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1/4. 'Coming out' with Alzheimer's disease: changes in awareness during a psychotherapy group for people with dementia.

    This paper forms part of the second phase of a project looking at those changes that occurred for participants during a series of time-limited psychotherapy groups for people with dementia. Using the Assimilation of Problematic Experiences Scale (APES), the accounts of one participant (Robert) are analyzed across the course of the group. Robert moves from a position in which he wards off awareness that he has dementia of the Alzheimer's type, to being able to joke about having brain changes that are symptomatic of the illness. This change in his discourse about Alzheimer's disease was accompanied by an increase in Robert's levels of affect. However, reflecting on the changes that had occurred for him, Robert commented that before he came to the group he had been frightened, thinking that 'I'm going crazy?...?what am I going to be like in another five years?'. For Robert, coming to the group had meant that this fear had been replaced by the knowledge that he was not alone. In the light of the move towards early diagnosis, the importance of this model of change in awareness as a means of increasing understanding of the process of emotional development is discussed.'...?but I think that a lot of people who I have met who have come out about Alzheimer's were quite shocked because I said that. It did help, it may not have helped others, but I suppose that it helps overcome a feeling of being different.'Janet, session six.
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ranking = 1
keywords = psychotherapy
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2/4. Opportunities for psychotherapy in the management of dementia.

    Demented patients are not usually thought of as candidates for psychotherapy due to their impaired memory, general intellectual decline, and waning ability to use insight. Families often accede to this view by perceiving their dementing relatives as unable to handle emotion-laden issues. This paper will illustrate with clinical examples that many dementing patients can benefit from psychotherapy. Practical suggestions will be outlined for integrating a psychotherapeutic approach into the management of dementia patients and their caregiving family members. The format of this paper will begin with suggested techniques for the initial interview, followed by separate consideration of psychotherapy issues in dementing patients and in caregiving family members.
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ranking = 1.4
keywords = psychotherapy
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3/4. Significance of premorbid adjustment and psychotherapy in selected case studies.

    Although psychiatric symptoms are common among elderly individuals, these symptoms are seldom treated by psychotherapy. This article proposes a model to help explain genesis of psychiatric symptoms in late life. The model, which is illustrated by case examples, suggests psychotherapeutic strategies and helps define methods of assessing therapeutic outcomes. The model emphasizes the importance of losses, premorbid adjustment, and mediating factors in determining whether stresses result in adaptation or symptom formation.
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ranking = 1
keywords = psychotherapy
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4/4. mental health issues in the elderly.

    A practical, clinical approach to the diagnosis of depression in the elderly is described, and guidelines are suggested for treatment of depression by pharmacotherapy, electroconvulsive therapy, and psychotherapy, Clinical dementia is reversible in one-fifth of elderly patients with this disorder. For those with irreversible dementias management of the environment and pharmacotherapy are recommended.
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ranking = 0.2
keywords = psychotherapy
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