Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-10-18T18:37:37Z No. of bitstreams: 1 RandolfodosSantosJunior_tese.pdf: 1610909 bytes, checksum: 28fc3685f524eb861999084083484f4a (MD5) / Made available in DSpace on 2018-10-18T18:37:37Z (GMT). No. of bitstreams: 1 RandolfodosSantosJunior_tese.pdf: 1610909 bytes, checksum: 28fc3685f524eb861999084083484f4a (MD5) Previous issue date: 2017-11-13 / The assessment and management of chronic pain are an important focus of attention, since these are pointed out as a major cause of disability and demand for health care.Objective: To evaluate the self-efficacy and indicators of anxiety and depression in patients diagnosed with chronic pain in two forms of treatment: a) structured program of Cognitive-Behavioral Therapy in group; B) control group who undergone the usual treatment of the institution.Materials and Methods: Adult patients of both genders at the beginning of care in the Pain Clinics. Those who met the inclusion criteria and agreed to participate in the study were randomized to allocation in the Experimental Group (EG) or Control Group (CG). All participants were evaluated in three moments: initial evaluation, reassessment and follow-up. They answered the following instruments: Questionnaire on clinical and sociodemographic data; Self-Efficacy Scale for Chronic Pain; Hospital Anxiety and Depression Scale; Numeric Pain Rating Scale; Inventory of Attitudes and Beliefs Facing Chronic Pain. The experimental group received, besides the habitual treatment provided by the institution, 10 sessions of Cognitive-Behavioral intervention in group. The control group received the usual treatment provided by the Pain Clinics. Results:A total of 114 adult patients undergoing chronic pain treatment participated in the first part of this study. Data pointed out high indicators of anxiety (53%) and depression (55%), in addition to low self-efficacy (63%). Low self-efficacy was associated with beliefs and dysfunctional attitudes towards pain and to higher indicators of anxiety and depression were observed. In the second part of the study, all participants were randomized into two groups: Experimental Group (EG) and Control Group (CG) . Fifty-seven patients participated in all the stages of this part of the study, 31 in EG and 26 in CG. Comparing the two groups according to the follow-up, the results showed that the experimental group had significantly higher self-efficacy scores (p <0.026) and. significantly lower anxiety scores (p < 0 , 01) and depression (p <0.023).Conclusion: In this study, the cognitive-behavioral therapy in group has improved important benefits for patients with chronic pain, playing on their beliefs and attitudes toward pain, anxiety management and reduction on depression indicators. / A avaliação e o manejo da dor crônica constituem importante foco de atenção, uma vez que são apontadas como uma das principais causas de incapacidade e de procura por cuidados de saúde. Objetivo: Avaliar autoeficácia e indicadores de ansiedade e depressão em pacientes com diagnóstico de dor crônica alocados em duas modalidades de tratamento: a) programa estruturado de Terapia Cognitivo Comportamental em grupo; b) grupo controle, que recebeu o tratamento habitual fornecido pela instituição. Materiais e Métodos: Participaram pacientes adultos de ambos os sexos, em início de atendimento na Clínica da Dor. Aqueles que atenderam aos critérios de inclusão e concordaram em participar do estudo foram randomizados para alocação no Grupo Experimental (GE) ou no Grupo Controle (GC). Todos os participantes foram avaliados em três momentos: avaliação inicial, reavaliação e seguimento. Responderam aos seguintes instrumentos: Questionário de dados clínicos e sociodemográficos; Escala de Autoeficácia para Dor Crônica; Escala Hospitalar de Ansiedade e Depressão; Escala Numérica de Dor; Inventário de Atitudes e Crenças Diante da Dor Crônica. O grupo experimental recebeu, além do tratamento habitual fornecido pela instituição, 10 sessões de intervenção Cognitivo Comportamental em grupo. O grupo controle recebeu o tratamento habitual, oferecido pela Clínica da Dor. Resultados: Participaram da primeira parte deste estudo 114 pacientes adultos em tratamento de dor crônica. Os dados apontaram indicadores elevados de ansiedade (53%) e depressão (55%), além de baixa autoeficácia (63%). Observou-se que a baixa autoeficácia está associada às crenças e atitudes disfuncionais diante da dor e a indicadores mais elevados de ansiedade e depressão. Na segunda parte do estudo, todos os participantes foram distribuídos por meio de randomização em dois grupos: Grupo Experimental (GE) e Grupo Controle (GC). Participaram de todas as etapas desta parte do estudo 57 participantes, sendo 31 no GE e 26 no GC. Comparando-se os dois grupos no que se refere ao seguimento, os resultados apontaram que o grupo experimental apresentou em relação ao grupo controle, escores significativamente maiores de autoeficácia (p < 0,026) e, significativamente,menores de ansiedade (p < 0,01) e depressão (p < 0,023). Conclusão: Neste estudo, a Terapia Cognitivo Comportamental em grupo promoveu benefícios importantes aos pacientes com dor crônica, atuando em suas crenças e atitudes diante da dor, manejo de ansiedade e redução nos indicadores de depressão.

O futebol é um esporte coletivo, em que desempenhos individuais podem definir o resultado de um jogo ou de um campeonato. Especialmente em cobranças de pênalti, o destino da partida encontra-se nos pés do cobrador. A ansiedade no momento das cobranças de pênalti em jogos de futebol de campo é um dos motivos que podem fazer com que um jogador de futebol não converta a cobrança em gol. Neste estudo experimental controlado foi testado um protocolo de biofeedback e psicologia cognitivo-comportamental com o objetivo de reduzir o estado de ansiedade em atletas de futebol amadores de futebol de campo de 15 e 16 anos de idade. Os participantes do grupo experimental foram avaliados antes de duas competições de pênaltis, que aconteceram antes e depois de quatro encontros de intervenção com o protocolo de biofeedback e psicologia cognitivo-comportamental para a redução de ansiedade dos jogadores de futebol que participaram do grupo ativo, em relação ao grupo controle / Soccer is a collective sport in which individual performances can define the outcome of a game or a championship. Especially at penalties shootouts, the destination of the match is at the feet of the penalty taker. Anxiety at the time of penalty kicks at soccer matches is one of the reasons why a soccer player may not score the goal. In this controlled experimental study, a protocol of biofeedback and cognitive-behavioral psychology was tested with the objective of reducing the state anxiety in 15 and 16 year old amateur soccer athletes. Participants in the experimental group were assessed before two penalty shoot-outs, which took place before and after four intervention sessions with a biofeedback and cognitive-behavioral psychology protocol. The results showed that the protocol was efficient as a method and effective in reducing the anxiety state of soccer players who participated in the experimental group, in comparison to the control group

No description available.

No description available.

Treatment for child abusers was evaluated using two methods: reviewing three areas of literature and surveying practitioners.

Dual diagnosis clients continue to have low treatment completion rates. The purpose of the current study was to understand if motivational interviewing helped to increase completion rates for clients receiving cognitive behavioral therapy (CBT). Studying the problem was necessary for identifying an evidenced-based model for mental health counselors to help clients with dual diagnoses complete CBT treatment. There were no studies available for understanding the effectiveness of motivational interviewing as a tool for improving treatment completion rates for dual diagnoses clients in intensive outpatient programs. The research question examined if motivational interviewing was effective for improving treatment completion rates for the dual diagnosis population. A quantitative methodology with a quasi-experimental design used for this study and included a paired samples t test, a chi-square test, and a logistic regression analysis. The results showed a statistically significant association between receiving the motivational interviewing techniques and completing CBT. Clients who received motivational interviewing were 4 times more likely to complete CBT treatment compared to clients who did not receive the technique. Clients with increased self-efficacy levels were 2 times more likely to complete treatment, thus addressing the problem of dual diagnosis clients having low treatment completion rates. The overall results demonstrated that clients reduced substance use relapse and recidivism improved. Completing treatment helped to reduce crimes related to drug use; it also prepared substance users for return to society as productive citizens, which promoted positive social change.

Evidence-Based Alternative Therapy to Reduce Anxiety in Ambulatory Mental Health Patients by Renee Denobrega MS, Widener University, 2013 BS, Alvernia University, 2007 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University January 2016

Although it is suggested that a dysfunctional stress response system may be associated with posttraumatic stress disorder (PTSD) the neurobiological underpinnings are not well established, especially in children. There is also limited research on how treatment for PTSD may impact associated physiology. Respiratory sinus arrhythmia (RSA) is a reliable measure of parasympathetic stress reactivity, and both resting RSA and RSA reactivity are physiological indicators related to children’s emotion functioning and regulation. The present study examined if pretreatment resting RSA levels predicted RSA reactivity at pretreatment and the trajectory of resting RSA, RSA reactivity, resting heart period (HP) and HP reactivity after Cognitive Behavioral Therapy (CBT). Forty-nine children who experienced at least 1 traumatic event and presented with PTSD symptoms were assessed for psychological measures, RSA and HP at pretreatment, post treatment and a 3-month follow up. At pretreatment, lower resting RSA was associated with increased RSA withdrawal. Analysis with repeated measures mixed models indicated that lower resting pretreatment RSA and lower RSA withdrawal increased during CBT, and individuals with higher resting RSA and RSA withdrawal decreased during CBT, so that those at the extreme ends of higher and lower indices converged in the middle by the end of treatment. These data suggest an optimal moderate range for resting RSA and RSA reactivity. There were also significant gender differences on RSA reactivity after CBT. Lower pretreatment resting RSA predicted lower resting heart period (higher heart rate) across all time points but did not change with CBT. Pretreatment resting RSA did not predict HP reactivity. Post hoc analysis also revealed that PTSD symptoms were significantly reduced after CBT but this change was not associated with pretreatment resting RSA levels. Overall, these results suggest that children may change physiologically after CBT and the direction of the changes may depend on initial resting RSA levels. / acase@tulane.edu

This paper reviews literature on the topic of death anxiety and therapy. The author conducted a study examining potential clients' perceptions of two different therapeutic approaches for working with terminally ill clients with death anxiety. A review of literature relevant to this topic indicates that death anxiety is correlated with many psychological problems; however, there are no clinical studies focused primarily on the treatment of death anxiety among clients with a terminal illness. In this study, potential clients were randomly assigned to watched either a short video of a cognitive behavioral therapy session or a short video of an acceptance and commitment therapy session focused on treating a terminal ill person's death anxiety. After watching the video, potential clients rated the session impact of the therapy approach using the Session Evaluation Questionnaire. In addition, participant's views of seeking psychotherapy were assessed with the Attitudes Toward Seeking Professional Psychology Help measure. No differences in ratings of session impact were found between participants who viewed the cognitive behavioral therapy session and the acceptance and commitment therapy session. However, participants' attitudes toward seeking therapy were positively associated with their views of the therapist and session depth. Consistent with past literature, women reported more death anxiety than men. In regards to potential clients' views of session impact variables, their view of postsession positivity was positively related to their view of session smoothness. Additionally, a positive correlation was found between potential clients' views of the therapist and session depth. Implications and conclusions are discussed.

The purpose of this study was to determine if there was a functional relation between the Cognitive-Behavioral Therapy-Based intervention curriculum, Tools for Getting Along (Smith & Daunic, 2012), and Externalizing Behaviors exhibited by students with EBD served in special education. Four students, nominated by their teacher and principal and receiving services in special education for behavioral goals addressing Externalizing Behaviors, participated in this single-subject, multiple-baseline study. Data collected to answer the research question were Systematic Direct Observations, Direct Behavior Ratings, The Strengths and Difficulties Questionnaire (Goodman, 1997), and the Social Problem-Solving Inventory-Revised (D’Zurilla et al. 2002). Participants began receiving Tools for Getting Along instruction in staggered intervals based on their baseline SDO, DBR, and consulting with their special education teacher. The SDQ and SPSI-R:S were administered pre- and post-intervention. Data indicated that although two students showed some improvements on DBR, there was not a functional relation between TFGA and Externalizing Behaviors. However, SDQ and SPSI-R:S sub-scale data did indicate some individual improvements. In addition to individual participant improvements, a number of implications for future research were noted from social validity data completed by the special education teacher, treatment fidelity observations, and in order to address the limitations of the study.