Beating burnout

Beating burnout
 www.expresshealthcare.in/sections/life/829-beating-burnout

Aversion Therapy

Aversion Therapy
Aversion Therapy is a behavioral therapy. It is one of the group therapies that attempt to change undesirable/destructive behavior. These undesirable behaviors come about because we associate them with pleasure, the brain learns that, let's say substance abuse makes the person feel relaxed and lowers our stress levels.
Aversion therapy is a form of treatment that utilizes behavioral principles to eliminate unwanted behavior. In this unwanted method, the unwanted stimulus is repeatedly paired with discomfort. The goal of the conditioning process is to make the individual associate the stimulus with unpleasant or uncomfortable sensation.
During aversion therapy, the client may be asked to think of or engage in the behavior they enjoy while at the same time being exposed to something unpleasant feelings. Once the unpleasant feelings become associated with the behavior, the hope is that the unwanted behavior or action will begin to decrease in frequency or stop entirely.

Meaning of Aversion Therapy
Aversion Therapy is a form of psychiatric treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This conditioning is intended to cause the patient to associate the stimulus with unpleasant sensation, and to then stop certain behavior.

Purpose
As with other therapies, aversion therapy is a treatment grounded in learning theory-one of its basic principles being that all behavior is learned and that undesirable behavior can be unlearned under the right circumstances the goal of aversion therapy is to reduce or eliminate undesirable behavior. Treatment focuses on changing a specific behavior itself. The behaviors that have been treated include such addictions as alcohol abuse, drug abuse, smoking and pathological gambling, sexual deviations, etc.


Different Methods 

• Chemical and Pharmacological stimulants
• Electric Shock Method
• Insight-oriented approaches( Verbal Aversion Therapy)

ART THERAPY

Art therapy is a powerful tool that helps one to get in touch with feelings through the creative process. By providing a visual explanation as to what is going on inside the mind. Art therapy makes the unconscious conscious. The art process taps into the rich inner resources of material where the experienced art therapist can help, guide and assist in understanding and healing.

Art therapy is used to help patients overcome emotional conflicts and become more self-aware. To do this, the art therapist will guide patients in the use of certain art materials, such as pastels or crayons, to express himself/herself. Clay, paper or finger painting can also be used, depending on the issue being addressed. These specifically selected materials can be used to express what is in the patient's mind before they are able to put it into words.(Sometimes art is an easier form of expression for patients than verbalizing their pain.)

Art therapy can provide a positive feeling of expression within patients as well as allow a physical release of creative energy as work is being created. Creative expressions improve self-esteem, self-awareness, and personal growth, and also provide a sense of mastery. It can also be less threatening than traditional forms of therapy, which go deep through the layers of consciousness to find new meanings, that would not ordinarily surface.

If a specific topic is not immediately apparent, the therapist might suggest a topic for expression, such as one's family or a vivid childhood memory. There is a misconception that one needs to be artistic to do art therapy. You absolutely do not need to be an artist. The emphasis is on the process, not on the product. 

THERPEAUTIC INTERVENTIONS in Rehabilitation

GROUP ORIENTED INTERVENTIONS

Small groups facilitated with all types of reinforcement and support from professionals to create rhythm in the day-to-day activities of clients. The professionals interact with all the clients and establish an empathetic relationship with them. Professionals facilitate variety of group-oriented activities with an intention to improve the social skills of the group members. The main focus is to enhance self confidence, self esteem, cooperation, adjustment, pattern of communication and helping the group members to accept criticism, to give criticism, to promote a healthy lifestyle among the members, to build capacity to share their views in the group, leadership quality and to become aware of one's own problems. The social workers act as a catalyst to improve or restructure the maladaptive pattern of the clients during the group sessions. The group interventions can be broadly classified as follows-

• ART THERAPY
• AVERSION THERAPY
• RELAXATION THERAPY
• YOGA THERAPY
• REMINISCENCE THERAPY
• FAMILY THERAPY

Psychiatric Rehabilitation

The growing recognition that a large proportion of persons having schizophrenia and mood disorders experience long term disability with persisting symptoms or a relapsing course of illness episodes has given birth to the field of psychiatric rehabilitation.A chronic mental illness is an illness where the illness has got a long prognosis course.The incidence rate of major mental disorder in the world is 35 people out of 1 lakh, which needs rehabilitation.Out of this, 80% of the problems can be dealt with effectively.So psychiatric rehabilitation is a process, which helps the individual to find an alternative for hospitalization.
Psychiatric rehabilitation emphasizes continuous and indefinite treatment of life long disorders. It also emphasizes the maintenance of symptom control, prevention,reduction or relapses and optimization of performance by the chronically ill patients in social, vocational, educational and familial roles with the least amount of support necessary. Rehabilitation is a helping process wherein the client is motivated, facilitated and encouraged to develop his lost skills and develop his/her residual skills so as to become a functional member of the society. Rehabilitation plan is different for each individual for each individual depending on his type of illness, duration, socio-cultural factors, severity, family background, etc.Team work is one of the important factors in the process of rehabilitation. Team cooperation and coordination is very essential for the success of the rehabilitation programme.

Goals and Objectives

1. To help them to involve actively in the treatment decisions.
2. To achieve the highest feasible quality of life in the community.
3. Maximize the residual capacity of the patients

Types of Rehabilitation


Hospital based:- For the patients who are left alone by the family and people who belonged to the low strata of society or people in rural ares, there were no rehabilitation facilities.
 Long Term Hospitals:- The patient who cannot restore completely for long time through medication.
Quarter Way Homes:-Residual facilities available inside the hospital only. Here patients may not need acute medical cure but cannot be discharged because of the clinical conditions. The patients are kept only for a short time.
Community Based:-
Hostels:-Meant for a group of long-term patients, who do not require long-term hospital care but they cannot work in an unstructured environment.
Foster Care Homes:-For mental patients,who cannot be sent back home.
Non-Governmental Charitable Agencies:-This is the modified version of mental hospitals. The organization takes mentally ill patients and allow them to live in an institutional setup.
Short Stay Wards:-It is like the casualty in medical hospitals. They live like a family for a maximum period of one week.

Paranoid Schizophrenia

Paranoid schizophrenia is characterized by presence of delusions, hallucinations and other thought disturbances like thought withdrawal, thought broadcasting etc.

Hallucinations- patients report hearing voices, someone talking to them,  commonly  they say that voices speak bad about me, or I hear people talking, planning about me etc

Delusions- patients report that everyone is looking at me or, someone is looking at me in a particular manner etc, these are called as delusions of reference, the other delusion is delusion of persecution- someone is going to harm me, someone is going to kill me etc.

Thought Disturbances- patients report that everyone can know my thought as if they are broadcasted. They can also report insertion or withdrawal of thoughts, eg.  These thoughts are not mine someone is putting them in my head, or someone is taking away my thoughts.

There can be some bizarre ideation like: transmitters are fitted in the room, my thoughts are being said on the TV etc. They are all part of the symptomatic process.

They  usual  presentation of a patient is they the  patients is withdrawn from the society , stays in the house is fearful, suspicious ,  and  is unwilling to come out or work etc, they also don’t take  care  of themselves- not taking bath , not changing clothes etc. there can also  be increased use of nicotine-smoking,  tobacco etc.

Management- patients should be taken to the doctor acute management can involve: use of anti psychotics, electroconvulsive therapy and admission. Details of treatment of schizophrenia will be posted after all types.

Schizophrenia

Schizophrenia is disease which has quizzed and puzzled people for years. It is one of the major mental illnesses and has been seen in varied forms, from calling it split personality to going and calling someone mad (wandering mentally ill).

You must have seen characters suffering from schizophrenia, in movies like –

English: The Beautiful Mind, Through a Glass Darkly..

Hindi: Sangharsh, Kartik Calling Kartik, 15 Park Avenue, Who Lamhe

and marathi movies like: Devrai, Ratra Aarambh, ek cup chya..

Let’s try and understand Schizophrenia.

 

Schizophrenia is a term coined by Paul Eugen Bleuler (April 30, 1857 – July 15, 1939).

It was derived from the word schisms (meaning) he gave four major symptoms of schizophrenia:-

ambivalence- inability to decide  to  or fro,

autism- regression of though process,

association- abnormal thoughts, and

affect- restricted  emotional response

What’s causes schizophrenia is still unknown but we know that there is dopamine imbalance in the brain. There is also strong evidence to suggest that family history increases the chances of schizophrenia.

Schizophrenia is characteristsed by Delusions, Halluctions and thought disturbances. Lets understand what are these.. The person suffering can present with any or all of the following-

Delusions are false unshakeable beliefs, eg. people are planning to kill me.

There are various types of delusions like:-

Persecutory- people try to kill me,

Grandiose- I am prime minister of India,

Infidelity- my partner is having an affair,

Hallucinations- perception without sensory

Stimulus- hearing voices, seeing things

Thought disturbances- someone is taking away my thoughts, everybody can  know my thoughts, thoughts being broadcasted, someone is commanding /controlling me.

There are many types and presentations of schizophrenia will be belonging about each every day.

- Dr. Rohan Jahagirdar

MD (Psychiatry)

Pune.

Mobile: 93 724 16 491

Clinic: 020 - 3240 5770