Dissociation of the Personality and EMDR Therapy in Complex Trauma-Related Disorders: Applications in Phases 2 and 3 Treatment

2014 ◽  
Vol 8 (1) ◽  
pp. 33-48 ◽  
Author(s):  
Onno van der Hart ◽  
Mariëtte Groenendijk ◽  
Anabel Gonzalez ◽  
Dolores Mosquera ◽  
Roger Solomon
Keyword(s):  
Complex Trauma ◽  
Adaptive Functioning ◽  
Phase 1 ◽  
Skills Training ◽  
Phase 3 ◽  
Traumatic Memories ◽  
Structural Dissociation ◽  
Emdr Therapy ◽  
Phase Phase ◽  
Subsequent Integration

Eye movement desensitization and reprocessing (EMDR) psychotherapy can play a major role in phase-oriented treatment of complex trauma-related disorders. In terms of the theory of structural dissociation of the personality and its related psychology of action, a previous article described Phase 1 treatment—Stabilization, Symptom Reduction, and Skills Training—emphasizing the use of EMDR procedures in this phase. Phase 2 treatment mainly involves applications of EMDR processing in overcoming the phobia of traumatic memories and their subsequent integration. Phase 3 treatment focuses on further integration of the personality, which includes overcoming various phobias pertaining to adaptive functioning in daily life. This article emphasizes treatment approaches that assist therapists in incorporating EMDR protocols in Phases 2 and 3 of phase-oriented treatment without exceeding clients’ integrative capacity or window of tolerance.

Dissociation of the Personality in Complex Trauma-Related Disorders and EMDR: Theoretical Considerations

2010 ◽  
Vol 4 (2) ◽  
pp. 76-92 ◽  
Author(s):  
Onno van der Hart ◽  
Ellert R. S. Nijenhuis ◽  
Roger Solomon
Keyword(s):  
Complex Trauma ◽  
Daily Life ◽  
Borderline Personality ◽  
The Other ◽  
Dissociative Disorders ◽  
Motivational Systems ◽  
Traumatic Memories ◽  
Action Systems ◽  
Structural Dissociation ◽  
Theoretical Considerations

As eye movement desensitization and reprocessing (EMDR) has been increasingly applied in complex trauma-related disorders, including complex dissociative disorders, and trauma-related borderline personality disorder, EMDR practice may benefit from theories developed to account for the dissociative nature of these disorders, such as the theory of structural dissociation of the personality (TSDP). TSDP postulates that the personality of traumatized individuals is unduly divided in two basic types of dissociative subsystems or parts. One type involves dissociative parts primarily mediated by daily life action systems or motivational systems. The other type involves dissociative parts, fixated in traumatic memories, primarily mediated by the defense action system. The more severe and chronic the traumatization, the more dissociative parts can be expected to exist. This article presents the basics of TSDP, and a second article will provide guidelines for the treatment of complex trauma-related disorders based on this theory.

An Evidence-based Approach to Developing the Collaborative, Client-Centred Nutrition Education (3CNE) Framework and Practice Points

2016 ◽  
Vol 77 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Catherine Morley ◽  
Deborah MacLellan ◽  
Karol Traviss ◽  
Theresa Cividin
Keyword(s):  
Nutrition Education ◽  
Online Survey ◽  
Phase 1 ◽  
Phase 2 ◽  
Phase 3 ◽  
Progressive Development ◽  
Third Phase ◽  
Phase Study ◽  
Subsequent Phase ◽  
Phase Phase

Purpose: The purpose of this, the third phase of a 3-phase research project, was to develop guidelines for client-centred nutrition education (NE). Methods: A 3-phase study was conducted using a progressive development design, where each phase informed the subsequent phase. Phase 1 was a national online survey of dietitians’ perceptions of consumers’ NE needs and preferences; results informed the Phase 2 national online survey of consumers about their NE needs and preferences. Phase 3 involved national 2-part teleconference consultations with dietitians to discuss implications of the Phase 2 findings for NE practice. This paper is the report of Phase 3. Results: Discussion group participants were 22 dietitians from around Canada who had been in practice for an average of 14.5 years. Discussions resulted in the development of the Collaborative Client-Centred Nutrition Education (3CNE) conceptual framework and related Practice Points that explicate the complexity of NE practice. Conclusion: The 3CNE framework and Practice Points provide a means to inform precepting students and interns, and for use in planning for the professional development of practicing dietitians on providing client-centred NE.

Medical Maximizing-Minimizing Preferences Predict Responses to Information about Prostate-Specific Antigen Screening

2018 ◽  
Vol 38 (6) ◽  
pp. 708-718 ◽  
Author(s):  
Laura D. Scherer ◽  
Jeffrey T. Kullgren ◽  
Tanner Caverly ◽  
Aaron M. Scherer ◽  
Victoria A. Shaffer ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Online Survey ◽  
Phase 1 ◽  
Specific Antigen ◽  
Phase 3 ◽  
Psa Screening ◽  
Risks And Benefits ◽  
Screening Design ◽  
To Receive ◽  
Phase Phase

Purpose: The recently developed Medical Maximizer-Minimizer Scale (MMS) assesses individual differences in preferences for active v. passive medical treatment. We hypothesized that men’s maximizing-minimizing preferences might have relevance in the case of prostate-specific antigen (PSA) screening, since there is considerable variability in men’s preference for being screened even among men who are informed that harm is more likely than benefit. The current research examined whether MMS preferences predict how men respond to didactic information and narrative stories about PSA screening. Design: US men 40+ years old ( N = 1208) participated in an online survey. Men viewed information about PSA screening in 3 phases and provided their preference for screening after each phase. Phase 1 described what PSA screening is. Phase 2 added didactic information about screening risks and benefits. Phase 3 added narrative stories; men were randomized to receive stories about 1) physical harm, 2) emotional harm, 3) overdiagnosis, or 4) all 3 stories. Participants also completed the validated MMS. Results: After receiving basic information, 76.8% of men wanted PSA screening. After receiving information about risks and benefits, 54.8% wanted screening (a significant reduction, P < 0.001). Men who changed their preferences were significantly more likely to be minimizers than maximizers; most men with maximizing tendencies wanted screening after both the didactic information and narratives, whereas most men with minimizing tendencies did not want the test after receiving information. Conclusions: Men who prefer a more minimizing approach to medicine are more responsive to evidence supporting limiting or forgoing screening than men who prefer a maximizing approach.

scholarly journals Pelatihan Desain Pembelajaran dengan E-learning Berbasis LMS Moodle

2021 ◽  
Vol 1 (1) ◽  
pp. 34-40
Author(s):  
Parulian Silalahi ◽  
Charlota Agripina ◽  
Yang Agita
Keyword(s):  
Phase 1 ◽  
Phase 2 ◽  
Phase 3 ◽  
E Learning ◽  
Phase Phase

Tujuan dari pengabdian ini adalah untuk melatih guru agar memiliki pengetahuan dan keterampilan dalam mendesain dan mengembangkan pembelajaran dengan E-learning berbasis LMS Moodle. Pelatihan ini diberikan pada guru SMP Maria Goretti Sungailiat Bangka. Metode pelaksanaan pengabdian dilakukan dengan tiga phase: phase 1. persiapan; phase 2. pelaksanaan; dan phase 3. Evaluasi. Pelaksanaan pengabdian dilakukan secara tatap muka dan daring. Melalui tatap muka pelatihan diberikan dengan ceramah dan demonstrasi yang diselenggarakan selama 3 kali pertemuan pada bulan Juli 2020 dengan jumlah yang guru yang ikut dalam pelatihan ini sebanyak 10 orang. Secara daring diberikan dengan menggunakan aplikasi Moodle..  Hasil pelatihan menunjukkan bahwa pengetahuan dan keterampilan guru dalam mendesain dan mengembangkan pembelajaran menggunakan aplikasi E-learning LMS Moodle meningkat. Selanjutnya dari aplikasi Moodle yang telah dikembangkan oleh pengabdi untuk pembelajaran yang diberikan guru kepada siswa, dapat  diterapkan dengan baik.  

Dissociation of the Personality and EMDR Therapy in Complex Trauma-Related Disorders: Applications in the Stabilization Phase

2013 ◽  
Vol 7 (2) ◽  
pp. 81-94 ◽  
Author(s):  
Onno van der Hart ◽  
Mariëtte Groenendijk ◽  
Anabel Gonzalez ◽  
Dolores Mosquera ◽  
Roger Solomon
Keyword(s):  
Complex Trauma ◽  
Treatment Plan ◽  
Traumatic Memories ◽  
Stabilization Phase ◽  
Extended Application ◽  
Wide Range ◽  
Preparatory Phase ◽  
Preparation Phase ◽  
Structural Dissociation ◽  
Maladaptive Beliefs

As proposed in a previous article in this journal, eye movement desensitization and reprocessing (EMDR) clinicians treating clients with complex trauma-related disorders may benefit from knowing and applying the theory of structural dissociation of the personality (TSDP) and its accompanying psychology of action. TSDP postulates that dissociation of the personality is the main feature of traumatization and a wide range of trauma-related disorders from simple posttraumatic stress disorder (PTSD) to dissociative identity disorder (DID). The theory may help EMDR therapists to develop a comprehensive map for understanding the problems of clients with complex trauma-related disorders and to formulate and carry out a treatment plan. The expert consensus model in complex trauma is phase-oriented treatment in which a stabilization and preparation phase precedes the treatment of traumatic memories. This article focuses on the initial stabilization and preparatory phase, which is very important to safely and effectively use EMDR in treating complex trauma. Central themes are (a) working with maladaptive beliefs, (b) overcoming dissociative phobias, and © an extended application of resourcing.

PENERAPAN MODEL QUANTUM LEARNING UNTUK MENINGKATKAN HASIL BELAJAR AUTOCAD SISWA KELAS X TEKNIK PEMESINAN SMK NEGERI 1 STABAT

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Abdul Hasan Saragih
Keyword(s):  
Positive Response ◽  
Phase 1 ◽  
First Grade ◽  
Learning Model ◽  
Second Phase ◽  
Phase 2 ◽  
Phase 3 ◽  
The Third ◽  
Third Phase ◽  
Quantum Learning

This classroom research was conducted on the autocad instructions to the first grade of mechinary class of SMK Negeri 1 Stabat aiming at : (1) improving the student’ archievementon autocad instructional to the student of mechinary architecture class of SMK Negeri 1 Stabat, (2) applying Quantum Learning Model to the students of mechinary class of SMK Negeri 1 Stabat, arising the positive response to autocad subject by applying Quantum Learning Model of the students of mechinary class of SMK Negeri 1 Stabat. The result shows that (1) by applying quantum learning model, the students’ achievement improves significantly. The improvement ofthe achievement of the 34 students is very satisfactory; on the first phase, 27 students passed (70.59%), 10 students failed (29.41%). On the second phase 27 students (79.41%) passed and 7 students (20.59%) failed. On the third phase 30 students (88.24%) passed and 4 students (11.76%) failed. The application of quantum learning model in SMK Negeri 1 Stabat proved satisfying. This was visible from the activeness of the students from phase 1 to 3. The activeness average of the students was 74.31% on phase 1,81.35% on phase 2, and 83.63% on phase 3. (3) The application of the quantum learning model on teaching autocad was very positively welcome by the students of mechinary class of SMK Negeri 1 Stabat. On phase 1 the improvement was 81.53% . It improved to 86.15% on phase 3. Therefore, The improvement ofstudent’ response can be categorized good.

Clinical Drug Development for the Treatment of Pulmonary Arterial Hypertension: Collaboration With the Pharmaceutical Industry and Regulatory Agencies

2010 ◽  
Vol 9 (4) ◽  
pp. 214-219
Author(s):  
Robyn J. Barst
Keyword(s):  
Clinical Trials ◽  
Pulmonary Arterial Hypertension ◽  
Drug Development ◽  
Phase 1 ◽  
Preclinical Studies ◽  
Phase 2 ◽  
Phase 3 ◽  
Preclinical Testing ◽  
New Drug ◽  
Pulmonary Arterial

Drug development is the entire process of introducing a new drug to the market. It involves drug discovery, screening, preclinical testing, an Investigational New Drug (IND) application in the US or a Clinical Trial Application (CTA) in the EU, phase 1–3 clinical trials, a New Drug Application (NDA), Food and Drug Administration (FDA) review and approval, and postapproval studies required for continuing safety evaluation. Preclinical testing assesses safety and biologic activity, phase 1 determines safety and dosage, phase 2 evaluates efficacy and side effects, and phase 3 confirms efficacy and monitors adverse effects in a larger number of patients. Postapproval studies provide additional postmarketing data. On average, it takes 15 years from preclinical studies to regulatory approval by the FDA: about 3.5–6.5 years for preclinical, 1–1.5 years for phase 1, 2 years for phase 2, 3–3.5 years for phase 3, and 1.5–2.5 years for filing the NDA and completing the FDA review process. Of approximately 5000 compounds evaluated in preclinical studies, about 5 compounds enter clinical trials, and 1 compound is approved (Tufts Center for the Study of Drug Development, 2011). Most drug development programs include approximately 35–40 phase 1 studies, 15 phase 2 studies, and 3–5 pivotal trials with more than 5000 patients enrolled. Thus, to produce safe and effective drugs in a regulated environment is a highly complex process. Against this backdrop, what is the best way to develop drugs for pulmonary arterial hypertension (PAH), an orphan disease often rapidly fatal within several years of diagnosis and in which spontaneous regression does not occur?

scholarly journals How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041743
Author(s):  
Christina Østervang ◽  
Annmarie Touborg Lassen ◽  
Charlotte Myhre Jensen ◽  
Elisabeth Coyne ◽  
Karin Brochstedt Dieperink
Keyword(s):  
Patient Outcomes ◽  
Participatory Design ◽  
Hospital Admissions ◽  
Phase 1 ◽  
Family Needs ◽  
Focus Group Interviews ◽  
Phase 3 ◽  
Ace Study ◽  
Group Interviews ◽  
Improve Patient

IntroductionThe development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient’s and family’s ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.Methods and analysisThe study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.Ethics and disseminationThe study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000–111). Findings will be published in suitable international journals and disseminated through conferences.

scholarly journals PSVI-3 Dietary supplementation with coated omega-3 fatty acids has positive effects on growth performance and nutrients digestibility in weaned pigs

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 196-197
Author(s):  
Woo Jung Seok ◽  
Je min Ahn ◽  
Jing Hu ◽  
Dexin Dang ◽  
Yanjiao Li ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Growth Performance ◽  
Phase 1 ◽  
Dietary Supplementation ◽  
Basal Diet ◽  
Phase 2 ◽  
Omega 3 ◽  
Phase 3 ◽  
Linear Effect ◽  
Weaning Pigs

Abstract The objective of this study was to evaluate the effects of dietary supplementation of coated omega-3 fatty acid (n-3 CFA) by corn cob power silica on performance of weaning pigs. A total of 200 weaned pigs [(Landrace x Yorkshire) x Duroc, average initial body weight at 6.97 ± 1.22 kg] were randomly assigned to four experimental treatments in a 6-week experiment in 3 phases as follows: CON, basal diet; 2) 0.3CFA, CON + phase 1(0.3% n-3CFA), phase 2(0.2% n-3CFA), phase 3(0.1% n-3CFA); 3) 0.6CFA, CON + phase 1(0.6% n-3CFA), phase 2(0.4% n-3CFA), phase 3(0.2% n-3CFA); 4) 0.9CFA, CON + phase 1(0.9% n-3CFA), phase 2(0.6% n-3CFA), phase 3 (0.3% n-3CFA). Each treatment had 10 replicates with 5 pigs (three gilts and two barrows) per replicate. The data were analyzed using the GLM procedure of SAS as a randomized complete block design. Pen served as the experimental unit. Linear, quadratic and cubic polynomial contrasts were used to examine effect of dietary treatment with coated n-3FA in the basal diet. Variability in the data was expressed as the standard error of means and P&lt; 0.05 was considered to statistically significant. Increasing the level of n-3CFA in the diet linearly increased ADG and G/F of pigs (Table 1). Increasing the level of n-3CFA showed a linear increment in the digestibility of DM (83.59, 84.38, 85.13, 85.89 %) whereas nitrogen digestibility (81.79, 82.38, 82.96, 83.64 %) showed a trend (linear effect, p=0.0594) at the end of experiment. The fecal lactobacillus count was increased (7.22, 7.27, 7.33, 7.35 log10cfu/g) with the increase in the supplemental level of n-3CFA (linear effect; p&lt; 0.05). However, there were no differences in the concentration of serum haptoglobin, or fecal E. coli, Clostridium and Salmonella counts despite the increase in n-3CFA levels in the diet. Supplementation of the diet with coated n-3 fatty acids positively affected growth performance and digestibility of dry matter and nitrogen, and enhanced the count of lactobacillus in weaning pigs.

165 Effects of Digestible Lysine Level on Growth Performance and Economics of Grow-finish Pigs

2021 ◽  
Vol 99 (Supplement_1) ◽  
pp. 58-59
Author(s):  
Larissa L Becker ◽  
Emily E Scholtz ◽  
Joel M DeRouchey ◽  
Mike D Tokach ◽  
Jason C Woodworth ◽  
...  
Keyword(s):  
Phase 1 ◽  
Information Criterion ◽  
Response Curves ◽  
Phase 3 ◽  
Ileal Digestibility ◽  
Distillers Dried Grains ◽  
Feed Cost ◽  
Best Fitting ◽  
Dietary Treatments ◽  
Fitting Model

Abstract A total of 2,124 barrows and gilts (PIC 1050′DNA 600, initially 48.9 kg) were used in a 32-d study to determine the optimal dietary standardized ileal digestibility (SID) Lys level in a commercial setting. Pigs were randomly allotted to 1 of 5 dietary treatments with 24 to 27 pigs/pen and 16 replications/treatment. Similar number of barrows and gilts were placed in each pen. Diets were fed over 3 phases (48.9 to 58.6, 58.6 to 70.9, and 70.9 to 80.8 kg respectively). Dietary treatments were corn-soybean meal-based and contained 10 (phase 1 and 2) or 5% (phase 3) distillers dried grains with solubles. Diets were formulated to 85, 95, 103, 110, or 120% of the current Pig Improvement Company (PIC, Hendersonville, TN) SID Lys gilt recommendations with phase 1 SID Lys levels of 0.90, 1.01, 1.09, 1.17 and 1.27%, phase 2 levels of 0.79, 0.87, 0.94, 1.03, and 1.10%, and phase 3 levels of 0.71, 0.78, 0.85, 0.92, and 0.99%, respectively. Dose response curves were evaluated using linear (LM), quadratic polynomial (QP), broken-line linear (BLL), and broken-line quadratic (BLQ) models. For each response variable, the best-fitting model was selected using the Bayesian information criterion. Overall (d 0 to 32), increasing SID Lys increased (linear, P&lt; 0.001) BW, ADG, G:F, Lys intake/d, and Lys intake/kg of gain. Modeling margin over feed cost (MOFC), BLL and QP estimated the requirement at 105.8% and 113.7% respectively. In summary, while growth increased linearly up to 120% of the PIC current feeding level, the optimal MOFC was 106% to 114% depending on the model used.

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