Pub Date : 2022-08-01DOI: 10.1177/15346501211073595
Alma Teresa C Molino, Kathryn D Kriegshauser, Dakota McNamara Thornblade
Social anxiety disorder (SAD) is a condition in which people consistently and persistently experience significant fear and/or anxiety about one or more social situations in which they may be scrutinized and negatively evaluated. SAD has historically been found to respond well to cognitive-behavioral therapy (CBT) delivered both in-person and via telehealth; however, comparatively little information is available regarding response to treatment in the context of Coronavirus Disease 2019 (COVID-19) pandemic social and physical distancing guidelines, which have affected the way in which behavioral health services are delivered, as well as opportunities for interpersonal interactions which are either spontaneous or assigned as exposures. The current case study describes "Jennifer" (a pseudonym), a college student with a primary diagnosis of SAD, who was treated with primarily CBT interventions for 18 individual sessions over the course of approximately 6 months, which included treatment with a psychologist and a graduate student, implemented both in-person and via telehealth, both before and during the COVID-19 pandemic. Jennifer responded well to treatment, as evidenced by her self-report and decreases in symptom measure scores, engaged in CBT adapted to pandemic restrictions, and was able to utilize strategies learned during SAD treatment to address generalized anxiety and pandemic-related concerns. This case study demonstrates the feasibility of transitioning SAD care between providers and formats, as well as the robustness and flexibility of CBT strategies in the face of significant change, stress, and limitations of the external environment.
{"title":"Transitioning From In-Person to Telehealth Cognitive-Behavioral Therapy for Social Anxiety Disorder During the COVID-19 Pandemic: A Case Study in Flexibility in an Adverse Context.","authors":"Alma Teresa C Molino, Kathryn D Kriegshauser, Dakota McNamara Thornblade","doi":"10.1177/15346501211073595","DOIUrl":"10.1177/15346501211073595","url":null,"abstract":"<p><p>Social anxiety disorder (SAD) is a condition in which people consistently and persistently experience significant fear and/or anxiety about one or more social situations in which they may be scrutinized and negatively evaluated. SAD has historically been found to respond well to cognitive-behavioral therapy (CBT) delivered both in-person and via telehealth; however, comparatively little information is available regarding response to treatment in the context of Coronavirus Disease 2019 (COVID-19) pandemic social and physical distancing guidelines, which have affected the way in which behavioral health services are delivered, as well as opportunities for interpersonal interactions which are either spontaneous or assigned as exposures. The current case study describes \"Jennifer\" (a pseudonym), a college student with a primary diagnosis of SAD, who was treated with primarily CBT interventions for 18 individual sessions over the course of approximately 6 months, which included treatment with a psychologist and a graduate student, implemented both in-person and via telehealth, both before and during the COVID-19 pandemic. Jennifer responded well to treatment, as evidenced by her self-report and decreases in symptom measure scores, engaged in CBT adapted to pandemic restrictions, and was able to utilize strategies learned during SAD treatment to address generalized anxiety and pandemic-related concerns. This case study demonstrates the feasibility of transitioning SAD care between providers and formats, as well as the robustness and flexibility of CBT strategies in the face of significant change, stress, and limitations of the external environment.</p>","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"273-290"},"PeriodicalIF":1.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44459311","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}
Pub Date : 2022-07-19DOI: 10.1177/15346501221115113
Samuel D. Spencer, Monet S Meyer, A. Masuda
Acceptance and commitment therapy (ACT) is a process-based, transdiagnostic approach to treatment that seeks to increase values-based, adaptive functioning (i.e., engaged living [EL]) in part through attenuating the impact of experiential avoidance (EA). The present case-series study examined EL and EA as mechanisms of change within a 10-week course of individual ACT delivered via a telehealth platform. Participants were two adult women with mental health concerns associated with clinically elevated EA. Throughout the study, we collected (a) daily self-monitored clinically relevant behaviors, (b) daily and weekly measures of EL and EA, and (c) pre-, mid-, post-treatment, and 3-month follow-up measures of psychopathology, quality of life, and ACT-related outcome variables. Results showed support for the efficacy of ACT, with both participants demonstrating slight improvements in clinically relevant behaviors, along with expected improvements in EL and EA. These favorable results were most pronounced for Participant 1. Results are discussed in the context of COVID-19-related adaptations (including telehealth), and within the framework of process-based ACT and its transdiagnostic applicability to a range of mental health concerns.
{"title":"A Case-Series Study Examining Acceptance and Commitment Therapy for Experiential Avoidance-Related Mixed Anxiety and Depression in a Telehealth Platform","authors":"Samuel D. Spencer, Monet S Meyer, A. Masuda","doi":"10.1177/15346501221115113","DOIUrl":"https://doi.org/10.1177/15346501221115113","url":null,"abstract":"Acceptance and commitment therapy (ACT) is a process-based, transdiagnostic approach to treatment that seeks to increase values-based, adaptive functioning (i.e., engaged living [EL]) in part through attenuating the impact of experiential avoidance (EA). The present case-series study examined EL and EA as mechanisms of change within a 10-week course of individual ACT delivered via a telehealth platform. Participants were two adult women with mental health concerns associated with clinically elevated EA. Throughout the study, we collected (a) daily self-monitored clinically relevant behaviors, (b) daily and weekly measures of EL and EA, and (c) pre-, mid-, post-treatment, and 3-month follow-up measures of psychopathology, quality of life, and ACT-related outcome variables. Results showed support for the efficacy of ACT, with both participants demonstrating slight improvements in clinically relevant behaviors, along with expected improvements in EL and EA. These favorable results were most pronounced for Participant 1. Results are discussed in the context of COVID-19-related adaptations (including telehealth), and within the framework of process-based ACT and its transdiagnostic applicability to a range of mental health concerns.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"22 1","pages":"78 - 96"},"PeriodicalIF":1.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48218308","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}
Pub Date : 2022-06-05DOI: 10.1177/15346501221107133
Ellen F. Finch, Bethany Shikatani, A. Snir, L. Smith
Elimination disorders are common in children, and numerous psychosocial treatments for pediatric enuresis and encopresis are available to guide clinicians. However, only five cases of functional elimination disorders in adults are published to date, all of which involve severe comorbid psychopathology, and no treatment guidelines for adult elimination disorders exist. This case report presents, to our knowledge, the first documented case of functional elimination disorder in an otherwise healthy, high-functioning adult. “Ben” is a 20-year-old male who sought treatment for chronic enuresis and encopresis, as well as difficulties with procrastination of schoolwork. Ben engaged in 21 weeks of cognitive behavioral therapy and reported substantial decreases in elimination disorder symptoms. However, improvements fluctuated throughout treatment and remained present at mild levels at 3-month follow-up. This report outlines the cognitive behavioral interventions applied throughout this treatment, which consisted of pediatric elimination disorder interventions adapted for an adult with additional cognitive behavioral tools.
{"title":"Treating Volitional Elimination Disorders in a Healthy Adult: Applying Cognitive Behavioral Principles in the Absence of Treatment Guidelines","authors":"Ellen F. Finch, Bethany Shikatani, A. Snir, L. Smith","doi":"10.1177/15346501221107133","DOIUrl":"https://doi.org/10.1177/15346501221107133","url":null,"abstract":"Elimination disorders are common in children, and numerous psychosocial treatments for pediatric enuresis and encopresis are available to guide clinicians. However, only five cases of functional elimination disorders in adults are published to date, all of which involve severe comorbid psychopathology, and no treatment guidelines for adult elimination disorders exist. This case report presents, to our knowledge, the first documented case of functional elimination disorder in an otherwise healthy, high-functioning adult. “Ben” is a 20-year-old male who sought treatment for chronic enuresis and encopresis, as well as difficulties with procrastination of schoolwork. Ben engaged in 21 weeks of cognitive behavioral therapy and reported substantial decreases in elimination disorder symptoms. However, improvements fluctuated throughout treatment and remained present at mild levels at 3-month follow-up. This report outlines the cognitive behavioral interventions applied throughout this treatment, which consisted of pediatric elimination disorder interventions adapted for an adult with additional cognitive behavioral tools.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"22 1","pages":"60 - 77"},"PeriodicalIF":1.0,"publicationDate":"2022-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46869976","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}
Pub Date : 2022-05-29DOI: 10.1177/15346501221091273
Lindsey Grove, A. I. Roche, Rena Doyle, Z. Stowe, E. Thomas
The literature describing psychological interventions for co-occurring obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) is limited. Acceptance and Commitment Therapy (ACT) is a transdiagnostic intervention that targets functionally avoidant behavior underlying both OCD and PTSD. The current case report describes how an ACT-informed approach to treatment was implemented over 14 sessions to treat co-occurring OCD and PTSD in a 9-months postpartum adult woman. The patient was initially referred to psychotherapy by her psychiatrist and showed high motivation to engage in treatment. This case presentation outlines how the intervention targeted core ACT processes while also incorporating components from both exposure and response prevention (ERP) and cognitive processing therapy (CPT) to address the patient’s presenting concerns. Measurements of OCD and PTSD symptom severity, as well as of depressive and anxiety symptoms, over the course of treatment are included. Health-related comorbidities, psychiatric medications, and implications are discussed.
{"title":"ACT-Informed Treatment of Co-morbid Psychiatric Disorders in the Postpartum Period: A Case Report","authors":"Lindsey Grove, A. I. Roche, Rena Doyle, Z. Stowe, E. Thomas","doi":"10.1177/15346501221091273","DOIUrl":"https://doi.org/10.1177/15346501221091273","url":null,"abstract":"The literature describing psychological interventions for co-occurring obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) is limited. Acceptance and Commitment Therapy (ACT) is a transdiagnostic intervention that targets functionally avoidant behavior underlying both OCD and PTSD. The current case report describes how an ACT-informed approach to treatment was implemented over 14 sessions to treat co-occurring OCD and PTSD in a 9-months postpartum adult woman. The patient was initially referred to psychotherapy by her psychiatrist and showed high motivation to engage in treatment. This case presentation outlines how the intervention targeted core ACT processes while also incorporating components from both exposure and response prevention (ERP) and cognitive processing therapy (CPT) to address the patient’s presenting concerns. Measurements of OCD and PTSD symptom severity, as well as of depressive and anxiety symptoms, over the course of treatment are included. Health-related comorbidities, psychiatric medications, and implications are discussed.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"22 1","pages":"38 - 59"},"PeriodicalIF":1.0,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44604875","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}
Pub Date : 2022-05-29DOI: 10.1177/15346501221090267
Carlos López-Pinar, Andrea Vicente-Gispert
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder among college students. Although there is growing literature supporting the effectiveness of cognitive behavioral therapy (CBT) for this population, no previous study has investigated the feasibility of it being delivered online. In addition, recent evidence suggests that online therapy could be possible for other diagnoses such as depression, anxiety, or health-related disorders. Therefore, research in this area could be critical, as online settings could also improve accessibility to evidence-based interventions for college students with ADHD. This study describes the implementation of CBT for ADHD intervention delivered online for two college students with this diagnosis. We found improvements in both self-reported and clinician-assessed outcomes, in measuring ADHD-related behaviors, executive functioning, emotional comorbidities, and quality of life. These changes were more evident in the case that was more severe at pre-treatment, and were maintained at a 6-month follow-up; even further improvements in self-reported quality of life were observed. These findings support the potential feasibility and clinical utility of online CBT in this population.
{"title":"Online Cognitive Behavior Therapy for Two College Students With Attention-Deficit/Hyperactivity Disorder","authors":"Carlos López-Pinar, Andrea Vicente-Gispert","doi":"10.1177/15346501221090267","DOIUrl":"https://doi.org/10.1177/15346501221090267","url":null,"abstract":"Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder among college students. Although there is growing literature supporting the effectiveness of cognitive behavioral therapy (CBT) for this population, no previous study has investigated the feasibility of it being delivered online. In addition, recent evidence suggests that online therapy could be possible for other diagnoses such as depression, anxiety, or health-related disorders. Therefore, research in this area could be critical, as online settings could also improve accessibility to evidence-based interventions for college students with ADHD. This study describes the implementation of CBT for ADHD intervention delivered online for two college students with this diagnosis. We found improvements in both self-reported and clinician-assessed outcomes, in measuring ADHD-related behaviors, executive functioning, emotional comorbidities, and quality of life. These changes were more evident in the case that was more severe at pre-treatment, and were maintained at a 6-month follow-up; even further improvements in self-reported quality of life were observed. These findings support the potential feasibility and clinical utility of online CBT in this population.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"22 1","pages":"18 - 37"},"PeriodicalIF":1.0,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48924491","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}
Pub Date : 2022-05-22DOI: 10.1177/15346501221092112
Laura E. Phipps, Sarah D Haney, Jason R. Zeleny, Ashley S. Andersen, Kathryn M. Peterson, Stephanie Orloski
Oral-motor skills needed for efficient consumption of table-textured foods (e.g., tongue lateralization) often develop as children are exposed to food at increasingly higher textures (e.g., soft meltable, crunchy, and chewy; Volkert et al., 2014). For children with avoidant/restrictive food intake disorder (ARFID; American Psychiatric Association, 2013; World Health Organization, 2019), these oral-motor skills may not develop without intervention. We review case studies of three children diagnosed with ARFID who did not display the skills necessary for efficient consumption of regular table-textured food. We collaborated with a speech-language pathologist to identify oral-motor targets and used a behavior-analytic treatment to teach tongue lateralization skills necessary for safe and effective chewing. We used a treatment package consisting of nonremoval of the utensil with prompting and differential reinforcement to shape functional tongue movements. We discuss considerations for practitioners and the importance of individualized treatment and collaboration with other disciplines while teaching oral-motor skills necessary for chewing and consuming table-textured food.
当儿童接触到质地越来越高的食物(如软的、易融化的、脆的、有嚼劲的;Volkert et al.， 2014)。对于有回避/限制性食物摄入障碍(ARFID)的儿童;美国精神病学协会，2013;世界卫生组织，2019年)，如果没有干预，这些口腔运动技能可能无法发展。我们回顾了三个被诊断为ARFID的儿童的案例研究，他们没有显示出有效食用普通餐桌食物所需的技能。我们与语言病理学家合作，确定口腔运动目标，并使用行为分析治疗来教授安全有效咀嚼所需的舌侧化技能。我们使用了一个治疗包，包括不移除的器具与提示和差别强化塑造功能舌运动。我们讨论了从业者的考虑和个性化治疗的重要性以及与其他学科合作，同时教授咀嚼和食用餐桌质地食物所需的口腔运动技能。
{"title":"Using Behavior-Analytic Treatment to Teach Tongue Lateralization Skills to Children With Avoidant/Restrictive Food Intake Disorder","authors":"Laura E. Phipps, Sarah D Haney, Jason R. Zeleny, Ashley S. Andersen, Kathryn M. Peterson, Stephanie Orloski","doi":"10.1177/15346501221092112","DOIUrl":"https://doi.org/10.1177/15346501221092112","url":null,"abstract":"Oral-motor skills needed for efficient consumption of table-textured foods (e.g., tongue lateralization) often develop as children are exposed to food at increasingly higher textures (e.g., soft meltable, crunchy, and chewy; Volkert et al., 2014). For children with avoidant/restrictive food intake disorder (ARFID; American Psychiatric Association, 2013; World Health Organization, 2019), these oral-motor skills may not develop without intervention. We review case studies of three children diagnosed with ARFID who did not display the skills necessary for efficient consumption of regular table-textured food. We collaborated with a speech-language pathologist to identify oral-motor targets and used a behavior-analytic treatment to teach tongue lateralization skills necessary for safe and effective chewing. We used a treatment package consisting of nonremoval of the utensil with prompting and differential reinforcement to shape functional tongue movements. We discuss considerations for practitioners and the importance of individualized treatment and collaboration with other disciplines while teaching oral-motor skills necessary for chewing and consuming table-textured food.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"22 1","pages":"3 - 17"},"PeriodicalIF":1.0,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44325974","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}
Pub Date : 2022-05-18DOI: 10.1177/15346501221091519
Ana Ganho-Ávila, Diana Vieira Figueiredo, P. Vagos
SAD is an intense fear or anxiety associated with past, current, or future social situations. The Clark and Wells (1995) cognitive model for SAD has been proved to be clinically effective in adults, and its developmentally sensitive adaptations for adolescents have recently shown promising results. Given this evidence and considering that adolescence is typically the age of onset for the first SAD symptoms and a critical developmental period for the delivery of evidence-based interventions, we adapted CT for adolescents for online intervention (CT@TeenSAD) encompassing 10 weekly, 90 min sessions, extended by two booster sessions. This work presents the first case study of that intervention as applied to Merida (M.; pseudonym; 17-year-old, girl). The estimated Reliable Change Index shows M.’s progress for most of her symptoms, from pre-to post-treatment (RCI-1 range: −.53 to −8.03), and the maintenance of benefits at 3 months follow-up (RCI-2 range: .00 to −2.25). A relapse in the adoption of safety behaviors was seen between post-treatment and follow-up, which might be explained by the life-changing challenges experienced by M. between session 10 and follow-up, concerning her transition from high school to college. M.’s case study offers a first glance on the promising results of CT@TeenSAD related to its efficacy and feasibility. Likewise, it offers the opportunity to critically appraise the limitations of the intervention as well as practical challenges and suggestions thought to be useful for therapists willing to implement CT@TeenSAD in the future.
{"title":"Online Cognitive Therapy for Social Anxiety Disorder in Adolescence: A Clinical Case Study Using the CT@TeenSAD","authors":"Ana Ganho-Ávila, Diana Vieira Figueiredo, P. Vagos","doi":"10.1177/15346501221091519","DOIUrl":"https://doi.org/10.1177/15346501221091519","url":null,"abstract":"SAD is an intense fear or anxiety associated with past, current, or future social situations. The Clark and Wells (1995) cognitive model for SAD has been proved to be clinically effective in adults, and its developmentally sensitive adaptations for adolescents have recently shown promising results. Given this evidence and considering that adolescence is typically the age of onset for the first SAD symptoms and a critical developmental period for the delivery of evidence-based interventions, we adapted CT for adolescents for online intervention (CT@TeenSAD) encompassing 10 weekly, 90 min sessions, extended by two booster sessions. This work presents the first case study of that intervention as applied to Merida (M.; pseudonym; 17-year-old, girl). The estimated Reliable Change Index shows M.’s progress for most of her symptoms, from pre-to post-treatment (RCI-1 range: −.53 to −8.03), and the maintenance of benefits at 3 months follow-up (RCI-2 range: .00 to −2.25). A relapse in the adoption of safety behaviors was seen between post-treatment and follow-up, which might be explained by the life-changing challenges experienced by M. between session 10 and follow-up, concerning her transition from high school to college. M.’s case study offers a first glance on the promising results of CT@TeenSAD related to its efficacy and feasibility. Likewise, it offers the opportunity to critically appraise the limitations of the intervention as well as practical challenges and suggestions thought to be useful for therapists willing to implement CT@TeenSAD in the future.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"533 - 551"},"PeriodicalIF":1.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42974548","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}
Pub Date : 2022-05-18DOI: 10.1177/15346501221091790
L. Botter, D. Gerritsen, R. O. Oude Voshaar
The use of schema therapy to treat personality disorders in older adults is gaining scientific attention. Personality disorders are prevalent in one out of ten older adults and have a detrimental effect on quality of life. Although 24% or more of nursing home residents may have personality disorders, psychotherapeutic treatment options in the case of comorbid cognitive impairment have not yet been studied. This study concerns a 63-year-old care-dependent male nursing home resident with a personality disorder, a substance use disorder, and several cognitive impairments due to cerebrovascular disease, who presented with complaints of loneliness, low self-esteem, sleeping problems and anger outbursts. Schema therapy was delivered based on the schema mode model for a period of 27 months. Post-treatment assessment demonstrated a decrease in early maladaptive schemas and dysfunctional schema modes and improved personality functioning overall. Although situational psychological distress fluctuated throughout treatment, quality of life improved after 7 months and remained stable onwards. Presented complaints either remitted or strongly diminished. Substance use was also addressed and was in remission for the last 20 months of therapy. This case study suggests that schema therapy is a viable treatment for older adults with personality disorders who present with cognitive impairments in nursing homes.
{"title":"Schema Therapy in the Nursing Home Setting: A Case Study of a Cognitively Impaired Patient","authors":"L. Botter, D. Gerritsen, R. O. Oude Voshaar","doi":"10.1177/15346501221091790","DOIUrl":"https://doi.org/10.1177/15346501221091790","url":null,"abstract":"The use of schema therapy to treat personality disorders in older adults is gaining scientific attention. Personality disorders are prevalent in one out of ten older adults and have a detrimental effect on quality of life. Although 24% or more of nursing home residents may have personality disorders, psychotherapeutic treatment options in the case of comorbid cognitive impairment have not yet been studied. This study concerns a 63-year-old care-dependent male nursing home resident with a personality disorder, a substance use disorder, and several cognitive impairments due to cerebrovascular disease, who presented with complaints of loneliness, low self-esteem, sleeping problems and anger outbursts. Schema therapy was delivered based on the schema mode model for a period of 27 months. Post-treatment assessment demonstrated a decrease in early maladaptive schemas and dysfunctional schema modes and improved personality functioning overall. Although situational psychological distress fluctuated throughout treatment, quality of life improved after 7 months and remained stable onwards. Presented complaints either remitted or strongly diminished. Substance use was also addressed and was in remission for the last 20 months of therapy. This case study suggests that schema therapy is a viable treatment for older adults with personality disorders who present with cognitive impairments in nursing homes.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"552 - 570"},"PeriodicalIF":1.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46162733","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}
Pub Date : 2022-05-17DOI: 10.1177/15346501221092415
Kaytryn D. Campbell, Amanda J. Hasselle, Kathryn H. Howell
Childhood victimization can negatively affect children’s self-perception, a multifaceted developmental asset that can be delineated into Global Self-Worth, Social Competence, and Behavioral Conduct. Despite the importance of self-perception, few studies have examined how strengths-based interventions impact self-perception among youth experiencing victimization. Using a familial case study design, the current study evaluated how a camp-based intervention, known as Camp HOPE, affected self-perception among siblings who experienced childhood victimization. Participants included three siblings and their mother who all identify as Black/African American and reside in the Midsouth, United States. The siblings participated in a week-long, overnight camp with other children exposed to victimization. The family was evaluated across three timepoints: pre-camp, 1 month post-camp, and 4 months post-camp. Participating in Camp HOPE appeared to have differential effects on the siblings’ self-perception. Specifically, all three children endorsed small to medium improvements in perceived Behavioral Conduct, but the camp differentially impacted their Global Self-Worth and Social Competence. Findings suggest that Camp HOPE may enhance self-perception among Black/African American children who have experienced victimization. This intervention may also be more accessible and acceptable, compared to traditional treatment formats.
{"title":"A Familial Case Study Exploring the Effects of a Strengths-Based Camp Intervention on Children’s Self-Perception","authors":"Kaytryn D. Campbell, Amanda J. Hasselle, Kathryn H. Howell","doi":"10.1177/15346501221092415","DOIUrl":"https://doi.org/10.1177/15346501221092415","url":null,"abstract":"Childhood victimization can negatively affect children’s self-perception, a multifaceted developmental asset that can be delineated into Global Self-Worth, Social Competence, and Behavioral Conduct. Despite the importance of self-perception, few studies have examined how strengths-based interventions impact self-perception among youth experiencing victimization. Using a familial case study design, the current study evaluated how a camp-based intervention, known as Camp HOPE, affected self-perception among siblings who experienced childhood victimization. Participants included three siblings and their mother who all identify as Black/African American and reside in the Midsouth, United States. The siblings participated in a week-long, overnight camp with other children exposed to victimization. The family was evaluated across three timepoints: pre-camp, 1 month post-camp, and 4 months post-camp. Participating in Camp HOPE appeared to have differential effects on the siblings’ self-perception. Specifically, all three children endorsed small to medium improvements in perceived Behavioral Conduct, but the camp differentially impacted their Global Self-Worth and Social Competence. Findings suggest that Camp HOPE may enhance self-perception among Black/African American children who have experienced victimization. This intervention may also be more accessible and acceptable, compared to traditional treatment formats.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"571 - 587"},"PeriodicalIF":1.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46711478","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}
Pub Date : 2022-05-10DOI: 10.1177/15346501221099218
L. A. Shawler, Joy C. Clayborne, Julia T. O’Connor
Behaviors maintained by automatic reinforcement are often more difficult to treat due to difficulty with identifying the relevant maintaining variable(s). One common intervention to treat automatically maintained behavior includes competing stimuli. Competing stimuli promote item engagement which may replace challenging behavior (i.e., response competition). Competing stimuli have shown to be a widely successful intervention across diverse topographies of challenging behavior; however, few studies have evaluated the use of competing stimuli on destructive behavior. The purpose of the current study was to treat automatically maintained destructive behavior with a competing stimuli intervention package for an adolescent with developmental disabilities. Results showed a decrease in destructive behavior when access to competing stimuli was a component of an intervention package in a clinic setting. Also, preliminary data are provided showing treatment effects when caregivers implemented the intervention. Due to the complexity of the final intervention package, recommendations for clinicians are provided which focus on improving feasibility, practicality, and sustainability of treatment components.
{"title":"A Competing Stimuli Intervention Package to Treat Automatically Reinforced Destructive Behavior","authors":"L. A. Shawler, Joy C. Clayborne, Julia T. O’Connor","doi":"10.1177/15346501221099218","DOIUrl":"https://doi.org/10.1177/15346501221099218","url":null,"abstract":"Behaviors maintained by automatic reinforcement are often more difficult to treat due to difficulty with identifying the relevant maintaining variable(s). One common intervention to treat automatically maintained behavior includes competing stimuli. Competing stimuli promote item engagement which may replace challenging behavior (i.e., response competition). Competing stimuli have shown to be a widely successful intervention across diverse topographies of challenging behavior; however, few studies have evaluated the use of competing stimuli on destructive behavior. The purpose of the current study was to treat automatically maintained destructive behavior with a competing stimuli intervention package for an adolescent with developmental disabilities. Results showed a decrease in destructive behavior when access to competing stimuli was a component of an intervention package in a clinic setting. Also, preliminary data are provided showing treatment effects when caregivers implemented the intervention. Due to the complexity of the final intervention package, recommendations for clinicians are provided which focus on improving feasibility, practicality, and sustainability of treatment components.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"22 1","pages":"138 - 154"},"PeriodicalIF":1.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47656282","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号