1.Training Group with Mental Health Professionals.
Hoo Kyeong LEE ; Sun Jae KIM ; Sung Chul YOON
Journal of Korean Neuropsychiatric Association 2001;40(5):789-803
OBJECTIVES: Training group with mental health professionals includes didactic process, experience as a member(patient) and a leader(therapist). It is divided into four parts as like 1) lecture, case conference, book reading and seminar about theory and practice, 2) observation, 3) training group(including workshop), and 4) supervision. Among them, the training group and the supervision have been accepted as the most effective methods. Authors have developed and practiced the training group model for mental health professionals including psychiatric residents which aim for the activation of group psychotherapy in mental health area, psychiatrists' initiative in group psychotherapy area, and the training and nurturing of qualified mental health professionals. The objectives of this study are as follows;firstly, we examine the change of defense mechanism and ego function after performing group psychotherapy for mental health professionals;secondly, we analyze the therapeutic factors reported that participants were helped;thirdly, we analyze main features which include group content and process manifested in training group:lastly, we have objectives that the training group is settled down as an effective educational method to foster the personal growth and qualification as a specialist, and also that this study provides a basic research data to set up the training program and the requirements for group psychotherapy. METHODS: This study was performed 5 times from 1997 to 2000. The participants were composed of 37 mental health professionals including psychiatric residents. Among them, 29 participants(male 2, female 27) were chosen as the final subjects except 9 participants dropped out in the process of this study. At first, we take an application of pre-treatment/post-treatment experimental design to evaluate the personality change after performing the training group. EDMT(Ewha Defence Mechanism Test) and EC(Egogram Checklist), the objective questionnaires, were used as the evaluation scale. And 13-therapeutic factor scale and simple subjective questionnaires were performed just after each session and the self-report total assessment questionnaires were performed at the end of this study. RESULTS: To compare mean scores between pre-treatment and post-treatment in EDMT, the mature defense was increased significantly, the immature defense was decreased significantly, and the narcissistic defense and neurotic defense were not changed significantly. To compare mean scores between pre-treatment and post-treatment in EC, Nurturing Parent(NP), Adult(A) and Free Child(FC) were increased significantly. Therapeutic factors ranked highly were interpersonal learning, existential factor, Identification with therapist, catharsis, and socializing technique in order. The total assessment questionnaires reported that the 100% of participants were helped, the 48.3% of participants were changed in their lives, the 89.7% of participants would propose training group to others positively, and the 58.6% of participants had minds to join this kind of program if given again for them. CONCLUSIONS: This result showed that the defense mechanism and ego function of participants were changed. The training group experience makes participants reflect themselves, examine their conflicts and understand others. That also gives them chances of improving insight about group phenomena and understanding about therapeutic factors essential to the mental health professionals, having confidence on the group therapy by learning leadership and techniques, and improving understanding about the psychotherapy on the whole. Therefore, it is needed in the future that the training group would be widely adapted as an educational tool of psychotherapy and group psychotherapy for the mental health professionals as well as psychiatric residents in mental health area.
Catharsis
;
Education
;
Ego
;
Female
;
Humans
;
Leadership
;
Learning
;
Mental Health*
;
Organization and Administration
;
Psychotherapy
;
Psychotherapy, Group
;
Surveys and Questionnaires
;
Research Design
;
Specialization
2.A Model of Inpatient Large Group Psychodrama.
Hoo Kyeong LEE ; Sung Chul YOON ; Sun Jae KIM
Journal of Korean Neuropsychiatric Association 2000;39(2):273-287
As an alternative to group psychotherapy, worked out by Dr. Moreno, the psychodrama is being carried on mainly for a large group of inpatients at 40-50% of the country's psychiatric and training hospitals. The authors have developed a Korean psychodrama model for a group mental health having following characteristics:(1) a one-time treatment, (2) open-group therapy, and (3) structured, large group approach. Korean psychodrama model was proved to be a low cost, highly effective approach in that patients could be dealt with en masse to quite a satisfactory degree: at the same time Korean psychodrama model is easily accessible for any psychiatric doctor or trainee in dealing with a patient. In addition, Korean psychodrama model is highly conducive to experiencing and training related people in psychotherapeutic practice as this model has shown up 79.4% approval rate among patients after treatment. Due to the recent crunch in medical insurance financing, psychotherapy is changing from individual long-term type to a more time-limited type. Despite the mental health law passed in 1995, from the human psychotherapy standpoint, the worsening economic situation has made it difficult for a psychiatrist to deal with patient on a one-to-one basis. As a result, the burden of most psychiatrists, is snowballing day by day. In this context psychodrama seems to be a promising, reliable alternative to group psychotherapy, both medically and economically. It will be a treatment modality for years to come.
Humans
;
Inpatients*
;
Insurance
;
Jurisprudence
;
Mental Health
;
Psychiatry
;
Psychodrama*
;
Psychotherapy
;
Psychotherapy, Group
3.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
4.Time-Limited Group Psychotherapy with Outpatients.
Hoo Kyeong LEE ; Jeong Hwa CHA ; Sung Chul YOON ; Jung Il KIM
Journal of Korean Neuropsychiatric Association 2001;40(3):381-395
OBJECTIVES: Recently, the outpatient group psychotherapy has been changed from traditional long-term therapy to short-term or time-limited therapy. The termination time and session numbers are given from start line in the time-limited therapy while 10 to 40 sessions are needed in the short-term therapy. And therapist and patients come to an agreement of the accomplishable therapeutic goal and work together actively. The time-limited group psychotherapy is being accepted newly as an efficient therapeutic modality because effective therapeutic outcomes within given time have been reported. The objectives of this study are as follows; firstly, we examine the therapeutic outcomes and the therapeutic factors after performing the time-limited group psychotherapy for outpatients in the psychiatric clinic; secondly, we analyze the characteristics showed in the process of study; lastly, we verify the feasibility and the validity of this group psychotherapy and then establish the basis of the effective outpatient therapy that would be settled down as an applicable treatment modality economically and efficiently in the current medical environment of Korea. METHODS: This study was performed weekly in total 12 sessions from July 1999, April 2000 to and each session took 70-80 minutes. The experimental group were composed of the highly-functioning psychotic patients among outpatients in the psychiatric clinic. The control group were composed of the similar patients through one-to-one matching of age, sex, diagnosis, and duration of illness. The participants were 8 patients each. BDI(Beck Depression Inventory), STAI(Spielbergs State-Trait Anxiety Inventory), MMPI(Minnesota Multiphasic Personality Inventory), and EDMT(Ewha Defence Mechanism Test) as the evaluation scales were performed before and after treatment. And 13-therapeutic factors scale was performed just after each session and the self-report total assessment questionnaire was performed only in experimental group at the end of this study. RESULTS: The mean score of BDI was decreased significantly in experimental group in comparison with control group. The mean score of STAI-S was not changed significantly in both group, and the mean score of STAI-T was decreased in experimental group in comparison with control group. The mean score of MMPI was decreased significantly in experimental group in comparison with control group, but the comparison of difference scores(post-treatment score - pre-treatment score) between the experimental and control group was not decreased significantly. This result may come from psychopharmacotherapy and individual supportive psychotherapy given equally to both group. The mean scores of immature defence and neurotic defence in EDMT were decreased significantly in experimental group compared with control group. Comparing the therapeutic factors to divide into the first, middle, and the last stage, existential factor was ranked first, and catharsis, identification with therapist, universality, and group cohesiveness were ranked high in all stages. Interpersonal learning was ranked first in the last stage although being ranked low in the first and middle stage. The total assessment questionnaires about group psychotherapy were reported that 100% of participants were helped, 75% of participants were changed in their lives, and 75% of participants had minds to join this kind of program again if given for them. CONCLUSIONS: This result shows that not only symptom relief but also personality change was achieved when the time-limited group psychotherapy was practiced in addition to simple psychophamarcotherapy and individual supportive psychotherapy for outpatients. The degree of satisfaction for group psychotherapy of participants were evaluated highly. Group psychotherapy has been accepted in public as a therapeutic modality that must be as equally effective as psychotherapy although group psychotherapy derives from individual psychotherapy. In our current medical environment that has been changed suddenly by the separation of medical practice and pharmaceutical dispensing and the decrease of medical fee, group psychotherapy or time-limited therapy would be settled down as low-expense and high-efficiency therapeutic modalities that were as equally effective as individual psychotherapy or long-term therapy.
Anxiety
;
Catharsis
;
Depression
;
Diagnosis
;
Fees, Medical
;
Humans
;
Korea
;
Learning
;
MMPI
;
Outpatients*
;
Psychotherapy
;
Psychotherapy, Group*
;
Surveys and Questionnaires
;
Weights and Measures
5.The Influence of Women on the Health Care-Seeking Behavior of Men.
Eun Sook PARK ; Yong Chul KIM ; Se Heon KIM ; Kyeong Kyu WANG
Journal of the Korean Academy of Family Medicine 1997;18(10):1069-1078
BACKGROUND: Gender and social relationships are believed to have a strong influence on health care attitudes and behavior. This study was designed to determine the effect of the gender of closely associated persons on t,he health care-seeking behavior of persons of the oppsite sex. METHODS: We developed a 10-item questionnaire that requested information on social and demographic characteristics, health status, and influences on the decision to seek health care, and administered it to 314 consecutive patients seen at two family medicine clinics in Seoul. Data were analyzed by means of one way analysis of variance for continuous variables and the chi-square test for categorical variables. Additionally, data were analyzed by means of a multivariate logistic regression model that calculated odds ratios and 95% confidence intervals. RESULTS: Men were 4.6 times more likely to be influenced than women to seek health care by a member of the opposite sex(95% CI, 2.4 to 8.9). CONCLUSIONS: Women make an important influene on the decisions for men to seek health care.
Delivery of Health Care
;
Female
;
Humans
;
Logistic Models
;
Male
;
Odds Ratio
;
Seoul
;
Surveys and Questionnaires
6.The Observation of Clebopride Malate Effect on Funchional Gastrointestinal Disease by Use of Gastric Emptying Time.
Soo Bong CHOI ; Kyeong Soon KWON ; Seong Chul YOON ; Moon Kwan CHUNG ; Chong Suhi KIM
Yeungnam University Journal of Medicine 1987;4(1):59-63
The measurement of gastric emptying time is useful in differentiation of the hypochondriacal neurosis from the functional gastrointestinal disturbance, and also useful in searching the hidden gastro-intestinal disease in patients who are believed as the functional gastrointestinal disturbance. We confirmed in this study that the more delayed gastric emptying time was measured in functional gastrointestinal disturbance compared to normal group, and more shortened gastric emptying time was found after treatment with dopamine antagonist (cleboril) in this group.
Dopamine
;
Gastric Emptying*
;
Gastrointestinal Diseases*
;
Humans
;
Hypochondriasis
7.Functional Brain Mapping Using H2 15O Positron Emission Tomography ( I ): Statistical Parametric Mapping Method.
Dong Soo LEE ; Jae Sung LEE ; Kyeong Min KIM ; June Key CHUNG ; Myung Chul LEE
Korean Journal of Nuclear Medicine 1998;32(3):225-237
PURPOSE: We investigated the statistical methods to compose the functional brain map of human working memory and the principal factors that have an effect on the methods for localization. MATERIALS AND METHODS: Repeated PET scans with successive four tasks, which consist of one control and three different activation tasks, were performed on six right-handed normal volunteers for 2 minutes after bolus injections of 925 MBq H0 at the intervals of 30 minutes. Irnage data were analyzed using SPM96 (Statistical Parametric Mapping) imple-mented with Matlab (Mathworks Inc., U.S.A.). Images from the same subject were spatially registered and were normalized using linear and nonlinear transformation methods. Significant difference between control and each activation state was estimated at every voxel based on the general linear model. Differences of global counts were removed using analysis of covariance (ANCOVA) with global activity as covariate. Using the mean and variance for each condition which was adjusted using ANCOVA, t-statistics was performed on every voxel To interpret the results more easily, t-values were transformed to the standard (saussian distri-bution (Z-score). RESULTS: All the subjects carried out the activation and control tests successfully. Average rate of correct answers was 95%. The numbers of activated blobs were 4 for verbal memory I, 9 for verbal memory II, 9 for visual memory, and 6 for canjunctive activation of these three tasks. The verbal working memory activates predominantly left-sided slruetures, and the visual memory activates the right hernisphere. CONCLUSION: We conclude that rCBF PET imaging and statistical parametric mapping method were useful in the localization of the brain regions for verbal and visual working memory.
Brain Mapping*
;
Brain*
;
Electrons*
;
Healthy Volunteers
;
Humans
;
Linear Models
;
Memory
;
Memory, Short-Term
;
Positron-Emission Tomography*
8.A Case of Non-IgE-mediated Scrosal Eosinophilic Gastrocenteritis in a Child with Chronic Asthma.
Yong Joo KIM ; Ha Baik LEE ; Hahng LEE ; Eun Kyeong HONG ; Hyun Chul RHIM
Journal of the Korean Pediatric Society 1995;38(12):1694-1700
No abstract available.
Asthma*
;
Child*
;
Eosinophils*
;
Humans
9.Chronic Hepatitis in the Idiopathic Hypereosinophilic Syndrome: A case report .
Kyeong Hee KIM ; Hae Joung SUL ; Sung Chul JUN ; Dae Young KANG
Korean Journal of Pathology 1999;33(8):624-626
Chronic hepatitis associated with the idiopathic hypereosinophilic syndrome has been very rarely reported worldwide. Recently, we experienced a case of chronic hepatitis with piecemeal necrosis as the clinical feature of the idiopathic hypereosinophilic syndrome. The patient was a 49-year-old woman who complained of a mild fever, nausea, vomiting, and pain in the right upper quadrant. The eosinophil count of peripheral blood increased up to 14,020/microliter (64% of WBC). Liver biopsy specimen showed severe porto-periportal inflammation with marked eosinophilic infiltration and ballooning degeneration of hepatocytes. Corticosteroid therapy significantly normalized the eosinophil count of peripheral blood.
Biopsy
;
Eosinophils
;
Female
;
Fever
;
Hepatitis, Chronic*
;
Hepatocytes
;
Humans
;
Hypereosinophilic Syndrome*
;
Inflammation
;
Liver
;
Middle Aged
;
Nausea
;
Necrosis
;
Vomiting
10.A study of osteonectin expression patterns in BAPN-induced cleft palate formed rats.
Ki Chul TAE ; En Chel KIM ; Sun Kyeong LEE
Korean Journal of Orthodontics 2000;30(4):433-440
The purpose of this study was to investigate osteonectin expression patterns in cleft palatecompare to normal palate rats. We used 4 pregnant rats, and beta-aminoproprionitrile was oral dose to rat according to lg/kg body weight at gestation days 13 to induce cleft palate. Total 6 fetus was got with cleft formed, then 3 fetus was used for immunohistostain and 3 fetus was used for western blot analysis. Expression patterns of osteonectin in mesenchymal cells of cleft palate was more dilute to mesenchymal cells of normal palate with immnunohistostain, and width and length of band of maxilla in cleft palate was more thin than maxilla of normal palate with western blot study.
Animals
;
Blotting, Western
;
Body Weight
;
Cleft Palate*
;
Fetus
;
Maxilla
;
Osteonectin*
;
Palate
;
Pregnancy
;
Rats*