Low frequency maintenance therapy with imiglucerase in adult type I Gaucher disease: a prospective randomized controlled trial

FWN – Publicaties zonder aanstelling Universiteit Leide

Midterm Self Evaluation Report November 2004 - June 2007 : Dutch National Research Programme Climate changes Spatial Planning (CcSP)

This self evaluation report is a product of the Climatic Change Spatial Planning consortium. It describes the progress on a programme level and within each theme of the CcSP-programme over the period November 2004 until May 200

Quantification of Globotriaosylsphingosine in Plasma and Urine of Fabry Patients by Stable Isotope Ultraperformance Liquid Chromatography-Tandem Mass Spectrometry

Bio-organic Synthesi

Plasma globotriaosylsphingosine: diagnostic value and relation to clinical manifestations of Fabry disease

FWN – Publicaties zonder aanstelling Universiteit Leide

Transglycosidase activity of chitotriosidase - Improved enzymatic assay for the human macrophage chitinase

Bio-organic Synthesi

Establishing an optimal working relationship with patients with an antisocial personality disorder:Aspects and processes in the therapeutic alliance

ObjectiveDeveloping good interpersonal relationships is one of the main impediments for people with an antisocial personality disorder (ASPD). However, in treatment of psychiatric disorders, establishing a strong therapeutic alliance (TA) is important for effective treatment. Nevertheless, there is little knowledge on how to establish this TA with this challenging patient group. This study investigates which factors are important in TA development.MethodFor this study, a qualitative research methodology is applied. In-depth interviews with therapists experienced in treating ASPD were conducted and analysed through thematic analysis.ResultsThe analysis revealed six themes important in alliance formation: the patient's needs, regulating interpersonal dynamics, connective attitude, connective skills, treatment process and treatment goals. Each theme is defined including aspects of the recommended therapeutic attitude and required skills for therapists working with patients with ASPD.ConclusionsThis study determined that, for therapists working with patients with ASPD, several key factors are essential in establishing a strong TA. These factors include the ability to be firm, authentic, non-judgmental and genuinely involved. An attentive presence is crucial, in which the therapist takes initiative in establishing contact and makes the patient feel that he is truly seen as an autonomous and equal person. In doing so, the therapist needs to provide clarity and structure while remaining perceptive to boundary violations. The therapist must be able to set limits using a clear yet kind tone of voice. Furthermore, it was notable that an intensive appeal is made to the therapist's reflective capacity in these treatments

Blended e-health in cognitive behavioral therapy: Usage intensity, attitude and working alliance in clinical practice

Background: Though internet based cognitive behaviour therapy is proven to be effective, e-health is applied only in a minority of treatments in specialised mental health care. The low application rates are associated with therapists’ attitudes towards e-health. One of the major concerns is limitations in the therapeutic relation and communication between patient and therapist. Since therapist involvement is important in an effective e-health treatment, negative attitudes towards e-health can be a risk for effective e-health application. Aims: This study aimed to examine the relationship between patients’ e-health usage as well as patients’ attitudes towards e-health and the therapeutic alliance. The possible influence of therapists’ attitudes on patients’ e-health usage is also examined. Method: In an outpatient mental health setting, patients attended a blended treatment program for major depressive disorder and completed questionnaires on attitudes towards e-health and the therapeutic alliance. Therapists completed an alliance and attitude questionnaire as well. Results: Patients with more positive attitudes used the e-health application more intensively. Higher work alliance rates were related to sharing digital homework assignments and seeking contact with their therapist. Also, when treated by therapists with more positive attitudes towards e-health, patients shared more assignments with their therapist. Patients with high symptom rates at start, had more negative attitude rates and tended to use the e-health application less frequently. Conclusions: In a treatment cohesion in which therapists are positive about blended e-health, patients’ attitudes are positively related to e-health usage and therefore a factor of interest in improvement of effective e-health application. Patients with severe symptoms may need extra attention like active support and iteration to promote adherence to the e-health program