No description available.

No description available.

Various community-based mental health and family agencies offer walk-in counselling services, where clients are provided with immediate access to a single session of brief therapy without appointments or referrals. Several studies have demonstrated the effectiveness of single-session therapy (SST) delivered within walk-in counselling clinics. This type of service delivery model has been found to be helpful for parents, who experience decreased hopelessness and psychological distress by increasing their confidence about their parenting. The purpose of this multiple case study was to investigate how parents perceived their parenting self-efficacy over time following a virtual single-session therapy at a children's mental health centre. Additionally, this study explored how parents perceived their overall experience utilizing this type of service delivery model. Eight mothers participated in a retrospective individual interview. Findings indicate that virtual SST provided parents with greater parental knowledge and concrete collaborative problem-solving strategies that improved parent-child interactions. Further, the emotional support received at the SST reduced parents' distress while increasing hopefulness in the parenting role. In addition, parents valued the accessibility and convenience of the virtual option. Overall, the findings of this study provide evidence that virtual SST can be beneficial for parents and can foster parental self-efficacy.

[pt] O presente trabalho tem como objetivo investigar os modos não verbais de comunicação presentes na dinâmica clínica, pelas perspectivas da psicanálise relacional e da etologia. Inicialmente apresentaremos possíveis interlocuções entre a psicanálise e a etologia, através de conceitos que se mostram intercambiáveis e frutíferos para ambas as ciências. Em seguida, resgataremos o viés biológico trazido por Freud em suas primeiras construções teóricas a partir das investigações sobre a neurose. Elas desembocam nos dilemas trazidos pelo conceito de pulsão e no papel da representação na metapsicologia freudiana. Em um terceiro momento, nos aprofundaremos sobre a psicanálise relacional e a teoria do apego, de onde extraímos importantes considerações sobre os aspectos primitivos da constituição psíquica e da comunicação não verbal. A dimensão sensorial da experiência e os processos intersubjetivos serão abordados como fatores essenciais no desenvolvimento do indivíduo. Por fim, dedicaremos especial atenção ao manejo da esfera não verbal no contexto clínico. Através de uma leitura eto-psicanalítica dos sofrimentos emocionais primitivos, destacaremos os fenômenos sensoriais que se apresentam em determinados quadros psicopatológicos. Discutiremos as adaptações filogenéticas adquiridas ao longo do processo evolutivo, que trazem um novo olhar sobre os processos de comunicação mediados pelo corpo e auxiliam o analista na compreensão das marcas sensoriais deixadas pelo trauma precoce. Defenderemos a hipótese de que há em todo sujeito um núcleo inacessível à fala, que aparece como material clínico principalmente na análise de pacientes graves, onde o comprometimento psíquico encontra-se em níveis mais profundos da personalidade. / [en] This paper aims to investigate non-verbal communication displayed in clinical settings from the perspectives of relational psychoanalysis and ethology. After revisiting Freud’s biological perspective on neurosis from his first theoretical constructions, we will initially set a dialogue between psychoanalysis and ethology through concepts that prove to be interchangeable and fruitful to both sciences. This discussion brings us to the dilemmas inherent to the concept of drive and the role of representation in Freudian metapsychology. Hereafter we will go deeper into relational psychoanalysis and attachment theory from which we derive important considerations about primitive aspects of the psychic constitution and non-verbal communication. The sensory dimension of the experience and the intersubjective processes will be addressed as essential factors in the individual s development. Finally, we will offer special attention to the management of nonverbal communication in clinical settings. We will then highlight through an eto-psychoanalytic approach of primitive emotional suffering the sensory phenomena displayed in certain psychopathological situations. We will discuss the phylogenetic adaptations acquired throughout the evolutionary process and how they introduce a new understanding to communication processes mediated by the body that may assist the analyst in understanding the sensory marks left by early trauma. We will defend the hypothesis that in every subject there is a nucleus inaccessible through speech which manifests itself clinically and how this nucleus is especially present in the analysis of critically ill patients whose psychic impairment is found at deeper levels of the personality.

[pt] A idealização da experiência subjetiva da mulher em relação à maternidade se contrasta com novos ideais femininos que não mais se restringem à maternidade e ao matrimônio. Com isso, as exigências advindas desse novo modelo de maternidade encontram-se em constante conflito com as conquistas femininas das últimas décadas. Nesta perspectiva, no presente trabalho abordaremos aspectos concernentes às ressonâncias psíquicas e às mudanças subjetivas que se forjam na nova mãe a partir do nascimento de um filho, fundamentais para o processo da construção da maternidade. Nosso intuito será apontar que os primeiros tempos da maternidade inauguram para a mulher um imprevisível e profundo trabalho psíquico, ancorado tanto em sua história pessoal quanto no contexto social no qual se vive, uma vez que o tornar-se mãe não está livre das suposições de seu tempo. / [en] The woman s idealization of the subjective experience of motherhood contrasts with the new feminine ideals which are no longer restricted to motherhood and marriage. Therefore, the demands arising from this new model of motherhood are in constant conflict with the female conquests of the last decades. With this perspective, in the present work we will approach aspects concerning the psychic resonances and the subjective changes that are molded in the new mother after the birth of a child, which are fundamental to the process of motherhood construction. Our intention will be to point out that the early days of motherhood inaugurate for women an unpredictable and deep psychic work, anchored both in their personal history and in the social context in which they live, since becoming a mother is not free from the assumptions of her time period.

[pt] O presente trabalho tem como objetivo investigar as contradições e possibilidades clínicas inauguradas pelo conceito de regressão. Partiremos das postulações freudianas, nas quais abordaremos a regressão em seu aspecto intrapsíquico, sendo associada aos processos oníricos e de formação sintomática, para depois seguirmos com autores que consideramos relacionais. Dentre eles, o primeiro a ser abordado é o húngaro Sándor Ferenczi, quem primeiro apresenta a regressão enquanto fenômeno clínico e destaca a importância dos processos internos do analista na relação terapêutica. Em sua esteira, seguiremos com Donald Winnicott e Michael Balint. Veremos nas contribuições dos dois autores uma descrição mais detalhada e assertiva sobre os estados regressivos. Em todos os três autores, na medida em que tratamos do fenômeno da regressão, estaremos cotejando também as ideias de contratransferência e as teorias acerca da constituição subjetiva. Em uma última parte do trabalho faremos uma aproximação da clínica contemporânea em uma tentativa de descrever como o conceito da regressão é um que exprime inovações importantes para se pensar a clínica hoje. Veremos como as discussões acerca do conceito ao longo da história da psicanálise contemplam aspectos essenciais para a clínica como o campo transferencial, o corpo e o manejo. / [en] The present work has as main objective investigate the contradictions as well as clinical possibilities initiated by the notion of regression. We ll start off from the freudian postulations, through which we ll approach the idea of regression in its intrapsychic aspect associating it with the process of dream and symptom formation. We ll then proceed with authors by us considered relational. Among them, the first to be addressed will be the Hungarian Sándor Ferenczi, who is the first to introduce the idea of regression as a clinical phenomena and to highlight the importance of the analyst s internal world in the therapeutic relationship. Following Ferenczi, we ll regard the works of Donald Winnicott e Michael Balint. Through their contributions we ll bring to light a more detailed and assertive description of the regressive states. However, in all threes authors, as we approach the phenomena of regression, we ll be also examining the idea of counter- transference and the theories regarding the constitution of subjectivity. In the last part of the work we ll propose an approximation to contemporary psychoanalysis in an attempt to describe how the concept of regression contains important innovations for clinical references today. We ll progress by presenting how the discussions about such phenomena through history of psychoanalysis contemplate pivotal clinical aspects such as transference, body and clinical handling.

Clinical Assisted Reproductive Technology (ART) practices seek to make improvements in embryo quality and resultant procedural success rates. There is a significant variance in live birth rates among clinics nationwide. The goal of this thesis is make comparisons of embryo quality among clinics and understand these differences. This analysis focuses on the stage between egg retrieval and embryo transfer. Because the currently accepted embryo scoring methods are not directly proportional to performance, a new scoring methodology is proposed and applied. Data provided by the Society for Assisted Reproductive Technology (SART) consisting of 36,836 patient cycles from 40 anonymous clinics nationwide is considered. After necessary reductions are made, the data is anatomized to link each embryo transferred to an implantation probability. A score is generated for each morphology grouping based on the average implantation rate of that group. This score is used as the basis for clinic comparisons. Top-performing clinics (in terms of live birth rates in patients agedold) are then shown to both produce embryos of higher score and achieve better results from embryos of identical morphology.

Själavård eller terapi? - En religionspsykologisk studie av en själavårds och samtalsmottagning i Svenska kyrkan Pastoral Care or Therapy? - A Religious Psychological Study of a Pastoral Care and Conversation Clinic in the Swedish Church The purpose of this thesis is to increase knowledge about how staff work in a pastoral care and call reception (called the conversation clinic) under the auspices of the Church of Sweden. The empirical material consists of five informants who in one way or another are employed by the parish conversation clinic. This study is carried out as a qualitative study, where the research questions posed problematize how employees work based on psychotherapeutic/therapeutic knowledge and a pastoral care perspective, how the conversation clinic receives people's existential and spiritual needs and how any differences and similarities are expressed between pastoral care and therapy at the conversation clinic. The methodological and theoretical perspective clarifies what characterizes qualitative studies by applying Sharan B Merriam's (1994) case study method. To handle the empirical material Kirsti Malterud's Qualitative Methods in Medical Research (2014) is used. In summary, it can be said that the answers to the first research question is that the conversation clinic is based on a client perspective. The result of the second research question is summed up by the fact that the conversation clinic care about people's existential health and spiritual needs by that fact that the clients always being welcome to the conversation clinic regardless of religious affiliation or outlook on life, regardless of conversations in pastoral care or therapy. The results of the third research question show that the reception works in an intersection between pastoral care and therapy, where the economic factor and record keeping are two clear markers between either pastoral care or therapeutic treatment. Summary conclusions are that the conversation clinic works with a human care and treatment holistic perspective that offers both pastoral care based on theology and various secular therapeutic, psychiatric and psychological theories and models.

No description available.

Background: Historically the identification of ACL injuries upon initial presentation is low and considerable diagnostic delays have been reported. However, specific evidence on the individual elements of, and factors which influence delay, is lacking. Aims: The overarching aim was to provide a comprehensive picture of delay to diagnosis and specialist consultation, including factors which influence delay. An additional aim was to determine whether the approach to examining acute knee injuries varied as a consequence of varying patient presentation or experience of the assessing clinician. Methods: Study 1: Cross -sectional survey. Study 2: Non-participant direct observation methodology. Results: Data from 194 patients were analysed in the survey. Only 15.5% of patients were given a correct diagnosis of ACL rupture at the initial consultation. Median delay to diagnosis was 67.5 days (IQR= 15 to 178 days) and specialist consultation 108 days (IQR= 38 to 292 days). The factors most influential on delay were whether a follow-up appointment was arranged after attending A&E, whether the site of attendance operated an acute knee clinic and whether MRI was performed. The direct observation study showed wide variation in approach to injury assessment. Specialist clinicians performed the most comprehensive examination. A&E clinicians were more likely to assess for bony, neurovascular and gross tendon injuries as opposed to ligamentous or meniscal injury. Conclusions: The diagnostic rate of ACL injury at initial presentation remains low. Considerable delays to diagnosis and specialist consultation are apparent following ACL injury, the majority of which is attributable to health system delay.