一例大学生社交恐惧症的案例分析报告

本文是一例女大学生因怀疑自己口臭、担心肠蠕动的声音像放屁声,因表现为在人多的场所感到紧张、不断地吞口水,回避人多的场所等症状的心理咨询案例。分析了求助者的生物学层面、社会层面和心理层面的相关资料,结合SCL-90、SAS、SDS的测验结果,分别做出了诊断和鉴别诊断。采用认知行为疗法和暴露疗法对来访者做了有效干预和治疗。根据求助者自我评估、咨询师评定、心理测验结果证明本咨询为有效咨询。     

Culture change: A training program for recent immigrant professionals from the former Soviet Union

The article describes a training program in structural/integrative family therapy for immigrant professionals from the former Soviet Union at the Training Center of the Shiluv Institute for Family and Couple Therapy in Jerusalem. The program was instituted to meet the pressing needs of a mass immigration of half a million people that came to Israel between 1990 and 1992. This is a retrospective look at the journey of the initial group of psychiatrists and psychologists who changed country, culture, language, and professional orientation in just two years. The authors state their conclusions as to the most expedient way to organize therapy for families from the former Soviet Union — a population in need of help but lacking an awareness of therapy and suspicious of the outsider.     

Supervisory styles index: Examining supervisees' perceptions of Supervisory Style

The goal of this research was to develop an instrument, the Supervisory Styles Index (SSI), that would examine supervisory style. Style has been described as the way in which the personality and convictions of the supervisor are demonstrated in the supervisory relationship (Leighton, 1991). This study focuses on the interplay between supervisory style and the influence of sex and gender. The findings of this study reveal that female supervisees discern their supervisors to be more self-disclosing than do male supervisees. Implications of the findings and utilization of the index are discussed.Portions of this paper were presented at the 52nd annual conference of the American Association for Marriage and Family Therapy, Chicago, Illinois, November, 1994.     

Open live supervision in family therapy

This article reviews changes in models of supervision, resulting from technological developments and reflecting a variety of theoretical approaches. The focus is on open live supervision, conducted in the presence of the family. The supervisor and a therapeutic team join the therapist and the family, creating a complex supra-system that opens up several options for therapeutic intervention. Sessions are videotaped, and therapists use recordings for additional supervision and independent study. Therapists may also show recordings to the family as part of the therapeutic process. The advantages and disadvantages of the model are considered, and examples of some of the therapeutic options are described.This model was developed in the course of the author's work teaching and supervising students at the Counseling Department of the School of Education at the Hebrew University of Jerusalem, and supervising a multi-disciplinary team including physicians, psychologists, and social workers engaged in family therapy at the Municipal Psychological Services for Schools in Jerusalem. A shorter version of this article appeared in Hebrew inSihot 5 1991. Appreciation is expressed to Batya Stein for translating the final version of this article from Hebrew. Reprint requests should be addressed to Katrit Ron, Neve Granot 3-B, Jerusalem 93706, Israel.     

新生儿重症监护室中放弃治疗的伦理问题

对于新生儿重症监护室中的一部分危重新生儿,虽然可以借助高新尖的医疗技术挽留他们的性命,但却不能避免其出现影响远期生存质量的后遗症。因此患儿家属和医务人员陷入了是否对这些危重新生儿实施放弃治疗的两难困境。对NICU中放弃治疗的对象、伦理学依据、伦理学意义以及如何实施放弃治疗的问题加以讨论,为NICU医务人员提供有益参考。     

我国恶性肿瘤的治疗现状与对策

尽管我国现在对恶性肿瘤的治疗已取得巨大成绩,但依然存在诸多问题及误区,一是医患双方对肿瘤治疗认识上存在误区;二是应调整肿瘤防治的思路,要努力做到“三早”,由过去的任其发展转变为有效检控;三是充分利用医疗资源避免晚期恶性肿瘤的过度治疗与必要时终止治疗;四是要不断更新观念,坚持个体化治疗,提高患者的生存质量。     

The quantity and quality of marital interaction related to marital satisfaction: A behavioral analysis

An assessment instrument is presented for the evaluation of the quantity and quality of dyadic interaction, as well as for the daily recording of behaviors presented and omitted which influence marital satisfaction. Comparison of data from ten happy couples and from ten couples entering therapy indicated two distinct dysfunctional patterns among distressed couples, with significantly different patterns of time-together and positive/negative ratios differentiating the happy versus therapy groups. Independent behavioral recording for 14 consecutive days significantly increased husband-wife agreement on a traditional adjustment questionnaire without significantly increasing or decreasing the level of satisfaction being assessed. There was no difference between groups as to interspousal agreement on amount of time together. However, the happy couples agreed on daily quality ratings of the 72 15-minute segments significantly more often than did the distressed couples. Couples at the extremes of the happy-distressed continuum reported rewarding and punishing, respectively, in response to the partners presence, regardless of behaviors emitted. Midrange happy couples defined "pleasant" as positive behaviors presented; midrange distressed couples defined "pleasant" as negative behaviors omitted. Theoretical and clinical implications of behavioral analysis of sequential patterns are discussed.     

Spirituality, Gender, and Supervisory Style in Supervision

This study used the following guiding question: Is gender associated with variations in perceptions of supervisory style and the frequency with which spiritual issues are addressed in supervision? Results suggest that spirituality is perceived relevant to numerous aspects of supervision. For example, findings indicate that a relationship exists between two characteristics of supervisory style and the frequency with which spirituality is addressed in supervision. Results also intimate that male therapists viewed male supervisors as addressing spirituality more frequently than female supervisors, and female therapists viewed female supervisors as addressing spirituality more frequently than male supervisors. Overall, these findings highlight the significance of spirituality within the context of supervision and underscore the critical need for attention to gender in the study of spirituality within clinical settings.     

Emotional Processing Theory (EPT) and Exposure Therapy for PTSD

Emotional processing theory developed by E. B. Foa and M. J. Kozak (1986) has informed the conceptualization of anxiety disorders and the development of effective treatments for these disorders, including posttraumatic stress disorder (PTSD). This article presents a summary and update of emotional processing theory as it applies to the treatment of PTSD, data in support of this theory, and clinical examples of how the theory can be used to assist in the treatment of clients with PTSD. Common difficulties confronted during exposure therapy for PTSD, including underengagement and overengagement, are discussed in the context of emotional processing theory and suggestions for how to manage these difficulties are presented.     

Internet-Delivered Exposure-Based Cognitive-Behavioral Therapy for Adolescents With Functional Abdominal Pain or Functional Dyspepsia: A Feasibility Study

Functional abdominal pain (FAP) and functional dyspepsia (FD) are common in adolescents and associated with low quality of life. Exposure-based cognitive-behavioral therapy (CBT) is efficient for adult and adolescent irritable bowel syndrome (IBS), but has never been evaluated for adolescent FAP/FD. The aim of this study was to evaluate the feasibility and potential efficacy of a novel disorder-specific Internet-delivered CBT (Internet-CBT) for adolescents with FAP or FD, using an uncontrolled open pilot including 31 adolescents. The Internet-CBT consisted of 10 weekly online modules, which focused mainly on exposure to abdominal symptoms. Parents received modules to help them reduce unhelpful parental behaviors. Participants reported the treatment to be credible, and an overall satisfaction with the treatment. Data attrition rate was low (7%) and adherence to treatment was acceptable. We saw a significant and large effect on the primary outcome, pain intensity, at posttreatment (d = 1.20, p < .001) that was further improved after 6 months (d = 1.69, p < .001). Participants also made significant and large improvements on gastrointestinal symptoms (d = 0.84, p < .001) and quality of life (d = 0.84, p < .001) that were sustained or further improved at follow-up 6 months after treatment. This study demonstrated that exposure-based Internet-CBT, tailored for adolescents with FAP or FD, is a feasible treatment that potentially improves pain intensity, gastrointestinal symptoms, and quality of life.