大学时期早期的通识伦理教育

通识教育的目的在于建立人的主体性,以完成人之自我解放,并与所互为之人文及自然环境建立生存主体性的关系.通识教育可区分为核心课程与一般课程两个层次.伦理是教养之大成,医学伦理是医者把认知、发展与修养在医患关系上的努力.动之以情,说之以理,诉立以法,是通识伦理教育的一般方法.     

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。     

中国传统的音乐治疗研究

音乐是人心理活动的产物,同时音乐还具有一定的治疗作用。音乐疗法是集心理学、医学、生理学、哲学、音乐、艺术于一体的综合性的新兴学科,作为一门应用科学,逐渐被社会所接受,并日趋成熟。中国有丰富的音乐治疗的思想。特别是五音疗法,反映了传统的“天人合一”思想。五音疗法整合了人与自然、社会的相互作用和影响;体现了对音乐与情绪及脏腑之间的互动关系;突现了音声与人格情志、脏气等的关系。五音疗法匹配了人体的不同脏腑,把五音、五行、五脏、人格配属用于音乐治疗实践。     

日本的学校心理咨询模式

伴随着日本学校临床心理士派遣制度的实施,探索有效的学校心理咨询模式被提到了议事日程上。在日本的学校中,学校心理学模式、社区心理学模式、短期治疗模式和叙事治疗等四种模式比较多的为学校临床心理士们所关注。     

箱庭疗法缓解初中生考试焦虑的有效性

以18名考试焦虑初中生为被试,采用等组前后测设计,以考察箱庭疗法缓解考试焦虑的效果,并与放松训练进行比较。结果表明:箱庭疗法与放松训练一样能够有效地缓解初中生的考试焦虑情绪,但其干预效果的保持性要优于放松训练。     

肥胖症患者的行为治疗与干预

行为疗法是治疗肥胖症常用、有效地一种方法。国外行为治疗一般有评估阶段、实际治疗阶段、治疗过渡阶段和治疗保持阶段,包括认识行为改变的准备动机、认知重组、目标确定、自我监督、刺激控制、应激处理、社会支持、反弹干预等组成成份。行为治疗需和其他方法整合有效治疗肥胖症。     

Drop-in suicide prevention group decreases suicidal ideation among Veterans

This study examined the effectiveness of a weekly, drop-in therapy support group designed for Veterans identified at increased risk for suicide. Veterans were identified as at risk for suicide and referred to the group following hospitalization on the inpatient psychiatric unit after an increase in suicidal ideation (SI), presentation to a provider with SI with a plan, or having made a suicide attempt. An archival chart review was performed on 359 patients who were referred to the Coping, Understanding, Support, and Prevention Group from 2009 through 2011. Documented risk of suicide was collected from the chart including: frequency of inpatient psychiatric hospitalization, visits to the emergency department or mental health walk in clinic for SI, reported SI in clinical notes, consults resulting from calls to the Veteran’s Crisis Line, and assignment or removal of suicide risk behavior flags in the electronic medical record, for a period of 12 months prior to referral to the group and for a period of 12 months after referral to the group. Negative binomial regression models found that Veterans attending the support group showed a significantly greater reduction in frequency of endorsing SI post-referral compared to those who did not attend the group. Results imply that offering Veterans an ongoing therapeutic group format to give and receive support from peers also struggling with suicide risk factors is an effective way to reduce suicide-related thoughts.     

Hope for the Worst: Occasional Reinforced Extinction and Expectancy Violation in the Treatment of OCD

An inhibitory learning conceptualization of treatment mechanisms in exposure-based therapy appears to better account for durability of symptom reduction and index overall learning. Presented here is an overview of two core elements of inhibitory learning, expectancy violation and occasional reinforced extinction, as they are thought to function in exposure and response prevention (ERP) for OCD. The overview is then followed by case examples illustrating these processes at work in a naturalistic clinical setting. Implications for treatment are broadly discussed.     

Perception des conditions de travail et perspectives professionnelles chez les enseignants des collèges en Tunisie

This study examines the impact of organizational work conditions on the mental health of secondary school teachers in Tunisia. It aims to understand teachers’ specific problems on the basis of their professional representations of the profession in order to identify the sources of their malaise at work. To conduct our research, Self-report questionnaires were completed by 34 teachers, aged 30 to 58 years, from different secondary schools. The thematic analysis highlights a bond between constraints perception related to working conditions and the negative evaluations of work situations and teaching profession as a whole. Professional experience reveals suffering and discomfort, they can lead to reconsidering future prospects.     

Differences in baseline and process variables between non-responders and responders in Internet-based cognitive behavior therapy for chronic tinnitus

Although Internet-based cognitive behavior therapy (iCBT) is an effective treatment for chronic tinnitus, several patients do not improve. In the current study, baseline and process variables were compared between non-responders and responders. Data from patients participating in two randomized controlled trials on iCBT for chronic tinnitus were re-analyzed. Based on the literature, a pre-post difference on the “Tinnitus Handicap Inventory” (THI) of less than seven points improvement was used to operationalize non-response. Associations between non-response and baseline variables (age, gender, and questionnaire scores), patient progress (THI), the process of the therapeutic alliance (“Working Alliance Inventory-Short Revised”; WAI-SR), as well as other process variables (number of logins, amount of messages sent from therapists to patients) were investigated. The results showed that non-responders had a less favorable change on the THI than responders already at mid-treatment (p < .05). The alliance (WAI-SR) during iCBT was not associated with non-response. Non-responders showed more severe sleep disturbances, logged in less in the iCBT platform, and received fewer messages from the therapists than responders, but these differences were mostly not significant anymore when correcting for multiple testing. To conclude, no symptom change in the first half of iCBT for chronic tinnitus patients is a risk factor of not benefiting from iCBT.