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The focus of this dissertation is a group of individuals applying for psychotherapy. They have attended an office that offers psychodynamic psychotherapy, based on a Christian outlook on mankind. My research questions dealt with why they did apply for psychotherapy and what their goals were. I had planned the study and selected my data collection methods considering three domains of hypothetical reasons for their decisions to apply for psychotherapy. These grounds were their object relations, existential/religious orientations, and psychological problems and goals for the treatment. The first part of the dissertation is a survey of concepts, theories and former studies in the mentioned domains. Concerning the object-relations I make use of psychoanalytical thinking on the importance of early experiences in relation to parents and other persons but also its application to a “religious relation”, namely to the relation of the individual to her/his socalled God-representation. Concerning the existential/religious orientations I make use of existential-analytical thinking on satisfaction and meaning of life and death as an existential problem. I also make use of research from the psychology of religion on different dimensions of religiosity and its correlations to mental health. In the second part of the dissertation there is an account of my development of methods to be used in data collection. In this part of the book one can also find data from a reference group of people not applying for psychotherapy. The main part of the dissertation is the third part, describing the data of eight persons applying for psychotherapy. The information, from interviews, projective methods and scales, from each of the study subjects is put together, analysed and interpreted as intensive case studies. Questions in the interview covered religious and existential matters, relations to important persons during childhood and later, the persons’ descriptions of themselves, and the reasons for applying for psychotherapy and their goals for the treatment. Their answers were analysed using a hermeneutic method. The projective methods covered a picture and unfinished sentences. The psychological scales covered religious beliefs and satisfaction and meaning of life and a semantic differential the symbolic meaning of the words Mother, Father and GOD. According to the results the influence of the object-relations on the decision to apply for psychotherapy was sometimes direct. But on the whole the most obvious reason was the persons’ experiences and descriptions of themselves as filled with conflicting feelings and lack of or difficulties in controlling them. The influence of existential themes was not so obvious and the effects of the religious orientations were sometimes direct and sometimes only indirect. Peoples’ mental problems and goals of the psychotherapy influenced directly their decisions to apply. Most individuals had been in therapy before. There was some difference in the description of goals between those individuals who finished recently and those applying for the first time or long time after an earlier therapy. The latter having more well-defined goals. Theoretically it is possible to classify goals into treatment and life goals, but in real life they often stick together. One important conclusion was that, when the persons experience themselves as filled with contradictory feelings or conflicting strivings and having lack of feelings or difficulties in controlling them, they also experience themselves as responsible to this and as a consequence they also apply for psychotherapy.

Made available in DSpace on 2014-08-20T13:57:55Z (GMT). No. of bitstreams: 1 Dissertacao_Erika_Alejandra_Giraldo_Gallo.pdf: 1240790 bytes, checksum: e1c81f5b6b4450551bde3768d0565387 (MD5) Previous issue date: 2010-11-04 / The aim of this study was to evaluate the association between fetal growth and size at birth with mental health problems at 11 years of age in the 1993 Pelotas (Brazil) Birth Cohort Study. Newborns were weighed and measured and calculated anthropometric indexes. At age 11, were assessed mental health problems with the strengths and difficulties questionnaire (SDQ). The prevalence of mental health problems was 32%. After adjustment for potential confounders, we found that newborns with the z score of weight for age and body mass index (BMI) for age <-2 SD were respectively 27% (95% CI: 7to 49) and 29% (95% CI: 10 to 51) greater risk of developing mental health problems at age 11 than born with normal scores. Newborns with BMI z score for age and head circumference > +2 SD were respectively 34% (95% CI: 6 to 71) and 19% (95% : 1 to 40) greater risk of developing the disease than babies with normal scores. The results suggest that factors occurring during pregnancy that are reflected in measures of size at birth can cause mental health problems in late stages. / O objetivo deste estudo foi avaliar a associação entre crescimento fetal e tamanho ao nascer com problemas de saúde mental aos 11 anos na Coorte de Nascimentos de 1993 de Pelotas, RS. Recém-nascidos foram pesados e medidos, e calculados índices antropométricos. Aos 11 anos, foram avaliados problemas de saúde mental com o questionário de capacidades e dificuldades (SDQ). A prevalência de problemas de saúde mental foi 32%. Após ajuste para fatores de confusão, recém-nascidos com escore z de peso/idade e índice de massa corporal (IMC)/idade <-2 DP apresentaram respectivamente 27% (IC95%: 7 a 21) e 29% (IC95%: 10 a 51) maior risco de desenvolver problemas de saúde mental aos 11 anos que nascidos com escore normal. Recém-nascidos com escore z de IMC/idade e perímetro cefálico >+2 DP apresentaram respectivamente 34% (IC95%: 6 a 71) e 19% (IC95%: 1 a 40) maior risco de desenvolver estes problemas que nascidos com escore normal. Os resultados sugerem que fatores ocorridos na gestação e refletidos nas medidas de tamanho ao nascer podem ocasionar problemas de saúde mental em etapas tardias.

Studiens syfte var att undersöka kriminalvårdens centrala riktlinjer för psykisk ohälsa bland anstaltsklienter och om dessa riktlinjer realiseras i praktiskt arbete på två olika avdelningar: normalavdelning och behandlingsavdelning på en anstalt av högsta säkerhetsklass i Sverige. Data samlades in genom intervjuer med åtta kriminalvårdare och en psykolog. Resultatet visade att psykisk ohälsa ur ett personalperspektiv är vanligt förekommande, främst ADHD, depression, ångest och sömnsvårigheter. Majoriteten av respondenterna visste inte om vilka riktlinjer som finns vid behandling av klienters psykiska ohälsa. Slutsatsen är att det råder brister i kommunikationen mellan ledningen och kriminalvårdarna inom anstalten. / The purpose of this study was to examine the correctional institutions central guidelines for mental problems among their clients and whether these guidelines are used in practical work within two different facilities: normal facilities and treatment facilities at an institution of a maximum security prison in Sweden. Data was collected through interviews with eight prison officers and a psychologist. The results showed that mental problems from a staff perspective are common, mainly ADHD, depression, anxiety and insomnia. The majority of the respondent did not have knowledge about the central guidelines for client’s mental problems. Conclusion is that there are deficiencies in communication between management and the prison officers within the correctional institution.

Since the closing of total institutions in Sweden people with severe mental problems have access to places in the society in a completely different way. Prior international studies indicate that so called therapeutic landscapes can contribute to the recovery of people with severe mental problems. The aim of this study is to examine if this can be applied in a Swedish context. What places can be included in a therapeutic landscape and what about these places can influence recovery? Qualitative semi-structured interviews were conducted with seven adults with severe mental problems, followed by a thematic analysis. The result indicates that places offered by the Swedish social services, in public places and in nature can be included in a therapeutic landscape. The places can evoke a feeling of affinity, offer a change of scenery and enable activities and relationships that can contribute to recovery. Social work plays an important part in offering access to different places, as well as creating them, and can therefore contribute to a recovery process. However, people with severe mental problems are also social agents that actively can influence their own recovery and thereby strengthen their sense of self.

Pour faire face à la stigmatisation et l’exclusion vécues par les personnes atteintes de troubles mentaux, le Ministère de la Santé et des Services Sociaux au Québec (province du Canada) a mis en place un plan d’action en santé mentale 2005-2010, la force des liens, afin d’offrir des services de première ligne en santé mentale accessibles et efficients dans la communauté.. Cette société de droit par son dispositif législatif, veut protéger les personnes vulnérables d’autant plus les personnes présentant un danger pour elles-mêmes ou pour autrui, ceci parfois même au prix de leur liberté, par des mesures de contrôle, ce qui implique ingérence médicale et sociale. La révision des services de santé mentale dans un centre de santé et des services sociaux au Québec permet de préciser ce qu’en disent les acteurs impliqués et les personnes souffrant de troubles mentaux. Cette démarche met en évidence les difficultés des personnes utilisatrices de services pour recevoir le support nécessaire à leur intégration dans la communauté et à l’atteinte de leur pleine citoyenneté. Un des défis de l’avenir est de solliciter leur participation à différents niveaux de décision, les stratégies législatives internationales viennent illustrer et compléter cet alignement. / In order to take on stigmatization and exclusion experienced by people who have mental health problems, the Quebec Minister of Health and Social Services (province of Quebec in Canada) put in place The Mental Health Action Plan 2005 – 2010 The Strength of Links offering first line services in Mental Health that are accessible and of quality to the community. The Legislative assembly of Quebec as a society of rights wants to protect vulnerable persons and even more so those persons who are a danger to others or themselves sometimes at the price of their freedom, by measures of restraint that implicate medical and social intrusion. The revision of Mental Health Services in a Quebec Health and Social Services Centre permits clearer understanding of needs expressed by those implicated who suffer from mental health as well as the users of the services. This method gives a greater overview of the difficulties people have in receiving the necessary care and support so as to integrate fully in society as full citizenship entails. This is a challenge for the future, to seek their participation at different decision levels; international legislative strategies do illustrate and complete this alignment.

The effects of perceived mental/emotional problems (psychopathology) in the family-of-origin on adult offspring marital satisfaction was tested in a model considering the mediating variables of parental marital satisfaction, mother-child relationship quality, father-child relationship quality, and resolution of issues from the family-of-origin. The nationally representative sample (n = 802) drawn from the RELATionship Evaluation (RELATE) database included mostly college educated, lower-middle-class individuals in their first marriage. This sample was used to test a structural equation model that results showed fit the data well. Results showed that historical (distal) factors (such as psychopathology in the family-of-origin) explain only a small portion of the variance in adult offspring marital satisfaction and suggest that more contemporary (proximal) factors (such as individual characteristics) have a stronger relationship to adult offspring marital satisfaction. Results showed that 56% of the variance in achieving resolution of issues from the family-of-origin was explained by the other variables in the model with the best predictor being parental marital satisfaction. Direct, indirect, and total effects of each of the independent variables were examined. Results showed no direct effect of perceived mental/emotional problems (psychopathology) in the family-of-origin on adult offspring marital satisfaction. Only the mother-child relationship quality had a direct effect on adult offspring marital satisfaction. Clinical implications for practitioners are discussed. This study helps practitioners know how to help a client find resolution to issues stemming from perceived family-of-origin mental/emotional problems. This study also shows that focusing on current interpersonal processes and skills that may be part of achieving resolution is more likely to help a couple with marital problems than focusing on negative effects from the family-of-origin. Future research should focus on exploring the applicability of this model to different variables such as gender, race, income levels, etc. Future research models should also incorporate both historical and contemporary factors to help determine the direct effects of these variables on adult offspring relationship satisfaction.