Talking treatment in general.
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1476 to 1500 of 1,623Fernández A, Haro JM, Codony M, Vilagut G, Martínez-Alonso M, Autonell J, Salvador-Carulla L, Ayuso-Mateos JL, Fullana MA, Alonso J (2006)MEDLINE-indexed journal, not yet read by usJournal of affective disorders52 citations Treatment adequacy of anxiety and depressive disorders: primary versus specialised care in Spain.
Background: Literature suggests that a high proportion of the population with mental disorders remains either untreated or poorly treated. This study aimed to describe the adequacy of treatment for Anxiety and Depressive disorders in Spain, how this differs between providers (primary versus specialised care) and which factors are associated with appropriate care.
Method: Data were derived from the Spanish sample (N=5473) of the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross sectional study in a representative sample of adults. The subsample analyzed was composed by the 133 subjects with a mental disorder in the year prior to the interview who received treatment. Treatment adequacy was evaluated in two different ways: (1) considering definitions of minimally adequate treatment evidence based guidelines and criteria used in other epidemiological studies; (2) consi…
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Increasing willingness to experience obsessions: acceptance and commitment therapy as a treatment for obsessive-compulsive disorder.
This study evaluated the effectiveness of an 8-session Acceptance and Commitment Therapy for OCD intervention in a nonconcurrent multiple-baseline, across-participants design. Results on self-reported compulsions showed that the intervention produced clinically significant reductions in compulsions by the end of treatment for all participants, with results maintained at 3-month follow-up. Self-monitoring was supported with similar decreases in scores on standardized measures of OCD. Positive changes in anxiety and depression were found for all participants as well as expected process changes in the form of decreased experiential avoidance, believability of obsessions, and need to respond to obsessions. All participants found the treatment to be highly acceptable. Implications and future directions are discussed.
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Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer.
Two previously studied cohorts of women with nonmetastatic breast cancer (Ns = 230 and 136) were reexamined. Participants were assessed during the year after surgery and 5-8 years later. Associations were examined between benefit finding (BF) and several indicators of psychosocial adjustment (e.g., perceived quality of life, positive affect, negative affect, social disruption, and intrusive thoughts). Significant curvilinear relations between BF and other outcomes were observed cross-sectionally during initial assessment and at long-term follow-up in both samples. Compared with the intermediate BF group, low and high BF groups had better psychosocial adjustment. Further analyses indicated that the high BF group reported higher optimism and more use of positive reframing and religious coping than the other BF groups. Discussion highlights the need to examine nonlinear as well as linear re…
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Dyadic intervention for family caregivers and care receivers in early-stage dementia.
Purpose: The Early Diagnosis Dyadic Intervention (EDDI) program provides a structured, time-limited protocol of one-on-one and dyadic counseling for family caregivers and care receivers who are in the early stages of dementia. The goals and procedures of EDDI are based on previous research suggesting that dyads would benefit from an intervention that increases the care receiver's active participation in his or her care plan, develops positive communication patterns between the caregiver and care receiver, increases knowledge and understanding about available services, and assists the dyad through the emotional turbulence of a diagnosis of Alzheimer's disease or other dementing condition.
Design and methods: EDDI was developed in response to research and clinical findings that suggested that care dyads in the early stages of dementia and dementia care are able to engage in a dialogue abou…
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Gender differences in coping with infertility among couples undergoing counselling for In Vitro Fertilization treatment.
Objective: To identify gender differences in coping responses and the association between coping and psychological distress in couples undergoing In Vitro Fertilization (IVF) treatment at the University of the West Indies (UWI).
Methods: All men and women (n = 52) who were offered psychological counselling prior to beginning IVF treatment between October 2003 and May 2004 were invited to complete questionnaires on their coping responses, self-reported distress and socio-demographic data. One female declined.
Results: Of the 51 participants, 52% had completed secondary education, 44% tertiary education, and 37% were 38 years or older; 42% of the couples were trying for more than seven years to have a child. Gender differences in coping included more women than men keeping others from knowing their pain (p < 0.01) and more women ruminating about what they did wrong to cause the infertility…
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How batterer intervention programs work: participant and facilitator accounts of processes of change.
Understanding what facilitates change in men who perpetrate domestic violence can aid the development of more effective batterer intervention programs (BIPs). To identify and describe key change processes, in-depth interviews were conducted with nine successful BIP completers and with 10 intervention group facilitators. The accounts described a range of individual-level processes of change consistent with prior research but also included several processes spanning the community, organizational, and group levels of analysis. Program completers and facilitators gave mostly similar accounts, though differed in their emphasis of criminal justice system sanctions, group resocialization of masculinity, and the participants' own decision to change. All accounts especially emphasized group-level processes and the importance of balancing support and confrontation from facilitators and group membe…
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Stabilizing the stabilizer: group psychoeducation enhances the stability of serum lithium levels.
Objective: To determine the effect on the serum lithium levels of a psychoeducational program in patients with bipolar disorder.
Method: This is a subanalysis of data obtained from a larger study on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar disorders. Data on plasma lithium levels were obtained at five time points: baseline, 6, 12, 18 and 24 months. Serum lithium levels of patients who had received psychoeduction (psychoeducated) (N = 49) and non-psychoeducated patients (N = 44) were compared.
Results: Mean serum lithium levels were significantly higher and more stable for the psychoeducation group.
Conclusions: As changes in serum lithium level may be a powerful predictor of recurrence for bipolar patients, the addition of group psychoeducation to standard pharmacological treatment may be beneficial to optimize serum lithium levels and, thereby i…
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Quality of life in long-term cervical cancer survivors.
Objectives: To describe the quality of life (QOL) and long-term psychosocial sequelae of women of childbearing age diagnosed with cervical cancer 5-10 years earlier.
Methods: Utilizing a cross-sectional descriptive design, 51 cervical cancer survivors and 50 age-matched controls completed a comprehensive QOL interview.
Results: Participants were predominantly married, non-Hispanic White, with a mean age at diagnosis of 37 years and a mean age at interview of 45 years. This disease-free sample enjoys a good QOL, with physical, social, and emotional functioning comparable to or better than comparative norms. However, certain psychological survivorship sequelae and reproductive concerns persist. Participants reporting good QOL were less likely to report ongoing coping efforts related to having had this illness and were more likely to report greater social support, greater sexual pleasure, a…
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What to do with a patient who smokes.
Despite the reality that smoking remains the most important preventable cause of death and disability, most clinicians underperform in helping smokers quit. Of the 46 million current smokers in the United States, 70% say they would like to quit, but only a small fraction are able to do so on their own because nicotine is so highly addictive. One third to one half of all smokers die prematurely. Reasons clinicians avoid helping smokers quit include time constraints, lack of expertise, lack of financial incentives, respect for a smoker's privacy, fear that a negative message might lose customers, pessimism because most smokers are unable to quit, stigma, and clinicians being smokers. The gold standard for cessation treatment is the 5 As (ask, advise, assess, assist, and arrange). Yet, only a minority of physicians know about these, and fewer put them to use. Acceptable shortcuts are asking…
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Multilingualism in Psychotherapists in Training in Germany: Results of a Nationwide Cross-Sectional Study.
Patients who speak languages other than those spoken by mental health professionals are significantly disadvantaged in mental health care settings. To bridge the communication gap, multilingual health professionals and professional interpreters are target-orientated solutions. This study was conducted to assess the multilingual resources, attitudes and needs of psychotherapist trainees in Germany. A cross-sectional nationwide online survey was conducted on psychotherapists-in-training. The 48-item survey consisted of a self-developed instrument to assess 'Attitudes towards working with an Interpreter in Health Care Services (AIHC-20)' with partly reasonable psychometric properties. Psychotherapists-in-training were reached via 238 institutes for psychotherapy training in Germany. Some 803 psychotherapists-in-training completed the survey, of whom 27% had a migration background and 76% wo…
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Challenges and facilitators in treating unaccompanied young refugees with posttraumatic stress disorder in a dissemination trial: a qualitative study with psychotherapists.
Background: Unaccompanied young refugees (UYRs) report high rates of post-traumatic stress, depression and anxiety, and low mental health service utilization. Studies have examined the experiences of psychotherapists and refugees in psychotherapy, focusing on barriers. Our stepped-care approach aims to reduce barriers through comprehensive support, such as training and case consultation for psychotherapists and interpreters, and treatment recommendations for UYRs.
Methods: A qualitative design with semi-structured interviews was employed, with 20 psychotherapists, of whom 13 were females. All psychotherapists participated in the 'BETTER CARE' project, which included trauma-focused cognitive-behavioral therapy training and case consultations. We analyzed psychotherapists' initial worries, challenges, and facilitators in treating UYRs with posttraumatic stress disorder, and compared the re…
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Dealing with couple infidelity in romantic relationships: A group intervention feasibility study.
The extent to which group therapy benefits individuals who have experienced couple infidelity remains unexamined. In this study, a brief group intervention for individuals who experienced couple infidelity was designed, and the feasibility of the intervention was evaluated (i.e., acceptability; implementation; measurements' performance and, limited-efficacy testing). The final sample was composed of 20 women and 4 men (M = 29.95 years, SD = 12.3). Twenty-four completed pre and post assessments and 20 of these completed the follow-up assessment. At pre, post, and follow-up, participants responded to a questionnaire packet that included measures of depression, anxiety and PTSD symptoms, relationship self-efficacy, centrality of event, cognitive fusion, and decision to forgive. Also, follow-up interviews were conducted. The closed group intervention consisted of eight 90-min weekly sessions…
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Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies.
Borderline personality disorder (BPD) was introduced in the DSM-III in 1980. From the DSM-III to the DSM-5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self-image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self-mutilation behavior, and transient stress-related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi-structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self-mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, wh…
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Barriers to use of interpreters in outpatient mental health care: Exploring the attitudes of psychotherapists.
The support of professional interpreters is an essential component of adequate mental health care for migrants with limited language proficiency. Nevertheless, for varied reasons, only a small proportion of outpatient psychotherapists provide interpreter-mediated psychotherapy for migrants. This study explored the perspectives of psychotherapists who have not worked with professional interpreters in outpatient mental health care to identify factors that may prevent the use of interpreters in outpatient care and explore possible incentives to provide interpreter-mediated psychotherapy for migrants with limited language proficiency. Semi-structured interviews were conducted with 13 outpatient psychotherapists in Northern Germany who had not yet worked with professional interpreters in outpatient care. The interviews were audio recorded, transcribed and analysed using a structured content a…
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Comeau A, Smith LJ, Smith L, Soumerai Rea H, Ward MC, Creedon TB, Sweezy M, Rosenberg LG, Schuman-Olivier Z (2024)MEDLINE-indexed journal, not yet read by usPsychological trauma : theory, research, practice and policy2 citations Online group-based internal family systems treatment for posttraumatic stress disorder: Feasibility and acceptability of the program for alleviating and resolving trauma and stress.
Objective: Demand for trauma-focused therapy continues to increase, especially in community mental health care settings where group treatment models can be cost-effective and increase access to care. The Internal Family Systems (IFS) model for posttraumatic stress disorder (PTSD) may offer an effective therapeutic approach. The purpose of this proof-of-concept study was to evaluate the feasibility and acceptability of a novel, trauma-focused, group-based treatment approach and investigate potential mechanisms of action.
Method: Study participants completed the Program for Alleviating and Resolving Trauma and Stress (PARTS), an online-delivered program including 16 weeks of 90-min IFS-based groups with eight 50-min individual IFS counseling sessions. Participants completed assessments including clinician-administered and self-report measures of PTSD, common comorbid conditions (e.g., comp…
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A balancing act: how interpreters affect the therapeutic alliance in psychotherapy with trauma-affected refugees-a qualitative study with therapists.
Objective: The therapeutic alliance (TA) has the highest predictive value concerning the success of psychotherapy. The presented study aimed to explore how the presence of an interpreter affects the TA when working with trauma-affected refugees.
Method: Semi-structured interviews were conducted with seven psychologists working in an outpatient clinic specialized in mental health care for migrant and refugee patients with trauma-related mental health problems in Denmark. Interviews were transcribed verbatim and analyzed using a structuring content analysis approach.
Results: TA has been described as a dynamic therapist-interpreter-patient alliance triangle consisting of three distinct but highly intertwined and mutually influential dyadic alliances. Specific factors affecting the quality of the TA were identified, e.g., interpreter being emotionally attuned yet not overly involved; interp…
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Feasibility and Acceptability of Group Compassion-Focused Therapy to Treat the Consequences of Childhood Maltreatment in People With Psychiatric Disorders in France.
Childhood maltreatment contributes to the development of psychiatric disorders. Shame appears to be an important mediating factor. Compassion-focused therapy (CFT) targets shame and seems relevant for adults with hard-to-treat psychiatric disorders associated with childhood maltreatment. Nevertheless, few studies have examined the feasibility and relevance of group CFT for this population and none in a French routine care setting. The aim of our study was to evaluate the feasibility and acceptability of group CFT for psychiatric disorders associated with childhood maltreatment. Eight adult patients with a history of childhood maltreatment participated in the 12-session group CFT. Feasibility and acceptability were assessed via a standardized satisfaction questionnaire, dropout rates, and attendance. Clinical benefits were assessed via changes in scores on scales of self-compassion, shame…
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Clinical Trainee Perspectives on the Implementation of Trauma-Focused Training.
Objective: Despite the high prevalence of trauma exposure in the United States and calls for the implementation of trauma-focused psychotherapy training, scant opportunities exist for such training in graduate clinical psychology programs. This study aimed to guide the implementation of trauma-focused psychotherapy training in graduate curricula by examining clinical trainees' perspectives on their current training and desired features for trauma-specific learning environments. The absence of research that centers trainee voices is notable; therefore, this study specifically focuses on trainee perspectives on implementation.
Methods: The New Haven competencies, developed by the American Psychological Association to support efforts to improve trauma-specific training, were used as a framework to guide the development of a mixed-methods survey. Current doctoral students (N=18) in one clini…
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International adaptation of Meaning-Centered Psychotherapy for Latinos: Providers' views on pre-implementation.
Background: This qualitative study aims to identify facilitators of and barriers to the implementation of Meaning-Centered Psychotherapy (MCP) by providers of mental health services to Latinos in the US and Latin America using the practical, robust implementation and sustainability model (PRISM). This information will be used to increase usability and acceptability of MCP for Latino patients with cancer and their providers in Latin America and the US.
Methods: A total of 14 Latino cancer patient mental health providers completed in-depth semi-structured interviews. Participants were recruited from 9 countries and 12 different sites. They provided feedback about barriers to and facilitators of implementation of MCP at the patient, provider, and clinic levels in their clinical setting. The qualitative data from the interviews was coded according to PRISM domains. Three analysts independent…
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Patient experiences of therapy for borderline personality disorder: Commonalities and differences between dialectical behaviour therapy and mentalization-based therapy and relation to outcomes.
Objectives: Dialectical behaviour therapy (DBT) and mentalization-based therapy (MBT) are widely used evidence-based psychological treatments for borderline personality disorder (BPD). The study aimed to establish evidence on common and unique, and helpful and unhelpful, treatment processes.
Design: Mixed-methods.
Methods: In-depth qualitative interview data on patient experiences during treatment were combined with quantitative outcome measures in 73 patients diagnosed with a personality disorder and receiving DBT or MBT.
Results: Across both DBT and MBT, accounts of learning not to react impulsively, learning to question one's thoughts and assumptions, learning to communicate more effectively, and exposure to painful emotions that may previously have been avoided were each associated with less baseline-adjusted self-harm at the end of treatment. Difficulties in interacting with other g…
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Psilocybin-Assisted Compassion Focused Therapy for Depression.
Psilocybin-assisted psychotherapy, i.e., psilocybin treatment with psychological support, has demonstrated the efficacy of psilocybin to reduce depressive symptoms. However, in clinical trials, the structure of psilocybin-assisted psychotherapy is primarily based on preparation, navigation (support during dosing sessions), and integration. For psychotherapeutic guidance, the application of this structure is favored over the usage of theoretical models. The applied psychotherapeutic models may be of critical importance if the effects are augmented due to the psychologically insightful experiences during the navigation and integration sessions. One of the important next steps is to provide therapists with guidance on how to provide psilocybin-assisted psychotherapy. We present an integrated protocol for psilocybin-assisted psychotherapy for depression based on the theoretical model and psy…
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Let's Get "REAL": A Collaborative Group Therapy for Moral Injury.
Moral injury is a particular response to profoundly distressing life events that manifests in damage to basic human/relational capacities, such as trust, autonomy, initiative, competence, identity, and intimacy. This paper describes and presents preliminary outcomes of "Reclaiming Experiences And Loss," or "REAL," which is an innovative moral injury group therapy that was developed collaboratively by Veterans Affairs mental health and spiritual care providers. Clinical outcome measures collected pre- and post-group indicates that REAL is effective at reducing symptoms of post-traumatic stress disorder and depression. Additionally, a cohort case example demonstrates the impact of REAL as told through individual stories as well as the intersectionality and interactions that comprise a typical REAL cohort and are considered central to care. Implications for ongoing care and future research …
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The Efficacy and Psychoneuroimmunology Mechanism of Camouflage Combined With Psychotherapy in Vitiligo Treatment.
Background and objectives: The efficacy of camouflage combined with psychotherapy and the underlying mechanisms are poorly understood in vitiligo management. This study aimed to investigate the joint efficacy and further explore psycho-neuro-endocrine-immune-skin interactions.
Patients and methods: In a prospective, non-randomized and concurrent controlled trial, patients were divided into two groups. Quality of life (QOL) was evaluated using the Chinese version of the Vitiligo Life Quality Index (VLQI-C). Serum levels of neuropeptides and cytokines were detected by enzyme-linked immunosorbent assay.
Results: A total of 149 patients were included for final evaluation. After treatment for 4 weeks, total and subcategory quality of life scores in the intervention group were much lower than in the control group. Serum levels of neuropeptide-Y (NPY) and melanin-concentrating hormone (MCH) sig…
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Premature Dropout From Psychotherapy: Prevalence, Perceived Reasons and Consequences as Rated by Clinicians.
Background: Why clients discontinue their psychotherapies has attracted more attention recently as it is a major problem for many healthcare services. Studies suggest that dropout rates may be affected by the mode of therapy, low-quality therapeutic alliance, low SES, and by conditions such personality disorders or substance abuse. The aims of the study were to investigate what happens in therapies which end in a dropout, and to estimate how common dropout is as reported by practicing clinicians.
Method: An online questionnaire was developed and completed by 116 therapists working in clinical settings. They were recruited via social media (Facebook and different online psychotherapy groups) in Sweden and worked with Cognitive Behavioural Therapy (CBT), Psychodynamic Therapy (PDT), Interpersonal Psychotherapy (IPT) and Integrative Psychotherapy (IP).
Results: Psychotherapists rated the fr…
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Integrating Breathing Techniques Into Psychotherapy to Improve HRV: Which Approach Is Best?
Introduction: Approaches to improve heart rate variability and reduce stress such as breathing retraining are more frequently being integrated into psychotherapy but little research on their effectiveness has been done to date. Specifically, no studies to date have directly compared using a breathing pacer at 6 breaths per minute with compassion focused soothing rhythm breathing.
Current study: In this randomized controlled experiment, 6 breaths per minute breathing using a pacer was compared with compassion focused soothing rhythm breathing, with a nature video being used as a control group condition.
Methods: Heart rate variability (HRV) measures were assessed via electrocardiogram (ECG) and respiration belt, and an automated blood pressure machine was used to measure systolic diastolic blood pressure, and heart rate (HR). A total of 96 participants were randomized into the three condi…
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