Inês Alexandre, Ana Catarina Costa, Ruben Santos (P):
Re-writing New Screenplay: a Dramatic Expression Activity and the Development of Social Skills (Ein neues Drehbuch schreiben: Eine dramatische Ausdrucksform und die Entwicklung von sozialen Fähigkeiten)
It is now known that social skills are an important component of psychosocial rehabilitation in patients with psychosis. We think that this might also apply to patients with depressive disorders, given that a characteristic of this illness social isolation. Bearing this in mind, our investigation was made to find out if a dramatic expression activity, with role-play of social situations can promote the acquisition of social skills more adapted to life outside the mental institution. In this investigation, ten individuals attended the activity of dramatic expression. Five of them had been diagnosed with psychosis, and the other five with depressive disorder. There were at least four sessions of this activity, each being held once a week. Two questionnaires of social skills were applied to each subject: one before beginning the activity and one at the end of our intervention, to see if there were improvements in social skills. The evaluation is still in course. If the results show significant improvements in both groups of subjects in the acquisition of social skills appropriate for life outside the mental institution, then, it would seem there is evidence that the dramatic expression activity is an appropriate technique in the field of psychosocial rehabilitation for subjects diagnosed with psychosis and depression disorder.
Francesco Bruni (I):
Observation and Evaluation of Therapies (Beobachtung und Auswertung von Therapien)
It is not in the ordinary practice to build up a therapies library that can be used as a counselling tool and to redefine therapy, besides teaching and research purposes. In family therapy and therapist training centers, the work experience is usually aimed at proving etiopathological hypotheses or at documenting the application of specific treatment protocols, but it often goes that, in so doing, the point of preserving and utilizing as a whole the historical memory of therapeutic work is missed.
As an answer to this, a therapies library was set up in our Center. The library archives contain 250 of the 1000 therapies issued in the period 1985-2003. The criteria guiding the filing and elaboration of the therapy material (session diaries and video-recordings) are as follows: 1. Setting the memory and narrating the history of therapy and training activity, 2. Allowing time-elapsing observation of the changes in the families and in the therapy, 3. Supplying data and elaborations helping therapists with their work with the families, 4. Evaluating the therapeutic action by means of a Beavers Scale adapted to this scope.
Results: Data will be presented describing the sample referring to: 1. Type of families seeking counseling, 2. Features of the therapies applied, divided into family, couple, and individual treatment, 3. Duration of treatment, 4. Incidence of the phases of the family life-cycle and of the features of the request and the pathologies each family presents. The quantitative data elaborated refer to the changes detected in the evaluation of the family under therapy from the first to the last session applying Beavers Scale.
Conclusions: In general, for therapies object of this evaluation there is a shift from dysfunctional systems (first session) to more adequate systems (last session). Specifically, only a few parameters reveal a definite change, whereas for others there is no particularly significant change. Also for family style there is a division between systems with a tendency to attraction/repulsion and systems with a median stance. Therapies themselves do not automatically determine preset changes, given the fact that at least two factors play a role: the family self-determination and the therapist figure.
Szymon Chrzastowski (PL):
Comparison of Parent-Offspring Relationship in Psychiatric and Non-Clinical Families
Objectives: Two main types of family interactions were distinguished according to Stierlin’s concept of transactional models: binding (BI) and expelling (EXP). The aim of this study is to explore relationships between parental interaction with schizophrenic young adult and I) phenomenon of “excommunication” (exclusion EXC) and II) family burden (B). Design and Method: Families were divided into three groups according to the diagnosis of the index offspring (18-35 years old): 1) schizophrenia (N=32), 2) personality disorder (N=30), 3) control group (N=35). Subjects (mother, father and young adult) completed originally designed questionnaires in which psychometric properties had been analyzed in earlier pilot research.
Results: In families with diagnosed schizophrenic child the levels of EX, EXC, B were elevated. When mothers had a schizophrenic child, the finding was as follows: a) the stronger was maternal BI the stronger was EXC of sons, b) the stronger was EXP, the more intensive was EXC of daughters. The more a mother bound a healthy child, the more she felt the burden The more a child was excluded by one parent, the more it was excluded by the other parent. The more a child was expelled by one parent, the more it was also expelled by the other parent. Conclusions: In families of schizophrenic young adults dysfunctional relationship patterns are enhanced.
Vergleich von Eltern-Nachkommen-Relationen in psychiatrischen und nicht-klinischen Familien
Ziel der Untersuchung: In Anlehnung an Transaktionsmodelle von Stierlin wurden zwei Haupttypen von Familienrelationen unterschieden: Bindung (BI) und Ausstoßung (EXP). Das Ziel der Studie war es, die Zusammenhänge zwischen Beziehungen der Eltern zu jungen schizophrenen Erwachsenen und den Phänomena der “Exkommunikation” (Ausschliessung, EXC) und Familienbelastung (B) zu erforschen. Versuchsmethode: Die Probe besteht aus Familien, die je nach Diagnose der identifizierten Nachkommen (18-35 Jahre alt) in drei Gruppen eingeteilt wurden: (1) Schizophrenie (N=32), (2) Persönlichkeitsstörungen (N=30), (3) Kontrollgruppe (N=35).
Ergebnisse: In Familien mit der diagnostizierten sch. wurde höheres Niveau von EXP, EXC, B festgestellt. Im Falle der Mütter von sch Kindern ließ sich folgendes nachweisen: a) je stärker die BI, desto stärker die EXC von Söhnen; b) je stärker die EXP, desto stärker die EXC von Töchtern. Je stärker bindet die Mutter das gesunde Kind, umso mehr belastet fühlt sie sich. Je mehr der eine Elternteil das Kind ausschließt, umso mehr schließt es auch der andere Elternteil aus. Je mehr der eine Elternteil das Kind ausstoßt, umso mehr stoßt es auch der andere Elternteil aus. Fazit: In den Familien der jungen sch. Erwachsenen verstärken sich die disfunktionalen Relationsmuster.
Paz Flores, Roser Izquierdo, Edzard Palomer, Rosa Sanchis (E):
Variations of Criteria Applied to Family Therapy (Verschiedene Kriterien in ihrer Anwendung auf Familientherapie)
To define the main criteria applied to family treatment in a CSM (Public Mental Health Centre) based on the requests made by other professionals over the last two years. The treatment in this CSM is carried out on a part time basis. Design and method: The data of 70 families have been analysed: the reason for the request for FT, clinical diagnosis of the identified patient, other pathologies both medical as well as psychiatric of other family members, organization and family relationships (GARF). All the patients were diagnosed using DSM-IV-TR. Results: The final data of the research, statistically analysed, show that the majority of families have been referred because of a behavioural disorder in the familiar environment. Related to the diagnosis, half of the sample shows more than one psychiatric disorder. 50% of identified patients present with a double diagnosis. Related to GARF scores, the vast majority of the families shows scores lower than 60. When more than one psychiatric disorder in the family group exists, the GARF scores are lower than 40.
Conclusions: The results of this study have allowed us to prioritize some selection criteria in applying family therapy. Firstly, treatment for families when several members have psychiatric pathologies. Secondly, family intervention as prevention when one or both parents have severe behavioural disorders.
K. Gini, Th. Papadakis, G. Bouldadaki, G. Miropoulou (GR):
The Greek Family in Therapy (Die Griechische Familie in Therapie)
Objectives: A study of the demographic and psychopathological characteristics of 831 greek families, is presented. Design and Method: The data are retrospectively collected from the archives of the Therapy Unit of the O.P.C. and have been statistically analysed by S.P.S.S. 8.0. Results: Families have an average of four members and live in Athens or in suburb (90,7 %). The parental couples are married (78,4%), the male member of the couple has an average of 45,4 years old,is a scientist or manager (26,2%) while the female averages 41,1 years old and is a housewife (31,6%). The presenting problem of the families concerns their preadolescent child (30,2%) which has an average of 12,2 years old, with behavioural difficulties (35,4 %),is a boy (61,2%), is the first child (36%) and attends a public school (71,2%). Most of the family members claim that they do not present or do not mention any previous psychiatric history (78%) and they have never before visited a mental health specialist (61,9%). For the majority of the cases (51,3%) 3 or 4 meetings are adequate, while the rest (48,7%) start a systematic therapeutic activity, which lasts 10,2 months. The therapeutic outcome is successful (72,6%, i.e. 36,3 % are fully recovered and the 36,3% present improvement without symptoms).
Conclusions: The authors discuss these findings with other similar studies.
Thomas Hegemann (D), Ben Furman (FIN):
Kid´s Skills - A Solution Focused Programme for the Work with Children
Kids' Skills is a solution-focused method with which you can help children solve their own problems by learning skills. Kid’s Skills was developed in Finland by Ben Furman and colleagues. It has been translated into several languages and was successfully introduced into rehabilitation programs for children with special needs in quite a number of countries. This program is a particularly practical method to adapt the solution focussed approach to the work with children in school settings and children orientated services. The poster will describe the program step by step in pictures and in writing. It will show materials, which were developed to support this program, and drawings of children, who used it, will be shown. Reference: www.kidsskills.org
(Ich schaff’s ein lösungsorientiertes Programm für die Arbeit mit Kindern)
"Ich schaff’s" ist ein lösungsorientiertes Programm um Kindern zu helfen, ihre Probleme durch das Lernen neue Fähigkeiten zu bewältigen. "Ich schaff’s" ist die deutsche Version von Kid’s Skills, welches von Ben Furman und Kollegen in Finnland entwickelt wurde. Es ist in mehrere Sprachen übersetzt worden und wurde in verschiedenen Ländern mit Erfolg in Rehabilitationseinrichtung für Kinder mit besonderem Förderbedarf eingeführt. Dieses Programm stellt eine besonders praktische Methode vor, wie der lösungsorientierte Ansatz für die Arbeit mit Kindern in Settings des Schulwesens und in Einrichtungen, die Kinder betreuen, angewendet werden kann. Das Poster beschreibt das Programm in seinen einzelnen Schritten sowohl in Bildern wie mit Text. Es werden Materialen vorgestellt, die zur Unterstützung dieses Programms entwickelt wurden, und es werden Zeichnungen von Kindern demonstriert, die damit gearbeitet haben. Referenz: www.ichschaffs.com
Dimitris Kiosses, G. Psaropoulos (GR):
„The times they are a-changing“ (?): The Discourse of the American Journal of Psychiatry vs. the Discourse of Family Process on Psychiatric Symptoms and Power in the Therapeutic Setting over the last 10 Years („Die Zeiten ändern sich” (?) Diskurse über psychiatrische Symptome und Wirksamkeit im therapeutischen Setting in den letzten 10 Jahren: Ein Vergleich von „American Journal of Psychiatry“ und „Family Process“)
Objectives: This study was designed to explore the ways in which psychiatric symptoms and power in the therapeutic setting are talked about in the context of predominant scientific texts. The overall aim was to highlight potential differences and similarities across texts. Design and Method: A qualitative analysis was applied to the titles and the abstracts of papers published by the American Journal of Psychiatry and the Family Process in the last 10 years (random sample). The two journals were selected following their predominant role, the first regarding the ‘mainstream’ psychiatry and the latter regarding the systemic field. Papers were selected following the criteria of their relevance to the matters of interest. Results: The demonstrated differences (and/or similarities) are discussed as constructed in the context of the postmodern, social constructionist trends circulating in the field.
Conclusions: Following a social constructionist / systemic epistemology, the demonstrated different ways of discoursing about mental health across time are argued as facilitating and promoting diverse practices.
Conny Leporatti, Rodolfo de Bernart (I):
Art´s Images Tests in Systemic Individual Therapy (Test zum Einsatz von Kunstwerken in Systemischer Einzeltherapie)
Our poster presents a test based on images from art, for systemic relational therapy. Design and method: presentation of the test; instruction on how to use the book of images, which are divided in 20 diagnostic categories. The research is still in progress. The authors try to demonstrate that images of art are able to increases positive results in therapy and to reduce its duration.
Conclusions: Use of images facilitate the contact and the access to patient’s optical unconscious, resulting in analogic connections useful for therapy and evaluation.
Howard A. Liddle (USA):
Outpatient vs. Residential Treatment for Adolescent Drug Abusers: Results of a Randomized Controlled Trial (Ambulante vs. Stationäre Therapie bei Drogenmißbrauch von Jugendlichen: Ergebnisse eines randomisierten Kontrollversuchs)
Objectives: Examined whether an intensive outpatient family-based treatment, Multidimensional Family Therapy (MDFT), could prove to be a clinically and cost effective alternative to residential treatment (RT) for adolescents with drug and mental health problems. Design, Method and Results: From intake to discharge, RT and MDFT had similar drug outcomes (RT reduced cannabis use by 77% from intake to discharge; and MDFT evidenced 62% reductions). But at 12 months post intake, RT gains decayed, while MDFT treatment gains increased. One year post-intake, MDFT adolescents had 65% reductions in cannabis use compared to 40% reductions by RT adolescents. A similar pattern across the treatments was found on behavioral outcomes. Cost analyses show that MDFT costs over one-third less than RT.
Conclusions: Adolescents routinely judged to be in need of RT can be treated more effectively and less expensively with a outpatient alternative which in this case was an intensive, multiple systems-focused treatment with considerable treatment development and controlled trial development, Multidimensional Family Therapy.
Nikolaos Marketos, Dionysos Sakkas, K. Korevi, M. Dialyna, T.
Mylonaki, P. Stathopoulou, O. Tsirkas, E. Pashalidou, S.
Antzoulatou, K. Anagnostopoulou, K. Alexandropoulos (GR):
A Dialectic Systemic Answer to the Paradox of Involuntary Admissions in an Open Doors Psychiatric Unit of a General Hospital (Eine dialektisch-systemische Antwort auf das Paradox der unfreiwilligen Aufnahme in einer offenen psychiatrischen Einrichtung in einem Allgemeinkrankenhaus)
Objectives: We present a responding process to hospitalizing patients, involuntarily admitted in an open-door psychiatric unit of a general hospital, after the destruction of the district psychiatric hospital from the earthquake, 1999. We focus on the last stage of changes in the therapeutic team, and therapeutic work. Facing unknown dangerous situations we were forced to invent and coconstruct new solutions.
Reference: We applied principles from the dialectic Systemic epistemology as it evolved in the Athenian Institute of Anthropos by G&V.Vassiliou and associates (common shared epistemology of many of the presenters), synthetic processes with other colleages of different approaches,with the family and patient and with correlated services. The efficacy of dialectic-systemic and paradox thinking was obvious. In a process of coevolution we often actualized the phenomena of resonance (Elkaim M.) that emerged in supervision, and the therapeutic settings.
Conclusion: Indicative for the results is the fact, that after four years of this experience the mean nursing duration diminished from 40 days to 20 days, while the majority of the involuntary admitted patients consented to a new contract for a voluntary cooperative work.
Nikolaos Marketos, E. Foka (GR):
Individual Therapy by Simultaneous Drawings for Children and Adolescents (Einsatz von Simultan-Zeichnungen in der Einzeltherapie von Kindern und Jugendlichen)
Objectives: This poster presentation describes an alternative approach to children and young adolescents individual therapy, by the use of child’s and therapist’s simultaneous drawing. The technique, the theoretical considerations, the indications and the experience, of 10 years work with children, are also presented. At the beginning of the session the therapist ask’s the child to define a topic, to draw. Then the child and the therapist draw separately the theme arisen from this topic. When they finish their work they join and reveal their drawings to each other. Structured Discussion concerning the emotions and thoughts emerged from drawings, follows. Reference:The technique is placed in the context of systemic therapy of children’s and adolescents’s families. It was inspired by the synallactic collective image technique (G. & V. Vassiliou).
Conclusion: Therapeutic relationship, expression of hidden emotions and positive mutual processes are facilitated. The approach is effective in the treatment of children with Psychiatric disorders. The complexity of therapist’s position is emphasized.
Baiba Martinsone (LV):
The Association between Adult Attachment with Parents and Internal Representations of Current Romantic Partner in Projective Drawings. A Latvian sample (Die Verknüpfung zwischen Bindungen von Erwachsenen an ihre Eltern und inneren Bildern des aktuellen Partners in projektiven Zeichnungen. Beispiele aus Lettland)
Research sample consisted of 136 respondents both men and women aged between 18 to 45 (with mean age 25,2 years). The research was based on Attachment Styles Inventory (ASI, Sperling & Berman, 1991) and projective drawings of current romantic partner. The differences among drawings of attachment figure were discussed with respect to ASI classification. There were a different features in projective drawings in relation to various attachment styles, associated with internal representations of current romantic partner. The Dependent attachment style was characterized by concise, finished drawings with emotionally positive mood. The Ambivalent attachment style was characterized with corrected or scattered, contradictory and ambiguous drawings. The Avoidant attachment category was characterized by emotionally neutral, more symbolic or abstract drawings. In the Hostile attachment style there were no symbolism and abstraction, the romantic partner was mostly drawn as a human, but was crippled or deformed. However there were emotional accents in the drawings which were absent in avoidantly attached respondents’ drawings.
George Moussas, A. Mhilia, P.S. Couloura, A. Karkanias,
A. Tselebis (GR):
Moderators of Anxiety and Depression in Parents of Children with Pervasive Developmental Disorder (Angst- und depressionsregulierende Faktoren bei Eltern von Kindern mit gravierenden Entwicklungsstörungen)
Objectives: The current study addresses the relationship between depressive symptoms and coping styles among parents of children diagnosed with Pervasive Developmental Disorder (PDD), along with the level of anxiety and the defense mechanisms interfering with the appearance of such symptoms. Other variables such as gender differences and demographic characteristics are also being evaluated in order to examine their relationship with levels of anxiety and depression. Design and Method: A sample of 60 parents of children diagnosed with PDD, aging 3 through 13 years old, participate in the study. Beck Depression Inventory (BDI), AECOM Questionnaire of Coping Styles, Spielberger’s Questionnaire for anxiety , and Defensive Scale Questionnaire (DSQ-40) were used for data collection. Surveys were completed by parents in the presence of the examiner. The statistical elaboration, was been made by the use of spss, and the ANOVA method.
Results: The mean age of the sample was 39,21±7,05, with a mean of education 14,9±3,3 years and an average of children 2,04. In the sample we have studied a 26% of the patients had depression and a 39,1% had anxiety. No significant differences have been marked between the coping styles of our sample and those of the witnesses, except in that of seeking help. We have found a significant correlation between levels of depression and the defense mechanisms of somatization, isolation and autistic phantasies. Anxiety was correlated to the mechanisms of displacement, substitution and dissociation.
Conclusions: Results are still under survey and further clinical implications of the findings are discussed with respect to gaining more knowledge about parental distress and how a thorough family assessment can let us establish supportive treatment strategies.