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Kroměříž, Czech Republic

Luzny J.,Palacky University | Valihrachova S.,Mental Hospital Kromeriz | Novak J.,Hospital in Kromeriz | Zapletal T.,Hospital in Kromeriz | And 2 more authors.
Biomedical Papers | Year: 2010

Background. Ileus states are serious conditions that may lead to pathophysiological changes which in turn can result in perforation of bowel, peritonitis, sepsis or death. Our paper discusses paralytic ileus states, which can be caused by psychopharmaceutics with anticholinergic side effects. Methods and Results. Retrospective analysis of cases of paralytic ileus in mentally ill patients admitted to Mental Hospital Kromeriz. Conclusion. Although some old psychopharmacs have a much higher potential for anticholinergic side effects than the new ones, there are still some of the new modern antipsychotics which also have anticholinergic side effects which could cause paralytic ileus. Both psychiatrists and surgeons should pay attention to atypical or changed signs of ileus states in mentally ill patients and should be aware of the confounding factors which could make the diagnosis of ileus difficult in mentally ill patients. © J. Luzny, S. Valihrachova, J. Novak, T. Zapletal, E. Donek, O. Arogunmati. Source


Prasko J.,Palacky University | Prasko J.,International Institute of CBT | Vyskocilova J.,International Institute of CBT | Mozny P.,Mental Hospital Kromeriz | And 5 more authors.
Neuroendocrinology Letters | Year: 2011

HYPOTHESIS: For cognitive behavioural therapy, acquisition and maintenance of psychotherapeutic and supervisory competencies is crucial. METHODS: The PubMed, Web of Science and Scopus databases were searched for articles containing the following keywords: cognitive-behavioural therapy, competencies, therapeutic relationship, intervention, technique, training, supervision, self-reflection, empirically supported, transference, countertransference, scheme of therapy, dialectical behaviour therapy. The search was performed by repeating the words in different combinations with no language or time limitations. The articles were sorted and key articles listed in reference lists were searched. In addition, original texts by A.T. Beck, J. Beck, C. Padesky, M. Linehan, R. Leahy, J. Young, W. Kuyken and others were used. The resources were confronted with our own psychotherapeutic and supervisory experiences and only most relevant information was included in the text. Thus, the article is a review with conclusions concerned with competencies in cognitive behavioural therapy. RESULTS: For cognitive behavioural therapy, four domains of competencies in psychotherapy are crucial - relationship, case assessment and conceptualization, self-reflection and intervention. These may be divided into foundational, specific and supervisory. The foundational competencies include recognition of empirical basis for a clinical approach, good interpersonal skills, ability to establish and maintain the therapeutic relationship, self-reflection, sensitivity to a difference and ethical behaviour. The specific competencies involve the skill of case conceptualization in terms of maladaptive beliefs and patterns of behaviour, ability to think scientifically and teach this to the patient, structure therapy and sessions, assign and check homework, etc. The supervisors competencies include multiple responsibilities in supporting the supervisee, identification and processing of the therapist's problems with the patient, continuous development, increasing the supervisee's self-reflection, serving as an example and being as effective as possible in the role of a clinical instructor. CONCLUSION: Both the literature and our own experiences underline the importance of competencies in cognitive behavioural therapy and supervision. © 2011 Neuroendocrinology Letters. Source


Prasko J.,Palacky University | Prasko J.,International Institute of CBT | Mozny P.,Mental Hospital Kromeriz | Mozny P.,International Institute of CBT | And 5 more authors.
Biomedical Papers | Year: 2012

Objective. Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. Methods. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. Results. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the ability to perceive other people's inner emotions, kindles altruism, and increases attunement to subtle signals indicating what others need or want. Self-reflection may be practised by the therapists themselves using traditional cognitive behavioural therapy techniques, or it may be learned in the course of supervision. If therapists are unable to recognize their own thoughts and feelings, or the effects of their attitudes in a therapeutic situation, then they are helpless against these thoughts and feelings, which may control the therapist's behaviour to the disadvantage of the client and therapist alike. Conclusion. Training and supervision focused on self-reflection are beneficial to both supervisees and their clients. The more experienced the supervisor is, the more self-reflection used in therapy and supervision. Source


Luzny J.,Mental Hospital Kromeriz | Luzny J.,Palacky University | Jurickova L.,Palacky University
Iranian Journal of Public Health | Year: 2012

Background: Elder abuse and neglect (EAN) comprises emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. Elder abuse and neglect in seniors with psychiatric morbidity was not monitored in the Czech Republic at all, despite the literature shows mental morbidity as one of the important risk factor for developing elder abuse and neglect.Methods: We designed comparative cross sectional study comprising 305 seniors hospitalized in Mental Hospital Kromeriz in June 2011 - group of 202 seniors hospitalized due to mental disorder in psychogeriatric ward and group of 103 seniors hospitalized due to somatic disorder in internal ward. Content analysis of medical records was done in both groups of seniors, with regards to symptoms of elder abuse. Then, we discussed the topic of elder abuse with 30 nurses of psychogeriatric ward in focus group interview. Results: Between two compared groups of seniors we detected statistically higher prevalence of elder abuse in seniors with psychiatric morbidity (48 cases, 23.8% prevalence of EAN), compared to somatically ill seniors (3 cases, 2.9%). As for nursing staff, 5 from 30 nurses (16.7%) have never heard about symptoms of elder abuse and neglect, 10 from 30 nurses (33.3%) had just a partial knowledge about elder abuse and neglect and its symptoms, the rest of nurses (15 from 30 nurses, 50.0%) had good knowledge about elder abuse and neglect and its symptoms. Conclusion: Elder abuse and neglect seems to be a relevant problem in senior population with mental disorders. Development of educational programs for nursing and medical staff about Elder abuse and neglect (symptoms of EAN, early detection of EAN, knowledge how to report cases of EAN) could improve the situation and help mentally ill seniors to better quality of life. Source


Prasko J.,University Hospital Olomouc | Prasko J.,Palacky University | Diveky T.,University Hospital Olomouc | Diveky T.,Palacky University | And 9 more authors.
Biomedical Papers | Year: 2010

Background. Both patients and psychotherapists can experience strong emotional reactions towards each other in what are termed transference and countertransference within therapy. In the first part of this review, we discuss transference issues. Although not usually part of the obvious language of cognitive behavioral therapy (CBT), examination of the cognitions related to the therapist, is an integral part of CBT, especially in working with difficult patients. In the second part, we cover counter-transference issues. We describe schematic issues that give rise to therapist counter-transference and explain how this interacts in different types of patient therapist encounter. We also examine ways in which the therapist can use CBT to help him/her modify the countertransference and, in the process, assist the patient. Methods. PUBMED data base was searched for articles using the key words "therapeutic relations", "transference", "countertransference", "cognitive behavioral therapy", "cognitive therapy", "schema therapy", "dialectical behavioral therapy". The search was repeated by changing the key word. No language or time constraints were applied. The lists of references of articles detected by this computer data base search were examined manually to find additional articles. We also used the original texts of A. T. Beck, J. Beck, M. Linehan, R. Leahy, J. Young and others. Basically this is a review with conclusions about how therapists can manage transference issues. Results. Transference. The therapist should pay attention to negative or positive reactions towards him/ her but should not deliberately provoke or ignore them. He/she should be vigilant for signs of strong negative emotions, such as a disappointment, anger, and frustration experienced in the therapeutic relationship by the patient. Similarly he/ she should be alert to exaggerated positive emotions such as love, excessive idealization, praise or attempts to divert the attention of therapy onto the therapist. These reactions open space for understanding the patient's past and actual relations outside the therapy. Countertransference. The therapist should be aware of countertransference schemas as they apply to him/her. He/she should monitor his/her own feelings that indicate countertransference. Further, the assistance of and discussion with supervisors and colleagues is useful in regard to countertransference even in experienced therapists. Countertransference can be used as an open window into the interpersonal relations of the patient. Conclusions. Both the literature and our experience underscore the importance of careful and open examination of both transference and counter-transference issues in CBT and their necessary incorporation in the complete management of all patients undergoing CBT. © J. Prasko, T. Diveky, A. Grambal, D. Kamaradova, P. Mozny, Z. Sigmundova, M. Slepecky, J. Vyskocilova. Source

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