Talking treatment in general.
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1326 to 1350 of 1,623Pre-treatment expectations in clients: impact on retention and effectiveness in outpatient substance abuse treatment.
Background: Common factors are important for the therapy outcome and also mediate the specific factors of therapy. As one of the common factors, client's expectations towards treatment have been understudied.
Aims: The aim was to examine the pre-treatment expectations of outpatient substance abuse treatment clients (N=327, 111 females, 216 males) and its impact on retention, effectiveness and satisfaction at 6-month follow-up.
Method: Dependent variables included the clients' attitudes towards the twelve-step principles and participation, medical treatment and therapists' role.
Results: An emphasis on the importance of medical treatment at baseline predicted dropping out. Similarly, it predicted a lower percent days abstinent (PDA6) at 6 months follow-up in comparison to those who did not consider medical treatment important for recovery. Percent days abstinent increased with a more posi…
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Narrative enhancement and cognitive therapy: a new group-based treatment for internalized stigma among persons with severe mental illness.
Internalized stigma has been suggested to play a major role in negative changes in identity in severe mental illness. Evidence suggests that roughly one-third of people with severe mental illness show elevated internalized stigma and that it is linked to compromised outcomes in both subjective and objective aspects of recovery. Despite substantial evidence for the impact of internalized stigma, few efforts have been made to develop professionally led treatment to address this issue. In this article, we discuss our development of a new group-based approach to the treatment of internalized stigma which we have termed "narrative enhancement and cognitive therapy (NECT)". We describe the treatment approach and offer an illustration of it by way of a case vignette.
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Dealing with Feelings: the effectiveness of cognitive behavioural group treatment for women in secure settings.
Background: Women in secure psychiatric settings have gender specific treatment needs. The current study examined the feasibility of a Dealing with Feelings Skills Group training for dual diagnosis women admitted to a medium secure setting.
Method: A pre-test--post-test design was used to evaluate a group programme adapted from dialectical behaviour therapy skills training.
Results: Most patients had a primary diagnosis of personality disorder. Treatment completers (n = 29) were compared with non-completers (n = 15). Clinically significant changes in treatment completers were apparent on coping response measures of positive reappraisal, problem solving and alternative rewards; on measures of anxiety and suicidality; on self-reported ability to engage in activities to reduce negative mood and to recognize mood changes. Self-harming and aggressive behaviours also reduced in the 3 months fo…
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What happens in session does not stay in session: changes within exposures predict subsequent improvement and dropout.
Previous exposure therapy research has suggested potential differences in emotional processing at different points in treatment (Hayes, Hope, & Heimberg, 2008). For example, indicators of emotional processing may be more related to outcome during the later exposure sessions than during the initial session. This is consistent with a growing body of psychotherapy research highlighting the importance of timing and change processes across therapy. The current study examined whether the learning-but-not-benefiting hypothesis is observed in a group based intervention for clients with a range of anxiety disorders. It was hypothesized that activation and within session habituation during later, but not the initial exposure session, would be related to outcome, whereas activation and within session habituation during the first session would be related to dropout status. Results revealed that lowe…
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Motivation for psychotherapy in patients with functional gastrointestinal disorders.
Background: The motivation of patients with functional gastrointestinal disorders to accept psychotherapy (PT) as a treatment option is not known.
Objective: The authors investigated motivation for patients' refusal to participate and dropout from PT/medical management programs.
Method: Consecutive patients with symptoms suggestive of functional bowel disorders, seen at the outpatient clinic of a tertiary gastrointestinal (GI) center were evaluated for their motivation to undergo PT. Data from 85 patients were evaluated in two phases: In Phase 1, patients were asked about willingness to participate in PT if it were offered; in Phase 2, patients were offered PT. In both samples, PT motivation was also measured by standardized psychometric scales.
Results: Age, gender, social status, and clinical symptom severity did not predict willingness to participate in or accept PT. Motivation was hi…
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Recovery After Psychosis (RAP): a compassion focused programme for individuals residing in high security settings.
Background: The aim of the study was to evaluate the effectiveness of a recovery group intervention based on compassionate mind training, for individuals with psychosis. In particular, the objective was to improve depression, to develop compassion towards self, and to promote help seeking.
Method: A within-subjects design was used. Participants were assessed at the start of group, mid-group (5 weeks), the end of the programme and at 6 week follow-up. Three group programmes were run over the course of a year. Nineteen participants commenced the intervention and 18 completed the programme.
Results: Significant improvements were found on the Social Comparison Scale; the Beck Depression Inventory; Other As Shamer Scale; the Rosenberg Self-Esteem Inventory and the General Psychopathology Scale from the Positive and Negative Syndrome Scale.
Conclusions: The results provide initial indications …
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An evaluation of large group CBT psycho-education for anxiety disorders delivered in routine practice.
Objective: To determine the clinical utility and acceptability of a brief CBT psycho-educational course delivered in an NHS psychotherapy service.
Methods: All patients referred, found suitable for CBT, and who had an anxiety disorder, were invited to enrol in a psycho-education course, delivered in an outpatient mental health clinic by two mental health nurses with post-registration training in CBT. There were up to 24 patients in each course. Outcome measures used were CORE-OM and Fear Questionnaire administered pre-course and at 12-week follow-up and Client Satisfaction Questionnaire administered post-course.
Results: One-hundred and ninety one patients were referred. Of these 120 remained in contact with the service to the follow-up meeting. Ninety-seven patients were discharged at the follow-up point and 92 requested further individual psychotherapy. A number of patients made a clin…
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Interviews of female patients with borderline personality disorder who dropped out of group psychotherapy.
Premature termination from group psychotherapy continues to be a serious problem in the treatment of patients with borderline personality disorder (BPD). Qualitative research is regarded as an important means to shed light upon the complex dynamics leading to dropout. We conducted an interview study with patients having a diagnosis of BPD (n = 8) who dropped out from long-term group psychotherapy as a continuation therapy following intensive day treatment. The group therapists for these patients were interviewed as well (n = 12). The findings suggest the operation of many processes that contribute to dropout. Most significant appeared to be experiences of separation and loss of the day hospital that were not worked through and a failure of the group to regulate and contain the patients' affects. To integrate patients at risk of premature termination it seems necessary to pay attention to…
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[Dialectical Behaviour Therapy for adolescents (DBT-A)--a pilot study on the therapy of suicidal, parasuicidal, and self-injurious behaviour in female patients with a borderline disorder].
Objectives: In Germany suicide ranks as the second leading cause of death in adolescents. Risk factors for suicide are impulsive and self-injurious behaviour, depression, and conduct disorder. The main hypothesis of our study is that Dialectical Behavior Therapy (DBT) for adolescents is an effective method of treatment for these patients.
Methods: DBT was developed by Marsha Linehan specifically for the outpatient treatment of chronically parasuicidal female patients with a diagnosis of borderline personality disorder. Miller & Rathus modified DBT for use with adolescents (DBT-A). and our group adapted the DBT-A for use in an outpatient treatment setting in Germany. In a pre-post comparison, the efficacy of treatment was measured using standardized instruments (SCL-90-R, CBCL, YSR, ILK, CGI, etc.).
Results: In a pilot study of 12 adolescents, we found effect sizes between 1.1 and 2.9. Du…
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Scheid D, Singh F (2019)editorial or commentMEDLINE-indexed journal, not yet read by usPsychiatric rehabilitation journal3 citations Can compassion focused therapy enhance dual recovery for veterans?
In our clinical work with veterans experiencing serious mental illness and substance use disorders, we noticed specific challenges not commonly addressed with traditional dual recovery group therapy-including having overactive threat systems and feelings of shame and self-criticism. For a program development project at our Veterans Affairs Psychosocial Rehabilitation and Recovery Center, we designed and implemented a group therapy program based on Compassion Focused Therapy (CFT), a therapeutic model that directly addresses the aforementioned challenges (Gilbert, 2009b). Results from pre- and post-intervention measures suggested veterans gained compassion and mindfulness skills and experienced reduced depressive symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Case formulation in emotion-focused therapy.
Case formulation in emotion-focused therapy aids therapists to both conceptualize core emotion schemes and follow markers across therapy that signify tasks aimed at emotional transformation. The case formulation process will be illustrated in the successful case of Jina, a woman with a history of childhood emotional abuse who sought therapy for depression. The three stages of case formulation are co-constructed between client and therapist. In stage one, the therapist assesses her initial emotion processing style and listens as the emotion-based narrative unfolds. In stage two, the core emotion scheme and formulation narrative organize around feelings of shame of inferiority and attachment-related feelings of being rejected and unloved. Attendant secondary emotions of powerlessness, and unmet needs for validation emerge. Stage three evolves as the therapist follows process markers, promp…
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Rachwal F, Gredecki N (2026)MEDLINE-indexed journal, not yet read by usInternational journal of offender therapy and comparative criminology2 citations A Phenomenological Investigation into the Use of Therapist Self-disclosure in Compassion-Focused Therapy With Forensic Clients.
Existing research has demonstrated the benefits of therapist self-disclosure (TSD) in strengthening therapeutic alliance. However, little is known about its effectiveness in the forensic context. The current research sought to address this gap by interviewing six Compassion Focused (CFT) therapists who had experience of working across a range of forensic settings. Results of an Interpretative Phenomenological Analysis (IPA) indicated that all participants advocated using TSD as a powerful therapeutic tool when working with forensic clients. However, there was a tension between balancing risk with the rewards of TSD, and participants expressed how the secure forensic environment was not conducive to its use. There was a consensus that TSD was more strongly discouraged with clients who had sexual convictions. For some, this had an impact on their own disclosures. Training on the function o…
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Making an MPCT: Building and Sustaining a Multicultural Psychology Consultation Team (MPCT) Within an Academic Medical Center.
The synergistic epidemics of COVID-19, racial injustice, and health inequities sparked an unprecedented commitment from US hospital systems and treatment settings to address health disparities by increasing access to care for historically oppressed and underserved communities. However, the inability of hospital systems to actually provide multiculturally responsive care and, more broadly, to consistently practice cultural humility will only exacerbate patient distrust and the deleterious health and social outcomes we seek to mitigate. This perspective article describes the development of a multidisciplinary team of mental health providers committed to delivering culturally responsive mental health treatment while promoting inclusive workplace environments. We outline the Multicultural Psychology Consultation Team's (MPCT) origin, design, process, and structure and discuss successes and c…
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A case series study of compassion-focused therapy for distressing experiences in psychosis.
Objectives: Compassion-focused therapy (CFT) is an evolution-informed biopsychosocial approach that seeks to cultivate attachment and care motivational systems and their psychophysiological regulators. These can counteract some of the harmful effects of social threat, inferiority, shame, self-criticism and depression, which are common in people with psychosis and undermine their well-being, social trust and ability to feel safe. This study aimed to test the acceptability of a novel manualized individual CFT intervention for psychosis (CFTp).
Design: A non-concurrent, multiple-baseline, case series design, with three phases: baseline, intervention and follow-up.
Methods: The 26-session CFTp intervention was provided for a sample of eight people with distressing psychotic experiences and a psychosis-related diagnosis. The study aimed to assess acceptability of CFTp and to test clinically r…
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Psychological distress, attitudes toward seeking help, and utilization of college counseling at a predominantly minority college.
Objective: This study examined psychological distress among students at a predominantly-minority college, attitudes toward seeking help, and utilization of college counseling services. Demographic variables and associations between 8 problem areas (depression, generalized anxiety, social anxiety, academic stress, eating concerns, family distress, hostility, substance use) were explored.
Participants: Participants were 347 students at a large public university.
Methods: In 2016-2017, students completed a Web-based questionnaire providing information about their mental health, attitudes toward seeking help, and utilization of counseling services.
Results: Psychological distress was significantly higher for LGBQT, Muslim and female students and lower for Christian affiliated and religious students. LGBQT students were less likely to seek psychological help than other students. Utilization o…
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Effectiveness of an online versus face-to-face psychodynamic counselling intervention for university students before and during the COVID-19 period.
Background: The COVID-19 pandemic has increased online counselling interventions, including those aimed at university students. The principal aim of the study is to evaluate the effectiveness of the online counselling intervention during the COVID-19 pandemic, also with regards to the effectiveness of the face-to-face intervention.
Methods: 34 students (Mean age = 23.74; Female = 27) who requested online university counselling during COVID-19 have been compared with 81 (Mean age = 22.8; Female = 60) students who requested university face-to-face counselling before the pandemic. The psychopathological problems were assessed with the Symptom Checklist 90 Revised, attachment styles with the Attachment Style Questionnaire, adverse childhood experiences with Adverse Childhood Experiences Questionnaire, and life satisfaction with the Life Satisfaction Scale.
Results: At the pre-intervention ph…
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Beyond Cyberbullying: Investigating When and How Cybervictimization Predicts Suicidal Ideation.
Cybervictimization is a public health concern in adolescence. Victims of cyberbullying may present with important short- and long-term sequelae. Specifically, past research has demonstrated positive associations between being cybervictimized and risk of suicide among adolescents. Nonetheless, the underlying mechanisms that may mediate or moderate this relationship remain unclear. The present research examined perceived stress as a mediator and forgiveness as a moderator to explore the relationship between cybervictimization and suicidal ideation. Specifically, vengeance, avoidance, and benevolence motivations, as a means of measuring forgiveness experienced, were analyzed as moderators in the relations between cybervictimization and suicidal ideation. The sample included 1,821 adolescents (954 girls) who ranged in age from 12 to 17 years from nine centers. Adolescents' self-reported perc…
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Carrique L, Quance J, Tan A, Abbey S, Sales I, Lilly L, Bhat M, Galvin Z, Cattral M, Ghanekar A, McGilvray I, Reichman T, Sapisochin G, Sayed B, Selzner M, Lynch MJ, Selzner N (2021)MEDLINE-indexed journal, not yet read by usGastroenterology57 citations Results of Early Transplantation for Alcohol-Related Cirrhosis: Integrated Addiction Treatment With Low Rate of Relapse.
Background & aims: In 2018, our team initiated a prospective pilot program to challenge the paradigm of the "6-month rule" of abstinence for patients with alcohol-related liver disease (ALD) requiring transplant. Our pilot involved an in-depth examination of patients' alcohol use, social support, and psychiatric comorbidity, as well as the provision of pre- and post-transplantation addiction treatment.
Methods: Patients with ALD were assessed for inclusion in the pilot by a multidisciplinary team. Relapse prevention therapy was provided directly to all patients deemed to meet the program's inclusion criteria. Random biomarker testing for alcohol was used pre and post transplantation.
Results: We received 703 referrals from May 1, 2018 to October 31, 2020. After fulfilling the program's criteria, 101 patients (14%) were listed for transplantation and 44 (6.2%) received transplants. There …
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Construction and evaluation of an online module addressing counseling patients with diabetes observing religious fasting.
Introduction: Little research has been conducted on training students of different health professions to deliver culturally appropriate care to patients observing religious fasting. This study aimed to formulate an online educational module on caring for patients with diabetes observing religious fasting and evaluate the module's impact.
Methods: Third-year doctor of pharmacy students participated in an online module at the end of their core pharmacist-patient communication class. The module involved discussions and case scenarios addressing Muslim, Jewish, and Hindu patients with diabetes considering fasting. Students were provided with Ramadan Communication (RAMCOM), a tool designed to facilitate counseling of patients on religious fasting and were encouraged to use principles of motivational interviewing in addressing cases. A 13-item questionnaire was administered before and after th…
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"Seeing a Brighter Future" - Experiences of Adolescents with Common Mental Disorders Receiving the Problem-Solving Therapy "Youth Friendship Bench" in Zimbabwe.
In Zimbabwe common mental disorders are prevalent among adolescents and the treatment gap is large. The recently introduced Youth Friendship Bench intervention (YouFB) addresses this gap by task-shifting youth lay health workers to offer a culturally contextualised, manual-based, six-session problem-solving therapy to adolescents, 16-19 years of age. The aim of this study was to explore participants´ experiences of YouFB to attain a first insight into this novel intervention. Interviews with nine adolescents were analysed using qualitative content analysis on a latent level. The experience of YouFB was positive, perceived to offer hope and relief from feelings of isolation and uncertainty, increase manageability of problems, and contribute to feelings of autonomy, resulting in a feeling of optimism about the future. The notion among participants that this brief intervention had such a po…
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Self-reliance and belonging: Guest experiences of a peer respite.
Objective: A peer respite is a voluntary, short-term, overnight program that provides community-based mutual support to people experiencing a mental health crisis. This qualitative study of guest experiences at 1 peer respite examines its role in fostering recovery and wellbeing. Method: Conventional content analysis of interviews with 20 peer respite guests resulted in a thematic framework containing 7 "clusters" of themes with related subthemes. Results: The following themes emerged from the analysis and include both positive and negative experiences: belongingness, confidence and hope, crisis self-management, experiencing mutual support, freedom and responsibility, linking to community, and conflict and confrontation. Some guests endorsed the peer respite as a temporary break from stressful life situations, a homelike space for mutual support and community, and a preferred alternative…
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Protective Elements of Mental Health Status during the COVID-19 Outbreak in the Portuguese Population.
The outbreak of COVID-19 might produce dramatic psychological effects on individuals' lives. In this study, we aimed to explore the elements that may reduce the negative effects on mental health of the quarantine period imposed by most governments during this worldwide crisis. We conducted an online survey to evaluate demographic, lifestyle and mental health variables in a sample of 1280 Portuguese individuals (79.8% females) with an average age of 37 years. We observed that factors related to living conditions, maintaining work either online or in the workplace, frequency of exercise and absence of previous psychological or physic disorders are protective features of psychological well-being (anxiety, depression, stress and obsessive-compulsive symptoms). Finally, the individuals previously receiving psychotherapeutic support exhibited better psychological indicators if they did not int…
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Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence.
Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance tran…
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Self-compassion training for certified nurse assistants in nursing homes.
Background/objectives: Certified nursing assistants (CNAs) who work in nursing homes (NHs) face significant work and personal stress. Self-compassion training has been shown to decrease stress postintervention in previous studies among healthcare providers and those in helping professions. This study examines the feasibility, acceptability, and preliminary outcomes of self-compassion training to address CNA stress and well-being.
Design: Pre-post intervention.
Setting: Three mid-size, nonprofit NHs in North Carolina.
Participants: Thirty CNAs, with a mean age of 49, 96% of whom were female, and 83% black/African American.
Intervention: In one NH, participants received an 8-week, 2.5-h/session (20 h total) group intervention. At the time of recruitment for NHs 2 and 3, a briefer format (6-week, 1-h/session; 6 h total) became available and was preferred by CNAs, thus both NHs 2 and 3 parti…
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Radically open dialectical behaviour therapy adapted for adolescents: a case series.
Background: Overcontrol is a transdiagnostic cluster of traits associated with excessive psychological, behavioural and social inhibitory control. It is associated with psychiatric diagnoses of depression, restrictive eating disorders and/or obsessive-compulsive personality disorder. Radically Open Dialectical Behaviour Therapy is a transdiagnostic treatment for maladaptive overcontrol. This case series evaluates an adolescent adaption (RO-A) for a transdiagnostic group of adolescents identified as overcontrolled.
Methods: Twenty-eight adolescents were consecutively referred for RO-A from two different National and Specialist Child and Adolescent Mental Health Services between June 2017 and February 2020. Baseline self-report measures assessed overcontrol characteristics, relationship and attachment quality and mental health symptoms of depression and eating disorders, which were repeate…
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