scholarly journals Die Wirksamkeitsforschung von systemischer Therapie/Familientherapie: Zeitbezogene Trends und Unterschiede in der Qualität von Studien zu verschiedenen Behandlungsmodellen

2007 ◽  
Vol 19 (2) ◽  
pp. 231-246
Author(s):  
Inge Seiffge-Krenke ◽  
Stefan Beher ◽  
Christian Skaletz

Sixty-eight studies investigating the effectiveness of systemic/family therapy for children and adolescents (published from 1973 to 2004) were analyzed to determine whether quality differences exist between studies of more integrative versus classically-orien¬tat¬ed systemic family therapy. These differences were examined with respect to the type of therapy model investigated, publication year, and origin of publication. Results indicate that, based on the consideration of important methodological criteria (e.g., existence of a control group, randomized study design, registration of clinical outcome), integrative family therapy is more effective than classic family therapy. Additional ana¬lyses revealed that the year and origin of publication predicted a high methodological standard, independent of family therapy orientation. The analyses also revealed that although the number of evaluation studies on systemic/family therapy has considerably increased, especially in the USA, comparable studies on German samples are lacking. Zusammenfassung Grundlage dieser Analyse sind 68 Wirksamkeitsstudien zur systemischen Therapie/Fa¬milientherapie bei Kindern und Jugendlichen im Zeitraum von 1973 bis 2004. Es wird der Frage nachgegangen, welche Qualitätsunterschiede in der Wirksamkeitsforschung zwischen eher integrativ und eher klassisch orientierten Modellen systemischer Familientherapie bestehen, und ob diese Unterschiede mit der Art der untersuchten Therapiemodelle, dem Zeitpunkt der Erforschung und dem Herkunftsland der Studien zusammenhängen. Die Ergebnisse zeigen, dass systemisch-integrative Familientherapie in einigen wichtigen Kriterien der klassisch-systemischen Familientherapie in der methodischen Güte der Studien überlegen ist (z.B. Vorhandensein einer Kontrollgruppe, randomisiertes Studiendesign, Erhebung eines klinisch relevanten Outcomes). Allerdings konnten weitere Analysen belegen, dass die Konfundierung zwischen Publikationsjahr und dem Herkunftsland ein methodisch hohes Niveau der Wirksamkeitsprüfung vorhersagte, unabhängig von der familientherapeutischen Ausrichtung der Studien. Die Analyse verdeutlicht darüber hinaus einen gerade in den letzten Jahren stark angewachsenen Bestand an Wirkstudien zur systemischen Familientherapie insbesondere in den USA, allerdings auch einen Mangel deutscher Wirksamkeitsstudien.

1990 ◽  
Vol 7 (3) ◽  
pp. 51-55 ◽  
Author(s):  
Jeffrey R. Greene ◽  
Martha Mueller Holden

2017 ◽  
Vol 41 (S1) ◽  
pp. S262-S262
Author(s):  
D. Gashi Bytyçi

IntroductionMulti-systemic family therapy is a type of psychotherapy that base on the assumption that all kinds of difficulties in individuals are at least partly explained by dysfunctions in the family system and other systems to which the individual belongs.ObjectivesThis study examined associations between bullying behavior and family ethos, and provides data for changes after treatment with Multi-systemic family therapy-Integrative model, as a culturally sensitive approach.MethodsThirty-six adolescents with bullying behavior and their families were evaluated. Participants were randomly assigned into two groups: Family therapy group (FT-G) and Control group (CG). The FT-G was treated with integrative model for 6 months; the focus of FT sessions was on proximity-control goals and plans, bugs in the plans, emotive, and types of relations between family members programs. The CG was treated with the same frequency as the FT-G, but with interventions consisting of a detailed survey of their mental health, adolescents’ feelings, daily routines and life events. Every month, data were collected through interviews, questionnaires, observation facilitating techniques and observations of a family play therapy.ResultsIn the study participated 36 outpatient adolescents ages 14–16. Seventeen adolescents were male and 19 female (Fig. 1).ConclusionsAt baseline, 70 percent of participants met criteria for more than one of the following disorders, by ICD-10: conduct disorder, substance use, bulimia, borderline personality disorder, and attention deficit/hyperactivity disorder. Six months after the baseline measurement, there was a significant decrease in bullying behavior, substance use, smoking, excessive social media use, and anger control for the FT-G compared with the CG.Disclosure of interestThe author has not supplied his/her declaration of competing interest.


2015 ◽  
Vol 2 (2) ◽  
pp. 22-23
Author(s):  
Nicola Dunn

Abstract Staff at the Katharine Dormandy Haemophilia Centre pioneered a systemic family therapy model for haemophilia, in which reviews combined medical care and family counselling. That approach has now been extended to specialised joint clinics such as in orthopaedics, women’s and genetic counselling. This multidisciplinary team approach enables specialist clinicians to focus on what they do best while the family therapy team manages the psychological, practical and family issues, and supports patients to make difficult decisions regarding their care.


Author(s):  
E. N. Simakova ◽  
O. V. Stenkova

Introduction. Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods. A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results. For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion. The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.


Work ◽  
2021 ◽  
pp. 1-12
Author(s):  
Qinghua Chen ◽  
Wenqing Zhao ◽  
Qun Li ◽  
Harnof Sagi

BACKGROUND: with the increase of study and life pressure, the number of depressed college students showed an increasing trend year by year, and the drug treatment alone could not achieve a comprehensive recovery of depression patients, so it was more necessary to pay attention to the spiritual treatment. OBJECTIVE: this research aimed to better understand the relationship between college students’ depression and life events, social support, psychological pressure, and coping style, and the influence of systematic family therapy on depression degree, psychological stress, and social adaptability of college students with depression. METHODS: in this study, 105 college students with depression were selected as the research object, and healthy college students were taken as the control group. Through questionnaire, the differences in life events, social support, psychological stress, and coping styles between the groups were compared. The correlation between the degree of depression and various variables were analyzed, and the impact path of each variable on depression was analyzed using the path analysis model. Depression patients were then divided into a conventional group treating with conventional medications and an observation group treating with systematic family interventions. Differences in Hamilton Depression Scale-17, (HAMD-17), CPSS, and Social Adaptive Functioning Evaluation (SAFE) scores were compared and analyzed between the two groups before treatment (T1), during the treatment (T2), and after treatment(T3). RESULTS: there were significant differences in scores of life events, social support, psychological stress, and coping styles between the healthy control group and the depressed patients (P <  0.05). There was an obvious correlation between different depression degrees and life events, social support, psychological stress, and coping styles (P <  0.05). Life events, social support, and psychological stress had a direct and significant impact on depression (0.250, 0.218, and 0.392; P <  0.05), and they also had an indirect and significant impact on depression through coping styles (P <  0.05). The systematic family treatment model could significantly reduce HAMD-17 and CPSS scores (P <  0.05), and significantly improve SAFE scores (P <  0.05). CONCLUSIONS: adverse life events, lack of social support, excessive psychological stress, and negative coping styles can aggravate college students’ depression. Systematic family therapy can improve the degree of depression, reduce the psychological stress, and enhance the social adaptability of college students with depression.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Brenna Lin ◽  
Christopher Prickett ◽  
Steven Woltering

Abstract Background Stress can negatively impact an individual’s health and well-being and high levels of stress are noted to exist among college students today. While traditional treatment methods are plagued with stigma and transfer problems, newly developed wearable biofeedback devices may offer unexplored possibilities. Although these products are becoming commonplace and inexpensive, scientific evidence of the effectiveness of these products is scarce and their feasibility within research contexts are relatively unexplored. Conversely, companies are not required, and possibly reluctant, to release information on the efficacy of these products against their claims. Thus, in the present pilot, we assess the feasibility of using a real-time respiratory-based biofeedback device in preparation for a larger study. Our main aims were to assess device-adherence and collaboration with the company that develops and sells the device. Method Data were collected from 39 college students who self-identified as experiencing chronic stress at a Southwestern university in the USA. Students were randomized into either a mindfulness-only control group without a biofeedback device (n = 21), or an experimental group with biofeedback device (n = 18). Both groups received mindfulness meditation training. Pre-test and post-test procedures were conducted 2 weeks apart. Further, both participant compliance and company compliance were assessed and collaboration with the company was evaluated. Results Participant device-adherence as well as the company’s collaboration necessary for a full-scale study was determined to be low. This may also have affected our results which showed a strong main effect for time for all outcome variables, suggesting all groups showed improvement in their levels of stress after the intervention period. No group by time effects were identified, however, indicating no added benefit of the biofeedback device. Conclusions Our findings suggest feasibility of future studies requires full collaboration and detailed and agreed upon data sharing procedures with the biofeedback company. The particular device under investigation added no value to the intervention outcomes and it was not feasible to continue a larger-scale study. Further, as the technology sector is innovating faster than it can validate products, we urge for open science collaborations between public and private sectors to properly develop evidence-based regulations that can withstand technological innovation while maintaining product quality, safety, and effectiveness. Trial registration NCT02837016. Registered 19 July 2016.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Federico Longhini ◽  
Laura Pasin ◽  
Claudia Montagnini ◽  
Petra Konrad ◽  
Andrea Bruni ◽  
...  

Abstract Background Post-operative pulmonary complications (PPC) can develop in up to 13% of patients undergoing neurosurgical procedures and may adversely affect clinical outcome. The use of intraoperative lung protective ventilation (LPV) strategies, usually including the use of a low Vt, low PEEP and low plateau pressure, seem to reduce the risk of PPC and are strongly recommended in almost all surgical procedures. Nonetheless, feasibility of LPV strategies in neurosurgical patients are still debated because the use of low Vt during LPV might result in hypercapnia with detrimental effects on cerebrovascular physiology. Aim of our study was to determine whether LPV strategies would be feasible compared with a control group in adult patients undergoing cranial or spinal surgery. Methods This single-centre, pilot randomized clinical trial was conducted at the University Hospital “Maggiore della Carità” (Novara, Italy). Adult patients undergoing major cerebral or spinal neurosurgical interventions with risk index for pulmonary post-operative complications > 2 and not expected to need post-operative intensive care unit (ICU) admission were considered eligible. Patients were randomly assigned to either LPV (Vt = 6 ml/kg of ideal body weight (IBW), respiratory rate initially set at 16 breaths/min, PEEP at 5 cmH2O and application of a recruitment manoeuvre (RM) immediately after intubation and at every disconnection from the ventilator) or control treatment (Vt = 10 ml/kg of IBW, respiratory rate initially set at 6–8 breaths/min, no PEEP and no RM). Primary outcomes of the study were intraoperative adverse events, the level of cerebral tension at dura opening and the intraoperative control of PaCO2. Secondary outcomes were the rate of pulmonary and extrapulmonary complications, the number of unplanned ICU admissions, ICU and hospital lengths of stay and mortality. Results A total of 60 patients, 30 for each group, were randomized. During brain surgery, the number of episodes of intraoperative hypercapnia and grade of cerebral tension were similar between patients randomized to receive control or LPV strategies. No difference in the rate of intraoperative adverse events was found between groups. The rate of postoperative pulmonary and extrapulmonary complications and major clinical outcomes were similar between groups. Conclusions LPV strategies in patients undergoing major neurosurgical intervention are feasible. Larger clinical trials are needed to assess their role in postoperative clinical outcome improvements. Trial registration registered on the Australian New Zealand Clinical Trial Registry (www.anzctr.org.au), registration number ACTRN12615000707561.


2021 ◽  
pp. 1-14
Author(s):  
Uta Roentgen ◽  
Loek van der Heide ◽  
Ingrid E.H. Kremer ◽  
Huub Creemers ◽  
Merel A. Brehm ◽  
...  

BACKGROUND: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. OBJECTIVE: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-) effectiveness compared with care as usual. METHODS: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n= 48) receiving care as usual and of an intervention group (optimized provision process) (n= 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Robert Bozick

Abstract Background Self-rated health (SRH) is one of the most commonly used summary measures of overall health and well-being available to population scientists due to its ease of administration in large-scale surveys and to its efficacy in predicting mortality. This paper assesses the extent to which SRH is affected by its placement before or after questions about bodyweight on a survey, and whether differences in placement on the questionnaire affects SRH’s predictive validity. Methods I assessed the validity of SRH in predicting the risk of mortality by comparing outcomes of sample members who were asked to rate their health before reporting on their bodyweight (the control group) and sample members who were asked to rate their health after reporting on their bodyweight (the treatment group). Both the control and treatment group were randomly assigned via an experiment administered as a module in a nationally representative sample of adults in the USA in 2019 (N = 2523). Results The odds of reporting a more favorable appraisal of health are 30% lower for sample members who were in the treatment group when compared with the control group. Additionally, the SRH of treatment group members is significantly associated with their risk of mortality, while the SRH of control group members is not. Conclusion The findings from this study suggest that for researchers to maximize the utility of SRH, closer attention needs to be paid to the context of the survey within which it asked. SRH is highly sensitive to the questions that precede it, and this sensitivity may in turn mischaracterize the true health of the population that the survey is intending to measure.


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