Relational Family Therapy in the Treatment of Sudden Cardiac Arrest Survivors and their Relatives
DOI:
https://doi.org/10.15633/pch.3894Słowa kluczowe:
Family, psychotherapy, sudden cardiac arrest, trauma, task analysisAbstrakt
Sudden cardiac arrest is the most common single cause of death in the contemporary world, but the proportion of survivors is increasing thanks to modern intensive methods of hospital treatment. However, data show that survivors experience high rates of neurological and cognitive deficits and poorer emotional well-being, which is a major challenge in treating these individuals and encouraging their integration in everyday life. These issues range from a number of emotional problems, such as anxiety and depression, to lower levels of participation in social life and a low rate of return to their workplace. The need for security and support increases because of the feelings of insecurity, vulnerability and fear of the recurrence of symptoms. Relatives/caregivers who report emotional problems and a higher level of post-traumatic stress are physically and mentally burdened, too. Hence, sudden cardiac arrest is a life-threatening event which is traumatic for survivors and their close relatives. It triggers strong emotional responses that are characteristic of all types of trauma (reliving the trauma, avoidance, negative thoughts and mood, increased agitation). People who have survived trauma thus suffer long-term effects, which are reflected in various dysfunctional behaviours and activities due to inadequate regulation of affective states. Because of these issues, there is a need for effective interventions that can psychologically help patients and relatives after surviving sudden cardiac arrest. In this paper, we will present the model of Relational Family Therapy, which can enable survivors and their relatives to appropriately emotionally-affectively process this experience and thus more appropriately integrate into a new way of life. With the qualitative research method of task analysis, we will show the process of change, which is based on the establishment of a new regulation of affect and allows in-depth processing of difficult emotional states after this event.
Bibliografia
Ballenger J. C., Davidson J. R. T., Lecrubier Y., Nutt D.J., Marshall R.D., Nemeroff C.B., Shalev A.Y., Yehuda R., Consensus statement update on posttraumatic stress disorder from the international consensus group on depression and anxiety, “Journal of Clinical Psychiatry” 65 (2004), pp. 55–62.
Benítez-Ortega J., Garrido-Fernández M., Review of task analysis research of significant events in psychotherapy, “Revista de Psicoterapia” 27 (2016), pp. 99–122.
Birk J. L., Sumner J.A., Haerizadeh M., Heyman-Kantor R., Falzon L., Gonzales C., Gershengoren L., Shapiro P., Edmondson D., Kronish I.M., Early interventions to prevent posttraumatic stress disorder symptoms in survivors of life-threatening medical events: A systematic review, “Journal of Anxiety Disorders” 64 (2019), pp. 24–39.
Bradley B., Furrow J.L., Toward a mini-theory of the blamer softening event: Tracking the moment-by-moment process, “Journal of Marital and Family Therapy” 30 (2004), pp. 233–246.
Cvetek R., Cvetek M., The Concept of Respect in the Bible and in Modern Sciences: A Descriptive Model of Respect in Interpersonal Relations, „Bogoslovni vestnik” Vol. 78 (2018), No. 3, pp. 855–869.
Cvetek R., Gostečnik C., Pate T., Simonič B., Valenta T., Repič Slavič T., Spirituality and psycho-organic regulation, “The Person and the Challenges” 8 (2018), pp. 147–166.
de Vos R., de Haes H.C., Koster R.W., de Haan R.J., Quality of survival after cardiopulmonary resuscitation, “Archives of Internal Medicine” 159 (1999), pp. 249–254.
Edmondson D., An enduring somatic threat model of Posttraumatic Stress Disorder due to acute life-threatening medical events, “Social and Personality Psychology Compass” 8 (2014), pp. 118–134.
Fisher J., Collins D., Psychocardiac disorders, in: R. Allan, J. Fisher (eds.), Heart & mind: The practice of cardiac psychology, Washington 2012, American Psychological Association, pp. 55–90.
Flaum Hall M., Hall S.E., When Treatment Becomes Trauma: Defining, Preventing, and Transforming Medical Trauma, “VISTAS” 2013, pp. 1–15. Retrieved from https://www.counseling.org/docs/default-source/vistas/when-treatment-becomes-trauma-defining-preventing-.pdf (28.07.2020).
Gostečnik C., Relacijska družinska terapija, Ljubljana 2004, Brat Frančišek and Franciscan Family Institute.
Gostečnik C., Inovativna relacijska družinska terapija, Ljubljana 2011, Brat Frančišek, Faculty of Theology and Franciscan Family Institute.
Gostečnik C., Relacijska paradigma in klinična praksa, Ljubljana 2013, Brat Frančišek and Franciscan Family Institute.
Gostečnik C., Relational family therapy, New York 2017, Routledge.
Gostečnik C., Cvetek R., Repič Slavič T., Pate T., Nove dimenzije analize, “Bogoslovni vestnik” 74 (2014), pp. 507–520.
Greenberg L. S., A guide to conducting a task analysis of psychotherapeutic change, “Psychotherapy Research” 17 (2007), pp. 15–30.
Islam S., Therapeutic hypothermia in cardiovascular disease [doctoral thesis], Cambridge 2017, Anglia Ruskin University, Faculty of Medical Science.
Ketilsdottir A., Albertsdottir H.R., Akadottir S.H., Gunnarsdottir T.J., Jonsdottir H., The experience of sudden cardiacarrest: Becoming reawakened to life, “European Journal of Cardiovascular Nursing” 13 (2014), pp. 429–435.
Kutz I., Shabtai H., Solomon Z., Neumann M., David D., Posttraumatic Stress Disorder in Myocardial Infarction patients: Prevalence study, “The Israel Journal of Psychiatry and Related Sciences” 31 (1994), 48–56.
Lundgren-Nilsson A., Rosen H., Hofgren C., Sunnerhagen K.S., The first year after successful cardiac resuscitation: function, activity, participation and quality of life, “Resuscitation” 66 (2005), pp. 285–289.
Middelkamp W., Moulaert V.R., Verbunt J.A., van Heugten C.M., Bakx W.G., Wade D.T., Life after survival: long-term daily life functioning and quality of life of patients with hypoxic brain injury as a result of a cardiac arrest, “Clinical Rehabilitation” 21 (2007), pp. 425–431.
Moulaert V. R., Verbunt J.A., van Heugten C.M., Wade D.T., Cognitive impairments in survivors of out-of-hospital cardiac arrest: A systematic review, “Resuscitation” 80 (2009), pp. 297–305.
Moulaert V. R., C. M. van Heugten, B. Winkens, W. G. M. Bakx, M. C. F. T. M. de Krom, T. P. M. Gorgels, D. T. Wade, J. A. Verbunt, Early neurologically-focused follow-up after cardiac arrest improves quality of life at one year: A randomised controlled trial, “International Journal of Cardiology” 193 (2015), pp. 8–16.
Moulaert V. R. M., van Heugten C.M., Gorgels T.P.M., Wade D.T., Verbunt J.A., Long-term outcome after survival of a cardiac arrest: A prospective longitudinal cohort study, “Neurorehabilitation and Neural Repair” 31 (2017), pp. 530–539.
Pusswald G., Fertl E., Faltl M., Auff E., Neurological rehabilitation of severely disabled cardiac arrest survivors. Part II. Life situation of patients and families after treatment, “Resuscitation” 47 (2000), pp. 241–248.
Randall G., Molloy G.J., Steptoe A., The impact of an acute cardiac event on the partners of patients: A systematic review, “Health Psychology Review” 3 (2009), pp. 1–84.
Roine R. O., Kajaste S., Kaste M., Neuropsychological sequelae of cardiac arrest, “JAMA” 269 (1993), pp. 237–242.
Rothschild B., The body remembers, Volume 2: Revolutionizing trauma treatment, New York 2017, W. W. Norton & Company.
Saner H., Borner Rodriguez E., Kummer Bangerter A., Schuppel R., von Planta M., Quality of life in long-term survivors of out-of-hospital cardiac arrest, “Resuscitation” 53 (2002), pp. 7–13.
Shapiro F., Eye movement desensitization and reprocessing: Basic principles, protocols and procedures, New York 2001, Guilford Press.
Stickgold R., EMDR: A putative neurobiological mechanism of action, “Journal of Clinical Psychology” 58 (2002), pp. 61–75.
van der Kolk B. A., Hopper J.W., Osterman J.A., Exploring the nature of traumatic memory: Combining clinical knowledge and laboratory methods, “Journal of Aggression, Maltreatment, and Trauma” 4 (2001), pp. 9–31.
van Wijnen H. G., Rasquin S.M., van Heugten C.M., Verbunt J.A., Moulaert V.R., The impact of cardiac arrest on the long-term wellbeing and caregiver burden of family caregivers: a prospective cohort study, “Clinical Rehabilitation” 31 (2017), pp. 1267–1275.
van’t Wount Hofland J., Moulaert V., van Heugten C., Verbunt J., Long-term quality of life of caregivers of cardiac arrest survivors and the impact of witnessing a cardiac event of a close relative, “Resuscitation” 128 (2018), pp. 198–203.
Vilchinsky N., Ginzburg K., Fait K., Foa E.B., Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review, “Clinical Psychology Review” 55 (2017), pp. 92–106.
Wachelder E. M., Moulaert V.R., van Heugten C., Verbunt J.A., Bekkers S.C., Wade D.T., Life after survival: long-term daily functioning and quality of life after an out-of hospital cardiac arrest, “Resuscitation” 80 (2009), pp. 517–522.
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