针刺配合放血治疗慢性头痛48例

目的:观察针刺配合放血治疗慢性头痛的疗效。方法:86例慢性头痛患者,分为针刺配合放血治疗组和西药对照组,观察治疗前后两组的疗效。结果:采用针刺配合放血治疗慢性头痛疗效显著,且与西药治疗组比较,差异有显著性。结论:采用针刺配合放血治疗慢性头痛是较好的治疗途径。     

Exploratory trial of schema-focussed therapy in a forensic personality disordered population

The management of needs and risks in personality disordered offender populations has become a focus for health and criminal justice services in the UK. Recent studies demonstrate the effectiveness of schema focussed therapy (SFT) for patients with borderline personality disorder. This study was an exploratory trial of the feasibility of implementing SFT in a population of patients with personality disorder in a high secure hospital in England. Preliminary evaluations of the effects of SFT were conducted to investigate whether those receiving SFT demonstrated significant improvements on measures of anger, impulsiveness, schemata and interpersonal style. No significant effects were evident although there was a significant increase in defectiveness/shame schema in the SFT group. Lack of effectiveness of SFT is likely due to the preliminary nature of this study. Future trials of SFT need to ensure comprehensive therapist preparation, control of TAU, bigger samples, address attrition and provide more intensive therapy.     

A survey of the provision of family therapy in medium secure units in Wales and England

A cross-sectional survey design was utilised to capture a snapshot of the provision of family therapy in medium secure units (MSUs) across Wales and England during 2013. Semi-structured interviews were administered via telephone interview with 39 MSUs. Information pertaining to the main research question was also gathered from a further 10 via email follow-up. Over a third of responding MSUs in Wales and England were offering family therapy, with team members being appropriately qualified and receiving regular supervision. Systemic psychotherapy was the most prevalent approach to working with families and it is suggested here that systemic psychotherapy fits well with the complexity and uniqueness of working with families in secure contexts.     

对生前预嘱相关问题的探讨

生前预嘱是指人在意识清楚时签署一份文书来事先表达出自己在生命末期的医疗意愿。本文针对生前预嘱的理解和适用中存在的相关问题作出探讨。本文以尊严死在我国的提出以及生前预嘱在我国的推广现状为基础,从法律的视角分析了生前预嘱的合法性和必要要件,并阐明了在目前的法律框架下生前预嘱还不是生效的法律文件,生前预嘱的落实还需要亲属的同意。本文借鉴其他国家和地区对生前预嘱的立法状况并结合我国的实际,提出了对于放弃治疗和尊严死的理解,以及针对医疗实践中放弃治疗的困惑提出了对放弃治疗应该严格遵循的原则。     

Treating high-risk rapists in a New Zealand intensive prison programme

The focus of this article is on the pilot development and implementation of a prison-based intensive treatment programme for high-risk adult-victim rape offenders in New Zealand. Advances in actuarial risk assessment enabled the identification of a group of high-risk adult sex offenders for whom no dedicated treatment programme existed. Based on a review of the treatment literature for rapists, a pilot programme was developed called the Adult Sex Offender Treatment Programme (ASOTP). The programme, based on the risk–need–responsivity and cognitive behavioural therapy principles, also used an adaptation of Young's schema therapy to address personality responsivity issues and specific idiosyncratic schema associated with participant offence pathways identified by the Massachusetts Treatment Centre classification (Version 3 for rapists). Measures of responsivity and dynamic risk administered in the ASOTP indicated some success in addressing treatment needs for the pilot participants (n=10). The programme has subsequently been expanded across prison specialist treatment unit sites and delivered to a further 52 participants. Although intermediate measures continue to indicate change in dynamic risk, recidivism outcome evaluations have not yet been possible, due to low numbers of paroled participants.     

中西医结合治疗脑干出血16例临床分析

目的 通过回顾性分析脑干出血患者的临床资料,为其临床治疗提供依据。 方法 16例脑干出血患者均接受中西医结合疗法,包括常规西药治疗、高压氧治疗、理疗、加减补阳还五汤内服、针灸、推拿,治疗前后分别采用格拉斯哥昏迷量表（Glasgow coma scale,GCS）评价昏迷程度,采用神经功能缺损程度评分减少率评定临床疗效。 结果 治疗前后GCS评分比较,差异具有统计学意义（29.81±6.88 vs 14.88±8.88,t=5.77,P=0.000）。16例脑干出血患者中,基本痊愈3例,显著进步5例,进步4例,无效4例。 结论 中西医结合疗法对提高脑干出血的临床疗效及改善预后有一定意义。     

Developing an intervention to overcome procrastination

ABSTRACT

The main goal of this study was the development of a reliable intervention to overcome general procrastination orientated to college students, designed to be used in practical clinical work. The workshops involved six meetings based on behavioral and cognitive techniques, paradox intervention, and psychoeducation. 175 students participated voluntarily. Their procrastination levels were measured in a pretest, post-test, and a 3-month follow-up. After the first interview, the participants were randomly divided into three groups (Intervention A, Intervention B, and a control group with no intervention). There was a significant improvement after the intervention. After 3 months, the average score was still significantly lower than in the pretest, whereas the score of the control group remained unchanged. The participants in Workshop A scored significantly lower in the post-test than the ones in Workshop B. After 3 months, the participants in Workshop B scored significantly lower in the follow up. So both interventions resulted to be effective in reducing procrastination sustainably.     

Effectiveness of a risk–need–responsivity‐based treatment program for violent and sexual offenders: Results of a retrospective,quasi‐experimental study

Purpose

Relapse prevention is an important goal in correctional settings. Although there is strong evidence for the effectiveness of certain treatment programs for juvenile offenders, those for adults lack such evidence. This study evaluated the effectiveness of a risk–need–responsivity (RNR)‐based intervention.

Methods

A quasi‐experimental, observational study design and cox regression analysis were used to compare treated violent and sexual offenders (n = 171) with untreated offenders (n = 241).

Results

Both groups were observed for an average of 7.9 years. Recidivism rates of treated offenders (11.7%, n = 20) were similar to those of control offenders (15.8%, n = 38; p = .25). When controlling for confounding variables, the hazard of recidivism in the treatment group was 5.2% lower than that in the control group. Subdividing the treatment group resulted in lower hazard ratios for offenders still in therapy when released and offenders cancelling therapy. However, none of the group differences was statistically significant.

Conclusion

Our results show that control and RNR‐based treatment groups had comparable recidivism rates with a trend towards a positive treatment effect, especially for people in outpatient treatment. However, criminal history, age at the start of follow‐up, and actuarial risk of recidivism were significantly associated with recidivism. Future research needs to apply elaborate methodological approaches to detect robust treatment effects and consider different criteria of treatment effectiveness. Furthermore, the influence of prison climate, motivational factors, intervention quality, and factors supporting the success of outpatient treatment should be considered in future studies of larger offender samples.     

Sibling Incest: A Model for Group Practice with Adult Female Victims of Brother–Sister Incest

Working with groups of people who have been sexually abused introduces mutual experiential themes into the process that can be beneficial and meaningful. This paper discusses brother–sister incestuous sexual abuse with implications for group work. Literature and research is reviewed concerning sexual abuse, incest, family relationships, and theories that aid in explaining incest. Themes covered include: effects of incest, coping methods, blaming, and family of the victim. Common themes are explored and implications for group work are suggested on the basis of length, detail, structure, content, and pre-group contact.     

美术治疗中的儿童绘画评价——基于系统论的视野

在系统论的视角下,儿童绘画评价既是美术治疗中的一个重要因素,同时也是一个有机的系统.在美术治疗中,儿童绘画评价要立足于治疗过程中治疗师与儿童的互动关系,综合考量儿童所处的生活背景对儿童的"绘画动机"、"绘画过程"和"绘画作品"的影响,进而对儿童的行为表现等作出全面、系统的诊断和评价,最终制定和实施有针对性的治疗方案.