1.Therapeutic Factors in the Long-Term Outpatient Group Psychotherapy with the Chronically Mentally Ill.
Hoo Kyeong LEE ; Sun Young LEE ; Sung Chul YOON ; Hyun Joo AHN
Journal of Korean Neuropsychiatric Association 2000;39(3):556-570
OBJECTIVES: The long-term outpatient group psychotherapy with the chronically ill is an effective, expedient therapeutic modality that makes patients maintain medication and improve their symptoms, helps patients resolve emotional conflict, and corrects their maladaptive interpersonal relationship. Therefore, we performed weekly the semi-opened, heterogeneous, long-term(open-ended), outpatient group psychotherapy to be applicable effectively for the chronically ill. The objectives of this study are as follows; first, we introduce therapeutic principles and management methods of the group psychotherapy to be applicable in the clinical environment with the chronically ill; second, we examine the therapeutic factors in each group development stage which are helped by participants, and analyze the characteristics showed in the process of study; third, we verify the appropriateness and the validity of this group psychotherapy and then establish the base of the effective long-term outpatient therapy for the chronically ill that will be settled down as a applicable treatment modality economically and efficiently in the present medical environment of Korea. METHODS: This study was performed in the subject of the chronically ill who attended at the day care program of Community Mental Health Center in Hanam city from January 1998 to June 1999. The participants were 27 patients, but we dropped 7 patients who attended under 6 months because of long-term group. So the last subjects were 20 patients (12 males and 8 females) who attended for 18 months. The 13 therapeutic factors scale was filled out by participants just after each session and the self-report total assessment questionnaire was performed at the time of study-termination and patient-termiation. RESULTS: The ranks of 13 therapeutic factors scale are as follows: in the forming stage, the upper ranks of therapeutic factors were existential factor, guidance of therapists, instillation of hope, altruism, and catharsis in order. And in the storming stage, the upper ranks of therapeutic factors were existential factor, instillation of hope, guidance of therapists, catharsis, and group cohesiveness in order. Lastly in the norming stage, the upper ranks of therapeutic factors were existential factor, altruism, corrective recapitulation, interpersonal learning, and catharsis in order. According to the total assessment questionnaire about group psychotherapy reported by the participants 90% of them were helped, 80% of them had an idea to recommend this program to other patients actively, and 75% of them had an opinion to attend again this program if given for them. And they evaluated positively about the structure of this program and the therapist. CONCLUSIONS: The long-term outpatient group psychotherapy would be applicable effectively to the chronically ill as a economic, efficient therapeutic modality for rehabilitation. It is much more effective for therapist to perceive in detail the therapeutic factors in each group develop-ment stage when he perfoms the group psychotherapy.
Altruism
;
Catharsis
;
Chronic Disease
;
Day Care, Medical
;
Gyeonggi-do
;
Hope
;
Humans
;
Korea
;
Learning
;
Male
;
Mental Health
;
Mentally Ill Persons*
;
Outpatients*
;
Psychotherapy, Group*
;
Surveys and Questionnaires
;
Rehabilitation
2.Therapeutic Factors in Large Group Psychodrama with Delinquent Adolescents.
Hoo Kyeong LEE ; Ji Eun HYUN ; Sung Chul YOON ; Sun Jae KIM
Journal of Korean Neuropsychiatric Association 2000;39(6):1023-1035
OBJECTIVES: This study is designed to develop a large group phychodrama for light delin-quent adolescents (hereinafter called as "Psychodrama") thereby determining therapeutic factors for dealing with them. METHODS: The study was conducted in the program of Seoul Metropolitan Youth Centre called "the class of love" during the period of July through December, 1998. The subjects consisted of a total of 827 young delinquents (759 boys and 68 girls, with the average age of 15.9 years old). To develop "this psychodrama", after we composed of therapeutic team centered by psychiatrists, we prepared from January to June, 1998 by practicing psychodrama with delinquent adolescents and by analyzing the results. "This psychodrama" has three basic steps: (1) warming-up (small group me-eting), (2) action (situation drama and main drama), (3) sharing. A survey of treatments, from a pool of participating adolescents, based on evaluation sheets and 13 therapeutic factors scale followed every session of this psychodrama. RESULTS: "This psychodrama" was helpful for 47.4%, interesting for 49.2%, not helpful for 12.1% and not interesting for 16%. In the whole group of subjects, the important therapeutic factors were existential factor, universality, identification with the therapist and the instillation of hope in the order of rank. When categorized in four different groups (audience, participants in situation drama, auxiliary egos, participants in sharing) the 4 groups displayed different results to one another. First, the therapeutic factors of audience were similar to that of the whole group. Second, participants in situation drama showed a higher catharsis than others. Third, auxiliary egos were leading in the guidance of members and therapists. Fourth, participants in sharing displayed higher group cohesiveness. CONCLUSION: As it is getting harder to find program's suitable for the treatment of increasing number of delinquents due to limited budget and experts, this psychodrama could be more cost-effective than any other measures.
Adolescent*
;
Budgets
;
Catharsis
;
Drama
;
Ego
;
Female
;
Hope
;
Humans
;
Psychiatry
;
Psychodrama*
;
Seoul
3.A Survey of Adolescent Substance Uses in a Small City.
Hoo Kyeong LEE ; Sun Jae KIM ; Sung Chul YOON ; Soo Yun BONG ; Hyun Joo AHN ; Sun Yong PARK
Journal of Korean Neuropsychiatric Association 2001;40(1):23-36
OBJECTIVES: The purpose of this research is to help solve adolescent issues involving substance uses, which may become begin to undergo many changes(i. e. practising various roles, thereby leading to independent life styles). More often than not, adolescent drug problems develop into social problems, chiefly behavioral imitations and heavy dependence on medicine. The authors conducted a survey of adolescent substance uses to develop preventive measures against the drug habit prevalent among young people, thereby formulating a policy to deal with problematic community. Funded by a Youth Counselling Center in the city of H. the research was conducted on the following assumptions that there will be:Firstly, a comparison of drug uses by sex and age:Secondly, variance of substance users by family background and peer group:Thirdly, a combination of heavy drinking, smoking and delinquency resulting in the drug habit. METHODS: The survey included a total of 1613 students during 3 days, 12 through 14, July, 1999. The subjects were 833 pupils(51.6%) from 4 middle schools and 780 students(48.4%) from 3 high schools in the city of H with a ratio of 49.5 %(males) and 50.5%(females). RESULTS: 1) Experience of substance use is most referable to drinking(59.4%) and smoking(34.4%) while given to analgesics(33.1%) among medicines, glue(0.7%) among inhalants and philophone(0.4%) among narcotics. 2) High school students found more than double the amount of smoking and drinking as well as uses of hypnotics, stimulants and sedatives by junior high school students. 3) Our resalt showed was significantly noted that non-users had a better relationship with their parents than most users. 4) Smoking and drinking problean could be more easily developing into adolescent substance uses. 5) Alcohol, cigarette, and drug users showed more misconducts than other adolescents. 6) Most adolescents believe that drinking is necessary for making friends(55.0%), while smoking is just for killing time(50.9%). 7) Drinking, smoking, and other substance users were found to develop into more problematic habits. CONCLUSION: The present survey and several others show that adolescent substance uses in Korea are on the rise. Therefore, extensive counter-measures will be necessary followed by nationwide epidemiological survey of the pending issue, with the psychiatrists participating in the campaign.
Adolescent*
;
Drinking
;
Drug Users
;
Financial Management
;
Homicide
;
Humans
;
Hypnotics and Sedatives
;
Korea
;
Narcotics
;
Parents
;
Psychiatry
;
Smoke
;
Smoking
;
Social Problems
;
Tobacco Products
4.Therapeutic Factors in the Outpatient Group Psychotherapy for the Adolescents with Conduct Disorder.
Hoo Kyeong LEE ; Sun Jae KIM ; Jeong Wha CHA ; Soo Yun BONG ; Hyun Joo AHN
Journal of Korean Neuropsychiatric Association 2000;39(2):309-322
OBJECTIVES: Group psychotherapy is known to be an effective treatment program for adolescents who attach importance to peer relationship, but it is not activated in Korea. Therefore, researchers performed weekly the closed, homogeneous, time-limited (10 sessions), outpatient group psychotherapy for adolescents with conduct disorder. Objectives of this study were as follows: first, we practiced the group psychotherapy for adolescents with conduct disorder and evaluated its effectiveness: second, we examined the therapeutic factors which were used by participants: third, we intended to settlee down the group psychotherapy for adolescents with CD as an effective and efficient treatment modality. METHODS: This study was performed two times from October to December in 1998 and from April to June in 1999. It was sponsored by Youth Counselling Center in H city. The case group were composed of 15 female students who were second grade in H high school, and 4 students were dropped out. The control group were composed of 18 female students who were same grade in H high school and 3 students were dropped out. Before and after this program, self-report delinquency scale, aggression scale and impulsivity scale were asked to them. And just after each session, Yalom 13 therapeutic factors scale and satisfaction questionnaire for group psychotherapy were asked to them. And at last meeting, total assessment questionnaire was asked to them. RESULTS: We compared the change of therapeutic factors between the former half sessions(1-5) and the later half sessions (6-10), and the results were as follows: in the former half, the upper ranks of therapeutic factors were existential factor, universality, catharsis, identification with leader, and identification with members in order. And in the later half, the upper ranks of therapeutic factors were catharsis, existential factor, identification with leader, identification with members, and guidance of members in order. The rank of catharsis and guidance of members went upward and the rank of universality went downward when we compared the ranks in the former half to those in the later half. Altruism and family enactment were the lowest ranked in both half. The satisfaction questionnaire for group psychotherapy showed to be helped by participants at the rate of 45.7% in former half, 83.3% in later half. The total assessment questionnaire showed the willingness of re-participation at the rate of 85.7% if future opportunity of group psychotherapy is given for them. CONCLUSIONS: The time-limited group psychotherapy for adolescents diagnosed by conduct disorder was very effectively practiced and the participants reported high level of the satisfaction. The outpatient group psychotherapy for adolescents would be expanded and practiced though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.
Adolescent*
;
Aggression
;
Altruism
;
Catharsis
;
Conduct Disorder*
;
Female
;
Humans
;
Impulsive Behavior
;
Korea
;
Motivation
;
Outpatients*
;
Psychotherapy, Group*
;
Surveys and Questionnaires
5.Effects of Interpersonal Group Therapy for Adolescents with Behavioral Problems.
Hoo Kyeong LEE ; Hyun Joo AHN ; Sun jae KIM ; Sung Chul YOON ; Soo Yun BONG
Journal of Korean Neuropsychiatric Association 2003;42(5):608-620
OBJECTIVES: Fast change and confusion of the value system in society affect the identity formation of adolescents. So Adolescents' behavioral problems seem to be increasing yearly. It is known that the interpersonal group therapy is the most effective treatment modality among many group programs for adolescents with behavioral problems. Objectives of this study are as follows; first, evaluate therapeutic effects of the interpersonal group therapy for adolescents with behavioral problems second, examine the therapeutic factors; third, analyze the group process; fourth, orgamize the group therapy for adolescents with behavioral problems as an applicable treatment modality. The types of group therapy performed in this study are small, closed, homogeneous, outpatient, time limited, and adolescent group. METHODS: This study was carried out at one of the adolescents mental health services in Uiwang Mental Health Center, from April to June and from September to November in 2000. The subjects were 2nd grade students in K middle school with behavioral proplems. The experimental groups were composed of 4 groups including 2 male groups and 2 female groups (male 11, female 17), and the control groups matched the same conditions as the experimental groups (male 10, female 19). The group therapy was performed weekly in CA (club activity) time, and it took 60-70 minutes at one time. They met total 10 sessions including preparatory meeting and termination meeting. Before and after this program, self-rating scales (behavioral problems, aggression, and impulsivity) were applied for subjects, and the teacher rating scales (behavioral problems, aggression and impulsivity) were performed by teachers in charge. After each session, Yalom's 13 therapeutic factors scale was performed. At the last meeting, total assessment questionnaire was completed. RESULTS: The mean scores of all self-rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) than the control groups, but not significant statistically except the behavioral problem scale of female students. The mean scores of all teacher rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) in comparison with the control groups, all significant statistically. As faras the therapeutic factors are concerned; first, the mean scores of all therapeutic factors in female students were higher than in male students and the mean scores of all therapeutic factors in the later half sessions were higher than the former half sessions; second, catharsis and existential factor were high in all students and sessions; third, identification with therapist factor was high in all students and sessions; fourth, during the later half sessions, interpersonal input was relatively high in male students and socializing technique was relatively high in female students. Its for the total assessment questionnaires; 100% of male students and 88.2% of female students reported that they were helped by this group therapy; 100% of male students and 82.4% of female students reported that they would participate willingly if future opportunity of the same group therapy is given for them. CONCLUSION: Adolescents with behavioral problems who participated in this study showed the decrease of behavioral problems and the change of aggressive and impulsive attitudes in comparison with the control groups although they had some differences between male and female students. The group therapy with adolescents would be practiced more broadly and extensively though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.
Adolescent*
;
Aggression
;
Catharsis
;
Female
;
Group Processes
;
Gyeonggi-do
;
Humans
;
Male
;
Mental Health
;
Mental Health Services
;
Motivation
;
Outpatients
;
Psychotherapy, Group*
;
Surveys and Questionnaires
;
Weights and Measures
6.Effects in Combining Pharmacotherapy and Group Psychotherapy for Outpatients with Schizophrenia.
Hoo Kyeong LEE ; Sun Jae KIM ; Sung Chul YOON ; Hyun Joo AHN
Journal of Korean Neuropsychiatric Association 2003;42(5):590-599
OBJECTIVES: The objective of this study is to prove that combining pharmacotherapy and group psychotherapy is more effective way to prevent recurrence and rehospitalization, to promote their interpersonal relations and to improve their satisfaction on treatment by making a comparison with pharmacotherapy and individual psychotherapy (supportive therapy). METHODS: This study was performed from September 2000 to October 2001. The subjects were all schizophrenic outpatients who were treated by authors in the specialized mental hospital, the psychiatric department of a general hospital, and psychiatric clinics. The experimental groups and the control groups were composed in matching, sex, diagnosis, duration of illness, number of admission and function level. During this period, the experimental groups had been treated by pharmacotherapy and group psychotherapy, and the control groups by pharmacotherapy and individual supportive therapy. Numbers of admission (ratio of readmission) and changes of drug doses were traced, at the same time' group psychotherapy effectiveness scales' were applied. Just after each session, Yalom's 13 therapeutic factors scale was administered. RESULTS: During study periods, 3 cases (17%) among total 18 cases of the experimental groups were re-admitted and 6 cases (33%) among total 18 cases of the control group were re-admitted. During study periods, the doses of chlorpromazine in the experimental groups were decreased from 267 mg at start to 185 mg at closure and the doses of chlorpromazine in the control groups were increased from 264 mg at start to 265 mg at closure. The mean scores of insight, satisfaction on treatment, and satisfaction toward therapist were statistically high in the experimental groups in comparison with the control groups (<0.05). CONCLUSION: 'Combining pharmacotherapy and group psychotherapy' to outpatients with schizophrenia is very effective and expedient for therapists. We expect that this combined treatment model would be practiced more broadly as an economic treatment method which could minimize problems caused by practicing pharmacotherapy only and to give patients full service, though there are accompanied problems including the difficulties of structuring, the eack of motivation of patients, and the financial burden.
Chlorpromazine
;
Diagnosis
;
Drug Therapy*
;
Hospitals, General
;
Hospitals, Psychiatric
;
Humans
;
Interpersonal Relations
;
Motivation
;
Outpatients*
;
Psychotherapy
;
Psychotherapy, Group*
;
Recurrence
;
Schizophrenia*
7.A Case of Adrenal Cavernous Hemangioma.
Jeong Oh LEE ; Seung Hun JEON ; Yang Hoo KIM ; In Gon KIM ; In Gi SEONG ; Bo Hyun HAN
Korean Journal of Urology 2000;41(6):803-806
No abstract available.
Hemangioma, Cavernous*
8.Epithelioid Angiomyolipoma of the Kidney: A case report.
You Kyung KIM ; Jong Sil LEE ; Ky Hyun CHUNG ; Sun Hoo PARK ; Gyung Hyuck KO
Korean Journal of Pathology 2000;34(11):953-956
Angiomyolipoma is considered by many authors to be a hamartoma, occurring in a sporadic form or in association with tuberous sclerosis. This lesion consists of thick walled blood vessels, smooth muscle, and mature adipose tissue in varying amounts. We have experienced a case of the angiomyolipoma composed of monotypic epithelioid cells. The patient was a 69-year-old female. Clinically, there was no evidence of tuberous sclerosis. Microscopically, the tumor was composed of polygonal cells with abundant eosinophilic granular or clear cytoplasm, pleomorphic nuclei, prominent nucleoli, and multinucleated giant cells. The tumor cells showed positive reaction for HMB45, CD68, smooth muscle actin, and S-100, and negative reaction for epithelial membrane antigen, cytokeratin, vimentin, desmin, CD34, estrogen receptor, and progesterone receptor. Ultrastructual analysis showed the presence of glycogen, mitochondria, and other microorganelles in neoplastic cells. Melanosome or premelanosome was not identified.
Actins
;
Adipose Tissue
;
Aged
;
Angiomyolipoma*
;
Blood Vessels
;
Cytoplasm
;
Desmin
;
Eosinophils
;
Epithelioid Cells
;
Estrogens
;
Female
;
Giant Cells
;
Glycogen
;
Hamartoma
;
Humans
;
Keratins
;
Kidney*
;
Melanosomes
;
Mitochondria
;
Mucin-1
;
Muscle, Smooth
;
Receptors, Progesterone
;
Tuberous Sclerosis
;
Vimentin
9.Correction of pronouced nasolabial fold using subgaleal fascia.
Jeong Jin KIM ; Jeong Cheol KIM ; Kyung Hoo LEE ; Dong Bo SUH ; Jung Hyun SEUL
Journal of the Korean Society of Plastic and Reconstructive Surgeons 1992;19(4):633-637
No abstract available.
Fascia*
;
Nasolabial Fold*
10.A case of coincidental occurence of Bochdalek hernia in mother & her newborn infant.
Sung Rim KIM ; Dae Hyun CHO ; Jong Wook KIM ; Sung Hoo LEE
Korean Journal of Obstetrics and Gynecology 1991;34(1):134-138
No abstract available.
Hernia*
;
Humans
;
Infant, Newborn*
;
Mothers*