ◽  
Michelle Middlemost ◽  
Narinder Pal ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psychotherapy Training ◽  
Discussion Group ◽  
Patient Relationship ◽  
Positive Experience ◽  
Case Discussion ◽  
Everyday Clinical Practice ◽  
The One ◽  
Balint Group ◽  
Balint Method

Psychotherapy training is mandatory before trainees can gain membership of the Royal College of Psychiatrists. One type of introduction to psychotherapy is via a case discussion group, such as the one pioneered by Michael Balint. Much has been published regarding psychotherapy training, but little describing the Balint method from a trainee's perspective. Our paper outlines trainees' experiences of participating in this type of group. The group encouraged trainees to think about the doctor–patient relationship in their everyday clinical practice. All of those who finished the group described a positive experience, giving a good grounding for further psychotherapy training.

scholarly journals Trainees' experiences of a Balint group

2003 ◽  
Vol 27 (07) ◽  
pp. 274-275 ◽  
Author(s):  
Arthita Das ◽  
Paul Egleston ◽  
Hany El-Sayeh ◽  
Michelle Middlemost ◽  
Narinder Pal ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psychotherapy Training ◽  
Discussion Group ◽  
Patient Relationship ◽  
Positive Experience ◽  
Case Discussion ◽  
Everyday Clinical Practice ◽  
The One ◽  
Balint Group ◽  
Balint Method

Psychotherapy training is mandatory before trainees can gain membership of the Royal College of Psychiatrists. One type of introduction to psychotherapy is via a case discussion group, such as the one pioneered by Michael Balint. Much has been published regarding psychotherapy training, but little describing the Balint method from a trainee's perspective. Our paper outlines trainees' experiences of participating in this type of group. The group encouraged trainees to think about the doctor–patient relationship in their everyday clinical practice. All of those who finished the group described a positive experience, giving a good grounding for further psychotherapy training.

General practitioners and clinical pharmacology

1989 ◽  
Vol 4 (4) ◽  
pp. 241-244
Author(s):  
P. Lemoine
Keyword(s):  
Clinical Pharmacology ◽  
General Practitioners ◽  
Field Studies ◽  
Discussion Group ◽  
Group Method ◽  
Study Group ◽  
Test Drug ◽  
Monthly Basis ◽  
One Year ◽  
The One

SummaryIt is difficult to undertake field studies with non marketed psychotropic drugs because of two apparently contradictory conditions : on the one hand, the methodology has to be rigorously controlled, and on the other hand, such studies have to be carried out in their future environment by general practitioners (GPs). Bearing in mind the lack of training and experience regarding this kind of approach, the author adopted a discussion group method according to the techniques developed by M. Balint. The study group comprised five GPs, a clinical pharmacology expert and a doctor from the pharmaceutical laboratory which had developed the test drug. These persons met on a monthly basis over a one year period. In the present paper, the author indicates the benefits of such a methodology, based on six years’ experience and several trials, with special emphasis placed on the pedagogical aspects.

scholarly journals Understanding the person with dementia: a clinicophilosophical case discussion

2013 ◽  
Vol 19 (5) ◽  
pp. 337-343 ◽  
Author(s):  
Julian C. Hughes ◽  
Aileen Beatty
Keyword(s):  
Clinical Practice ◽  
Mental Health Professionals ◽  
Case Vignette ◽  
Case Discussion ◽  
Broad View ◽  
People With Dementia ◽  
Person With Dementia ◽  
Conceptual Underpinning ◽  
Embodied Agent ◽  
Practical Implications

SummaryThis article examines the notion of personhood and shows how it offers a robust conceptual underpinning to person-centred care. We use a fictitious case vignette to clarify the nature of personhood. Mental health professionals need a broad view of personhood, which we feel is best captured by regarding the person as a 'situated embodied agent'. Using this characterisation, we aim to demonstrate how it can underpin the notion of person-centred care and show the practical implications of this in connection with our fictitious case. The broad view supports a specific approach to people with dementia, but also shows the challenges that face the implementation of good-quality dementia care. Discussion of this case shows both the relevance of philosophy to clinical practice and the ways in which clinical practice can enrich the debates of philosophy.

scholarly journals In the light of Bournewood

2000 ◽  
Vol 24 (2) ◽  
pp. 52-54 ◽  
Author(s):  
Norma Kearney ◽  
Adrian Treloar
Keyword(s):  
Clinical Practice ◽  
Clinical Implications ◽  
The South ◽  
Before And After ◽  
Incapacitated Patients

Aims and MethodA postal audit of practice in the South-East Thames Region of England before and after the Bournewood judgements.ResultsThere was a trebling in the rate of admission under section of elderly incapacitated patients occurred prior to the Houseof Lords' ruling. By the time of the ruling many consultants had not changed their practice. There is now, however, no impact of the ruling upon clinical practice. The majority of consultants remain concerned about the lack of safeguards for mentally incapacitated elders at the present time.Clinical ImplicationsAlthough the Bournewood judgement was expected by some to have a permanent impact upon the management of the mentally incapacitated this has not happened. There is a need for effective and resource efficient safeguards for the mentally incapacitated to be developed.

THE ETHICS OF FETOCIDE

2007 ◽  
Vol 18 (4) ◽  
pp. 289-309
Author(s):  
FRANK A CHERVENAK ◽  
LAURENCE B McCULLOUGH
Keyword(s):  
Clinical Practice ◽  
Moral Status ◽  
Clinical Management ◽  
Ethical Framework ◽  
Clinical Implications ◽  
Ethical Justification ◽  
Before And After

The purpose of this article is to provide an ethical framework for fetocide in the practice of obstetrics. Ethically responsible clinical management of pregnancy and its complications requires ethical justification: the giving of reasons that derive from an ethical framework and that together support a conclusion about what ought or ought not to be done in the care of pregnant patients. An ethical framework provides an account of the concepts that are relevant to clinical practice and identifies the clinical implications of these concepts. In this chapter we will present an ethical framework for fetocide based on the ethical concepts of moral status and of the fetus as a patient and identify the clinical implications of this concept for fetocide both before and after fetal viability.

Klein with Lacan: A Study on the Reception of Lacanian Ideas in Uruguay and Its Effects on Clinical Practices (1955–82)

2020 ◽  
Vol 22 (3) ◽  
pp. 341-361
Author(s):  
Gonzalo Grau-Pérez ◽  
J. Guillermo Milán
Keyword(s):  
Clinical Practice ◽  
Clinical Material ◽  
Clinical Practices ◽  
Before And After ◽  
The Difference ◽  
The 1960S ◽  
The Relationship ◽  
Discursive Approach ◽  
The Way ◽  
Clinical Cases

In Uruguay, Lacanian ideas arrived in the 1960s, into a context of Kleinian hegemony. Adopting a discursive approach, this study researched the initial reception of these ideas and its effects on clinical practices. We gathered a corpus of discursive data from clinical cases and theoretical-doctrinal articles (from the 1960s, 1970s and 1980s). In order to examine the effects of Lacanian ideas, we analysed the difference in the way of interpreting the clinical material before and after Lacan's reception. The results of this research illuminate some epistemological problems of psychoanalysis, especially the relationship between theory and clinical practice.

scholarly journals Droperidol dropped; consultants not consulted

2003 ◽  
Vol 27 (08) ◽  
pp. 301-304
Author(s):  
Gavin Reid ◽  
Mark Hughson
Keyword(s):  
Questionnaire Survey ◽  
Clinical Care ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
The West ◽  
Abrupt Withdrawal ◽  
Before And After ◽  
Adequate Evaluation ◽  
Psychiatric Profession ◽  
The Impact

Aims and Method We conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer. Results One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. Clinical Implications The abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.

scholarly journals Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan

2021 ◽  
Vol 11 (6) ◽  
pp. 478
Author(s):  
Ching Chang ◽  
Chien-Hao Huang ◽  
Hsiao-Jung Tseng ◽  
Fang-Chen Yang ◽  
Rong-Nan Chien
Keyword(s):  
Hepatic Encephalopathy ◽  
Real World ◽  
Ammonia Level ◽  
Decompensated Cirrhosis ◽  
Control Group ◽  
Multivariable Logistic Regression Model ◽  
Before And After ◽  
One Year ◽  
The One ◽  
Serum Ammonia

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Therefore, the aim of this study is to evaluate the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission in Taiwan. Methods: We conducted a real-world single-center retrospective cohort study to compare the long-term efficacy of rifaximin add-on to lactulose (group R + L) versus lactulose alone (group L, control group). Furthermore, the treatment efficacy before and after rifaximin add-on to lactulose was also analyzed. The primary endpoint of our study was time to first HE recurrence (Conn score ≥ 2). All patients were followed up every three months until death, and censored at one year if still alive. Results and Conclusions: 12 patients were enrolled in group R + L. Another 31 patients were stratified into group L. Sex, comorbidity, ammonia level, and ascites grade were matched while age, HE grade, and model for end-stage liver disease (MELD) score were adjusted in the multivariable logistic regression model. Compared with group L, significant improvement in the maintenance of HE remission and decreased episodes and days of HE-related hospitalizations were demonstrated in group R + L. The serum ammonia levels were significantly lower at the 3rd and 6th month in group 1. Concerning changes before and after rifaximin add-on in group R + L, mini-mental status examination (MMSE), episodes of hospitalization, and variceal bleeding also improved at 6 and 12 months. Days of hospitalization, serum ammonia levels also improved at 6th month. Except for concern over price, no patients discontinued rifaximin due to adverse events or complications. The above results provide evidence for the one-year use of rifaximin add-on to lactulose in reducing HE recurrence and HE-related hospitalization for patients with decompensated cirrhosis.

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