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1126 to 1150 of 1,623Self-forgiving processes in therapy for romantic relationship infidelity: An evidence-based case study.
Self-forgiveness is related to positive connections with self and others and may be particularly important for clients who have hurt others. Relational hurt is heightened within the most intimate relationships and is particularly salient in cases of romantic relationship infidelity. Therefore, self-forgiveness may be indicated for romantic partners who have engaged in infidelity. This evidence-based case study examines the treatment of a Caucasian woman in her early 50s who presented with self-unforgiveness following marital infidelity. An 8-week manualized individual counseling program for self-forgiveness was used, which incorporates emotion-focused therapy techniques and principles of positive psychology to facilitate clients' engagement with a 4-component therapeutic model of self-forgiveness-responsibility, remorse, restoration, and renewal. This evidence-based case study demonstrat…
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Markin RD (2016)case reportMEDLINE-indexed journal, not yet read by usPsychotherapy (Chicago, Ill.)5 citations What clinicians miss about miscarriages: Clinical errors in the treatment of early term perinatal loss.
In this article, clinical errors in the treatment of perinatal grief after a miscarriage are discussed, including (a) minimizing or avoiding painful affects related to the miscarriage, (b) assuming grief is resolved upon a subsequent healthy pregnancy, and (c) neglecting early unresolved losses that are reawakened by the loss of the pregnancy. It is argued that these unintentional errors, frequently committed by significant others in the patient's life, are similarly made by well-intentioned clinicians due to a lack of knowledge about the psychological impact of miscarriage and, moreover, an unconscious avoidance of such a common yet distressing loss. Background information relevant to each clinical error is briefly reviewed, followed by recommendations for a better approach to the situation and verbatim clinical exchanges. The author suggests that, in general, a better approach to treat…
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Henry HM (2015)case reportMEDLINE-indexed journal, not yet read by usJournal of religion and health9 citations Spiritual energy of Islamic prayers as a catalyst for psychotherapy.
Islamic prayers can produce spiritual energy that may yield many psychological benefits, such as amelioration of stress and improvement in subjective well-being, interpersonal sensitivity, and mastery. Islamic prayers can also be integrated into mainstream therapeutic interventions with religious Muslim clients, and this integration can mobilize, transform, and invigorate the process of psychotherapy. This paper provides methods that can be used for the explicit integration of Islamic prayers into traditional psychotherapy. Further, the paper offers strategies for avoiding potential pitfalls that may hamper this process. Finally, a case study illustrating this therapeutic integration and its psychological benefits will be presented.
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Toward an adaptation of interpersonal psychotherapy for Hispanic patients with DSM-IV major depressive disorder.
Background: Spanish-speaking individuals comprise a growing percentage of the United States population. They have greater difficulty than most in accessing and remaining in psychiatric treatments, including psychotherapy, their stated preference. The literature on cultural competence in treating Hispanic patients provides few details of psychotherapeutic adaptations.
Objective: This article, based on interpersonal psychotherapy (IPT) supervision for a low-socioeconomic sample of monolingual Spanish-speaking New York City patients, describes culturally specific psychotherapy.
Method: In conducting IPT for Spanish-speaking patients with DSM-IV major depressive disorder, we reviewed cases in weekly supervision over 3 years (January 2005 to January 2008) to explore treatment themes and evaluate the congruence of IPT in addressing them. Important themes are illustrated by case example.
Result…
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The psychotherapist and the sign language interpreter.
Specialized psychotherapy for deaf people in the Dutch and Western European mental health systems is still a rather young specialism. A key policy principle in Dutch mental health care for the deaf is that they should receive treatment in the language most accessible to them, which is usually Dutch Sign Language (Nederlandse Gebarentaal or NGT). Although psychotherapists for the deaf are trained to use sign language, situations will always arise in which a sign language interpreter is needed. Most psychotherapists have the opinion that working with a sign language interpreter in therapy sessions can be a valuable alternative option but also see it as a second-best solution because of its impact on the therapeutic process. This paper describes our years of collaborationship as a therapist and a sign language interpreter. If this collaborationship is optimal, it can generate a certain "the…
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Advancing Pain Care for Individuals with Sickle Cell Disease: Two Innovative Psychological Approaches.
Sickle cell disease (SCD) is a hemoglobin disorder impacting red blood cell and resulting in difficult-to-control pain, which significantly impacts quality of life and psychological wellbeing. There are barriers preventing patients living with SCD from receiving psychological care, and limited work demonstrating best psychological pain care practices. We describe two innovative approaches for incorporating psychological care in two clinics (i.e., pediatric and adult) serving patients living with SCD in a Southeastern United States health system. The first is psychological screening and referral to psychotherapy program. The second is a mindfulness program offering bedside interventions, retreats, and individual sessions. These innovative treatment approaches emphasize adapting psychological care to address care barriers (e.g., access to care, cultural stigma). Adaptable, patient-centered…
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Refinement of a meaning-centered counseling program for Chinese patients with advanced cancer: integrating cultural adaptation and implementation science approaches.
Background: This mixed methods study identified needed refinements to a telehealth-delivered cultural and linguistic adaptation of Meaning-Centered Psychotherapy for Chinese patients with advanced cancer (MCP-Ch) to enhance acceptability, comprehensibility, and implementation of the intervention in usual care settings, guided by the Ecological Validity Model (EVM) and the Practical, Robust Implementation and Sustainability Model (PRISM).
Methods: Fifteen purposively sampled mental health professionals who work with Chinese cancer patients completed surveys providing Likert-scale ratings on acceptability and comprehensibility of MCP-Ch content (guided by the EVM) and pre-implementation factors (guided by PRISM), followed by semi-structured interviews. Survey data were descriptively summarized and linked to qualitative interview data. Three analysts independently coded the transcripts acco…
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Compassion-Focused Therapy for an Older Adult with Motor Functional Neurological Disorder: A Case Study.
Objectives: Motor functional neurological disorder (mFND) is a condition where individuals may experience difficulties such as tremors, gait impairments, and paralysis which are not explained by identified structural damage to the brain. Studies on chronic conditions have suggested that psychological interventions such as compassion-focused therapy (CFT) may be effective in improving well-being in people with mFND. However, no evidence is currently available on psychotherapy for older people with mFND.
Methods: A 12-session CFT intervention was delivered to an 81-year-old British male with mFND. Standardized measures were administered at baseline and post-intervention.
Results: At post-intervention, a 30% decrease in perceived psychological impact of mFND was found, along with clinically significant changes in anxiety and depression. Good levels of feasibility and acceptability were also…
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A qualitative study of alcohol use disorder psychotherapies for transgender and nonbinary individuals: Opportunities for cultural adaptation.
Background: Transgender and nonbinary (TGNB) populations experience high rates of hazardous drinking (HD) and alcohol use disorder (AUD) as well as unique treatment barriers. This is due, in-part, to discrimination and stigma within and outside of the healthcare system. Cultural adaptation of clinical interventions can improve outcomes for marginalized populations, but no such adapted interventions exist for AUD among TGNB individuals. This study sought to understand how TGNB individuals perceive currently available AUD psychotherapies and to generate knowledge about potential areas for cultural adaptation.
Methods: As part of a qualitative study of HD among TGNB individuals (N=27), participants were asked to imagine that they were clients in psychotherapy vignettes corresponding to cognitive behavioral therapy, motivational enhancement therapy, and twelve step facilitation. Interviews w…
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Rethinking Research on Prediction and Prevention of Psychotherapy Dropout: A Mechanism-Oriented Approach.
Dropout is a ubiquitous psychotherapy outcome in clinical practice and treatment research alike, yet it remains a poorly understood problem. Contemporary dropout research is dominated by models of prediction that lack a strong theoretical foundation, often drawing on data from clinical trials that report on dropout in an inconsistent and incomplete fashion. In this article, we assert that dropout is a critical treatment outcome that is worthy of investigation as a mechanistic process. After briefly describing the scope of the dropout problem, we discuss the many factors that limit the field's present understanding of dropout. We then articulate and illustrate a transdiagnostic conceptual framework for examining psychotherapy dropout in contemporary research, concluding with recommendations for future research. With a more comprehensive understanding of the factors affecting retention, re…
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Psychotheraputic Dimensions of an Islamic-Sufi-Based Rehabilitation Center: A Case Study.
Due to limited professional mental health facilities in Indonesia, traditional and faith-based mental health care is essential to provide an alternative treatment. This study explored the therapeutic aspects of treatment at Pesantren Tetirah Dhikr (PTD), an Islamic-Sufi-based rehabilitation center for people with mental illness and drug addiction in Yogyakarta, Indonesia. We employed a case-study method to understand the process of therapy and the theoretical ideas behind the practice. We conducted interviews with the Kyai (head of PTD), his assistants, and sixteen patients (called santri). The results of a thematic analysis revealed that the practice of dhikr was the essential therapeutic component for improving the participants' mental health. From an Islamic psychological perspective, the process of therapy at PTD was comparable with the process of purification of the soul in Sufism. …
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Indicators of Sensory and Intellectual Thinking Based on Clinical Psychology and Islamic Perspective and their Role in Psychotherapy and Spiritual Health: Introducing a New Model of Thinking.
Today, the field of health is not limited to physical and mental health, but is related to all aspects of life, including spirituality. Spiritual health is so important that it is suggested as the fourth dimension of health, and in the near future, it will form part of the definition of health by the WHO. According to research in clinical psychology, in addition to spiritual health, another important issue in most psychotherapy theories is the issue of thinking. Given the importance of health and thinking, so far, no model has been presented in the field of the relationship between "thinking and health". So, the purpose of the present study is introducing a new model of healthy thinking based on human soul faculties. In this study, qualitative content analysis method has been used. Indicators of sensory and intellectual thinking have been noted within research results, which are the main…
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Three Emerging Spiritual Practices in the Canadian Association for Spiritual Care (CASC): From Pastoral Care and Counselling to Multi-Faith, Evidence-Based Spiritual Care and Psycho-Spiritual Therapy.
Describes the relationship between practice and theory (praxis) along with an examination of changes in the last 40 years in the praxis of pastoral care and counselling in the Canadian Association for Spiritual Care (CASC) that led to spiritual care and psycho-spiritual therapy. Developments in spiritual practices include growth in multi-faith, evidence-based spiritual care, and spiritually integrated psychotherapy (psycho-spiritual therapy). Suggests further areas of research and reflection including process theology.
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A practice-based evidence investigation of God representations in spiritually integrated psychotherapies.
Objective: This practice-based evidence study examined trajectories of God representations and psychological distress among Christians participating in spiritually integrated psychotherapies (SIPs).
Methods: In total, 17 clinicians practicing SIPs in a mid-sized city on the US Gulf Coast implemented session-to-session assessments of these outcomes with 158 clients over a 4-month period and also reported their use of specific spiritual interventions after each session (e.g., affirmed client's divine worth).
Results: Multivariate growth modeling revealed clients' psychological distress decreased over the study period whereas authoritarian God representations increased and benevolent God representations remained stable. In addition, clients who increased in benevolent representations of God had a greater likelihood of experiencing alleviation of psychological distress.
Conclusion: These fin…
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Meaning-Centered Psychotherapy for Latino Patients with Advanced Cancer: Cultural Adaptation Process.
Background: Latino patients with advanced cancer need culturally responsive, effective psychotherapeutic interventions that can assist them in coping with their diagnosis and improve spiritual and existential well-being and psychological adjustment. Objective: This study describes the cultural and linguistic adaptation of individual meaning-centered psychotherapy for Latinos with advanced cancer. Design: A mixed-methods, concurrent integrative approach was used for this study, using the ecological validity and cultural adaptation process models as frameworks for cultural adaptation. Setting/Subjects and Measurements: Quantitative and qualitative data were collected through (1) a survey of mental health professionals (n = 70) who offer services to Latino cancer patients; (2) a questionnaire for Latino patients with advanced cancer (n = 54), measuring relevant intervention concepts; and (3…
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What gets in the way? Men's perspectives of barriers to mental health services.
Background: This study describes barriers to accessing mental health services among men currently experiencing a mental health concern.
Methods: Mental health help-seeking survey data from 778 male respondents who self-reported experiencing a mental health concern were analyzed.
Results: Of these men, 65% (n = 513) wanted treatment and 35% (n = 265) did not want treatment. The most frequently endorsed barriers to mental health treatment were believing that a lot of people feel sad and down (80%; n = 620), not knowing what to look for in a psychotherapist (counselor; 80%; n = 618) and needing to solve one's own problems (73%; n = 569). Compared with men who wanted help for their mental health concern, those men who did not want help were significantly more likely to be unsure if psychotherapy (counseling) really works or is effective, not tell their physician if they were feeling down or …
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Once bitten, twice shy: Dissatisfaction with previous therapy and its implication for future help-seeking among men.
Objective: Men can be reluctant to disclose distress and many men have ambivalence toward seeking help for depression, leading to poor uptake of and engagement in psychotherapy. The present study sought to explore whether a previously dissatisfying therapy experience leads to greater doubts about the effectiveness of treatment, in turn impacting on a man's willingness to disclose their distress in future.
Method: An online survey of 133 Canadian men was conducted to investigate their current depressive symptoms, previous experience of, and belief in, the effectiveness of psychotherapy and likelihood of disclosing distress to their physician. A regression model with mediation was employed to analyze the relationship between these responses.
Results: The regression model highlighted a significant negative association between satisfaction with previous therapy and doubt about the effectiven…
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The development of the Compassion Focused Therapy Therapist Competence Rating Scale.
Objectives: Compassion-focused therapy (CFT) has shown promise as a treatment for a number of clinical presentations; however, existing studies have not adequately addressed issues of treatment fidelity. The aims of the present study were to identify initial candidate items that may be included in a CFT therapist competence rating scale and to develop the behavioural indicators to anchor these items.
Design: The Delphi method was used to develop and operationalize the competencies required for inclusion in a CFT therapist competence rating scale over five rounds.
Methods: Face-to-face meetings with two CFT experts were conducted in rounds one, two, and five, and these were used to define and operationalize the competencies. Nine other CFT experts were invited to complete online surveys in rounds two and four. An 80% consensus level was applied to the online surveys.
Results: The resultin…
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Was Eysenck right after all? A reassessment of the effects of psychotherapy for adult depression.
Aims: In the 1950s, Eysenck suggested that psychotherapies may not be effective at all. Twenty-five years later, the first meta-analysis of randomised controlled trials showed that the effects of psychotherapies were considerable and that Eysenck was wrong. However, since that time methods have become available to assess biases in meta-analyses.
Methods: We examined the influence of these biases on the effects of psychotherapies for adult depression, including risk of bias, publication bias and the exclusion of waiting list control groups.
Results: The unadjusted effect size of psychotherapies compared with control groups was g = 0.70 (limited to Western countries: g = 0.63), which corresponds to a number-needed-to-treat of 4.18. Only 23% of the studies could be considered as a low risk of bias. When adjusting for several sources of bias, the effect size across all types of therapies dro…
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Adverse effects of psychotherapy: protocol for a systematic review and meta-analysis.
Background: While it is well known that psychotherapy is efficacious in the treatment of mental disorders, much less is known about the adverse effects of psychotherapeutic interventions. The aim of this systematic review is to examine the definition, frequency, nature, and severity of adverse effects occurring parallel to or following psychotherapeutic treatment and to compare it against control groups.
Methods: All registered randomised controlled trials published since 2004 (publication year of harm-reporting extension of the CONSORT statement) with adult patients fulfilling clinical criteria of defined mental disorders, which compare individual or group psychotherapy against a control group, will be included. First, a search through international trial registers as well as a search in literature databases (e.g. MEDLINE) and in relevant journals (e.g. Trials) for study protocols will …
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The impact of personality disorder pathology on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder.
Background: Despite extensive research, there is no consensus how Personality Disorders (PD) and PD features affect outcome for Major Depressive Disorder (MDD). The present study evaluated the effects of PD (features) on treatment continuation and effectiveness in Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for MDD.
Methods: Depressed outpatients were randomized to CT (n=72) and IPT (n=74). Primary outcome was depression severity measured repeatedly with the Beck Depression Inventory-II (BDI-II) at baseline, three months, at the start of each therapy session, at post-treatment and monthly during five months follow-up.
Results: Comorbid PD and PD features did not affect dropout. Multilevel and Cox regression models indicated no negative effect of PD on BDI-II change and remission rates during treatment and follow-up, irrespective of the treatment received. For both therap…
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Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program: A Randomized Controlled Trial.
Background: In previous research, variables such as age, education, treatment credibility, and therapeutic alliance have shown to affect patients' treatment adherence and outcome in Internet-based psychotherapy. A more detailed understanding of how such variables are associated with different measures of adherence and clinical outcomes may help in designing more effective online therapy.
Objective: The aims of this study were to investigate demographical, psychological, and treatment-specific variables that could predict dropout, treatment adherence, and treatment outcomes in a study of online relaxation for mild to moderate stress symptoms.
Methods: Participant dropout and attrition as well as data from self-report instruments completed before, during, and after the online relaxation program were analyzed. Multiple linear and logistical regression analyses were conducted to predict earl…
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Exploration of the reasons for dropping out of psychotherapy: A qualitative study.
Elucidating the reasons for dropping out of psychotherapy can lead to the development of interventions aimed at reducing patient drop out. The present study aimed to explore patients' reasons for dropping out of psychotherapy in Kermanshah, Iran. The present qualitative study was performed using conventional content analysis. The current sample included 15 participants consisting of 7 patients who dropped out of psychotherapy and 8 psychotherapists who have previously experienced patient dropout. A semi-structured interview was used for data collection. All interviews were audio recorded and subsequently transcribed. Content analysis using constant comparisons was performed for transcribed interviews. Four main categories emerged as reasons for dropping out of psychotherapy: dissatisfaction with the quality of psychotherapy, financial problems in psychotherapy, unprepared socio-cultural …
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Early treatment withdrawal from evidence-based psychotherapy for PTSD: telemedicine and in-person parameters.
Objective: To determine differences in reported barriers to treatment completion associated with telemedicine vs. in-person delivery of evidence-based treatment for PTSD in combat veterans.
Method: The present study was derived from two ongoing randomized controlled trials (RCTs) comparing in-person vs. telemedicine delivery of exposure therapy for PTSD. A one-time telephone assessment of participants who dropped out from the treatment phase of these two studies was conducted, with measures focusing on reported reasons for dropout, and perceived comfort and efficacy of the treatment modality. Dichotomous data were analyzed via chi-square and logistic regression; continuous data via ANOVA.
Results: Forty-seven of 69 total dropouts participated. There was no difference in rate of dropout between modalities. A greater proportion of participants receiving in-person exposure therapy reported …
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Ravitz P, Cooke RG, Mitchell S, Reeves S, Teshima J, Lokuge B, Lawson A, McNaughton N, Skinner W, Cooper C, Fefergrad M, Zaretsky A (2013)MEDLINE-indexed journal, not yet read by usCanadian journal of psychiatry. Revue canadienne de psychiatrie13 citations Continuing education to go: capacity building in psychotherapies for front-line mental health workers in underserviced communities.
Objective: To address the gaps between need and access, and between treatment guidelines and their implementation for mental illness, through capacity building of front-line health workers.
Methods: Following a learning needs assessment, work-based continuing education courses in evidence-supported psychotherapies were developed for front-line workers in underserviced community settings. The 5-hour courses on the fundamentals of cognitive-behavioural therapy, interpersonal psychotherapy, motivational interviewing, and dialectical behaviour therapy each included videotaped captioned simulations, interactive lesson plans, and clinical practice behaviour reminders. Two courses, sequentially offered in 7 underserviced settings, were subjected to a mixed methods evaluation. Ninety-three nonmedical front-line workers enrolled in the program. Repeated measures analysis of variance was used to a…
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