Journal of clinical psychology
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Recent research suggests that entering an immersive virtual environment can serve as a powerful nonpharmacologic analgesic for severe burn pain. The present case study describes an attempt to use water-friendly virtual reality (VR) technology with a burn patient undergoing wound care in a hydrotherapy tub. ⋯ We believe that VR analgesia works by drawing attention away from the wound care, leaving less attention available to process incoming pain signals. The water-friendly VR helmet dramatically increases the number of patients with severe burns that could potentially be treated with VR (see http://www.vrpain.com).
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Although considerable research has been conducted on the efficacy of psychotherapy for depression, with and without medication, relatively few studies have focused on chronic forms of depression. Approximately 20% of individuals with depression experience episodes that last for two years or longer. ⋯ In chronic major depression, combined treatment has demonstrated significant superiority over medication or psychotherapy alone. Possible explanations for the discrepant findings among dysthymics and those with chronic major depression are discussed.
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A new 26-item self-report measure, the Pain Distress Inventory (PDI), was designed to assess affective distress symptoms related to physical pain. Phases 1 to 3 were designed to construct the PDI using contemporary test development strategies. Studies 1 and 2 were conducted to define and confirm the four-factor oblique structure of the PDI: PDI-Depression, PDI-Anger, PDI-Pain Sensitivity, and PDI-Somatic Anxiety. ⋯ Study 4 was designed to replicate previous findings of reliability and validity. The PDI total and scale scores were useful in differentiating between the responses of the clinic and nonclinic study participants. Limitations and potential uses of the PDI are discussed.
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Although cognitive-behavior therapy emphasizes between-session change, therapist self-disclosure within the session can be an effective tool for strengthening the therapeutic bond and facilitating client change. After noting the use of self-disclosure in other theoretical orientations, we place self-disclosure in the context of cognitive-behavioral theories of reinforcement and modeling. ⋯ Therapists need to observe appropriate boundaries when self-disclosing, and in particular, should consider their own motivations for self-disclosing. Although more research is needed on the effects of self-disclosure, cognitive-behavior therapists have found that self-disclosure can be a powerful intervention.
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Psychotherapists who work with the chronic illness tend to disregard their own self-care needs when focusing on the needs of clients. The article discusses the concept of compassion fatigue, a form of caregiver burnout among psychotherapists and contrasts it with simple burnout and countertransference. ⋯ The model also suggests that, to limit compassion stress, psychotherapists with chronic illness need to development methods for both enhancing satisfaction and learning to separate from the work emotionally and physically in order to feel renewed. A case study illustrates how to help someone with compassion fatigue.