A Case Study of Cognitive-Behavioral Conjoint Therapy for Combat-Related PTSD in a Same-Sex Military Couple

Military deployments to Iraq and Afghanistan are associated with increased risk for posttraumatic stress disorder (PTSD), depression, and relationship impairment. Unfortunately, the perceived stigma associated with seeking deployment-related behavioral health care in military settings has been a significant barrier to care. Historically, active-duty military service members involved in same-sex intimate relationships have experienced further stressors and barriers to care related to additional stigma and lack of social support. Prior federal regulations excluded sexual minorities from openly serving in the military, thereby limiting the available behavioral health services for same-sex couples. Since this ban was lifted after the repeal of the U.S. policy known as "Don’t Ask, Don’t Tell" in 2010, gay and lesbian service members have increased opportunities to obtain behavioral health care. One therapy that is newly available to sexual minority military couples is Cognitive-Behavioral Conjoint Therapy (CBCT), which effectively addresses co-occurring PTSD and relationship dysfunction. This case study illustrates the use of CBCT for the treatment of deployment-related PTSD in a same-sex active-duty military couple. After completing all 15 CBCT sessions, the couple reported clinically meaningful changes in the service member’s PTSD symptoms, which was maintained at the 2-month follow-up. The results of this case study indicate that CBCT for PTSD can have positive treatment outcomes with military same-sex couples. Further clinical implications are discussed.     

Empirically Supported Therapies and Therapy Relationships: What are the Serious Problems and Plausible Alternatives?

Task forces have identified practice guidelines based upon empirically supported therapies and therapy relationships. A case is made for (a) the serious problems in and (b) the plausible alternatives to, the general strategy underlying the task forces. The invitation is to address and to solve the serious problems, and to give serious consideration to the plausible alternatives.     

An exploration of obese adults’ experience of attempting to lose weight and to maintain a reduced weight

The aim of this study was to explore obese adults’ accounts of their experiences and feelings during their attempts to lose weight and to maintain a reduced weight. Qualitative research methods were used, based on interviews with individuals and groups. Eighteen obese men and women were recruited from the general public, with BMIs ranging from 30 to 50. All participants had attempted weight loss treatment, but without lasting success. Participants were unanimous in saying they needed help. Results suggest that counselling could play a greater role in the treatment of obesity.     

治疗决策十题

治疗决策是临床决策中的重要组成部分。为了提高治疗决策水平,临床医生可以从以下几个基本环节入手深究决策依据、明确治疗目标、坚持疗效优化、强调安全第一、注意条件约束、注重时效原则、突出救治重点、减损方案危害、分析失悔程度和了解敏感阈值。     

犯罪受害人的应激障碍及其干预

曾经在犯罪现场遭到犯罪人威胁或伤害的受害人,可能会因为这种遇害经历而产生各种各样的应激障碍.描述犯罪受害人有可能发生的应激障碍的临床表现,介绍国内外常用的评估工具,总结能够有效干预犯罪受害人应激障碍的方法,并做出简要评价.     

微创手术治疗肺癌面临问题的思考

作为一种新兴技术,微创外科手术治疗肺癌备受争议.运用唯物辩证法的基本原理,分析这种技术产生的背景、临床应用价值及发展前景,并与传统手术方法作了客观辨证的比较.认为微创外科治疗肺癌,在临床应用有其积极意义,值得肯定.     

慢性乙型肝炎诊断和治疗方法学探讨

探讨慢性乙型肝炎诊断和治疗的方法学。仔细谨慎评价病毒载量等指标,客观准确地把握治疗时机,重视情绪障碍和营养不当,恰当选择抗病毒治疗方案。尽力形成慢性乙型肝炎诊断和治疗的完善方法系统。     

巧用中西医结合,提高临床医学水平

通过对现代医学辨病的缺陷和临床与基础医学联系性、融合性不足的分析,阐述中医经典理论与现代医学基础理论结合,提高临床决策水平的重要意义。     

超声内镜在诊治上消化道异位胰腺中的价值

异位胰腺是正常胰腺解剖部位以外的孤立胰腺组织,可发生在消化道或消化道外的许多部位。异位胰腺可以产生分泌各种胰酶和胰液,也可以发生急性、慢性胰腺炎甚至囊肿、肿瘤等正常的胰腺可发生的任何病变,并且通常难以通过病理学检查确诊。超声内镜提供了更准确的诊断异位胰腺的方法,对选择恰当的治疗措施有重要的指导作用。