Due to personality disorders recovery being paid much attention, we observe psychotherapy obtaining great importance in schizophrenics combination therapy. Successful adaptation to social functioning various conditions depends largely on psychological defence. An adequate reaction to disease and realistic attitude to treatment promote life upgrading.

The objectives of the research is to define the effectiveness of psychotherapy in connection of adaptive mechanism of the psychological defence.

The aims include the study of the correction possibilities of unadapted psychological mechanism with the help of psychotherapy.

We examined 53 patients with schizophrenic spectrum disorders. Used Positive and Negative Syndromes Scale (PANSS) to estimate patients clinical state, a test method TOBOL to diagnose attitude to disease. Psychological defence mechanisms were investigated by the help of enquirers FKBS, SBAK

We discovered that disease syntonic attitude increased noticeably (p < 0,05). Also we registered anxious, dysphoric and sensitive attitudes decrease (p < 0,041; p < 0,036; p < 0,05). There is a tendency to reduce anosognosic and anergic relationship towards disease (p < 0,053; p < 0,06).

These data indicate patients intention to estimate realistically their condition without over- or under- statements. We observe less anxiety, suspicion and dismay concerning catadromes, complications, ineffective treatment and mental activity increase.

After psychotherapy being applied, the maximum indices reduction was fixed in defence mechanisms such as: “against object”, “denial” (p < 0,05), “against the self’ appeal (p < 0,05), “social contacts avoidance” (p < 0,01). The symptoms investigation results prove that schizophrenics subjected to psychotherapy observe primitive defences tension decrease. All the validation, anxiety and self-aggression decrease.

This poster is aiming at presentation of program together with some data on effectiveness of intensive cognitive-behavior group psychotherapy (CBGT) for social phobia (SP) carried out in Center for Psychotherapy at the 2nd Department of Psychiatry Medical University of Warsaw. Intensive CBGT for social phobia has been conducted in Center for Psychotherapy for five years. Therapy lasts 12 weeks, five days a week, with two sessions each day. Therapeutic program consists of 4 modules: I. A standard cognitive therapy for SP based on Clark and Wells model (1986); II. A behavior module with primary focus on exposition and behavioral experiments; III. An interpersonal and assertiveness training and IV. Mindfulness training which focus on increasing mindfulness and acceptance skills and is based on MBCT and ACT exercises. Preliminary data on efficacy of the program carried out on 40 patients (17 F, 23 M) suffering from SP, reveled a significant reduction of SP and other neurotic symptoms, together with decreasing of depression and anxiety measures. What is interesting, we have found that intensive CBGT led to change in defense mechanisms, a concept belonging to a psychodynamic approach, with decrease in neurotic and immature mechanisms. In conclusion, intensive CBGT seems to be an effective treatment for SP, that changes not only symptoms but also some of the underlying dysfunctional personality mechanisms, but more studies with different methodologies are needed.

Bipolar disorder is a chronic, recurrent disorder, and its dysfunction has been correlated with poor outcomes and increased risk of recurrence. The main purpose of the family therapy model at issue is to prevent the bipolar patient against recurrent episode.

The focuses of the therapy sessions are on the apples drawn by the patient(DDAA), the patient, and the patient-parent relationship. Keywords are gathered from every participant during the therapy session. Besides, the subjects to have verbalized meaningful ideas or successful experiences are immediately, intensely praised by applause during the session. DAILY DRAW AN APPLE(DDAA) homework is that the patient has drawn an apple on a calendar everyday and shares with parents about the apple as well as the patient's feelings of the day. The participants of the family therapy are the patient, parents, and the therapists. The frequency of the model is once monthly. Each session consists of the 10 minutes pre-session, the 60 minutes family therapeutic session, and the 30 minutes post-session. It needs to be emphasized that the frequency of re-hospitalization definitely decreased after receiving therapy.

Finally, positive transference was demonstrated in the high attendance rate, in their excitement in receiving the applause, and in their collaboration in presenting the keywords. With the aid of the family therapy, they have been almost free from affective symptoms, and the hostile dependent tie with their parents having been steadily improved. To prevent the bipolar patient against recurrent episode has been achieved in the five cases family therapy presented here.

The aim of this investigation was to study the effectiveness of a combination of differentiated short-term psychotherapy and pharmacotherapy with antidepressants.

In many patients cognitive reconstruction helps to understand their problems in life and symptoms of stress or psychiatric disorders. Change in the thoughts and beliefs help them to feel better. But there are many patients who suffer with strong traumatic experiences deep in their mind and typically dissociate them or want to avoid them voluntarily. There is typical for patients suffering with dissociative disorders, borderline personality disorder and many people with various psychiatric disorders who were abused in childhood. The processing of the traumatic emotions from childhood can be helpful in the treatment of these patients. For the help is important:

• a) Understanding what was happen in childhood

• b) Making clear of repeated figures of maladaptive behaviors, mostly in interpersonal relations

• c) Making a connection between childhood experiences and here and now emotional reactions on various triggers

• d) Experiencing repeatedly the traumatic memories and elaborate them with imaginal coping.

We describe:

• - how to map and elaborate emotional schemas

• - Socratic questioning with the patients with traumatic memories

• - how to work with traumatic experiences from childhood in borderline personality disorder.

Supported by the research grant IGA MZ CR NS 10301-3/2009

Theme therapy is a new technique to prescribe art works, special musical peaces, which during several researches, were found three therapeutic musical themes: Relaxation Themes (Cognitive Themes), Mood-Making Themes (Emotional Themes) and Somatization Themes (Body Themes) (Joharifard, 2009).

In this investigation, were studied the effect of therapeutic musical themes and their presentation techniques (active and passive) on reducing anxiety.

96 students, were chose randomly from 386 anxious students, assigned to 8 groups (6 experimental groups and 2 control groups), and each group was measured two times, before investigation (as pretest) and after investigation (as posttest) during 6 weeks.

Data were calculated by description and deductive statistics, such as ANOVA and post-hoc tests. The findings suggested that, the relaxation theme with relaxation technique has been most effect on reducing anxiety. Also the effect of active presentation is more than the effect of passive music therapy on reducing anxiety.

This study assessed whether decrease in depressive symptoms after group psychodynamic psychotherapy was due to change in neuroticism score.

Patients were treated with group psychodynamic psychotherapy lasting 12 weeks. Every working day patients had 2 therapeutic sessions of 1,5 hour each. Personality trait neuroticism was measured with Eysenck Personality Questionnaire - Revised (EPQ-R), depressive symptoms with Depression Scale of Symptoms Checklist 90 - Revised (SCL-90-R) questionnaire.

Of 139 patients included in the study, 110 patients (79.1%) completed it. They were 37 men and 78 women, all with mean age of 34.25 years old. 64 patients were diagnosed with a neurotic disorder (ICD-10/F4), 28 with a personality disorder (F6), 15 with both a personality and a neurotic disorder and 3 with depression (F32) with personality disorder. In total 53 patients were on medication, mainly selective serotonin reuptake inhibitors.

Initial mean neuroticism score was 18.9, and after treatment it was 17.6. This difference is statistically significant as a change (t = 2.88, p = 0.005), but not as an independent mean value (t = 1.9, p = 0.06). Difference in severity of depressive symptoms is far more considerable: before treatment 2.08, after treatment 1.61, and it is statistically significant in comparison as dependent (t = 5.29, p = 0.000001), as well as independent (t = 3.53, p = 0.0005).

Looking at proportion of the change, neuroticism score dropped by 7%, whereas depressive symptoms score dropped by 22.6%. We can say that change of depressive symptoms severity is caused mainly by other factors than change in personality trait neuroticism score.

Group psychotherapy of paranoid patients implies gradualism in achieving therapeutic goals. Establishing reality is the first therapeutic goal, and acquiring insight and understanding of the current conflicts in the situation here-and-now connected with conflicts from the past in the situation there-and-then is the second one. Five Small psychotherapeutic groups of paranoid patients were included in our study. We measured the participation of the therapist's communications in group communication structure and the structure of the therapist's interventions. The therapist's communications in the group were determined using Bales’ category system. The therapist's interventions were determined according to the Scale of therapist's interventions. We made two measurements: at the beginning and after a period of two months. The total score of the therapists’ communications in the first measuring (38.2%) was significantly higher than in the second measuring (25.79%) (p < 0.01). In the structure of the therapists’ communications, a high level of the emotionally positive communications was maintained in the first (55.45%), as well as in the second measuring (41.17%). Explanations, clarifications and alternative solutions could be found in the beginning of the group therapist's interventions. The most frequent therapist's interventions in the second measurement were interpretations and confrontations. In the therapeutic process, members of the group were taught to observe communication and to search for its meaning together. The group responded to the reality of its world and defined reality for every single member. Communications brought new meanings to old experiences and enabled the acquisition of new experiences with meaning.

The purpose of this presentation is to familiarize the attendants with a systemic view of treatment of patients with alcohol problems. The systemic approach takes account of relational and interactional issues which gives a new understanding of alcohol use as a symptom.

There will be treated theoretical aspects of family transactions and constellations in alcoholic systems, showed how to investigate the systemic function of drinking and how to use this knowledge in therapy.

This systemic view of treatment for patients with alcohol problems offer a new perspective and new resources in our therapeutically approach, for all psychiatrists, not only for those who practice systemic family therapy.

The psychotherapeutic care in Ukraine is carried out in structure specialized psychiatric, psychoneurological and somatic hospitals and polyclinics of public health services. Since independence, Ukraine still has inefficient public health care system, with its unbalanced structure of services, especially in mental health care. In 2008 parameters of mental illness and disturbances of behavior was 243,3 per 100 thousand population and in comparison with 1990 decreased per 2,5%. Maximal parameters of mental illness and disturbances of behavior in 1995 consisted 263,1 per 100 thousand population. In structure of parameters of mental illness and disturbances of behavior, in 2008 (72,7 % or 176,1 per 100 thousand population) prevailed nonpsychotic. The basic organizational unit of the psychotherapeutic care is the cabinet of psychotherapy, which common number on 1.01.2009 year was 223, from them at the psychiatric network 134 (61 %), at the somatic - 89 (that makes about 39 %). The psychotherapeutic care is carried out within the limits of medical and psychological model. Thus since 1997 the speciality medical psychology and a staff of the doctor-psychologist is entered. From now on in a medical network medical psychologists with medical (85 person) and psychological (315 person) base education in parallel work. The psychotherapeutic network requires immediate expansion, especially in somatic treatment-and-prophylactic hospitals and polyclinics. The staff could be taken from psychiatrists after reduction psychiatric beds which would pass a training for a new profession on corresponding faculties and chairs of psychotherapy of postgraduate education organizations.

Self-perception, as a part of self - concept, is a form of perception where the object being observed and the observer are one and the same. The self-concept is a cognitive structure and it mediates between social structures and behavior. In group psychotherapy, a therapist's interventions are focused on the replacement of a false paranoid identity (where the overestimation of one's own intelligence is part of the false image one has of himself) with a real one. Six psychotherapeutic groups of paranoid patients were studied. The methodological procedure known as the analysis of relations was used. It is a combination of the sociometric questionnaire and the test of social perception. The degree of appropriateness of auto-perception of intelligence is evaluated. The determination of the auto-perception of intelligence was carried out by comparing real ranks (from the real IQ) and the ascribed ranks (on the basis of the selected positions where the patient marked his own intelligence to be). The results for all the groups are consistent: there is a definitive (both in terms of the number and the degree) overestimation of one's own intelligence. It can be found at the basis of the paranoid pathology expression where we find the parallel nature of the projection of the introject of the aggressor and the introject of narcissistic superiority, partially incorporated into the unreal self concept. Psychotherapy at this level of solidly fixated conceptual categorization with a “falsification” of perceptual data is of crucial importance for the “dissolution” of the paranoid state.

Animal assisted therapy (AAT) is being used increasingly for patients with syndromes not responding adequately to traditional therapies (severe stress/anxiety reactions, interpersonal deficits, limited verbal skills, trauma, and violence). Some have suggested that larger animals, such as horses, may be more effective therapy enhancers for some patients than commonly employed smaller animals. We have been developing an AAT protocol at a 500 bed state psychiatric hospital in NJ, supported by observations of dramatic functional improvement with equine facilitated therapy (EFT) in some highly regressed or violent patients. Logistic issues in establishing an equine program in a psychiatric hospital include site development, animal/therapist selection and training, safety and liability; scheduling, and hospital staff integration with the equine therapists. EFT technique modifications have addressed the needs and limitations of chronic, highly regressed or violent patients. A clinical research project comparing 10 weekly EFT and canine-facilitated (CFT) group sessions in >100 patients is nearing completion. The background, principles, and practices of EFT will be reviewed as will its relative benefits compared with AATs such as CFT.

Research findings will compare AAT groups and standard therapies with respect to psychological, behavioral, and functional outcomes (e.g., violent and regressed behaviors, hospital discharge). Clinical value vs costs, including unique benefits associated with AAT subtypes, will be presented.

Carl Rogers, one of the founders of humanistic approach in psychology, sees people as basically good and healthy. He considers mental health as the normal progression of life, and believes that mental illness and criminality are distortions of that natural tendency.

Rogers felt that a good therapist must have three very special qualities: Congruence, Empathy and Respect -- acceptance, unconditional positive regard towards the client. These qualities are “necessary and sufficient”.

We present the case of an 18-year-old adolescent with distressing thoughts of killing someone, a colleague or a family member, and compulsions like the wish to be restrained to the bad so that he couldn’t hurt someone. He was first diagnosed with premorbid symptoms of a psychotic disorder by a psychologist, and he was recommended to begin antipsychotic treatment. We subsequently diagnosed him with obsessive-compulsive disorder due to the fact that he felt repulsion and remorse for having these thoughts. He began the treatment with selective serotonin reuptake inhibitors and Rogersian therapy.

We intend to demonstrate that the lack of acceptance and unconditional positive regard as well as communication problems with the patient can interfere with giving the correct diagnose and decision of treatment.

“If I accept the other person as something fixed, already diagnosed and classified, already shaped by his past, then I am doing my part to confirm this limited hypothesis. If I accept him as a process of becoming, then I am doing what I can to confirm or make real his potentialities”, Carl Rogers.