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Results for “Transactional Analysis”

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PubMed1989

Is expressed emotion an index of a transactional process? II. Patient's coping style.

This article examines the extent to which expressed emotion (EE) indexes not only relatives' behavior toward schizophrenic patients but also patients' behavior toward their relatives. The coping styles (CS) of schizophrenic patients were assessed during interactions with their parents and were compared with parental EE attitudes assessed during an acute hospitalization and during the aftercare period. It was found that parental EE attitudes measured during the inpatient period strongly predicted patients' outpatient transactional behavior: patients interacting with low-EE relatives showed significantly fewer critical and more autonomous statements than patients interacting with high-EE relatives. Further, the dominant patient coping style (autonomous, neutral, externalizing, or internalizing) was strongly related to the relatives' interactional affective style (AS) and to their pattern of EE attitudes. Patient coping style was not related to clinical attributes of these patients themselves. This article and its preceding companion (17) together suggest that EE indexes a transactional process so that the quality of both parents' and patients' transactional behaviors may predict subsequent patient functioning.

Adaptation, Psychological↗
PubMed1994

Relational control patterns and expressed emotion in families of persons with schizophrenia and bipolar disorder.

The process of relational control, that is, the negotiation of "who's in charge," was examined in 40 families of persons with schizophrenia and bipolar disorder. Verbal interaction recorded during problem-solving tasks was coded with the Relational Control Coding System (RCCS). Patterning of message and response sequences was compared by diagnosis of the patient and level of expressed emotion (EE) of the family. Results indicated that patients with either diagnosis assert control more than their parents, that high-EE families compete for control more than low-EE families, and that families of bipolar patients compete for control whatever their EE status. The most dramatic differences in control patterns were in the dual-parent, high-EE families of persons with schizophrenia, in which the patients successfully challenged parents for control, and parents often yielded. It was concluded that EE reflects transactional processes in families that vary by diagnosis of the patient.

Bipolar Disorder↗
PubMedDate not supplied

Intercultural communication: finding common ground.

Diversity has become a leading topic of discussion in virtually all sectors of our society. This is certainly true in health care; the nursing profession has long been dealing with issues of cultural appropriateness. This article looks at the relationship of culture to communication. The current approach to intercultural communication discussed in much of the nursing literature is judged to be short-sighted. An alternative approach based on the development of a functional cultural communication perspective is offered.

Awareness↗
PubMed1975

Some dynamic and transactional aspects of family theraphy with psychotic patients.

The application of family therapy to families with psychotic patients involves both technical and theoretic observations and underpinnings. The implications of these for the understanding of certain family dynamics and the use of family therapy in general are investigated. The rhythm of real participation and observation on the therapist's part and the utilization of co-therapists is contrasted with a more authoritarian, 'director' model of intervention. Tendencies in these families towards frozenness and immobility, as well as splitting and chaos, must be counteracted, and are reflected in interactions and transactions between co-therapists. The importance of unravelling these patterns and aiding therapists in the framework of a specially designed, ongoing supervisory seminary is stressed.

Countertransference↗
PubMed1976

Patients' perceptions of the therapeutic relationship and group therapy outcome.

The authors review the empirical literature examining the hypothesized relationship between the patient's perception of the therapeutic relationship and treatment outcome in group therapy and describe studies of both inpatient and outpatient group therapy. Their review indicates that, in contrast to the overwhelming evidence in support of the perceived relationship-outcome hypothesis in individual psychotherapy, there is no persuasive evidence in favor of the proposed relationship between the therapist-patient relationship and the efficacy of group treatment. The authors discuss the clinical and theoretical differences between individual and group therapy that would contribute to this result.

Ambulatory Care↗
PubMed1981

Severe psychosomatic illness in children: effect on a pediatric ward's staff.

Observations of a pediatric ward's response to the repeated hospitalization of an asthmatic child revealed a close parallel to the transactional patterns described in families of children with psychosomatic illnesses. Characteristics of such families include enmeshment, overprotectiveness, rigidity and resistance to change, lack of conflict resolution, and use of the child's sick role to relieve tension and discomfort within the family. In this article we have attempted to demonstrate the similarity of responses between these families and groups of hospital ward personnel. Resolution of the ward personnel's internal conflict was followed by changes in the coping abilities of the staff, with a successful outcome for a second child with a similar clinical condition.

Asthma↗
PubMed2001

Using a modification of the classic Drama Triangle to enhance pastoral care.

Describes the Drama Triangle of Victim-Persecutor-Rescuer conceptual model and suggests helpful ways to use it in order to understand and intervene in the difficult situations often encountered by pastors, pastoral counselors, and chaplains. Attempts to join this conceptual model to a theological understanding of persons to deepen self-examination, ground pastoral identity, and enhance pastoral competence.

Drama↗
PubMed2006

The German specimen case, Amalia X: empirical studies.

The authors provide a perspective on how psychoanalytic process research can be implemented. This is based on a process research model described elsewhere and summarizes the kinds of studies that can be situated on the four levels of the model. The authors summarize multiple empirical studies that were performed in a completely tape-recorded psychoanalytic therapy and have been published. These studies demonstrate the many modalities empirical process research has available to objectively study psychoanalytic process phenomena and their implication for outcome.

Countertransference↗
PubMed1998

The cost of caring for end-stage kidney disease patients: an analysis based on hospital financial transaction records.

The costs of care for end-stage renal disease patients continue to rise because of increased numbers of patients. Efforts to contain these costs have focused on the development of capitated payment schemes, in which all costs for the care of these patients are covered in a single payment. To determine the effect of a capitated reimbursement scheme on care of dialysis patients (both hemodialysis [HD] and peritoneal dialysis [PD]), complete financial records (all reimbursements for inpatient and outpatient care, as well as physician collections) of dialysis patients at a single medical center over 1 year were analyzed. For the period from July 1994 to July 1995, annualized cost per dialysis patient-year averaged $63,340, or 9.8% higher than the corrected estimate from the U.S. Renal Data Service (USRDS; $57,660). The "most expensive" 25% of patients engendered 44 to 48% of the total costs, and inpatient costs accounted for 37 to 40% of total costs. Nearly half of the inpatient costs resulted from only two categories (room charges and inpatient dialysis), whereas other categories each made up a small fraction of the inpatient costs. PD patients were far less expensive to care for than HD patients, due to reduced hospital days and lower cost of outpatient dialysis. Care for a university-based dialysis population was only slightly more expensive than estimates predicted from the USRDS. These results validate the USRDS spending data and suggest that they can be used effectively for setting capitated rates. Efforts to control costs without sacrificing quality of care must center on reducing inpatient costs, particularly room charges and the cost of inpatient dialysis.

Accounts Payable and Receivable↗