Clinical Psychology

Different psychotherapeutic approaches claim positive changes in patients as a result of therapy. Explanations related to the change process led to different change models. Some of the change models are experimentally oriented whereas some are theoretical. Apart from the core models of behavioral, psychodynamic, humanistic, cognitive and spiritually oriented models there are specific models, within psychotherapy that explains the change process. Integrative theory of a person as depicted in Indian thought provides a common ground for the integration of various therapies. Integrative model of change based on Indian thought, with specific reference to psychological concepts in Upanishads, Ayurveda, Bhagavad Gita and Yoga are presented. Appropriate psychological tools may be developed in order to help the clinicians to choose the techniques that match the problem and the origin of the dimension. Explorations have to be conducted to develop more techniques that are culturally appropriate and clinically useful. Research has to be initiated to validate the identified concepts.

The study was conducted on a group of 12 lay counsellors and 12 professionals in order to compare the empathy of the two groups. The lay counsellors underwent six months, biweekly training and the professionals were senior students belonging to mental health professions. A 15 minutes simulated interview with an acting client was recorded and three 2 minute segments were coded, randomnized and rated. The 72 segments were rated by one rater, trained sufficiently in rating using the Accurate Empathy scale. The inter rater reliability for 30 segments was found to be .36 (significant at 0.05 level). The results showed that the empathy of the professionals group (mean score 6.7) was superior to lay counsellors group (mean score 5) which was statistically significant at 0.02 level.

The study was conducted on 12 professionals and 12 trained lay counsellors. The two groups were matched for sex (7 males and 5 females'! and their mean age was 27.5 and 32.25 years respectively. Ten hypothetical problem situationts were given and empathy was assessed using, accurate empathy rating scale by two independent raters. The inter rater reliabilitywas found to be quite high (.61 significant at .01 level). There was no significant difference between the two groups and the sex groups. On comparing the results with the scores on audiotaped interview, there, was no significant correlations obtained between the two methods. Problems involved in assessing empathy from questionnaire and suggestions for further research are also discussed.

Induced delusional disorder or folie a deux in a 19 year old girl from India whose 16 years old younger sister had paranoid schizophrenia is described. Transient sharing of delusional beliefs by those living with the patients may be an extension of unsubstantiated beliefs held by the community.

A study was conducted on 57 relatives (34 male and 23 female) of 57 (32 male and 25 female) schizophrenic patients in Kerala. The rejection response was found to be related to gender of patients and relatives, being significantly higher in males. The test reliability alpha of the Patient Rejection Scale was found to be 0.93 and it is higher than English and German version of the scale. Compared to the German and New York sample, the present sample tend to have high rejection feeling.

The articles that appeared in Indian Journal of Psychiatry were related to different areas of psychotherapy. Case reports dealt with a wide variety of cases. The review papers focused on the suitability of psychotherapy in the Indian context, different approaches in psychotherapy, psychotherapy training and supervision. Psychotherapy has been viewed very close to faith orientation. There were attempts to identify the indigenous concepts that are applicable to psychotherapy. Empirical studies are low in number. Concerted effort is needed to generate interest in psychotherapy, conduct more research on evidence-based therapies as well as on psychotherapeutic process variables.

Realising the need for rehabilitation services in Kerala, it was planned to open a day care centre in the capital ciiy, Thiruvanathapuram, in the southern district of Kerala. The announcement was made through a print media and the responses to avail the services of the centre are reported. Only one person contacted personally for help and there were 38 people who responded through mail. Majority of the respondents was from other districts of Kerala and there were requests from outside Kerala. Though it was expected that the relatives of the chronically i l l would respond, there were enquires from patients, friends and neighbour of mentally i l l . Request for sedces came from more number of men than women and it might be a reflection of the socio cultural role expectation of the male gender of this society The study points towards initiating psycho educational programmes on rehabilitation for the relatives of the chronically mentally i l l to help the patients and to ease the burden of the families.

problem. The measures provide a global 10-point of the rating of problem severity and standardised of' Mi chi gan composite or factor scores. Another tool available Screeni ng Test (MAST) was administered On 241 is a brief addiction rating scale (BARS) developed hospitalized alcohol dependent patients. 96.68% showed clear evidence or higher level of evidence by Janakiramaiah et al , and it is a less time consuming tool, but has to be administered by of' problems related to alcohol thus validating the the clinician scale and test retest reliability was found to be 92 which is highly significant. None of the variables like age, education, place of domicile, socio economic siaius, duration of drinking appears to have any significant relation on the scores.

Persons with marital conflict contact professionals when it goes beyond their control and the problem they present with are usually verbal or physical abuse. Consecutive six couples who were referred for psychological evaluation for marital problem and who had sexual dissatisfaction as reported by the spouses, were taken up for this study. Though the female partners were referred for evaluation, they did not have major psychiatric disorders. However, the female spouses reported that their partners have either low sexual desire or sexual dysfunction. The SIS-II was administered to understand their personality and therapeutic management. The findings showed that there was significant agreement in the scores of the couples except on Sex scores. Analysis of the types of the pattern of responses and its implications are discussed.

Psychogenic cough in adults is not commonly reported and the treatment of the medically unexplainable symptom is a challenge to the health professionals. A case of 26 year old married male from Afghanistan, who was having cough for one year duration, diagnosed as psychogenic headache was administered Somatic Inkblot Series (SIS-II). He avoided perceiving sexual responses on images generally depicting sexual imagery, may indicate deep rooted sexual conflict. The SIS responses further helped in planning and providing integrative psychotherapy to him. Follow up of the client after one year showed that he is free of symptoms, has legally migrated to one of the European countries and is effectively engaged in work. There were two responses, which may be typical for Afghans, which needs further exploration. There is a need for revamping the therapeutic supervision of the trainees while dealing with clients who have sexual misconceptions and those who hail from multi-cultural settings.

A study was conducted on 19 community volunteers and the training module they underwent is presented. The subjects were given 7 days in-training with the objectives of imparting knowledge ana skill to identify and motivate alcohol and drug dependent person, to motivate them and their family to seek treatment to provide social support to them and to organise prevention programmes in the community. Their knowledge, skills and attitudes have shown significant improvement and change as a result to training. Extraversion was found to be significantly related to change in all the above variables, psychoticism was related to attitude and self-esteem was related to improvement in skills. Need for under taking further research in this area is also emphasized.

Secondary School in a rural area in Chennai was conducted. Out of the 28 children referred for counselling, 27 boys were assessed and 24 were provided with psychological intervention at the school. Evaluation of the program after a period of 6 months showed marginal improvement. While the teachers identified several problems of the students, the students reported not only their problems as perceived by the teachers, they also reported several family related factors, like parental conflict, absence of father, parental alcoholism and poverty. While providing services, the students were found to be less motivated to study and to participate in the intervention programs. 26 teachers of the same school were also provided with training in identifying some of the problem behaviours in the classroom. Better co-ordination with mental health service providers and the schoolteachers might help identify more children that could benefit from the psychological intervention. Adopting student friendly and flexible strategies in approaching the children may result in better outcome of the programs. Keywords: school mental health program, problem behaviours in school children, rural school psychology Reviewing the studies of research

The study was conducted on 12 professionals and 12 Trained Lay Counsellors. The t w o groups were matched for sex (7 males and females) and their mean ages were 27.25 and 35.25 respectively. The members were asked t o report how they felt immediately after audiotaping a 15 minutes interview w i t h a simulated client. The results showed that 87.5% of the total group felt comfortable during recording whereas 12.5 felt incomfortable; 90.28% of the total group did not feel anxious whereas 9.72% felt anxious as the interview was being recorded. There were no significant differences between the professionals and the trained lay co~nsellors or between males and females