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.     

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.     

针刺联合正念认知疗法治疗经前期综合征随机对照研究

目的观察针刺联合正念认知疗法(mindfulness-based cognitive therapy,MBCT)治疗经前期综合征(premenstrual syndrome,PMS)的疗效。方法将130例PMS患者随机分为针刺组43例、MBCT组43例和针刺+MBCT组44例,其中针刺组和针刺+MBCT组各脱落4例,MBCT组脱落3例。针刺组取穴百会、神庭、命门、腰俞、腰阳关、关元、中脘、中极,根据穴位位置取仰卧位和俯卧位,每穴治疗各15 min,每周2次;MBCT组进行正念认知干预,每周1次;针刺+MBCT组在行针刺治疗的同时联合MBCT。3组均以8周为1个疗程,共治疗1个疗程。治疗前后,采用经前期症状评定简表(shortened premenstrual assessment form,SPAF)评定PMS症状改善情况,状态-特质焦虑问卷评定治疗前后状态焦虑(state-anxiety inventory,S-AI)和特质焦虑(trait-anxiety inventory,T-AI)的变化。结果与治疗前比较,3组患者治疗前后SPAF总分和情感因子、水肿因子、疼痛因子以及S-AI和T-AI总分均显著降低(P<0.05);3组SPAF总分和情感因子、水肿因子、疼痛因子、S-AI和T-AI评分治疗前后差值比较,差异均有统计学意义(P<0.05),针刺+MBCT组差值最大。结论针刺联合MBCT较单纯应用针刺和MBCT治疗PMS的效果更佳。     

低频电刺激联合针刺治疗神经重症昏迷合并吞咽障碍临床观察

目的 观察低频电刺激联合针刺疗法治疗神经重症昏迷合并吞咽障碍的疗效。方法 选取神经重症昏迷合并吞咽障碍患者63例,按照随机数字表法分为对照组、低频组、联合组,每组21例。3组患者均给予常规吞咽训练,低频组在常规吞咽训练基础上给予低频电刺激治疗,联合组在低频组疗法基础上予以针刺治疗。观察3组临床疗效,采用标准吞咽功能评价量表（standardized swallowing assessment,SSA）、洼田饮水试验、吞咽障碍程度分级、吞咽时间参数［口腔运送时间(oral transit time,OTT)和舌骨运动时间（hyoid movement time,HMT）］和舌骨喉复合体活动度评价吞咽功能。结果 联合组患者临床疗效显著优于对照组（P＜0.05）,但与低频组比较,差异无统计学意义（P＞0.05）。与治疗前比较,治疗后3组患者SSA评分、洼田饮水试验评分、OTT、HMT均显著降低（P＜0.05）,吞咽障碍程度、舌骨移动幅度、甲状软骨移动幅度均显著增加（P＜0.05）;联合组患者SSA评分、洼田饮水试验评分、OTT、HMT降低程度和吞咽障碍程度评分、舌骨移动幅度、甲状软骨移动幅度增加程度均显著大于对照组、低频组（P＜0.05）。结论 在常规吞咽训练和低频电刺激治疗的基础上联合应用针刺疗法,可有效改善神经重症昏迷合并吞咽障碍患者的吞咽功能,改善舌部肌肉运动,缩短吞咽时间,提高舌骨喉复合体活动度。     

清热凉血法治疗血热型银屑病的疗效及对血清P物质、血管内皮生长因子的影响

目的 探讨清热凉血法治疗血热型银屑病的临床疗效及对血清P物质(substance P,SP)、血管内皮生长因子(vascular endothelial growth factor, VEGF)的影响。方法 将43例血热型银屑病患者随机分为观察组(22例)和对照组(21例),在外用尿素乳膏的基础上,观察组予以口服清热凉血方剂,对照组予以口服复方氨肽素片,疗程均为8周。比较两组患者治疗前后银屑病面积与严重性指数(psoriasis area and severity index, PASI)、四条目瘙痒问卷(four-item itch questionnaire, FIIQ)评分、血清SP和VEGF水平,并评估临床疗效和不良反应发生率。结果 观察组临床疗效显著优于对照组(P<0.05)。两组治疗后PASI、FIIQ评分、SP水平、VEGF水平均较治疗前显著降低(P<0.05),且观察组降低程度较对照组更为显著(P<0.05)。与对照组比较,观察组的不良反应发生率更低(P<0.05)。结论 清热凉血法能有效治疗血热型银屑病,缓解瘙痒,降低血清SP和VEGF水平,且...     

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。     

从气虚络瘀论特发性肺纤维化自噬机制

中医理论认为,特发性肺纤维化（idiopathic pulmonary fibrosis, IPF）的关键病机在于“气虚络瘀”。IPF患者自噬水平不足,不能及时清除异常病理物质,造成细胞外基质过度沉积而致肺纤维化。这与气虚无力推动新陈代谢,形成病理产物堆积,进而壅滞肺络,最终导致肺叶痿弱而不用相对应。因此,自噬不足导致的病理过程可视为“气虚络瘀”病机的微观机制,运用气虚络瘀理论阐释IPF自噬机制并通过调控自噬以防治本病可能成为新的重要靶点。