Talking treatment in general.
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1526 to 1550 of 1,623Optimizing expectations and distraction leads to lower cortisol levels after acute stress.
Background: A new approach of psychological interventions prior to stress aiming to optimize expectations may have beneficial effects on a person's health status by reducing physiological stress. The purpose of this experiment was to determine whether a brief psychological intervention designed to optimize personal control expectations prior to acute stress would affect perceived and biological stress responsiveness in comparison to two more established interventions (fostering gratitude or distraction) in a healthy sample.
Methods: 74 healthy participants were randomized to one of three psychological interventions prior to stress: (i) writing about ways to influence stress to optimize personal control expectations (EXPECTATION), (ii) writing a gratitude-letter (GRATITUDE) (iii) or a distraction writing task (DISTRACTION). After completing the intervention, the Maastricht acute stress te…
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Compassion focused therapy: Exploring the effectiveness with a transdiagnostic group and potential processes of change.
Objectives: This study aimed to examine the effectiveness of a compassion focused therapy (CFT) group with a transdiagnostic population, as compared to treatment as usual (TAU). A secondary aim was to explore the potential processes of change within the treatment.
Design: A non-randomized control trial was used.
Method: Fifty-eight participants who engaged in group CFT were compared to 29 participants receiving TAU. Group CFT consisted of 14 sessions twice weekly for 5 weeks and once weekly for 4 weeks. Participants completed measures of psychopathology, shame, self-criticism, fears of self-compassion, and social safeness, at pre-treatment, post-treatment, and 2-month follow-up. Potential processes of change were examined using correlations and regression analysis.
Results: Significantly greater improvements were found for levels of psychopathology, fears of self-compassion and social sa…
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Van Dam NT, van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Kerr CE, Gorchov J, Fox KCR, Field BA, Britton WB, Brefczynski-Lewis JA, Meyer DE (2018)MEDLINE-indexed journal, not yet read by usPerspectives on psychological science : a journal of the Association for Psychological Science536 citations Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation.
During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and "key to building more resilient soldiers." Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state o…
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Compassion focused therapy for people with dementia: A feasibility study.
Objectives: There is a lack of evidence-based psychological therapies for dementia and psychological distress. The study aimed to develop a compassion focused therapy intervention for people with dementia with depression and/or anxiety, and to assess its feasibility, acceptability, and utility.
Methods: A mixed methods multiple case series (n = 7) was used to assess the intervention's feasibility and changes in self-compassion, mood, anxiety, and quality of life. Outcome measures were administered at pre-intervention, midpoint, and post-intervention. Data were analysed using reliable change and clinically significant change. Thematic analysis on post-therapy interviews and session rating forms was used to assess acceptability and perceived change from the intervention.
Results: Over the course of the intervention, improvements in mood, anxiety, and self-compassion were seen, and three of…
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Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs.
Objective This study evaluated the effectiveness of cognitive processing therapy and prolonged exposure in conditions reflective of current clinical practice within the Veterans Health Administration. Method This study involved a retrospective review of 2030 charts. A total of 750 veterans from 10 U.S. states who received cognitive processing therapy or prolonged exposure in individual psychotherapy were included in the study (participants in cognitive processing therapy, N = 376; participants in prolonged exposure, N = 374). The main dependent variable was self-reported posttraumatic stress disorder symptoms as measured by total scores on the Posttraumatic Stress Disorder Checklist. The study used multilevel modeling to evaluate the absolute and relative effectiveness of both treatments and determine the relationship between patient-level variables and total Posttraumatic Stress Disorde…
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Perception of inpatients following remission of a manic episode in bipolar I disorder on a group-based Psychoeducation program: a qualitative study.
Background: This forms the first study of a group-based psychoeducation program for inpatients following remission of a manic episode in patients suffering from bipolar I disorder in a Chinese population. The aim was to explore the patient's perspectives of the program and their suggestions regarding ways to improve the intervention in the future.
Methods: Semi-structured and in-depth interviews were conducted with 15 participants who had participated in 8 sessions of a group psychoeducation program over 2 weeks. The verbatim transcripts of those interviews were analysed using thematic analysis.
Results: Five themes emerged from the data, including the patients' perception of participating in the program, their perception of the setting, perception of participating in a group program, perception of the learning content and of the outcome of participating in the program.
Conclusions: The …
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Effectiveness of a 10-week group program based on Dialectical Behaviour Therapy skills among patients with personality and mood disorders: findings from a pilot study.
Objectives: Community mental health services are often required to manage people experiencing repeated crises. Personality disorders are not uncommon, accounting for up to one-third of such presentations. These patients are often difficult to treat, leading to a revolving-door phenomenon. This study evaluated the effectiveness of a pilot intervention in reducing psychological symptoms and distress, and examined the impact of the intervention on mental health service utilization.
Methods: A pre- versus post-treatment evaluation was conducted of the effectiveness of a 10-week group psychological intervention based on Dialectical Behaviour Therapy skills, conducted in a regional Australian community mental health service with patients diagnosed with either Cluster B personality disorder or a mood disorder.
Results: Of those who completed the program ( N = 38 patients), 84% were female, with…
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Compassion-Based Therapy for Trauma-Related Shame and Posttraumatic Stress: Initial Evaluation Using a Multiple Baseline Design.
Accumulating research suggests that shame can strongly contribute to the development and maintenance of posttraumatic stress disorder (PTSD). Interventions that promote self-compassion have shown promise for reducing shame related to various clinical problems, but this approach has not been systematically evaluated for traumatized individuals. The aim of this study was to develop a brief compassion-based therapy and assess its efficacy for reducing trauma-related shame and PTSD symptoms. Using a multiple baseline experimental design, the intervention was evaluated in a community sample of trauma-exposed adults (N=10) with elevated trauma-related shame and PTSD symptoms. Participants completed weekly assessments during a 2-, 4-, or 6-week baseline phase and a 6-week treatment phase, and at 2 and 4weeks after the intervention. By the end of treatment, 9 of 10 participants demonstrated reli…
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Mindfulness-based forgiveness groups for older adults.
Interventions that enable individuals to be more forgiving toward themselves and others are important for older adults. This article describes a group intervention for adults aged 60 or older that integrates forgiveness-related skills with a mindfulness approach. The Mindfulness-based Forgiveness Group was designed to meet for eight sessions. The skills taught included: recognizing one's own expectations and unenforceable rules, broadening one's perspectives about the context of the transgression, and discovering positive intentions through exercises as well as a variety of meditations to cultivate mindfulness, self-compassion and forgiveness. Data from five Mindfulness-Based Forgiveness Groups were collected. Based on pre- and post-test measures, analyses indicate that participants improved significantly in relation to forgiveness, mindfulness/self-compassion, and mental health. Using q…
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The influence of a learning to forgive programme on negative affect among mentally disordered offenders.
Background: Clinical trials and meta-analyses provide some evidence for effectiveness of forgiveness therapy delivered individually or in groups. To date, however, forgiveness therapy has not been evaluated with mentally disordered offenders. Given the high prevalence of experienced and perpetrated trauma among such people, this population may particularly benefit from such an intervention.
Aim: The aim of this study is to test the feasibility and impact of a 'learn to forgive' group programme among mentally disordered offenders on a specialist secure hospital setting.
Methods: We conducted a non-randomised trial with 36 offenders with mental disorders and 29 comparison patients. The intervention group engaged in a six-week manual-based 'learn to forgive' treatment programme, while the comparison group watched a 90-minute video on forgiveness. Both groups completed measures of anger, dep…
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Exploring the effectiveness of combined mentalization-based group therapy and dialectical behaviour therapy for inpatients with borderline personality disorder - A pilot study.
Objectives: Borderline personality disorder (BPD) is characterized by emotional instability, interpersonal dysfunction, and other features that typically develop before a background of insecure attachment and traumatic experiences. Dialectical behaviour therapy (DBT) has proven highly effective in reducing self-harm and improving emotion regulation, whereby problems concerning social cognition, which are also characteristic of BPD, may need additional approaches such as mentalization-based treatment (MBT).
Methods: Here, we examined, in a pilot study, the effectiveness of MBT given adjunct to DBT, compared to DBT alone, in an inpatient sample with BPD, whereby mentalization was measured using a novel cartoon-based task.
Results: Both treatments were highly effective in reducing symptom severity. The combination of DBT and MBT was superior in reducing fearful attachment and in improving a…
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Public attitudes towards psychiatry and psychiatric treatment at the beginning of the 21st century: a systematic review and meta-analysis of population surveys.
Public attitudes towards psychiatry are crucial determinants of help-seeking for mental illness. It has been argued that psychiatry as a discipline enjoys low esteem among the public, and a "crisis" of psychiatry has been noted. We conducted a systematic review and meta-analysis of population studies examining public attitudes towards various aspects of psychiatric care. Our search in PubMed, Web of Science, PsychINFO and bibliographies yielded 162 papers based on population surveys conducted since 2000 and published no later than 2015. We found that professional help for mental disorders generally enjoys high esteem. While general practitioners are the preferred source of help for depression, mental health professionals are the most trusted helpers for schizophrenia. If respondents have to rank sources of help, they tend to favor mental health professionals, while open questions yield r…
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King AP, Block SR, Sripada RK, Rauch S, Giardino N, Favorite T, Angstadt M, Kessler D, Welsh R, Liberzon I (2016)MEDLINE-indexed journal, not yet read by usDepression and anxiety131 citations ALTERED DEFAULT MODE NETWORK (DMN) RESTING STATE FUNCTIONAL CONNECTIVITY FOLLOWING A MINDFULNESS-BASED EXPOSURE THERAPY FOR POSTTRAUMATIC STRESS DISORDER (PTSD) IN COMBAT VETERANS OF AFGHANISTAN AND IRAQ.
Background: Recent studies suggest that mindfulness may be an effective component for posttraumatic stress disorder (PTSD) treatment. Mindfulness involves practice in volitional shifting of attention from "mind wandering" to present-moment attention to sensations, and cultivating acceptance. We examined potential neural correlates of mindfulness training using a novel group therapy (mindfulness-based exposure therapy (MBET)) in combat veterans with PTSD deployed to Afghanistan (OEF) and/or Iraq (OIF).
Methods: Twenty-three male OEF/OIF combat veterans with PTSD were treated with a mindfulness-based intervention (N = 14) or an active control group therapy (present-centered group therapy (PCGT), N = 9). Pre-post therapy functional magnetic resonance imaging (fMRI, 3 T) examined resting-state functional connectivity (rsFC) in default mode network (DMN) using posterior cingulate cortex (PCC)…
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Moving on in life after intensive care--partners' experience of group communication.
Background: Partners have a burdensome time during and after their partners' intensive care period. They may appear to be coping well outwardly but inside feel vulnerable and lost. Evaluated interventions for partners on this aspect are limited.
Aim: The aim of this study was to describe the experience of participating in group communication with other partners of former intensive care patients.
Design: The study has a descriptive intervention-based design where group communication for partners of former, surviving intensive care unit (ICU) patients was evaluated.
Methods: A strategic selection was made of adult partners to former adult intensive care patients (n = 15), 5 men and 10 women, aged 37-89 years. Two group communication sessions lasting 2 h were held at monthly intervals with three to five partners. The partners later wrote, in a notebook, about their feelings of participating…
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Mechanisms of change during group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder.
Repetitive negative thinking (RNT) is a transdiagnostic process that serves to maintain emotional disorders. Metacognitive theory suggests that positive and negative metacognitive beliefs guide the selection of RNT as a coping strategy which, in turn, increases psychological distress. The aim of this study was to test the indirect effect of metacognitive beliefs on psychological distress via RNT. Patients (N=52) with primary and non-primary generalized anxiety disorder attended a brief, six-week group metacognitive therapy program and completed measures of metacognitive beliefs, RNT, and symptoms at the first and final treatment sessions, and at a one-month follow-up. Prospective indirect effects models found that negative metacognitive beliefs (but not positive metacognitive beliefs) had a significant indirect effect on psychological distress via RNT. As predicted by metacognitive theor…
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"It Might Actually Work This Time": Benefits and Barriers to Adapted 12-Step Facilitation Therapy and Mutual-Help Group Attendance From the Perspective of Dually Diagnosed Individuals.
Most U.S. healthcare professionals encourage mutual-help group involvement as an adjunct to treatment or aftercare for individuals with substance use disorders, yet there are multiple challenges in engaging in these community groups. Dually diagnosed individuals (DDIs) may face additional challenges in affiliating with mutual-help groups. Twelve-step facilitation for DDIs (TSF-DD), a manualized treatment to facilitate mutual-help group involvement, was developed to help patients engage in Double Trouble in Recovery (DTR), a mutual-help group tailored to DDIs. Given the promising role that TSF-DD and DTR may have for increasing abstinence while managing psychiatric symptoms, the aim of the current study was to systematically examine reasons for TSF-DD and DTR attendance from the perspective of DDIs using focus group data. Participants were a subset (n = 15) of individuals diagnosed with a…
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Effectiveness of cognitive-behavioral group therapy for patients with hypochondriasis (health anxiety).
Cognitive behavioral therapy (CBT) has been shown to be highly effective in the treatment of health anxiety. However, little is known about the effectiveness of group CBT in the treatment of health anxiety. The current study is the largest study that has investigated the effectiveness of combined individual and group CBT for patients with the diagnosis of hypochondriasis (N=80). Therapy outcomes were evaluated by several questionnaires. Patients showed a large improvement on these primary outcome measures both post-treatment (Cohen's d=0.82-1.08) and at a 12-month follow-up (Cohen's d=1.09-1.41). Measures of general psychopathology and somatic symptoms showed significant improvements, with small to medium effect sizes. Patients with more elevated hypochondriacal characteristics at therapy intake showed a larger therapy improvement, accounting for 7-8% of the variance in therapy outcome. …
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Patients' perspectives of the feasibility, acceptability and impact of a group-based psychoeducation programme for bipolar disorder: a qualitative analysis.
Background: Although there is some quantitative evidence to suggest the benefits of group psychoeducation for people with bipolar disorder, patients' perspectives and experiences of group psychoeducation require in-depth exploration to enable us to better understand the feasibility, acceptability and impact of these interventions, the potential facilitators and barriers to engagement, and how to improve these interventions in the future.
Methods: In-depth, semi-structured interviews were conducted with 13 participants of a psychoeducation programme for bipolar disorder in Wales, following their involvement in the programme. The data were recorded and transcribed verbatim and analysed using thematic analysis.
Results: Findings demonstrate that group psychoeducation may impact on participants' perceived social support, knowledge and acceptance of bipolar disorder, personal insights, attitu…
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Using telepsychology to provide a group parenting program: A preliminary evaluation of effectiveness.
Telepsychology offers the potential to reach rural and underserved children and families with mental health concerns. The current study evaluated the effects of using videoconferencing technology to deliver an evidence-based parenting program, the Group Triple P Positive Parenting Program (Group Triple P; Turner, Markie-Dadds, & Sanders, 2002), with families who had a child experiencing behavioral problems. Using a pre/post design, families (N = 13) from low socioeconomic backgrounds in Kentucky completed the Group Triple P via a videoconferencing delivery format. A benchmarking strategy (Weersing & Hamilton, 2005) indicated that treatment effect sizes for the videoconferencing format were generally comparable to treatment effect sizes for Group Triple P studies conducted in-person. Specifically, child behavior and parenting outcomes were similar across delivery formats. Implications of …
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Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers.
Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child's early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers' mental health, parenting competence, and engagement in treatment. Mothers were referred from community health providers for a phase 1 trial to assess feasibility, acceptability, and pilot outcomes. At baseline, man…
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Wampold BE (2015)MEDLINE-indexed journal, not yet read by usWorld psychiatry : official journal of the World Psychiatric Association (WPA)697 citations How important are the common factors in psychotherapy? An update.
The common factors have a long history in the field of psychotherapy theory, research and practice. To understand the evidence supporting them as important therapeutic elements, the contextual model of psychotherapy is outlined. Then the evidence, primarily from meta-analyses, is presented for particular common factors, including alliance, empathy, expectations, cultural adaptation, and therapist differences. Then the evidence for four factors related to specificity, including treatment differences, specific ingredients, adherence, and competence, is presented. The evidence supports the conclusion that the common factors are important for producing the benefits of psychotherapy.
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Group attachment-based intervention: trauma-informed care for families with adverse childhood experiences.
This article outlines the main premises of an innovative trauma-informed intervention, group attachment-based intervention, specifically developed to target vulnerable families with infants and toddlers, living in one of the poorest urban counties in the nation. It also reports on the trauma-relevant characteristics of 60 families entering a clinical trial to study the effectiveness of Group Attachment-Based Intervention. Initial survey results revealed high levels of neglect, abuse, and household dysfunction in mothers' histories (77% reported ≥4 adverse childhood experiences, with more than 90% reporting 2 or more current toxic stressors, including poverty, obesity, domestic and community violence, and homelessness).
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Psaros C, Kagan L, Shifren JL, Willett J, Jacquart J, Alert MD, Macklin EA, Styer AK, Denninger JW, LaRoche KL, Park ER (2015)MEDLINE-indexed journal, not yet read by usJournal of psychosomatic obstetrics and gynaecology15 citations Mind-body group treatment for women coping with infertility: a pilot study.
Objectives: To evaluate the feasibility of a 10-week mind-body intervention (MBI) for women coping with fertility challenges, examine the impact of an MBI on psychological distress and cortisol levels, and assess adherence to MBI skills 12-months after completion of the intervention.
Design: Prospective open pilot study of 51 women with infertility enrolled in a group MBI. Psychological variables and salivary cortisol levels were obtained pre- and post-intervention; a 12-month follow-up survey assessed MBI skill adherence. Participants completed practice logs throughout the intervention.
Results: Participants attended an average of eight sessions (SD = 2.0), and practiced mind-body techniques which elicited the relaxation response (RR) an average of 5.9 (SD = 0.8) days/week and 20.1 (SD = 9.9) min/day; 80% completed the post-treatment assessment. The intervention resulted in a significan…
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Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis.
We conducted a meta-analysis of randomized trials in which the effects of treatment with antidepressant medication were compared to the effects of combined pharmacotherapy and psychotherapy in adults with a diagnosed depressive or anxiety disorder. A total of 52 studies (with 3,623 patients) met inclusion criteria, 32 on depressive disorders and 21 on anxiety disorders (one on both depressive and anxiety disorders). The overall difference between pharmacotherapy and combined treatment was Hedges' g = 0.43 (95% CI: 0.31-0.56), indicating a moderately large effect and clinically meaningful difference in favor of combined treatment, which corresponds to a number needed to treat (NNT) of 4.20. There was sufficient evidence that combined treatment is superior for major depression, panic disorder, and obsessive-compulsive disorder (OCD). The effects of combined treatment compared with placebo …
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Family skills training in dialectical behaviour therapy: the experience of the significant others.
Aim: The aim was to describe significant others' experiences of dialectical behaviour therapy-family skills training (DBT-FST), their life situation before and after DBT-FST, and measurement of their levels of anxiety and depressive symptoms.
Methods: The study had a descriptive mixed method design. Data were collected with free text questionnaires (n=44), group interviews (n=53) and the HAD scale (n=52) and analysed by qualitative content analysis and descriptive and inferential statistics.
Results: The results show that life before DBT-FST was a struggle. DBT-FST gave hope for the future and provided strategies, helpful in daily life. For the subgroup without symptoms of anxiety and depression before DBT-FST, anxiety increased significantly. For the subgroup with symptoms of anxiety and depression the symptoms decreased significantly. This indicates, despite increased anxiety for one g…
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