Floriana Caccamo

“Emotionally Focused Couple Therapy With Neurodegenerative Diseases: A Pilot Study”.

ABSTRACT This research wants to verify the effectiveness of couples treatment, when a neurodegenerative disease affects one of the two partners. The disease affects not only the ailing individual, but also the dynamics within the couple. Fourteen patients affected by neurodegenerative diseases participated in an emotionally focused couple therapy (EFT) with their spouses. We collected a measure of the quality of life (SF-36) and relationship satisfaction (DAS) at the beginning and at the end of the treatment for both partners. The results show an improvement in quality of life and couple contentment, underlining the usefulness of such a psychotherapeutic intervention on the couple.

Il gruppo e il processo terapeutico tra cambiamenti ed evoluzioni

Gli autori descrivono il processo terapeutico in un gruppo slow-open di pazienti psichiatrici a partire da una considerazione del processo in termini intersoggettivi. Ci si propone di trattare un’analisi del gruppo alla luce del sottile legame tra pratica clinica e ricerca, attraverso l’utilizzo di un questionario che indaga il processo terapeutico da due vertici di osservazione, quello dei pazienti e quello del terapeuta. Il gruppo come luogo di elaborazione dell’esperienza e di condivisione dei vissuti puo consentire la mentalizzazione, ovvero la capacita di simbolizzare, di collegare i propri sintomi a trame di pensiero e giungere cosi a nuove significazioni. L’esperienza svolta permette di riflettere sull’evoluzione di un processo gruppale, a partire dai cambiamenti del setting che si verificano al suo interno, tra cui il piu rilevante, il cambio di conduzione.

The measure of effectiveness of a short-term 2-week intensive Cardiac Rehabilitation program in decreasing levels of anxiety and depression

Research on heart disease have found a strong and consistent evidence of association between some psychosocial risk factors, including depression, anxiety, self-efficacy, lack of social support and outcome of disease. Depression increases the risk of cardiac death and is highly predictive of reduced adherence to recommended treatments; anxiety appears to be linked to adverse cardiac outcomes. It was demonstrated that Cardiac Rehabilitation (CR) leads to substantial improvements and positive outcomes because combines the prescription of physical activity with the modification of risk factors and aims to reduce symptoms related to the disease and the risk of new cardiovascular events. The main objective of this study is to determine if a short and intense CR program can produce a positive impact on anxious and depressive symptoms revealed in cardiac patients, confirming results of previous researches. The protocol was proposed to all patients referred for an outpatient CR after an acute event who attended the short 2-week intensive rehabilitation program. A total of 157 patients recruited at the operating unit of Cardiology, in the Hospital of Cittadella (Italy), was included in the analysis. The Beck Depression Inventory-II and the State-Trait Anxiety Inventory-Y were administered to the patients. SPSS 17.0 was used for statistical analysis. T-tests for paired samples were used to evaluate differences between the beginning and the end of the CR program. There was a statistically significant difference between the beginning and the end of the CR program. Results for paired samples showed significant differences in all factors of the BDI-II and in the total score. In addition, a statistically significant difference was found even in the state - anxiety subscale. No significant difference was detected for the trait anxiety. According to recent studies, this research shows that the CR program has a significant impact on levels of anxiety and depression, because all activities focus their commitment on changing the patients personal beliefs and perception of illness, promoting the exchange of information and sharing of concerns and fears, increasing the patients resilience with the aim of enabling him/her to reorganize positively his/her personal, family and professional sphere.

Transitando nell’istituzione carceraria: l’esperienza di un gruppo di "discussione civile"

Questo lavoro si propone di indagare il ruolo dell’istituzione carceraria nel proteggere l’individuo dalle angosce persecutorie e depressive. Gli autori, nel trattare il tema del campo istituzionale che si crea in carcere, sottolineano il criterio dell’isomorfismo tra offerta di servizi e modelli organizzativi adottati. La fenomenologia dell’isomorfismo considerata dal punto di vista del gruppo permette di osservare come il gruppo, confrontato su alcune specifiche immagini, fantasie ed esperienze portate dal singolo, senta direttamente tali eventi mentali come loro e metta in atto una reazione sostanziale che e difensiva e inconscia.

Coppie inter-rotte. Ripensare la relazione in un gruppo per coniugi di persone con una Grave Cerebrolesione Acquisita

Dopo una Grave Cerebrolesione Acquisita (GCA) possono manifestarsi menomazioni sensomotorie, cognitive o comportamentali permanenti, con relative disabilita. La dimissione ospedaliera e la fase di reinserimento socio-familiare costituiscono un ulteriore momento di crisi per il nucleo familiare, poiche si trova sprovvisto di strumenti adeguati per fronteggiare il carico pratico ed emotivo che tale compito determina. Il legame con il coniuge viene stravolto e i caregiver, pervasi da sentimenti di impotenza, rabbia e colpa, ricorrono frequentemente a meccanismi di difesa quali l’agito, il diniego e la negazione. Nella nostra esperienza il dispositivo del gruppo omogeneo a tempo limitato favorisce l’elaborazione di questi vissuti grazie all’attivazione di fattori terapeutici quali l’universalita, l’informazione, l’apprendimento interpersonale e la coesione di gruppo. Il dispositivo gruppale e l’attivazione di questi fattori terapeutici consentono ai familiari la sospensione dal fare, dalle emergenze e dalle stimolazioni che i pazienti traumatizzati inesorabilmente e contuativamente sollecitano: episodi di trattamento (Fasolo, 2002) che offrono una possibilita trasformativa dei vissuti di colpa e impotenza in vissuti di rassegnazione e adattamento alla nuova situazione.

Validation of the Italian version of the Apathy Evaluation Scale (AES-I) in institutionalized geriatric patients.

OBJECTIVES Apathy is a very common symptom in the institutionalized elderly and represents a condition of both clinical and public health importance. The Apathy Evaluation Scale (AES) has been shown to be a valid and reliable tool for characterizing, quantifying and differentiating apathy in various health conditions. The aims of this study were to establish the validity and reliability of the Italian version of the AES, and to assess the severity of apathy in a sample of Italian institutionalized geriatric patients. METHOD Data were collected from clinical interviews using the AES informant version (AES-I). Associations between measures of apathy and depression, cognitive functioning and perceived quality of life were evaluated, as well as the effects of the living environment on apathetic symptoms. RESULTS Multiple forms of reliability and validity (i.e. test-retest, internal consistency, discriminability of apathy rating from a standard measure of depression) were satisfied. Our results also show that the characteristics of the care setting may affect the severity of apathetic symptoms. CONCLUSIONS The AES-I Italian version is a reliable and valid instrument for measuring apathy in Italian patients, also allowing a direct comparison with data gathered in other countries.