Talking treatment in general.
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1226 to 1250 of 1,623A Point in the Heart: Concepts of Emotional Distress Among Albanian-Speaking Immigrants in Switzerland.
Cultural variability regarding concepts of distress for common mental disorders (CMD) has been reported extensively in cultural clinical psychology across the globe. However, little is known about illness narratives in social communities from Southeast Europe. The purpose of this paper is to identify cultural concepts of distress (CCDs) among Albanian-speaking immigrants in Switzerland and to integrate the findings into literature from other parts of the world. Twenty semi-structured qualitative interviews were conducted using the Barts Explanatory Model Inventory (BEMI). A set of concepts was described through content analysis and semantic network analysis. The results show complex expressions of distress, which are mainly associated with post-migration living difficulties. Social problems and life-changing events mark the onset of the most common symptoms. Self-management and social su…
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Snodgrass JL (2019)MEDLINE-indexed journal, not yet read by usThe journal of pastoral care & counseling : JPCC The Future of Spiritually Integrated Psychotherapy in the AAPC Tradition.
The consolidation of AAPC and ACPE created an opportunity to advance the discipline and practice of spiritually integrated psychotherapy in a distinctive, sustainable way. AAPC's way of educating and forming counselors is like a tree whose root system is strong, but its previous location was no longer viable. This article expands the metaphor of transplanting the AAPC tree and outlines how the consolidation will facilitate the growth of spiritually integrated psychotherapy in the AAPC tradition into the future.
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Patient perspectives on adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population.
The Chinese immigrant community faces multiple obstacles to effective cancer support and psychosocial care post diagnosis. Meaning-centered psychotherapy (MCP) is an empirically based treatment (EBT) that has been found to significantly reduce psychological distress while increasing spiritual well-being and a sense of meaning and purpose in life in patients with advanced cancer. However, it has not yet been adapted for Chinese immigrants who have unique linguistic and cultural needs. This study presents a community needs assessment to inform the cultural adaptation of MCP for Chinese patients with advanced cancer using Bernal et al.'s ecological validity model and the cultural adaptation process model of Domenech-Rodriquez and Weiling. Interviews were conducted until saturation with 12 Chinese immigrants with advanced cancer to determine the community's needs and preferences regarding th…
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Schoenherr D, Paulick J, Strauss BM, Deisenhofer AK, Schwartz B, Rubel JA, Lutz W, Stangier U, Altmann U (2019)MEDLINE-indexed journal, not yet read by usPsychotherapy (Chicago, Ill.)28 citations Nonverbal synchrony predicts premature termination of psychotherapy for social anxiety disorder.
Premature termination is a problem in psychotherapy. In addition to the examination of demographic and clinical variables as predictors of dropout, research indicates the importance of dyadic variables. Nonverbal synchrony (e.g., movement synchrony) operationalizes the coordination of patient and therapist and is a promising candidate for predicting premature termination. This secondary data analysis included data on patients with social anxiety disorder (N = 267) that were treated with > 20 sessions of cognitive-behavioral therapy or psychodynamic therapy. Therapy outcome was measured by the Inventory of Interpersonal Problems and the Beck Depression Inventory. Individual movements in the third session were assessed by motion energy analysis. Movement synchrony was identified with a windowed cross-lagged correlation and peak-picking algorithm. We performed logistic regressions and mixed…
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Zhou X, Zhang Y, Furukawa TA, Cuijpers P, Pu J, Weisz JR, Yang L, Hetrick SE, Del Giovane C, Cohen D, James AC, Yuan S, Whittington C, Jiang X, Teng T, Cipriani A, Cipriani A, Xie P (2019)MEDLINE-indexed journal, not yet read by usJAMA psychiatry56 citations Different Types and Acceptability of Psychotherapies for Acute Anxiety Disorders in Children and Adolescents: A Network Meta-analysis.
Importance: Anxiety disorders are common in children and adolescents, and uncertainty remains regarding the optimal strategy of psychotherapies in this population.
Objective: To compare and rank the different types of psychotherapies and the different ways of delivering psychological treatments for anxiety disorders in children and adolescents.
Data sources: PubMed, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, Web of Science, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ProQuest Dissertations, LILACS (Literatura Latino Americana em Ciências da Saúde), international trial registers, and US Food and Drug Administration reports were searched from inception to November 30, 2017.
Study selection: Randomized clinical trials that compared any structured psychotherapy with another psychotherapy or a control condition for anxiety disorders in children an…
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Kazdin AE (2018)MEDLINE-indexed journal, not yet read by usPsychotherapy research : journal of the Society for Psychotherapy Research17 citations Implementation and evaluation of treatments for children and adolescents with conduct problems: Findings, challenges, and future directions.
Objective: The intervention work of our clinical-research team has focused on the treatment of children and young adolescents referred for Conduct Disorder or Oppositional Defiant Disorder.
Method: We have evaluated two interventions: parent management training (PMT) and cognitive problem-solving skills training in several randomized controlled clinical trials.
Results: Our findings have indicated the treatments, alone or in combination, produce reliable and significant reductions in oppositional, aggressive, and antisocial behaviour and increases in prosocial behaviour among children. Parent dysfunction (depression, multiple symptom domains) and stress decline and family relations improve as well. Apart from outcome studies, we have studied the therapeutic alliance, factors that influence dropping out and retaining cases, and variations of treatment delivery (e.g., computer based, reduc…
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Adapting Meaning-Centered Psychotherapy in Advanced Cancer for the Chinese Immigrant Population.
The Chinese immigrant community faces multiple barriers to quality cancer care and cancer survivorship. Meaning-centered psychotherapy (MCP) is an empirically-based treatment shown to significantly reduce psychological distress while increasing spiritual well-being and a sense of meaning and purpose in life in advanced cancer patients. However, it has not yet been adapted for racial and ethnic minority populations for whom the concept of "meaning" may likely differ from that of westernized White populations. In this study, we conducted a community needs assessment to inform the cultural adaptation of MCP for Chinese patients with advanced cancer, in accordance with Bernal et al. ecological validity model and the cultural adaptation process model of Domenech-Rodriquez and Weiling. We conducted interviews until saturation with 11 key Chinese-serving community leaders and health professiona…
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Premature psychotherapy termination in an outpatient treatment program for personality disorders: a survival analysis.
Objective: Psychological treatment for patients with personality disorders (PD) is plagued with a high proportion of early dropouts, and attempts to identify risk factors for attrition have generated very few conclusive results. The purpose of the present study is to identify significant predictors of early treatment termination in a long-term psychotherapy program for PD.
Methods: Data was retrospectively retrieved from 174 files of patients who began long-term psychotherapy in an outpatient treatment program in Quebec City, Canada. Socio-demographic, initial disturbance, and diagnostic variables were considered for prediction, along with a measure specifically designed to identify PD patients at risk of dropping out early from psychotherapy, the Treatment Attrition-Retention Scale for Personality Disorders (TARS-PD). Survival analysis using Cox proportional hazard regression was perfor…
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TRR's Warrior Camp: An Intensive Treatment Program for Combat Trauma in Active Military and Veterans of All Eras.
Effective treatments for combat trauma in military service members exist, but barriers to care abound, including poor access, stigma, and dropout. Although the effects of post-traumatic stress disorder (PTSD) can be severe, recovery is possible when proper treatment is implemented. Trauma and Resiliency Resources, Inc.'s Warrior Camp (WC) program is designed to address the effects of combat trauma in military service members and veterans. This intensive, 7-d treatment incorporates eye movement desensitization and reprocessing therapy, equine-assisted psychotherapy, yoga, and narrative writing in context of community. This single-group pretest-posttest design included paired t-tests and effect size analyses for 85 participants of WC. Outcome measures included the Mississippi Scale for Combat-related PTSD, the Patient Health Questionnaire, the Revised Adult Attachment Scales, and the Moral…
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Inhibitors and facilitators of compassion-focused imagery in personality disorder.
Background: Compassion-focused therapy (CFT) has potential to benefit clients with a personality disorder (PD), given the inflated levels of shame and self-criticism in this population. However, clinical observation indicates that clients with PD may find techniques from this approach challenging.
Aims: The aim of this study is to trial one aspect of CFT, compassion-focused imagery (CFI), with this population, and identify factors that predict clients' ability to generate CFI and experience self-compassion during the task, including type of CFI exercise and, second, to establish whether CFI outcomes increase with practice.
Method: In Study 1, 53 participants with a diagnosis of PD completed measures of self-compassion, self-reassurance, shame, self-criticism, fear of self-compassion, affect, anxious and avoidant attachment, and mental imagery abilities. Participants were assigned to tria…
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Early development of mechanisms of change as a predictor of subsequent change and treatment outcome: The case of working alliance.
Objective: Advanced statistical tools have created the opportunity to systematically examine the effect of early trajectories in predictors of therapeutic change, such as early alliance development patterns, on outcome. To date, however, these methods have been used almost exclusively to examine the effect of the development of early symptoms on later ones. Development patterns of alliance early in treatment, and their association with treatment outcome, have received much theoretical attention, but few systematic examinations have been conducted so far.
Method: We integrated exploratory cluster analysis with the accumulated theoretical and empirical knowledge on patterns of alliance development to identify distinct patterns of early alliance development across the 1st 4 sessions of treatment in a sample of 166 patients receiving psychotherapy.
Results: Three patterns of early alliance d…
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Therapist Effects on and Predictors of Non-Consensual Dropout in Psychotherapy.
Background: Whereas therapist effects on outcome have been a research topic for several years, the influence of therapists on premature treatment termination (dropout) has hardly been investigated. Since dropout is common during psychological treatment, and its occurrence has important implications for both the individual patient and the healthcare system, it is important to identify the factors associated with it.
Method: Participants included 707 patients in outpatient psychotherapy treated by 66 therapists. Multilevel logistic regression models for dichotomous data were used to estimate the impact of therapists on patient dropout. Additionally, sociodemographic variables, symptoms, personality style and treatment expectations were investigated as potential predictors.
Results: It was found that 5.7% of variance in dropout could be attributed to therapists. The therapist's effect remai…
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'Do You Practice What You Preach?' A Qualitative Exploration of Therapists' Personal Practice of Compassion Focused Therapy.
Background: Therapists' personal practice of therapy techniques can impact on a range of areas, including: empathy for the client, therapeutic understanding, therapist skills and self-awareness. Compassion Focused Therapy (CFT) draws extensively on personal practice during training, and on-going personal practice is encouraged. However, the impact of this has not been examined.
Objectives: To explore therapists' experiences of personal practice in relation to CFT, and the impact this has upon them and their therapeutic work.
Design: A qualitative approach was adopted, using inductive thematic analysis.
Methods: Ten therapists, who had trained in CFT, took part in a semi-structured interview to explore their experiences of personal practice.
Results: Five main themes were identified. These highlighted that: (1) experiences of personal practice often felt strange to start with but were sur…
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Schlüter-Müller S (2017)MEDLINE-indexed journal, not yet read by usPraxis der Kinderpsychologie und Kinderpsychiatrie7 citations [AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders].
AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders Personality disorders are patterns of maladaptive personality traits that have an impact on the individual throughout the life span. Borderline Personality Disorder (BPD) is a very severe, but treatable mental disorder. Identity disturbance is seen as the central construct for detecting severe personality pathology - and, most notably, borderline personality disorder - in adults and adolescents. Crises in the development of identity usually resolve into a normal and consolidated identity with flexible and adaptive functioning whereas identity diffusion is viewed as a lack of integration of the concept of the self and significant others. It is seen as the basis for subsequent personality pathology, including that of borderline personality disorder. Although BPD has its onset in …
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Eclectic approach to anxiety disorders among rural children.
Introduction: Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study.
Methods: 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for th…
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[The relationship between forgivingness, mental health and psychotherapy].
Forgivingness occupies a prominent place in religions as well as in various philosophical systems of ethics and can be defined as the free, personal distancing from feelings of rage and resentment toward a person or persons having committed an injustice. The main psychological function of forgiveness consists in allowing for the replacement of negative emotions by positive ones, such as generosity, goodness, compassion, empathy, or even love toward the offender. It must be emphasized that forgiveness is independent from reconciliation, and it is not simply a form of tolerance, justification, oblivion, underestimation, denial or amnesty. Intrapsychic processes are sufficient and necessary for the genesis of forgiveness, although it is likely that these are also influenced by complex interpersonal events. Current research identifies various dimensions of forgiveness, which must be distingu…
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Therapist competencies necessary for the delivery of compassion-focused therapy: A Delphi study.
Objectives: Compassion-focused therapy (CFT) has shown promising results for a range of clinical presentations. This study explored the therapeutic competencies required to deliver CFT and organized these into a coherent framework.
Design: The Delphi method was used to explore and refine competencies for delivering CFT in three rounds of data collection.
Methods: The first round involved interviews with 12 experts in CFT. Data were analysed using template analysis to generate a draft competency framework. The main competencies were used to create a survey for rounds two and three involving CFT experts and practitioners. Data collected from the surveys were used to refine the competencies.
Results: The CFT competency framework (CFT-CF) that was produced comprised 25 main competencies within six key areas of competence. The areas were as follows: competencies in creating safeness, meta-ski…
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Hsiao FH (2017)MEDLINE-indexed journal, not yet read by usHu li za zhi The journal of nursing1 citations [The Application of Body-Mind-Spirit Integrated Psychotherapy in Nursing Practice].
Body-mind-spirit integrated psychotherapy reflects the core value of nursing by emphasizing the inseparable concept of body, mind, and spirit and caring for the holistic needs of the patient. Body-mind-spirit integrated psychotherapy was developed based on Western psychotherapy (positive psychology and forgiveness therapy), traditional Chinese medicine, and the Eastern philosophies of Buddhism, Taoism, and Confucianism. The present paper describes the holistic concepts that underpin this therapeutic approach. Physical health is sustained through proper nutrition, physical relaxation, and harmonized breathing; psychological well-being helps maintain inner peace and harmony in interpersonal relationships; and spiritual well-being helps develop an optimistic and meaningful life. We report on several cases in which body-mind-spirit integrated psychotherapy was applied to the care of clients …
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Translation of the Outcome Questionnaire-45 (OQ) into Japanese: A cultural adaptation.
Objective: While there are several Japanese, qualitative, case studies examining psychotherapy outcome, there is a growing need for quantitative psychotherapy outcome research in Japan. This study adapted the Outcome Questionnaire-45 (OQ), one of the most common quantitative measures of clinical outcome, for use in Japan.
Method: With the help of 6 translators and 116 native Japanese pilot respondents, the original OQ was translated into Japanese following Beaton et al.'s methodology and includes forward translation, synthesis, back translation, and expert committee meetings.
Results: The study produced four pre-final versions, two pretest version, and one pilot version of the Japanese OQ. With permission from the original questionnaire developers, a few items were modified to achieve cultural equivalence. The rigorous translation and adaptation processes, evaluated through the Translati…
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Collaborative stepped care for somatoform disorders: A pre-post-intervention study in primary care.
Objective: The successful management of somatoform disorders in primary care is often limited due to low diagnostic accuracy, delayed referral to psychotherapy, and unstructured overuse of health care. This study aimed to investigate the feasibility of establishing a collaborative stepped health care network for somatoform disorders, and its impact on the diagnostic process and treatment recommendations in primary care.
Method: The Network for Somatoform and Functional Disorders (Sofu-Net) was established to connect 41 primary care physicians (PCP), 35 psychotherapists, and 8 mental health clinics. To evaluate Sofu-Net, primary care patients at high risk of having a somatoform disorder were identified using the Patient Health Questionnaire, and were assessed in detail at the patient and PCP level. Discussion of psychosocial distress in the consultations, diagnostic detection rates and tr…
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Miles SR, Thompson KE (2016)MEDLINE-indexed journal, not yet read by usPsychological trauma : theory, research, practice and policy16 citations Childhood trauma and posttraumatic stress disorder in a real-world Veterans Affairs clinic: Examining treatment preferences and dropout.
Objective: The Department of Veterans Affairs (VA) has promoted large-scale dissemination efforts of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). In spite of efforts to make gold-standard treatments available to veterans, few veterans with PTSD receive a full course of psychotherapy. It is unclear if type of trauma experienced is related to treatment initiation and completion. This study aimed to identify patient factors, including experiencing childhood trauma that related to treatment preferences and dropout in a real-world VA PTSD clinic.
Method: A chart review was conducted for veterans who were referred for individual EBPs for PTSD (N = 199). Extracted variables included demographics, PTSD symptoms, treatment preferences, and treatment completion/dropout.
Results: Veterans choose to engage in individual EBP (48%), group treatment (11%), nontrauma f…
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Treatment adequacy of anxiety disorders among young adults in Finland.
Background: Anxiety disorders are common in early adulthood, but general population studies concerning the treatment adequacy of anxiety disorders taking into account appropriate pharmacological and psychological treatment are scarce. The aims of this study were to examine treatments received for anxiety disorders in a Finnish general population sample of young adults, and to define factors associated with receiving minimally adequate treatment and with dropping out from treatment.
Methods: A questionnaire containing several mental health screens was sent to a nationally representative two-stage cluster sample of 1894 Finns aged 19 to 34 years. All screen positives and a random sample of screen negatives were invited to a mental health assessment including a SCID interview. For the final diagnostic assessment, case records from mental health treatments for the same sample were obtained. …
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Utilization of evidence-based psychotherapies in Veterans Affairs posttraumatic stress disorder outpatient clinics.
In response to the growing numbers of veterans with posttraumatic stress disorder (PTSD), the Department of Veterans Affairs (VA) has sought to make evidence-based psychotherapies for PTSD available at every VA facility. We conducted a national survey of providers within VA PTSD clinical teams (PCTs) to describe utilization of prolonged exposure (PE) and cognitive processing therapy (CPT) and to identify individual and organizational factors associated with treatment uptake and adherence. Participants (N = 128) completed an electronic survey assessing reported utilization of PE and CPT treatments, adherence to treatment manuals, and characteristics of the provider and workplace environment. Participants reported conducting a weekly mean of 4.5 hours of PE, 3.9 hours of CPT (individual format), 1.3 hours of CPT (group format), and 13.4 hours of supportive care. Perceived effectiveness of …
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The role of therapists' treatment adherence, professional experience, therapeutic alliance, and clients' severity of psychological problems: Prediction of treatment outcome in eight different psychotherapy approaches. Preliminary results of a naturalistic study.
In this naturalistic study, 262 audiotaped psychotherapy sessions--randomly drawn from 81 individual therapies from eight different psychotherapy approaches--were rated completely on treatment adherence using a newly developed rating manual. In the therapy sessions, a relatively low percentage of treatment specific interventions (ranging from 4.2% to 27.8%) was found for all eight approaches, 50% to 73% of the interventions were nonspecific or common, and approximately 18% to 27% were intervention techniques from other approaches. Different types of psychotherapy differed highly significantly in levels of treatment adherence. There was no statistically significant association between the type of psychotherapy and its outcome, or between the degree of therapists' treatment fidelity and the treatment outcome. However, there were significant associations between therapists' degree of profes…
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Brazilian Portuguese version of the CORE-OM: cross-cultural adaptation of an instrument to assess the efficacy and effectiveness of psychotherapy.
Introduction: The Clinical Outcome in Routine Evaluation - Outcome Measurement (CORE-OM) was developed in the 1990s, with the aim of assessing the efficacy and effectiveness of mental health treatments.
Objective: To adapt the CORE-OM for use in the Brazilian population.
Method: The instrument was translated and adapted based on the international protocol developed by the CORE System Trust which contains seven steps: translation, semantic equivalence analysis, synthesis of the translated versions, pre-testing in the target population, data analysis and back translation.
Results: After semantic analysis, modifications were necessary in seven of the 34 original items. Changes were made to avoid repetition of words and the use of terms difficult to understand. Internal consistency analysis showed evidence of score stability in the CORE-OM adapted to Brazilian Portuguese.
Conclusion: The ins…
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