No description available.

Bakgrund: Smärta från axelleden är vanligt förekommande hos simmare, därav finns begreppet ”simmaraxel”. Etiologin till tillståndet och smärtan är dock ännu inte fastställd, flertalet studier visar på varierande orsaker och symtom. Den oklara etiologin, skapar delade meningar sett till lämplig behandling för simmaraxlar. Flera teorier finns kring den bästa behandlingsmetoden för axelsmärta hos simmare. Många olika studier har gjorts med syfte att undersöka sambandet mellan axelspecifik styrketräning på axelfunktion hos simmare med axelsmärta. Få studier har gjorts med syfte att undersöka effekten av axelspecifik styrketräning på just smärtan vid simmaraxlar. Syfte: Syftet med denna studie var att på individnivå undersöka hur axelspecifik styrketräning påverkar simmare med axelsmärta gällande smärta och funktion. Metod: Studien baseras på single-case experimentell design (SCED), med en AB-design. I studien medverkade tre deltagare från en simklubb i Stockholm. Deltagarna fick under totalt nio veckor skatta smärta via Numeric Rating Scale (NRS) och axelfunktion via Western Ontario Shoulder Instability Index (WOSI), för att undersöka förändringen på smärta och funktion över tid. Resultatsammanfattning: En deltagare uppnådde signifikant förbättring sett till självskattad smärta. Sett till självskattad funktion fanns signifikant försämring hos två deltagare. En deltagare uppnådde en stabil baslinje. Resterande två deltagare uppgav spridda värden under samtliga faser för NRS och WOSI.  Slutsats: Inga specifika slutsatser går att dras utifrån studiens resultat eftersom endast en deltagare uppnådde en stabil baslinje och på grund av oklarheten kring orsakerna till deltagarnas smärta. / Background: Pain originating from the shoulder joint is frequent among swimmers, therefore the term “swimmer’s shoulder” was constructed. However, the etiology of the condition has not yet been established and numerous studies indicate varying origins. Divided opinions have formed about effective interventions due to the confusion regarding swimmer’s shoulder. Several studies have investigated the interaction between various interventions and their effect on swimmer’s shoulders, however only a few have studied the effect strength training has on pain in the shoulder joint due to the condition.  Purpose: The aim of this study was to investigate at an individual level, how strength training of the shoulders affects active swimmers with shoulder pain, concerning pain and function. Method: This study is designed after a single-case experimental design (SCED), with an AB-design. Three swimmers from a swimming club in Stockholm participated. During a total of nine weeks, the participants had to assess pain via the numeric rating scale (NRS) and shoulder function via the Western Ontario Shoulder Instability Index (WOSI). Results: One participant acquired significant improvement in self-rated pain. Regarding self-rated function two participants showed significant impairment. One participant acquired a stable baseline. The remaining two participants reported scattered values during all phases for both NRS and WOSI.  Conclusion: No specific conclusions can be made based on the results of the study as only one participant achieved a stabile baseline, and there is ambiguity regarding the causes of pain among the swimmers.

Performing arts consist of live arts shows, rehearsals, classes, or workshops and participating as a professional, amateur, or an audience person. Benefits of participating in performing arts for youth and adults include access to peer social groups, increases in one’s own self-concept, and improved physical coordination. This systematic and quality review was conducted to identify applications of Applied Behavior Analysis (ABA) interventions designed to improve performing arts skills. The search yielded 10 articles with single case experimental designs (SCEDs) from four different ABA journals across five databases. Results yielded 19 ABA interventions across nine different intervention categories for 62 participants. Varying degrees of quality and methodological effectiveness were identified in ABA procedures to increase a range of performing arts skills. Limitations and future directions for the application of ABA interventions in the performing arts are discussed. / Applied Behavioral Analysis

Text in English / This exploratory study creates a post-modern narrative context for psychotherapy and extends these ideas to an individual living with a psychiatric disorder, namely obsessive-compulsive disorder. The present study explores OCD through the ecosystemic perspective and aims to obtain a holistic understanding of an individual's experience of living with OCD and to describe the recursive connections between OCD and the individual's ecological context. This investigation includes the re-authoring therapy of Michael White and David Epston and the application of their ideas to the individual's life story. A qualitative method within the naturalistic paradigm is employed focussing on the unique experience of the individual, which allows for an understanding of the individual's personal meaning. The dominant narratives, that emerged from the individual's life story, were deconstructed. Significant shifts in attribution of meaning took place. / Psychology / M.A.(Clinical Psychology)

Résumé : Dans la sclérodermie systémique (ScS), les contractures aux mains, pour lesquelles il n'existe aucun traitement prouvé, sont courantes et associées à de l'incapacité de la main, globale et au travail. Toutefois, quelques études sur les effets d'interventions comprenant des techniques manuelles ont montré des résultats prometteurs. Ainsi, le but de l'étude était d'explorer les effets d’un traitement ostéopathique sur la fonction de la main, des symptômes globaux de la maladie et le statut fonctionnel de personnes atteintes de ScS. Une série d'études à cas uniques (A[indice inférieur 1]-B-A[indice inférieur 2]) fut réalisée. Six participantes atteintes de ScS ont été recrutées parmi la cohorte du Groupe de recherche canadien sur la sclérodermie à deux sites (Hôpital général juif de Montréal et Centre hospitalier universitaire de Sherbrooke). Les participantes ont reçu neuf séances hebdomadaires d’ostéopathie semi-standardisées, ciblées sur les membres supérieurs, le thorax et la base du crâne. Des mesures répétées pendant les trois phases de l'étude ont été prises à une fréquence bihebdomadaire pour la raideur aux mains (RM) et les symptômes de douleur, dyspnée et fatigue; et hebdomadaire pour l'amplitude de mouvement des doigts (AMD), la fonction de la main (FM) et l'incapacité globale (IG). L'épaisseur/rigidité de la peau main/avant-bras (ÉPMA), l'incapacité au travail (IT) et la qualité de vie reliée à la santé (QVS) ont été mesurées à trois temps (avant et après l'intervention, ainsi qu'au suivi à un mois). Les variables à mesures répétées ont été représentées sur des graphiques linéaires soumis à des analyses visuelles, complétées du test Sheward's two Standard Deviation Band. Les différences ont été calculées pour les variables mesurées à trois temps. Toutes les participantes (n=6) ont montré une amélioration des variables reliées à la fonction manuelle (RM, AMD et FM), sauf pour l'ÉPMA (n=4). La majorité des participantes ont montré une amélioration des symptômes (douleur n=6, fatigue n=4 et dyspnée n=3/4) et des variables reliées au statut fonctionnel (IG n=5/5, IT n=4, score résumé physique n=6 et mental n=4 de la QVS). La plupart des effets se sont maintenus au suivi à un mois. Lorsque la comparaison était possible, presque toutes les améliorations observées ont été supérieures aux différences minimales cliniquement importantes suggérées pour cette population. Ces résultats suggèrent que l'ostéopathie pourrait être efficace pour réduire l'incapacité découlant des contractures aux mains de personnes souffrant de ScS, et devraient être vérifiés dans un essai clinique randomisé. // Abstract : In systemic sclerosis (SSc), hand contractures are common and associated with hand, global and work disability. There are no known effective treatments, although there have been a few promising studies with manual therapies. Our aim was to explore the effects of osteopathy on hand function, disease symptoms and functional status in SSc patients. A series of single case studies (A[subscript 1]-B-A[subscript 2] was undertaken. Six female SSc patients with hand contractures were recruited among subjects enrolled in the Canadian Scleroderma Research Group cohort at 2 sites (Jewish General Hospital, Montreal and Centre hospitalier universitaire de Sherbrooke, Sherbrooke). Participants received 9 weekly semi-standardized sessions of osteopathy targetted on upper limbs, thorax and cranial base. Repeated measures were taken during the three phases of the study, twice a week for hand stiffness and disease symptoms of pain, dyspnea and fatigue; and once a week for range of motion of fingers, hand disability and global disability. Upper limbs skin score, work disability and health-related quality of life were measured at baseline, after treatments and at 1-month follow-up. Data for each variable with repeated measures were represented on simple line graphs and visually interpreted, completed by the Sheward's two Standard Deviation Band test. Differences were calculated for variables measured at 3 time points. All participants (n=6) showed improvement in variables related to hand function (hand stiffness, range of motion of fingers and hand disability), except for upper limbs skin score (n=4). The majority of participants showed improvement in disease symptoms (pain n=6, fatigue n=4, et dyspnea n=3/4) as well as variables related to functional status (global disability n=5/5, work disability n=4, physical n=6 and mental n=4 component summary of health-related quality of life). Most improvements were maintained at 4 week follow up. When the comparison was possible, almost all observed improvements were higher than the minimal clinically important differences suggested for this population. These findings suggest that osteopathy may be effective in reducing disability from hand contractures in SSc. A randomized controlled trial is needed to confirm these results.

The overall aim was to describe how persons with dementia (PwDs) reflecton being outdoors and to investigate the support provided by a passivepositioning alarm (PPA) in making daily life safer for PwDs and theirspouses. Repeated conversations were held with 11 PwDs living in their own homesregarding their reflections on being outdoors (Study I). Interview study with14 spouses to a person with dementia (PwD) with their reflections on differentkinds of information and communication technology (ICT) devicesthat were used or can be used in the daily care of PwDs (Study II). An ethnographicapproach with participant observations and conversations withfive couples, a PwD and his/her spouse, describing and exploring their useand experiences of using a PPA, over time, in daily life (Study III). An experimentalsingle-case ABAB-design with three cases, a PwD and hisspouse, investigating the effects of using tracking technology on independentoutdoor activities and psychological well-being (Study IV). In summary, the results of the thesis show that being outdoors was describedby the PwDs as a confirmation of their identity, the `Self´. The useof ICT in daily care of PwDs was described by the spouses as shifting betweentheir own needs for safety and security and the perceived need forsafety and security from the perspective of the PwD. The use of a PPA indaily life among PwDs living in their own homes can give a sense of freedom,support and strengthen the feeling of independence for both PwDsand their spouses as well as give a feeling of safety and security for themboth. Use of the PPA may also increase PwDs’ independent outdoor activitiesand decrease spouses’ worries.

This single-case design study examined the effectiveness of adapting evidence-based treatments (EBTs) for children in a community clinic through a university-community partnership. Community clinic therapists treated eight youths (five males), ages 10 to 14, of whom four were Caucasian, two were Latino, one was African-American, and one was Caucasian/African-American. Youths presented with a primary diagnosis of a DSM-IV (American Psychiatric Association, 1994) internalizing disorder (plus multiple comorbidities). An adapted treatment combining multiple elements based on two primary treatment manuals: Coping Cat (Kendall et al., 1990) and PASCET (Weisz et al., 1999) was used. Youths with comorbid externalizing symptoms were also treated with elements from a parent-training manual (Barkley, 1997). Results of visual and clinical significance analysis demonstrated mixed support for the adapted treatment in a community clinic setting. The findings support further efforts to test the effectiveness of adapted EBTs in a community clinic setting and population.

A Psicoterapia Analítica Funcional (FAP) aponta a relação terapêutica como meio de promoção de mudanças clínicas. Os comportamentos do cliente em sessão são classificados como CCR1s (comportamentos problema), CCR2s (comportamentos de melhora) e CCR3 (descrições funcionais a respeito do próprio comportamento). É papel do terapeuta atuar sobre esses CCRs com o intuito de aumentar CCR2 e CCR3, bem como diminuir a emissão de CCR1, o que é planejado por meio das regras: estar atento aos CCRs (regra 1), evocar diretamente CCRs (regra 2), consequenciar CCRs (regra 3), observar os efeitos do seu comportamento sobre o comportamento do cliente (regra 4) e fornecer interpretações analítico-funcionais e implementar estratégias de generalização (regra 5). Compreende-se que a similaridade funcional do contexto terapêutico com outros ambientes do cliente possibilita o acesso do terapeuta à classe de comportamentos alvo de intervenção clínica e que, ainda, é papel do terapeuta evocá-los diretamente, componente da FAP expresso pela regra 2. As pesquisas que investigam o mecanismo de mudança da FAP têm enfatizado o papel da consequenciação (regra 3) sobre a mudança comportamental observada nos clientes, entretanto, há indícios de que tal mudança seja também resultado de um processo evocativo ocorrendo em sessão, responsável por produzir o aumento da emissão de CCR2s e diminuição de CCR1s quando a FAP é conduzida. Sendo assim, o objetivo do presente estudo foi o identificar quais os efeitos da evocação direta pelo terapeuta na FAP (variável independente) sobre os CCRs do cliente em sessão (variáveis dependentes), sendo utilizado delineamento experimental de caso único de reversão, com arranjo A-B1-BC1-B2-BC2 para uma cliente, com controle da inserção da evocação (arranjo A-BC1-B1-BC2-B2) para outro cliente. A fase A foi correspondente à linha de base, com realização de análise de contingências externas, as fases B corresponderam à condução de FAP sem evocação direta e as fases BC, à FAP completa. As sessões foram categorizadas com o Functional Analytic Psychotherapy Rating Scale (FAPRS) pela terapeuta e aferidoras de concordância, foi aplicado semanalmente o Outcome Questionnaire (OQ-45.2) que possibilitou o acompanhamento da evolução global dos clientes. Após três meses do encerramento do estudo, foi realizada uma sessão de follow-up com cada cliente, a qual indicou a manutenção de progressos com os mesmos. Como resultado no FAPRS, registrou-se o abrupto aumento de CCR2s e diminuição de CCR1s quando a evocação direta foi inserida, o aumento de CCR1 e diminuição de CCR2 quando a mesma foi retirada, bem como a replicação dessas duas fases e de seus efeitos sobre os comportamentos dos dois clientes. Nas fases em que a evocação não esteve presente, as porcentagens de CCRs assemelharam-se às observadas na linha de base. Observou-se também a importância da consequenciação com função evocativa, o que sustenta que a evocação e a consequenciação atuam de forma complementar. Tais resultados solidificam a proposta de que a produção de CCR2 nas sessões FAP tenha também por base a existência de processos evocativos atuantes, já que diante da ausência da evocação, registrou-se imediata diminuição de sua ocorrência. Nesse sentido, a evocação direta pode ser destacada como possuindo impacto relevante no mecanismo de mudança dessa psicoterapia / Functional Analytic Psychotherapy (FAP) points to the therapeutic relationship as a way of promoting clinical changes. The client behaviors in session are classified as CRB1s (problem behaviors), CRB2s (improvement behaviors) and CRB3 (functional descriptions regarding any client´s behavior). FAP therapist should act on these CRBs in order to increase CRB2 and CRB3 and to reduce the emission of CRB1, which is planned by using the rules: to be aware of CRBs (rule 1), to evoke CRBs directly (rule 2), to contingently respond to CRBs (rule 3), to observe the effects of therapist´s behavior on client´s behavior (rule 4) and to provide analytic-functional interpretations and implement generalization strategies (rule 5). It is understood that the functional similarity of the therapeutic context to other client environments allows the therapist to access the class of target behaviors of clinical intervention and that it is also the role of the therapist to directly evoke them, a component of FAP expressed by rule 2. Researches focused on investigate the mechanism of change in FAP have emphasized the role of consequence (rule 3) on behavioral change observed in clients, however, there is evidence that such a change is the result of an evocative process occurring in session, which is responsible for producing increased CRB2s and decreased CRB1s emissions when FAP is conducted. Thus, the goal of this investigation was to identify the effects of direct evocation by the therapist in FAP (independent variable) on client CRBs in session (dependent variables), using an experimental design of a single-case experimental procedure, with design A -B1-BC1-B2-BC2 for one client, with control of the insertion of the independent variable (design A-BC1-B1-BC2-B2) to another client. Phase A corresponded to the baseline, without systematic use of FAP, phases B corresponded to FAP without direct evocation and phases BC, to the use of complete FAP. The sessions were categorized with the instrument Functional Analytical Psychotherapy Rating Scale (FAPRS) by the therapist and independent coders. The Outcome Questionnaire (OQ-45.2) was applied weekly, allowing the therapist to monitor the overall evolution of clients and after three months of the end of the phases, a follow-up session was conducted with each client, which indicated the maintenance of the observed effects. As a result in FAPRS, it occurred the abrupt increase of CRB2s and decrease of CCR1s when direct evocation was inserted, the increase of CRB1 and decrease of CRB2 when it was withdrawn, as well as the replication of these two phases and their effects on the behaviors of the two clients. In the phases in which evocation was not present, the percentages of CRBs were similar to those observed in baseline. It was also observed the importance of the consequences with evocative function, which maintains that the evocation and the consequences provided by the therapist act in a complementary way. These results solidify the proposal that the increase of CRB2 in FAP is also based on the existence of evocative processes, since in the absence of evocation it is observed its immediate decrease. Therefore, direct evocation can be highlighted as having a relevant impact on the mechanism of change of this psychotherapy

Made available in DSpace on 2016-07-27T14:20:52Z (GMT). No. of bitstreams: 1 Maira Ribeiro Magri.pdf: 752733 bytes, checksum: af7ce31e8751e2549e6bc05bca14762c (MD5) Previous issue date: 2015-12-16 / This study aimed to compare the effects of FAP and THS interventions on behaviors related to social skills class (or social anxiety disorder) of an adult participant with social phobic, to assess the level of anxiety during the intervention and between sessions, and to compare the results of the SPIN and IHS before and after the intervention and compare. For that, it was used an AB1CB2 multiple baseline design between behaviors where A was the baseline phase, B1 and B2 were phases in which two classes of behavior (C1 and C2) were submitted to FAP interventions and other two (C3 and C4) were submitted to THS interventions, and C was intervention phase classes of behavior (C1 and C2) were submitted to THS interventions and other two (C3 and C4) were submitted to FAP interventions. The results showed an increase in the frequency of occurrence of classes throughout the sessions and the highest frequencies were in the sessions of FAP. The participant related a higher level of anxiety in THS sessions compared to FAP. The application of the instruments, showed no difference between aplications before and after interventions. The data indicated that FAP may be effective in the interventions for social skill behaviors. However, further studies should be performed either to evaluate the generalization and for provide more evidence of the effectiveness and provide the area of research and application the possibility of providing more effective treatments to behavior problems. / O presente estudo teve como objetivo comparar os efeitos das intervenções FAP e THS nas classes de comportamentos relacionados a habilidades sociais (ou ansiedade social) de um participante adulto fóbico social, comparar os resultados das aplicações do SPIN e do IHS antes e depois da intervenção; avaliar o nível de ansiedade ao longo da intervenção e entre as sessões. Para isso, foi utilizado um delineamento AB1CB2 de linha de base múltipla entre comportamentos sendo A a fase de linha de base, B1 e B2 as fases em que duas classes de comportamento (C1 e C2) passaram por intervenções FAP e outras duas (C3 e C4) por intervenção THS e C a fase em que as classes C1 e C2 passaram por THS e C3 e C4 foram submetidas a intervenção FAP. Os resultados apontaram um aumento na frequência de ocorrência das classes de comportamento sob intervenção ao longo das sessões, com maiores frequências nas sessões de FAP. O participante relatou maior nível de ansiedade nas sessões de THS comparado às de FAP. Em relação às aplicações dos instrumentos, não foi possível observar diferença entre as aplicações realizadas antes da linha de base e ao final das intervenções. Os dados indicaram que a FAP também pode ser eficaz no tratamento de comportamentos relacionados a habilidades sociais. Contudo, novos estudos devem ser realizados tanto para avaliar a generalização como para fornecer mais evidências da eficácia e prover à área de pesquisa e de aplicação a possibilidade de fornecer tratamentos mais eficazes aos comportamentos problemas.

A Psicoterapia Analítica Funcional (FAP) baseia-se no behaviorismo radical e propõe como mecanismo de mudança a modelagem de comportamentos clinicamente relevantes (CCR) na interação terapêutica. Diversas pesquisas tem comprovado a eficácia desse mecanismo de mudança, porém um estudo detalhado das variáveis envolvidas nessa modelagem se faz necessário. Nesse sentido, o presente estudo teve como objetivos verificar os efeitos sobre os CCRs produzidos por dois tipos de intervenções: FAP não sinalizada (FAPNS) e FAP sinalizada (FAPS), e comparar essas intervenções com intervenções analítico comportamentais com foco em análise de contingências externas à terapia (ACE). As intervenções FAPNS consistiram na modelagem de CCRs na interação terapêutica. Já as intervenções FAPS, além da modelagem continham as seguintes variáveis: 1. sinalização e descrição pelo terapeuta da ocorrência de CCRs na interação com o cliente; 2. descrição do terapeuta ao cliente do impacto que os CCRs produzem nele (com relação a sentimentos, pensamentos, etc.); e 3. paralelos realizados pelo terapeuta dos comportamentos do cliente em sessão e fora dela.. Foi utilizado um delineamento intra-sujeito de reversão, de tratamentos múltiplos (A1 B1 A2 C1 A3 B2 A4 C2 A5) para estudar os efeitos dessas intervenções em dois clientes com problemas em relacionamentos interpessoais. A ordem de apresentação das fases foi alternada para cada participante. As sessões foram filmadas e analisadas utilizando o instrumento Functional Analytic Psychotherapy Rating Scale FAPRS. Foram analisadas 27 sessões de cada participante. Os resultados corroboram que a modelagem dos CCRs é o mecanismo de mudança na FAP, visto que os CCRs2 aumentaram de frequência e os CCRs1 diminuíram nas fases em que a FAPS ou FAPNS foram introduzidas. Com o delineamento utilizado conseguimos observar as reversões nas frequências de CRBs nas mudanças entre as fases FAP e ACE. Não foram encontradas diferenças evidentes entre as duas formas de intervenção, FAPS e FAPNS, indicando que a modelagem ocorre quando o terapeuta apresenta a consequência adequada aos CCRs, independente da descrição dos comportamentos / Functional Analytic Psychotherapy (FAP) is based on radical behaviorism and proposes that the shaping of clinically relevant behavior (CRB) is the instrument of behavioral change. Many researches demonstrated this mechanism, but a detailed analysis of the variables is necessary. The objective of this research was to study the effects of two different FAP interventions on CRBs: Non-signalized FAP Interventions (FAPNS) and signalized FAP interventions (FAPS), and compare those interventions with sessions of behavioral psychotherapy, with focus on analysis of contingencies external to therapy (ACE). FAPNS interventions consist of shaping the client´s behavior throughout the course of therapeutic interaction. FAPS interventions, in addition to shaping CRBs during therapeutic interaction, contain the following variables: 1) signaling and description by the therapist of the occurrence of CRBs during the interaction with the client, 2) description of the CRBs impact on the therapist (e.g., the therapists feelings, thoughts, etc., produced by the clients CRBs), and 3) description of parallels between CRBs and the clients behavior outside therapeutic setting. We used a within-subject withdrawal design with multiple treatments (A1 - B1 - A2 - C1 - A3 - B2 - A4 - C2 - A5) to study those variables in two clients with interpersonal relationship problems. We controlled the order of presentation of each phase for the participants. The sessions were filmed and then coded using the Functional Analytic Psychotherapy Rating Scale-FAPRS. 27 sessions of each participant were analyzed. The results show that the shaping process of CRBs is the main mechanism of change in FAP since the CRBs 2 increased while the CRBs 1 decreased during FAPS and FAPNS phases. We observed the reversion of CRBs frequencies between FAP and non FAP phases (ACE), but we did not find differences between FAPS and FAPNS interventions. This indicates that the shaping process of CRBs occur when the therapist presents the precise consequences for each CRBs, even if the consequences do not include the description of the behaviors that take place between therapist and client