Evaluation of a behaviour analysis and treatment of progressive myoclonus epilepsy, type Unverricht-Lundborg: a case study

This case study evaluates the clinical effectiveness of a psychological treatment within a behaviour medicine approach to epilepsy of a subject with progressive myoclonic epilepsy. The pattern of seizure behaviour was identified in the behaviour analysis. Self-management skills were taught to the client and in vivo exposure was subsequently used in a desensitization process. The main findings in this study were that the debilitating effects of the myclonic jerks can be reduced and functioning level improved when fear of seizures is reduced. These results indicate that psychological treatment can increase the level of functioning in clients with progressive myoclonic epilepsy.     

Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial

Although 14% to 42% of people with whiplash injuries end up with chronic debilitating pain, there is still a paucity of empirically supported treatments for this group of patients. In chronic pain management, there is increasing consensus regarding the importance of a behavioural medicine approach to symptoms and disability. Cognitive behaviour therapy has proven to be beneficial in the treatment of chronic pain. An approach that promotes acceptance of, or willingness to experience, pain and other associated negative private events (e.g. fear, anxiety, and fatigue) instead of reducing or controlling symptoms has received increasing attention. Although the empirical support for treatments emphasizing exposure and acceptance (such as acceptance and commitment therapy) is growing, there is clearly a need for more outcome studies, especially randomized controlled trials. In this study, participants (N = 21) with chronic pain and whiplash-associated disorders were recruited from a patient organization and randomized to either a treatment or a wait-list control condition. Both groups continued to receive treatment as usual. In the experimental condition, a learning theory framework was applied to the analysis and treatment. The intervention consisted of a 10-session protocol emphasizing values-based exposure and acceptance strategies to improve functioning and life satisfaction by increasing the participants' abilities to behave in accordance with values in the presence of interfering pain and distress (psychological flexibility). After treatment, significant differences in favor of the treatment group were seen in pain disability, life satisfaction, fear of movements, depression, and psychological inflexibility. No change for any of the groups was seen in pain intensity. Improvements in the treatment group were maintained at 7-month follow-up. The authors discuss implications of these findings and offer suggestions for further research in this area.     

From Boulder to Stockholm in 70 Years: Single Case Experimental Designs in Clinical Research

The Psychological Record - With the objective of increasing the magnitude of treatment effects in behavioral health, there is steadily growing interest in tailoring assessments and interventions to...