Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reality Therapy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,063 records · Page 59Linked to original sources
PubMedDate not supplied

The resource utilization groups system of nursing home reimbursement policies: influences on occupational therapy practice.

OBJECTIVE: This study explored the effects of federal and state reimbursement mechanisms on occupational therapy practice in the nursing home setting, specifically, the selection and scheduling of patients for treatment programs, the content of the therapy provided, and the documentation requirements. METHOD: A questionnaire developed for the study was mailed to the chief occupational therapist in each of the 171 nursing homes located in New York city. Descriptive data on the research variables were collected from 83 respondents. RESULTS: Government regulation and reimbursement mechanisms specifically affected therapists' treatment decisions and patient programming and scheduling in the nursing home setting. Survey results described the clinical impact of the resource utilization groups (RUGs) data collection periods. Negative effects were seen in a substantial incidence of withholding therapies from patients and the decline in the use of some traditional occupational therapy treatments. Positive effects included an increase in staff and equipment and therapists' improved documentation skills. CONCLUSION: Occupational therapy practitioners in the nursing home setting need to find ways to live with the realities of government reimbursement without compromising professionalism or clinical judgment. Documentation is the key to assuring that patients receive the therapy they need. Therapists should be aware of the regulations, document accordingly, and review those cases that were denied reimbursement to learn of documentation errors.

Health Policy↗
PubMed1987

On description of family therapy.

This article offers a critical analysis of the convergence of two perspectives, constructivism and the cybernetics of cybernetics, as they affect the value placed upon description of family therapy. An analogy to the problem of describing interaction in family therapy is drawn from the history of the representation of reality in art. It is argued that (a) the "interactional approach" is incompatible with radical constructivism, and (b) "the shift from observed to observing systems" has resulted in an unnecessary devaluation of representational description of family interaction.

Cybernetics↗
PubMed2002

Virtual reality treatment of flying phobia.

Flying phobia (FP) might become a very incapacitating and disturbing problem in a person's social, working, and private areas. Psychological interventions based on exposure therapy have proved to be effective, but given the particular nature of this disorder they bear important limitations. Exposure therapy for FP might be excessively costly in terms of time, money, and efforts. Virtual reality (VR) overcomes these difficulties as different significant environments might be created, where the patient can interact with what he or she fears while in a totally safe and protected environment-the therapist's consulting room. This paper intends, on one hand, to show the different scenarios designed by our team for the VR treatment of FP, and on the other, to present the first results supporting the effectiveness of this new tool for the treatment of FP in a multiple baseline study.

Adult↗
PubMed1997

Toward a developmentally informed narrative therapy.

Narrative approaches to psychotherapy emphasize the impact of the stories or narratives we construct on our reality and behavior. However, little effort has been made to elucidate how individuals' differential capacities for meaning-making influence the process of re-storying lives. The present article introduces to family therapy a model of the changing nature of individuals' ability to create meaning. The model, referred to as developmental-constructivism (Kegan, 1994), suggests that, in addition to contextual factors, individual differences in the capacity for organizing experience will influence therapeutic efforts to generate new and more adaptive narratives. The model is also presented as a heuristic for comparing and integrating two influential approaches to narrative therapy: the externalizing approach of Michael White and the solution-focused approach of Steve de Shazer.

Adult↗
PubMed2000

Perception, mental imagery and reality discrimination in hallucinating and non-hallucinating schizophrenic patients.

OBJECTIVES: In this study the hypothesis was tested that hallucinations result from confusing external and internal stimulus sources, i.e., perception and imagery, respectively. DESIGN AND METHODS: Thirteen hallucinating and 19 non-hallucinating schizophrenic patients, as well as 14 control participants performed multiple tests of perception, vividness of mental imagery and the ability to discriminate between them (reality discrimination). These functions were tested in both the auditory and the visual modalities. RESULTS: There were no group differences on perceptual acuity. The results on one imagery task indicated that for the hallucinating patients, the relative, but not the absolute, level of vividness of mental images might be higher in the auditory modality, which was the modality in which 12 of the patients also experienced hallucinations, than in the visual modality. Finally, there was a positive relationship between severity of (auditory) hallucinations and reality discrimination problems. CONCLUSIONS: Hallucinations may result from increased vividness of mental imagery, and their severity increases with larger impairments in reality discrimination. It is recommended that research into, and cognitive behavioural therapy for, hallucinations should also focus on their sensory qualities.

Adult↗
PubMedDate not supplied

Interventions for confusion and dementia. 2: Reality orientation.

This article, the second of a five-part series exploring interventions for confusional states, discusses reality orientation (RO). For many decades, this form of intervention has been widely used and accepted as a way of reducing symptoms of confusion. However, an argument against RO is that it makes the person a passive recipient and reinforces feelings of disempowerment. This article describes the development of RO, exploring its strengths and weaknesses. Literature on the subject is largely anecdotal and dated as RO has been largely superseded by the interventions discussed in later articles, e.g. reminiscence and validation therapy.

Behavior Therapy↗
PubMed1999

Central pain mechanisms: A new horizon in manual therapy.

Central pain mechanisms are deeply embodied in the psychophysical problem of pain. They are located in the brain and spinal cord and are becoming increasingly recognised as playing a major role in the generation and maintenance of pain and disability associated with neuromusculoskeletal problems. Central mechanisms participate in all pain states, acute and chronic. They are universally influenced by psychological and physical factors, whether or not a specific pathology can be identified. Misconceptions are that manual therapy operates on peripheral mechanisms without influencing the central ones and that when a central problem exists, psychological management is preferable. In reality, as key players in the healing process, central mechanisms are profoundly affected by manual therapy even when it is directed at a peripheral problem. Treatment of peripheral mechanisms can be performed through central techniques because both peripheral and central mechanisms are always part of the same clinical problem. Consequently, manual therapy must change its mindset from a peripheral standpoint and integrate central mechanisms into clinical practice as a means of improving therapeutic efficacy and to prevent the descent of acute pain into chronic.

Journal Article↗
PubMed2006

B-cell targeting in rheumatoid arthritis and other autoimmune diseases.

B-cell-targeted therapy for autoimmune disease emerged from theoretical proposition to practical reality between 1997 and 1998, with the availability of the B-cell-depleting monoclonal antibody rituximab. Since then, a score of autoantibody-associated disorders have been treated, with most convincing evidence of efficacy seen in subjects with rheumatoid arthritis. Several classes of B-cell-targeted agent are now under investigation. From the outset, a major goal of B-cell targeting has been the re-establishment of some form of immunological tolerance. In some subjects, the observed improvement of disease for years following therapy fuels hope that this goal might ultimately be achievable.

Animals↗
PubMed1999

Cancer information: a cost-effective intervention.

There is a considerable knowledge base about the information needs of patients with cancer (and their relatives and friends). Those needs will vary according to the disease, the stage of disease, the patient and his or her age, social class and culture. Lack of information may lead to increased anxiety and distress, may impact negatively on the patient's satisfaction and may influence a patient's treatment choices. Other articles in this special edition deal with psychosocial interventions and complementary therapies for cancer patients and explore their efficacy. The reality is that these are unlikely to be made available to all cancer patients for reasons of cost and practicability. Information, however, is a relatively cheap intervention that could--and should--be part of standard care. This article explores some of the research about the provision of information for cancer patients.

Adolescent↗
PubMed2002

[Partial hospitalisation -- indication and characteristic aspects of the setting, shown by the example of the day clinic in Freiburg/Germany].

Until now, in comparison to psychiatric day clinics, there is only a limited amount of psychotherapeutic day clinics which offer an intense, multimodal treatment on a psychodynamic basis comparable to that of inpatient settings. We present the example of the day clinic in Freiburg to discuss characteristic aspects of the setting and criteria for indication. Preliminary empirical results indicate, that even severely disturbed patients can be adequately treated. The combination of an intense therapy program with the daily involvement in the outside reality has substantial advantages for some groups of patients and eases the transition at discharge.

Day Care, Medical↗
PubMed2001

Research on presence in virtual reality: a survey.

Virtual Reality (VR) is starting to be used in psychological therapy around the world. However, a thorough understanding of the reason why VR is effective and what effect it has on the human psyche is still missing. Most research on this subject is related to the concept of presence. This paper gives an up-to-date overview of research in this diverse field. It starts with the most prevailing definitions and theories on presence, most of which attribute special roles for the mental process of attention and for mental models of the virtual space. A review of the phenomena thought to be effected by presence shows that there is still a strong need for research on this subject because little conclusive evidence exists regarding the relationship between presence and phenoma such as emotional responses to virtual stimuli. An investigation shows there has been substantial research for developing methods for measuring presence and research regarding factors that contribute to presence. Knowledge of these contributing factors can play a vital role in development of new VR applications, but key knowledge elements in this area are still missing.

Communication↗
PubMedDate not supplied

The difficult problem of acute myeloid leukemia in the older adult.

Acute myeloid leukemia (AML) in older adults is a biologically and clinically distinct entity. Based on analysis of cytogenetic and molecular data, it is known that leukemic cells in older patients are intrinsically resistant to standard chemotherapy. Due to comorbid disease and impaired bone marrow stem cell reserve, older adults tolerate myelosuppressive chemotherapy poorly, with a treatment-related mortality rate of 25 percent. About 35 percent of adults under age 40 are cured, but the complete remission rate (likelihood of temporary disease eradication) is 45 percent in those over age 60, considerably lower than the 75% rate among younger patients, and the possibility of long-term disease free survival is 20 percent in those achieving remission or less than 10 percent overall. Standard allogeneic bone marrow transplantation is too dangerous to be considered as a means to eradicate minimal residual disease after remission is obtained and myelointensive chemotherapy is not a beneficial post-remission strategy in this age cohort. These disappointing results call for more effective and less toxic therapeutic options. Advances in our understanding of the pathophysiology of AML and promising early clinical data suggest that the era of truly targeted therapy in this difficult disease may soon be a reality.

Aged↗
PubMedDate not supplied

Exploring complementary and alternative medicine in pediatrics: parents and professionals working together for new understanding.

In the United States, consumer interest in and use of complementary and alternative medicine (CAM), including in pediatrics, is growing. Despite the reservations of many conventional practitioners, the multi-billion dollar industry is here to stay. To maintain positive relationships with pediatric patients and their families, health care professionals must acknowledge the reality of CAM, be informed themselves about its various therapies, and encourage open dialogue with patients and families. This article offers background about the current status of CAM, in general as well as specific information about CAM in pediatrics. The parent/family perspective, a list of suggested questions to help initiate parent/professional discussion about exploration and use of CAM, and a resource list for use by both parents and professionals are provided.

Child↗
PubMed2005

Emotional and performance attributes of a VR game: a study of children.

In this paper we present the results of a study to determine the effect and efficacy of a Virtual Reality game designed to elicit movements of the upper extremity. The study is part of an on-going research effort to explore the use of Virtual Reality as a means of improving the effectiveness of therapy for children with motor impairments. The current study addresses the following questions: 1. Does a VR game requiring repetitive motion sufficiently engage a child? 2. Are there detrimental physiological or sensory side-effects when a child uses an HMD-based VR? 3. Are the movements produced by a child while playing a VR game comparable to movements produced when carrying out a similar task in the real-world? Based on study results, the enjoyment level for the game was high. ANOVA performed on the results for physical well-being pre- and post-VR showed no overall ill-effects as perceived by the children. Playing the game did not effect proprioception based on pre- and post-VR test scores. Motion data show similar, but not identical, overall movement profiles for similar tasks performed in the real and virtual world. Motor learning occurs in both environments, as measured by time to complete a game cycle.

Child↗
PubMed2006

Gene therapy in cardiac arrhythmias.

Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within the left bundle branch can provide stable heart rates. Genetic modification of the AV node mimicking beta blockade can be therapeutic in the management of atrial fibrillation. G protein overexpression to modify the AV node also is experimental. Modification and expression of potassium channel genes altering the delayed rectifier potassium currents may permit better management of congenital long QT syndromes. Arrhythmias in a failing heart are due to abnormal calcium cycling. Potential targets for genetic modulation include the sarcoplasmic reticulum calcium pump, calsequestrin and sodium calcium exchanger. Lastly the ethical concerns need to be addressed.

Journal Article↗
PubMed1991

AIDS in the hand patient: the team approach.

Hand surgeons and therapists were faced with a new clinical entity in the 1980s with the emergence of hand and upper extremity infections in patients with AIDS and HIV disease. This entity has become a worldwide epidemic of vast proportions and has proven to be one of the major health concerns of the 1990s. It seems likely that treatment of patients with this devastating disease for hand infections or more routine upper extremity problems will become routine in the future. The reality of surgical treatment and hands-on rehabilitative therapy for patients with a life-threatening infectious disease has been a concern voiced publicly by very few health care professionals, yet discussed quietly among colleagues quite frequently. Our aim must be to provide the highest quality of health care to this group of hand patients, just as we do for all other patients, while at the same time providing the safest possible environment for all members of the health care team. It appears that there is a higher incidence of HIV infection among hand patients than is noted in the general public; therefore, the hand surgeon and medical team should pay particular attention to the rapidly advancing front of new information available regarding care for this challenging group of patients. Hand surgeons and therapists are entering the 1990s armed with a wealth of new and valuable information about HIV disease that has been produced by intensive basic science research and clinical observations accumulated over the last 10 years. The fears generated by the initial misinformation and lack of information concerning modes of transmission of HIV have generally been supplanted by a more rational approach to patient care, fostered by the more accurate scientific information currently becoming available. Unfortunately, the rational approach to the HIV-related political and socioeconomic issues has not yet overtaken the discrimination and stereotyping of the populace stricken with HIV disease. It remains the responsibility of the medical community to continue research efforts aimed at delineating the clinical deficiencies manifested by these patients and determining their effects on treatment regimens for both the unique and commonplace medical and orthopedic problems noted in this patient population.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Laser light: waves of the future.

The use of lasers is becoming more prevalent in the health care arena. Lasers can perform functions from lightening spider veins to correcting nearsightedness. Nurses must become familiar with lasers as 21st century medicine becomes a reality.

Humans↗
PubMed2003

Internet-based telehealth system for the treatment of agoraphobia.

In this work that is being validated within the VEPSY project, we present a system that allows the patient to continue a psychological virtual reality treatment from his or her home PC as complementary therapy. In the consulting room, we have been using virtual therapy for panic disorder and agoraphobia treatment to expose the patient to several situations. For the complementary therapy, a structured treatment via the Internet has been prepared, which consists of several parts: an assessment protocol; a structured treatment protocol organized in several blocks (such as psychoeducation and exposure); and an outcome protocol. The same situations as in the consulting room have been selected for the exposure, but each of them has been divided into several virtual environments with specific characteristics that limit its difficulty level. The stimuli that are used at each level are controlled automatically by the system. The information of the patient is stored in a database, which is placed in a remote server using XML format and used to control which stages of the treatment he or she can access. The psychologist can limit the evolution of the patient. The virtual environments are installed in the patient's PC, and they are implemented with a mechanism that ensures that they can only be run when the patient connects to the web. The user should not have any special virtual reality hardware at home, so head rotations have been simulated with the navigation system.

Agoraphobia↗