 |
 |
|
|
 |
HIV infections and AIDSThrough the use of cognitive coping strategies, relaxation, and social support, multimodal cognitive behavioral stress management (CBSM) has shown great promise in improving psychological, neuroendocrinological and immunological functions in folks with HIV infection (, , , , ). These effects seem to operate on the sympathetic nervous system, and on the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal neuroendocrine axes. Reduction in depressed mood has been associated with decreased cortisol, and increased serum DHEA-S and testosterone. Reduction in anxiety has been associated with decreased norepinephrine. Immunological effects have been shown on increased CD8 cytotoxic/suppressor cells, conversion of naïve CD4 cells, and boosting of antiviral antibody titers Developed by Michael Antoni, Gail Ironson, and their colleagues at the University of Miami (, , , ), CBSM helps alter cognitive appraisals, teaches new coping strategies and relaxation, and encourages access to social support, and it may improve the quality of life in HIV infected men () and women (, ). CBSM is based upon social support theory that stress is easier to handle in a positive social context. The 10-week CBSM program is a mixture of emotion-focused and problem-focused coping strategies. Sessions are typically 90 minutes of didactic expressive supportive therapy followed by 30 minutes of relaxation. Groups usually consist of 4 to 8 individuals. The CBSM intervention is often referred to as GET SMART (Group-Experienced Therapy for Stress Management and Relaxation Training). CBSM with an added expressive supportive component is called SMART/EST or CBSM+. Various stress management techniques are presented and the group participants are encouraged to discuss these techniques and associate them with the stressors they may be experiencing. One or more group activity, such as role playing, group interactions or in-session worksheets, is introduced in each session and the participants are encouraged to practice these relevant techniques. Evidence is accumulating that accepting diagnosis and planning for the future decreases isolation and depression, and actually delays progression of disease (, , ). Perceiving self-efficacy and taking control may be important. It may also foster better treatment compliance, decrease risky behavior such as transmission of the virus, and increase ability to cope. |
|
|
||||||
|
|
 Site By: Coastal Web Innovations
Copyright © 2007 Heather Hills Therapy Center.
Privacy | Legal |
|
|