Clinical Case Studies最新文献_第4页

Combined ACT-Based Contingency Contracting Intervention for Aggressive Behavior and Psychologically Flexibility in an Adolescent With Comorbid Autism, Bipolar Disorder, and Schizophrenia 基于ACT的联合应急契约干预对患有自闭症、双相情感障碍和精神分裂症的青少年攻击行为和心理灵活性的影响

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-05-03 DOI: 10.1177/15346501231171867

Raymond Burke, Elana Sickman, Jordan Belisle, Steve Taylor, Dana Paliliunas

Comorbid diagnoses including autism spectrum disorder, bipolar disorder, schizophrenia, and intellectual disability can present a variety of personal barriers and challenges to interventions that promote safety and autonomy. The current case study provides an overview of a 10-week intervention that included elements of Acceptance and Commitment Therapy and contingency contracting to target psychological flexibility and aggressive behavior in a 17-year-old presenting with these comorbid diagnoses. The treatment was fully individualized to include the client’s interests in Star Wars and focused on supporting the client’s self-identified valued outcomes associated with independent living. Prior to intervention, baseline data showed high levels of aggressive behavior in both frequency and duration, and low levels of psychological flexibility and adaptive behaviors were reported. Following implementation of the combined intervention, aggressive behavior reduced significantly below baseline levels, psychological flexibility improved, and the client engaged in a greater frequency of adaptive behaviors relative to baseline. Positive outcomes were also maintained 1-month and 1-year following the intervention. Implications of this case for clinicians and staff are discussed.

包括自闭症谱系障碍、双相情感障碍、精神分裂症和智力残疾在内的合并症诊断可能给促进安全和自主的干预措施带来各种个人障碍和挑战。当前的案例研究概述了一个为期10周的干预措施，包括接受和承诺治疗的要素，以及针对17岁的心理灵活性和攻击行为的应急收缩，并提出了这些共病诊断。治疗是完全个性化的，包括客户对星球大战的兴趣，并专注于支持客户自我认同的与独立生活相关的有价值的结果。在干预前，基线数据显示攻击行为的频率和持续时间都很高，而心理灵活性和适应性行为的水平较低。实施联合干预后，攻击行为显著减少到基线水平以下，心理灵活性得到改善，患者参与适应行为的频率相对于基线更高。干预后1个月和1年均保持阳性结果。本病例对临床医生和工作人员的影响进行了讨论。

{"title":"Combined ACT-Based Contingency Contracting Intervention for Aggressive Behavior and Psychologically Flexibility in an Adolescent With Comorbid Autism, Bipolar Disorder, and Schizophrenia","authors":"Raymond Burke, Elana Sickman, Jordan Belisle, Steve Taylor, Dana Paliliunas","doi":"10.1177/15346501231171867","DOIUrl":"https://doi.org/10.1177/15346501231171867","url":null,"abstract":"Comorbid diagnoses including autism spectrum disorder, bipolar disorder, schizophrenia, and intellectual disability can present a variety of personal barriers and challenges to interventions that promote safety and autonomy. The current case study provides an overview of a 10-week intervention that included elements of Acceptance and Commitment Therapy and contingency contracting to target psychological flexibility and aggressive behavior in a 17-year-old presenting with these comorbid diagnoses. The treatment was fully individualized to include the client’s interests in Star Wars and focused on supporting the client’s self-identified valued outcomes associated with independent living. Prior to intervention, baseline data showed high levels of aggressive behavior in both frequency and duration, and low levels of psychological flexibility and adaptive behaviors were reported. Following implementation of the combined intervention, aggressive behavior reduced significantly below baseline levels, psychological flexibility improved, and the client engaged in a greater frequency of adaptive behaviors relative to baseline. Positive outcomes were also maintained 1-month and 1-year following the intervention. Implications of this case for clinicians and staff are discussed.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43328836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Intervention Program for Families of Adults on the Autism Spectrum: A Case Study 自闭症谱系成人家庭干预计划的个案研究

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-04-17 DOI: 10.1177/15346501231170149

Daina M. Tagavi, Gary A. Stobbe, K. Bearss

Caregivers of adults on the autism spectrum report having limited access to resources that aid in supporting their child and helping them lead more independent lives. There is a need for interventions designed to teach caregivers strategies that address challenging behaviors, as well as promote independence. Using a case study design, we evaluated the preliminary feasibility and acceptability of Research Units in Behavioral Intervention (RUBI) with caregivers of three adults on the autism spectrum. Outcomes support preliminary feasibility and acceptability, as indicated by low attrition (0%) and high adherence to the RUBI manual (mean adherence = 91%). Following intervention, all adults on the autism spectrum demonstrated decreased levels of challenging behaviors and increased independence. The results of this study provide insight on next steps for investigation, including avenues for RUBI adaptation when delivered to adults on the autism spectrum and their families.

自闭症谱系成年人的照顾者报告说，他们获得的资源有限，这些资源有助于支持他们的孩子，帮助他们过上更独立的生活。有必要采取干预措施，向护理人员传授应对挑战性行为的策略，并促进独立性。通过案例研究设计，我们评估了行为干预研究单位（RUBI）对三名自闭症谱系成年人的照顾者的初步可行性和可接受性。结果支持初步的可行性和可接受性，如低损耗（0%）和对RUBI手册的高依从性（平均依从性=91%）所示。干预后，所有自闭症谱系的成年人都表现出挑战性行为水平下降，独立性增强。这项研究的结果为下一步的调查提供了见解，包括向自闭症谱系的成年人及其家人提供RUBI适应途径。

引用次数: 0

Simultaneous Individual Complicated Grief Treatment With a Couple 夫妻同时治疗个人复杂悲伤

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-04-01 DOI: 10.1177/15346501221112665

Sanela Kalakovic, Kyra Katte, Brooke M. Smith, S. Gaynor

Persistent complex bereavement/complicated grief occurs when, after a period of 12 months following a death, there remains an ongoing intense yearning and sorrow for the deceased, preoccupation with the death and its circumstances, difficulty accepting its reality, and disruption in personal identity. This case study illustrates the successful application of Complicated Grief Treatment (CGT), a manualized research-supported intervention, with a husband and wife each receiving individual therapy simultaneously with separate clinicians. The core of CGT involves graded completion of imaginal and situational revisiting (i.e., exposure) exercises. To target maladaptive rumination and counterfactual thinking more explicitly, strategies from a research-based treatment for trauma, Cognitive Processing Therapy, were also incorporated for one member of the couple. To our knowledge, CGT has not been examined with couples receiving individual therapy delivered simultaneously. As such, practitioners have little information about how to proceed with cases where multiple members of the same family are experiencing complicated grief. We will detail the treatment provided, outlining the course of care for each member of the couple, highlighting unique adjustments made to tailor implementation to each individual and to deliver the intervention simultaneously. Quantitative and qualitative data show the effects of treatment on symptoms of complicated grief, depression, and relationship satisfaction.

持续的复杂丧亲之痛/复杂的悲伤发生在死亡后12个月后，对死者仍有持续的强烈思念和悲伤，对死亡及其环境的关注，难以接受其现实，以及个人身份的破坏。本案例研究说明了复杂悲伤治疗（CGT）的成功应用，这是一种由研究支持的手动干预措施，夫妻双方同时接受单独的临床医生的单独治疗。CGT的核心包括分级完成想象和情景重访（即暴露）练习。为了更明确地针对适应不良的沉思和反事实思维，这对夫妇中的一名成员还采用了基于研究的创伤治疗策略——认知加工疗法。据我们所知，尚未对同时接受个体治疗的夫妇进行CGT检查。因此，从业者几乎没有关于如何处理同一家庭的多个成员正在经历复杂悲伤的情况的信息。我们将详细介绍所提供的治疗，概述夫妇中每一位成员的护理过程，强调为针对每一个人进行实施并同时提供干预而做出的独特调整。定量和定性数据显示了治疗对复杂悲伤、抑郁和关系满意度症状的影响。

{"title":"Simultaneous Individual Complicated Grief Treatment With a Couple","authors":"Sanela Kalakovic, Kyra Katte, Brooke M. Smith, S. Gaynor","doi":"10.1177/15346501221112665","DOIUrl":"https://doi.org/10.1177/15346501221112665","url":null,"abstract":"Persistent complex bereavement/complicated grief occurs when, after a period of 12 months following a death, there remains an ongoing intense yearning and sorrow for the deceased, preoccupation with the death and its circumstances, difficulty accepting its reality, and disruption in personal identity. This case study illustrates the successful application of Complicated Grief Treatment (CGT), a manualized research-supported intervention, with a husband and wife each receiving individual therapy simultaneously with separate clinicians. The core of CGT involves graded completion of imaginal and situational revisiting (i.e., exposure) exercises. To target maladaptive rumination and counterfactual thinking more explicitly, strategies from a research-based treatment for trauma, Cognitive Processing Therapy, were also incorporated for one member of the couple. To our knowledge, CGT has not been examined with couples receiving individual therapy delivered simultaneously. As such, practitioners have little information about how to proceed with cases where multiple members of the same family are experiencing complicated grief. We will detail the treatment provided, outlining the course of care for each member of the couple, highlighting unique adjustments made to tailor implementation to each individual and to deliver the intervention simultaneously. Quantitative and qualitative data show the effects of treatment on symptoms of complicated grief, depression, and relationship satisfaction.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46272821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Integrating Mindfulness and Acceptance Into Traditional Cognitive Behavioral Therapy During the COVID-19 Pandemic: A Case Study of an Adult Man With Generalized Anxiety Disorder. 在COVID-19大流行期间将正念和接受融入传统认知行为疗法:一名患有广泛性焦虑症的成年男性的案例研究

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-04-01 Epub Date: 2022-08-23 DOI: 10.1177/15346501221123568

Alisa R Garner, Gregory L Stuart

Generalized Anxiety Disorder (GAD) can be chronic and impairing, highlighting the need for effective treatments. Although Cognitive Behavior Therapy (CBT) is an effective treatment for GAD, a number of patients continue to report GAD symptoms treatment. Integrating evidenced-based treatment components into CBT treatments, such as mindfulness- and acceptance-based treatment components found in Acceptance and Commitment Therapy (ACT), may help improve the efficacy of treatment. Emerging interventions and research suggest that the cognitive restructuring aspect of CBT and acceptance stance of ACT (e.g., cognitive defusion) can be implemented into treatment concurrently from a stance of increasing a patient's coping skills repertoire and psychological flexibility. This systemic case analysis examined the efficacy and clinical utility of integrating ACT into a manualized CBT treatment for GAD. Furthermore, this study examined treatment efficacy and therapeutic alliance as the treatment rapidly and unexpectedly transitioned from in-person to telehealth due to the COVID-19 pandemic. Pre- to post-treatment and time-series analyses showed significant decreases in anxiety symptoms, worry, depressive symptoms, and emotion dysregulation. Although there was an initial increase in depressive and anxiety symptoms, worry, and emotion dysregulation following the switch from in-person to telehealth services, these quickly subsided and resumed a downward trend. The therapeutic relationship did not deteriorate during the transition to telehealth. This case study provides evidence of feasibility and efficacy of an integrated CBT/ACT approach in treating GAD. It also suggests that despite some temporary increase in symptoms, therapeutic alliance and treatment efficacy were not impacted by the switch to telehealth.

广泛性焦虑障碍(GAD)可能是慢性和损害的，强调需要有效的治疗。尽管认知行为疗法(CBT)是一种有效的治疗广泛性焦虑症的方法，但仍有一些患者继续报告广泛性焦虑症症状的治疗。将基于证据的治疗成分整合到CBT治疗中，例如在接受和承诺治疗(ACT)中发现的基于正念和接受的治疗成分，可能有助于提高治疗效果。新兴的干预措施和研究表明，CBT的认知重构方面和ACT的接受立场(例如，认知融合)可以从增加患者应对技能和心理灵活性的立场同时实施到治疗中。本系统的病例分析检验了将ACT与手动CBT结合治疗广泛性焦虑症的疗效和临床应用。此外，由于COVID-19大流行，治疗迅速而意外地从面对面医疗过渡到远程医疗，本研究考察了治疗效果和治疗联盟。治疗前后和时间序列分析显示焦虑症状、担忧、抑郁症状和情绪失调显著减少。虽然在从面对面医疗服务转向远程医疗服务后，最初出现了抑郁和焦虑症状、担忧和情绪失调的增加，但这些症状很快消退并恢复了下降趋势。在向远程保健过渡期间，治疗关系没有恶化。本案例研究为CBT/ACT综合治疗广泛性焦虑症的可行性和有效性提供了证据。它还表明，尽管症状暂时有所增加，但转向远程保健并不影响治疗联盟和治疗效果。

{"title":"Integrating Mindfulness and Acceptance Into Traditional Cognitive Behavioral Therapy During the COVID-19 Pandemic: A Case Study of an Adult Man With Generalized Anxiety Disorder.","authors":"Alisa R Garner, Gregory L Stuart","doi":"10.1177/15346501221123568","DOIUrl":"10.1177/15346501221123568","url":null,"abstract":"<p><p>Generalized Anxiety Disorder (GAD) can be chronic and impairing, highlighting the need for effective treatments. Although Cognitive Behavior Therapy (CBT) is an effective treatment for GAD, a number of patients continue to report GAD symptoms treatment. Integrating evidenced-based treatment components into CBT treatments, such as mindfulness- and acceptance-based treatment components found in Acceptance and Commitment Therapy (ACT), may help improve the efficacy of treatment. Emerging interventions and research suggest that the cognitive restructuring aspect of CBT and acceptance stance of ACT (e.g., cognitive defusion) can be implemented into treatment concurrently from a stance of increasing a patient's coping skills repertoire and psychological flexibility. This systemic case analysis examined the efficacy and clinical utility of integrating ACT into a manualized CBT treatment for GAD. Furthermore, this study examined treatment efficacy and therapeutic alliance as the treatment rapidly and unexpectedly transitioned from in-person to telehealth due to the COVID-19 pandemic. Pre- to post-treatment and time-series analyses showed significant decreases in anxiety symptoms, worry, depressive symptoms, and emotion dysregulation. Although there was an initial increase in depressive and anxiety symptoms, worry, and emotion dysregulation following the switch from in-person to telehealth services, these quickly subsided and resumed a downward trend. The therapeutic relationship did not deteriorate during the transition to telehealth. This case study provides evidence of feasibility and efficacy of an integrated CBT/ACT approach in treating GAD. It also suggests that despite some temporary increase in symptoms, therapeutic alliance and treatment efficacy were not impacted by the switch to telehealth.</p>","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9403529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41374745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Clinical Case Study of Solution-Focused Brief Therapy for Young Adult Cancer Patients’ Psychological Distress: Focusing on Positive Emotions 以解决方案为中心的简短治疗青年癌症患者心理困扰的临床案例研究:以积极情绪为重点

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-03-13 DOI: 10.1177/15346501231161776

Anao Zhang, Adam S. Froerer

Psychological distress is highly prevalent among adolescent and young adult (AYA) cancer patients, an age-defined population (15–39) disproportionately impacted by their cancer diagnosis. Solution-focused brief therapy (SFBT) is a strength-based and evidence-supported approach for youth with medical conditions. The use of SFBT in young cancer patients, however, has been rarely described. Building on the broaden-and-build theory of positive emotions, this study describes how SFBT clinicians intentionally foster positive emotions, especially hope, in an AYA cancer patient to foster therapeutic change. We found improvements in the patient’s psychological distress as well as growth in levels of hope both in the immediate post-intervention assessment and in the 2-week follow-up. The findings of the study suggested that SFBT is a promising approach to the unique challenges confronting AYAs with cancer. It was not feasible for this case study to match the sex and racial identities for a therapist with the client’s preference, which is considered a main limitation of this study.

心理困扰在青少年和年轻人（AYA）癌症患者中非常普遍，这一年龄段人群（15-39）受到癌症诊断的影响尤为严重。以解决方案为中心的短暂治疗（SFBT）是一种基于力量和证据支持的方法，适用于有疾病的年轻人。然而，SFBT在年轻癌症患者中的应用很少被描述。本研究以积极情绪的广义和广义理论为基础，描述了SFBT临床医生如何在一名AYA癌症患者中有意培养积极情绪，尤其是希望，以促进治疗变化。我们发现，在干预后的即时评估和两周的随访中，患者的心理困扰有所改善，希望水平也有所提高。研究结果表明，SFBT是应对癌症AYA面临的独特挑战的一种很有前途的方法。本案例研究不可能将治疗师的性别和种族身份与客户的偏好相匹配，这被认为是本研究的主要局限性。

引用次数: 2

Grandparent-Implemented Interventions to Reduce Challenging Behavior of an Adult With Autism: A Pilot Telehealth Case Study 祖父母实施干预以减少自闭症成人的挑战行为:一项试点远程医疗案例研究

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-03-06 DOI: 10.1177/15346501231159140

Emily Gregori, C. Drew, Catharine Lory, N. Kim

Adults with autism spectrum disorder (ASD) often engage in challenging behavior that requires individualized intervention to remediate. However, access to high-quality services is limited for adults, leaving this population without necessary behavioral healthcare. This study addressed the needs of a 22-year-old man with ASD and intellectual disability (ID) who lived with his grandmother and engaged in tangibly maintained challenging behavior. The interventionist coached his grandmother via telehealth in the implementation of two behavior analytic interventions: signaled multiple schedule arrangement and a modified contingency contract. The effects of the interventions were evaluated using an alternating treatments design with baseline. While both interventions were effective at decreasing challenging behavior when compared to baseline, the signaled multiple schedule arrangement resulted in zero instances of challenging behavior. Both the participant and the grandparent completed post-intervention social validity assessments and reported overall positive satisfaction with the interventions. Practice recommendations are presented.

患有自闭症谱系障碍(ASD)的成年人通常会做出具有挑战性的行为，需要个性化的干预来纠正。然而，成年人获得高质量服务的机会有限，这使得这一人群没有必要的行为保健。本研究针对一名22岁患有ASD和智力残疾(ID)的男子的需求，他与祖母住在一起，并从事明显的挑战性行为。干预师通过远程医疗指导其祖母实施两种行为分析干预:信号多重时间表安排和修改后的应急合同。采用基线交替治疗设计评估干预措施的效果。虽然与基线相比，两种干预措施都有效地减少了挑战行为，但信号多时间表安排导致零挑战行为。参与者和祖父母都完成了干预后的社会效度评估，并报告了对干预的总体积极满意度。提出了实践建议。

{"title":"Grandparent-Implemented Interventions to Reduce Challenging Behavior of an Adult With Autism: A Pilot Telehealth Case Study","authors":"Emily Gregori, C. Drew, Catharine Lory, N. Kim","doi":"10.1177/15346501231159140","DOIUrl":"https://doi.org/10.1177/15346501231159140","url":null,"abstract":"Adults with autism spectrum disorder (ASD) often engage in challenging behavior that requires individualized intervention to remediate. However, access to high-quality services is limited for adults, leaving this population without necessary behavioral healthcare. This study addressed the needs of a 22-year-old man with ASD and intellectual disability (ID) who lived with his grandmother and engaged in tangibly maintained challenging behavior. The interventionist coached his grandmother via telehealth in the implementation of two behavior analytic interventions: signaled multiple schedule arrangement and a modified contingency contract. The effects of the interventions were evaluated using an alternating treatments design with baseline. While both interventions were effective at decreasing challenging behavior when compared to baseline, the signaled multiple schedule arrangement resulted in zero instances of challenging behavior. Both the participant and the grandparent completed post-intervention social validity assessments and reported overall positive satisfaction with the interventions. Practice recommendations are presented.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65484220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Therapist-Assisted Internet-Delivered Cognitive Behavioral Therapy for Insomnia: A Case Report 治疗师辅助互联网提供的失眠认知行为治疗：一例报告

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-03-02 DOI: 10.1177/15346501221145944

Meredith S. H. Landy, Leorra Newman, Alison E. Carney, Victoria Donkin, Jocelyn Nicholls, S. Krol, P. Farvolden

Despite its well-documented efficacy, few clinicians are trained to deliver Cognitive Behavioral Therapy for Insomnia (CBT-I), and it remains an inaccessible treatment. Therapist-Assisted Internet-Delivered Cognitive Behavioral Therapy for Insomnia (TAI-CBT-I) holds promise for overcoming barriers to accessing this evidence-based treatment. However, to date, there have been no case reports published that describe how to deliver TAI-CBT-I. This case report fills in this gap by illustrating the application and utility of such a treatment on an asynchronous platform. We report on a course of TAI-CBT-I for a 34-year-old Caribbean Canadian male who presented with chronic insomnia characterized by difficulty falling and staying asleep, night awakenings, and reduced helpfulness from medication. Self-report measures of sleep, depression, functioning and ability, and therapist satisfaction were administered throughout treatment, post-discharge, and at follow-up. Improvement was noted across all measures. This case report demonstrates that TAI-CBT-I can be an effective treatment for chronic insomnia and showcases how to deliver it.

尽管认知行为疗法(CBT-I)的疗效有据可查，但很少有临床医生接受过提供失眠认知行为疗法(CBT-I)的培训，而且它仍然是一种难以获得的治疗方法。治疗师辅助网络认知行为治疗失眠(TAI-CBT-I)有望克服障碍，获得这种循证治疗。然而，到目前为止，还没有发表的病例报告描述如何提供TAI-CBT-I。本案例报告通过说明这种处理在异步平台上的应用程序和实用程序填补了这一空白。我们报告一名34岁加勒比海加拿大男性的taii - cbt - i疗程，他表现为慢性失眠，其特征是难以入睡和保持睡眠，夜间醒来，药物治疗的帮助减少。在整个治疗过程、出院后和随访中，对睡眠、抑郁、功能和能力以及治疗师满意度进行自我报告测量。所有指标均有所改善。本病例报告表明，TAI-CBT-I可以有效治疗慢性失眠，并展示了如何实现它。

{"title":"Therapist-Assisted Internet-Delivered Cognitive Behavioral Therapy for Insomnia: A Case Report","authors":"Meredith S. H. Landy, Leorra Newman, Alison E. Carney, Victoria Donkin, Jocelyn Nicholls, S. Krol, P. Farvolden","doi":"10.1177/15346501221145944","DOIUrl":"https://doi.org/10.1177/15346501221145944","url":null,"abstract":"Despite its well-documented efficacy, few clinicians are trained to deliver Cognitive Behavioral Therapy for Insomnia (CBT-I), and it remains an inaccessible treatment. Therapist-Assisted Internet-Delivered Cognitive Behavioral Therapy for Insomnia (TAI-CBT-I) holds promise for overcoming barriers to accessing this evidence-based treatment. However, to date, there have been no case reports published that describe how to deliver TAI-CBT-I. This case report fills in this gap by illustrating the application and utility of such a treatment on an asynchronous platform. We report on a course of TAI-CBT-I for a 34-year-old Caribbean Canadian male who presented with chronic insomnia characterized by difficulty falling and staying asleep, night awakenings, and reduced helpfulness from medication. Self-report measures of sleep, depression, functioning and ability, and therapist satisfaction were administered throughout treatment, post-discharge, and at follow-up. Improvement was noted across all measures. This case report demonstrates that TAI-CBT-I can be an effective treatment for chronic insomnia and showcases how to deliver it.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46617665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Skills Training in Affective and Interpersonal Regulation Narrative Therapy Delivered via Synchronous Telehealth: A Case Study of a Rural Woman Veteran With Complex Posttraumatic Stress Disorder 通过同步远程健康进行情感和人际调节叙事治疗的技能训练——一名患有复杂创伤后应激障碍的农村女退伍军人的个案研究

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-02-20 DOI: 10.1177/15346501231158400

B. Zaccari, T. Lovejoy, Maya E. O’Neil

The International Classification of Diseases–11 th Revision (ICD-11) includes the diagnosis of complex posttraumatic stress disorder (CPTSD). Clinical practice guidelines support the use of phased care for individuals with CPTSD. This case study illustrates the use of synchronous telehealth to deliver phased treatment to a rural woman veteran with CPTSD. Mrs. A experienced sexual, physical, and emotional abuse throughout her life, perpetrated by family members, intimate partners, and military authority figures. She sought treatment for posttraumatic nightmares and body image issues; she also had pain related to fibromyalgia and chronic migraine headaches. Mrs. A participated in 19 sessions of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative therapy via synchronous telehealth. Trauma and eating disorder symptoms were assessed before and after treatment and the patient demonstrated clinically significant improvement on measures of these disorders. Patient-provider working alliance and quality of life were assessed post-treatment. Synchronous telehealth use drastically increased with the onset of COVID-19; however, little information on treating CPTSD via synchronous video teleconferencing is available. This case study illustrates an evidence-based, phased therapy for CPTSD while highlighting the feasibility and value of in-home delivery of psychotherapy for CPTSD via synchronous telehealth.

国际疾病分类第11次修订版（ICD-11）包括复杂创伤后应激障碍（CPTSD）的诊断。临床实践指南支持对CPTSD患者使用分阶段护理。本案例研究说明了使用同步远程医疗为一名患有CPTSD的农村女性退伍军人提供分阶段治疗。A女士一生都遭受过家庭成员、亲密伴侣和军事权威人士的性虐待、身体虐待和情感虐待。她寻求治疗创伤后的噩梦和身体形象问题；她还患有纤维肌痛和慢性偏头痛。A女士通过同步远程医疗参加了19期情感和人际调节技能培训（STAIR）叙事治疗。在治疗前后评估创伤和饮食障碍症状，患者在这些障碍的测量方面表现出临床显著改善。治疗后评估患者-提供者工作联盟和生活质量。随着新冠肺炎的爆发，同步远程医疗的使用急剧增加；然而，关于通过同步视频电话会议治疗CPTSD的信息很少。本案例研究说明了一种基于证据的、分阶段的CPTSD治疗方法，同时强调了通过同步远程医疗在家提供CPTSD心理治疗的可行性和价值。

{"title":"Skills Training in Affective and Interpersonal Regulation Narrative Therapy Delivered via Synchronous Telehealth: A Case Study of a Rural Woman Veteran With Complex Posttraumatic Stress Disorder","authors":"B. Zaccari, T. Lovejoy, Maya E. O’Neil","doi":"10.1177/15346501231158400","DOIUrl":"https://doi.org/10.1177/15346501231158400","url":null,"abstract":"The International Classification of Diseases–11 th Revision (ICD-11) includes the diagnosis of complex posttraumatic stress disorder (CPTSD). Clinical practice guidelines support the use of phased care for individuals with CPTSD. This case study illustrates the use of synchronous telehealth to deliver phased treatment to a rural woman veteran with CPTSD. Mrs. A experienced sexual, physical, and emotional abuse throughout her life, perpetrated by family members, intimate partners, and military authority figures. She sought treatment for posttraumatic nightmares and body image issues; she also had pain related to fibromyalgia and chronic migraine headaches. Mrs. A participated in 19 sessions of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative therapy via synchronous telehealth. Trauma and eating disorder symptoms were assessed before and after treatment and the patient demonstrated clinically significant improvement on measures of these disorders. Patient-provider working alliance and quality of life were assessed post-treatment. Synchronous telehealth use drastically increased with the onset of COVID-19; however, little information on treating CPTSD via synchronous video teleconferencing is available. This case study illustrates an evidence-based, phased therapy for CPTSD while highlighting the feasibility and value of in-home delivery of psychotherapy for CPTSD via synchronous telehealth.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42415765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increasing Food Consumption With an Antecedent and Reinforcement-Based Treatment Generalized Via Telehealth 通过远程医疗推广的基于前因和强化的治疗增加食物消费

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2023-01-04 DOI: 10.1177/15346501221149974

Lisa Tereshko, M. Weiss, A. Granfield

We report a case with a 7-year-old girl with autism spectrum disorder and anxiety disorder who had severe restrictive eating leading to various medical concerns raised by her pediatrician. Following medical consultation and a descriptive functional assessment, a therapist implemented behavioral intervention consisting of a visual cue, choice, and differential reinforcement of alternative behaviors. The intervention was focused on both in-home meals and telehealth consultation during mealtimes, as the COVID-19 pandemic necessitated moving to remote consultation for continued treatment. The success of this study has long-standing implications for the benefits of positive feeding interventions and telehealth as well as parental training strategies.

我们报告了一个7岁的患有自闭症谱系障碍和焦虑症的女孩，她有严重的限制性饮食，导致她的儿科医生提出了各种医疗问题。在医疗咨询和描述性功能评估之后，治疗师实施了行为干预，包括视觉提示、选择和不同行为的差异强化。干预措施的重点是在家用餐和用餐时间的远程医疗咨询，因为COVID-19大流行需要转向远程咨询以继续治疗。这项研究的成功对积极喂养干预和远程医疗以及父母培训策略的益处具有长期意义。

引用次数: 1

The Impact of Maternal Depression on Internet-Parent–Child Interaction Therapy for Child Attention-Deficit/Hyperactivity Disorder: A Case Study 母亲抑郁对儿童注意力缺陷/多动障碍网络亲子互动治疗的影响：一项个案研究

IF 1 4区心理学 Q3 Psychology

Clinical Case Studies

Pub Date : 2022-12-09 DOI: 10.1177/15346501221145662

Lindsay R. Druskin, Erinn J. Victory, Robin C. Han, Sharon T. Phillips, Emily Aman, C. McNeil

Conduct disorders and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid, with an estimated prevalence rate of 51.5% for children between 2–17 years of age (Centers for Disease Control and Prevention, 2020). Parent–Child Interaction Therapy (PCIT) is an empirically supported behavioral parent training program for children with disruptive behavior. PCIT research consistently demonstrates decreases in disruptive behaviors and increases in positive parenting strategies among families of young children with ADHD; however, PCIT has yet to become widely recognized as a treatment for ADHD. This case study presents the treatment of a 6-year-old boy with ADHD and severe behavior problems. The case was further impacted by the single mother’s depressive symptoms and internet delivery of PCIT during the COVID-19 pandemic. Findings from this case report documented an improvement in disruptive child behaviors and emotion regulation and increased positivity during parent–child interactions, despite worsening maternal depressive symptoms. This case study highlights the utility of PCIT to improve child disruptive behaviors and ADHD symptoms in the midst of several complicating factors.

行为障碍和注意力缺陷/多动障碍（ADHD）是高度共病，2-17岁儿童的患病率估计为51.5%（疾病控制和预防中心，2020）。亲子互动治疗（PCIT）是一项经验支持的行为父母培训计划，针对有破坏性行为的儿童。PCIT研究一致表明，在患有多动症的幼儿家庭中，破坏性行为减少，积极的育儿策略增加；然而，PCIT作为多动症的一种治疗方法尚未得到广泛认可。本案例研究介绍了一名患有多动症和严重行为问题的6岁男孩的治疗方法。在新冠肺炎大流行期间，单身母亲的抑郁症状和PCIT的互联网交付进一步影响了该病例。该病例报告的研究结果表明，尽管母亲的抑郁症状不断恶化，但破坏性儿童行为和情绪调节有所改善，亲子互动中的积极性也有所提高。这项案例研究强调了PCIT在几个复杂因素中改善儿童破坏性行为和多动症症状的效用。

{"title":"The Impact of Maternal Depression on Internet-Parent–Child Interaction Therapy for Child Attention-Deficit/Hyperactivity Disorder: A Case Study","authors":"Lindsay R. Druskin, Erinn J. Victory, Robin C. Han, Sharon T. Phillips, Emily Aman, C. McNeil","doi":"10.1177/15346501221145662","DOIUrl":"https://doi.org/10.1177/15346501221145662","url":null,"abstract":"Conduct disorders and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid, with an estimated prevalence rate of 51.5% for children between 2–17 years of age (Centers for Disease Control and Prevention, 2020). Parent–Child Interaction Therapy (PCIT) is an empirically supported behavioral parent training program for children with disruptive behavior. PCIT research consistently demonstrates decreases in disruptive behaviors and increases in positive parenting strategies among families of young children with ADHD; however, PCIT has yet to become widely recognized as a treatment for ADHD. This case study presents the treatment of a 6-year-old boy with ADHD and severe behavior problems. The case was further impacted by the single mother’s depressive symptoms and internet delivery of PCIT during the COVID-19 pandemic. Findings from this case report documented an improvement in disruptive child behaviors and emotion regulation and increased positivity during parent–child interactions, despite worsening maternal depressive symptoms. This case study highlights the utility of PCIT to improve child disruptive behaviors and ADHD symptoms in the midst of several complicating factors.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46599764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1