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Biomedical subjects

T C Todd

Publications and source records attributed to T C Todd.

13 recordsLinked to original sources
PubMed1991

Outcomes for cocaine abusers after once-a-week psychosocial therapy.

OBJECTIVE: The authors studied the efficacy of once-weekly psychotherapy, family therapy, or group therapy led by paraprofessionals among patients with cocaine use disorders. METHOD: Of subjects who sought outpatient treatment, 168 consented to participate in the study and were each randomly assigned to one of the three forms of therapy; 122 patients were interviewed 6-12 months later. Their pre- and posttreatment scores on the Addiction Severity Index were compared. RESULTS: Significant improvements were observed for the cohort as a whole, but virtually all of the improvement was restricted to the 23 subjects (19%) who were not using cocaine at follow-up. There was a strong relationship between abstinence from cocaine use and absence of addiction-related problems, especially psychiatric symptoms and family problems. CONCLUSIONS: The results of the study indicate that outpatient therapy once a week is ineffective for cocaine use disorder. The 19% abstinence rate probably represents spontaneous remission among patients with enough motivation to seek treatment, as the number of therapy sessions attended was not related to improvement. Either an intense level of outpatient contact or residential treatment followed by aftercare is probably needed, at least initially, while the patient is attempting to initiate and sustain abstinence.

Adult↗
PubMed1981

Engaging "resistant" families in treatment.

Many families, when presented with the option of family therapy, are less than eager to participate. This paper comprises the second and third parts of a series on engaging "resistant" families. Part II presents 21 principles and a number of techniques and strategies that have been developed for successfully recruiting such families. These techniques should be applicable for engaging resistant families with all types of presenting problems. Part III provides an analysis of the important variables involved, along with data on cost efficiency and administrative costs. It was found that when therapists had administrative control of their cases, serving in dual roles as both therapists and drug counselors, the recruitment effort was (a) more effective (i.e., complete families, including both parents or parent surrogates, were recruited in 77 per cent of the cases), and (b) twice as cost efficient. Two-thirds of the non-engaged families were not recruited because the index patient would not allow family members to be contacted. Black families were more difficult to recruit than whites. Data on cost efficiency and on the actual administrative costs of recruiting families are also provided.

Adult↗
PubMed1980

A critique of the Wells and Dezen review of the results of nonbehavioral family therapy.

Although the Wells and Dezen review made many valuable points about family therapy outcome research, their handling of the various included studies appeared uneven. To test this impression, a content analysis was performed on the "favorableness" or "positiveness" of the statements made by Wells and Dezen about the studies they reviewed. The degree of positiveness was compared across studies with the Design Quality and with the level of sophistication of these studies. All of the statistical correlations were negative--half of them significantly so--a result completely opposite to what would be expected. We conclude that Wells and Dezen tended to give undue praise to many uncontrolled studies and inordinate criticism to more sophisticated and better-designed research. In addition, other inconsistencies in the evaluation of studies were noted. Further, specific studies were presented in a distorted and inacurate manner, and without proper attention to statistical principles. In sum, it appears that Wells and Dezen (a) have not been sufficiently careful in their analysis of the reviewed research, and (b) have, through their evaluative remarks, provided a biased review which obscures many important comparisons within this field.

Behavior Therapy↗
PubMed1978

Heroin addiction as a family phenomenon: a new conceptual model.

The chronic relapsing nature of heroin addiction can be explained from a family systems viewpoint. The addiction cycle is part of a family pattern involving a complex homeostatic system of interlocking feedback mechanisms. These serve to maintain the addiction and consequently the overall family stability. Drug-taking usually starts at adolescence. It is related to an intense fear of separation experienced by the family in response to the addict's attempts at individuation. The family becomes stuck at a particular developmental stage. Heroin provides a solution at several levels to the dilemma of whether or not to allow him independence. Paradoxically, it permits him to simultaneously be both close and distant, "in" and "out", competent and incompetent, relative to his family of origin. This is pseudoindividuation. An understanding of these concepts, and their integration into a homeostatic model, can provide the basis for effective treatment.

Adolescent↗
PubMed1975

A conceptual model of psychosomatic illness in children. Family organization and family therapy.

Linear and open systems (multiple feedback) models of psychosomatic illness in children are contrasted in terms of their implications for cause and treatment. An open systems family model is presented that describes three necessary (but not independently sufficient) conditions for the development and maintenance of severe psychosomatic problems in children: (1) a certain type of family organization that encourages somatization; (2) involvement of the child in parental conflict; and (3) physiological vulnerability. Predisposition for psychosomatic illness, symptom choice, and maintenance are discussed within this conceptual framework. We report on family therapy strategies based on this model and the results of family treatment with 48 cases of "brittle" diabetes, psychosomatic asthma, and anorexia nervosa.

Adolescent↗
PubMed1975

A context analysis of psychological states prior to petit mal EEF paroxysms.

This is the first report in the literature of an application of the rigorous symptom-context method for determining the nature of the psychological antecedents of petit mal EEG paroxysmal activity. The activity is defined by the presence of a 3 cycle/second spike and wave on the EEG which is recorded concurrently while the patient is speaking his thoughts freely during interviews. The content of the patient's speech before each petit mal episode is compared with the content of speech during nonparoxysmal periods. Three petit mal patients were examined in this way for four sessions each. (Total petit mal EEG paroxysms for patient no. 1 were 19, patient no. 2 were 25, and patient no. 3 were 55.) For the first patient, strong psychological antecedents were found before petit mal EEG paroxysms as compared with comparison periods from the same patient. These consisted of such usual negative affects as feeling depressed and blocked. For the two other patients, only a few psychological antecedents discriminated significantly and these were not of the same type across the three patients. We conclude that the patients differ in amount and type of psychological antecedents. The differences may be attributed to differences in the type of petit mal and/or differences in the psychological component to the petit mal. The differences among the patients are probably not related to the average length of the paroxysms since we have shown that the relationships with the duration were generally silences than during the patient's speech (for two of the three patients)--talking probably requires more focused attention than silence; more focused attention or activity tends to reduce these episodes.

Adolescent↗