bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilizing Reflected Countertransference: Applying the Reflection Process as a Teaching Tool in Supervision
Authors: Nadler Raoul P. 
Published: April 2017

There are times when teaching cannot proceed through the abstract presentation of content and must progress by the demonstration of what is to be taught. This is true whenever a student is unable, for whatever reason, to appropriately apply such abstract material to the concrete task before him. This may be due to a number of factors, one of the most common of which is the lack of qualitatively similar experiences to which to refer. The teaching of complicated processes such as psychotherapy is an example, especially when the trainee is relatively unsophisticated and/or seems unable to abstract from discussion of blocking phenomena, where it may become necessary to ‘act in’ the feeling tones which are to be the cues for the behaviour to be learned, instead of persisting with abstract interpretations. When, in supervision, a supervisee recreates the conditions existing in the therapeutic situation, this procedural behaviour is called the ‘Reflection Process’. This process often appears to be unconsciously motivated by the need of the supervisee to solicit from the supervisor a practical demonstration which he does not know how to solicit otherwise. Even if the Reflection Process is due mainly to unresolved, unconscious conflicts of the supervisee, it can be a useful clue as to what transference-countertransference problems he is having difficulties with. The fact that such behaviour on the part of the supervisee may arise out of unresolved unconscious conflictual material should not become a reason for dismissing it. Instead, supervisors should become proficient at recognizing the countertransferential feelings in themselves, which can be an accurate reflection of the feelings troubling the supervisee in his dealings with this patient; and they should recognize the distress signal on the part of the supervisee, which can often be responded to constructively. In the supervision, the supervisor at times can, almost unwittingly, come to play the role which the supervised therapist plays in the supervised therapy and, if not aware of the Reflection Process, he may not realize that the countertransferential feelings which underly his assuming that role may not be primarily a response to the character of the therapist he is supervising but rather to that of the patient. They may also be a reflection of the process problem in the supervised therapy. It is not essential that this process be labeled in the supervision; what is essential is that its ramifications be recognized by the supervisor.
Combined Approaches in the Treatment of Latency Children and their Families
Authors: Ney Philip G. 
Published: April 2017

For conflicted children and their families, there are many advantages to using a combination of behaviour modification and a dynamic understanding of the meaning of behaviour to modify transactions (10). Unless fact is incompatible with fact, there are no irreconcilable differences between dynamic and behaviouristic therapy. When the behaviour is well understood, insight can be given and techniques directed to changing that key behaviour to unhappy transactions. There is always the possibility that parents will use these techniques to terrorize and restrict their children, but experience has shown that parents gain confidence and, as they gain confidence, they become much more relaxed with their children, and their children then blossom. Children in consistent, ordered environments are less anxious and more cooperative. As the relationship improves, the child tries harder to please his parents and eventually what was once an alien technique becomes a natural way of responding to children.
Therapeutic Abortion and Psychiatric Disturbance in Canadian Women
Authors: Greenglass Esther R. 
Published: April 2017

Summary The majority of one hundred and eighty-eight women interviewed after having legal, therapeutic abortions did not experience psychiatric disturbance. While women with a psychiatric history were more likely than their more mentally healthy counterparts to experience some psychiatric disturbance afterwards, the majority of those with psychiatric problems in the past appeared to be coping reasonably well afterwards. It was pointed out that factors and circumstances other than the abortion itself, but occurring around the same time, may constitute reasons for the subsequent appearance of psychiatric disturbance, such as suicide attempts. Finally, the grounds for legal abortion in Canada were questioned — particularly the artificial practice of compartmentalizing and labeling reasons for abortion as psychiatric and non-psychiatric. While such practices may facilitate the decision-making processes involved in reviewing applications for abortion, they do not take account of the full range of human and social need.
Suicide and Prevention Centres
Authors: Eastwood M.R. , Brill Linda , Brown J.H. 
Published: April 2017

Summary Suicide and parasuicide rates have been underestimated in the past although there is evidence to show that the individuals in the official statistics are representative of the suicidal population as a whole. Both medical and non-medical agencies are involved in suicide prevention and while their effectiveness is uncertain their efforts should be judged by the same criteria with the whole spectrum ideation taken into account.
Patterns in the Delivery of Psychiatric Care in Saskatchewan 1971–1972 (II): Types of Contacts and Some Patient Career Characteristics
Authors: D'arcy Carl 
Published: April 2017

A previous paper dealt with an overview of service sectors and patient volumes (2), whereas this one concentrates on types of contacts and some patient career characteristics. Analysis of a comprehensive psychiatric care utilization data file for Saskatchewan for the 1971–1972 period shows that ‘public’ sector patients were hospitalized for a greater average length of time than were ‘private’ sector patients. This may reflect differences in the styles of practice, exigencies of the demand for hospital beds in the ‘private’ as opposed to the ‘public’ sector and/or intrinsic differences in the nature of the problem treated in each sector. Some interesting facts regarding patterns of contact were uncovered. The bimodal nature of the ‘psychiatric population’ was further evident from the data which show that the majority of patients used relatively few services whereas a few used a large number of services. This suggests that the majority of the people seen for psychiatric reasons by medical practitioners were suffering from relatively minor psychiatric disorders. Heavy users of services were much more likely to have had some ‘public’ or University Hospital-based contact. Conversely, light users were predominantly private sector patients. In the ‘public’ sector, those who had had some inpatient treatment were consistently higher users of all services. It is evident that psychiatrists held a dominant position in this community-oriented public sector, having seen a large number of patients, but having had a low average rate of services per patient. In contrast, community nurses saw relatively few patients but saw them very often. This no doubt reflects their role in providing ‘maintenance’ services to chronic patients in approved homes in the community. In the ‘private’ sector, 69 percent of the services were delivered by GPs and 23 percent by psychiatrists. Patients seen by psychiatrists were more likely to have had ‘public’ sector activity than were those seen only by GPs; also once in the ‘public’ sector, they were likelier to have had inpatient as well as outpatient treatment. This suggests a ‘sifting’ of the more ‘difficult’ patients through the private specialist sector into the public sector.
Patterns in the Delivery of Psychiatric Care in Saskatchewan 1971–1972: Part III: Patient Socio-Demographic and Medical Characteristics
Authors: D'Arcy Carl 
Published: April 2017

This paper is one of several examining he variety of patterns in the delivery of psychiatric health care in the Province of Saskatchewan during 1971 and 1972. Previous papers dealt with an overview of service sectors, patient volumes, types of contacts and some patients career characteristics. This paper deals with sociodemographic and medical characteristics of patients treated in the various sectors of the psychiatric care delivery system in Saskatchewan. The private and public psychiatric care delivery systems deal with essentially separate psychiatric populations. These differ in volume, in type of psychiatric disorder, in socio-demographic characteristics and in patient career characteristics. The “private” sector saw proportionately more females in the 20-39 year age group, whereas the public sector saw proportionately more males and females in the 0-19 year age category. The “private” sector also treated more people in rural, village and town areas whereas the public sector appeared to be more city-based. General practitioners were more active in rural and small towns, while psychiatrists tended to be more active in the larger urban areas. This reflects the general practitioner's role as a primary health care source. The vast majority of private sector patients were seen for neurotic and psychosomatic disorders. The public sector patients included those treated for the more intractable schizophrenic, organic, affective, and neurotic depression diagnoses. Comparative data on both the private and public sectors show considerable increases in the volume of services being delivered. Previous data demonstrate a relatively strong relationship between availability of psychiatric services and utilization rates within a region. It would appear that the presence of a psychiatric inpatient facility serves an educative function and increases the volume of general practitioner treatment for psychiatric problems. The present data indicate that the majority of persons seen for psychiatric reasons by medical practitioners in Saskatchewan suffer from relatively minor psychiatric ailments. Therefore, we must question the suitability of the present service delivery system. Is there a need to screen out “medical problems” from “problems of living” which may be better treated by non-medically-oriented counselling services, thus freeing some of the medically-skilled manpower to focus on better and more comprehensive care for the more intractable mental disorders?
On Being Therapeutic
Authors: Greben Stanley E. 
Published: April 2017

Psychotherapy is both an art and a science. The art deserves as careful study as does the science. In this paper the author puts forward the view that the effectiveness of psychotherapy is dependent to a marked degree upon certain innate characteristics of the therapist: these include his character structure, his personal values, and his spontaneous personality style. In order to explore this thesis, the author examines what has been written about some successful and well-known psychotherapists, by their patients, their colleagues, and their friends. He concludes that these therapists strongly evidenced the following characteristics: empathy and concern, caring and protectiveness, warmth, therapeutic force-fulness, expectation of improvement, freedom from despair, reliability, friendliness and respectfulness. It is felt that such factors in the therapist must be taken into account in order to achieve a view of psychotherapy which is not reductionistic.
Two New Cases of XYY Chromosome Complement: And a Review of the Literature
Authors: Hoffman Brian F. 
Published: April 2017

Two cases with XYY chromosome complement are presented and compared with 153 cases described in the literature.Some patients with abnormalities of personality development and manifest psychopathology may have sex chromosome abnormalities and should be studied further for the interaction of genetic and environmental factors in personality development. In particular, tall, schizoid impulsive men with a history of criminality, arson or sexual offences should be screened for this particular genetic configuration. Because of the biased manner by which most of the cases are found, it is not yet known whether an XYY genotype results in a characteristic phenotype. What is needed is a genetic study of a normal population and a prospective study of newborns with various genotypes which would, unfortunately, create complex research and ethical problems.
L'adaptation Psycho-Sociale Des Malades Mentaux Chroniques Dans un Centre de Sante Mentale Communautaire
Authors: Gascon Louis , Thibaudeau Marie-France , Jean Richard ST. 
Published: April 2017

The results of this study which lasted 27 months corroborate the approach advocated by the centre dealing with an underprivileged population of chronic patients. Indeed, our patients, in spite of the chronic character of their problem, have shown a continual improvement concerning their psychosocial adaptation, a better utilization and a more open perception of their environment. Nevertheless, we have the feeling that the approach taken by the centre begins, after two years, to reach a plateau and this requires a major modification of the strategies of treatment. This change is needed in order to utilize more efficiently the non-psychiatric resources of the catchment area and to limit the involvement of the regular staff of the clinic.
Types of Disorders and Demographic Variables in A Canadian Child Psychiatry Population
Authors: Beitchman Joseph , Bell Kathy , Simeon Susan 
Published: April 2017

The value and extent of epidemiologic investigations of adult psychopathology is contrasted with the paucity of similar data in child psychiatry. Some findings from American and British sources on the epidemiology of childhood psychopathology are noted but it is not known whether these findings would also be true in the Canadian setting, and what little Canadian data are available are not readily comparable with much of these foreign data. Using both the D.S.M.II diagnostic schema and the child's symptoms as the definition of type of disorder, the relationship between type of disorder and demographic variables among 96 children attending a Canadian Regional Treatment Centre was investigated. The results indicate that, in general, the relationship between type of disorder and age is consistent with reports from American and other foreign studies. No significant associations between social class and type of disorder could be discerned. The analysis of sex and type of disorder produced somewhat contradictory results. Using symptom data, the possibility of changing patterns of symptom expression (toward increased proportion of externalizing symptoms) among girls is raised. If the reference point is diagnosis rather than symptom type, the results are more consistent with expected notions of neurotic disturbances being more common among girls, and conduct problems being more common among boys, but the possibility of sex stereotyping on the part of the diagnosing physician cannot be ruled out. Finally, it is suggested that population studies are needed to investigate further the relationships between childhood psychopathology and demographic variables.
Psychiatric Aspects of Geriatric Crisis Intervention
Authors: Grauer H. , Frank D. 
Published: April 2017

Data on 64 geriatric patients treated by the Psychiatric Crisis Team at the Jewish General Hospital were reviewed. A control group of non-geriatric patients was selected at random for comparison. The average age of the geriatric group was 69.4 years compared to 33 in the control group. Women predominated in the geriatric group. Precipitating factors were more easily delineated in the geriatric group. Physical illness, loss of a close relative and relocation were the most common precipitating events in the geriatric group. Depression, psychotic and neurotic, was the predominant diagnosis in the older group and schizophrenic psychosis in the control group. Compared to the control group, the geriatric patients were discharged sooner and were more easily managed. Only two geriatric patients required institutionalization. The study supports the value of prompt and comprehensive geriatric crisis intervention.
Suicidal Behaviour in Halifax, Nova Scotia
Authors: Hirsch Solomon , Lowman Margaret , Perry Roland 
Published: April 2017

A brief report of suicide statistics — completed suicides, attempts with lethal intent (a new category), and other attempts — is presented. The highest risk group in Halifax County is the male from late adolescence to early middle life.Statistics from Canada and Nova Scotia reveal a marked increase in the rate of completed suicides in the young adult male during the past twenty years.It is noteworthy that completed suicides and attempts with lethal intent frequently occur in persons with no clear evidence of significant depressive illness and that many patients with severe depressive illness are never seriously suicidal.Many persons and some families have a pattern of reacting to stress and/or psychiatric illness with suicidal behaviour. There is often little correlation between the seriousness of the stress and/ or illness and the seriousness, of the suicidal behaviour.Most suicide's were considered to be not preventable by ordinary techniques of management. Various patterns of behaviour relevant to preventability are described.A brief description of reactions of physicians and nurses to suicidal behaviour is given. There is a negative reaction of both groups to suicidal attempts which are not serious, particularly to repeaters; and this reaction is much stronger in nurses than in physicians.There is also a brief description of unusual complications of suicidal attempts and of the very high medical costs of caring for those who make attempts.
Psychiatric Services in China
Authors: Allodi F. , Dukszta J. 
Published: April 2017

Reportedly, the People's Republic of China has made great progress in health care services, particularly at preventive, primary and community levels. Information on their psychiatric services is still scarce. A group of 12 health professionals visited the country for three weeks in July 1977. This paper provides a description and an analysis of the network of mental health services using a sample of one mental hospital, six general hospitals and a number of health units in cities, factories and communes. The basic principles of policy and administration are those of a collective socialism with strong central guidelines and considerable local administrative initiative. Admissions to the mental hospital in Shanghai reveal that 83% are young acute schizophrenic cases and very few are neurotic or non-psychotic. This distribution stands in great contrast with admissions to mental hospitals in the West, as is the case in Canada, where schizophrenics represent only 12% of all first admissions to mental hospitals and non-psychotic or minor conditions amount to two-thirds. An impressionistic survey of Chinese traditional medicine rooms in general hospitals revealed that a good proportion of their cases (60-70%) are diagnosed as suffering from minor organic or vague organic conditions without evidence of organic pathology and which in the West would be considered as neurotic or psychosomatic conditions. Outside the institutions, in the communes of the rural and urban areas behavioural, interpersonal and family problems are not defined specifically as mental health problems, but handled within the moral and political ideology prevalent in the country. None of the general hospitals visited had a psychiatric unit, but every patient in every hospital or health unit in the cities and countryside received a combination of traditional Chinese medicine (herbal preparations, acupuncture and moxibustion) besides the Western or modern type of treatment. Officially mental illness is not considered a major problem and it is given very low priority in medical school curricula or in the planning of health services. It is concluded that psychiatric services in China are concerned primarily with cases of psychosis and severe neurosis, that neuroses are viewed as general health problems, and personality and behaviour disorders are considered social or community matters.
Ecg Changes in Pure Imipramine Overdose as Function of Plasma Level*
Authors: Reed K. , Mckim H.R. 
Published: April 2017

ECG changes occur with therapeutic doses of tricyclic antidepressants and cardiovascular conduction alteration is the lethal effect in overdoses on these drugs. These ECG changes depend on the plasma level and metabolism of the particular antidepressant. Information about the relative toxicity and metabolism characteristics can be obtained by studying overdoses if the attempt simply involves one tricyclic and no other drug ingestion. Such a case report involving a known quantity of imipramine is presented. The early toxic signs leading to cardiac arrest and the recovery from coma are discussed. The ECG along with corresponding plasma levels of imipramine and its metabolite desmethylimipramine are given as a function of time after ingestion. The relative toxicity of these metabolites and the use of anticholinesterase in the acute management is considered.
The Canadian Certification Examination in Psychiatry: III: Towards Better Certification Techniques
Authors: Lowy F.H. , Prosen H. 
Published: April 2017

Although there has been much criticism of specialty certification examinations there is general agreement that they are an important safeguard of competence in medical specialties where the consumer cannot judge this. The Canadian Royal College has made strenuous attempts to improve certification techniques but these have not been heretofore widely reported. This paper reports on the rationale for the replacement of the essay examination by multiple choice questionnaires, the problems associated with MCQ, and the efforts made to improve the fairness, validity and reliability of the clinical (oral) examination. These efforts have been in the areas of selection of examiners, training for examiners, standardization of marking and the conduct of the examination. A description is given of the conduct of the examination and what the examiners look for in the candidate's performance. The development and increasing importance of the In-Training Evaluation are discussed. The publication of A Resident's Guide to Psychiatric Education with multinational participation advances the possibility of future reciprocity in psychiatric examinations conducted in several English speaking countries.
The Analysis of a Case of Dysmorfophobia (Psychopathology and Psychodynamics)
Authors: Philippopoulos George Spyros 
Published: April 2017

A case history is presented of a 16 year old adopted girl, diagnosed as having dysmorfophobia and successfully treated by psychoanalytically-oriented psychotherapy, during which time much material for discussion and interpretation was provided by the patient's dreams. The psychodynamics of the case are explored. In this case, dysmorfophobia is seen as a façade covering up the patient's unconscious urge to yield to sexual temptation. Clinically, the case may be seen and classified as follows: It may be a syndrome or a cluster of symptoms that do not currently exist in the standard psychiatric nomenclature. The diagnosis of a personality trait disorder in a not yet fully structured personality might be a second alternative diagnosis. The author, however, is inclined to consider the case as a “transitional” or “potential” emotional disturbance, in accordance with Edward Glover's views (4).