Assessing the potential of submaximal extended duration exercise as an adjunct treatment for sub-acute schizophrenic in-patients: a pilot study
- Authors: Munnik, James Barry
- Date: 2006
- Subjects: Aerobic exercises -- Therapeutic use , Schizophrenia , Schizophrenia -- Treatment , Exercise therapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3029 , http://hdl.handle.net/10962/d1002538 , Aerobic exercises -- Therapeutic use , Schizophrenia , Schizophrenia -- Treatment , Exercise therapy
- Description: Research into the therapeutic potential of aerobic exercise has proven fruitful over the past few years; however, no true experimental research undertakings have investigated the psychological benefits of aerobic exercise with schizophrenic semi-acute in-patients. The main objective of this thesis was to seek out evidence for the possibility that aerobic (submaximal long duration) exercise could be considered an adjunct treatment for hospitalised schizophrenic in-patients. In order to accomplish this objective the effects of a 45-minute walking programme, completed three days a week, for five weeks, was investigated. Various areas of mental health were explored in search of evidence of the therapeutic potential of aerobic exercise. These areas included, amongst other things: transfer and discharge rates, improvements in mood levels - Beck Depression Inventory-II (BDI-II; Beck, Steer, and Brown, 1996) Xhosa version; decreasing of anxiety levels (Beck Anxiety Inventory (BAI; Beck and Steer, 1993), Xhosa version); improved Global Assessment of Functioning (GAF; DSM-IV), Scale Scores; and decreases in the number of symptoms patients exhibited. 22 schizophrenic inpatients were randomly selected for this study and randomly assigned to either an aerobic (long duration submaximal) treatment group or (primarily anaerobic) control group. Results revealed that statistical significance could not be found in any of the treatment group's t-test results; despite the treatment group generally bordering on significance more so than the control group. Out of the five variables studied (Positive Symptoms, Negative Symptoms, BAI, BDI-II, and GAF Scale) three variables (Negative Symptoms, BDI-II, and GAF Scale) in the treatment group bordered more on significance than did the control group. Thus three (60 %) out of the five areas studied revealed that the treatment group had more significant results. This suggests an overall impression that the treatment group responded slightly better. The Researcher recommended that aerobic exercise therapy be considered a treatment protocol in psychiatric institutions and offered further suggestions pertaining to the effective implementation of these programmes. Included in these recommendations were motivational strategies and warnings about the possible negative effects of exercise therapy. A supplemental goal of this thesis was to explore all of the previously offered theoretical psychological mechanisms of positive mental change; and to seek out evidence, for or against these forces. Participants were given pre- and post- treatment quantitative interviews; as well as, qualitative posttreatment interviews where their phenomenological responses were analysed to seek out evidence of these mechanisms. Evidence of various causative factors was found and a new theoretical mechanism was proposed in this thesis.
- Full Text:
- Authors: Munnik, James Barry
- Date: 2006
- Subjects: Aerobic exercises -- Therapeutic use , Schizophrenia , Schizophrenia -- Treatment , Exercise therapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3029 , http://hdl.handle.net/10962/d1002538 , Aerobic exercises -- Therapeutic use , Schizophrenia , Schizophrenia -- Treatment , Exercise therapy
- Description: Research into the therapeutic potential of aerobic exercise has proven fruitful over the past few years; however, no true experimental research undertakings have investigated the psychological benefits of aerobic exercise with schizophrenic semi-acute in-patients. The main objective of this thesis was to seek out evidence for the possibility that aerobic (submaximal long duration) exercise could be considered an adjunct treatment for hospitalised schizophrenic in-patients. In order to accomplish this objective the effects of a 45-minute walking programme, completed three days a week, for five weeks, was investigated. Various areas of mental health were explored in search of evidence of the therapeutic potential of aerobic exercise. These areas included, amongst other things: transfer and discharge rates, improvements in mood levels - Beck Depression Inventory-II (BDI-II; Beck, Steer, and Brown, 1996) Xhosa version; decreasing of anxiety levels (Beck Anxiety Inventory (BAI; Beck and Steer, 1993), Xhosa version); improved Global Assessment of Functioning (GAF; DSM-IV), Scale Scores; and decreases in the number of symptoms patients exhibited. 22 schizophrenic inpatients were randomly selected for this study and randomly assigned to either an aerobic (long duration submaximal) treatment group or (primarily anaerobic) control group. Results revealed that statistical significance could not be found in any of the treatment group's t-test results; despite the treatment group generally bordering on significance more so than the control group. Out of the five variables studied (Positive Symptoms, Negative Symptoms, BAI, BDI-II, and GAF Scale) three variables (Negative Symptoms, BDI-II, and GAF Scale) in the treatment group bordered more on significance than did the control group. Thus three (60 %) out of the five areas studied revealed that the treatment group had more significant results. This suggests an overall impression that the treatment group responded slightly better. The Researcher recommended that aerobic exercise therapy be considered a treatment protocol in psychiatric institutions and offered further suggestions pertaining to the effective implementation of these programmes. Included in these recommendations were motivational strategies and warnings about the possible negative effects of exercise therapy. A supplemental goal of this thesis was to explore all of the previously offered theoretical psychological mechanisms of positive mental change; and to seek out evidence, for or against these forces. Participants were given pre- and post- treatment quantitative interviews; as well as, qualitative posttreatment interviews where their phenomenological responses were analysed to seek out evidence of these mechanisms. Evidence of various causative factors was found and a new theoretical mechanism was proposed in this thesis.
- Full Text:
Difficulties in psychotherapy with a residual schizophrenic
- Authors: Schock, Sandra Lynn
- Date: 1991
- Subjects: Schizophrenics , Schizophrenia -- Treatment , Psychotherapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3149 , http://hdl.handle.net/10962/d1007457 , Schizophrenics , Schizophrenia -- Treatment , Psychotherapy
- Description: This work addresses some of the difficulties encountered while working in psychotherapy with a residual schizophrenic. While there is an abundance of literature on psychotherapy for schizophrenia, both supporting and also refuting its merit, what the literature fails to reveal is that there appears to be a class of schizophrenic who, while apsychotic and able to communicate in the everyday sense of the word, is in a psychic space which speaks of a break with the basic relational elements of the human order. The quality of the patient's psychic life is such that almost nothing of what the literature describes as useful and appropriate in working with schizophrenics seems to help in the psychotherapeutic work with this type of patient. This study describes these issues with relevance to a particular residual schizophrenic. The Illustrative-didactic case-study method was used to discuss the four-and- a-half month psychotherapy with this patient. The patient's early developmental history, premorbid personality functioning, family and interpersonal relationships, mental state, diagnosis and a rationale for psychotherapy were presented and considered in detail. The structure of the psychotherapeutic process was reviewed in depth. The hermeneutic guidelines to understanding the case were drawn from Object-Relations Psychoanalytic theory, particularly Balint, Khan, Karon & VandenBos, Bollas, Romanyshyn, Perry, Symington, Fordham and others. Various psychic and personality features, as unveiled through the psychotherapeutic process, were elaborated and the implications of these for the therapeutic endeavour were considered as follows: Firstly, the psychic space of the patient, which precluded mirroring, symbolization find object-relationship - and which made psychotherapy untenable, was discussed. Secondly, therapeutic ambivalence and other counter-transference issues were reviewed. Thirdly, the shadow sides of both therapeutic optimism and of psychotherapeutic change were considered. Fourthly, the issues of therapeutic failure and of other treatment possibilities for a residual schizophrenic patient were examined. It was concluded that there needs to be an important countertransference shift with regard to the psychotherapeutic goals for those patients whose condition may be chronic, and for whom it appears that psychotherapy is not going to be of any therapeutic benefit - find where an 'empathic accompaniment' might be as much as it is possible to hope for or achieve.
- Full Text:
- Authors: Schock, Sandra Lynn
- Date: 1991
- Subjects: Schizophrenics , Schizophrenia -- Treatment , Psychotherapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3149 , http://hdl.handle.net/10962/d1007457 , Schizophrenics , Schizophrenia -- Treatment , Psychotherapy
- Description: This work addresses some of the difficulties encountered while working in psychotherapy with a residual schizophrenic. While there is an abundance of literature on psychotherapy for schizophrenia, both supporting and also refuting its merit, what the literature fails to reveal is that there appears to be a class of schizophrenic who, while apsychotic and able to communicate in the everyday sense of the word, is in a psychic space which speaks of a break with the basic relational elements of the human order. The quality of the patient's psychic life is such that almost nothing of what the literature describes as useful and appropriate in working with schizophrenics seems to help in the psychotherapeutic work with this type of patient. This study describes these issues with relevance to a particular residual schizophrenic. The Illustrative-didactic case-study method was used to discuss the four-and- a-half month psychotherapy with this patient. The patient's early developmental history, premorbid personality functioning, family and interpersonal relationships, mental state, diagnosis and a rationale for psychotherapy were presented and considered in detail. The structure of the psychotherapeutic process was reviewed in depth. The hermeneutic guidelines to understanding the case were drawn from Object-Relations Psychoanalytic theory, particularly Balint, Khan, Karon & VandenBos, Bollas, Romanyshyn, Perry, Symington, Fordham and others. Various psychic and personality features, as unveiled through the psychotherapeutic process, were elaborated and the implications of these for the therapeutic endeavour were considered as follows: Firstly, the psychic space of the patient, which precluded mirroring, symbolization find object-relationship - and which made psychotherapy untenable, was discussed. Secondly, therapeutic ambivalence and other counter-transference issues were reviewed. Thirdly, the shadow sides of both therapeutic optimism and of psychotherapeutic change were considered. Fourthly, the issues of therapeutic failure and of other treatment possibilities for a residual schizophrenic patient were examined. It was concluded that there needs to be an important countertransference shift with regard to the psychotherapeutic goals for those patients whose condition may be chronic, and for whom it appears that psychotherapy is not going to be of any therapeutic benefit - find where an 'empathic accompaniment' might be as much as it is possible to hope for or achieve.
- Full Text:
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