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Kaufman A, Nemeroff R. Motivation to change predicts college students' utilization of self-help resources. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38592799 DOI: 10.1080/07448481.2024.2334082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Background: Stress and mental health difficulties are common burdens on college students. College counseling centers have been overrun by demand. Thus, self-help interventions may offer a promising alternative to traditional college counseling services. Methods: The current study examined the influence of perceived stress, motivation to change, and self-efficacy beliefs on college students' use of self-help resources, to determine whether these factors would predict follow-up with self-help recommendations. Results: Results of stepwise linear regression models suggest that perceived stress and self-efficacy did not predict self-help resource utilization. Different types of self-help recommendations did not predict different levels of follow-up. However, motivation to change was a significant predictor college students' self-help resource use, and this variable was particularly important when self-help recommendations were less structured. Conclusions: These findings can help to predict which college students are likely to make use of self-help resources, and inform targeted individual treatment.
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Affiliation(s)
- Alyson Kaufman
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Robin Nemeroff
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
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Everson G, Spring B, Middleton J, Richardson A, Gardiner FW. Culturally appropriate psychotherapy and its retention: An example from Far North Queensland (Australia). Acta Psychol (Amst) 2024; 242:104122. [PMID: 38145592 DOI: 10.1016/j.actpsy.2023.104122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Culturally appropriate mental health care is essential in remote Australia. However, while associated with the development of an effective therapeutic alliance, current literature insufficiently reports the retention and psychotherapy outcomes of Indigenous adults. We aimed to describe the characteristics and retention of clients attending the Far North Mental Health and Wellbeing Service (FNS). METHODS We conducted a retrospective cross-sectional study on clients who received one or more psychotherapy consultations between 1st July 2019 and 31st December 2020. Population, entrance, and treatment characteristics were described, with retention compared between the major cultural groups. Entrance characteristics comprised referral pathway and reason for presentation and were investigated as alternative predictors of client retention. FINDINGS There were 186 non-Indigenous (68.3 % female) and 174 Indigenous (62.6 % female) clients, with a median number of 3.0 consultations (IQR 2.0-5.3). Indigenous status did not significantly predict retention. Referral pathway significantly predicted the number of consultations (Wald X2(6) = 17.67, p = .0071) and immediate discontinuation (Wald X2(6) = 12.94, p = .044), with self-referred clients having the highest retention. Initial presentation reason significantly predicted the number of consultations (Wald X2(5) = 13.83, p = .017), with clients with potential health hazards related to socioeconomic and psychosocial circumstances having the lowest retention. Significantly more Indigenous clients presented for this reason (20.1 % vs 4.3 %). INTERPRETATION Comparable retention of Indigenous clients suggests cultural appropriateness of the psychotherapy being delivered by the FNS. Services might use the described therapeutic approach as a guide for culturally appropriate care.
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Affiliation(s)
- George Everson
- The ANU School of Medicine and Psychology, Australian National University, ACT, Canberra, Australia
| | - Breeanna Spring
- Royal Flying Doctor Service of Australia, 10-12 Brisbane Avenue, Barton, ACT, Australia; Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - Jocelyn Middleton
- Royal Flying Doctor Service of Australia, 12 Casuarina Street, Brisbane Airport, QLD, Australia
| | - Alice Richardson
- The Statistical Support Network, Australian National University, ACT, Canberra, Australia
| | - Fergus W Gardiner
- The ANU School of Medicine and Psychology, Australian National University, ACT, Canberra, Australia; Royal Flying Doctor Service of Australia, 10-12 Brisbane Avenue, Barton, ACT, Australia; The Rural Clinical School of Western Australia, The University of Western Australia, WA, Australia.
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Muacevic A, Adler JR, Chagin K, Bier J, Einstadter D, Gunzler D, Glenn A, McLaughlin E, Cook K, Misak J, Bolen SD. Food as Medicine Clinic: Early Results and Lessons Learned. Cureus 2022; 14:e31912. [PMID: 36579189 PMCID: PMC9792141 DOI: 10.7759/cureus.31912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Hospital-based food pantries are commonly used to address food insecurity. However, few studies have examined the impact of these food pantries on patients with chronic health conditions. In this study, we sought to assess the effect of a hospital-based food pantry clinic on self-reported dietary changes, health outcomes, and resource utilization. METHODS This study included food insecure participants with suboptimally controlled congestive heart failure, hypertension, or diabetes who visited a Food as Medicine (FAM) clinic at an academic healthcare system between October 2018 and November 2019. The clinic provided a three-day supply of food for participants and their families up to two times per month for up to 12 months. Baseline, three-month, and six-month surveys were used to assess dietary behaviors, and electronic health record (EHR) data were used to assess health outcomes and utilization. Multivariable Poisson regression was used to explore variables associated with FAM clinic use. RESULTS At three months, participants self-reported improved dietary behaviors, including increased consumption of fruits and vegetables as snacks and an increased variety of fruits and vegetables consumed. There were no statistically significant changes in clinical or healthcare utilization measures, despite small absolute improvements in systolic blood pressure (SBP), hospitalizations, and emergency department (ED) visits. There was a weak association between FAM clinic visit frequency and changes in dietary behaviors. CONCLUSION Among patients with chronic diseases, the use of the FAM clinic was associated with improved self-reported dietary behaviors and a nonsignificant improvement in health outcomes and resource utilization.
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Reflections from a Psychologist Working with Sickle Cell and Thalassaemia Patients during the COVID-19 Pandemic. Medicina (B Aires) 2022; 58:medicina58091286. [PMID: 36143963 PMCID: PMC9505742 DOI: 10.3390/medicina58091286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/06/2022] [Accepted: 09/11/2022] [Indexed: 12/04/2022] Open
Abstract
Sickle cell disease and thalassaemia are life-long haematological diseases that can impact the quality of life of patients. This impact on quality of life can require intermittent psychological input throughout the lifespan for management. Managing everyday life during the COVID-19 pandemic could be challenging for people with these health conditions, which could impact their health, their mood and anxiety, their perception of control, and their engagement with their regular healthcare services. This report describes the characteristics of these health conditions and discusses reflections, from a specialist psychology service working with this clinical population, about the impact of COVID-19 on patient engagement with the service. The main aim of this report is to highlight the relevance and usefulness of videoconferencing as a therapy format, suggest implications for further service development and suggest alternate ways of working therapeutically with clients.
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de la Coba P, Rodríguez-Valverde M, Hernández-López M. Online ACT intervention for fibromyalgia: An exploratory study of feasibility and preliminary effectiveness with smartphone-delivered experiential sampling assessment. Internet Interv 2022; 29:100561. [PMID: 35855947 PMCID: PMC9287477 DOI: 10.1016/j.invent.2022.100561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/28/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Acceptance and commitment therapy (ACT) is an effective treatment for chronic pain conditions. ACT seeks to produce clinical change by enhancing Psychological Flexibility (PF). This exploratory (feasibility and preliminary effectiveness) study presents a pilot application of an online ACT group intervention for fibromyalgia (FM) with an extensive Experiential Sampling (ES) assessment of outcome and process variables via smartphone. METHOD 5-weekly ACT online group sessions were applied to 9 female FM patients. Questionnaire-based assessments of several clinical outcomes and PF processes were conducted pre- and post-intervention, and at 6-month follow-up. Extensive (6 weeks pre- and 6 weeks post-intervention) smartphone-delivered ES was implemented to gather process and outcome data in the patients' usual contexts. Clinically significant change was evaluated both at the group level and individually. RESULTS This treatment format appears to be feasible and acceptable to participants, with good adoption and completion rates (75 %) and excellent rates of treatment completion and clinical adherence (100 %). Participants showed significant reductions in affective pain, distress and biopsychosocial impact of FM both post-intervention and at 6-month follow-up (as measured with questionnaires), as well as significant improvements in satisfaction with actions and emotional discomfort (as measured through ES). Multilevel regression analyses indicated that PF-related processes assessed through ES had a significant impact on clinical outcomes and predicted the impact of FM at the 6-month follow-up. CONCLUSIONS A brief online group ACT intervention for FM was both feasible and acceptable to participants. Also, there was preliminary evidence of effectiveness in enhancing pain-related PF and producing clinical benefits in FM.
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Affiliation(s)
- Pablo de la Coba
- Corresponding author at: Departamento de Psicología, Universidad de Jaén, 23071 Jaén, Spain.
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Isbăşoiu AB, Tulbure BT, Rusu A, Sava FA. Can We Boost Treatment Adherence to an Online Transdiagnostic Intervention by Adding Self-Enhancement Strategies? Results From a Randomized Controlled Non-inferiority Trial. Front Psychol 2021; 12:752249. [PMID: 34925157 PMCID: PMC8675898 DOI: 10.3389/fpsyg.2021.752249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Internet-delivered psychotherapy represents an impactful large-scale solution for addressing psychological disorders. In spite of its flexibility and scalability, the fact that the ones in need have to initiate and sustain the curse of the treatment by themselves comes with considerable downsides in terms of treatment adherence. One solution could be to increase the ease of use and attractivity of the strategies and assignments from such programs. The present study aims to address this issue by incorporating a series of self-oriented strategies to the validated internet-delivered short version of the Unified Protocol (UP). By this mean we intend to complement the symptom-focused assignments, which may be more suitable in a therapist assisted context, with ones designed for self-enhancement, which may be easier approached as self-initiated. Based on a randomized controlled non-inferiority trial we compared the modified version of the UP with the standard short version. Method: The trial design was factorial, with two parallel arms and three measurement moments (baseline, post-intervention and 6-months follow-up). A total of 284 participants were randomly assigned to the intervention or the active control groups. The intervention group (baseline n = 142) received the self-enhanced nine modules of the UP (Self-enhanced 9UP) while the active control (baseline n = 142) received the standard nine modules (9UP). The newly added techniques were inspired by the acceptance and commitment therapy and were specific for self-concepts such as self-compassion or unconditional self-acceptance. Both programs lasted for 9 weeks. The non-inferiority of the Self-enhanced 9UP was tested against a margin of d = -0.35, on the following primary outcome measures: Patient Health Questionnaire 9 (PHQ9) - operationalization for depression; Generalized Anxiety Disorder 7 (GAD7) - operationalization for generalized anxiety or worry; Social Phobia Inventory (SPIN) - operationalization for social phobia; and Panic Disorder Severity Scale-Self Report (PDSS-SR) - that showed participants' level of panic. Treatment adherence was assessed through the drop-out analyses and the engagement in completing the homework assignments. Secondary outcome measures included several self-concept measures: Self-Compassion Scale (SCS); Rosenberg Self-Esteem Scale (RSES); Unconditional Self-Acceptance Questionnaire (USAQ); New General Self-Efficacy Scale (NGSE); and Self-Concept Clarity Scale (SCCS). On the secondary outcomes we explored the potential boost of effectiveness produced by the newly added self-enhancement components. Results: The dropout rates were similar in both groups (approximately 45%) and high overall. Adherence to treatment assignments was also modest and similar between groups (on average participants completed approximately half of the tasks), without a statistically significant bias toward the self-enhancement ones. Overall, both the intention-to-treat and completers analyses yielded no significant group by time interactions for any of the post-intervention and follow-up measurements, but a few non-inferiority analyses suggested that the Self-enhanced 9UP had a significantly weaker effectiveness than the standard 9UP. Within-group analyses showed significant alleviations on all the primary and secondary outcomes for both groups. The effect size estimates were mainly medium and high, and their magnitude tended to be kept also at 6-months follow-up. Discussion: We failed to increase treatment adherence, but we found support with some exceptions, for the non-inferiority hypothesis. Hence, the alterations performed to the 9UP protocol, although they did not boost the treatment attractiveness, they also did not decrease the treatment effectiveness as suggested by most non-inferiority analyses. Likewise, the gain on self-concepts was produced by both groups. Hence, the short version of the UP seems to have the potential of effectively alleviating a larger palette of psychological variables associated with mental health symptoms than previously known. Even though our main objective was only partially achieved, these secondary results are insightful and could open new avenues of research. Clinical Trial Registration: This trial has been registered at ClinicalTrials.Gov (NCT03917550; 17 April 2019; https://clinicaltrials.gov/ct2/show/NCT03917550).
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Affiliation(s)
| | | | | | - Florin Alin Sava
- Department of Psychology, West University of Timişoara, Timişoara, Romania
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Ribeiro E, Sampaio A, Gonçalves MM, Taveira MDC, Cunha J, Maia Â, Matos M, Gonçalves S, Figueiredo B, Freire T, Soares T. Telephone-based psychological crisis intervention: the Portuguese experience with COVID-19. COUNSELLING PSYCHOLOGY QUARTERLY 2020. [DOI: 10.1080/09515070.2020.1772200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Eugénia Ribeiro
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Adriana Sampaio
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Miguel M. Gonçalves
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Maria Do Céu Taveira
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Jácome Cunha
- , HASLab/INESC TEC & University of Minho, Braga, Portugal
| | - Ângela Maia
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Marlene Matos
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Sónia Gonçalves
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Bárbara Figueiredo
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
| | - Teresa Freire
- School of Psychology, Psychology Research Centre (CPsi)-university of Minho, Braga, Portugal
- Association of Psychology, University of Minho (Apsi-uminho), Braga, Portugal
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