INTRODUCTION: PAdverse Childhood Experiences (ACEs) are associated with an increased risk of mental health issues in general, but their relationship with panic disorder (PD) and obsessive-compulsive disorder (OCD) has received less attention compared to borderline personality disorder (BPD). Dissociative experiences are significant predictors of increased symptoms, reduced treatment adherence, and poor prognosis in several psychiatric conditions, including PD, OCD, and BPD; still, their impact remains underexplored. This part of the study focuses on the overall efficiency of psychotherapeutic programs on treatment-resistant patients diagnosed with PD, OCD, and BPD (or combined), as well as the relationship between ACEs, dissociation rates, and treatment results. METHOD: The study was conducted under standard conditions in an inpatient psychotherapy unit that specialized in anxiety, affective disorders, and personality disorders. Patients were hospitalized for 6 weeks and treated with a comprehensive CBT program and pharmacotherapy. The study included patients diagnosed with PD, OCD, or BPD (or combined). Two independent psychiatrists confirmed the inclusion and exclusion criteria. Patients were assessed using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Clinical Global Impression Scale - Severity (CGI-S), Dissociative Experience Scale (DES), and Childhood Trauma Questionnaire (CTQ-SF). RESULTS: A total of 349 out of 357 patients completed the study. The average age of patients was 33.33 ± 11.59 years. After the 6 week treatment, there was a statistically significant decrease in mean scores across all assessed scales. Changes in any scale during treatment did not correlate with the total CTQ-SF score or sub-scores. The relative change in CGI-S showed a statistically significant negative correlation with the total dissociation score on the DES scale at the beginning of treatment but not with pathological dissociation assessed by the DES-T questionnaire. Statistically significant decreases in mean CGI-S scores were observed in patients with a single diagnosis of PD, OCD, and BPD. Among comorbid groups, significant changes were observed only in patients with comorbid OCD and BPD. No statistically significant change in mean BDI-II scores was observed in patients with comorbid PD and OCD or comorbid OCD and BPD. CONCLUSIONS: Our analysis showed that treatment led to a significant decrease in the severity of depressive symptoms assessed by BDI-II and anxiety symptoms assessed by BAI in patients with PD, OCD, and BPD. This decrease was not statistically significant in patients with comorbid disorders, suggesting that the presence of multiple diagnoses may affect treatment efficacy. ACEs did not correlate to treatment results, but dissociation rates were linked with poorer treatment outcomes.
- MeSH
- disociační poruchy * terapie psychologie MeSH
- dospělí MeSH
- hospitalizovaní pacienti MeSH
- hraniční porucha osobnosti * terapie psychologie MeSH
- kognitivně behaviorální terapie * metody MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- obsedantně kompulzivní porucha * terapie psychologie MeSH
- panická porucha * terapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
AIM: The paper describes the characteristics of relationship obsessive-compulsive disorder (R-OCD), including the types of obsessions and compulsions, the common triggers and the impact on psychological well-being and relationship functioning. It also offers basic cognitive-behavioural strategies to help patients change their attitudes towards obsessive thoughts and reduce compulsive behaviours. METHODS: This article is a narrative review of the literature and case studies on R-OCD. To search for relevant sources, we used PubMed, PsycINFO and Web of Science databases with the keywords "relationship obsessive compulsive disorder", "R-OCD", "relationship OCD" and "partner-focused OCD". We included only studies published in English from January 1990 to June 2023. The paper provides examples of how basic cognitive-behavioural strategies help individuals with R-OCD. RESULTS: People with R-OCD experience intrusive thoughts about whether they have the right feelings for their partner, whether their partner loves them, whether the relationship is suitable or whether their partner has flaws. These thoughts trigger the urge to perform various rituals to alleviate anxiety, such as repeated checking, reassurance or comparison. However, this behaviour leads to disruption of the relationship and long-term maintenance of the anxiety. Examples of basic cognitive-behavioural strategies can be applied in clinical practice to help individuals change their attitudes towards relational obsessive thoughts and reduce compulsive behaviours.
The purpose of supervision is to ensure that clients' needs are met and to monitor the effectiveness of therapeutic interventions and the therapeutic relationship. Cognitive behavioural therapy (CBT) supervision is the systematic cooperation of the supervisee with the supervisor, which aims at increasing the therapists' competencies when working with specific clients. The advantage of supervision is the possibility to shape and develop the therapist's practical skills through specific techniques. This paper aims to review currently available CBT supervision strategies that boost the development of therapists' skills and provide possible examples. Various techniques are discussed, including behavioural, cognitive, imagery and psychodrama methods that facilitate supervisors in enhancing therapists' skills. In addition, complementary approaches are discussed, such as role-playing, modelling, chaining, or imitation to present at a particular moment of the therapy, increase the insight into the client's perspective or the treatment itself, and search for an alternative approach to improve the therapeutic outcomes for the client. Overall, the article describes the supervisor's need to have a flexible variety of skills and know which learning methods might be most effective for boosting the supervisee's skill level and needs with a particular client.
- MeSH
- behaviorální terapie * výchova MeSH
- klinické kompetence * MeSH
- kognitivně behaviorální terapie * metody MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- kognitivně behaviorální terapie * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- lumbalgie * etiologie psychologie terapie MeSH
- posttraumatická stresová porucha etiologie komplikace patologie terapie MeSH
- strach MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- anamnéza MeSH
- chronická bolest * etiologie patologie psychologie terapie MeSH
- dospělí MeSH
- kognitivně behaviorální terapie * metody MeSH
- kognitivní restrukturace metody MeSH
- lidé MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
- MeSH
- cévní mozková příhoda * komplikace MeSH
- deprese etiologie MeSH
- klinická psychologie metody MeSH
- kognitivně behaviorální terapie metody MeSH
- kognitivní poruchy etiologie MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- psychoterapie * metody MeSH
- úzkost etiologie MeSH
- vztahy mezi zdravotnickým pracovníkem a pacientem MeSH
- zátěž pečovatele MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- přehledy MeSH
Ethical reflection is a process that comes from the deeper attitudes and values of the therapist and supervisor. The capability to recognize one's perspectives and ethical dimensions and how they affect own practice is one of the crucial tasks of a responsible therapist. Attitudes and values of an individual or a group may significantly influence the therapeutic process and a choice of strategies and behaviour towards the patient, often working at an unconscious, unreflected levels. Ethics is closely connected with psychotherapeutic treatment. Basic principles, such as expediency, honesty, integrity, justice, and respect, apply to all people equally, including psychologists, psychiatrists, psychotherapists, and supervisors. The goal of supervision is to cultivate the therapeutic process in the client's best interest. The supervisor-supervisee relationship is then grounded on principles similar to those in the therapeutic relationship.
- MeSH
- Brassicaceae * MeSH
- kognitivně behaviorální terapie * metody MeSH
- lidé MeSH
- psychoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- chronická bolest * terapie MeSH
- dospělí MeSH
- kognitivně behaviorální terapie * metody MeSH
- lidé MeSH
- lumbalgie terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- MeSH
- deprese etiologie terapie MeSH
- dospělí MeSH
- emoce MeSH
- epilepsie * komplikace psychologie terapie MeSH
- kognitivně behaviorální terapie * metody MeSH
- lidé MeSH
- panická porucha etiologie terapie MeSH
- statistika jako téma MeSH
- topiramat terapeutické užití MeSH
- úzkostné poruchy etiologie klasifikace terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Článek se věnuje možnostem využití některých prvků Terapie přijetí a odhodlání (Acceptance and Commitment therapy, ACT) při provádění klasické KBT u klientů s úzkostnými a úzkostně depresivními poruchami. Zmiňován je koncept mysli jako nástroje pro řešení problémů, vybrané techniky odstupu od negativních myšlenek a zaměření na životní hodnoty a odhodlané jednání klientů. Vedle kompatibilních prvků je poukazováno i na rozdílnosti mezi ACT a KBT. Uváděny jsou ilustrativní zkušenosti z terapeutické praxe, včetně kazuistiky, která popisuje průběh KBT obohacené o prvky ACT u klientky s vtíravými myšlenkami.
Traditional CBT is commonly used with clients suffering from anxiety and mixed anxiety with depression disorders but it can be enriched by icluding some strategies from ACT (Acceptance and Commitment Therapy). This article will introduce ACT view of human mind as a problem solving machine, selected strategies for defusion from negative thoughts, and focus on values and committed action. Besides compatible components of these two approaches their differences will also be highlited. A case study of a client with intrusive thoughts will be described with whom CBT enriched with ACT strategies was used in her therapy sessions and other practical examples from therapy sessions will also be mentioned.
