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A Familial Case Study Exploring the Effects of a Strengths-Based Camp Intervention on Children’s Self-Perception 基于力量的营地干预对儿童自我感知影响的家庭案例研究
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-05-17 DOI: 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.
儿童受害会对儿童的自我认知产生负面影响,这是一种多方面的发展资产,可分为全球自我价值、社会能力和行为行为。尽管自我感知很重要,但很少有研究考察基于力量的干预措施如何影响受害青年的自我感知。通过家庭案例研究设计,目前的研究评估了基于营地的干预措施,即camp HOPE,如何影响童年受害兄弟姐妹的自我认知。参与者包括三个兄弟姐妹和他们的母亲,他们都是黑人/非裔美国人,居住在美国中南部。这对兄弟姐妹与其他受害儿童一起参加了为期一周的通宵夏令营。该家庭在三个时间点进行了评估:夏令营前、夏令营后1个月和夏令营后4个月。参加希望营似乎对兄弟姐妹的自我认知有不同的影响。具体而言,这三个孩子都支持在感知行为行为方面的中小型改善,但营地对他们的全球自我价值和社会能力产生了不同的影响。研究结果表明,希望营可能会增强受害黑人/非裔美国儿童的自我认知。与传统的治疗形式相比,这种干预措施也可能更容易获得和接受。
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引用次数: 1
A Competing Stimuli Intervention Package to Treat Automatically Reinforced Destructive Behavior 竞争刺激干预包治疗自动强化破坏性行为
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-05-10 DOI: 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.
由于难以识别相关的维持变量,由自动强化维持的行为通常更难以治疗。一种治疗自动维持行为的常见干预措施包括竞争刺激。竞争刺激促进项目参与,这可能取代挑战行为(即反应竞争)。竞争刺激已被证明是一种广泛成功的干预在不同地形的挑战行为;然而,很少有研究评估竞争性刺激对破坏性行为的影响。本研究的目的是用竞争性刺激干预包治疗发育障碍青少年的自动维持破坏性行为。结果显示,当获得竞争刺激是在诊所设置干预包的组成部分时,破坏性行为减少。此外,初步数据显示了护理人员实施干预后的治疗效果。由于最终干预方案的复杂性,为临床医生提供了建议,重点是提高治疗方案的可行性、实用性和可持续性。
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引用次数: 0
A Socially Distanced Case Study: Implementing the Unified Protocol-Adolescent in the Treatment of Comorbid Depression and Anxiety via Telehealth 社会距离案例研究:实施统一协议-青少年通过远程医疗治疗共病抑郁和焦虑
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-05-07 DOI: 10.1177/15346501221099651
McKenzie R. Martin, J. Bolden, Jaima Walton
Anxiety and depression are two of the most common mental health diagnoses in adolescents, with higher prevalence rates for gender-nonconforming youth relative to an age-equivalent population of cisgender youth (Veale et al., 2017). This case study examined the effectiveness of the Unified Protocol-Adolescent (UP-A) for a gender-nonconforming 13-year-old diagnosed with both generalized anxiety and mild depression. Amid the ongoing COVID-19 pandemic, this transdiagnostic implementation provided psychoeducation and targeted emotion identification, present-moment awareness, cognitive restructuring, and problem-solving over 21 sessions. Outcome data demonstrated significant reductions in anxiety and depression symptoms, with a notable qualitative change on three subjective measures of anxiety/depression symptoms, as ratings moved from clinical to nonclinical score ranges. Moreover, outcome data demonstrated the potential efficacy of the UP-A administered via telehealth for nonbinary youth with comorbid anxiety and depression. Clinical and research implications regarding the utility of implementing a flexible, transdiagnostic approach to treating diverse adolescents’ emotional disorders are discussed.
焦虑和抑郁是青少年中最常见的两种心理健康诊断,相对于年龄相当的顺性青少年,性别不一致的青少年的患病率更高(Veale等人,2017)。本案例研究检验了统一协议-青少年(UP-A)对一名诊断为广泛性焦虑和轻度抑郁症的性别不一致的13岁儿童的有效性。在当前的COVID-19大流行期间,这种跨诊断实施在21次会议上提供了心理教育和有针对性的情绪识别、当下意识、认知重构和问题解决。结果数据显示焦虑和抑郁症状显著减少,焦虑/抑郁症状的三个主观测量有显著的质变,评分从临床评分范围转移到非临床评分范围。此外,结果数据表明,通过远程医疗给药的UP-A对患有焦虑和抑郁共病的非二元青年的潜在疗效。关于实施灵活的跨诊断方法治疗不同青少年情绪障碍的效用的临床和研究意义进行了讨论。
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引用次数: 0
Prolonged Exposure Therapy in the Treatment of Functional Neurological Disorder and Posttraumatic Stress Disorder 延长暴露疗法治疗功能性神经障碍和创伤后应激障碍
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-05-05 DOI: 10.1177/15346501221098458
A. Putica, M. O'Donnell, K. Felmingham
Functional neurological disorder (FND) symptoms resemble neurological symptoms but are unexplained by disease or injury to the body. Psychological trauma and posttraumatic stress disorder (PTSD) are prevalent among patients with FND. This is a case report of a 64-year-old female who began treatment 2 years after developing PTSD, generalised anxiety disorder, major depressive disorder and agoraphobia following a physical assault. She subsequently developed FND approximately 18 months later. Her FND symptomology was characterised by aphasia and paraplegia. These symptoms usually lasted for a period of hours to days and usually occurred on a weekly basis. She had not previously engaged in psychological therapy due to limited insight into the relationship between her psychological and physiological symptomology. She was treated with Prolonged Exposure for PTSD (PE), and by the last session, she no longer met the diagnostic criteria for either FND or PTSD disorder. PE successfully treated both PTSD and FND. Theoretical understandings of the mechanisms underpinning this improvement are discussed.
功能性神经障碍(FND)症状类似于神经系统症状,但无法解释疾病或身体损伤。心理创伤和创伤后应激障碍(PTSD)在FND患者中普遍存在。这是一名64岁女性的病例报告,她在遭受身体攻击后出现创伤后应激障碍、广泛性焦虑症、重度抑郁症和广场恐怖症,两年后开始接受治疗。大约18个月后,她患上了FND。她的症状表现为失语和截瘫。这些症状通常持续数小时至数天,通常每周发生一次。由于对她的心理和生理症状之间的关系了解有限,她以前没有从事过心理治疗。她接受了创伤后应激障碍(PE)的长期暴露治疗,到最后一次治疗时,她不再符合FND或创伤后应激障碍的诊断标准。PE治疗PTSD和FND均成功。讨论了支持这种改进的机制的理论理解。
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引用次数: 1
Object Relations-Focused Psychoanalytic Psychotherapy in the Treatment of Narcissistic Personality Disorder 以客体关系为中心的精神分析疗法治疗自恋型人格障碍
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-05-04 DOI: 10.1177/15346501221098071
Chloe T. Cohen, T. Hulsey
The current study examines the psychotherapeutic treatment of an early-20s Caucasian male diagnosed with narcissistic personality disorder. The patient was treated with 56 sessions of psychoanalytic psychotherapy utilizing an object relations approach. Treatment aimed at decreasing the patient’s anger, anxiety, depression, and improving emotion regulation. Another focus of this patient’s treatment was helping him gain insight into the nature of his unconscious predictions and interpretations of others’ behavior in the hope that he may begin to experience relationships with greater emotional connection and less conflict. Treatment outcomes were measured using Reliable Change Index analyses, which indicated a significant reduction in anxiety, depression, anger, and emotion regulation difficulty between the beginning of treatment and the most recent session. The patient also demonstrated increased mentalization abilities and fewer anger outbursts throughout the course of treatment. During the sessions surrounding a therapeutic rupture, the patient’s emotion regulation abilities worsened temporarily; therapy shifted during this time to a more supportive analytic framework. An object relations-focused theoretical background and clinical treatment implications are discussed in relation to this case.
目前的研究调查了一名20岁早期被诊断为自恋型人格障碍的白人男性的心理治疗。患者接受了56次精神分析心理治疗,采用对象关系法。治疗旨在减少患者的愤怒、焦虑、抑郁,并改善情绪调节。该患者治疗的另一个重点是帮助他深入了解自己对他人行为的无意识预测和解释的性质,希望他能开始体验到更大的情感联系和更少的冲突。使用可靠变化指数分析来测量治疗结果,该分析表明,从治疗开始到最近一次治疗,焦虑、抑郁、愤怒和情绪调节困难显著减少。在整个治疗过程中,患者还表现出更强的心理化能力和更少的愤怒爆发。在治疗破裂期间,患者的情绪调节能力暂时恶化;在这段时间里,治疗转向了更具支持性的分析框架。以客体关系为中心的理论背景和临床治疗意义将针对本案进行讨论。
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引用次数: 1
School-Based Cognitive-Behavioral Therapy in an Inclusion Model for an Adolescent with Comorbid Major Depressive Disorder, Generalized Anxiety Disorder, and Attention Deficit Hyperactivity Disorder: A Case Study 以学校为基础的认知行为疗法纳入一名患有合并严重抑郁障碍、广泛性焦虑障碍和注意力缺陷多动障碍的青少年的模型:一项案例研究
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-04-15 DOI: 10.1177/15346501221078329
Teresa M. Goff, M. E. Moody, Liliana L. Acosta, Diana Joyce-Beaulieu
The goal of the current case study was to illustrate evidence-based cognitive-behavioral treatment (CBT) for an adolescent female with comorbid major depressive disorder, generalized anxiety disorder, attention deficit hyperactivity disorder, suicidal ideations, and a history of multiple involuntary hospitalizations. Multimodal assessment of the child’s symptoms was conducted, including parent, teacher, and child self-report, academic data, and hospital records to inform case conceptualization. Treatment included a combination of psychoeducation, cognitive restructuring, positive self-talk, relaxation skills, and the support of a school-based personal aide. Significant improvements with inattentive, anxiety, and depressive symptoms were reported, with gains being maintained at 1 year follow-up. In addition to a reduction of reported psychosocial problems, treatment benefits also included a decrease in classroom disruptions, improvement in academic performance, and withdrawal of paraprofessional support at school. This study illustrates the use of school-based CBT strategies coupled with additional focused Tier 4 behavior supports as an efficacious treatment for youth with significant comorbidity.
本案例研究的目的是说明一名患有严重抑郁症、广泛性焦虑症、注意力缺陷多动障碍、自杀意念和多次非自愿住院史的青春期女性的循证认知行为治疗(CBT)。对孩子的症状进行了多模式评估,包括家长、老师和孩子的自我报告、学术数据和医院记录,为病例概念化提供信息。治疗包括心理教育、认知重组、积极的自我对话、放松技巧和学校私人助理的支持。据报道,注意力不集中、焦虑和抑郁症状有显著改善,随访1年后仍有改善。除了减少报告的心理社会问题外,治疗的好处还包括减少课堂干扰、提高学习成绩和取消学校的非专业支持。这项研究表明,使用基于学校的CBT策略,再加上额外的重点四级行为支持,是治疗患有严重合并症的年轻人的有效方法。
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引用次数: 0
A Blended Cognitive–Behavioral Intervention for the Treatment of Postpartum Depression: A Case Study 认知-行为混合干预治疗产后抑郁症的个案研究
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-04-12 DOI: 10.1177/15346501221082616
Mariana Branquinho, M. C. Canavarro, A. Fonseca
Postpartum depression is a highly prevalent mental health problem with harmful consequences for women, babies, and mother–infant relationships. Cognitive–behavioral therapy (CBT) is among the most effective treatment options for postpartum depression. However, a large number of postpartum women do not seek professional help, suggesting the need for new treatment delivery formats. The present article describes the application of Be a Mom Coping with Depression, a blended CBT treatment for postpartum depression, for a 31-year-old postpartum woman. The intervention was provided over a period of 13 weeks, integrating seven biweekly sessions with a psychologist and six sessions within an online program, and it is described in detail. A summary of the patient’s progress and the results obtained throughout treatment is reported. At the end of the intervention, a significant decrease in depressive and anxiety symptoms was observed, as well as increased perceived maternal self-efficacy, higher psychological flexibility, and higher self-compassion. This case study provides encouraging data for the preliminary evidence of the acceptability, feasibility, and efficacy of the Be a Mom Coping with Depression intervention in the reduction of depressive symptoms during the postpartum period. Advantages of this treatment format and implications for clinical practice and future research are discussed.
产后抑郁症是一种非常普遍的心理健康问题,对妇女、婴儿和母婴关系都有有害的影响。认知行为疗法(CBT)是产后抑郁症最有效的治疗方法之一。然而,大量产后妇女不寻求专业帮助,这表明需要新的治疗分娩形式。本文介绍了一种产后抑郁症的混合CBT治疗方法“做一个母亲应对抑郁”在一位31岁产后妇女中的应用。干预提供了为期13周的时间,包括与心理学家的七次双周会议和在线程序中的六次会议,并详细描述了它。总结了患者的进展和整个治疗过程中获得的结果。在干预结束时,观察到抑郁和焦虑症状的显著减少,以及母亲自我效能感的增加,心理灵活性的提高和自我同情的提高。本案例研究提供了令人鼓舞的数据,初步证明了“做一个母亲应对抑郁”干预在减少产后抑郁症状方面的可接受性、可行性和有效性。讨论了这种治疗形式的优点及其对临床实践和未来研究的意义。
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引用次数: 1
Narrative Exposure Therapy: A Case for Use With Refugees via Telehealth With the use of an Interpreter 叙事暴露疗法:通过远程医疗使用口译员的难民案例
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-04-11 DOI: 10.1177/15346501221077703
Gabriela A. Olavarrieta, L. Benuto
Rates of PTSD and depression are as high as or higher among samples of refugees than in the general population. There have been few randomized controlled trials of trauma-focused therapies conducted with refugees. Additionally, there has been little research on the use of interpreters in psychotherapy with refugees, but across the studies included in a meta-analysis, a nonsignificant difference between studies that used an interpreter and those that did not was found. Due to COVID-19, mental health providers have had to adapt to the crisis by utilizing telemental health. Research on telemental health with refugee clients is limited, despite a recognition in the literature that telemental health can address some mental healthcare disparities. We review the case of a 26-year-old Afghani/Iranian bilingual diagnosed with post-traumatic stress disorder (PTSD) who presented with intrusive thoughts, panic attacks, nightmares, and flashbacks. Narrative Exposure Therapy (NET) was used with an interpreter via telehealth because it is effective in reducing symptoms of trauma in refugee populations. Treatment success for this case was reflected in the client’s self-reported reduction in symptoms. From this case study, we can conclude that (a) NET is a short-term, cost-effective means for providing trauma-focused care for refugees/asylum-seekers; (b) NET diminishes trauma symptoms with the use of an interpreter via telehealth; (c) a good relationship between therapist, interpreter, and client aids in the effectiveness of NET; and (d) clinician flexibility in the delivery of telemental health and interventions being utilized with refugee/asylum-seeker populations is imperative.
难民样本中创伤后应激障碍和抑郁症的发病率与一般人群一样高,甚至更高。很少有针对难民的创伤治疗的随机对照试验。此外,很少有关于在难民心理治疗中使用口译员的研究,但在荟萃分析中包含的研究中,发现使用口译员和不使用口译员的研究之间没有显著差异。由于COVID-19,心理健康提供者不得不通过利用远程心理健康来适应危机。尽管在文献中认识到远程心理健康可以解决一些心理保健差异,但对难民客户的远程心理健康研究有限。我们回顾了一个26岁的阿富汗/伊朗双语诊断为创伤后应激障碍(PTSD)的病例,其表现为侵入性思想,恐慌发作,噩梦和闪回。叙述性暴露疗法(NET)通过远程保健与口译人员一起使用,因为它对减轻难民人口的创伤症状有效。这个病例的治疗成功反映在病人自我报告的症状减轻上。从这个案例研究中,我们可以得出这样的结论:(a) NET是向难民/寻求庇护者提供以创伤为重点的护理的一种短期、具有成本效益的手段;(b) NET通过远程保健使用口译员减轻创伤症状;(c)治疗师,口译员和客户之间的良好关系有助于NET的有效性;(d)临床医生在向难民/寻求庇护者提供远程心理保健和干预措施方面必须具有灵活性。
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引用次数: 2
Enhanced Cognitive-Behavioral Treatment for Anxiety Disorders in Children of Clinically Anxious Parents: Two Case Studies 临床焦虑父母的儿童焦虑症的强化认知行为治疗:两个案例研究
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-04-08 DOI: 10.1177/15346501221078979
Chloe A. Salvaris, Samantha Galea, Marie B. H. Yap, Katherine A. Lawrence
Children with anxiety disorders are significantly less likely to recover following cognitive-behavioral therapy (CBT) if they have a parent with clinical anxiety. Despite this, prior research which has adapted CBT treatments to cater for this vulnerable clinical cohort of children is limited. In response to the identified need to optimize treatment outcomes for this particular group of children with anxiety disorders, an enhanced CBT intervention was recently developed, specifically to target anxiety maintenance factors in clinically anxious child–parent dyads. This dual case study presents the implementation of the enhanced intervention with two children with complex clinical presentations. Prior to treatment, both children met criteria for multiple anxiety disorders, as did their mothers. The presented case studies describe session-by-session treatment accounts, with a particular focus on the children’s experiences of individual and joint-observational exposure treatment components. Outcome data is provided for both children and their mothers, based on assessment measures collected at pre- and post-treatment, and during the intervention. At post-treatment, both children demonstrated symptom reduction and improved functioning across all diagnoses, including remission on a secondary diagnosis, although both still met criteria for their primary diagnoses. Additionally, self-reported outcomes on intervention acceptability measures were favorable. Results implied that the enhanced intervention provided a viable alternative treatment approach for children and their parents with co-occurring anxiety disorders. Recommendations are provided for clinicians delivering CBT to clinically anxious child–parent dyads.
患有焦虑症的儿童在接受认知行为疗法(CBT)后,如果他们的父母患有临床焦虑症,那么他们康复的可能性就会大大降低。尽管如此,先前的研究已经适应CBT治疗,以满足这一脆弱的临床队列的儿童是有限的。为了满足对这一特殊焦虑症儿童群体优化治疗结果的明确需求,最近开发了一种增强型CBT干预,专门针对临床焦虑的亲子二代的焦虑维持因素。这个双重案例研究提出了对两个具有复杂临床表现的儿童实施强化干预。在接受治疗之前,两个孩子都符合多重焦虑症的标准,他们的母亲也是如此。所提出的案例研究描述了每次治疗的情况,特别关注儿童在单独和联合观察暴露治疗方面的经验。根据治疗前后和干预期间收集的评估措施,为儿童及其母亲提供了结果数据。在治疗后,两名儿童在所有诊断中均表现出症状减轻和功能改善,包括二次诊断的缓解,尽管两名儿童仍符合其初步诊断的标准。此外,自我报告的干预可接受性措施的结果是有利的。结果表明,强化干预为并发焦虑障碍的儿童及其父母提供了一种可行的替代治疗方法。建议临床医生提供CBT临床焦虑的孩子-父母双。
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引用次数: 0
Case Study of Cognitive Behavioral Therapy for Nightmares in Children With and Without Trauma History 有或无创伤史儿童噩梦的认知行为治疗个案研究
IF 1 4区 心理学 Q3 Psychology Pub Date : 2022-04-04 DOI: 10.1177/15346501221081122
Lisa DeMarni Cromer, Brooke A F Pangelinan, Tara R. Buck
These case examples depict the adaptation of Exposure, Relaxation, and Rescripting Therapy (ERRT) for use with children. ERRT was developed for trauma-related nightmares in adults. The current study modified ERRT to be developmentally appropriate for children, incorporating child appropriate language, interactive activities, and parent coaching. The modified treatment, called cognitive-behavioral therapy for nightmares in children (CBT-NC), added additional stress-management components to further adapt the treatment for children with anxiety-related nightmares and no trauma history. These case studies describe the course of treatment for two girls whose nightmares had different etiologies—one experiencing trauma-related nightmares and the other experiencing idiopathic anxiety-related nightmares. This was the first application of CBT-NC for idiopathic nightmares. Both children responded positively to treatment, and treatment gains were maintained at 3- and 6-month follow-up. Improvements were seen not only for nightmare frequency and distress, but overall sleep also improved. Findings demonstrate that this adapted nightmare treatment for children is feasible and promising for nightmares in children, regardless of nightmare etiology.
这些案例描述了暴露、放松和重写疗法(ERRT)对儿童使用的适应性。ERRT是为成年人的创伤相关噩梦而开发的。目前的研究将ERRT修改为适合儿童的发展,包括适合儿童的语言、互动活动和家长辅导。这种改良的治疗方法被称为儿童噩梦认知行为疗法(CBT-NC),增加了额外的压力管理成分,以进一步适应有焦虑相关噩梦且无创伤史的儿童的治疗。这些案例研究描述了两名女孩的治疗过程,她们的噩梦有不同的病因——一名女孩经历了与创伤相关的噩梦,另一名女孩则经历了特发性焦虑相关的噩梦。这是CBT-NC首次应用于特发性噩梦。两个孩子对治疗都有积极的反应,并且在3个月和6个月的随访中保持了治疗效果。不仅噩梦频率和痛苦有所改善,而且整体睡眠也有所改善。研究结果表明,无论噩梦病因如何,这种针对儿童的适应性噩梦治疗都是可行的,并且有希望治疗儿童的噩梦。
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引用次数: 2
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Clinical Case Studies
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