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Introduction: Obsessive-compulsive disorder (OCD) is one of the most challenging pathologies for therapists, being chronic and often characterized by frequent relapses. The therapeutic relationship plays a critical role in the outcome of therapy. The dynamic interaction between therapist and client schema modes determines the quality of the relationship., The Objective: of the present qualitative research is to investigate and conceptualize the triggers for therapists when working with OCD clients, the therapists' schema modes that are activated, and the strategies they use to get back into the Healthy Adult mode., Method: Using the in-depth interview technique, we interviewed 15 psychotherapists of various therapeutic orientations. After several demographic items, the therapists answered some introductory questions about their general perceptions of working with this pathology. They were then guided to go through a specific therapeutic situation in imagery that they identified as particularly difficult to manage in the therapeutic relationship. For data analysis, we used the interpretative phenomenological analysis (IPA) method and thematic analysis., Results: For therapists working with clients with OCD, two main categories of triggers have been identified: Perceived resistance to change and Superiority. Two other categories, Client immobilized by conflict and Abusive, emerged from our analysis. Therapists' reactions to triggers were synthesized into mode processes that (1) were not acted on and (2) were displayed in relation with the client. For mode processes that therapists did not explicitly act on, there was triggering of the Vulnerable Child in relationship with a Demanding Parent, followed by various coping modes, depending on the category of trigger, and in the displayed mode, most therapists operated in the Healthy Adult mode. With respect to the process, strategies used by therapists to return to Healthy Adult mode that stood out were: focusing on the process, self-acceptance, self-compassion, and somatic grounding strategies, and focusing on the client's resources., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Semeniuc, Sterie, Soponaru, Butnaru and Gavrilovici.)

Background: This article explores elder abuse in a hospitalised population. We wanted to identify details related to psychological and emotional abuse in the older population in our region and to determine the importance of the Elderly Abuse Suspicion Index (EASI © ) in comprehensive geriatric assessments., Methods: This cross-sectional study conducted between March 2015 and May 2016 included 386 consecutive hospitalised patients over 65 years of age. All patients underwent a geriatric assessment, data were collected about their medical history, and the EASI © was administered to each. The main outcome was identifying the presence, the type of abuse and the factors associated with abuse., Results: There were 21.5% of patients who suffered any form of abuse. Women were more frequently abused than men. Emotional abuse was the most common (60.2%) followed by neglect (53%) and physical abuse (22.91%); sexual abuse was absent in our study group. The abused patients had an impaired cognitive function (P = 0.034). They were also malnourished (P ≤ 0.001) and depressed (P = 0.001). The presence of peripheral artery disease, stroke, pneumonia, chronic kidney disease, musculoskeletal diseases and anxiety correlated with the presence of abuse. No statistically significant correlation was found between the degree of independence in instrumental activities of daily living and the presence of abuse (r = 0.105, P = 0.051)., Conclusions: EASI is a tool for detecting elder abuse and should be included in the standard geriatric assessment to prevent ageism. The number of abused elderly patients is significant, and the multiple factors associated with abuse are diverse., (© 2019 Japanese Psychogeriatric Society.)

Abuse of the elderly is a major issue debated worldwide. The most commonly identified form of abuse is the physical abuse. It is also the most frequently studied in the medical literature. However, at least six types of elder abuse are identified, and physical abuse is found in a small proportion of the cases. The consequences of abuse are frequent and, by prolonging hospitalizations, they will be associated with high costs of medical services, and patient's lack of self-confidence which, in time, may lead to social isolation, somatization, anxiety, depression, and suicide attempts. In this context, the identification and correction of psychological abuse becomes a desideratum of utmost importance for ensuring an optimal therapeutic response. This should be done by using a simple method that does not require qualified personnel, but allows the patient to be guided towards psychological consultation; this study was carried out with the help of the EASI EASI (The Elder Abuse Suspicion Index) questionnaire. We present the case of an 80-year old patient in a rural area, who has been hospitalized several times, admitted for numerous episodes of global cardiac decompensation (about four over the last year). The causes of cardiac decompensation were, systematically, non-compliance with treatment, regardless of all attempts to readjust and simplify the therapeutic schemes. The dynamic geriatric assessment showed a deterioration of the patient's mental and nutritional status and an accentuation of depression. The EASI questionnaire used during the last admission corroborated with the psychological consultation and detected several types of abuse: abandonment, negligence and financial abuse. Given that the complexity of care, the frequency of hospitalizations and the length of stay were reduced, therapeutic compliance increased and the mental and nutritional status improved after correcting the abuse.

Aim: To describe a pilot, innovative intervention project combining the adoption and adaptation for hospital use of a screening instrument designed for use in primary health care settings in Canada (and translated into 6 other languages) and a dialogical narrative therapeutic approach. The development of a complementary multidisciplinary elder abuse service (CMEAS) in a private-public partnership., Material and Methods: Between June 2015 – March 2016 elderly hospitalized in Iasi town, Geriatric Clinic and suspected of being abused had the benefit of a complementary multidisciplinary elder abuse service (CMEAS) after being screened for abuse, neglect or abandonment experiences., Results: A total of 450 patients admitted to the Geriatric Clinic were invited for the study and 152 raised suspicion of abuse experiences and were screened with EASI. Of these patients, 132 where found positive and were invited to participate in CMEAS., Conclusions: Such a multidisciplinary service requires the collaboration between the geriatric team (medical service), psychologist, social worker, legal advisor, and psychiatrist, referral of cases to relevant public and private community services and their monitoring after hospital discharge throughout project duration.