Rehabilitation, Especially the chronically ill and disabled deserve to benefit from "socially integrated psychotherapy" in view of their specific situation of distress, which has often arisen without warning and unexpectedly. Dealing with bodily impairments, there are the so-called "organismic" methods using the hypnoid state as major component that have proven to be highly efficient. Dealt with are autogenic training, guided affective imagery, respiratory feedback and hypnosis. Hypnoid states can be regarded as a third basic state of consciousness in humans (besides waking and sleep). They play a major role in many forms of psychotherapy. The knowledge and selective use of underlying mechanisms enhance the potentialities of psychotherapy. The psychotherapeutic basic dialogue stays in constant accompanying function. We are opposed to a widespread misconception that psychotherapy is a method for the treatment of psychogenic disorders only. We obtained good results in the treatment of palsied patients of extrapyramidal and pyramidal type with hypnosis or autohypnosis as well as with our own model of group psychotherapy (autogenic training with concomitant analytic discussion, over a period of up to nine months). In this set-up we successfully mix patients with psychogenic and with somatogenic disorders. Although not a primarily psychotherapeutic method, respiratory feedback also makes use of the hypnoid state. Good results have been achieved with patients in rehabilitation and chronic pain sufferers. Occasional experience with guided affective imagery have been encouraging. We can conclude that psychotherapy with organically ill patients is indicated and promising. We need more appropriate training, supervision and concomitant scientific research. neuropsychologists and rehabilitation psychologists who have expertise in the evaluation and treatment of the cognitive, emotional, social and behavioral disturbances of patients with conditions such as traumatic brain injury, learning disability, spinal cord injury, stroke, tumors, multiple sclerosis, Parkinsons Disease, amputations, Alzheimer's Disease, cancer, and other disabling conditions. The focus of our practices is with medical patients (child, adolescent, adult, and older adult) whose difficulties stem from their respective disabling conditions and their psychological reactions to them. Psychotherapy depends on developing an intensely personal patient-therapist relationship. He contends it is essential that the psychotherapist possess a capacity for empathy with a wide range of personality types and that he be more concerned about understanding patients as whole individuals than diagnosing precise kinds of neurosis. For Rehabilitation call Dr. Sherri Edelman at Triune Chiropractic, counseling and wellness, Cherry Street, Philadelphia, Pennsylvania, PA. In addition, psychotherapy today is not just a means of curing neurotic symptoms but of helping people suffering from "problems of living. Cognitive psychotherapy, often incorporating behavioral therapy techniques, has been found to be more effective than other types of psychotherapy in treating several specific types of psychological problems, including depression and panic attacks. Sometimes this treatment approach is called cognitive-behavioral psychotherapy because of the ease with which the two approaches combine to effectively treat a variety of psychological problems. This combination of treatment techniques is also effective in the treatment of schizophrenia. Behavioral therapy has been used in the treatment of schizophrenia for many years, but usually within a structured psychosocial rehabilitation program, rather than a part of an individual treatment approach. There are many reasons for this. First, schizophrenia is seen as a life-long illness, and few insurance plans were willing to provide coverage for treatment in the private sector because of the anticipated expense. This continues to be true, especially with managed care. The psychosocial rehabilitation programs that incorporated behavioral treatments were usually either hospital based, or funded by public money or non-profit grants. As such, budget constraints would encourage group behavioral treatment, offered by treatment providers with limited training or experience. These approaches demonstrated some success, but the potential value of behavioral treatment was often lost within the greater structure of the broad rehabilitation program. In other words, the program as a whole was evaluated, rather than specific components of the program. This is further complicated by the variety of rehabiltation programs that incorporate many different behavioral treatment modalities. If no two rehabilitation programs are identical, then it is difficult, or impossible, to evaluate the relative effectiveness of specific components. However, an assessment of the interpersonal deficits produced by schizophrenia predicts which behavioral treatments are most likely to be effective. The misinterpretation of events in the world is common in schizophrenia. Using cognitive therapy with schizophrenia requires the psychologist to accept that the cognitive distortions and disorganized thinking of schizophrenia are produced, at least in part, by a biological problem that will not cease simply because the "correct" interpretation of reality is explained to the client. Cognitive therapy can only be successful if the psychologist accepts the client's perception of reality, and determines how to use this "misperception" to assist the client in correctly managing life problems. The goal is to help the client use information from the world (other people, perceptions of events, etc.) to make adaptive coping decisions. The treatment goal, for the cognitive therapist, is not to "cure" schizophrenia, but to improve the client's ability to manage life problems, to function independently, and to be free of extreme distress and other psychological symptoms. Cognitive family treatment usually identifies the expectations of family members and how those expectations affect their interactions with the person diagnosed with schizophrenia. Additionally, connections are made between the family expectations and their emotional response to their ill relative. Appropriate expectations are explored, and problem solving sessions allow family members to meet their own emotional needs. Family members frequently need stress management training as well, and need to learn what their limits are, and what to do when those limits are reached.
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