Clinical Case Studies最新文献_第2页

Continuous Saliva Packing Resulting in Feeding Tube Dependence: In-Home Behaviour-Analytic Treatment 持续唾液包裹导致喂食管依赖：居家行为分析治疗

IF 1 4区心理学

Clinical Case Studies Pub Date : 2024-03-21 DOI: 10.1177/15346501241241540

Tessa Taylor, Nikolas F. Roglić

{"title":"Continuous Saliva Packing Resulting in Feeding Tube Dependence: In-Home Behaviour-Analytic Treatment","authors":"Tessa Taylor, Nikolas F. Roglić","doi":"10.1177/15346501241241540","DOIUrl":"https://doi.org/10.1177/15346501241241540","url":null,"abstract":"Saliva packing can be one of the most severe life-threatening and challenging behaviours to treat. A 9-year-old male with autism spectrum disorder and intellectual disability had 100% nasogastric (NG) feeding tube dependence and significant adaptive behaviour regression (in speaking, using the toilet and his hands, school attendance, sleep). He participated in an intensive behaviour-analytic paediatric feeding treatment programme. Saliva packing, as an automatically-maintained undifferentiated behaviour that persisted in all waking contexts despite high engagement in activities, warranted an additional outside of meal approach. He began swallowing, met 100% of his 21 goals, gained weight, and eliminated tube dependence. He reached a variety of 94 across all food groups, drinks, and supplements. Caregivers were trained and reported high social validity, and gains generalised and maintained in 1-month follow-up. This is the first case to our awareness in Australia of an in-home solely behaviour-analytic intervention to eliminate tube dependence, and it was conducted without hunger provocation, weight loss, or limited nutritional variety.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140196941","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

When the Perpetrator is Found Not Guilty: Implications for the Treatment of Adolescent Sexual Assault Survivors 当犯罪者被判无罪时：对青少年性侵犯幸存者治疗的影响

IF 1 4区心理学

Clinical Case Studies Pub Date : 2024-01-16 DOI: 10.1177/15346501241228250

Brendan Willis, William O'Donohue

{"title":"When the Perpetrator is Found Not Guilty: Implications for the Treatment of Adolescent Sexual Assault Survivors","authors":"Brendan Willis, William O'Donohue","doi":"10.1177/15346501241228250","DOIUrl":"https://doi.org/10.1177/15346501241228250","url":null,"abstract":"Sexual assault survivors can experience a wide variety of psychological consequences—from none to Major Depression Disorder to Substance use and, most commonly, Acute Stress Disorder/Post Traumatic Stress Disorder. These clinical outcomes depend on the severity of the assault, as well as pre-assault psychological status, and post-assault social support, the effectiveness of therapy, and events that occur during therapy. This case study will focus on one particular event that can arise during the treatment of a survivor of sexual assault, namely the impact of a not guilty verdict on the survivor occurring during the course of therapy. The client in question experienced an immediate and significant increase in depressive symptoms and the course of therapy needed to be altered significantly to respond to the not guilty verdict rendered during the therapy process. This case study will explore how therapy was altered in response to this guilty verdict and the lessons that were learned from this experience in order to better prepare assault survivors who are involved in legal proceedings during their therapy. Overall, this case study demonstrated the vital need to prepare survivors who plan to testify in court against the perpetrator beforehand for all possible outcomes of the trial. Furthermore, the case study demonstrated the need to implement effective interventions in the aftermath of a trial to help buffer against the effects of a “not guilty” verdict.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139528288","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

ACT-Enhanced Behavior Therapy for a Hispanic Adult with Trichotillomania: A Case Report 对一名患有毛手毛脚症的西班牙裔成人进行 ACT 行为疗法强化治疗：病例报告

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-12-28 DOI: 10.1177/15346501231225505

Marissa L. Donahue, M. Twohig

引用次数: 0

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":null,"pages":null},"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

Integration of Motivational Interviewing and Self-Affirmation Theory into a Culturally Adapted Motivational Interview: A Case Study 将动机访谈和自我肯定理论融入适应不同文化的动机访谈：案例研究

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-12-15 DOI: 10.1177/15346501231222554

Christina S. Lee, David K. Sherman

{"title":"Integration of Motivational Interviewing and Self-Affirmation Theory into a Culturally Adapted Motivational Interview: A Case Study","authors":"Christina S. Lee, David K. Sherman","doi":"10.1177/15346501231222554","DOIUrl":"https://doi.org/10.1177/15346501231222554","url":null,"abstract":"Annually, alcohol, tobacco, and illicit drug use are responsible for the 11.8 million deaths worldwide, exceeding the number of deaths from all cancers ( Ritchie & Roser, 2018 ). Motivational Interviewing (MI), a person-centered addiction counseling approach ( Miller & Rollnick, 2013 ), is designed for those with low motivation to change. MI is presumed to minimize client defensiveness by avoiding confrontation. Culturally adapting evidence-based treatments such as MI may reduce alcohol-related health disparities among Latinx adults. A completed randomized trial tested the relative efficacy of Culturally Adapted Motivational Interview (CAMI) compared to MI in Latinx drinkers. CAMI had beneficial alcohol use effects among persons who reported high discrimination and stigma ( Lee et al., 2019 ). Self-Affirmation Theory, which provides a mechanism where stigma effects can be buffered, was integrated into the CAMI. Augmenting affirmation in the CAMI is postulated to lower defensiveness and increase openness to information that pose a threat to self-image ( Sherman & Cohen, 2006 ). The purpose of this case example is to present the novel features of CAMI and to suggest how affirmation may have played in the CAMI’s beneficial effects for individuals with high discrimination. The case example illustrates how the CAMI addresses three conditions for self-affirmation associated with strongest effects on motivating behavior change ( Ferrer & Cohen, 2019 ): the presence of psychological threat, timing and availability of resources.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138997034","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":null,"pages":null},"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":null,"pages":null},"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

High Intensive Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder for a 72-year-Old Man 高强度暴露和反应预防疗法治疗一名 72 岁男子的强迫症

IF 1 4区心理学

Clinical Case Studies Pub Date : 2023-11-15 DOI: 10.1177/15346501231209334

Melissa Gabriella Guineau, Richard Oude Voshaar, Gert-Jan Hendriks

{"title":"High Intensive Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder for a 72-year-Old Man","authors":"Melissa Gabriella Guineau, Richard Oude Voshaar, Gert-Jan Hendriks","doi":"10.1177/15346501231209334","DOIUrl":"https://doi.org/10.1177/15346501231209334","url":null,"abstract":"The prevalence of Obsessive-compulsive disorder (OCD) among older adults varies between .5% and 4.5%. OCD typically develops at a young age, and many clinicians consider the chances of successful treatment in older adults to be minimal based on the chronicity of their symptoms. To date, no randomized controlled trial have been conducted on the effectiveness of treatments for OCD in older adults. This case study describes a high intensive cognitive behavioral therapy (CBT) provided to a 72-year-old man with OCD. This CBT program includes psychoeducation, exposure and response prevention, and cognitive therapy. The treatment was provided by a team of 5 therapists over one week. The patient’s score on the Yale Brown Obsessive-Compulsive Scale decreased from 31 at the start of the treatment to 2 by the end of treatment, which is below the recommended cut-off for a clinical diagnosis. Secondary depressive symptoms, as assessed with the Inventory of Depressive Symptomatology Self-Report, decreased from 57 at the start of treatment, to 1 by the end of treatment, which indicates the absence of depressive symptoms. The treatment gains were maintained with persistent remission until the 18-month follow-up. This study highlights an effective high intensive CBT program for older adults with OCD and challenges the false assumptions that (a) psychological interventions are ineffective for older adults and (b) existing treatments are unsuited for older adults. Future research should investigate the effects of this program in large sample with sufficient power.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274030","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":null,"pages":null},"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":null,"pages":null},"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