Experimental study of person-centered psychotherapy effectiveness (based on sample with chronic gastrointestinal diseases). Part II

Bondarenko A.F., Maksimenko K.S. (Kiev, Ukraine)

Abstract

This article touches upon the problem of Person-centered psychotherapy in the treatment of specific psycho-emotional problems which are caused by chronic physical illnesses.

The study involved the patients with chronic diseases of gastroenterological spectrum on the exacerbation stage. Total sample size was 144 people: 85 females (59.09%) and 59 males (40.01%) at the age from 24 to 59 y. The average duration of therapy ranged from 15 to 20 hours. A separate group of patients (15 people) were treated with medications prescribed by a psychiatrist in accordance with psychopathological report taking into account the basic diagnosis (anxiolytic, sedative, nootropic, anti-depressants).

Methods. At the sample selection and the final stages the MMPI, M. Lüscher Colour Test and L. Szondi Test were applied. Before each psychotherapy session and after it: Express-diagnostics on the basis of SAM- techniques (self-esteem, activity, mood), in form of personal semantic differential.

Results and conclusions. The most significant results in the clinical sense (health, strengthening, stress reduction, reduction of scales, indicating the severity of the reactive state, positive dynamics of the lab tests, etc.) have been observed in group of patients receiving concomitant (psychological, pharmacological and nosology-oriented) therapy. It can be assumed that the various psychotherapeutic approaches should be considered as subsidiary, rather than independent means of chronic illness treatment. Purely psychological methods will be useful for the emotional abreaction, switching attention from the dominant physical suffering to the patient’s personal resources, as well as self-presentation processes.

Key words: medical psychology; somatogenic; gastroenterological diseases; chronic illness; existential-humanistic psychotherapy.

 

Received:
March 18, 2017

Accepted:
April 19, 2017

Publisher:
May 15, 2017

  For citation  

 

 

The dynamics of patients’ psycho-emotional and physical condition after the Cognitive-Behavioral psychotherapy. At the first stage of the psycho-emotional state assessment, the presence of changes in the subjective assessment of the patient’s emotional state was analyzed using the semantic differential technique. Since the values of the scales of the modified version of the semantic differential, proved to be sufficiently homogeneous, we analyzed the average values for the whole group of each scale.

As can be seen from the graph of Figure 7, the dynamics of the indicators for each of the scales is sufficiently explicit. The most obvious improvement of well-being observed on the "Weak — Strong" scale. The patients feel more confident, balanced and "nice" after the course of group therapy. But it is worth noting that the figures for all the scales in the diagnosis after the psychotherapeutic course vary within no more than the average level of expression (1.5 points on the SD scales). The high rates, reflecting the positive subjective assessment of the patients are not available, that gives us the ground for the assumption once again that exclusively psychotherapeutic measures are insufficient to improve the psycho-emotional state of patients.

 

Figure 7. Dynamics of subjective assessment of patient’s emotional state
(mean values) before and after a course of Cognitive-Behavioral group therapy
(based on semantic differential).

 

The dynamics of the subjective assessment of the patient’s physical condition is also positive and sufficiently expressed (Figure 8). The indicators for all scales tended to a positive pole, but also within the framework of the average level. The most obvious improvement of mental well-being can be observed on the "Weak — Strong" scale. The patients felt the increasing of strength and self-confidence, the readiness for changing behavior after the course of Cognitive-Behavioral group psychotherapy.

 

Figure 8. Dynamics of subjective assessment of the patient’s physical condition
(mean values) before and after a course of Cognitive-Behavioral therapy
(based on a modified version of the semantic differential).

 

But in general, after a course of Cognitive-Behavioral group therapy, the patients continued to complain on apathy, lethargy, lack of motivation for professional activity.

The analysis of the results obtained by using the Mini-Mult Test in a group of patients at the beginning and at the end of Cognitive-Behavioral psychotherapy. Since we analyze the dependent samples (up to 35 people) — before and after the course of group of psychotherapy sessions and psychopharmacological therapy — we chose a nonparametric criterion of signs as the main statistical method to compare two dependent samples based on the comparison of the number of positive and negative shifts of values. A non-parametric Wilcoxon test was chosen as an auxiliary method of mathematical analysis. As a null and alternative hypothesis of our experimental research, the following statements were accepted:

H0 — the differences between the scores of the Mini-Mult scales in the group of patients with diseases of the gastroenterological spectrum before and after a course of Cognitive-Behavioral psychotherapy are not significant.

H1 — the differences between the scores of the Mini-Mult scales in the group of patients with diseases of the gastroenterological spectrum before and after a course of Cognitive-Behavioral psychotherapy are statistically significant.

The differences were estimated between the indicators for each scale of the Mini-Mult Test. Since the nonparametric criteria allow us to estimate only one pair of variables characterizing the dependent groups per one analytical stage, the results tables describe each pair separately.

The result of checking the significant differences between the indicators before and after the psychotherapeutic course according to the Mini-Mult Test showed that the reliable dynamics of the indexes was revealed on three scales — F (Aggravation), K (Correction) and of Pa (Paranoia). For the remaining eight scales, the significant differences were not detected.

Hypothesis Test Summary

Asymptotic significances are displayed. The significance level is .05.
1 Exact significance is displayed for this test.

 

Figure 9. The resulting table of the reliable differences analysis of D-scale (Depression)on the criterion of signs and Wilcoxon test which support the null hypothesis.

 

In the table in Fig. 9, we estimate Sig.-index, which in both cases has a value that exceeds the maximum allowable significance level of 0.05. This gives us grounds for the null hypothesis confirmation: the differences between the D-scores in the group of patients with diseases of the gastroenterological spectrum before and after a course of Cognitive-Behavioral psychotherapy are not significant.

The same conclusions can be applied to the following scales: Correction (K), Lie (L), Hysteria (Hy), Psychopathy (Pd), Paranoid (Pa), Psychasthenia (Pt), Schizoid (Se) and Hypomania (Ma). The lack of significant differences in these scales confirms the stability of the individual characteristics of a person and the stability of the clinical condition, even in case of relatively long-term psychotherapy.

Hypothesis Test Summary

Asymptotic significances are displayed. The significance level is .05.
1 Exact significance is displayed for this test.

 

Figure 10. The resulting table of the reliable differences analysis of F-scale (Aggravation) on the criterion of signs and Wilcoxon test which support the alternative hypothesis.

 

As can be seen from the Fig. 10—11 the Sig.-indicator value is below the acceptable level of significance of 0.05. This fact gives us grounds to confirm the alternative hypothesis, that the differences between the scores on the F (Aggravation) and Hs (Hypochondria) scales in the group of patients with diseases of the gastroenterological spectrum before and after the course of Cognitive-Behavioral psychotherapy are statistically significant.

Hypothesis Test Summary

Asymptotic significances are displayed. The significance level is .05.
1 Exact significance is displayed for this test.

 

Figure 11. The resulting table of the reliable differences analysis of Hs-scale (Hypochondria) on the criterion of signs and Wilcoxon test which support
the alternative hypothesis.

 

After revealing the significant differences in Aggravation (F) and Hypochondria (Hs) scales before and after the Cognitive-Behavioral psychotherapy, to disclose the nature of the changes in these scales, we have calculated the descriptive statistics: mean and standard deviation (Tables 3—4).

 

Table 3

The mean values of indicators of the Mini-Mult scales in the group of patients
at the beginning of the Cognitive-Behavioral group psychotherapy

 

Assessing the minimum and maximum values on the scales, it can be argued that there are no emissions in the distribution of values within data-dependent samples. The absence of emissions makes it statistically legitimate to assess the mean values in the future.

 

Table 4

The mean values of indicators of the Mini-Mult scales in the group of patients
at the end of the Cognitive-Behavioral group psychotherapy

 

At the end of the Cognitive-Behavioral group psychotherapy, the average scores on the Lie (L), Schizoid (Se) and Hypomania (Ma) have decreased.

For the purpose of more meaningful analysis of the differences, we derived two graphs (Fig. 12). Statistically significant differences between the scores in the group of patients before and after the course of psychotherapy were identified on two scales: Aggravation (F) and (Hs) Hypochondria. The changes in the Aggravation scale among patients were manifested in the reduction of the tendency to hyperbolize the symptomatic characteristic of their physical state. Moreover, the desire to emphasize the severity of the physical state was leveled as a result of psychotherapy.

 

Figure 12. The dynamics of indicators on the Mini-Mult scales before and after
the Cognitive-Behavioral psychotherapy.

 

A predominance of the passive personal position, a high level of awareness of the existing problems through the prism of frustration and a pessimistic assessment of its prospects, the tendency to a negative perception of the world due to illness, inertness in a decision-making were noticed at the beginning of group psychotherapy. But at the end of the Cognitive-Behavioral group psychotherapy the focus shifted towards positive understanding of the future prospects, positive health and lifestyle changes.

The analysis of the dynamics of test results by the M. Lüscher Color Test and the Method of Portrait Elections by L. Szondi in the group of patients at the beginning and end of the Cognitive-Behavioral psychotherapy. The main feature of this group of patients, as well as the others, was the depressed mood that led to a significant deterioration in sleep quality (the high frequency of nightmares reported by patients). The patients were dissatisfied with the life situation that provoked gloomy and pessimistic thoughts about the future. There was a loss of interest and a decrease in satisfaction from the activities that they were interested in before the disease. The examined patients showed a low viability that is likely to seriously limit the psychological and physical resources as well as contribute to the inability to cope with despair and loss of the meaning of life. Due to the severe underlying pathology, the increased fatigue, decreased vitality, communication in connection with the deterioration of the physical and emotional state, were observed.

As a result of meaningful interpretation of the vectors and factors of the Szondi Portrait Elections Test before and after psychotherapy, the following changes were found: the tendencies to outwardly aggressive response and selfishness have become less pronounced; the increased self-control and distrustfulness have also reduced after a course of psychotherapy.

The analysis of diagnostic results by the M. Lüscher Color Test, identified changes in the following characteristics: the frustration of the need for hope for the best decreased as well as the desire for peace and rest; the dissatisfaction with the attitude towards oneself remained unchanged but the negative attitude to the situation completely leveled and the anxiety decreased. The will power and the self-confidence increased.

The dynamics of patients’ psycho-emotional and physical condition after the group Art Therapy course. At the first stage of the psycho-emotional state assessment, the presence of changes in the subjective assessment of the patient’s emotional state was analyzed using the semantic differential technique. Since the values of the scales of the modified version of the semantic differential, proved to be sufficiently homogeneous, we analyzed the average values for the whole group of each scale. As can be seen from the graph of Figure 13, the dynamics of the indicators for each scale is sufficiently explicit. The most obvious improvement of well-being observed on the "Bad — Good" scale. The patients felt more relaxed, balanced and "nice" after a group therapy course. But it is worth noting that the figures for all the scales in the diagnosis after the psychotherapeutic course vary within no more than the average level of expression (1.5 points on the SD scales). High rates, reflecting the positive subjective assessment of the patients are not available, which gives us the ground for the assumption that exclusively psychotherapeutic measures are insufficient to improve the patients’ psycho-emotional state.

 

Figure 13. The dynamics of subjective assessment of patient’s emotional state
(mean values) before and after the Art Therapy course
(based on semantic differential).

 

The dynamics of the subjective assessment of the patient’s physical condition is also positive and sufficiently expressed (Figure 14). The indicators for all scales tended to a positive pole, but also within the framework of the average level.

 

Figure 14. Changes in the subjective assessment of the patients’ physical condition (mean values) before and after the group Art Therapy (based on a modified version of the semantic differential).

 

The important thing to note here is that after the course of group Art Therapy the patients continued to complain on headaches, mood swings, apathy and lack of motivation for professional activity.

Analysis of the results obtained by using the Mini-Mult Test at the beginning and at the end of group Art Therapy course. Since the small dependent samples (up to 15 people) were analyzed, we chose a nonparametric criterion of signs as the main statistical method to compare two dependent samples based on the comparison of the number of positive and negative shifts of values before and after the course of group of psychotherapy sessions and psychopharmacological therapy. A non-parametric Wilcoxon test was chosen as an auxiliary method of statistical analysis. As a null and alternative hypothesis the following statements were accepted:

H0 — the differences between the scores of the Mini-Mult scales in the group of patients with diseases of the gastroenterological spectrum before and after a course of Art Therapy are not significant.

H1 — the differences between the scores of the Mini-Mult scales in the group of patients with diseases of the gastroenterological spectrum before and after a course of Art Therapy are statistically significant.

The differences were estimated between the indicators of each scale of the Mini-Mult Test. Since the nonparametric criteria allow us to estimate only one pair of variables characterizing the dependent groups per one analytical stage, the results tables describe each pair separately.

The result of checking the significant differences between the indicators before and after the psychotherapeutic course according to the Mini-Mult Test showed that the reliable dynamics of the indexes was revealed on two scales — F (Aggravation) and Hs (Hypochondria). For the remaining nine scales of this technique, the significant differences were not detected.

Hypothesis Test Summary

Asymptotic significances are displayed. The significance level is .05.
1 Exact significance is displayed for this test.

 

Figure 15. The resulting table of the reliable differences analysis of L-scale (Lie),
by the criterion of signs and Wilcoxon test, which support the null hypothesis.

 

In the table in Fig. 16, we estimate Sig.-index, which in both cases has a value that exceeds the maximum allowable significance level of 0.05. This gives us grounds for confirmation of the null hypothesis: the differences between the L-scores in the group of patients with diseases of the gastroenterological spectrum before and after a course of Art Therapy are not significant.

The same conclusions can be applied to the following scales: Aggravation (F), Depression (D), Hysteria (Hy), Psychopathy (Pd), Paranoid (Pa), Psychasthenia (Pt), Schizoid (Se) and Hypomania (Ma). The lack of significant differences in these scales confirms the stability of the individual characteristics of a person and the stability of the clinical condition, even in case of relatively long-term psychotherapy.

Hypothesis Test Summary

Asymptotic significances are displayed. The significance level is .05.
1 Exact significance is displayed for this test.

 

Figure 16. The resulting table of the reliable differences analysis of F-scale
(Aggravation) on the criterion of signs and Wilcoxon test which support
the alternative hypothesis.

 

As can be seen from the Fig. 16—17 the Sig.-indicator value is below the acceptable level of significance of 0.05. This fact gives us grounds to confirm the alternative hypothesis, that the differences between the scores on the F (Aggravation) and Hs (Hypochondria) scales in the group of patients with diseases of the gastroenterological spectrum before and after the course of Art Therapy are statistically significant.

Hypothesis Test Summary

Asymptotic significances are displayed. The significance level is .05.
1 Exact significance is displayed for this test.

 

Figure 17. The resulting table of the reliable differences analysis of Hs-scale (Hypochondria) on the criterion of signs and Wilcoxon test which support
the alternative hypothesis

 

After revealing the significant differences in Aggravation (F) and Hypochondria (Hs) scales before and after the Art Therapy course, to disclose the nature of the changes in these scales, we have calculated the descriptive statistics: mean and standard deviation (Table 5).

Table 5

The mean values of indicators of the Mini-Mult scales in the group of patients
at the beginning of the group Art Therapy

 

Assessing the minimum and maximum values on the scales, it can be argued that there are no emissions in the distribution of values within data-dependent samples. The absence of emissions makes it statistically legitimate to assess the mean values in the future.

After the course of group Art Therapy the average indexes of the Lie (L), Schizoid (Sc) and Hypomania (Ma) scales decreased.

For the purpose of more meaningful analysis of the differences, we derived two graphs (Fig. 18). Statistically significant differences between the scores in the group of patients before and after the course of psychotherapy were identified on two scales: Aggravation (F) and Hypochondria (Hs). The changes in the Aggravation scale were manifested in the reduction of the tendency to hyperbolize the symptomatic characteristic of patients’ physical state. Moreover, the desire to emphasize the severity of the physical state was leveled as a result of psychotherapy.

 

Figure 18. Dynamics of indicators on the Mini-Mult scales before and after
the Art Therapy.

 

A predominance of the passive personal position, a high level of awareness of the existing problems through the prism of frustration and a pessimistic assessment of its prospects, the tendency to a negative perception of the world due to illness, inertness in a decision-making, sharpness of feeling were noticed at the beginning of group psychotherapy. But at the end of the group Art Therapy the focus shifted towards positive understanding of the future prospects, new meanings of life, further actions aimed at restoring health and lifestyle changes.

The analysis of the dynamics of results ofthe M. Lüscher Color Test and the Method of Portrait Elections by L. Szondi in the group of patients at the beginning and end of group Art Therapy. As a result of meaningful interpretation of the vectors and factors of the Szondi Portrait Elections Test before and after psychotherapy within the framework of the individual typological approach, the following changes were found: the tendencies to outwardly aggressive response and selfishness have become less pronounced; the conflictness, increased self-control and distrustfulness have also reduced after a course of psychotherapy.

The analysis of diagnostic results by the M. Lüscher Color Test, identified changes in the following characteristics: the frustration of the need for hope for the best and the anxiety have decreased; the desire for peace, rest, and also, the dissatisfaction with the attitude towards oneself remained unchanged; the negative attitude to the situation have leveled; the willpower and the self-confidence have increased.

 

References

1.   Babich V.V. Psikhoterapiya u kompleksnomu likuvanni rozladiv adaptatsi¿ u khvorikh z gostrim infarktom miokardu. Avtoref. dis. kand. med. nauk [Psychotherapy in a Comprehensive Treatment of Adaptation Disorder in Patients with Acute Myocardial Infarction. Cand. med. sci. diss.]. Kiev, 2008. 20 p.

2.   Bulyubash I.D., Morozov I.N., Prikhod’ko M.S. Psikhologicheskaya reabilitatsiya patsientov s posledstviyami spinal’noi travmy [Psychological Rehabilitation of Patients with the Consequences of Spinal Cord Injury]. Samara: Izdatel’skii Dom “Bakhrakh-M” Publ., 2011. 272 p.

3.   Burno M.E. Klinicheskaya psikhoterapiya [Clinical Psychotherapy]. 2nd edition. Moscow, Akademicheskii proekt Publ., 2006. 800 p.

4.   Amosova K.M., Samar S.A., Vinnikov D.M., et al. Vikoristannya psikhoterapi¿ v kompleksnomu likuvanni ta reabilitatsi¿ revmatologichnikh khvorikh [The Use of Psychotherapy in the Comprehensive Treatment and Rehabilitation of Rheumatologic Patients]. In: Pitannya diagnostiki ta likuvannya [The Issues of Diagnostics and Treatment]. Kiev, 1995, p. 83.

5.   Vorobiov V.V. Psikhologichni i seksual’ni chinniki v genezi mastopati¿ ta ¿kh psikhokorektsiya. Avtoref. dis. kand. med. nauk [Psychological and Sexual Factors in the Genesis of Mastopathy and Their Psychological Correction. Cand. med. sci. diss.]. Kharkov, 2009. 20 p.

6.   Voronov M. Psikhosomatika. Pakticheskoe rukovodstvo [Psychosomatics. Practical Guidance]. Kiev, Nika-Tsentr Publ., 2004. 256 p.

7.   Gas’kov V.S. [Psychotherapy in Patients with Hypertensive Disease with Account for Leading Representative Channels]. Ukra¿ns’kii visnik psikhonevrologi¿, 1995, vol. 3, no. 1, pp. 166–167 [in Russian].

8.   Groisman A.L. Meditsinskaya psikhologiya: Lektsii dlya vrachei — slushatelei kursov poslediplomnogo obrazovaniya [Medical Psychology. Lectures for Doctors — Participants of Postgraduate Courses]. Moscow, Izdatel’stvo Magistr Publ., 1997. 360 p.

9.   Kabanov M.M., Lichko A.E., Smirnov V.M. Metody psikhologicheskoi diagnostiki i korrektsii v klinike [Methods of Psychological Diagnostics and Correction in a Clinical Setting]. Leningrad, Meditsina Publ., 1983. 312 p.

10.   Kaplan H.I., Sedok B.J. Klinicheskaya psikhiatriya [Clinical Psychiatry]. In 2 volumes. Transl. from English. Moscow, Meditsina Publ., 1994, vol. 1. 670 p.

11.   Karvasarskii B.D., ed. Klinicheskaya psikhologiya [Clinical Psychology]. 4th edition. St. Petersburg, Piter Publ, 2011. 864 p.

12.   Korostii V.I. The Place of Psychotherapy in a Comprehensive Treatment of Non-Psychotic Mental Disorders in Patients with Psychosomatic Diseases. Meditsinskaya psikhologiya, 2009, vol. 4, no. 2–3, pp. 139–141 [in Russian].

13.   Korolenko Ts.P., Dmitrieva N.V. Sotsiodinamicheskaya psikhiatriya [Social Dynamic Psychiatry]. Moscow, Akademicheskii Proekt Publ.; Ekaterinburg, Delovaya kniga Publ., 2000. 460 p.

14.   Koryagin Yu.A., Rashevskii A.I. The Work of a Psychotherapist in Rehabilitation Department for Cardiological Patients. Voprosy klinicheskoi i sotsial’noi psikhologii i psikhiatrii: tez. dokl. [The Issues of Clinical and Social Psychology and Psychiatry. Abstracts]. Dnepropetrovsk, 1996, pp. 93–94 [in Russian].

15.   Kocharyan A.S. The Efficiency of the Instruments of Psychological Diagnostics of Complex Multi-Level Psychological Formations (on the Example of the Complex of Masculinity/Feminity Symptoms). Zhurnal praktikuyushchego psikhologa, 2010, no. 17, pp. 163–174 [in Russian].

16.   Kulakov S.A. Praktikum po psikhoterapii psikhosomaticheskikh rasstroistv[Practical Course on the Psychotherapy of Psychosomatic Disorders]. St. Petersburg, Rech’ Publ., 2007. 294 p.

17.   Kutova N.V., Markova M.V. Chronic Pancreatitis as a Model of a Somatic Disease with Stressful Effects. Ukra¿ns’kii visnik psikhonevrologi¿: Tezi naukovo-praktichno¿ konferentsi¿ z mizhnarodnoyu uchastyu "Suchasni pidkhodi do diagnostiki, terapi¿ ta reabilitatsi¿ posttravmatichnikh stresovikh rozladiv" 28-29.05.2015 r. m. [Ukrainian Bulletin of Psychoneurology: Proceedings of the applied research conference with international participation "Modern Approaches to Diagnostics, Therapy and Rehabilitation of Post-Traumatic Stress Disorders"]. Kharkiv, 2015, vol. 23, no. 2(83), pp. 111–112 [in Ukrainian].

18.   Kocharyan A.S., Saprykina E.V., Saprykin A.V., Topalov D.P., Lapin I.P., Demin Yu.A. The Personality of Patients with Neurotic Disorders: a Sex-Role Aspect. Mezhdunarodnyi meditsinskii zhurnal, 2002, no. 2, pp. 67–70 [in Russian].

19.   Maksimenko K.S. Lichnostno-orientirovannaya terapiya emotsional’nykh rasstroistv pri somatogeniyakh [Person-Centered Therapy of Emotional Disorders in Case of Somatogeny]. Kiev, Izdatel’skii Dom "Slovo" Publ., 2015 352 p.

20.   Mendelevich V.D. Klinicheskaya i meditsinskaya psikhologiya [Clinical and Medical Psychology]. 5th edition. Moscow, MEDpress-inform Publ., 2005. 432 p.

21.   Mikhailov B.V., Serdyuk A.I., Fedoseev V.A. Psikhoterapiya v obshchesomaticheskoi meditsine. Klinicheskoe rukovodstvo [Psychotherapy in General Somatic Medicine: A clinical practice guideline]. Kharkov, Prapor Publ., 2002. 128 p.

22.   Moroz S.M. Psikhopatologiya i patopsikhologiya invalidnosti vnaslidok somatichnikh zakhvoryuvan’ (fenomenologiya, mekhanizmi formuvannya, printsipi sotsial’no¿ reabilitatsi¿). Avtoref. dis. doc. med. nauk [Psychopathology and Pathopsychology of Disability Caused by Somatic Diseases (Phenomenology, Mechanisms of Development, and Principles of Social Rehabilitation). Doc. med. sci. diss.]. Kharkov, 2010. 39 p.

23.   Obukhov Ya.L. Glubinno-psikhologicheskii podkhod v psikhoterapii psikhosomaticheskikh zabolevanii [Depth Psychological Approach in the Psychotherapy of Psychosomatic Diseases]. Moscow, RMAPO Publ., 1997. 33 p.

24.   Prostomolotov V.F. Psikhosomaticheskie rasstroistva. Klinika. Patogenez. Terapiya. Profilaktika [Psychosomatic Disorders. Clinical Picture. Pathogenesis. Therapy. Prophylaxis]. Odessa, KP OGT Publ., 2007. 295 p.

25.   Roslyakova V.A. Clinical Psychopathological Characteristics of Non-Psychotic Depressive Disorders in Patients with Tumors of Maxillofacial Area. Meditsinskaya psikhologiya, 2012, vol. 7, no. 1, pp. 85–88 [in Russian].

26.   Samushiya M.A., Zubova I.V. Nosogenia (Psychogenic Responses) in Case of Breast Cancer. Psikhicheskie rasstroistva v obshchei meditsine, 2009, no. 1, pp. 24–29 [in Russian].

27.   Tkhostov A.Sh. A Psychotherapist and His Magic. Psikhologiya, 2006, vol. 3, no. 1, pp. 103–109 [in Russian].

28.   Shcheglov L.M. Psychology of a Somatic Patient. Meditsinskaya psikhologiya, 2006, vol. 1, no. 3, pp. 22–28 [in Russian].

29.   Garcia-Vega E., Fernandez-Rodriguez C. A stress management programme for Crohn’s disease. Behav Res Ther, 2004, vol. 42, no. 4, pp. 367–383.

30.   Maksimenko K. Mental Conditions. In: Maksimenko S.D. Genesis of Personality Existence. Montreal, Accent Graphics Communication, 2015, pp. 271–293.

31.   Bitton A., Sewitch M.J., Peppercorn M.A., Edwardes M.D., Shah S.A., Ransil B., Locke S.E. Psychosocial determinants of relapse in ulcerative colitis: a longitudinal study. Am J Gastroenterol, 2003, vol. 98, no. 10, pp. 2203–2208.

32.   Von Wietersheim J., Kessler H. Psychotherapy with chronic inflammatory bowel disease patients: A Review. Inflamm Bowel Dis, 2006, vol. 12, no. 12, pp. 1175–1184.

 

For citation

Bondarenko A.F., Maksimenko K.S. Experimental study of person-centered psychotherapy effectiveness (based on sample with chronic gastrointestinal diseases). Part I. Med. psihol. Ross., 2017, vol. 9, no. 3(44), p. 8 [in Russian, in English]. Available at: http://mprj.ru 



Activities

Questions left?