How to deal with psychopharmacotherapeutic inefficiency

W leczeniu farmakologicznym, a zwłaszcza psychofarmakologicznym, powinny być w większym stopniu uwzględniane czynniki psychologiczne, które wpływają na skuteczność lub brak skuteczności leczenia. Ważne jest wzięcie pod uwagę konieczności całościowego podejścia do pacjenta, a w ramach takiego podejścia koncepcja wzajemnej relacji „mózgu−umysłu” jest czynnikiem, który nie może być pominięty. Brak skuteczności farmakoterapii, oporność wobec leczenia farmakologicznego, trudności w przestrzeganiu zaleceń, efekt nocebo to jedynie kilka przykładów zjawisk, których zrozumienie i poradzenie sobie z nimi wymagają podejścia psychodynamicznego i pewnego rodzaju kreatywności w sposobie stosowania farmakoterapii. Autorka proponuje zastosowanie zasad i metod psychodynamicznej psychofarmakoterapii w celu rozwiazywania problemów w trakcie prowadzenia terapii lekami psychotropowymi, a także uwzględnienie zjawisk opisywanych przez teorię przywiązania w kontekście poprawy współpracy w leczeniu, stosowania się do zaleceń oraz w celu tworzenia wzajemnej relacji terapeutycznej w ramach poprawy skuteczności farmakoterapii.There is more need in the pharmacotherapeutical treatment, particularly in psychopharmacotherapy, to take into account the psychological factors that influence the effectiveness or ineffectiveness of treatment. It’s important to takes into account the holistic approach to the patient and a “brain-mind” concept is also inevitable in this approach. Inefficiency of pharmacotherapy, treatment-resistence, non-adherence, nocebo etc. are only some of the phenomena that require a psychodynamic approach and the kind of creativity in prescribing drugs

PSYCHIATRIC ASPECTS OF BASAL GANGLIA DISEASES

This review clarifies the fact that basal ganglia diseases are psychiatric as much as neurological diseases. It illustrates psychiatric aspects in Parkinson\u27s disease and other hereditary basal ganglia diseases such as Wilson\u27s disease, Huntington\u27s chorea and others. In these diseases, psychological disorders can be difficult to diagnose, whether they are concomitant with the primary (neurological) disease, they are its consequence, or they are the result of a specific pharmacotherapy prescribed for these disease, etc. Thus, the choice of appropriate psychopharmacotherapy for these disorders represents a very subtle problem

EFFECTIVE CONTENT FOR DIGITAL EMPLOYER BRANDING

The significance of the employer brand during the ‘global war for talent’ has been undeniable. Organizations have applied marketing principles of brand management to talent management in the attempt to attract and employ adept and motivated workers. However, just as successful marketing has switched from being transactional to relationship oriented, the same in-depth shift needs to happen regarding employer branding, transferring it from traditional communication tools and messages usage to continuous communication based on customized value proposition. Communicating and promoting the image of an employer as generally ‘a great place to work’ has been proven not to be enough. Moreover, as job-hopping Millennials have entered the workforce, it is imperative that employee value proposition (EVP) in employer branding campaigns is determined by potential employees’ actual needs and delivered through communication channels of their choice. This paper proposes the most effective content for employer branding and marketing campaigns based on the results of the empirical research using the Herzberg\u27s theory of work motivation, including 528 Millennials. The results show a substantial change in the expectations this generation has from work and the workplace, which should be included in digital employer branding and content marketing, and used to build long-term employer reputation

Empathy in Group Psychoanalytic Psychotherapy: Questionnaire Development

The aim of this study is to develop a questionnaire that can observe empathy in group psychoanalytic psychotherapy and examine the structure of its factors. A questionnaire comprised of 160 items in five-point Likert-type scale was developed through analysis of communication and interaction related to empathizing during group sessions. The questionnaire was applied on 256 patients from 40 therapy groups in 9 cities in Croatia. All 20 group analysts are trained in the Institute for Group Analysis in Zagreb. The patients were selected based on group analysis criteria. After item discrimination and principal component analysis limited to five factors were assessed, 80 items were isolated, 20 of which made a control scale for socially desirable responses. Two parallel questionnaire forms were developed: Group-Analysis-Empathy 1 (GA-Em1) and Group-Analysis-Empathy 2 (GA-Em2). A new, reliable and valid questionnaire for empathy observation employable in group psychotherapy was designed. The following factors were isolated by means of factor analysis: 1. Emotional disclosure and sensibility; 2. Containing and metabolizing; 3. Immersion; 4. Resonance and responsiveness; 5. Insight. A new questionnaire on empathy in group-analytical psychotherapy can measure the capacity for emotional communication among group members and between the group and the group analyst – conductor

Group Members’ Assessment of Their Conductor in Small Analytic Group

In this pilot study the authors present the group members’ assessment of their conductor in group analysis – the treatment conducted in accordance with concept »groupas- a-whole« of S. H. Foulkes. There will be presented the results obtained by scale for evaluation of characteristics of the group therapist. In the scale, developed by the authors of the study, there were 30 items and by factorial analysis it gave three interpretable factors: authenticity, empathy and distrust. By self-evaluation the members of three small groups, i.e. 20 patients, ranked characteristics of their conductor. The patients, assessing the degree of their accordance with 30 items of the evaluation scale, expressed whether and how much they experienced their conductor as an authentic, empathic and trustworthy person. While in the beginning of the group analytic process the conductor’s role was important, his importance decreased as the group-as-a-whole developed. Group experience became more important than the conductor. In other words, the group itself became the therapist, what is one more the proof of the Foulkes’ concept of »the groupas- a-whole«

Patients’ Ranking of Therapeutic Factors in Group Analysis

The aim of this research is to assess which therapeutic factors are of greatest importance to patients in group analytic psychotherapy, and whether the patients’ characteristics and the phase of the group process influenced their evaluation of therapeutic factors. The Yalom’s group therapeutic factors questionnaire was filled out by 66 patients, members of small groups conducted according to group analytic principles. The average scores for each therapeutic factor were subsequently ranked by importance to the patients and related to their age, sex, education, previous psychotherapeutic experience and phase of group process. Self-understanding was the highest-ranking therapeutic factor for the patients (average score 21.32±0.04 out of 25 maximum), whereas identification was the lowest ranking factor (15.88±0.06 in average). Group therapeutic factors were scored higher by women, patients up to 30 years of age, high-school graduates, and those with previous psychotherapeutic experience. Self-understanding seems to be the most important therapeutic factor in group analysis, emphasizing the importance of appropriate selection of patients for group analysis in order to utilize therapeutic factors the best

The Assessment of the Analytic Group Treatment Efficiency According to Yalom’s Classification

The authors expose the assessment of therapeutic factors during group analytic treatment. In the methodology of research several measuring instruments were applied. In this study it will be exposed the results obtain by Yalom\u27s questionnaire containing 60 items. Three small analytic groups were followed up, encompassing 20 group members. By self-evaluation they ranked the assessment of every of 12 therapeutic factors according to their importance. The variability of results was shown more inside then among groups. The highest-ranking therapeutic factors the group members sorted out were: self-understanding, family re-enactment, cohesiveness and universality. The factor of identification was the lowest ranking in all group

Changes of Defense Mechanisms and Personality Profile during Group Analytic Treatment

Researching efficiency of group-analytic treatment and following Foulkes’ principle of the »group-as-a-whole«, the methodology was applied. That enabled the evaluation of expected changes of group members individually, as well as the group-as-a-whole. In this study three small groups (20 patients) were followed up and changes were evaluated after second and after fourths years of group analysis. Two measuring instruments – The Life Style Index and Defence Mechanisms Scale (LS-DM) and Minnesota Multiphase Personality Inventory (MMPI-201) were applied. Each member of the group was assessed by self-evaluation as well as the group-as-a-whole. The results of the research indicated that changes of the personality occurred. Changes consisted in lowering of defensive activities that was tending towards more mature defences. Changes also consisted in lowering ratings on the pathological parts of the MMPI-scales reflecting shifting of the conflict level. The results could be predictive for positive outcome of group analysis. More studies are needed

EFFECTS OF MEANING OR PSYCHODYNAMIC PSYCOPHARMACOTHERAPY

Despite advances in psychiatry, treatment outcomes are still a big problem, and are not always substantially better than it was in the past time. Treatment resistance remains a serious psychiatric problem. One of the reasons for that is that the pendulum has swung from a psychodynamic framework to a biological one, and the impact of meaning (i.e. the role of psychodynamic and psychosocial factors in treatment-refractory illness) has been relatively neglected. Dynamic factors in psychopharmacology play a pivotal role in pharmacological treatment responsiveness. There is a small but impressive evidence base that shows that psychological and interpersonal factors play that role. Psychodynamic psycho pharmacotherapy combines rational prescribing with tools to identify irrational interferences with effective use of medications, i.e. to resolve the problems of the pharmacologicaltreatment resistance. Psychodynamic psychopharmacology represents an integration of biological psychiatry and psychodynamic insights and techniques