Predictors of outcome in LAAM, buprenorphine, and methadone treatment for opioid dependence.

This study examined (1) predictors of treatment outcome for opioid-dependent participants in a single-site controlled trial comparing methadone, buprenorphine, and LAAM treatments and (2) the extent to which various subpopulations of patients may have more successful outcomes with each medication. The relationships between patient demographics, drug use history, and psychological status and outcome measures of treatment retention, opiate use, and cocaine use were assessed. We believe this study to be the first to demonstrate that predictors of treatment success appear to be largely similar in LAAM, buprenorphine, and methadone treatment for opioid dependence. We did not find any factors that would strongly guide selection of one medication over others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Continuous Renal Replacement Therapy for Liver Disease

Continuous renal replacement therapy (CRRT) is becoming the treatment of choice for critically ill patients with acute renal failure around the world. In particular, CRRT is used for patients with combined liver and acute renal failure, because they are often hemodynamically unstable. The question arises as to whether the use of CRRT should be extended to those patients with acute and chronic liver failure who do not have dialysis-dependent renal failure. CRRT could potentially allow some detoxification by removing water-soluble toxins and also allow regulation of intravascular volume and correction of sodium and other electrolyte and acid–base imbalances. By providing homeostatic control, CCRT could potentially help support patients by bridging to liver transplantation and managing those who eventually recover with hepatic regeneration.     

Analytic methods for modeling longitudinal data from rolling therapy groups with membership turnover.

Interventions for a variety of emotional and behavioral problems are commonly delivered in the context of treatment groups, with many using rolling admission to sustain membership (i.e., admission, dropout, and discharge from group are perpetual and ongoing). The authors present an overview of the analytic challenges inherent in rolling group data and outline commonly used (but flawed) analytic and design approaches to addressing (or sidestepping) these issues. Moreover, the authors propose use of latent class pattern mixture models (LCPMMs) as a statistically and conceptually defensible approach for modeling treatment data from rolling groups. The LCPMM approach is illustrated with rolling group data from a group-based alcoholism pilot treatment trial (N = 128). Different inferences were made with regard to treatment efficacy under LCPMM vs. the commonly used standard group-clustered latent growth model (LGM); coupled with other preliminary findings in this area, inferences from LGMs may be overly liberal when applied to data from rolling groups. Continued work on data analytic difficulties in groups with membership turnover is critical for furthering the ecological validity of research on behavioral treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intensive filial therapy with child witnesses of domestic violence: A comparison with individual and sibling group play therapy.

The rationale for utilizing filial therapy as a treatment intervention with child witnesses of domestic violence while residing with their mothers in a shelter facility is explored and the effectiveness of an intensive 12-session filial therapy parent training group, conducted within 2-3 weeks, is described (n=11; aged 4-10 yrs). Results of analysis of covariance revealed that child witnesses in the experimental group significantly reduced behavior problems prevalent in child witnesses and significantly increased their self-concept as compared to child witnesses in the non-treatment comparison group. In addition, t-test results showed that mothers who facilitated treatment of the experimental group scored significantly higher after training on both their attitudes of acceptance and their empathic behavior. Comparative analysis revealed that intensive filial therapy as facilitated by the children's mothers was as effective in reducing behavior problems as was intensive individual play therapy and intensive sibling group play therapy as facilitated by professionally trained therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are all cognitive therapies alike? A comparison of cognitive and noncognitive therapy process and implications for the application of empirically supported treatments.

The definition of an empirically supported treatment (EST) arguably embodies 2 untested assumptions: (a) that different manualized renditions of the same therapy are functionally equivalent and (b) that therapies can be reliably applied independently of therapist, setting, and format. These assumptions were tested as applied to cognitive therapy (CT), using process data from a large multisite study (N=235) that included 3 cognitive and 6 alternative therapies. Although the non-CTs were more variable than the CTs on 2 of 4 dimensions studied (directiveness and emotional arousal), there was considerable variation among the 3 CTs, even when implemented in the current context of rigorous training, manualization, and adherence checks. Results are discussed as related to the assumptions underlying EST criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Tale of Two Cities: Financing Two Voucher Programs for Substance Abusers Through Community Donations.

Voucher-based reinforcement therapy (VBRT) is an effective drug abuse treatment, but the cost of VBRT rewards has limited its dissemination. Obtaining VBRT incentives through donations may be one way to overcome this barrier. Two direct mail campaigns solicited donations for use in VBRT for pregnant, postpartum, and parenting drug users in Toronto, Ontario, Canada, and in Los Angeles, California. In Toronto, 19% of those contacted over 2 months donated $8,000 ($4,000/month) of goods and services. In Los Angeles, nearly 26% of those contacted over 34 months donated $161,000 ($4,472/month) of goods and services. Maintaining voucher programs by soliciting donations is feasible and sustainable. The methods in this article can serve as a guide for successful donation solicitation campaigns. Donations offer an alternative for obtaining VBRT rewards for substance abuse treatment and may increase its dissemination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment to the therapist.

This study examines the ways in which therapists function as attachment figures for patients. Patients in long-term psychoanalytic therapy answered questionnaires about their feelings about their therapists and their closest personal relationships. Components of attachment prominent in the therapeutic relationships were looking up to the therapist and feeling the therapist was responsive to emotional needs. Stronger attachment to therapists was associated with greater frequency and duration of therapy, a stronger working alliance, and greater security of the patients' attachment style, as well as with the gender of the patient and therapist. Using attachment theory to understand psychoanalytic relationships emphasizes the unique importance of a therapist to a patient and can offer new perspectives on both therapeutic and attachment processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alliance and Dropout in Family Therapy for Adolescents With Behavior Problems: Individual and Systemic Effects.

This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent and adolescent) and family levels (within-family differences). Participants were 34 families who received functional family therapy for the treatment of adolescent (aged 12-18 years) behavior problems. Families were classified as treatment dropouts (n=14) or completers (n=20). Videotapes of the first sessions were rated to identify parent and adolescent alliances with the therapist. Results demonstrated that individual parent and adolescent alliances did not predict retention. However, as hypothesized, dropout cases had significantly higher unbalanced alliances (parent minus adolescent) than did completer cases. These findings highlight the importance of alliances in functional family therapy and suggest that how the alliance operates in conjoint family therapy may be a function of systemic rather than of individual processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

城市建设的休克疗法——大连现象解说

在启动大规模的现代化建设的进程中，应对发展中听中型城市实施“休克疗法”，强调性终止城市发展的无序而缓慢的自然进程。选择短暂的“回归”或“中断”历史的调整时，应以能否适当地的历史文化特质从而把握当代的发展机遇为依据。     

溴化亚铜脉冲激光光动力学疗法治疗鲜红斑痣临床研究

用ＣｕＢｒ脉冲激光光动力学疗法治疗鲜红斑痣８例２１个区域，其中１１个区红色完全褪去，７个区残留少量浅色，３个区红色明显褪去，２０个区域无疤痕形成。