Problem: Vulvodynia, an unexplained vulvar pain, is a medical condition affecting women of all ages, races, and ethnicities and causes pain levels ranging from very mild discomfort to extreme suffering. Purpose: The purpose of this study was to explore women’s knowledge toward seeking care for vulvodynia and to explore the different types of treatments prescribed after diagnosis. The secondary purpose of this review was to describe the treatments most effective in reducing pain caused by vulvodynia. Methods: A review of the literature was conducted using articles from 2001 to 2021 that focused on diagnosis of vulvodynia and the relief of pain with various types of treatment options for women diagnosed with vulvodynia. Multiple databases were used, and world-wide research was compiled for context on diagnosis of vulvodynia and treatment options that worked best to reduce pain. From the literature review, 14 articles met the inclusion criteria and were used to compare diagnosis of vulvodynia and the different treatment methods to relieve pain. Results: All studies suggest women did not seek immediate care or have a timely diagnosis for vulvodynia because of speculation by health care providers that vulvodynia is a pseudoscience. Women avoided seeking early diagnosis due to embarrassment discussing the condition and fear of skepticism about the level of pain associated with vulvodynia. The studies showed topical ointments and complementary treatments were the most prescribed agents. Effectiveness ranged from no pain relief to complete relief, but the conclusions were relatively similar in all the results. A multidisciplinary approach to vulvodynia, with mental health professionals and gynecologic providers had the best outcomes in relieving pain and optimizing treatment. Conclusion: Knowledge about vulvodynia is very limited due to under diagnosis and embarrassment of admitting that something is wrong. Most of the research conducted was a general overview of cases and is focused on diagnosis of the condition. Benefits of therapy differ from woman to woman and complete pain relief, or remission is elusive in many instances. CAM therapies in combination with medications for individuals with vulvodynia to alleviate pain can be useful and finding multiple methods that can be used together for pain relief is of value for further research.

Aims: The experience of abuse in childhood can lead to psychological distress later in life. In particular the impact of trauma on the development of the self can render survivors more vulnerable to chronic feelings of shame and guilt. The aims of this research portfolio are twofold. First, a systematic review examines the impact of therapeutic interventions on depression outcomes for survivors of Childhood Sexual Abuse. Second, a research study explores experiences of shame and guilt for this population. More specifically, the study examines those factors in the therapeutic process which survivors find helpful in their changing relationship with these emotions. Method: To address the first aim a systematic review of the literature was carried out. The methodology employed strict inclusion criteria and ten Randomised Control Studies were identified and included in the review. A prospective longitudinal qualitative study was conducted to explore the experiences of shame and guilt for survivors of childhood abuse. Participants (n=10) were interviewed at two different time intervals whilst accessing psychological therapy. Data was analysed using the Framework Method. Results: Findings from the systematic review show existing studies are mostly of poor to medium methodological quality; but that therapeutic interventions do improve depression outcomes for survivors of Childhood Sexual Abuse. Results from the empirical study suggest feelings of shame more so than guilt are core emotions in the experience of psychological distress for survivors. Conclusion: Evidence-based therapeutic interventions for the range of complexities experienced by survivors of CSA are still to be established and more strong methodological trials are required. Shame is a core emotion in psychological distress for survivors and requires to be assessed and addressed routinely in therapeutic interventions.

This study is focused on clients' daily experiencing of stress, and measures how this stress might affect their implementation of ideas and recommendations from therapy. Typically, clients attend therapy with the intention of making positive changes. Part of the therapeutic process involves clients completing therapeutic work in their daily lives (Conklin, Strunk, Cooper, 2017); however, stressful tasks and other elements often preclude this therapeutic work from occurring (Kazantzis & L'Abate, 2005). In this study we examine which interventions from therapy are most likely to be attempted at home, and the level of stress in making these attempts. A series of multi-level models were used, controlling for daily stress and examining partner effects. This study will be viewed from the conceptual lenses of window of tolerance (Siegel, 1999) and the Yerkes-Dodson law (Hanoch, Vitouch, 2004) on stress.

Modern psychological approaches currently being used with Muslim clients in therapy have consistently been criticised for being decontextualised, Eurocentric, individualistic, reductionist and for not taking Muslim clients’ cultural and religious values into account (Amri, & Bemak, 2013; Carter & Rashidi, 2004). Hence a need for making use of models, techniques and therapeutic interventions based on Muslim perspectives for Muslim clients has repeatedly been expressed (Haque, 2004a; Helms, 2015; Inayat, 2007; Keshavarzi & Haque, 2013; Utz, 2012; Weatherhead & Daiches, 2010). Despite recommendations for using therapeutic interventions from Muslim perspectives with Muslim clients in therapy (Abu Raiya & Pargament, 2010; Haque & Kamil, 2012; Qasqas & Jerry, 2014), empirical research on these interventions has lagged behind (Abu-Raiya & Pargament, 2011). The aim of the current study is to provide more insight into how interventions from Muslim perspectives can be administered by Muslim therapists with their Muslim clients in therapy in United Kingdom. This study explored the experiences of six Muslim therapists who were all using interventions from Muslim perspectives with Muslim clients in their therapeutic practice. Semi-structured interviews were conducted, transcribed, and analysed using Interpretative Phenomenological Analysis (IPA), and from this three main themes emerged (i) Psychotherapeutic approaches, (ii) Journey of becoming a Muslim therapist (iii) Obstacles faced by Muslim clients and therapists. The implications for further research and therapeutic practice have also been considered.

This work deals with the importance of psychodynamic approaches in practice of a day care center for an addictological treatment. The research core of this thesis are qualitative case analyses with a comment on the etiology of the dependency problem (anamnestic analysis revealing uncontrolled or conflicting developmental stages according to E. H. Erikson) and at the same time on the accentuation of the importance of psychodynamic approaches in routine clinical practice, which focuses primarily on good nonverbal interventions (i.e. an authentic technique using stones, an art therapy, nonverbal techniques) and transference phenomena. The aim of this thesis is to understand an individual case through selected psychoanalytic theories and to describe the key therapeutic interventions leading to curing an addicted person using an ambulant addiction treatment. For this particular research I chose a qualitative approach. I processed five clients' life stories into a set of case studies. Several methods were used to obtain the needed data. The crucial one was a semi-structured interview, then a life curve and a projective method. In each case study, I explained one developmental stage by E. H. Erikson, which I interpreted as crucial for creating and developing an addiction. For the data analysis, I used a...

Orientador: Maria Inês Rubo de Souza Nobre Gomes / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T18:25:38Z (GMT). No. of bitstreams: 1 Reis_CarolinaTrombeta_M.pdf: 2005779 bytes, checksum: 5619a4e23c9bce5add872e60cf278ac7 (MD5) Previous issue date: 2011 / Resumo: Classicamente, no Brasil, crianças com disfunções neurológicas severas vêm se submetendo a métodos de intervenção para a melhora do desenvolvimento global em ambientes clínicos controlados. Questiona-se, entretanto, se o tratamento clínico de maneira isolada traz ganhos significativos às habilidades da criança em seus diversos ambientes (casa, escola e comunidade). O Programa Mobility Opportunities Via Education (MOVE®) é uma abordagem de avaliação e tratamento funcional para crianças com disfunções severas. O objetivo deste estudo de caso foi compreender a percepção dos professores e monitores referente à utilização da abordagem do MOVE em uma escola de educação especial na cidade de Paulinia-SP. Foram aplicadas entrevistas semi-estruturadas, que visaram qualificar a percepção dos profissionais sobre o MOVE na escola. Verificou-se que a aplicação do MOVE na instituição resultou em uma visão mais humanitária dos profissionais, enfatizou a importância do trabalho em equipe e da promoção do aprendizado motor em ambientes naturais, aumentou a expectativa dos profissionais em relação aos alunos e fez com que os profissionais percebessem mais motivação nas crianças. As principais dificuldades encontradas na adaptação do programa para a realidade brasileira, foram: a falta de tempo dos profissionais; número insuficiente de funcionários; falta de materiais e equipamentos e necessidade de orientações sistemáticas referentes à aplicação do MOVE / Abstract: Classically, in Brazil, children with Cerebral Palsy are still being submitted to methods of intervention to improve overall development in controlled clinical environments. However, it has been questioned if the isolated clinical treatment results in important gains in the child's performance in various environments (home, school, community). The Mobility Opportunities Via Education (MOVE®) program is a functional approach designed to assess and treat children with severe disabilities. The aim of this case study was to understand the perception of the teachers and assistants regarding the MOVE approach in a special education school in the city of Paulinia-SP. A semi-structured interview was conducted, in order to qualify the perception of the professionals about the MOVE program in the school. It was verified that the MOVE program resulted in a more human view from the professionals, enfatized the importance of team work and motor learning in natural environments, increased the expectations of the professionals regarding the students and made it possible for the professionals to notice more motivation in the children. The main difficulties found in the adaptation of the program to the brazilian reality, were: lack of time of the professionals, insufficient number of workers, lack of materials and equipment and the need of systematic orientations regarding the MOVE program / Mestrado / Interdisciplinaridade e Reabilitação / Mestre em Saúde, Interdisciplinaridade e Reabilitação

This study is an investigation into the use of an African indigenous narrative game, Masekitlana, which I used as a therapeutic medium for four children, aged eight to 12 years. The participants are of Zulu origin and culture and were affected and orphaned as a result of HIV/AIDS. The game involved the participants in activities, such as hitting stones together or arranging them at will, that they felt familiar with and that enabled freer verbal expression from them. I employed a single-system research design that consisted of mixed methods approaches in the form of a qualitative thematic analysis and a quantitative graphic presentation of the results. The research design was a time series design that involved using, at four different times along the process of therapy, the measure of the Roberts-2 test (ethnic version). Therapy consisted of three sessions of standard of care therapy (therapy that was routinely being used in the psychology clinic) and three intervention therapy sessions of Masekitlana. I found the mixed-methods approach to be a practice-friendly form of research as it helped to describe the concerns of the participants in depth and enabled a concrete, quantitative conclusion about the efficacy of Masekitlana as an intervention. Syncretism of both approaches meant that qualitative data helped to clarify and confirm the findings of quantitative data and vice versa. Qualitative analysis showed how Masekitlana helped participants to express their traditional African beliefs, such as belief in the guidance of their ancestors, in the influence of bewitchment in their lives, and in the animation of the natural world. Thematic analysis also revealed the anger that participants felt resulting from the sense of disempowerment they experienced in Children’s Homes and from their separation from their biological families, and their need to sublimate this anger into future careers in the police force or alternatively to resort to crime. Thematic analysis also revealed the strategies employed by participants for coping with peer conflict in the Children’s Homes, and the challenges they face with schooling difficulties. Quantitative analysis revealed how participants progressed to complex forms of adaptive functioning and explanation of situations in their lives as a result of Masekitlana therapy. Recommendations arising out of this study are that psychologists strive to use forms of therapy that are familiar to the cultural backgrounds of indigenous children, and that training psychologists learn about the cultural beliefs of their patients and be exposed to the rituals used in traditional environments in order to understand indigenous clients. Psychologists should also be aware of the fact that, with the effects of television on children, and with present globalization and ease of international travel, children of African origin and culture are a mixture of traditional African and modern Western values. Therefore an integration of Western and indigenous forms of psychology might be considered. / Thesis (PhD)--University of Pretoria, 2012. / Educational Psychology / unrestricted

O biofeedback (BFD) é uma estratégia terapêutica em que ocorre aprendizagem por associação de sensações com o propósito de controlá-las levando a melhor enfrentamento fornecendo novas respostas e permitindo novos padrões, mesmo que se mantenha a ativação dos estímulos originais disfuncionais. Em migranosos ocorreria inibição da expressão da angústia relacionada ao nível fisiológico, devido a persistência de estados induzidos de estresse. Pesquisas de enfrentamento da migrânea incluem tratamento por condicionamento operante, biofeeback e outras técnicas como tratamento psicodinâmico. Tais tratamentos apontam para a redução do reforçamento do comportamento doloroso e melhora de comportamentos adaptativos para o enfrentamento das dificuldades. Objetivo geral: verificar a efetividade da técnica do biofeeback térmico como tratamento auxiliar em migranosos, através do Multidimensional Pain Inventory (MPI), antes e depois da intervenção. População: 60 doentes (masculino e feminino); idade variando entre 20 e 60 anos, com duração dos sintomas superior à 6 meses; em condições de locomoção e retorno às consultas e aceite do termo de Consentimento Pós-Informado CAPPesq. Instrumentos e Procedimento: Entrevista psicológica semi-dirigida para doentes com dor, através de protocolo próprio (Perissinotti, 2001); PRIME-MD + Qp; ABIPEME; Multidimensional Pain Inventory - MPI; ProComp + BioGraph 2.1. Duas amostras randomizadas foram separadas: grupo experimental (30 doentes) e grupo comparativo (30 doentes). O procedimento foi composto por triagem e direcionamento para grupo experimental, treinamento por BFD, 10 sessões que objetivaram o treino de dimensão de sensibilização discriminativa; e para o grupo comparativo adotado tratamento médico preventivo com medicação profilática padrão, para crise de migrânea. Resultados: O BFD alterou o comportamento da amostra experimental estudada, ocorrendo melhora geral da adaptabilidade, quando dos cálculos pela análise paramétrica. Quando da análise pelo teste qui-quadrado para variáveis qualitativas, houve resultados significantes para a amostra experimental, quanto aos sinais e sintomas psicopatológicos, qualidade das queixas e qualidade da saúde auto-referida. Houve diminuição da escala de intensidade de dor com BFD de 5,0 (83,3%) no pré-tratamento, e para 3,15 (52,5%) no pós-tratamento. Mostraram-se sem anormalidades mentais 20 doentes (60%) da amostra experimental. Transtornos de ansiedade foram encontrados em 11 doentes (36,6%) e transtorno depressivo em 9 doentes (33,3%). Para 18 (60%) doentes da amostra experimental o BFD melhorou as condições psicológicas, e para 14 (46,6%) doentes a melhora estaria relacionada exclusivamente ao relacionamento interpessoal, conjugal, afetivo e psicocomportamental. Para 4 (13,3%) deles primariamente reconheceram melhora no enfrentamento das condições psicofisiológicas, além dos aspectos psicológicos associados. Conclusões: O BFD alterou o comportamento da amostra experimental, fornecendo maior adaptabilidade geral, quando da análise paramétrica. Foi possível a ruptura do círculo vicioso entre percepção, tensão, estresse e dor, também pelo relacionamento estabelecido entre psicólogo e paciente. O psicólogo, portanto operador do método que calculou aspectos psicopatógicos, psicodinâmicos, além de servir como aquele que certifica as percepções do paciente consigo mesmo e suas expressões psicofisiológicas, é o operador funcional como um todo. Futuras pesquisas devem se desenvolver para esclarecer a compreensão entre os mecanismos psicofisiológicos que induzem a diferentes interpretações em distintos sintomas e as subseqüentes respostas psicofisiológicas quanto aos aspectos psicológicos dos migranosos. / Biofeedback (BFD) is a therapeutic strategy in which occurs the learning by the sensations association, with the purpose of controlling them leading to a behavior of better copping because provides new responses permitting new patterns, even with a new activation of dysfunctional original stimuli. In migrainers there would be the inhibition of anger expression related to the physiological level due to persistence of stressor-induced activation states. The migraine management research includes operant behavior treatment, biofeeback and other techniques as psychodynamic treatments. These treatments point out to reduce the reinforcement for pain behaviors and to improve adaptative behaviors to copping difficulties. General Objective: Verify the thermal biofeeback technique effectiveness as an auxiliary treatment in migraine patients by Multidimensional Pain Inventory (MPI), before and after intervention. Population: 60 patients (female and male): variance age between 20 and 60 years old, symptoms duration superior to 6 months, in condition to locomotion, to return to consultation and acceptance of the Post-Informed Consenting Term CAPPesq. Instruments and Procedure: Semi-directed structured psychological interviews for pain patients by Owner Protocol (Perissinotti, 2001); PRIME MD + PQ; ABIPEME; Multidimensional Pain Inventory - MPI; ProComp + BioGraph 2.1. Two random samples were separated: experimental group (30 patients) and comparative group (30 patients). The procedure was composed by triage and directionless: for experimental group, the BFD training, 10 sessions for sensitive-discriminative dimension training; for comparative group, the preventive medical treatment with standard prophylactic medication for migraine crisis. Results: The BFD has interfered in the behavior of the experimental sample studied, occurring a general better in adaptability, when calculated the parametric analysis. When the analysis by qui-square test for qualitative variables, there were significant results to the experimental sample, as to psychopathological signs and symptoms, quality of complains and quality of auto-referred health. The pain severity scale has decreased with BFD into 5.0 (83.3%) in the pre-treatment and into 3.15 (52.5%) in the post-treatment. No mental abnormalities were seen in 20 patients (60%) of the experimental sample. Anxiety disorders were found in 11 patients (36.6%) and depressions disorders in 9 patients (33.3%). For 18 (60%) patients of the experimental sample, the BFD improved the psychological conditions, and for 14 (46.6%) patients we could relate improving exclusively in interpersonal, conjugal, affective and behavior relationship. For 4 (13.3%) of them, primarily was recognized improvement in the psychophysiological conditions, further to the psychological aspects associated. Conclusions: The BFD has interfered in the behavior of the experimental sample, providing bigger general adaptability on the occasion of the parametric analysis. It was possible the break of the vicious circle among perception, tension, stress and pain, also by the relationship established between psychologist and patient. The psychologist, the method operator which has calculated the psychopathologic, psychodynamic aspects, besides of being the one who certifies the patient perceptions with himself and his psychophysiological expressions, is the functional operator of the whole. Future researches must be developed to clarify the comprehension between the psychophysiological mechanisms inducing different kinds of interpretation in distinct symptoms, and the subsequent psychophysiological responses as to psychological aspects in migrainers.

Parental responses to their children are crucially influenced by stress. However, brain-based mechanistic understanding of the adverse effects of parenting stress and benefits of therapeutic interventions is lacking. We studied maternal brain responses to salient child signals as a function of Mom Power (MP), an attachment-based parenting intervention established to decrease maternal distress. Twenty-nine mothers underwent two functional magnetic resonance imaging brain scans during a baby-cry task designed to solicit maternal responses to child's or self's distress signals. Between scans, mothers were pseudorandomly assigned to either MP (n = 14) or control (n = 15) with groups balanced for depression. Compared to control, MP decreased parenting stress and increased child-focused responses in social brain areas highlighted by the precuneus and its functional connectivity with subgenual anterior cingulate cortex, which are key components of reflective self-awareness and decision-making neurocircuitry. Furthermore, over 13 weeks, reduction in parenting stress was related to increasing child- versus self-focused baby-cry responses in amygdala–temporal pole functional connectivity, which may mediate maternal ability to take her child's perspective. Although replication in larger samples is needed, the results of this first parental-brain intervention study demonstrate robust stress-related brain circuits for maternal care that can be modulated by psychotherapy.

O presente estudo investigou o processo psicoterápico através da análise das intervenções do terapeuta e dos insights associados a elas durante uma psicoterapia pais-bebê, em famílias em que a mãe apresentava depressão pós-parto. Participaram do estudo duas famílias com mães deprimidas, com base no Inventário Beck de Depressão e em uma entrevista diagnóstica. Os pais não apresentavam depressão. Foi utilizado um delineamento de estudo de casos, a fim de se analisar o processo de mudança ao longo de todas as sessões de psicoterapia. Com a primeira família foram realizadas 16 sessões de psicoterapia e com a segunda família 12 sessões. Todas as sessões foram filmadas e as verbalizações foram transcritas para fins de análise, que foi baseada em cinco categorias: 1) intervenções para obter informações, que incluiu intervenções de assinalamento e de confrontação; 2) intervenções utilizadas para informar o paciente, que incluiu intervenções de informação propriamente dita, esclarecimento e interpretação; 3) intervenções de apoio; 4) intervenções de encenação; e, 5) intervenções de interpretação transgeracional. Os insights, por sua vez, foram classificados em três tipos: cognitivos, afetivos e pragmáticos. Os resultados revelaram que as intervenções de interpretação, esclarecimento e encenação estiveram associadas a um maior número de mudanças ao longo da psicoterapia, e se constituem em importantes fatores no tratamento de pais e seus bebês. As demais intervenções examinadas também se mostraram relevantes, principalmente nas situações em que as mudanças ocorreram como resultado de um conjunto de intervenções e não apenas de uma intervenção específica. Além disto, a terapeuta moldou sua forma de intervir para se adequar ao funcionamento de cada família. Juntos os resultados, sugerem que a psicoterapia pais-bebê, ainda que realizada em poucas sessões, pode ser uma alternativa para o alívio tanto para os sintomas no bebê, como para os pais e/ou para as relações entre os membros da família. Por se tratar de uma intervenção realizada nos momentos iniciais da vida do bebê, possui um potencial preventivo e de promoção da saúde mental, particularmente frente à depressão pós-parto. / The present study investigated the psychotherapeutic process by analyzing the therapist's interventions and insights in parent-infant psychotherapy, in families in which the mother had post-partum depression. Two families with depressed mothers, as assessed by the Beck Depression Inventory and a diagnostic interview, took part in this analysis. The fathers did not have depression. A case-study design was used in order to analyze the process of change throughout all sessions of psychotherapy. In the first family there were 16 sessions of psychotherapy and in the second family 12 sessions. All sessions were videotaped and the verbalizations were transcribed for analysis, based on five categories: 1) interventions for information, which included measures of punctuation and confrontation, 2) interventions used for informing the patient including interventions of information, clarification and interpretation, 3) support interventions, 4) enactment interventions, and 5) transgenerational interpretation interventions. Insights were classified into three types: cognitive, affective and pragmatic. The results revealed that interventions for interpretation, clarification and enactment were associated with a large number of changes during the psychotherapy, and they may be important factors in the treatment of parents and their babies. The other interventions were also considered relevant, especially in situations where the changes occurred as a result of a range of interventions, not just one specific intervention. Furthermore, the therapist adapted her interventions to the needs of each family. The results together suggest that parentinfant psychotherapy, even if carried out in a few sessions, could be an alternative to relieve the symptoms of both the baby and the parents and/or relationships between family members. Because it is an intervention in the early stages of the baby's life, it has a preventive potential for mental health promotion, particularly with the post-partum depression.