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Module State of the Art Research of Psycho-Social Aspects of APA (2002)

Module State of the Art Research of Psycho-Social Aspects of APA (2002). general introduction Prof. H. Van Coppenolle, co-ordinator. Psycho-Social Aspects are maybe the most important ones in APA . and maybe as well the most forgotten.

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Module State of the Art Research of Psycho-Social Aspects of APA (2002)

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  1. Module State of the Art Research of Psycho-Social Aspects of APA (2002) general introduction Prof. H. Van Coppenolle, co-ordinator

  2. Psycho-Social Aspects are maybe the most important ones in APA • and maybe as well the most forgotten

  3. There are two major groups of persons with a disability involved in the psychosocial approach of APA • 1. The psychosocial approach of APA in persons with psychiatric and intellectual problems (psychomotor therapy) • 2. The psychosocial approach of persons with a physical disability

  4. Pascal Duquennes

  5. Psychiatric problems • What is the scientific (systematic) way using movement activities (psychomotor therapy) for persons a psychiatric problems (depression, anorexia nervosa, schizophrenia, dementia) ?

  6. Basic scientific (systematic) principles and concrete Applications of Psychomotor Therapy in Psychiatric Patients

  7. Psychomotor Therapy • tries to have therapeutic effects on psychiatric patients (for example depressed patients, patients with eating disorders (anorexia nervosa) and different personality problems

  8. Psychomotor Therapy for adult Psychiatric Patients • is a form of treatment that has been systematically used in Belgium (Flanders) since 1965 • in that year a post-graduate course was started at the KU Leuven (and is now also open for international students) • this form of treatment attempts to act systematically on the body perception and the behaviour in order to achieve therapeutic objectives

  9. A New International Specialisation Programme in Psychomotor Therapy

  10. A Postgraduate Specialisation programme in Psychomotor Therapy exists since 1964 in the Faculty of Physical Education and Physiotherapy at the K.U. Leuven

  11. During these 36 years 500 specialists were trained who work now: • in Belgian psychiatric hospitals • in special schools • in centres for special education for children and adults :

  12. This specialisationprogram at a universitylevel is unique • In Belgium • in Europe • in the whole world

  13. And therefore we wanted to open it for students coming from other countries (in English)

  14. Special Topics • Psychomotor therapy in patients with Eating Disorders (Anorexia Nervosa) • Psychomotor Therapy in psychiatric patients with mood disorders or anxiety disorders • psychomotor therapy in dementia patients • Psychomotor Therapy in Children

  15. The program consists of : • A period of 6 month’s practice in Psychomotor Therapy in several clinical settings (children and adults) • depressed patients • anxious patients • eating disorders • schizophrenia • autism • learning disorders and intellectual deficiency

  16. and a program of 8 theoretical and practical lectures ( 60 credits)

  17. PMT can start from 1: • theories in therapy such as: • biological therapy • psychological forms of therapy such as: • behaviour therapy, • supporting therapy, • cognitive therapy, • psychotherapy

  18. but this approach was not individualised on the psychomotor characteristics • of the patient • and moreover was quite speculative • because most theories on which this approach was based are quite speculative and unscientific as well

  19. PMT can start from 2: • The psychopathological characteristics and the objective of PMT will be the normalisation of the pathological characteristics • DSM IV (diagnostical manual of Mental Diseases): lecture of P. Van de Vliet • the great advantage of PMT is the basic motivating power of movement activities for most psychiatric patients (72%) (PhD H. Van Coppenolle)

  20. PMT can start from 3: • The observed psychomotor characteristics : for example on the basis of the LOFOPT (The Leuven Observation Scales for Objectives in Psychomotor Therapy) • this scale is valid and reliable (PhD J. Simons)

  21. The Leuven Observation Scales for objectives in Psychomotor Therapy (general approach for all psychiatric patients • emotional relations • self-confidence • activity • relaxation • movement control • focusing on the situation • movement expressivity • verbal communication • social regulation ability

  22. the Leuven Observation Scales for Objectives in Psychomotor Therapy • Adapted Physical Activity Quarterly, 1989,6,145-153

  23. We prefer this third approach because then the PMT therapist • Works on a systematic way • tries to counteract the deviations on the LOFOPT scales • works on an practical and concrete basis (observations) • because the psychomotor characteristics expressed in the LOFOPT are the expression of the basic personality

  24. For example: applied on psychotic patients • We see usually deviations in the LOFOPT scores for:

  25. the 9 groups of therapeutic objectives improving: • 1. emotional relations (-) • 2. self-confidence • 3. Activity (-) • 4. relaxation • 5. movement control • 6. focusing on the situation (-)

  26. other therapeutic objectives • 7. movement expressivity (-) • 8. verbal communication (-) • 9. social regulation ability(-)

  27. PMT in psychotic patients tries • To motivate as much the patients for participation by making the situations (working against apathy and indifference) • attractive (3 different situations in one session) • funny • co-operation stimulating (include everybody) • expression (verbal) stimulating

  28. The warm empathic contact of the therapist is very important • Directive (handle the group in a directive way) • all the time stimulate them verbally by talking loudly and every 15 seconds) • trying to have a personal warm relation with them

  29. Example of how to use the LOVIPT scales • Film “Psychomotor Observation and Therapy in a psychotherapeutic community” which expresses the psychomotor characteristics of some psychiatric patients • and how these characteristics are observed and scored on the LOVIPT scales

  30. Psychomotor therapy in patients with Eating Disorders (Anorexia and Bulimia Nervosa) (Ph D M. Probst) • distorted body experience • hyperactivity • fear to lose self-control

  31. General goals for Psychomotor Therapy • rebuilding a realistic self-image • curbing hyperactivity, impulses and tensions • developing social skills • learning how to enjoy the body

  32. FILM ” Psychomotor Therapy in Anorexia Nervosa Patients” • An example of the way the techniques of evaluation and psychomotor therapy • First Prize on the International Filmcontest in Berlin (1989)

  33. The systematic evaluation and therapy tools are • The videoconfrontation • the videodistortion • the LOFOPT • the body attitude scale • the body composition technique • the body awareness methods • the body enjoyment methods (relaxation massage) • cf article Body Experience and Body Composition in Anorexia Nervosa Patients, Issues in Special Education and Rehabilitation)

  34. Psychomotor Therapy in psychiatric patients with mood disorders or anxiety disorders

  35. Therapeutic Goals (PhD P. Van de Vliet-Jan Knapen) • reduction of feelings of anxiety, tension and depression • rebuilding an adequate self-esteem through regular success-achievements • rebuilding an adequate body image and self-esteem • confrontation with healthy behaviour and healthy movement behaviour • (cf lecture and text P. Van de Vliet: The physical self in clinically depressed patients)

  36. Film: “Fitness as Psychomotor Therapy in Depressive Patients” • Shows the specific and systematic evaluation methods and Psychomotor Therapy in depressive patients • Magna Cum Laude Award” International Filmcontest Hanover 1992 • CF First Thenapa CD-ROM

  37. Psychomotor Therapy in patients suffering from dementia • Is a quickly growing group in the psychiatric hospitals • is almost a “forgotten group” • for which as well PMT can be useful by trying to keep them at the highest possible level in general psychomotor functioning

  38. The basic fundamentals for Psychomotor therapy are: • Try to motivate them and giving them physical cognitive and emotional stimuli • let them experience that they are still able to have success-experiences • improve the social interactions

  39. Psychomotor Therapy in Children: psychomotor aspects (Dr. J. Simons) • Movement anamnesis • psychomotor observation and diagnostics • motor development • body co-ordination and laterality • manual dexterity • writing abilities • body image • orientation in space and time • self-esteem and physical competence

  40. Global approach of the personality of the child in psychomotor therapy • The objectives are situated as well in the motor domain • the motor-cognitive domain • the social-affective domain

  41. Practical organisation • We work with the own body and the body of the others • we manipulate the situation on 3 aspects

  42. On the motor domain we try • To improve the motor abilities and give them some movement experiences • because most of the children with psychiatric disorders have motor developmental problems

  43. On the motor-cognitive domain we let them experience different styles of motor learning • To let find them their own strategy • we try to reach them aspects of body concept

  44. On the motor-affective domain the objectives are: • Working with an adult • trusting him or her again • working with other children • focusing attention to adults • improving self-esteem

  45. Aspect 1: the therapy room • Each session starts with exercises on bodyconcept and ends with the same type of exercises • by doing this the child becomes aware of the aspect TIME • the room is structured by using mats and the children have to stay on it

  46. Aspect 2: the child • Each exercise starts from a safe place “the house” for which the child is sitting between the legs of the adult • by doing this we try to get the feeling of safety and as well to focus their attention on the movement situation

  47. Aspect 3: exercises • We choose the exercises in such a way that they can experience the feeling of success • the child is sometimes helping the adult in performing the exercises • later on the adult helps the child in the exercises

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