Talking treatment in general.
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1151 to 1175 of 1,623[Relapse prevention group therapy for paedophiles: French adaptation].
Psychotherapy for sex offenders has only very recently started to develop in France. The French law on compulsory treatment for sex offenders was voted in 1998, and many mental health practitioners are not trained to treat such patients yet. In our ambulatory forensic consultation, sex offenders have been treated since 1992 and group psychotherapy has been offered to them since 1994. Our first therapeutic models were the North-American behavioural-cognitive therapy and Pithers' relapse prevention model. Behavioural-cognitive theory describes paedophilia as an acquired sexual preference maintained by positive reinforcement. Pithers (1990) considered that relapse only occurs in high-risk situations, and that high-risk situations always come after offence precursors. In North America, relapse prevention consists in helping paedophiles spot their high-risk situations and offence precursors, …
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Cognitive behavioral therapy-based interventions for problematic pornography use: a scoping review.
Introduction: Problematic pornography use (PPU) has attracted increasing interest due to its reported associations with psychological distress, sexual difficulties, and relationship concerns in a subset of users. Several psychotherapeutic interventions have been proposed. Still, there is no widely accepted, evidence-based, standardized protocol for its treatment.
Objective: This scoping review aimed to identify and synthesize intervention protocols based on cognitive behavioral therapy (CBT) for the treatment of PPU, published between 2019 and 2024.
Methods: A systematic search was conducted in the PubMed, Scopus, and PsycINFO databases, using predefined terms such as "cognitive behavioral therapy," "pornography," "PPU," and "problematic pornography use." Empirical studies presenting CBT-based protocols for PPU, published in English, Portuguese, or Spanish between 2019 and 2024, were inc…
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Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review.
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response …
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Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review.
Unaccompanied minors (UAMs) are considered a particularly vulnerable population, facing severe threats regarding their physical and mental health. As their number has increased in recent years worldwide, research on mental health interventions has become necessary. The implementation of psychotherapeutic interventions has been documented, but psychosocial interventions seem to not have been consistently studied. In this review, we summarize the psychotherapeutic and psychosocial interventions with UAMs that have been studied up to now. Following the PRISMA guidelines for scoping reviews, we searched four databases and included studies and practice papers; there were no restrictions on publication date, geographical region, language, or method. We identified 46 studies on psychotherapeutic interventions and 16 studies on psychosocial interventions that met the inclusion criteria. Psychoth…
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Treatment Options for Fear of Blushing.
Purpose of review: To review mechanisms of blushing and fear of blushing from physiological, neuropharmacological and psychological viewpoints, and to evaluate current forms of treatment for blushing-related fear.
Recent findings: Blushing appears to be driven primarily by sympathetic adrenomedullary and neural vasodilator discharge, possibly in association with secondary neurovascular inflammation. Psychological risk factors for fear of blushing include social anxiety, coupled with heightened self-focused attention and inflated beliefs about the likelihood and social costs of blushing. In addition, schemas of emotional inhibition, social isolation and alienation may underlie blushing-related fears. Established psychological treatments for fear of blushing include task concentration training, exposure, cognitive therapy, social skills training, psychoeducation and applied relaxation. Mor…
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Shahar B (2020)reviewMEDLINE-indexed journal, not yet read by usJournal of clinical medicine5 citations New Developments in Emotion-Focused Therapy for Social Anxiety Disorder.
Social anxiety disorder (SAD) is a highly complex, chronic, disabling and costly anxiety disorder. Although cognitive-behavioral therapy (CBT) is effective for many patients, many others do not respond to CBT or remain considerably symptomatic at the end of treatment. Pharmacological effects are also modest. More empirically-supported treatment options are needed in order to increase patient access to effective treatment. Emotion-focused therapy (EFT) shows great promise in treating SAD effectively and is particularly suitable for treating SAD because pervasive emotional avoidance, difficulties with emotional differentiation, and high levels of self-criticism, which are central psychopathological processes in SAD, are also primary therapeutic targets in EFT. EFT is based on the assumption that the most efficient way to change a maladaptive emotion is not through reason or skill learning,…
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Grief Before and After Bereavement in the Elderly: An Approach to Care.
Grief is the natural response to the death of a loved one and is encountered frequently in clinical practice with the elderly; it can also precede the death. Knowledge about four distinct forms of grief can aid clinicians with the conceptualization of grief, and the assessment and care of grievers. First, predeath grief is experienced by many caregivers of terminally ill patients. Second, acute grief arises immediately after the death of a loved one; and third, this normally evolves to a permanent state of integrated grief after a process of adaptation. Finally, failure of adaptation results in Prolonged Grief Disorder (PGD) which has been recently included in ICD-11. The hallmark feature of PGD is intense longing for the deceased or persistent preoccupation with the deceased that lasts longer than 6 months after the death. Validated instruments are available to assist practitioners with…
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Positive psychology perspective on traumatic brain injury recovery and rehabilitation.
Recovery from traumatic brain injury (TBI) is heterogeneous, with injury characteristics and neuropathological findings accounting for a relatively modest proportion of the variance in clinical outcome. Furthermore, premorbid personality traits and psychological characteristics may moderate psychosocial recovery. Constructs from the field of positive psychology have been examined in multiple illness populations and are increasingly gaining attention as factors that may influence recovery from TBI. Positive affect, hope, optimism, adaptive coping style, and resilience have all been examined in the context of TBI. These phenomena are of particular interest because they may inform treatment, either by reducing psychological distress and promoting better adjustment, or by augmenting existing therapies to improve engagement. In general, research suggests that higher levels of these factors pr…
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Lampe L, Malhi GS (2018)reviewMEDLINE-indexed journal, not yet read by usPsychology research and behavior management40 citations Avoidant personality disorder: current insights.
Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD), schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the "severity continuum hypothesis", in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, fac…
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Advancing psychosocial care in cancer patients.
Cancer is a devastating disease causing significant psychological problems among patients and their families. In the past few decades, there have been growing implementation and dissemination of screening methods for the psychological consequences of cancer, including distress, depression, anxiety, post-traumatic stress, and demoralisation. Also, guidelines for the management of psychological distress have been developed and endorsed by a number of scientific cancer associations. This review examines some of the most significant related issues, also focusing on recent advances in psychosocial and psychopharmacological interventions as a part of a mandatory, integrated, and comprehensive approach to cancer care.
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Duquette P (2017)reviewMEDLINE-indexed journal, not yet read by usFrontiers in neuroscience29 citations Increasing Our Insular World View: Interoception and Psychopathology for Psychotherapists.
Interoception has been determined to be an elemental aspect of the neural foundations of physiological homeostasis, subjective experience, and motivated behavior. This paper reviews current neuroscience research regarding interoception and forms of interoceptive dysfunction that may result in psychopathology, focusing on depression, and anxiety, in a manner conducive to psychotherapists engaging with it to consider clinical applications. Pertinent aspects of interoceptive system processes in relation to psychopathology are addressed: Functional interoceptive ability and the forms of its expression, the difficulty of accurate measurement of such within an individual or group, interoceptive inference processes and perturbations. Predictive coding, considered in this context as interoceptive inference, a process that integrates bottom-up and top down lines of neural information emerging fro…
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Counseling-supportive interventions to decrease infertile women's perceived stress: A systematic review.
Background: Infertility all around the world and in every culture is recognized as a stressful and critical experience that threatens individual, familial, marital, and social stability. Thus, in accordance with the importance of a woman's mental health and the possible impact of mental health on treatment outcome, finding a way to deal with perceived stress in women can help improve pregnancy outcomes.
Methods: This study is a systematic review on reducing perceived infertility stress in infertile women. The current study was undertaken using multiple databases such as SID, Irandoc, Magi ran, Google Scholar, PubMed, Science Direct, Scopus, Cochrane library, and CINAHL selected from articles pertinent to the study. The selection of papers was undertaken from 1990 through May 2016. The methodological quality was assessed.
Results: The initial search yielded a list of 725 papers, and then …
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Characteristics of binge eating disorder in relation to diagnostic criteria.
The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included "binge eating disorder," DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and "shape and weight concerns." Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors' knowledge and/or on a review of…
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Bendit N (2014)reviewMEDLINE-indexed journal, not yet read by usAustralasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists8 citations Reputation and science: examining the effectiveness of DBT in the treatment of borderline personality disorder.
Objective: This paper examines the evidence base for dialectical behaviour therapy (DBT) in the treatment of patients with borderline personality disorder (BPD).
Conclusion: DBT has built an impressive reputation within psychology and psychiatry as an effective treatment for deliberate self harm and chronic suicidal behaviours in patients with BPD. However, when each of the randomised controlled trials that comprise this evidence base is examined carefully, the actual results are less convincing about DBT's positive reputation.
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Do indicated preventive interventions for depression represent good value for money?
Objective: The prevention of depression is of growing interest to researchers and policy makers. However, the question of whether interventions designed to prevent depression provide value for money at a population level remains largely unanswered. The current study assesses the cost-effectiveness of two indicated interventions designed to prevent depression: a brief psychological intervention based on bibliotherapy and a more comprehensive group-based psychological intervention following opportunistic screening for sub-syndromal depression in general practice.
Method: Economic modelling using a cost utility framework was used to assess the incremental cost effectiveness ratios (ICERs) of the two interventions within the Australian population context, modelled as add-ons to current practice. The perspective was the health sector and outcomes were measured using disability-adjusted life y…
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Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches.
The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war. The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal …
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Mansell W (2011)editorial or commentMEDLINE-indexed journal, not yet read by usClinical psychology review12 citations Core processes of psychopathology and recovery: "does the Dodo bird effect have wings?".
This editorial proposes that the task of identifying common processes across disorders and across psychotherapies will be the most fruitful way to develop efficient, easily trainable and coherent psychological interventions. The article adapts the concept of the 'Dodo Bird Effect' to argue for a mechanistic, testable account of functioning, akin to other unified approaches in science. The articles in the special issue complement this perspective in several ways: (1) three articles identify common processes across disorders within the domains of anger dysregulation, sleep disruption and perfectionism; (2) one article emphasises a case conceptualisation approach that is applied across different disorders and integrates theoretical approaches; (3) three articles focus on the utility of a control theory approach to understand the core processes of maintenance and change. Critically, there is…
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Never underestimate fears, blocks, and resistances: The interplay between experiential practices, self-conscious emotions, and the therapeutic relationship in compassion focused therapy.
Experiential practices are a core component of compassion focused therapy (CFT). Throughout the treatment process, the client's engagement with these practices may become blocked, resulting in a rupture in the therapeutic relationship. In these instances, the interplay between these experiential practices and the therapeutic relationship becomes an essential focus of therapy to repair the rupture, re-engage the client in the therapeutic process, and proceed with the CFT treatment plan. This paper presents the case of a man diagnosed with social anxiety disorder, with the presence of shame-based self-criticism, treated via 12 sessions of CFT. CFT was proceeding well until certain embodiment practices and chair work were introduced, at which point the client refused to continue and became disengaged in the session. The process of repair and re-engagement will be discussed from the perspect…
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"You are already all you need to be": A case illustration of compassion-focused therapy for shame and perfectionism.
This paper presents the case of a 28-year-old woman diagnosed with major depressive disorder, with strong features of perfectionism, shame, and self-criticism, treated via 12 sessions of compassion-focused therapy (CFT). CFT is an integrative therapeutic approach that draws upon evolutionary psychology, attachment theory, and applied psychological processes from neuroscience, clinical and social psychology. The effectiveness of compassion focused approaches with perfectionism and self-criticism across a range of clinical disorders is becoming increasingly well-established. Given this mounting evidence, a four-phase, 12-session CFT treatment plan was developed for this case: (1-2) establishing the therapeutic relationship; (3-4) psychoeducation regarding the evolutionary model of compassion; (5-8) compassionate mind training and skills development; (9-11) working with perfectionism, shame…
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Cognitive-behavioral conjoint therapy for posttraumatic stress disorder: application to a couple's shared traumatic experience.
Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD) is designed to improve PTSD symptoms and enhance intimate relationship adjustment. Phase 1 includes psychoeducation about the reciprocal influences of PTSD symptoms and relationship functioning, exercises to promote positive affect and behaviors, and conflict management skills. In Phase 2, behavioral methods are used to address avoidance and emotional numbing and to increase relationship satisfaction. Couples engage in activities to promote approaching, rather than avoiding, feared situations. Phase 3 focuses on specific trauma appraisals and here-and-now cognitions that maintain PTSD and relationship problems. This article provides an overview of the treatment, a review of the outcome research, and a case illustration of a couple with a shared trauma (a stillborn child).
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Adaptation of the preventive intervention program for depression for use with predominantly low-income Latino families.
This paper describes the process for and safety/feasibility of adapting the Beardslee Preventive Intervention Program for Depression for use with predominantly low income, Latino families. Utilizing a Stage I model for protocol development, the adaptation involved literature review, focus groups, pilot testing of the adapted manual, and open trial of the adapted intervention with 9 families experiencing maternal depression. Adaptations included conducting the intervention in either Spanish or English, expanding the intervention to include the contextual experience of Latino families in the United States with special attention to cultural metaphors, and using a strength-based, family-centered approach. The families completed preintervention measures for maternal depression, child behavioral difficulties, global functioning, life stresses, and an interview that included questions about acc…
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"I would not want the mechanic to direct me to an engine repair manual": a qualitative analysis of provider perspectives on low-intensity treatments for patients on waiting lists.
Background: Low-intensity treatments (LITs), such as bibliotherapy or online self-help, have the potential to reach more individuals than traditional face-to-face care by circumventing many of the common barriers to mental health treatment. Despite substantial research evidence supporting their usability and efficacy across several clinical presentations, prior work suggests that mental health providers rarely recommend LITs for patients waiting for treatment.
Methods: The present study analyzed provider open responses to a prompt asking about perceived barriers, thoughts, and comments related to additional treatment resources for patients on treatment waiting lists. We surveyed 141 practicing mental health providers, 65 of whom responded to an open text box with additional thoughts on using LITs for patients on treatment waiting lists. Responses were qualitatively coded using a thematic…
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Strategies to Promote Social Connections Among Older Adults During "Social Distancing" Restrictions.
Older age and medical comorbidity are factors associated with more severe illness and risk of death due to COVID-19 infection. Social distancing is an important public health strategy for controlling the spread of the virus and minimizing its impact on the older adult population. It comes at a cost, however. Loneliness is associated with myriad adverse health outcomes, one of which is impaired immune functioning, which adds even greater risk for coronavirus infection, complications and death. Older adults, therefore, are at compound risk, making effective management of loneliness and social isolation in our older patients a high priority target for preventive intervention. In this paper, the authors describe a cognitive-behavioral framework for social connectedness, including evidence-informed strategies clinicians can use to help patients develop a "Connections Plan" to stay connected a…
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Gamliel T (2017)MEDLINE-indexed journal, not yet read by usTranscultural psychiatry1 citations Collective in exile: Utilizing terror management theory to understand women's wailing performance.
Although women's wailing at death rites in various cultures typically amplifies mortality salience, this ritual phenomenon is absent in the research literature on terror management theory (TMT). This study explored Yemenite-Jewish wailing in Israel as an example of how a traditional performance manages death anxiety in a community context. Observations of wailing events and interviews with Yemenite-Jewish wailers and mourners in Israel were analyzed to understand respondents' perceptions of the experience of wailing as well as the anxiety-oriented psychotherapeutic expertise involved. The findings are discussed to propose an alternative outlook on the intersubjective adaptive value of death anxiety. After describing TMT's view on the role of culture in coping with death anxiety, I consider the extent to which Yemenite-Jewish wailing is consistent with the premises of TMT.
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Self-compassion in clinical practice.
Self-compassion is conceptualized as containing 3 core components: self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus overidentification, when relating to painful experiences. Research evidence demonstrates that self-compassion is related to psychological flourishing and reduced psychopathology. Mindful Self-Compassion (MSC) is an 8-week training program, meeting 2.5 hours each week, designed to help participants cultivate self-compassion. MSC contains a variety of meditations (e.g., loving-kindness, affectionate breathing) as well as informal practices for use in daily life (e.g., soothing touch, self-compassionate letter writing). A detailed clinical case illustrates the journey of a client through the 8 weeks of MSC training, describing the key features of each session and the client's response.
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