A Case-Based Approach to Learning Ethics in Physical Therapy. Ethics in Physical Therapy utilizes a unique case-based approach to teach students and clinicians how to apply theoretical concepts to real-world situations. The cases were carefully selected to encourage thinking and discussion. The accompanying text provides a framework to answer the "should" questions, such as "What should I do?" and "How should I act?" The format provides the opportunity to move beyond the individual realm, when appropriate, resolving (...) issues within an institutional or societal perspective. The text is divided into two sections: "Ethics for the Physical Therapist" and "Types of Ethical Decisions: Case Analysis." They are designed to integrate with one another, but, each section can also be used separately. Part I provides more didactic, foundational material, while Part II strives to apply ethical decision-making tools to relevant cases in physical therapy practice, with the second section focusing on case analyses. The purpose of Ethics in Physical Therapy is to give students and clinicians a lens through which to analyze contemporary ethical challenges. Philosophical theory within the text is limited to that which can be applied practically in the clinical setting. This book is not intended to be a work on ethical behavior, rather, it is designed to provide students and clinicians with a framework in which to approach the uncertainty of ethical decision making with tools to aid their inherent judgment. (shrink)

This article presents a study on the ethical dilemma of whistleblowing in physical therapy, and suggests some lines for further research on this topic as well as ways for integrating it in the physical therapy curriculum. The study examines the self-reported willingness of physical therapy students to report misconduct, whether internally or externally, to protect the patient's interests. Internal disclosure entails reporting the wrongdoing to an authority within the organisation. External disclosure entails reporting the (...) offence to an outside agency, such as the police, professional organisation, or press. The findings indicate that the students view the acts that are detrimental or cause injustice to the patient in a very serious light. In dilemma situations such as these, the students reported a willingness to act. The students also report considerably greater likelihood of whistleblowing internally than externally. The pattern reveals a desire to correct the misconduct coupled with a marked decline in the willingness to blow the whistle as this act moved from the workplace to an external authority. (shrink)

The purpose of this text is to give physical therapy students and clinicians a lens through which to analyze contemporary ethical challenges.

In recent decades, phenomenology has been utilized not only as a conceptual framework from which to understand medical encounters in healthcare settings, but also to guide medical professionals in providing care. In the realm of physical therapy, phenomenology has been touted as a philosophically-based avenue to aid in helping to understand what it means to be a patient. The works of Edmund Husserl and Martin Heidegger have been utilized as paths to approach phenomenologically-informed care in physical (...) class='Hi'>therapy. However, to our knowledge, no significant connection has been made in regard to the work of Hans-Georg Gadamer’s phenomenology and hermeneutics in the realm of physical therapy. The authors aim to close that gap by showing the ways in which Gadamer’s philosophy can help physical therapists provide phenomenologically-informed patient care. They begin by outlining some of the touchpoints between phenomenology and healthcare and then introduce Gadamer as a figure who deserves attention in the question of how to apply phenomenology to healthcare settings. Upon analyzing Gadamer’s account of what it means to experience an altered body, they outline Gadamer’s understanding of tact, practical knowledge, and good sense in order to show how to understand at a conceptual level what it means to empathize with patients on the path to building therapeutic alliance, that is, a cooperative working relationship. They then look closely at Gadamer’s hermeneutics and particularly his comments on how to cultivate a fusion of horizons in order to attempt to help guide physical therapists in theoretically understanding how to empathize with their patients. Ultimately, they argue that physical therapists who practice phenomenologically-informed care, which they call “hermeneutical healing,” are positioned well to form strong working relationships with their patients. (shrink)

OBJECTIVES: To identify ethical dilemmas experienced by occupational and physical therapists working in the UK National Health Service (NHS). To compare ethical contexts, themes and principles across the two groups. DESIGN: A structured questionnaire was circulated to the managers of occupational and physical therapy services in England and Wales. SUBJECTS: The questionnaires were given to 238 occupational and 249 physical therapists who conformed to set criteria. RESULTS: Ethical dilemmas experienced during the previous six months were reported (...) by 118 occupational and 107 physical therapists. The two groups were similar in age, grade, and years of experience. Fifty of the occupational therapy dilemmas occurred in mental health settings but no equivalent setting emerged for physical therapy. Different ethical themes emerged between the two groups, with the most common in occupational therapy being difficult/dangerous behaviour in patients and unprofessional staff behaviour, and for physical therapists resource limitations and treatment effectiveness. No differences were found in the ethical principles used. CONCLUSION: The ethical dilemmas reported by the therapists were primarily concerned with health care ethics, rather than the more dramatic ethics reported in much of the biomedical ethics literature. Differences were found between the two professional groups when ethical contexts and themes were compared but not when ethical principles were compared. This suggests that educators and researchers need to be aware of work settings and the interdisciplinary nature of employment as well as ethical principles held by individual therapists. (shrink)

Using a longitudinal case study design, we have tracked the recovery of motor function following severe traumatic brain injury (TBI) through a multimodal neuroimaging approach. In 2006, Canadian Soldier Captain (retired) Trevor Greene (TG) was attacked with an axe to the head while on tour in Afghanistan. TG continues intensive daily rehabilitation, which recently included the integration of physical therapy (PT) with neuromodulation using translingual neurostimulation (TLNS) to facilitate neuroplasticity. Recent findings with PT+TLNS demonstrated that recovery of motor (...) function occurred beyond conventional time limits, currently extending past 14-years post-injury. To investigate whether PT+TLNS similarly resulted in associated cognitive function improvements, we examined event-related potentials (ERPs) with the brain vital signs framework. In parallel with motor function improvements, brain vital signs detected significant increases in basic attention (as measured by P300 response amplitude) and cognitive processing (as measured by contextual N400 response amplitude). These objective cognitive improvements corresponded with TG’s self-reported improvements, including a noteworthy and consistent reduction in ongoing symptoms of post-traumatic stress disorder (PTSD). The findings provide valuable insight into the potential importance of non-invasive neuromodulation in cognitive rehabilitation, in addition to initial indications for physical rehabilitation. (shrink)

Compared to other health care professions such as medicine, nursing and pharmacy, few studies have been conducted to examine the nature of practice errors in occupational and physical therapy. In an ongoing study to determine root causes, typographies and impact of occupational and physical therapy error on patients, focus group interviews have been conducted across the United States. A substantial number of harmful practice errors and/or other patient safety events (deviations or accidents) have been identified. Often (...) these events have had moral dimensions that troubled the therapist involved. In this article, six of these transcribed cases are analyzed, using predominant bioethical theories, ethical principles and professional codes of ethics. The cases and their analyses are intended to be exemplary, improving the readers’ ability to discern and critically address similar such events. Several patient safety strategies are suggested that might have prevented the events described in these cases. (shrink)

IntroductionCouple violence (CV) affects many, and the consequences of those actions are grave, not only for the individual suffering at the hand of the perpetrator but also for the other persons in the family. Violence often happens among more than just the adults within one family. Even if CV has been thoroughly investigated in the general population very few studies have investigated this objective on a clinical sample, and none of these have included family violence.AimThis article identifies and describes the (...) group of clients that have issues of physical couple and family violence. It analyses a model that can help to discover physical violence and help therapists to assess what actions to take in therapy to prevent further physical violence.MethodologyDescriptive analysis, t-tests, and structural equation modeling (SEM) are used on a sample of clients receiving couple and family therapy (CFT) in Norway (N = 830). Family violence is modeled by the partner’s expectations toward each other, levels of anger, sexual satisfaction, and self-control.ResultsOne-in-five clients experienced physical CV in their current relationship and one-in-four experienced physical family violence. The group of clients who experienced CV differed from those without such experiences in having lower income, more prior experience with psychotherapy, more experience with alcohol abuse in childhood, and far more physical family violence in their current family. Our model predicting physical coupl... (shrink)

The use of growth attenuation therapy (GAT) is becoming more common in order to enable a family to care for a child with profound cognitive and physical disabilities (PCPD) as they age into adulthood. The first published study on the use of GAT was done with the family of a six-year-old girl with PCPD by Daniel Gunther and Douglas Diekema in Pediatrics in 2006. The ethical application of GAT generated considerable discussion on the use among children with PCPD (...) in the medical and ethics communities. This paper discusses the use of GAT for children with profound cognitive and physical disabilities from a Catholic bioethics perspective. (shrink)

The purpose of the present study was to evaluate the effectiveness of a physical activity intervention program designed to enhance levels of engagement in PA. Despite robust evidence supporting the beneficial effects of PA on overall health, only about 22% of individuals engage in the recommended minimum amount of PA. Recent surveys suggested that most individuals express intentions to be physically active, though the psychological state of amotivation dismissed these struggles. In the current study, we pilot-tested a new intervention (...) program, aimed at enhancing engagement in PA among sedentary individuals. The intervention was based on two behavioral change and motivational psychological frameworks: Self-Determination Theory and Acceptance and Commitment Therapy. During a 14-week intervention program, 94 sedentary Israeli college students were randomly assigned into one of three groups: SDT and ACT-based intervention, traditional intervention, and a non-treatment group. Prior to and following the intervention, participants completed the Behavioral Regulation in Exercise Questionnaire-3 to examine motivation to exercise and the International Physical Activity Measurement IPAQ to evaluate their training frequency. Results showed that the SDT and ACT-based intervention group exhibited a significant increase in motivation to exercise between time 1 and time 2, while the other two groups showed insignificant differences in motivation to exercise. Furthermore, neither of the groups showed significant differences in their training frequency per week. However, those in the SDT and ACT-based groups reported an increase in activity intensity from time 1 to time 2 compared to the two other groups. Further, exercise psychology consultants and scholars can use the intervention protocol and utilize these findings to improve PA behaviors and promote health in the general population. Limitations, future directions, and implications are discussed in detail. (shrink)

During the past decade, debate has intensified about the role of long-term opioid therapy in the management of chronic nonmalignant pain. Specialists in pain management have discussed the issues extensively and now generally agree that a selected population of patients with chronic pain can attain sustained analgesia without significant adverse consequences. This perspective, however, is not uniformly accepted by pain specialists and has not been widely disseminated to other disciplines or the public. Rather, the more traditional perspective, which ascribes (...) both transitory benefit and substantial cumulative risk to long-term opioid therapy, continues to predominate. According to this perspective, the inevitability of tolerance limits the possibility of sustained efficacy, and other pharmacological properties increase the likelihood of adverse outcomes, including persistent side-effects, impairment in physical and psychosocial functioning, and addiction. If accurate, these outcomes would indeed justify the withholding of opioid therapy for all but the most extreme cases of chronic nonmalignant pain. (shrink)

During the past decade, debate has intensified about the role of long-term opioid therapy in the management of chronic nonmalignant pain. Specialists in pain management have discussed the issues extensively and now generally agree that a selected population of patients with chronic pain can attain sustained analgesia without significant adverse consequences. This perspective, however, is not uniformly accepted by pain specialists and has not been widely disseminated to other disciplines or the public. Rather, the more traditional perspective, which ascribes (...) both transitory benefit and substantial cumulative risk to long-term opioid therapy, continues to predominate. According to this perspective, the inevitability of tolerance limits the possibility of sustained efficacy, and other pharmacological properties increase the likelihood of adverse outcomes, including persistent side-effects, impairment in physical and psychosocial functioning, and addiction. If accurate, these outcomes would indeed justify the withholding of opioid therapy for all but the most extreme cases of chronic nonmalignant pain. (shrink)

There is mounting evidence that strong personal relationships and spiritual beliefs contribute to our well-being. In Divine Therapy, Janet Sayers employs a biographical approach to the lives and writings of a range of eminent psychotherapists and psychologists to illuminate the link between physical and mental well-being and the 'at-one-ness' provided by love, religious and mystical experiences.

Background: Chinese Taoist cognitive therapy (CTCT), a culture-oriented psychological therapy for Chinese mental well-being, has been proposed for decades. However, the evidence for its effects is unclear. This study aimed to systematically assess the effect of this therapy on symptoms of depression and anxiety in Chinese adults. Methods: Relevant studies were searched from major electronic databases through November 2018 without language limits. Several search terms used include “anxiety” OR “depression” AND “Taoism” OR “Daoism” OR “Chinese Taoist Cognitive (...) Therapy”. A total of 11 clinical trials focusing on CTCT were included in this meta-analysis. Random-effects meta-analytical models were conducted. Heterogeneity and publication bias were also explored. Results: Eight clinical trials for 580 subjects were included. The majority of these studies explored samples with depressive symptoms. Overall, CTCT significantly reduced depressive symptoms with a small positive effect (SMD = 0.16, 95% CI: -0.36-0.68). Medium-to-large effect sizes were observed across individuals with clinical or nonclinical depression and chronic physical diseases (SMD = 0.70, 95%CI: 0.27-1.13 and SMD = 0.72, 95%CI: 0.09-1.35, respectively). However, the effectiveness for anxiety symptoms remains debatable. Conclusions: Our findings hold promise that CTCT can help reduce depressive symptoms in Chinese adults, including patients with chronic physical diseases and clinical or nonclinical depression. Our findings may be generalized to Chinese communities in other countries. (shrink)

Sound is one of the types of waves that can be felt by the sense of hearing (ears). In physics, the definition of sound is something that is produced from objects that vibrate. Objects that produce sound are called sound sources. The sound source that vibrates will vibrate the molecules into the air around it. Sound is mechanical compression or longitudinal waves that propagate through the medium. This medium or intermediate agent can be liquid, solid, gas. So, sound waves can (...) propagate for example in water, coal, or air. Most sounds are a combination of various vibratory signals composed of harmonic waves, but pure sound can theoretically be explained by oscillating vibrational speed or frequency measured in Hertz (Hz) vibration units and amplitude or loudness of sound with measurements in decibels (dB). The effect sounds can have on us humans is simply astounding. While everyday life becomes stressful, overcrowded and increasingly hectic, we seek ways for inner peace and balance. The power of music, felt through overtone-rich sound therapy and sound massage, can be a solution. No matter how much scientific explanation is behind it, healing through music remains fascinating, even magical. This paper introduces a new field called cymatics and sound healing with their plausible impact to spirituality and consciousness research. (shrink)

Doping can be both of chemical and protein nature or may involve prohibited methods, such as illegal blood transfusions. The rapidly increasing number of genetic therapies as a promising new branch of regular medicine, has raised the issue whether these techniques might be abused in the field of sports. The risks involved in gene doping are several, and are related both to the vector protein used (DNA, chemical, viral) and to the encoded transgene. A concern in the athletic community is (...) that no one knows how easily gene doping can be detected. The DNA used for gene transfer is of human origin, and not different from that of the person applying gene doping. A combination of developing detection methods based on gene arrays or proteomics and a clear education program on the associated risks seems to be the most promising preventive method to counteract the possible application of gene doping. (shrink)

In the book The invention of tradition historian Eric Hobsbawm claims that the process of the invention of tradition serves the formation of group cohesion. The different versions of the life story of the founder bishop of the Corinthian Church of South Africa, as documented during many years of conducting qualitative field work in this church, are used in this article as a case study in this regard. The article unpacks the way in which the invention of tradition as a (...) process is in this particular AIC currently a work in progress contributing to the formation of a particular type of group cohesion that stretches over racial, religious and denominational boundaries especially by means of the unique liturgical rituals that were influenced by the life story of the founder. The group cohesion that this process fosters is in essence aimed at healing in all its multifaceted dimensions, which includes healing from physical ailments, ‘healing’ from barrenness, healing from spirit possession to healing as incorporation of an individual into the larger group, the healing of a nation as well as healing from a dualistic spirit-matter worldview. (shrink)

Over 50% of the world population will develop a psychiatric disorder in their lifetime. 1 In the realm of psychiatric treatment, two primary modalities have been established: pharmacotherapy and psychotherapy. Yet, pharmacological interventions often take precedence as the initial treatment choice despite their comparable outcomes, severe side effects and disputed evidence of their efficacy. This preference for medication foregrounds a vital re-examination of what it means to be invasive in medical treatments, namely in psychiatric care. De Marco _et al_ challenge (...) the standard account of invasiveness, presenting considerations that transcend the traditional criteria of physical intrusion. 2 Through case studies centred on treatments for schizophrenia and depression, we aim to (1) reinforce De Marco _et al_’s challenge to the standard account of invasiveness and (2) extend the dialogue to the moral imperative of redefining mental invasiveness. Our aims are to broaden the definition of mental invasiveness, aligning... (shrink)

In this paper, we discuss the perspective of intra-organismal ecology by investigating a family of ecological models. We consider two types of models. First order models describe the population dynamics as being directly affected by ecological factors (here understood as nutrients, space, etc). They might be thought of as analogous to Aristotelian physics. Second order models describe the population dynamics as being indirectly affected, the ecological factors now affecting the derivative of the growth rate (that is, the population acceleration), possibly (...) through an impact on non-genetically inherited factors. Second order models might be thought of as analogous to Galilean physics. In the joint paper, we apply these ideas to a situation of gene therapy. (shrink)

The present work aims to efficiently carry out life-death education for college students, improve their psychological problems, and reduce suicide accidents by combining LDE with Dance Movement Therapy. DMT is a psychosomatic cross therapy that treats mental or physical diseases through dance or improvisation. Firstly, this paper introduces LDE and DMT and designs the activities of DMT intervention. Secondly, the relationship between DMT and LDE is analyzed. Finally, a questionnaire survey is conducted on the research objects. The (...) research objects are divided into the experimental group receiving DMT intervention, the control group participating in sports dance courses, and the benchmark group. The research data show no significant difference in interpersonal skills and emotional psychology among the three groups. The DMT intervention group has substantial changes in other factors except for the conflict control ability before and after the intervention. In addition, the questionnaire survey results after the intervention demonstrate that the DMT intervention group gets a significantly higher score in the interpersonal relationship, interpersonal relationship building ability, moderate rejection ability, self-disclosure ability, and emotional support ability. Therefore, DMT intervention positively impacts college students’ interpersonal relationships. After the sports dance course, there are differences in the total score of interpersonal ties and scores of interpersonal relationships building ability, self-disclosure ability, and emotional support ability in the control group, but with no significant difference in moderate rejection ability and conflict control ability. Therefore, compared with traditional psychotherapy methods, the DMT method reported here is conducive to releasing pressure and alleviating physical and mental anxiety. The research content provides new ideas for psychological education in colleges and universities and contributes to improving college students’ suicidal tendencies and helping college students grow up healthily. (shrink)

Objective: We aimed to analyze the characteristics and psychological mechanism of depressive symptoms in elderly patients with alcohol dependence under the COVID-19 epidemic and to observe the effect of acupuncture combined with emotional therapy of Chinese medicine treatment on depressive symptoms in elderly patients with alcohol dependence.Methods: Sixty patients were randomly divided into two groups. One group was treated by a set of emotional therapy of Chinese medicine treatment for 12 weeks. One group was treated by a set (...) of acupuncture combined with emotional therapy of Chinese medicine treatment for 12 weeks. We compared the curative effect between the control group and the treatment group, the mean alcohol consumption, the SF-36 scores before and after treatment, and the scores of Hamilton Depression Scale before and after treatment of 3, 6, and 9 weeks.Results: Based on the cognitive behavior model, the characteristics and psychological mechanism of depression in elderly patients with alcohol dependence under the COVID-19 epidemic situation were summarized. The total effective rate of the control group was 60%, and that of the treatment group was 100%. After 12 weeks of treatment, there were significant differences in PF, RF, physical pain, general health status, energy, and mental health between the treatment group and the control group. Before and after treatment, there were significant differences in PF, RF, physical pain, general health, energy, emotional function, and mental health of the treatment group. The PF, energy, and mental health of the control group were significantly different before and after treatment. There was no significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale before treatment. There was significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale at 3, 6, and 9 weeks after treatment.Conclusion: Attention, cognition, emotion, behavior, and physical response reinforce each other, creating a vicious cycle that reinforces and sustains the depressive symptoms of elderly alcohol dependence under the COVID-19 epidemic, and acupuncture combined with emotional therapy of Chinese medicine treatment for improving the depressive symptoms of elderly alcohol dependence during the epidemic period of COVID-19 has a brilliant therapeutic effect. (shrink)

The aim of this essay is to provide an overview of how Existential Therapy is fundamentally different from every kind of psychotherapy, including existential psychotherapy. Existential Therapy is no kind of psychotherapy. Confusing the practicing of the two can harm people and thoughts. Existential Therapy is therapy for existence, whereas psychotherapy is therapy for life, a remedy for the problems of living. The adequate distinction between life and existence is an issue that shamefully has gone (...) unaddressed in existential philosophy, existential psychology and research, and existential psychotherapy. This essay describes the main differences between life and existence, and then takes a look at what is healthy for existence versus what is healthy for life. What is found to be most unhealthy for existence is metacarnalizing, recoiling from carnal limits. Metacarnalizing is a primary existential reversal. Existential therapy unreverses existential reversals. Existential therapy unreverses metacarnalizing. Existential therapy essentially de-metacarnalizes. The issue of metacarnalizing and de-metacarnalizing is absolutely alien to all forms of psychotherapy for life. The essay is followed by an appendix, "An Existential View of Physics," which mainly describes the metacarnalizing basis of physics throughout its history. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Breathing:Proustian Therapy1Christopher Prendergast (bio)I begin with a question I would never have imagined myself asking. Is Proust good for you? Might there even be, albeit in carefully controlled doses, a place for him in modern 'health care'? He certainly belongs in the select, if occasionally scary, company of writers whose name, or that of one of their fictional characters, has lent itself to the designation of a psycho-physical (...) condition often with medical characteristics. A short list includes: Stendhal ('Stendhal syndrome,' the condition of obsessional attachment to works of art); Musset (the 'Musset Sign,' manifested as an uncontrollable tremor of the head); Gogol's Plyushkin in Dead Souls ('compulsive hoarding syndrome'); Dickens's Miss Havisham in Great Expectations ('senile squalor syndrome'); Wilde's Lady Windermere ('Lady Windermere syndrome,' associated with pulmonary illness and breathing difficulties).There is no evidence that Proust was directly acquainted with Wilde's play, but there can be little doubt that what came to be called 'Lady Windermere Syndrome' would have spoken to him loud and clear. In an early story called L'Indifférent, Proust penned an encomium to the air we breathe: "A child who from birth has always breathed without paying any attention has no idea how much the air, which swells so sweetly his chest that he doesn't even notice it, is essential to life." A memory of this is doubtless somewhere in the background of the passing mention in Le Côté de Guermantes of "the alpine resort" that teaches him "that the act of breathing, to which we habitually pay no attention, can be a constant source of pleasure." It was almost certainly also in Proust's thoughts when, in the final volume, he penned the famous definition of Paradise Lost as the place and time of "an air we have breathed before, this purer air which the poets have tried in vain to make reign in paradise and which could not provide this profound feeling of renewal if it has not already been breathed, for the only true paradise is a paradise that we have lost."But the early story, like the novel itself, is also haunted by a subtext in which what is precious to life can also be the enemy of life, as, in an access of fever and sudden convulsion, the child feels himself to be suffocating. The story clearly has its origins in Proust's own life, the moment of his first asthma attack as a young boy on a family outing to the Bois de Boulogne. It struck out of the blue with a frightening intensity, and was to pursue [End Page 49] him throughout his life like a fury, proliferating further symptoms such as emphysema and cardiac seizures. As late as 1919, he writes in a letter of an attack that leaves him "gasping like someone half-drowned who is pulled out of water." And it was there again at the moment of Proust's exit from the world, carried off by a bout of pneumonia exacerbated by a pulmonary abscess.There were treatments and consultations galore, the former on a spectrum from inhalations to cauterizing of the nasal tubes, and the latter including a meeting with his father's colleague, Dr. Buissand, who inclined to the view– and increasingly fashionable in medical circles–that the prime cause was neurasthenic. Proust himself hesitated: in a letter he described it as "a bodily illness," but in the Recherche, "asthma crises" are linked to a "mystery" of the "unconscious" and strike out of the blue. The 'mystery' is often, and plausibly, associated with fear of separation from the protective mother. This will be one of the major themes of the novel, and the source of the "sobs that never cease" of which the narrator speaks in the opening volume. But whether physical or psychosomatic, a guaranteed trigger was proximity to tree blossoms (apple especially virulent) and certain flowers–that is, the very things that, for Proust, often something approaching quasi-sacred status, thus illustrating the law that it is what you most love that can kill you.In the novel, however, much of this is distilled into comedy, all terrifying... (shrink)

This multi-centre research investigates the effects of dance movement therapy (DMT) on participants diagnosed with depression. In total, 109 persons participated in the study in various locations in Finland. The participants were 39 years old, on average (range = 18–64 years), and most were female (96%). All participants received treatment as usual (TAU). They were randomised into DMT+TAU (n = 52) or TAU-only (n = 57). The participants in the DMT + TAU group were offered 20 DMT sessions twice (...) a week for 10 weeks in addition to standard care. The measurement points included pre-treatment measurement at the baseline, post-treatment measurement at the end of the intervention, and a follow-up measurement 3 months afterward. The observed effects of the intervention among participants in the DMT+TAU group were a greater reduction in depression (BDI-I) and in indicators of physical and psychological distress (CORE-OM and SCL-90) in comparison to the participants who received TAU-only. At the 3-month follow-up, the corrected between-group effect sizes (ES) were medium and in favour of the DMT+TAU group (d = 0.60–0.72). These results are in line with the increasing number of research studies showing the benefits of DMT intervention among participants with depression, and these results indicate that DMT may improve the effectiveness of standard care. (shrink)

I-BLOCKS are an innovative concept of building blocks allowing users to manipulate conceptual structures and compose atomic actions while building physical constructions. They represent an example of enabling technologies for tangible interfaces since they emphasise physicality of interaction through the use of spatial and kinaesthetic knowledge. The technology presented in this paper is integrated in physical building blocks augmented with embedded and invisible microprocessors. Connectivity and behaviour of such structures are defined by the physical connectivity between the (...) blocks. These are general purpose, constructive, tangible user interface devices that can have a variety of applications. Unlike other approaches, I-BLOCKS do not only specify a computation that is performed by the target system but perform at the same time the computation and the associated action/functionality. Manipulating I-BLOCKS do not only mean constructing physical or conceptual structures but also composing atomic actions into complex behaviours. To illustrate this concept, the paper presents different scenarios in which the technology has been applied: storytelling performed through the construction of physical characters exhibiting emotional states, and learning activities for speech therapy in cases of dyslexia and aphasia. The scenarios are presented; discussing both the features of the technology used and the related interaction design issues. The paper concludes by reporting about informal trials that have been conducted with children. It should be noted that, even if both trials represent application scenarios for children, the I-BLOCKS technology is in principle open to different kinds of applications and target users like, for example, games for adults or brainstorming activities. (shrink)

This paper offers theoretical explanations for why “guided touch” or manual touch with verbal communication can be an effective way of treating the body and the mind. The active inference theory suggests that chronic pain and emotional disorders can be attributed to distorted and exaggerated patterns of interoceptive and proprioceptive inference. We propose that the nature of active inference is abductive. As such, to rectify aberrant active inference processes, we should change the “Rule” of abduction, or the “prior beliefs” entailed (...) by a patient’s generative model. This means pre-existing generative models should be replaced with new models. To facilitate such replacement—or updating—the present treatment proposes that we should weaken prior beliefs, especially the one at the top level of hierarchical generative models, thereby altering the sense of agency, and redeploying attention. Then, a new prior belief can be installed through inner communication along with manual touch. The present paper proposes several hypotheses for possible experimental studies. If touch with verbal guidance is proven to be effective, this would demonstrate the relevance of active inference and the implicit prediction model at a behavioral level. Furthermore, it would open new possibilities of employing inner communication interventions, including self-talk training, for a wide range of psychological and physical therapies. (shrink)

The 20th century saw a profound change to the model of humanity commonly accepted in the West. At the start of the century the tripartite model of personhood included the components of mind, body and soul, or the physical, mental and moral/spiritual aspects of being. By the end of the century, this had changed to physical, mental and emotional. This substitution of 'emotional' for 'moral' has had profound effects, not the least on teaching. The effects have included alterations (...) to the content of education, including the introduction of programs to preserve/promote children's self esteem, and interest in topics such as 'emotional intelligence'. Also affected, however, has been how teaching itself is conceptualised. This paper will consider some of these effects and their consequences for teaching and teachers. (shrink)

The 20th century saw a profound change to the model of humanity commonly accepted in the West. At the start of the century the tripartite model of personhood included the components of mind, body and soul, or the physical, mental and moral/spiritual aspects of being. By the end of the century, this had changed to physical, mental and emotional. This substitution of ‘emotional’ for ‘moral’ has had profound effects, not the least on teaching. The effects have included alterations (...) to the content of education, including the introduction of programs to preserve/promote children's self esteem, and interest in topics such as ‘emotional intelligence’. Also affected, however, has been how teaching itself is conceptualised. This paper will consider some of these effects and their consequences for teaching and teachers. (shrink)

This perspective paper aims at discussing theoretical principles that could explain how emotion regulation and physical diseases mutually influence each other in the context of borderline personality disorder (BPD). Furthermore, this paper discusses the clinical implications of the functional relationships between emotion regulation, BPD and medical conditions considering dialectical behavior therapy (DBT) as a well-validated therapeutic intervention, which encompasses these issues. The inflexible use of maladaptive emotion regulation strategies (e.g., suppression, experiential avoidance, and rumination) might directly increase the (...) probability of developing physical diseases through a physiological pathway, or indirectly through a behavioral pathway. Some metabolic and chronic medical conditions could significantly impact emotional functioning through biological alterations involved in emotion regulation. Several empirical studies have shown high co-occurrence rates between BPD and several chronic physical diseases, especially ones linked to emotion-based maladaptive behaviors. DBT addresses physical diseases reported by individuals with BPD reducing problematic behaviors functionally associated to emotion dysregulation and identifying physical health as a goal forBuilding a Life Worth Living. (shrink)

A broad sociocultural perspective defines trauma as the result of an event, a series of events, or a set of circumstances that is experienced as physically or emotionally harmful or life threatening, with lasting impacts on an individual’s physical, social, emotional, or spiritual wellbeing. Contexts and practices that aim to be “trauma-informed” strive to attend to the complex impacts of trauma, integrating knowledge into policies and practices, and providing a sanctuary from harm. However, there is a body of critical (...) and decolonial scholarship that challenges the ways in which “trauma-informed” practice prioritizes individualized interventions, reinscribes colonial power relations through its conceptualizations of safety, and obscures the role of systemic injustices. Within music therapy trauma scholarship, research has thus far pointed to the affordances of music in ameliorating symptoms of trauma, bypassing unavailable cognitive processes, and working from a strengths-based orientation. In critiquing the tendency of the dominant trauma paradigm to assign vulnerability and reinforce the individual’s responsibility to develop resilience through adversity, this conceptual analysis outlines potential alternatives within music therapy. Drawing on a case example from a research project with young people in school, I elucidate the ways in which music therapy can respond to power relations as they occur within and beyond “trauma-informed” spaces. I highlight two overarching potentials for music therapy within a shifting trauma paradigm: (1) as a site in which to reframe perceived risk by fostering young people’s resistance and building their political agency and (2) in challenging the assumption of “safe spaces” and instead moving toward practices of “structuring safety.”. (shrink)

This article presents critical psychology in some new light. First, it presents the history of US critical psychology in terms of the overall foundation of its critique (identity-based, ideologically-based, and epistemologically-based). Second, it broadens the population that can be called critical psychologists. The argument is made to include: (1) philosophers of language, science, and mind critical of psychology’s foundational assumptions, conceptions, and methods of inquiry; and (2) non-professional, ordinary people who live their lives critical of psychology by eschewing mainstream approaches (...) and taking alternative routes to getting help with their emotional and physical pain, or the education of their children. Third, the article discusses ontology-based critique through the example of the practical-critical theory/practice of social therapy. (shrink)

The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination (...) therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden. (shrink)

Difficulty in emotional regulation is significantly correlated with depression. Depression is a psychological disease that seriously affects the physical and mental health of college students. Therefore, it is of great importance to develop diversified preventive interventions such as group impromptu music therapy. The main purpose of this study was to evaluate the effect of GIMT on the improvement of emotional regulation ability and the reduction of depressive symptoms in college students. A 71 college students were recruited to carry (...) out randomized controlled trial was used. The experimental group was intervened by GIMT. After the 4th week of intervention, follow-up and scale measurement were carried out. In the experimental group, emotional regulation difficulty scales showed significant difference before and after GIMT, implying the improvement in the emotional regulation. But there was no significant improvement in the control group. In addition, the depressive symptoms of experimental group were relieved. All findings showed that GIMT can effectively improve college students’ emotional regulation and reduce depressive symptoms. (shrink)

BackgroundBurnout is a major societal issue adversely affecting employees’ health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the (...) rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research.AimThe study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout.Methodological ApproachWe build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts.ResultsWe identified six key outdoor intervention elements: physical activity; reconnecting body and mind; nature metaphors; creating relationships; observing natural interactions; and experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist, therapy, and of the clients.ConclusionThe intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation. (shrink)

New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of (...) a series of adaptable questions for the patient–physician encounter based on the capability approach. The goal is to improve geriatric rehabilitation and thereby increase participation in social life and well-being. To achieve this goal, we first analyzed what is considered important for participation on basis of the capability approach, human rights, and ethics of care. Second, we conducted an ethical analysis of each of the four identified dimensions of participation: political, economic, socio-cultural, and care. To improve compliance with rehabilitation measures, health professionals must align rehabilitation measures in an open dialogue with the patient’s aspiration for participation in each dimension. A discussion template based on the capability approach allows for a proactive approach in patient information and stimulates a critical assessment of treatment alternatives while reducing the risk of imposing personal values. (shrink)

The aim of this exploratory study was to examine client demographics and expectations, reasons for use, sensations during treatment, and perceived outcomes of Pranic Healing, an energy healing system lacking in scientific documentation but whose use in the general population is becoming more widespread internationally. This study consisted of a cross-sectional survey of adults (18+ years of age) receiving care from 12 Pranic Healing practices in four different states in the U.S. (N = 179) completing online questionnaires. Closed-ended response sets (...) were analyzed descriptively, while qualitative data were analyzed using content analysis. Reasons to use the therapy included physical, mental/emotional, and metaphysical issues, dissatisfaction with conventional care, and overall well-being. Expectations of care included enhanced abilities, cure or relief, or unsure. Respondents were more likely to cite a specific problem from which they needed alleviation than to cite overall health or wellness as their goal. Sensations experienced were reported to be of a relaxing nature and not, as was hypothesized, of an energizing nature. Results show that those who use Pranic Healing fit the sociodemographic profile of CAM (complementary and alternative medicine) users in the United States, that their reasons for use are not homogeneous, and that preliminary descriptive data from a selective subsample of respondents indicated that some respondents are experiencing positive outcomes attributed to this modality. (shrink)

This paper records four stories that emerged from four group therapy members. These stories are stories of fundamentally broken hearts. I utilise this material to address two psychological phenomena in group therapy - self-disclosure and the corrective emotional experience. The overarching theoretical framework is the existential approach to group therapy, and the underlying theoretical assumptions of relational psychoanalysis applied to group therapy. In the context of the material I present several theoretical points. Some of the chief (...) points are the notion of the “in-between-ness of healing” and the importance of two processes in healing - i) the process of telling the story (remembering) in such as way that it is relived both emotionally and physically, and ii) followed closely by a corrective emotional experience. The emphasis in this paper is that remembering and reliving in therapy is not enough and a corrective emotional experience is required. Broadening this perspective of the healing mechanism of a corrective emotional experience, a principle argument of this paper is that the therapeutic action in group therapy (as it can be in individual therapy) is not insight but a new relationship. Indo-Pacific Journal of Phenomenology , Volume 2, Edition 2, September 2002. (shrink)

Gender dysphoria in children has become a hot-button topic; however, clinical data still remain sparse on the effects of hormone therapy and transitional surgery on the physical and psychological well-being of those children. The American College of Pediatricians cites studies indicating that anywhere from 77 to 94 percent of boys and 73 to 88 percent of girls desist in GD; that is, following puberty the majority of children who experience GD will identify with their assigned biological sex. After (...) reviewing the clinical studies, this paper addresses the notion of gender from a Thomistic perspective, locating gender as a differentiation in the matter of the person flowing from the essence of the soul, resulting from the power of generation as opposed to other differences such as sight, which functions the same regardless of material differences. As a result, the paper concludes that hormone therapy cannot be morally licit for children. (shrink)

Background: Cinematherapy and video treatments are artistic therapeutic techniques by which the individuals are exposed to their psycho-physical difficulties through the stories of the characters on the screen who are coping with the same issues that the patients are. Although these techniques are increasingly common within modern art therapies, there are neither comprehensive classifications of the different approaches nor agreement on their effectiveness. We performed a scoping review, describing different methodological approaches and outcome measures in cinematherapy and video treatments.Methodology: (...) We searched articles in PubMed, PsycINFO and Google Scholar. We included: articles in which subjects were treated for their difficulties with videos or films, articles written in English. Review articles and papers describing a research protocol without data collection were not included.Results: We analyzed 38 studies. Thirty-six reported a positive effect of the treatment. Seven studies used classical cinematherapy, adopting a qualitative approach to measure the therapy outcome. Thirty-one studies used different video treatments, 8 of which were defined as randomized controlled trials with specific objective therapy outcomes. Studies were mainly focused on behavioral and psychological difficulties in Autism Spectrum Disorders and Schizophrenia.Conclusion: Studies using video treatments more often rely upon structured experimental designs; on the contrary, those who used classical cinematherapy produced descriptive results. A more standardized methodological approach in terms of experimental design, procedure, and objective outcome measure is needed to provide evidence on the effectiveness of these techniques, promoting its application in the clinical field. (shrink)

In recent years, precise high flow oxygen therapy as a new type of oxygen therapy machine has gradually attracted people’s attention and has been widely used in hospital emergency and clinical treatment of respiratory diseases; especially in recent years, severe coronavirus disease has played an important role in the treatment of patients. This paper presents a new type of precise high flow oxygen therapy machine with electromagnetic pneumatic flow valve as the core control element. A sliding mode (...) control strategy based on the system is proposed to realize the accurate control of oxygen concentration and output flow of oxygen therapy mixture. The physical equipment of the precision high flow system is established, and its working performance is verified through the test platform. The optimization design goal of the precision high flow equipment is achieved. (shrink)

As infancy is characterized by rapid physical growth and critical periods of development, disruptions due to illness or disease reveal vulnerability associated with this period. Spinal cord injury has devastating consequences at any age, but its onset neonatally, at birth, or within the first year of life multiplies its impact. The immediate physical and physiological consequences are obvious and immense, but the effects on the typical trajectory of development are profound. Activity-based restorative therapies capitalize on activity-dependent plasticity of (...) the neuromuscular system below the lesion and when provided to children with SCI aim to improve the child’s neuromuscular capacity, health and quality of life. This is a report of an infant with a cervical SCI at birth resulting in paralysis of leg and trunk muscles and paresis of arm and hands who was enrolled in an ABRT program at 3 years of age. After 59 sessions of ABRT, the child demonstrated significant improvements in trunk control and arm function, as well as social and emotional development. Despite the chronicity of injury and low expectations for improvement with therapeutic interventions, ABRT had a positive impact on the child’s physical capacity and provided benefits across multiple developmental domains. (shrink)

Biotechnology now makes it possible to enhance human traits as well as treat illnesses and disorders. What it has neglected to establish, however, is a clear line between these two functions, a distinction between what counts as treatment or therapy and what counts as enhancement. The bulk of the literature on enhancements focuses on the ethics of enhancements, not on the criteria that qualify a procedure as an enhancement . While the ethical questions regarding the desirability of enhancements are (...) certainly worthy of consideration, so is the issue of what constitutes an enhancement versus a form of treatment or therapy. Scholars have debated the issue of whether a distinction between therapy and enhancement exists, but the placement of that distinction has not yet been sufficiently addressed . Much like the field of bioethics itself, my study of this issue is a work in progress, so this paper will ask and explore questions relevant to this topic without providing answers to all of them. Nonetheless, they are important questions to ask with important implications for the future of bioethics. This paper will describe the line between enhancement and therapy, map the terrain and define the terms. It will also investigate where the line is at present, and where and how it has been set by legislation and private companies. It will then illustrate the issues, using two examples, to demonstrate the difficulties and complexities involved. Finally, it will explore the implications of the line for society’s financial as well as physical interests, and for healthcare access in the United States. It will conclude by considering the open question of how a company, a government, and a just society should go about setting the line. I hope that asking the questions and exploring their complexities will help draw attention to and prompt serious consideration of the placement of the line between therapy and enhancement. (shrink)

ObjectiveThe studies showed the benefits of virtual reality training for functional mobility and balance in older adults. However, a large variance in the study design and results is presented. We, thus, completed a systematic review and meta-analysis to quantitatively examine the effects of VRT on functional mobility and balance in healthy older adults.MethodsWe systematically reviewed the publications in five databases. Studies that examine the effects of VRT on the measures of functional mobility and balance in healthy older adults were screened (...) and included if eligible. Subgroup analyses were completed to explore the effects of different metrics of the intervention design on those outcomes related to functional mobility and balance.ResultsFifteen studies of 704 participants were included. The quality of these studies was good. Compared to traditional physical therapy, VRT induced greater improvement in TUG and one-leg stance with open eyes. Subgroup analyses revealed that immersive VRT with more than 800 min of total intervention time over 8 weeks and at least 120 min per week and/or designed by the two motor-learning principles was optimal for functional mobility and balance.ConclusionVirtual reality training can significantly improve functional mobility and balance in healthy older adults compared to TPT, and the findings provided critical knowledge of the optimized design of VRT that can inform future studies with more rigorous designs.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021297085]. (shrink)