典型儿童强迫症个案的整合主义心理治疗分析

分析一例典型儿童强迫官能症的整合主义心理疗法理念和治疗过程，及其治疗的有效性，探讨整合主义心理治疗的发展趋向和综合成因。结论：整合主义心理治疗是一种有效治疗手段，符合一般发展规律，在减轻患者强迫症状，增强社会功能方面均有较好的效果。     

A case of suspected child abuse by an adolescent mother: The use of short-term psychotherapy

The incidence of pregnancy during adolescence has escalated dramatically in recent years, with an estimated half a million infants born to teenagers each year in the United States. A disproportionately high amount of child abuse and/or neglect is encountered among adolescent parents, underscoring the need for an effective intervention strategy. Short-term psychotherapy may be beneficial in these cases for forging a therapeutic alliance expeditiously and rigorously challenging the patient's resistance. The case described involves alleged abuse by a 16-year-old mother. An intervention was designed to clarify the allegations surrounding the abusive incident, help the mother confront episodes of loss in her own life and overcome feelings of hopelessness engendered by separation from her infant.     

论道教“祝由符咒”的实用价值及其对中医“意疗”的影响

道教“祝由符咒”起源于巫术,后世用以为人治病时,又体现出一定的实用价值。中医学受其启发,以祝由之术治疗情志疾病,其疗效受到历代医家推崇,由此丰富和发展了中医学的治疗方法。     

Using a capabilities approach to understand poverty and social exclusion of psychiatric survivors

The purpose of this project is to better understand poverty and social exclusion of psychiatric survivors using a capabilities approach to social justice as part of a larger mixed-methods longitudinal study (N=380) in Ontario, Canada. Using thematic coding, four themes emerged: poverty, ‘You just try to survive’; stigma, ‘People treat you like trash’; belonging, ‘You feel like you don’t belong’; and shared concern and advocacy, ‘Everyone deserves housing’. This analysis provides a deeper understanding of poverty and other social determinants of experiences of psychiatric survivors, including the synergism of poverty and social exclusion.     

The duty to care and the need to split

This paper arises out of psychoanalytically oriented consultancy to teams of staff in the helping professions where there is a statutory 'duty to care'. It takes as its premise the seemingly paradoxical hypothesis that workers may need to split off part of their emotional experience in order to preserve their own mental health and provide reliable services to their clients. I argue that while a professional 'duty to care' requires us to be emotionally 'in touch', the demands of our clients together with the demands of the institutional response to the 'duty to care' cause us to split off parts of our awareness. I also argue that provided the splitting does not become extreme we are doing no more or less than the rest of society. In other words, there is a degree of 'normal splitting' which numbs our awareness of danger and destructiveness and seeks to protect us from too much anxiety and pain. Yet if professional workers are charged with the responsibility of assessing risk and acting accordingly for the protection of all concerned they need ways of being 'in touch' (re-integrating the splits) for some or enough of the time. Finally, I will describe ways of being 'in touch', illustrating the difficulty and the pain of re-integrating the splits and some of the insights that can arise out of this work with examples from my consultancy work.     

A CHILD PSYCHOTHERAPIST IN PRIMARY MENTAL HEALTH

This paper outlines the author's application of psychodynamic thinking and approaches to brief therapeutic work with children, adolescents and their families in community mental health settings. It is the author's belief that systemic and narrative therapy insights and techniques combine well with psychoanalysis in the assessment and treatment of many concerns felt and expressed by parents and young people. The therapist's tasks are to listen empathically to clients who are in distress and to explore the clients' beliefs about the origins of their problems, as well as their previously attempted solutions. In proceeding at the family's pace, opportunities arise for facilitating more effective ways of resolving conflict. Clients are often more free than they realise to change their interpretation of their experience, and this has important consequences for the maintenance and solution of problems. Brief therapy seeks to remind clients of their strengths and resources and to share ways to encourage clients to resume effective ways of learning about themselves.     

Assessing emotional and social health using photographs: An innovative research method for rural studies and its applicability in a care-farming program for youth

A framework for assessing photographs for the emotional and social health of young people (SHAPE) is described and tested, within the context of a rural program. Two independent raters assessed the photographs of participants. To assess inter-rater reliability, Cohen’ K and Kendall’s W were calculated. The two reviewers’ assessments of photographs were in agreement. The assessment of emotional/behavioural display showed 82% agreement. Agreement between reviewers’ judgements of proxemics (W = .866), interaction (W = .722), engagement (W = .932) and overall impression (W = .804) were all significant (p < .005). The method yielded results indicating that participants found gardening immediately engaging but their approach to equines exhibited a change from fascination to confidence during the program. The visual-diary method is a useful and sensitive method for research: where resources are limited; to complement traditional measures; for use with people who lack appropriate verbal communication or literacy skills to complete questionnaires; young children; other underrepresented groups.     

‘Queen of the world’: experiences of ‘at-risk’ young people participating in equine-assisted learning/therapy

There is a significant body of research into the benefits of animal-assisted therapy (AAT) but less into the fields known as equine-assisted learning and therapy (EAL/EAT) where horses are incorporated in therapeutic and learning interventions. This paper explores the experiences of seven ‘at-risk’ young people who participated in a therapeutic horsemanship (TH) programme. The study followed a practice-near approach seeking to capture the young people's experiences within a participative ethnography. Themes related to the risk and resilience literature such as self-confidence, self-esteem, self-efficacy and a sense of mastery, empathy and the opening of positive opportunities are explored in this paper.     

Recovery From Mental Health Problems: Scratching The Surface Without Ethnography

This article examines a central plank of mental health policy (‘recovery’) in societies which have attempted to reverse the long-term warehousing of those with a diagnosis of mental disorder (de-institutionalisation). The emergence of the concept is traced in relation to the shift from an institutional to a more dispersed and community-based form of service organisation. Different usages of the term ‘recovery’, each with distinct implications for practice are considered on the part of three main interest groups (traditional bio-medical psychiatrists; social psychiatrists emphasising social skills training; and dissenting service users). These different usages suggest that ‘recovery’ is a polyvalent concept that creates an uneasy consensus point to define the management philosophies of local services enacting mental health policy. Also mental health work is about more than the group of patients mainly considered in relation to recovery (those with ‘severe and enduring mental health problems’). Practice-near research strategies are now required to investigate the varied practical scenarios these contradictions generate and ethnographic research is therefore indicated. Without multiple ethnographies, we will be left with competing rhetoric about recovery and its meaning or meanings may be rendered worthless.     

Client Personality,Working Alliance and Outcome

Abstract

The relationship of the five-factor model of personality to working alliance, symptoms and well-being was examined in a diverse community mental health sample (N = 103). Agreeableness, openness, extraversion and conscientiousness were associated with alliance. Neuroticism was strongly associated with symptoms, and negatively associated with well-being. Extraversion was moderately associated with well-being. Personality is deserving of further study as a potentially important influence on therapy process and outcome. Part of the much-replicated association of alliance with outcome may be accounted for by personality. Implications for social work practice and research are discussed.