Incorporating trauma-informed care into evidence-based sex offender treatment

Abstract

As we move forward in the field of sex offender treatment, clinicians should consider incorporating principles of trauma-informed care (TIC) into evidence-based sex offender treatment models. Early adverse experiences are prevalent in the general population and more so in criminal and sex offender populations. Early trauma paves the way for maladaptive coping and interpersonal deficits, which can lead to abusive behaviour. Content-oriented sex offender treatment models emphasising cognitive-behavioural skills should integrate process-oriented components that address the ways in which early trauma shapes adult cognitions and behaviour. Relational approaches to therapy can enhance clients' interpersonal skills and improve general well-being. This type of personal growth would be expected to mitigate future offending as the client adopts and successfully practices healthier, non-destructive strategies for meeting emotional needs.     

Evaluation of the assessment and treatment of a child sex offender: A case study

Abstract

There is indisputable necessity for engaging child sex offenders in effective therapy to reduce recidivist rates. However, it is becoming increasingly recognised that, to do this, more contemporary psychological methods of treatment are being utilised instead of, or as well as, imprisonment.

To establish what constitutes effective therapy requires the constant search for new and successful treatments. To achieve this, it is advantageous to follow preexisting successful methods of treatment but to acknowledge that therapy must be adapted according to an individual's unique presenting difficulties and therapeutic needs.

This paper details assessment techniques, evaluation of psychological dysfunctions, the therapy plan and treatment outcome of a convicted child sex offender. Specifically, Mr X's background history, psychological dysfunctions and progress, using a functional analysis approach, are examined in detail with critical review of the therapeutic intervention.     

Alcohol and Other Drug Problems in Older Adults

SUMMARY

While there is considerable awareness and knowledge on the part of the health and human service community on the problems of the misuse and abuse of alcohol and other drugs in the general population, this unfortunately often does not extend to older adults, those who are 60+. Problems with alcohol and other drugs in older persons is in itself not a sudden crisis or new problem. However, as with any health problem affecting a specific demographic group, when the problem is not recognized and appropriately dealt with the repercussions pose greater risks for the individuals with the problem as well as for the larger community. This is particularly true in regard to older adults where natural physical changes and increased age related health risks can only be exacerbated by the misuse and abuse of substances.     

中药外用治疗膝关节骨性关节炎的临床观察

目的:观察中药外用治疗膝骨性关节炎的疗效.方法:将58例膝骨性关节炎患者随机分为治疗组(35例)和对照组(23例),治疗组采用中药外敷和熏洗,对照组内服芬必得,治疗6周后按JOA的膝骨性关节炎治疗效果判定标准进行打分评估.结果:治疗组优良率为85.7%,对照组优良率为82.6%.治疗组在改善关节屈曲角度及强直挛缩方面优于对照组(P<0.05),且没有内服药的不良反应.结论:中药外治法是非手术治疗膝骨性关节炎的一种可行方法.     

腰椎间盘突出症康复治疗的疗效观察

目的:探讨运动训练治疗对腰椎间盘突出症的疗效的影响。方法:将86例腰椎间盘突出症患者随机分成两组。试验组(48例):接受运动训练,牵引,直流电药物导入,超短波综合治疗。对照组(38例):接受牵引,直流电药物导入,超短波常规治疗。两组患者年龄、病程病情相近,具有可比性。结果:实验组和对照组近期治愈率无显著差异(p>0.05),实验组远期复发率低于对照组(p<0.05)有显著差异性。结论:运动训练加物理疗法是治疗腰间盘突出症的一种有效办法。     

辨证论治结合生物反馈治疗功能性排便障碍临床研究

目的 观察中医辨证分型结合生物反馈治疗功能性排便障碍（functional defecation disorders,FDD）的临床疗效。方法 选取90例符合FDD诊断标准的患者,根据随机分组方法分为生物反馈组30例、中医辨证组30例、综合治疗组30例。生物反馈组患者接受盆底生物反馈治疗,中医辨证组患者在中医辨证分型基础上给予中药口服,综合治疗组患者在口服中药的基础上联合盆底生物反馈治疗,10 d为1个疗程,共治疗3个疗程。观察治疗前后3组患者的临床症状积分、便质积分、肛管直肠压力、直肠感觉值、盆底Glazer评估及球囊逼出试验情况并作前后对比,观察不同治疗方法的临床疗效。结果 综合治疗组在肛门坠胀、排便间隔时间、排便方式、便质的改善程度上优于生物反馈组（P<0.05）,在肛门坠胀、便感的改善程度上优于中医辨证组（P<0.05）。综合治疗组治疗后肛管静息压、肛管收缩压、直肠排便压改善程度与其他两组比较,差异具有统计学意义（P<0.05）,直肠静息压低于中医辨证组（P<0.05）。综合治疗组治疗后初始感觉阈值、疼痛阈值改善程度均优于生物反馈组和中医辨证组,差异具有统计学意义（P<0.05）,排便阈值改善程度优于中医辨证组（P<0.05）。综合治疗组治疗后快速收缩值、耐久收缩值改善程度优于其他两组,差异均有统计学意义（P<0.05）,持续收缩值改善程度优于中医辨证组（P<0.05）。3组治疗后球囊逼出试验转阴率比较,差异具有统计学意义(P<0.05),以综合治疗组转阴率为最高。结论 中医辨证论治结合生物反馈治疗FDD的临床效果优于单纯中医辨证治疗或者生物反馈治疗。     

四维一体疗法治疗粘连性肠梗阻临床研究

目的 观察四维一体疗法治疗粘连性肠梗阻的临床疗效。方法 将87例粘连性肠梗阻患者随机分为观察组（45例）和对照组（42例）。对照组给予外科基础治疗,观察组除外科基础治疗外,给予四维一体疗法治疗,即中药辨证胃管注入、中医辨证敷脐、中医辨证灌肠、中医针刺。治疗结束后观察两组腹痛缓解时间、自主排气时间、自主排便时间、泛影葡胺到达升结肠和降结肠时间,并观察临床疗效及中转手术率。结果 与对照组比较,观察组腹痛缓解时间、自主排气时间、自主排便时间以及泛影葡胺到达升结肠和降结肠时间明显缩短,差异均有统计意义（P＜0.05）。两组临床疗效比较,差异无统计意义（P>0.05）。观察组中转手术率较对照组明显降低,差异有统计意义（P＜0.05）。结论 在外科基础治疗的基础上,联合中医四维一体疗法治疗粘连性肠梗阻疗效确切,能够提高临床疗效,缩短患者康复时间和降低中转手术率。     

益气活血方加减改善妇科恶性肿瘤患者高凝状态临床观察

目的 观察血府逐瘀汤合乌药散加减对妇科恶性肿瘤患者高凝状态的改善作用。方法 将60例妇科恶性肿瘤患者随机分为观察组和对照组,每组30例,观察组以血府逐瘀汤合乌药散加减治疗,对照组以低分子肝素及常规抗凝治疗。治疗前和治疗3周后,分别检测两组患者外周血小板计数（platelet, PLT）,血浆纤维蛋白原（fibrinogen, FIB）、D-二聚体（D-Dimer,D-D）水平,并观察静脉血栓栓塞症（venous thromboembolism, VTE）积分、卡氏功能状态量表（Karnofsky’s performance scale,KPS）积分和中医证候积分。结果 两组综合疗效比较,差异无统计学意义（P>0.05）。与治疗前比较,两组治疗后D-D、FIB水平和血瘀证积分、VTE积分均显著降低（P<0.05）,观察组治疗前后血瘀证积分差值显著大于对照组（P<0.05）。两组治疗后KPS变化比较,差异有统计学意义（P<0.05）,观察组生活质量改善情况明显优于对照组。对照组有2例齿龈出血和2例大便带血,观察组未见不良反应。结论 血府逐瘀汤合乌药散可改善妇科肿瘤患者的高凝状态。     

补肾活血法对自然流产血栓前状态早期干预研究

目的 观察补肾活血法对自然流产血栓前状态的临床疗效。方法 将50例自然流产血栓前状态患者随机分为治疗组和对照组,每组25例。对照组口服阿司匹林肠溶片治疗,治疗组在对照组治疗基础上服用补肾活血中药。观察治疗前后患者血清D-二聚体（D-dimer, D-D）、纤维蛋白降解产物（fibrinogen degradation product, FDP）水平、凝血功能相关实验室指标,并对患者妊娠结局进行评价。结果 与治疗前比较,两组治疗后FDP、纤维蛋白原（fibrinogen, Fib）显著降低（P<0.05）,活化部分凝血活酶时间（activated partial thromboplastin time,APTT）、凝血酶时间（thrombin time,TT）均显著延长（P<0.05）。治疗组Fib降低值和TT升高值显著大于对照组（P<0.05）。对照组治疗后19例妊娠,成功妊娠11例,妊娠成功率为57.9%;治疗组妊娠20例,成功妊娠18例,妊娠成功率为90.0%。两组妊娠成功率比较,差异有统计学意义（P＜0.05）。结论 补肾活血法协同阿司匹林能明显改善自然流产血栓前状态,提高患者妊娠成功率。     

中西医结合非手术治疗老年外伤性稳定型硬膜下积液16例

目的 观察中西医结合非手术治疗老年外伤性稳定型硬膜下积液的临床疗效。〖JP2〗方法 将28例老年外伤性稳定型硬膜下积液患者分为治疗组16例和对照组12例,对照组采用常规治疗,治疗组在对照组疗法基础上采用补阳还五汤加减配合治疗。治疗相同疗程后观察两组临床疗效及脑积液消失时间。结果 两组临床疗效比较,差异无统计学意义（P>0.05）;治疗组脑积液消失时间显著少于对照组（P<0.05）。结论 中西医结合非手术疗法对老年稳定型外伤性硬膜下积液具有较好的疗效,可加快脑积液的消失时间。