糖尿病性视网膜病变的个体化治疗

糖尿病性视网膜病变(DRP)是糖尿病患者致盲的一个主要原因.其发病的多样性决定了对其治疗应该个体化.就其个体化治疗的依据、方法的研究及具体的措施运用哲学原理加以综述.     

从ACCORD研究中再认识2型糖尿病强化降糖治疗

心血管并发症是2型糖尿病患者的主要死亡风险.减少2型糖尿病患者的心血管病死亡风险是2型糖尿病患者临床治疗的重要目的.强化降糖治疗能减少糖尿病患者心血管并发症及糖尿病相关死亡,但不同的个体应有不同的强化降糖措施和不同的标准.对于老年人、糖尿病病程长、心脑血管疾病高危人群需要在注重安全性的基础上进行个体化治疗.     

西藏老年病房2型糖尿病患者的血糖管理

西藏老年2型糖尿病患者有着知晓率低、病程长、慢性并发症多、其他相关疾病多等特点。加强糖尿病教育、控制饮食、合理用药、注意相关疾病的处理和个体化治疗是血糖管理的有效方案。     

糖尿病防治的几点认识

根据世界卫生组织的健康定义,健康是人的生理、心理和社会的协调一致,反之产生疾病。糖尿病在影响人们生理、心理健康的同时,影响着人们的生活方式、社会关系、收入和社会期望度。因此糖尿病的诊断和治疗必须考虑到患者的心理社会因素。临床医生应学会使用现代的生物心理社会模式,倡导正确的行为生活方式、落实连续性医疗服务、提高卫生服务整体效能、提供多方位社会支持、选择个体化的糖尿病治疗方案,针对性地进行糖尿病的防治。     

老年2型糖尿病药物治疗的选择策略

老年人是糖尿病的高发人群,约占糖尿病总人数的一半以上.这些人群整体健康状态较差,合并疾病多,必须综合考虑,制定个体化的血糖控制目标；对胰腺β细胞功能状态、主要器官状态等因素全面评估,选择适合老年人的安全有效的降糖药物治疗方案.     

糖尿病防治的几点认识

根据世界卫生组织的健康定义,健康是人的生理、心理和社会的协调一致,反之产生疾病.糖尿病在影响人们生理、心理健康的同时,影响着人们的生活方式、社会关系、收入和社会期望度.因此糖尿病的诊断和治疗必须考虑到患者的心理社会因素.临床医生应学会使用现代的生物心理社会模式,倡导正确的行为生活方式、落实连续性医疗服务、提高卫生服务整体效能、提供多方位社会支持、选择个体化的糖尿病治疗方案,针对性地进行糖尿病的防治.     

高血压个体化治疗的哲学思考

高血压病是全球范围内最常见的心血管系统疾病,其发病率,死亡率和致残率高,是严重危害人们健康的疾病之一。高血压个体化治疗是根据患者的具体情况,选择适宜的药物和治疗方案,从而达到最有利于患者的治疗效果。从哲学的角度对高血压个体化治疗的依据。目的和措施进行综合分析。     

循证医学与个体化治疗的共存和矛盾

从人体个体差异的绝对性出发,论述了个体化治疗与循证医学共存的必然性及两者之间的矛盾。循证医学的结论可通过对大量个体化治疗病例的循证研究而不断刷新,从而更好地指导个体化治疗,这是解决两者矛盾的途径。     

对哮喘患者进行教育管理的内容和方法

目前尚不能根治哮喘,然而长期管理有助于达到哮喘控制,哮喘教育是其重要组成部分。哮喘教育内容应包括哮喘的诊断、预防及治疗相关的知识、技能。应当采取个体化、循序渐进的教育方式,集体教育是个体化教育重要的补充。     

循证医学与个体化治疗的共存和矛盾

从人体个体差异的绝对性出发,论述了个体化治疗与循证医学共存的必然性及两者之间的矛盾.循证医学的结论可通过对大量个体化治疗病例的循证研究而不断刷新,从而更好地指导个体化治疗,这是解决两者矛盾的途径.     

Women counsellors' experiences of personal therapy: A thematic analysis

Background: Following recent moves to relax the requirements for clinical mental health trainees to undergo personal therapy, this qualitative project explored the effects of personal therapy on volunteer counsellors. Method: Interviews were conducted with 19 volunteer counsellors at a women's community centre, and the data were analysed using thematic analysis. Findings: Emerging themes included the importance of personal therapy for trainee development, key elements of personal therapy and the idea that personal therapy is ‘a double‐edged sword’. Discussion: Allowing for evident methodological difficulties in evaluating the impact of personal therapy on trainees, this study suggests that close consideration should be given to the potentially adverse effects of reducing requirements for personal therapy in clinical trainings.     

"It's led me astray": How Cognitive Behavioural Therapists experience personal therapy in clinical practice

Personal therapy is considered to be an essential component of most psychotherapeutic training programmes. However, it remains peripheral to cognitive behavioural therapy (CBT) training courses. We present a subsection of results from a qualitative study that examines how CBT therapists use personal therapy in their clinical practice. Seven CBT therapists who have undergone personal therapy were interviewed. Participants were asked about how they used personal therapy in their clinical practice and their accounts were analysed using interpretative phenomenological analysis (IPA) to identify common themes. This article presents the results of the first master theme, “Personal therapy creates conflict”, which explores a paradox that arises between personal therapy and CBT clinical practice; participants suggest that personal therapy equips them with therapeutic tools that paradoxically hinder their capacity to practice a standardised protocol‐led CBT. Results show that participants found personal therapy created considerable internal conflict, where their use of technical evidence‐based treatment protocols as practitioners was experienced in tension with the relationally oriented therapy they had received as clients. We discuss results in the context of Gabriel Marcel's philosophical insights on the dehumanising effects of technology on human relationships. We conclude with a brief consideration of the current political climate that increasingly privileges short‐term technical solutions to psychological distress.     

The psychotherapist's own psychotherapy: educating and developing psychologists

In this article, the author synthesizes 25 years of his research on the personal therapy of mental health professionals. The author summarizes the high prevalence of personal treatment, its use by seasoned practitioners, its personal and professional goals, its typically positive outcomes, and its lasting lessons concerning the practice of psychotherapy. Particular attention is devoted to the therapist's selection of a personal therapist and the conduct of treatment with patients who are themselves psychotherapists in comparison with patients who are laypersons. The cumulative results indicate that personal therapy is an emotionally vital, interpersonally dense, and professionally formative experience that should be central to the development of health care psychologists.     

A Place at the Table: Integrating Diet and Nutrition into Family Therapy Practice

Most schools of family therapy directly or indirectly recognize that personal qualities of the therapist influence therapy process. If personal qualities of therapists are associated with therapy process, it seems plausible that there would be some interaction between their personal relationships and therapy process. The present study examines the relationship between emotion management at home and emotion management at work to job satisfaction and marital satisfaction of marriage and family therapists. Results suggest that men and women experience a different interaction between emotion management, relationship satisfaction, and job satisfaction.     

Counselling psychologists' perceptions of the impact of mandatory personal therapy on professional development--an exploratory study

A qualitative study was carried out with recently qualified and trainee counselling psychologists to investigate their opinions as to the impact of mandatory personal therapy on their professional development. The methodology employed was grounded theory using data obtained from indvidual and group interviews. The results indicate that mandatory personal therapy can lead to perceived positive outcomes in terms of professional development including: a sense of the self as a professional through developing reflexivity as a result of being in the role of client; socialization into a professional role through validational and normative experiences such as the therapist modelling good and poor practice; support during times of personal difficulty; and, personal development that leads to a perceived improved ability for the participant to distinguish between personal issues and those of the client. An important effect for participants who did not have a previous substantial experience of personal therapy appeared to be the validation of therapy as an effective psychological intervention.     

Qualified therapists’ experience of personal therapy

Recent work shows that the majority of therapists strongly value personal therapy for what it can bring to their professional practice, and for personal development. The aim of this study was to explore qualified therapists’ experiences of personal therapy. Of the 220 qualified therapists who were contacted via post and asked to take part in a questionnaire study, 48 returned the completed questionnaire, which consisted of a series of closed and open questions. Two‐thirds of respondents had engaged in personal therapy. The two most frequently cited reasons for engaging in personal therapy were personal growth and personal distress. Interpretative phenomenological analysis (IPA) identified two broad domains: impact on the person and impact on the professional. Results show that those surveyed recognised the value of personal therapy to themselves as a form of self‐care and personal development. Personal therapy was valued in professional practice as a form of experiential learning from being in the client role. The limitations of this research included a relatively low response rate, raising the question of whether those most likely to have had positive experiences of personal therapy were more likely to participate. Future research might deliberately seek to understand negative experiences of personal therapy. Other avenues for future research include the need to understand how experiences of therapy relate to gender, profession, and therapeutic orientation.     

Psychodynamic therapists' dilemmas in providing personal therapy to therapists in training: An exploratory study

Aim: This study explores dilemmas facing psychodynamic therapists who provide personal therapy to therapists in training. Method: Eight experienced psychodynamic psychotherapists were interviewed using a semi‐structured interview format during which they were asked about the importance of personal therapy, if they encountered any dilemmas and, if so, how they resolved those dilemmas. Their responses were analysed using a qualitative form of content analysis. Findings: Two categories of dilemma emerged: clinical and personal. Clinical dilemmas arose out of the mandatory requirement for therapy, boundaries, fitness to practice and the suitability of trainees. Personal dilemmas included pressure to model, sense of responsibility, therapeutic narcissism, countertransference reactions, over‐use of self and stressful involvement. The therapists' strategies for resolving the dilemmas are described. Conclusion: The results show participants considered personal therapy to be essential for trainees and thought it should be mandatory even though it led to difficulties in the therapy. Questions arose about the suitability of some trainees, the person of the therapist and stressful involvement. Further research into these important areas is recommended.     

A trans-disciplinary study of the therapist's self

Participation in personal therapy during training is required by British accreditation bodies for counselling psychology as well as by most psychotherapy trainings. By contrast, trainee clinical psychologists are not required to undertake personal therapy, although they may elect to. Prior research in Britain and the US suggests that practitioners have a wide range of motives for entering therapy as well as motives for not doing so (Norcross &; Connor, 2005). This study addresses the fact that no research to date has specifically explored what individuals beginning their counselling psychology, clinical psychology and counselling training think and feel about participation in personal therapy during training. Data from open-ended questionnaires was analysed using inductive thematic analysis. Two main themes were identified. These consisted of: ‘Personal therapy helps me to be a better practitioner’, and ‘Personal therapy costs me’. The study results are considered in light of the limited prior research and recommendations for training are made.     

Personal therapy for family therapy graduate students

This study explores students' attitudes about personal therapy as a component of training and assesses the effects of providing a list of community therapist who were willing to see family therapy graduate students at a reduced fee on students' behaviors. Students' personal therapy experiences and attitudes about faculty involvement in their personal lives were also investigated. Most students believe that student therapists should have personal therapy sometime during their training, and the majority of students had al-ready been in therapy. Individual issues and relationship problems were the most frequently cited reasons for starting personal therapy.