by Brenda J. Crawford-Bee

For me, there is no one particular approach or technique in discovering how to become master of my spiritual destiny. As a matter of truth, I have not really mastered any one thing fully. Every day, every situation in some way is the same yet in some ways, different, so... What I have done though is become better in some things today and I was say, a couple of months ago, a year ago, 10 years ago or even a lifetime(s) ago. My reminder is, "A little progress in many areas is better than no progress in most."

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Therapy process research helps delineate common and specific elements essential to positive outcomes as well as develop best practice training protocols. Child involvement and therapist flexibility were rated in 63 anxious youth (ages 8-14) who received cognitive-behavioral therapy. Therapist flexibility, defined as therapist attempts to adapt treatment to a child's needs, was hypothesized to act as an engagement strategy that serves to increase child involvement during therapy. Flexibility was significantly related to increases in later child engagement, which subsequently predicted improvement in posttreatment diagnosis and impairment. Therapist flexibility was not associated with earlier measures of child engagement, so a mediation model could not be supported. It was also hypothesized that the impact of flexibility would be greatest for cases who began treatment highly disengaged (i.e., early involvement would moderate the effect of flexibility). Basic descriptive data supported this model, but formal analyses failed to confirm. Further descriptive analyses suggest therapists employ a range of adaptations and a profile of flexible applications within a manual-based treatment is provided. Treatment, measurement, and dissemination issues are discussed.

J Clin Psychol. 2009 Jul;65(7):736-54. Chu BC, Kendall PC. Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA. BrianChu@rci.Rutgers.edu

OBJECTIVE: The role of music therapy in psychiatric care in Australia is briefly traced from the early 1990s to the present. With the shift to community-based care, contemporary music therapy practice for the severely mentally ill is reappraised alongside the principles of the recovery model. CONCLUSIONS: Music therapy is a viable option within the creative arts therapies for enhancing quality of life in people with severe and enduring mental illness.

Australas Psychiatry. 2008 Dec;16(6):442-5. Grocke D, Bloch S, Castle D. National Music Therapy Research Unit, Faculty of Music, University of Melbourne, VIC, Australia. d.grocke@unimelb.edu.au

By Prof Tam Llewellyn-Edwards, PhD

Introduction

As the various 'new' Energy Therapies have developed we have seen a movement towards shorter more rapid versions of them. For instance, the original tapping method of BSFF developed into a faster non-tapping version of instant BSFF, and EFT developed into short form tapping and the standard tapping sequence was reduce by omitting the 9-Gamet part.

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Twenty-two patients with multiple sclerosis (MS) and chronic pain we recruited into a quasi-experimental trial comparing the effects of self-hypnosis training (HYP) with progressive muscle relaxation (PMR) on pain intensity and pain interference; 8 received HYP and the remaining 14 participants were randomly assigned to receive either HYP or PMR. HYP-condition participants reported significantly greater pre- to postsession as well as pre- to posttreatment decreases in pain and pain interference than PMR-condition participants, and gains were maintained at 3-month follow-up. Most of the participants in both conditions reported that they continued to use the skills they learned in treatment and experienced pain relief when they did so. General hypnotizability was not significantly related to treatment outcome, but treatment-outcome expectancy assessed before and after the first session was. The results support the efficacy of self-hypnosis training for the management of chronic pain in persons with MS.

Int J Clin Exp Hypn. 2009 Apr;57(2):198-221. Jensen MP, Barber J, Romano JM, Molton IR, Raichle KA, Osborne TL, Engel JM, Stoelb BL, Kraft GH, Patterson DR. University of Washington School of Medicine, Seattle, Washington 98195-6490, USA. mjensen@u.washington.edu

A computer aided method for closed tibial shaft fracture reduction based on measurements of 12 projection parameters (6 angulations and 6 translations) from an anteroposterior radiograph, a lateral radiograph, and a transverse projection photograph is examined. The development, validation and reliability of the computer aided method are presented. A custom-made unilateral external fixation device consisting of 7 calibrated one-degree-of-freedom joints was employed to execute the reduction. Five tibial fracture phantoms with initial deformities that covered a wide range of misalignments were tested. The mean (standard deviation) resultant rotational and translational errors after the reduction were 3.32 degrees (0.96 degrees ) and 1.65 (0.86) mm, respectively, which indicates good reduction accuracy. Three indFrelendent raters made the measurements of the projection parameters to test inter-rater reliability. The intra-class correlation coefficients were found to range between 0.935 and 1, indicating good reliability. Since ideal patient positioning for AP, lateral and transverse image acquisition is not easily attainable, the effect of patient positioning errors on the measurement of projection parameters was explored using a tibial phantom. The preliminary results revealed that 10 degrees deviations in positioning do not greatly affect the measurement of AP and lateral angulation parameters (<1.7 degrees ). However, a 10 degrees positioning error about the long bone axis may result in a change of as much as 10.7 degrees in the measurements of transverse projection angulation parameters. In addition, a 10 degrees positioning error about an arbitrary anatomical axis may result in translational projection parameter changes of up to 6.8 mm. For these reasons, a previously validated method that allows for accurate positioning of the tibia about its long axis and a two-step reduction strategy to achieve the best possible deformity reduction are proposed. Procedures to facilitate reliable measurement of tibial torsion are also discussed. It appears that the projection-based reduction method exposes the patient to less radiation and allows for simple, quick and accurate reductions, making it an attractive choice for acute clinical applications.

Comput Aided Surg. 2009 Jun 10:1-13. Koo TK Assistant Professor, Papuga MO. Foot Levelers Biomechanics Research Laboratory, Department of Research, New York Chiropractic College, Seneca Falls, New York.

INTRODUCTION: The primary aim of this study was to examine the role of patient characteristics in predicting response to treatment in a sample of HIV-positive patients receiving 12 weekly sessions of a CBT-based pain management protocol. METHOD: A pre/post test single group design was used. Pain-related functioning was assessed at baseline and 12 weeks post-treatment using the Pain Outcomes Questionnaire-VA. DATA ANALYSIS AND RESULTS: Multivariate regression analysis showed that higher baseline levels of pain-related anxiety were related to greater improvement in pain-related functioning at post-treatment, and non-Caucasian participants reported a greater response to treatment when compared to Caucasian participants. Attendance to CBT treatment sessions focused on progressive muscle relaxation and cognitive reconceptualization of pain were also related to treatment outcome. CONCLUSION: Non-Caucasian patients reporting higher levels of pain-related anxiety may respond particularly well to treatment. Treatment sessions focused on progressive muscle relaxation and cognitive reconceptualization of pain may be particularly helpful.

J Behav Med. 2009 Aug;32(4):340-8. Cucciare MA, Sorrell JT, Trafton JA. Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (152), Menlo Park, CA 94025, USA. cucciare@hotmail.com

by Bernie Siegel, MD

As doctors we are not trained to communicate and understand the power of our words as they relate to a patient's ability and desire to survive. It is also not only doctors but all the authority figures in our patient's lives that affect their ability to survive and the outcome of their disease. Parents, teachers, clergy and physicians change lives with their words. It is hypnotic for a child or patient to hear an authority figures words. As I am always sharing, wordswordswords can become swordswordswords and we can kill or cure with either words or swords.

Up to the age of six a child's brain wave pattern is similar to that of a hypnotized individual. To quote a woman, whose mother only gave her failure messages and dressed her in dark colors, and who as an adult has more trouble with her mother's words than she does with cancer. "My mother's words were eating away at me and maybe gave me cancer." We know from recent studies that loneliness affects the genes which control the immune system. So as doctors we need to ask the right questions and know what a patient has experienced and is experiencing in their lives. Can you imagine treating Christopher Reeve's wife for cancer without knowing her family history?

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Ligia obtained her B.A. from the University of Miami in Psychology and Religious Studies and a Masters Degree in Religious Studies and Gerontology from Florida International University. She also has a graduate certificate in Loss and Healing from St. Thomas University, a certificate in Thanatology and is a Fellow of the American Academy of Grief Counseling. Besides being a speaker, she is an author, coach, counselor and consultant. She is an adjunct professor of Kaplan University, Florida International University and Miami Dade College where she teaches courses on Ethics, Religion and Death and Dying.

For more information visit www.LigiaHouben.com

The study purpose was to test the effectiveness of a psychological intervention combining cognitive-behavioral therapy and hypnosis (CBTH) to treat radiotherapy-related fatigue. Design: Women (n = 42) scheduled for breast cancer radiotherapy were randomly assigned to receive standard medical care (SMC) (n = 20) or a CBTH intervention (n = 22) in addition to SMC. Participants assigned to receive CBTH met individually with a clinical psychologist. CBTH participants received training in hypnosis and CBT. Participants assigned to the SMC control condition did not meet with a study psychologist. Main Outcome Measures: Fatigue was measured on a weekly basis by using the fatigue subscale of the Functional Assessment of Chronic Illness Therapy (FACIT) and daily using visual analogue scales. Results: Multilevel modeling indicated that for weekly FACIT fatigue data, there was a significant effect of the CBTH intervention on the rate of change in fatigue (p < .05), such that on average, CBTH participants' fatigue did not increase over the course of treatment, whereas control group participants' fatigue increased linearly. Daily data corroborated the analyses of weekly data. Conclusion: The results suggest that CBTH is an effective means for controlling and potentially preventing fatigue in breast cancer radiotherapy patients. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Health Psychol. 2009 May;28(3):317-22. Montgomery GH, Kangas M, David D, Hallquist MN, Green S, Bovbjerg DH, Schnur JB. Department of Oncological Sciences, Mount Sinai School of Medicine.