Clinical Case Studies最新文献_第2页

Weight Restoration and Symptom Remission for Longstanding, Untreated Anorexia Nervosa in a Remote Eating Disorder Treatment Program: A Case Study 远程饮食失调症治疗项目中长期未愈的神经性厌食症患者的体重恢复和症状缓解：案例研究

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-12-19 DOI: 10.1177/15346501231222495

Caitlin B. Shepherd, Rebecca G. Boswell, Jessica Genet, Wendy Oliver-Pyatt, Christine Stockert, Rebecca Brumm, Shaun Riebl, Katie Piel

{"title":"Weight Restoration and Symptom Remission for Longstanding, Untreated Anorexia Nervosa in a Remote Eating Disorder Treatment Program: A Case Study","authors":"Caitlin B. Shepherd, Rebecca G. Boswell, Jessica Genet, Wendy Oliver-Pyatt, Christine Stockert, Rebecca Brumm, Shaun Riebl, Katie Piel","doi":"10.1177/15346501231222495","DOIUrl":"https://doi.org/10.1177/15346501231222495","url":null,"abstract":"For severe cases of anorexia nervosa (AN), including when poor prognostic factors like low body mass index (BMI) and longer illness duration are present, intermediate levels of care are often indicated. Current guidelines call for treatment programs to use an evidence-based practice approach to individualize treatment and optimize outcomes. Research supports the effectiveness of intermediate levels of care, including remote programs which increase access to treatment. However, conflicting evidence exists regarding the ability to safely weight restore clients during remote care, necessitating further research. This case report highlights the viability of treating clients with AN remotely using an evidence-based practice approach, resulting in weight restoration and symptom remission. The client presented with a longstanding history of severe binge-eating/purging AN with numerous medical complications but was motivated and treatment-compliant. Her eating disorder (ED) was conceptualized using a biopsychosocial perspective and treated using a multidisciplinary, evidence-based practice approach encompassing individual, group, and supportive interventions. She was successfully discharged from treatment after 150 days, having restored weight to a healthy range and showing substantial improvements in ED, depressive, and anxiety symptoms based on validated measures. This case contributes to the evidence that remote care can be an accessible and effective treatment option, even in cases of severe AN. The case highlights how an evidence-based practice approach can enable safe weight restoration via a personalized treatment plan that emphasizes the use of remote devices and self-monitoring.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"122 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138958883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional Communication Training Without the Removal of a Tangible Item 不移除有形物品的功能性交流训练

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-12-08 DOI: 10.1177/15346501231221284

David W. Cosottile, Emily Exline, Jessica S. Akers, Stephanie Gerow, Remington Swensson

{"title":"Functional Communication Training Without the Removal of a Tangible Item","authors":"David W. Cosottile, Emily Exline, Jessica S. Akers, Stephanie Gerow, Remington Swensson","doi":"10.1177/15346501231221284","DOIUrl":"https://doi.org/10.1177/15346501231221284","url":null,"abstract":"Children with autism spectrum disorder (ASD) engage in challenging behavior that can result in missing out on potential reinforcers. A common intervention for challenging behavior is functional communication training (FCT). In FCT, the clinician reinforces an appropriate communicative response using the same reinforcer maintaining the challenging behavior. In some cases, the challenging behavior is too severe for traditional FCT procedures to efficiently teach a new response. In this case study, we treated a 4-year-old boy with ASD referred to as Mostafa using a modified version of FCT. We did not include a typical component of traditional FCT procedures – the removal of the putative reinforcer prior to the trial. Instead, we provided components of toys and games contingent on the appropriate communication response. None of the components had to be removed to continue conducting learning trials. Mostafa’s communication increased and challenging behavior decreased as a result of this modification. This modification may be useful for other cases in which the removal of a tangible item interferes with learning a communication response.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"52 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138588155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Merging Acceptance and Commitment Therapy with Exposure Exercises to Treat Social Anxiety in a Teen 将 "接受与承诺疗法 "与 "暴露练习 "相结合，治疗青少年的社交焦虑症

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-11-20 DOI: 10.1177/15346501231217745

Caleb D. Farley, M. Twohig

{"title":"Merging Acceptance and Commitment Therapy with Exposure Exercises to Treat Social Anxiety in a Teen","authors":"Caleb D. Farley, M. Twohig","doi":"10.1177/15346501231217745","DOIUrl":"https://doi.org/10.1177/15346501231217745","url":null,"abstract":"Social anxiety disorder (SAD) often develops during teenager years, and it is important to conceptualize developmentally appropriate interventions. Exposure therapy framed from a perspective of acceptance and commitment therapy (ACT) shows promise for decreasing pathology and increasing wellbeing. This case illustrates the process through which exposure therapy was integrated with ACT to elicit meaningful outcomes in a case of SAD with a 16-year-old female. Treatment outcomes assessed included engagement in values-based activities as well as assessments of depression, anxiety, experiential avoidance, and context-specific wellness. Intervention focused on learning ACT principles through relatable metaphors and experiential exercises and practicing them with values-guided social exposures. This integration resulted in increased engagement of socially meaningful experiences and associated changes in treatment outcomes. Implications, guidelines, and recommendations are presented, including the need for skill-focused treatments, identifying deficits in psychological flexibility, and maintaining a compassionate yet growth-oriented course of treatment.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"271 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using Cognitive Analytic Therapy as a Transdiagnostic Intervention for Comorbid Personality Disorder, Posttraumatic Stress Disorder, and Functional Neurological Symptom Disorder: A Case Report of a 68 Woman’s Journey Toward the Integration of Dissociated Self-States 使用认知分析疗法作为对共病型人格障碍、创伤后应激障碍和功能性神经症状障碍的跨诊断干预:一名68岁女性迈向分离自我状态整合之旅的病例报告

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-08-29 DOI: 10.1177/15346501231198483

Rowan Tinlin-Dixon

{"title":"Using Cognitive Analytic Therapy as a Transdiagnostic Intervention for Comorbid Personality Disorder, Posttraumatic Stress Disorder, and Functional Neurological Symptom Disorder: A Case Report of a 68 Woman’s Journey Toward the Integration of Dissociated Self-States","authors":"Rowan Tinlin-Dixon","doi":"10.1177/15346501231198483","DOIUrl":"https://doi.org/10.1177/15346501231198483","url":null,"abstract":"Functional neurological symptom disorder (FND) is associated with complex specialist investigations and poor prognosis. The theoretical understanding of FND posits that functional symptoms are predisposed by both psychological factors, including attachment disturbances and childhood trauma, and biological factors such as neuroplasticity and epigenetics. Current treatment recommendations include psychological therapy, with moderate effects observed with cognitive-behavioural therapy and psychodynamic therapy modalities, however, psychological understanding is key to success. The current case report describes cognitive analytic therapy (CAT) with a 68 year-old woman presenting to services with diagnoses of FND and borderline personality disorder (BPD). The target problem for therapy was integration of fragmented self-states (dissociative and driven) pertinent to both FND and BPD. 16 session CAT was delivered, with four follow up sessions, exploring unhelpful patterns of relating with self and others, based on an unconscious repertoire of internalised patterns and procedures from early life. CAT tools were used to facilitate change; reformulation and ending letters, mapping and the therapeutic relationship. Scores on the personality structure questionnaire (PSQ) and an idiosyncratic measure of state-shifting indicated positive outcomes, sustained at 3 month follow up. This shows modest early acceptability and feasibility of CAT for working with comorbid BPD and FND, providing a validating and blame free formulation of the development and maintenance of symptoms. Additional measures would have improved the ability to comment on the effectiveness of the treatment and future research implications are discussed.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47351104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Integrating Cognitive-Behavioral Therapy With Compassion-Focused Therapy for the Treatment of Social Anxiety Disorder: An Evidence-Based Case Study 整合认知行为疗法与同情疗法治疗社交焦虑障碍:基于证据的案例研究

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-08-26 DOI: 10.1177/15346501231197403

Mary Baumgardner, Kristy Benoit Allen

{"title":"Integrating Cognitive-Behavioral Therapy With Compassion-Focused Therapy for the Treatment of Social Anxiety Disorder: An Evidence-Based Case Study","authors":"Mary Baumgardner, Kristy Benoit Allen","doi":"10.1177/15346501231197403","DOIUrl":"https://doi.org/10.1177/15346501231197403","url":null,"abstract":"Cognitive-behavioral therapy (CBT) is an evidence-based treatment for social anxiety disorder that has been found to elicit significant changes in process-based mechanisms (e.g., emotion regulation strategies), which subsequently lead to reductions in social anxiety and associated functional impairment; however, CBT may be less effective for socially anxious individuals experiencing high self-criticism and low self-compassion. Compassion-focused therapy (CFT) has been used to address these tendencies in socially anxious individuals, but research in this area is limited. The present case study examined changes in social anxiety symptoms, self-compassion, emotion regulation strategies, and functional impairment throughout the course of treatment with a young, Chinese American woman using a novel integration of CBT and CFT for social anxiety disorder. The client experienced significant reductions in social anxiety and functional impairment across treatment, which was accompanied by reductions in fear and avoidance ratings for feared social scenarios. Significant mechanistic changes were also observed, including decreases in maladaptive emotion regulation strategies (i.e., suppression, rumination) and increases in self-compassion and adaptive emotion regulation strategies (i.e., expressive engagement, cognitive reappraisal). Findings support the efficacy of integrating compassion-focused strategies with CBT for social anxiety for a young adult with prominent tendencies of self-criticism and low self-compassion.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45055492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Reflections and Treatment Adaptations for Avoidant Restrictive Food Intake Disorder: A Case Study 回避型限制性食物摄入障碍的临床反思和治疗适应:一个案例研究

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-07-28 DOI: 10.1177/15346501231190913

J. Webb, N. Dhopatkar, P. Croft, H. Himmerich, C. Baillie, L. Dodwell, K. Tchanturia

引用次数: 0

Opening Treatment Windows for Treatment-Resistant Schizophrenia: Improving Emotion Regulation Strategies Using the Unified Protocol in a Case Study in Spain 打开治疗难治性精神分裂症的治疗窗口：使用统一方案改善情绪调节策略——以西班牙为例

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-07-21 DOI: 10.1177/15346501231190912

E. Grasa, I. Corripio, Ó. Peris-Baquero, A. Roldán, Judit Selma, J. Osma

{"title":"Opening Treatment Windows for Treatment-Resistant Schizophrenia: Improving Emotion Regulation Strategies Using the Unified Protocol in a Case Study in Spain","authors":"E. Grasa, I. Corripio, Ó. Peris-Baquero, A. Roldán, Judit Selma, J. Osma","doi":"10.1177/15346501231190912","DOIUrl":"https://doi.org/10.1177/15346501231190912","url":null,"abstract":"Approximately 30%-50% of people with schizophrenia worldwide have treatment-resistant schizophrenia (TRS). Currently available standard psychopharmacological and psychological treatments have proven insufficient to achieve full recovery in these patients. Alternative psychological interventions focused on improving emotion regulation, such as the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), could potentially improve treatment outcomes in this difficult to treat population. The aim of the present case study is to demonstrate how the UP can be adapted for the treatment of TRS. We decided to use UP to treat this particular patient due to the presence of intense unpleasant emotions, aversive reactions, and emotional avoidance strategies. After completing the full treatment protocol, the patient showed significant decreases in scores on the Difficulties in Emotion Regulation Scale (DERS), including total and emotional rejection, life interference, and emotional lack of control. A significant reduction was also observed in anxiety (OASIS) and depressive symptoms (ODSIS). The intervention had a positive impact on auditory hallucinations, with decreased severity, less intense anxiety, and less interference in life. The treatment led to greater control over voices and the patient reported feeling more confident in her relationship with those voices. These results provide preliminary support for the use of UP for the treatment of TRS.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42437152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disentangling the Consequences of Systemic Racism and Clinical Paranoia to Promote Effectiveness of a Cognitive-Behavioral Intervention for Persecutory Delusions in Minoritized Individuals: A Case-Example 解开系统性种族主义和临床偏执的后果以提高认知行为干预对未成年个体顽固性妄想的有效性：一个案例

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-07-19 DOI: 10.1177/15346501231190920

A. Moussa-Tooks, Julia M. Sheffield, D. Freeman, Aaron P. Brinen

{"title":"Disentangling the Consequences of Systemic Racism and Clinical Paranoia to Promote Effectiveness of a Cognitive-Behavioral Intervention for Persecutory Delusions in Minoritized Individuals: A Case-Example","authors":"A. Moussa-Tooks, Julia M. Sheffield, D. Freeman, Aaron P. Brinen","doi":"10.1177/15346501231190920","DOIUrl":"https://doi.org/10.1177/15346501231190920","url":null,"abstract":"While everyone experiences threats, some threats are culturally specific and not universally recognized or addressed by providers. A prominent example is threat-based worry and hypervigilance in Black Americans and other minoritized individuals, which is higher due to systemic racism and increases risk for psychopathology like clinically significant paranoia. To date, there have been no adaptations of cognitive-behavioral therapies for Black Americans with psychosis, despite the long-standing history of systemic racism in the United States, and its increasingly recognized contribution to psychotic experiences. Accordingly, we present the first step towards developing an adapted cognitive-behavioral intervention for Black and minoritized Americans with psychosis. This adaptation of an empirically supported worry-based treatment for persecutory delusions was accomplished by comprehensive conceptualization and integration of how systemic racism and minoritization drive the prevalence and perception of threats. This contrasts with conceptualizing racism-related hypervigilance and cognitions as worry or ignoring these critical experiences altogether, which is invalidating and neglects optimal identification and intervention on behavioral targets. Using a validating and normalizing approach, the individual was able to identify how frequent threats related to systemic racism resulted in increased worry, vigilance, and distress. By identifying and intervening on the perception of threat and associated worry, the individual engaged in more helpful responses to the threat, which in turn increased participation in more meaningful activities and reduced worry and clinical paranoia. This case illustrates how accurate conceptualization clarifies behavioral targets and increases patient engagement, which together enhance the effectiveness of the intervention for minoritized individuals.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44130016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dialectical Behaviour Therapy Enhanced Habit Reversal Training: A Clinical Case of Childhood-Onset Trichotillomania in an Adult With Impulsive Personality Features 辩证行为疗法强化习惯逆转训练:儿童期冲动型成人拔毛癖临床一例

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-07-13 DOI: 10.1177/15346501231189552

Sheeba Shamsudeen, Prasad Kannekanti

{"title":"Dialectical Behaviour Therapy Enhanced Habit Reversal Training: A Clinical Case of Childhood-Onset Trichotillomania in an Adult With Impulsive Personality Features","authors":"Sheeba Shamsudeen, Prasad Kannekanti","doi":"10.1177/15346501231189552","DOIUrl":"https://doi.org/10.1177/15346501231189552","url":null,"abstract":"Research has recognised the psychosocial impairments linked to Trichotillomania (TTM) and established a relationship between problematic hair-pulling and affective regulation. Significant relationships between pulling triggers, their severity, and emotional dysregulation have also been predicted. The current case focused on the efficacy of combined DBT (Dialectical Behaviour Therapy) and HRT (Habit Reversal Training) in a client with TTM and Impulsive Personality features. The client received 11 weekly sessions of DBT-enhanced HRT, which took 3 months to complete. Following the end of this acute treatment phase, four maintenance sessions (two sessions per month) were delivered. The maintenance of treatment benefits was assessed using self-report measures and therapist observations at four time points: at pre-treatment, after the acute treatment phase (at the end of 3 months), and then at a 3-month and a 6-month follow-up. The intervention results suggested a substantial reduction in hair-pulling, hair regrowth in affected parts of the scalp, and self-reported improvements in mood. The study also shows preliminary evidence of DBT-enhanced HRT’s efficacy in a client with TTM and Impulsive Personality features, suggesting the importance of addressing personality structures and distressing emotional regulation that cause functional impairment during TTM treatment.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42712663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Differential Reinforcement Without Extinction and Stimulus Fading to Teach Tolerance of a Sleep Study 无消差强化与刺激消退对睡眠耐受性的影响

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-06-15 DOI: 10.1177/15346501231184269

Sarah E. Martinez, Seth G. Walker, Amanda N. Zangrillo, Alicia N. Graham

{"title":"Differential Reinforcement Without Extinction and Stimulus Fading to Teach Tolerance of a Sleep Study","authors":"Sarah E. Martinez, Seth G. Walker, Amanda N. Zangrillo, Alicia N. Graham","doi":"10.1177/15346501231184269","DOIUrl":"https://doi.org/10.1177/15346501231184269","url":null,"abstract":"There are a growing number of publications supporting behavior-analytic strategies to increase compliance with medical procedures. However, little research has been conducted on the application of applied behavior analysis to teach compliance with and completion of the setup required for an overnight sleep study (polysomnography). The client in this report presented with autism, cerebral palsy, epilepsy, strokes, and severe destructive behavior (i.e., aggression, property destruction, self-injury). These conditions combined with a poor sleep/wake schedule and gasping during the night necessitated a sleep study. The caregiver referred their child to behavioral outpatient services due to medical noncompliance and severe destructive interfering behaviors with similar procedures (e.g., failed electroencephalogram [EEG]). We evaluated the effects of differential reinforcement without extinction and stimulus fading on compliance and reduction of destructive behavior with a 25-step sleep study procedure. Our approach successfully taught tolerance of the procedure and reduced destructive behavior. The client completed the scheduled sleep study and received a diagnosis of mild obstructive sleep apnea.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47766025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0