Coping,psychological adjustment,and complementary and alternative medicine use in persons living with hiv and aids

Abstract

Many HIV-positive individuals dissatisfied with allopathic approaches to disease management have turned to complementary and alternative medicines (CAM). Although people use CAM for a variety of reasons (e.g., symptom management, holistic approach towards healthcare, improved immunity), the psychological benefits that these treatments may have are still not fully understood. The present study was designed to further previous research that demonstrated relationships between CAM use, stress appraisals, and coping behaviors. HIV-positive individuals (N= 127) completed measures assessing stress appraisals, coping, psychological adjustment, satisfaction with life, and immune functioning. After controlling for ethnicity and sexual orientation, stress appraisals and coping behaviors were found to be related to CAM use. Further, curvilinear relationships between CAM use and adjustment emerged, suggesting that some CAM use may be adaptive. Self-reported immune measures were unrelated to CAM use. In all, it appears that CAM use may be a complex form of coping that assists individuals in adjusting to a life-threatening illness. The implications of these findings with respect to adherence to highly active antiretroviral therapies (HAART) are also discussed.     

Art Speaks in Healing Survivors of War

Abstract

Mental health clinics can use creative art therapies as a means of reaching out to war refugees in their communities who may not respond to traditional talk therapy. In this case, the use of quilting and other artwork was utilized by the staff at Chicago Health Outreach to assist displaced Bosnians to cope with their war-related trauma and integration into their new environment in the United States. It can be difficult to reach refugee populations within a community whose culture and language are different from the majority, but finding other means of communicating can make a real difference for these individuals as they find safety and understanding by working on and sharing special creative projects.     

A Critical Methodological Review of Discourse and Conversation Analysis Studies of Family Therapy

Discourse (DA) and conversation (CA) analysis, two qualitative research methods, have been recently suggested as potentially promising for the study of family therapy due to common epistemological adherences and their potential for an in situ study of therapeutic dialog. However, to date, there is no systematic methodological review of the few existing DA and CA studies of family therapy. This study aims at addressing this lack by critically reviewing published DA and CA studies of family therapy on methodological grounds. Twenty‐eight articles in total are reviewed in relation to certain methodological axes identified in the relevant literature. These include choice of method, framing of research question(s), data/sampling, type of analysis, epistemological perspective, content/type of knowledge claims, and attendance to criteria for good quality practice. It is argued that the reviewed studies show “glimpses” of the methods’ potential for family therapy research despite the identification of certain “shortcomings” regarding their methodological rigor. These include unclearly framed research questions and the predominance of case study designs. They also include inconsistencies between choice of method, stated or unstated epistemological orientations and knowledge claims, and limited attendance to criteria for good quality practice. In conclusion, it is argued that DA and CA can add to the existing quantitative and qualitative methods for family therapy research. They can both offer unique ways for a detailed study of the actual therapeutic dialog, provided that future attempts strive for a methodologically rigorous practice and against their uncritical deployment.     

The Efficacy of Systemic Therapy for Childhood and Adolescent Externalizing Disorders: A Systematic Review of 47 RCT

Systemic (family) therapy is a widely used psychotherapy approach. However, most systematic efficacy reviews have focused solely on “family‐based treatment” rather than on the theoretic orientation “systemic therapy.” We systematically review trials on the efficacy of systemic therapy for the treatment of childhood and adolescent externalizing disorders. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems‐oriented therapy in various forms (family, individual, group, multi‐family group therapy) with child or adolescent index patients (0–17 years) suffering from mental disorders were identified by data base searches and cross‐references. Inclusion criteria were as follows: index patient diagnosed with a DSM‐ or ICD‐listed mental disorder, and trial published in any language up to the end of 2011. The RCTs were analyzed for their research methodology, interventions applied, and results (postintervention; follow‐up). A total of 47 trials from the United States, Europe, and China, published in English, German, and Mandarin, were identified. A total of 42 of them showed systemic therapy to be efficacious for the treatment of attention deficit hyperactivity disorders, conduct disorders, and substance use disorders. Results were stable across follow‐up periods of up to 14 years. There is a sound evidence base for the efficacy of systemic therapy for children and adolescents (and their families) diagnosed with externalizing disorders.     

An Activities Approach to the Treatment of Mentally Retarded Clients in an Acute Care Psychiatric Hospital

This article describes therapeutic activities offered in an occupational therapy treatment program for mentally retarded patients in an acute-care hospital facility. Implications of therapeutic activities for the building of ego strengths are discussed.     

Personhood of the Therapist in Couples Therapy

SUMMARY

Integrity Therapy (Lander, 1986; Lander & Nahon, 1992a, 1995a; Mowrer, 1961b, 1964a) views the personhood of the therapist as the very essence of therapy. By meeting the deepest part of the therapist with the deepest self of individuals in therapy, a healing process unfolds which opens up the healing potential of both the individuals and the couple. This article offers couple therapists and other mental health professionals an Integrity Therapy perspective of the personhood of the therapist and its therapeutic potential for helping couples in distress to reclaim their personhood. Two aspects of the Integrity Therapy approach which play a critical role in enhancing therapists' use of their personhood in the therapeutic process are explored: (a) the use of therapist self-disclosure, and (b) therapists' awareness and therapeutic use of counter-transference issues.     

Telephone-Administered Cognitive Behavior Therapy for Obsessive-Compulsive Disorder

Exposure with response prevention and cognitive behavior therapy are widely recognized as effective treatments for obsessive-compulsive disorder. Unfortunately, many people with obsessive-compulsive disorder - particularly those living in rural areas - do not have access to therapists providing these treatments. Accordingly, we investigated the efficacy of telephone-administered cognitive behavior therapy for obsessive-compulsive disorder. Two open trials are reported, for a total of 33 people with obsessive-compulsive disorder (without major depression). The first trial consisted of 12 weeks on a waiting list followed by 12 weeks of treatment (delayed treatment). The second trial consisted of 12 weeks of immediate treatment. Obsessive-compulsive symptoms did not change during the waiting period. Symptoms declined from pre- to post-treatment, with gains maintained at 12-week follow-up. For the pooled sample our pre-to-post-treatment effect size was as large or larger than those obtained in other studies of reduced contact treatment, and similar to those of face-to-face exposure with response prevention. Our proportion of treatment dropouts tended to be lower than those of other reduced contact interventions. The results suggest that telephone-administered cognitive behavior therapy is effective and well-tolerated, at least for people with obsessive-compulsive disorder without major depression. It remains to be seen whether this treatment is safe and effective when comorbid major depression is present.     

Dietary Control of Rumination: Two Case Studies

Chronic rumination of 2 institutionalized men with profound mental retardation was treated using a dietary approach. In the first case, a peanut butter or honey supplement was given, whereby 2 spoonfuls of either food was added to every meal, with drinks moved to a later time. In the second case, food satiation together with a honey supplement was applied. In the first case, an ABABACA design was used. In the second case, the non-experimental AB design was applied. In both cases, rapid decrease in rumination was achieved. Anecdotal follow-up confirmed the permanency of the results.