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Oostermeijer S, Morgan A, Cheesmond N, Green R, Reavley N. The Effects of Australia's First Residential Peer-Support Suicide Prevention and Recovery Centre (SPARC). CRISIS 2024; 45:217-224. [PMID: 38375762 DOI: 10.1027/0227-5910/a000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Aim: This paper reports preliminary evidence of the impacts of Australia's first residential peer-support service for people at risk of suicide. Methods: Psychological distress was measured preintervention, postintervention, and after 3 months and analyzed using paired t tests. Interviews were held postintervention and were analyzed using thematic analysis. Results: Psychological distress significantly improved from preintervention to postintervention (n = 16, d = 1.77) and at follow-up (n = 5, d = 1.12). Interviews (n = 10) indicated that participants experienced improvements in mental well-being and feelings of connectedness, respite, and confidence to engage with other services. The peer-support workers were key. Some participants felt that the location was too remote, too little information was given, and a longer stay would have been preferable. Limitations: The study did not include a control group, the sample was relatively small, and participants may have been subject to socially desirable answers. Conclusions: These findings indicate that residential peer-support services potentially offer a valuable alternative to conventional inpatient treatment for people at risk of suicide.
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Affiliation(s)
- Sanne Oostermeijer
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Amy Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | | | - Rachel Green
- Independent Community Living Australia, Surry Hills, NSW, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
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2
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Yirmiya K, Constantinou M, Simes E, Bateman A, Wason J, Yakeley J, McMurran M, Crawford M, Frater A, Moran P, Barrett B, Cameron A, Hoare Z, Allison E, Pilling S, Butler S, Fonagy P. The mediating role of reflective functioning and general psychopathology in the relationship between childhood conduct disorder and adult aggression among offenders. Psychol Med 2024:1-12. [PMID: 38563288 DOI: 10.1017/s003329172400062x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e., the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression. METHODS A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires. RESULTS Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression. CONCLUSIONS These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies.
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Affiliation(s)
- Karen Yirmiya
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Matthew Constantinou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Anthony Bateman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - James Wason
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jessica Yakeley
- Portman Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Mary McMurran
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Mike Crawford
- Division of Psychiatry, Imperial College, London, UK
| | - Alison Frater
- School of Law, Royal Holloway, University of London, London, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| | - Barbara Barrett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angus Cameron
- National Probation Service London Division, London, UK
| | - Zoe Hoare
- NWORTH Clinical Trials Unit, School of Health Sciences, Bangor University, Bangor, UK
| | - Elizabeth Allison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Butler
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
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3
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Biringer E, Bjørkvik J. Is there a prospective association between psychological distress as measured by the CORE-OM and treatment attendance and treatment duration? A follow-up study at a Norwegian Community Mental Health Centre. Nord J Psychiatry 2024; 78:220-229. [PMID: 38270392 DOI: 10.1080/08039488.2024.2306217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Feasible and reliable methods for identifying factors associated with treatment duration and treatment attendance in mental health services are needed. This study examined to what degree the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the start of treatment is associated with treatment attendance and treatment duration. METHODS Outpatients (N = 124) at a community mental health centre in Norway completed the 34-item CORE-OM questionnaire addressing the domains of subjective well-being, problems and symptoms, functioning and risk at the start of treatment. The CORE-OM subscales and the 'all' items total scale were used as predictor variables in regression models, with treatment duration, number of consultations attended, treatment attendance (number of therapy sessions attended divided by number of sessions offered) and termination of treatment (planned versus unplanned) as outcome variables. RESULTS Higher CORE-OM subscale scores and the 'all' scale were associated with longer treatment duration. No association was found between CORE-OM scales and number of therapy sessions, treatment attendance (sessions attended/offered) or whether the patients unexpectedly ended treatment. CONCLUSION Higher patient-reported psychological distress as measured by the CORE-OM at the start of treatment was prospectively associated with treatment duration but not with treatment attendance or drop-out of treatment. The findings imply that patients with higher initial psychological distress need longer treatment but that treatment attendance may be related to factors other than the severity of distress.
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Affiliation(s)
- Eva Biringer
- Helse Fonna HF, Department of Research and Innovation, Stord Hospital, Stord, Norway
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4
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Felix CB, Sand P. Feasibility and Efficacy of Intensive Dialectical Behavior Therapy Skills Training in An Outpatient Setting for A Group of Patients with Extensive Care Needs - A Transdiagnostic Approach. Psychiatr Q 2023; 94:691-704. [PMID: 37792150 PMCID: PMC10638174 DOI: 10.1007/s11126-023-10052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Dialectical behavior therapy (DBT) is a treatment originally developed för chronically suicidal adults. It is common to adapt it by using one specific component, the DBT skills training (DBT-ST) and apply it in a group therapy setting for a variety of mental disorders. The primary aim of the study was to explore whether patients with extended care needs would report improved mental health after participating in an intensive form of DBT-ST. The secondary aim was to explore whether the use of psychiatric inpatient care for the group would decrease. METHODS Thirty-seven participants completed the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), and visual analogue scale (VAS) at three time points: pre-intervention, post-intervention and at 6-month follow-up after intensive DBT-ST. RESULTS One-way ANOVA showed a significant effect for time on the CORE-OM: F (2,35) = 7.93, p = .001, η2 = 0.312 (large effect size). Post hoc tests indicated a significant difference between pre-intervention and post-intervention (p = .001) and between pre-intervention and follow-up (p = .01). A Friedman test indicated a statistically significant difference in the VAS scale scores across the three time points, with p-values between 0.00 and 0.05. There was no difference in psychiatric healthcare consumption. CONCLUSION These study results confirm to some extent the feasibility and effectiveness of the intensive DBT-ST in a transdiagnostic clinical setting. The participants had a positive outcome from the skills training program, but psychiatric healthcare consumption did not decrease.
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Affiliation(s)
- Christina Bertholds Felix
- Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Peter Sand
- Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
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5
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Potts C, Bond RR, Jordan JA, Mulvenna MD, Dyer K, Moorhead A, Elliott A. Process mining to discover patterns in patient outcomes in a Psychological Therapies Service. Health Care Manag Sci 2023; 26:461-476. [PMID: 37191758 PMCID: PMC10186289 DOI: 10.1007/s10729-023-09641-8] [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: 03/11/2021] [Accepted: 04/21/2023] [Indexed: 05/17/2023]
Abstract
In the mental health sector, Psychological Therapies face numerous challenges including ambiguities over the client and service factors that are linked to unfavourable outcomes. Better understanding of these factors can contribute to effective and efficient use of resources within the Service. In this study, process mining was applied to data from the Northern Health and Social Care Trust Psychological Therapies Service (NHSCT PTS). The aim was to explore how psychological distress severity pre-therapy and attendance factors relate to outcomes and how clinicians can use that information to improve the service. Data included therapy episodes (N = 2,933) from the NHSCT PTS for adults with a range of mental health difficulties. Data were analysed using Define-Measure-Analyse model with process mining. Results found that around 11% of clients had pre-therapy psychological distress scores below the clinical cut-off and thus these individuals were unlikely to significantly improve. Clients with fewer cancelled or missed appointments were more likely to significantly improve post-therapy. Pre-therapy psychological distress scores could be a useful factor to consider at assessment for estimating therapy duration, as those with higher scores typically require more sessions. This study concludes that process mining is useful in health services such as NHSCT PTS to provide information to inform caseload planning, service management and resource allocation, with the potential to improve client's health outcomes.
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Affiliation(s)
- C Potts
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Coleraine, Northern Ireland.
| | - R R Bond
- School of Computing, Faculty of Computing Engineering & the Built Environment, Ulster University, Belfast, Northern Ireland
| | - J-A Jordan
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - M D Mulvenna
- School of Computing, Faculty of Computing Engineering & the Built Environment, Ulster University, Belfast, Northern Ireland
| | - K Dyer
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern Ireland
- Psychological Therapies Service, Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - A Moorhead
- School of Communication and Media, Institute of Nursing and Health Research, Ulster University, Belfast, Northern Ireland
| | - A Elliott
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern Ireland
- Psychological Therapies Service, Northern Health and Social Care Trust, Antrim, Northern Ireland
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La Tona A, Tagini S, Brugnera A, Poletti B, Aiello EN, Lo Coco G, Del Piccolo L, Compare A. Italian validation of the Clinical Outcomes in Routine Evaluation 10 (CORE-10): a short measure for routine outcome monitoring in clinical practice. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2023; 26. [PMID: 37017222 DOI: 10.4081/ripppo.2023.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/12/2023] [Indexed: 04/05/2023]
Abstract
The customization of the intervention using patient feedback is an evidence-based practice aimed at the continuous evaluation, during the course of treatment, of the patient's change at a clinical level. There are few easy-to-use tools for common assessment of psychological distress, designed to be used for screening and during treatment to monitor progress. The CORE-10 is definitely one of them. Thus, the aim of the present study was to examine the psychometric properties of the Italian version of the Clinical Outcomes in Routine Evaluation - 10 (CORE-10). A sample of 548 participants (females, N = 463, 84,5%; mean age 23.29 ± 7.21 years) was recruited in the study and filled out a battery of measures. The internal validity of the CORE-10 was investigated through a confirmatory factor analysis (CFA) which evidenced a good fit to the data, suggesting a unidimensional factorial structure of the measure. Further, the scale had a good internal reliability and was significantly associated with other measures of distress, interpersonal problems, wellbeing, and insecure attachment. Finally, it showed excellent diagnostic accuracy, as well as intrinsic and post-test diagnostics. Given its validity and reliability, the CORE-10 may be adopted by Italian-speaking psychotherapists and researchers to evaluate the outcomes of mental health interventions as well as to track the session-to-session changes over time in psychological distress among patients.
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Rosan C, Dijk KAV, Darwin Z, Babalis D, Cornelius V, Phillips R, Richards L, Wright H, Pilling S, Fearon P, Pizzo E, Fonagy P. The COSI trial: a study protocol for a multi-centre, randomised controlled trial to explore the clinical and cost-effectiveness of the Circle of Security-Parenting Intervention in community perinatal mental health services in England. Trials 2023; 24:188. [PMID: 36915170 PMCID: PMC10012495 DOI: 10.1186/s13063-023-07194-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/20/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Perinatal mental health difficulties affect up to 27% of birthing parents during pregnancy and the first postnatal year, and if untreated are associated with difficulties in bonding and long-term adverse outcomes to children. There are large evidence gaps related to psychological treatment, particularly in group therapy approaches and parent-infant interventions. One intervention showing preliminary efficacious findings and user acceptability is Circle of Security-Parenting (COS-P), which is a brief, weekly, group programme. However, these studies were underpowered and predominantly non-randomised, and there has never been a research trial in England or with birthing parents experiencing severe and complex perinatal mental health difficulties. The aim of the research is to conduct a randomised control trial to test whether COS-P will reduce perinatal mental health symptoms in birthing parents accessing NHS perinatal mental health services, compared to treatment as usual (TAU). Secondary objectives include exploring whether the intervention improves parenting sensitivity, emotion regulation skills, attachment security and infant development. Additionally, the project aims to examine whether the intervention is acceptable to parents and NHS staff, and whether it is cost-effective. METHODS COSI is an individually randomised, single-blind parallel arm controlled trial with an embedded internal pilot aiming to recruit 369 participants in a 2:1 ratio (intervention: TAU). Participants will be recruited from ten NHS community perinatal mental health services in England and screened based on clinical levels of both mental health symptoms (average CORE-OM score ≥ 1.1) and postnatal bonding difficulties (total PBQ score ≥ 12). This trial has 90% power to detect a MCID of 5 points on the CORE-OM. Primary and secondary outcomes will be measured at baseline, 3, 7 and 12 months after baseline. Service use and quality of life measures will also be collected alongside a process evaluation of parents' and interveners' views and experiences. DISCUSSION This will be the first large pragmatic trial to test whether COS-P is effective for birthing parents with severe and complex perinatal mental health difficulties in improving their mental health symptoms. If shown to be effective, the intervention could be delivered widely across the NHS and other similar services globally. TRIAL REGISTRATION ISRCTN, ISRCTN18308962. Registered 18 February 2022.
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Affiliation(s)
- Camilla Rosan
- Department of Clinical, Educational and Health Psychology, University College London, London, UK. .,Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK.
| | | | - Zoe Darwin
- University of Huddersfield, Huddersfield, UK
| | - Daphne Babalis
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | - Rachel Phillips
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | - Lani Richards
- Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| | - Hannah Wright
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| | - Steve Pilling
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Pasco Fearon
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
| | - Elena Pizzo
- Department of Applied Health Research, University College London, London, UK
| | - Peter Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
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8
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Jacob J, Edbrooke-Childs J, Costa da Silva L, Law D. Notes from the youth mental health field: Using movement towards goals as a potential indicator of service change and quality improvement. J Clin Psychol 2023; 79:697-710. [PMID: 34114660 DOI: 10.1002/jclp.23195] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/16/2021] [Accepted: 05/30/2021] [Indexed: 11/09/2022]
Abstract
The aim of this paper is to report our notes from the field on using movement toward goals at an aggregate level as an inference of service effectiveness. Analysis of routinely collected data from UK youth mental health services was conducted (N = 8,172, age M = 13.8, 67% female, 32% male) to explore the impact of including goal-based outcome data in combined calculations of standardized measures based on the principles of reliable change ("measurable change"). Due to the broad nature of standardized measures, inferred validity becomes diluted in any team or service level aggregate analysis. To make inferences that are closer to the person's interpretation of their difficulties, we argue that Idiographic Patient Reported Outcome Measures (I-PROMs) counterbalance these limitations. This is supported by our findings. The measurable change metric is the first step towards enabling national analysis of aggregated I-PROMs. I-PROMs, supplemented by standardized measures should be used to consider service evaluation.
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Affiliation(s)
- Jenna Jacob
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Julian Edbrooke-Childs
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,Department of Clinical, Educational and Health Psychology, UCL, London, UK.,Evidence Based Practice Unit, Anna Freud Centre, London, UK
| | - Luís Costa da Silva
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Duncan Law
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,MindMonkey Associates Ltd, London, UK
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9
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Sales CMD, Cooper M. Special section: Idiographic tools for routine outcome monitoring in psychotherapy. J Clin Psychol 2023; 79:593-595. [PMID: 36772999 DOI: 10.1002/jclp.23489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/03/2023] [Indexed: 02/12/2023]
Affiliation(s)
- Celia M D Sales
- Faculty of Psychology and Education Sciences (FPCEUP), Center for Psychology at the Universidade do Porto (CPUP), Porto, Portugal
| | - Mick Cooper
- School of Psychology, University of Roehampton, London, UK
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10
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Cooper M, Xu D. Goals Form: Reliability, validity, and clinical utility of an idiographic goal-focused measure for routine outcome monitoring in psychotherapy. J Clin Psychol 2023; 79:641-666. [PMID: 35366375 PMCID: PMC10084194 DOI: 10.1002/jclp.23344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/12/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aimed to assess the reliability, validity, and clinical utility of an idiographic, goal-focused patient-reported outcome measure: The Goals Form. METHODS Data were analyzed from 88 participants, across three samples, who had participated in collaborative-integrative psychotherapy at university-based clinics in the UK. The samples were approximately 70% female with mean age of 30 years old. RESULTS The psychometric properties of the Goals Form were generally good. Noncompletion of individual items was low, temporal stability tended to be at target levels, and mean change scores showed moderate to good convergent validity against measures of psychological distress. The measure appeared sensitive to change in psychotherapy and was experienced by most patients as helpful. CONCLUSIONS The Goals Form shows acceptable psychometric and clinical properties for routine outcome monitoring in psychotherapy.
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Affiliation(s)
- Mick Cooper
- School of Psychology, University of Roehampton, London, UK
| | - Dan Xu
- School of Psychology, University of Roehampton, London, UK.,Department of Psychology, Zhejiang University of Technology, Hangzhou, Zhejiang, China
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11
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Sales CMD, Ashworth M, Ayis S, Barkham M, Edbrooke-Childs J, Faísca L, Jacob J, Xu D, Cooper M. Idiographic patient reported outcome measures (I-PROMs) for routine outcome monitoring in psychological therapies: Position paper. J Clin Psychol 2023; 79:596-621. [PMID: 35194799 DOI: 10.1002/jclp.23319] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/26/2021] [Accepted: 01/09/2022] [Indexed: 11/07/2022]
Abstract
Idiographic patient-reported outcome measures (I-PROMs) are a growing set of individualized tools for use in routine outcome monitoring (ROM) in psychological therapies. This paper presents a position statement on their conceptualization, use, and analysis, based on contemporary evidence and clinical practice. Four problem-based, and seven goal-based, I-PROMs, with some evidence of psychometric evaluation and use in psychotherapy, were identified. I-PROMs may be particularly valuable to the evaluation of psychological therapies because of their clinical utility and their alignment with a patient-centered approach. However, there are several challenges for I-PROMs: how to generate items in a robust manner, their measurement model, methods for establishing their reliability and validity, and the meaning of an aggregated I-PROM score. Based on the current state of the literature, we recommend that I-PROMs are used to complement nomothetic measures. Research recommendations are also made regarding the most appropriate methods for analyzing I-PROM data.
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Affiliation(s)
- Célia M D Sales
- Faculty of Psychology and Education Sciences (FPCEUP), Center for Psychology at the Universidade do Porto (CPUP), University of Porto, Porto, Portugal
| | - Mark Ashworth
- School of Life Course and Population Sciences, King's College London, Guy's Campus, London, United Kingdom, SE1 1UL, UK
| | - Salma Ayis
- School of Life Course and Population Sciences, King's College London, Guy's Campus, London, United Kingdom, SE1 1UL, UK
| | - Michael Barkham
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Julian Edbrooke-Childs
- Anna Freud Centre, Applied Research and Evaluation, The Kantor Centre of Excellence, 4-8 Rodney Street, London, N1 9JH, UK
| | - Luís Faísca
- FCHS & Center for Research in Health Technologies and Information, Universidade do Algarve, Faro, Portugal
| | - Jenna Jacob
- Anna Freud Centre, Applied Research and Evaluation, The Kantor Centre of Excellence, 4-8 Rodney Street, London, N1 9JH, UK
| | - Dan Xu
- Zhejiang University of Technology, Hangzhou, China
| | - Mick Cooper
- Department of Psychology, University of Roehampton, London, UK
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12
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Gislon MC, Sattin D, Cis M, Fiaschi M, Tognasso G, D’Ambrosio V, Villa M, Ruffino M, Bergamaschi S. Integrated focal psychotherapy: Results from a retrospective study. Front Psychol 2023; 14:945644. [PMID: 36860776 PMCID: PMC9968753 DOI: 10.3389/fpsyg.2023.945644] [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] [Received: 05/16/2022] [Accepted: 01/12/2023] [Indexed: 02/17/2023] Open
Abstract
Background The focus-based integrated model (FBIM) is a form of psychotherapy that integrates psychodynamic and cognitive psychotherapy and Erikson's life cycle model. Although there are many studies on the effectiveness of integrated models of psychotherapy, few have examined the efficacy of FBIM. Objective This pilot study explores clinical outcome measures concerning individual wellbeing, the presence/absence of symptoms, life functioning, and risk in a cohort of subjects after they received FBIM therapy. Methods A total of 71 participants were enrolled at the CRF Zapparoli Center in Milan, 66.2% of whom were women (N = 47). The mean age of the total sample was 35.2 years (SD = 12.8). We used the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) to test treatment efficacy. Results The results revealed that participants improved in all four dimensions of CORE-OM (i.e., wellbeing, symptoms, life functioning, and risk), women improved more than men, and in most cases (64%), the change was clinically reliable. Conclusion The FBIM model seems to be effective for treating several patients. Most of the participants saw significant changes in symptoms, life functioning, and general wellbeing.
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Affiliation(s)
| | - Davide Sattin
- Istituti Clinici Scientifici Maugeri IRCCS, Milan, Italy
| | - Mattia Cis
- Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy,*Correspondence: Mattia Cis,
| | - Mara Fiaschi
- Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy
| | - Giacomo Tognasso
- Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy
| | - Vincenzo D’Ambrosio
- Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy
| | - Maria Villa
- Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy
| | - Milena Ruffino
- Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy
| | - Susanna Bergamaschi
- Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy
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13
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Wickramasekera N, Tubeuf S. Measuring quality of life for people with common mental health problems. J Ment Health 2023; 32:3-10. [PMID: 32915686 DOI: 10.1080/09638237.2020.1818190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND It is important to identify valid and acceptable outcome measures so that interventions evaluating common mental health problems can be assessed appropriately. Some advocate the use of generic preference-based measures claimed to be applicable for all health interventions, but others argue that they are insensitive for common mental health problems. The aim of this paper is to evaluate the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), to be used in cost-effectiveness studies in people with common mental health problems. METHOD The CORE-OM measure was tested for completeness, acceptability and responsiveness in a pilot study. Analyses for missing data, distribution of scores, and standardised response means (SRMs) were calculated. RESULTS Missing data did not exceed 5% for any of the CORE-6D items both at baseline and follow-up. The overall comprehension rate was high, and only 19 participants (14%) requested clarifications to complete the questionnaire. As expected in a feasibility study, there was a small and non-significant SRM. CONCLUSION CORE-OM is a valid and acceptable instrument to evaluate quality of life for people with common mental health problems. More research is needed with larger sample sizes to compare CORE-6D with other condition specific quality of life instruments.
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Affiliation(s)
| | - Sandy Tubeuf
- Institute of Health and Society (IRSS) and Institute of Economic and Social Research (IRES), Université Catholique de Louvain, Clos Chapelle-aux-Champs, Brussels, Belgium
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The Effectiveness of Psychological Interventions Delivered in Routine Practice: Systematic Review and Meta-analysis. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:43-57. [PMID: 36201113 PMCID: PMC9832112 DOI: 10.1007/s10488-022-01225-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 02/04/2023]
Abstract
This review presents a comprehensive evaluation of the effectiveness of routinely delivered psychological therapies across inpatient, outpatient and University-based clinics. This was a pre-registered systematic-review of studies meeting pre-specified inclusion criteria (CRD42020175235). Eligible studies were searched in three databases: MEDLINE, CINAHL and PsycInfo. Pre-post treatment (uncontrolled) effect sizes were calculated and pooled using random effects meta-analysis to generate effectiveness benchmarks. Moderator analyses were used to examine sources of heterogeneity in effect sizes. Overall, 252 studies (k = 298 samples) were identified, of which 223 (k = 263 samples) provided sufficient data for inclusion in meta-analysis. Results showed large pre-post treatment effects for depression [d = 0.96, (CI 0.88-1.04), p ≤ 0.001, k = 122], anxiety [d = 0.8 (CI 0.71-0.9), p ≤ 0.001, k = 69], and other outcomes [d = 1.01 (CI 0.93-1.09), p ≤ 0.001, k = 158]. This review provides support for the effectiveness of routinely delivered psychological therapy. Effectiveness benchmarks are supplied to support service evaluations across multiple settings.
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15
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Foote H, Bowen A, Cotterill S, Hill G, Pieri M, Patchwood E. A scoping review to identify process and outcome measures used in acceptance and commitment therapy research, with adults with acquired neurological conditions. Clin Rehabil 2022; 37:808-835. [PMID: 36540937 PMCID: PMC10134096 DOI: 10.1177/02692155221144554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Acceptance and Commitment Therapy interventions are increasing in use in neurological populations. There is a lack of information on the measures available. Purpose To identify and classify the measures used in Acceptance and Commitment Therapy research studies with adults with acquired neurological conditions. Methods PRISMA-ScR guided scoping review. MEDLINE, PsycInfo and CINAHL databases searched (up to date 29/06/2022) with forward and backward searching. All study types included. Extraction of Acceptance and Commitment Therapy process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy. Results Three hundred and thirty three papers found on searching. Fifty four studies included and 136 measurement tools extracted. Conditions included multiple sclerosis, traumatic brain injury and stroke. Thirty-eight studies measured processes of change, with 32 measures extracted. The process measure most often used was the Acceptance and Action Questionnaire ( n = 21 studies). One hundred and four health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently, and were used in all included neurological conditions. COMET domains most frequently coded were emotional functioning/well-being ( n = 50), physical functioning ( n = 32), role functioning ( n = 22) and psychiatric ( n = 22). Conclusions This study provides a resource to support future identification of candidate measures. This could aid development of a Core Outcome Set to support both research and clinical practice. Further research to identify the most appropriate and relevant targets and tools for use in these populations should include expert consensus, patient, carer and public involvement and psychometric examination of measures.
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Affiliation(s)
- Hannah Foote
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
- Hannah Foote, Geoffrey Jefferson Brain
Research Centre, The Manchester Academic Health Science Centre, Northern Care
Alliance and University of Manchester, Manchester, UK.
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
| | - Sarah Cotterill
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Geoff Hill
- South Tees Hospitals NHS Foundation
Trust, The James Cook University Hospital, Middlesbrough, UK
| | | | - Emma Patchwood
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
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16
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Aafjes-Van Doorn K, Meisel J. Implementing routine outcome monitoring in a psychodynamic training clinic: it’s complicated. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2110451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
| | - Jordan Meisel
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
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17
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Lorentzen V, Fagermo K, Handegård BH, Neumer SP, Skre I. Long-term effectiveness and trajectories of change after treatment with SMART, a transdiagnostic CBT for adolescents with emotional problems. BMC Psychol 2022; 10:167. [PMID: 35791020 PMCID: PMC9258229 DOI: 10.1186/s40359-022-00872-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
Background There is a need for long-term effectiveness trials of transdiagnostic treatments. This study investigates the effectiveness and diagnosis-specific trajectories of change in adolescent patients attending SMART, a 6-week transdiagnostic CBT for anxiety and depression, with 6-month follow-up. Methods A randomized controlled trial with waiting list control (WLC) was performed at three child and adolescent mental health outpatient services (CAMHS) in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% females) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to treatment or to WLC. Long-term follow-up (N = 83, baseline age = 15.57, 94% females) was performed 6 months after treatment completion (Mean = 7.1 months, SD = 2.5). Linear mixed model analysis was used to assess time by group effects in patients with no diagnosis, probable anxiety, depressive disorder, and combined anxiety and depressive disorder. Results Almost one third (31%) obtained full recovery according to the inclusion criterium (SDQ emotional). There was highly significant change in all outcome variables. Effect sizes (ES) were largest for general functioning, measured with CGAS (ES: d = 2.19), and on emotional problems measured with SDQ (ES: d = 2.10), while CORE-17, BDI-II and CGAS all obtained ES’s close to 1. There were no significant time by diagnostic group interactions for any outcomes, indicating similar trajectories of change, regardless of diagnostic group. Waiting 6 weeks for treatment had no significant impact on long-term treatment effects. Limitations Possible regression to the mean. Attrition from baseline to follow-up. Conclusions Six weeks of transdiagnostic treatment for adolescents with emotional problems showed highly significant change in emotional symptoms and functioning at 6-month follow-up. Patients with anxiety, depression, combined anxiety and depression, and emotional problems with no specific diagnoses, all had similar trajectories of change. Hence this transdiagnostic SMART treatment can be recommended for adolescent patients with symptoms within the broad spectrum of emotional problems. Trial registration: ClinicalTrials.gov Identifier: NCT02150265. First registered May 29, 2014.
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Affiliation(s)
- Veronica Lorentzen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway. .,Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway.
| | - Kenneth Fagermo
- Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Simon-Peter Neumer
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, 0484, Oslo, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Department of General Psychiatry, University Hospital of North-Norway, P.O. Box 6124, 9291, Tromsø, Norway
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18
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Wongpakaran N, Wongpakaran T, Kövi Z. Development and validation of 21-item Outcome Inventory (OI-21). Heliyon 2022; 8:e09682. [PMID: 35711988 PMCID: PMC9193908 DOI: 10.1016/j.heliyon.2022.e09682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/04/2022] [Accepted: 06/01/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 50200, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 50200, Thailand
- Corresponding author.
| | - Zsuzsanna Kövi
- Institute of Psychology, Centre of Specialist Postgraduate Programmes in Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary
- Corresponding author.
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19
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Shalaby R, Spurvey P, Knox M, Rathwell R, Vuong W, Surood S, Urichuk L, Snaterse M, Greenshaw AJ, Li XM, Agyapong VIO. Clinical Outcomes in Routine Evaluation Measures for Patients Discharged from Acute Psychiatric Care: Four-Arm Peer and Text Messaging Support Controlled Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073798. [PMID: 35409483 PMCID: PMC8997547 DOI: 10.3390/ijerph19073798] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 12/10/2022]
Abstract
Background: Peer support workers (PSW) and text messaging services (TxM) are supportive health services that are frequently examined in the field of mental health. Both interventions have positive outcomes, with TxM demonstrating clinical and economic effectiveness and PSW showing its utility within the recovery-oriented model. Objective: To evaluate the effectiveness of PSW and TxM in reducing psychological distress of recently discharged patients receiving psychiatric care. Methods: This is a prospective, rater-blinded, pilot-controlled observational study consisting of 181 patients discharged from acute psychiatric care. Patients were randomized into one of four conditions: daily supportive text messages only, peer support only, peer support plus daily text messages, or treatment as usual. Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM), a standardized measure of mental distress, was administered at four time points: baseline, six weeks, three months, and six months. MANCOVA was used to assess the impact of the interventions on participants’ scores on four CORE-OM subscales across the three follow-up time points. Recovery, clinical change, and reliable change in CORE-OM all-item analysis were examined across the four groups, and the prevalence of risk symptoms was measured. Results: A total of 63 patients completed assessments at each time point. The interaction between PSW and TxM was predictive of differences in scores on the CORE-OM functioning subscale with a medium effect size (F1,63 = 4.19; p = 0.045; ηp2 = 0.07). The PSW + TxM group consistently achieved higher rates of recovery and clinical and reliable improvement compared to the other study groups. Additionally, the text message group and the PSW + TxM group significantly reduced the prevalence of risk of self/other harm symptoms after six months of intervention, with 27.59% (χ2(1) = 4.42, p = 0.04) and 50% (χ2(1) = 9.03, p < 0.01) prevalence reduction, respectively. Conclusions: The combination of peer support and supportive text messaging is an impactful intervention with positive clinical outcomes for acute care patients. Adding the two interventions into routine psychiatric care for patients after discharge is highly recommended.
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Affiliation(s)
- Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
| | - Pamela Spurvey
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Michelle Knox
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Rebecca Rathwell
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Wesley Vuong
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Shireen Surood
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Liana Urichuk
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Mark Snaterse
- Alberta Health Services Addiction and Mental Health, Edmonton, AB T5J 3E4, Canada; (P.S.); (M.K.); (R.R.); (W.V.); (S.S.); (L.U.); (M.S.)
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (A.J.G.); (X.-M.L.)
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
- Correspondence:
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20
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Pereira DR, Silva ER, Carvalho-Maia C, Monteiro-Reis S, Lourenço C, Calisto R, Teixeira RJ, Carlson LE, Bart G, Vainio SJ, Sales MGF, Jerónimo C, Henrique R. The modulatory role of internet-supported mindfulness-based cognitive therapy on extracellular vesicles and psychological distress in people who have had cancer: a protocol for a two-armed randomized controlled study. Trials 2022; 23:118. [PMID: 35123569 PMCID: PMC8817152 DOI: 10.1186/s13063-022-06045-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/19/2022] [Indexed: 01/10/2023] Open
Abstract
Background Mindfulness-based interventions (MBIs) have been used in oncology contexts as a promising tool with numerous benefits for various health-related and psychosocial outcomes. Despite the increasing popularity of MBIs, few randomized controlled trials (RCTs) have examined their effects upon biological parameters. Specifically, no previous study has examined the effects of MBIs on extracellular vesicles (EVs), which are potentially important markers of health, disease, and stress. Moreover, the lack of RCTs is even more limited within the context of technology-mediated MBIs and long-term effects. Methods The current study protocol presents a two-arm, parallel, randomized controlled study investigating the effects of internet-supported mindfulness-based cognitive therapy (MBCT) compared with treatment as usual (TAU). Primary outcomes are psychological distress and EV cargo of distressed participants with previous breast, colorectal, or prostate cancer diagnoses. Secondary outcomes are self-reported psychosocial and health-related measures, and additional biological markers. Outcomes will be assessed at baseline, 4 weeks after baseline (mid-point of the intervention), 8 weeks after baseline (immediately post-intervention), 24 weeks after baseline (after booster sessions), and 52 weeks after baseline. Our goal is to recruit at least 111 participants who have been diagnosed with breast, prostate, or colorectal cancer (cancer stage I to III), are between 18 and 65 years old, and have had primary cancer treatments completed between 3 months and 5 years ago. Half of the participants will be randomized to the TAU group, and the other half will participate in an 8-week online MBCT intervention with weekly group sessions via videoconference. The intervention also includes asynchronous homework, an online retreat after the fifth week, and 4 monthly booster sessions after completion of the 8-week programme. Discussion This study will allow characterizing the effects of internet-based MBCT on psychosocial and biological indicators in the context of cancer. The effects on circulating EVs will also be investigated, as a possible neurobiological pathway underlying mind-body intervention effects. Trial registration ClinicalTrials.govNCT04727593 (date of registration: 27 January 2021; date of record verification: 6 October 2021). Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06045-x.
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21
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Nyman-Salonen P, Kykyri VL, Tschacher W, Muotka J, Tourunen A, Penttonen M, Seikkula J. Nonverbal Synchrony in Couple Therapy Linked to Clients' Well-Being and the Therapeutic Alliance. Front Psychol 2021; 12:718353. [PMID: 34858258 PMCID: PMC8631962 DOI: 10.3389/fpsyg.2021.718353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Nonverbal synchrony between individuals has a robust relation to the positive aspects of relationships. In psychotherapy, where talking is the cure, nonverbal synchrony has been related to a positive outcome of therapy and to a stronger therapeutic alliance between therapist and client in dyadic settings. Only a few studies have focused on nonverbal synchrony in multi-actor therapy conversations. Here, we studied the synchrony of head and body movements in couple therapy, with four participants present (spouses and two therapists). We analyzed more than 2000min of couple therapy videos from 11 couple therapy cases using Motion Energy Analysis and a Surrogate Synchrony (SUSY), a procedure used earlier in dyadic psychotherapy settings. SUSY was calculated for all six dyads per session, leading to synchrony computations for 66 different dyads. Significant synchrony occurred in all 29 analyzed sessions and between the majority of dyads. Complex models were used to determine the relations between nonverbal synchrony and the clients’ well-being and all participants’ evaluations of the therapeutic alliance. The clients’ well-being was related to body synchronies in the sessions. Differences were found between the clients’ and therapists’ alliance evaluations: the clients’ alliance evaluations were related to synchrony between both dyads of opposite gender, whereas the therapists’ alliance evaluations were related to synchrony between dyads of the same gender, but opposite to themselves. With four participants present, our study introduces a new aspect of nonverbal synchrony, since as a dyad synchronizes, the other two participants are observing it. Nonverbal synchrony seems to be as important in couple therapy as in individual psychotherapy, but the presence of multiple participants makes the patterns more complex.
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Affiliation(s)
- Petra Nyman-Salonen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.,Faculty of Humanities and Social Sciences, Department of Social Sciences and Philosophy, University of Jyväskylä, Jyväskylä, Finland
| | - Virpi-Liisa Kykyri
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.,Faculty of Social Sciences/Psychology, University of Tampere, Tampere, Finland
| | - Wolfgang Tschacher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Joona Muotka
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Anu Tourunen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Penttonen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Jaakko Seikkula
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.,Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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22
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Can early change in eating disorder psychopathology predict outcome in guided self-help for binge eating? Eat Weight Disord 2021; 26:2143-2152. [PMID: 33145729 PMCID: PMC8437919 DOI: 10.1007/s40519-020-01059-3] [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: 07/30/2020] [Accepted: 10/16/2020] [Indexed: 11/02/2022] Open
Abstract
PURPOSE This study tests the value of a measure of eating disorder (ED) psychopathology in predicting outcome following guided self-help in a non-underweight sample with regular binge eating. It examines whether early reductions in ED psychopathology are associated with remission status at post-treatment. METHODS Seventy-two adults with bulimia nervosa, binge-eating disorder, or an atypical form of these illnesses received up to ten sessions of cognitive behaviour therapy-based guided self-help. Using a session-by-session measure of eating pathology and associated reliable change indices, response was analysed using receiver operating characteristic analysis to predict outcomes at post-treatment. RESULTS In this routine care setting, nearly one-quarter of the sample achieved remission following GSH, approximately two-thirds of whom showed early change in ED psychopathology. Early change prior to session 6 was accurate in predicting later remission. Individuals showing early change did not differ from others on baseline characteristics or rates of attrition. CONCLUSION Data suggest that a majority of those who respond to treatment will do so before the second half of treatment, information that could be used to ensure that evidence-based treatments are used as effectively as possible. LEVEL OF EVIDENCE Level III.
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23
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Vos J, Chryssafidou E, Rijn B, Stiles WB. Outcomes of beginning trainee therapists in an outpatient community clinic. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - William B. Stiles
- Metanoia Institute London UK
- Miami University Oxford OH USA
- Appalachian State University Boone NC USA
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Di Biase R, Evans C, Rebecchi D, Baccari F, Saltini A, Bravi E, Palmieri G, Starace F. Exploration of psychometric properties of the Italian version of the Core Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE). RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:554. [PMID: 34568114 PMCID: PMC8451219 DOI: 10.4081/ripppo.2021.554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 11/25/2022]
Abstract
There is an increasing need of outcome measures for young people suitable to evaluate treatments and routine settings. However, measures must show suitable psychometric characteristics for such use. This is the first psychometric evaluation of the Italian version of the Core Young Person Clinical Outcomes in Routine Evaluation (YP-CORE). Data are reported for a clinical sample, aged 11-17 (n=175) and non-clinical sample, aged 11-17 (n=206). Analyses included acceptability, confirmatory factor analysis, internal reliability, influence of gender and age on cutoff scores and reliable change. The YP-CORE acceptability was good, with a very high completion rate (98.7% fully completed). Internal consistency was good: the overall Cronbach’s alpha value (α) equal to 0.75 (95% confidence interval=0.69-0.80). The measure was sensitive to change (Cohen dz=1.35). The Italian version of the YP-CORE showed acceptable psychometric properties is suitable for use in services for young people as a change/outcome measure.
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Affiliation(s)
- Rosalba Di Biase
- Department of Mental Health, Azienda Unità Sanitaria Locale, Modena, Italy
| | - Chris Evans
- Department of Psychology, Cathedral Court, Vicar Lane, Sheffield, UK
| | - Daniela Rebecchi
- Italian Society of Hospital and Territorial Psychology, Modena, Italy
| | | | - Anna Saltini
- Department of Mental Health, Azienda Unità Sanitaria Locale, Modena, Italy
| | - Elena Bravi
- Department of Mental Health Services, Trento; and Italian Society of Hospital and Territorial Psychology, Italy
| | | | - Fabrizio Starace
- Department of Mental Health, Azienda Unità Sanitaria Locale, Modena, Italy
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25
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Gelkopf M, Mazor Y, Roe D. A systematic review of patient-reported outcome measurement (PROM) and provider assessment in mental health: goals, implementation, setting, measurement characteristics and barriers. Int J Qual Health Care 2021; 34:ii13–ii27. [PMID: 32159763 DOI: 10.1093/intqhc/mzz133] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 11/08/2019] [Accepted: 12/03/2019] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To review and integrate the literature on mental-health-related patient-reported outcome measures (PROMs) and routine outcome measures (ROMs), namely in the domains of goals, characteristics, implementation, settings, measurements and barriers. PROM/ROM aims mainly to ascertain treatment impact in routine clinical practice through systematic service users' health assessment using standardized self-report, caretaker and/or provider assessment. DATA SOURCES Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science's Direct. STUDY SELECTION Systemized review of literature (2000-2018) on implementation and sustainability of PROMs/ROMs in adult mental health settings (MHS). DATA EXTRACTION AND SYNTHESIS Systemized review of literature (2000-2018) on numerous aspects of PROM/ROM implementation and sustainability in adult MHS worldwide. RESULTS Based on 103 articles, PROMs/ROMs were implemented mostly in outpatient settings for people with assorted mental health disorders receiving a diversity of services. Frequency of assessments and completion rates varied: one-third of projects had provider assessments; about half had both provider and self-assessments. Barriers to implementation: perceptions that PROM/ROM is intrusive to clinical practice, lack of infrastructure, fear that results may be used for cost containment and service eligibility instead of service quality improvement, difficulties with measures, ethical and confidentiality regulations and web security data management regulations. CONCLUSION Improving data input systems, sufficient training, regular feedback, measures to increase administrative and logistic support to improve implementation, acceptability, feasibility and sustainability, follow-up assessments and client attrition rate reduction efforts are only some measures needed to enhance PROM/ROM efficiency and efficacy.
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Affiliation(s)
- Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.,Center for Community Mental Health, Research, Practice and Policy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - Yael Mazor
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.,Center for Community Mental Health, Research, Practice and Policy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.,Center for Community Mental Health, Research, Practice and Policy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.,Department of Clinical Medicine, Psychiatry, Aalborg University, Denmark
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Jenkins PE, Luck A, Violato M, Robinson C, Fairburn CG. Clinical and cost-effectiveness of two ways of delivering guided self-help for people with an eating disorder: A multi-arm randomized controlled trial. Int J Eat Disord 2021; 54:1224-1237. [PMID: 33998020 DOI: 10.1002/eat.23554] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Increasing the availability and accessibility of evidence-based treatments for eating disorders is an important goal. This study investigated the effectiveness and cost-effectiveness of guided self-help via face-to-face meetings (fGSH) and a more scalable method, providing support via email (eGSH). METHOD A pragmatic, randomized controlled trial was conducted at three sites. Adults with binge-eating disorders were randomized to fGSH, eGSH, or a waiting list condition, each lasting 12 weeks. The primary outcome variable for clinical effectiveness was overall severity of eating psychopathology and, for cost-effectiveness, binge-free days, with explorative analyses using symptom abstinence. Costs were estimated from both a partial societal and healthcare provider perspective. RESULTS Sixty participants were included in each condition. Both forms of GSH were superior to the control condition in reducing eating psychopathology (IRR = -1.32 [95% CI -1.77, -0.87], p < .0001; IRR = -1.62 [95% CI -2.25, -1.00], p < .0001) and binge eating. Attrition was higher in eGSH. Probabilities that fGSH and eGSH were cost-effective compared with WL were 93% (99%) and 51% (79%), respectively, for a willingness to pay of £100 (£150) per additional binge-free day. DISCUSSION Both forms of GSH were associated with clinical improvement and were likely to be cost-effective compared with a waiting list condition. Provision of support via email is likely to be more convenient for many patients although the risk of non-completion is greater.
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Affiliation(s)
- Paul E Jenkins
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Amy Luck
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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27
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Männikkö N, Mustonen T, Tanner N, Vähänikkilä H, Kääriäinen M. Effectiveness of a Brief Group Intervention Program for Young Adults with Gaming-Related Problems. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00559-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AbstractExcessive digital gaming can have unfavorable effects on gamers’ well-being and everyday functioning. The aims of this study were to investigate the effects of a novel group intervention “Limitless Gaming Bootcamp” on (i) gaming disorder (GD) tendencies, (ii) the amount of time spent on leisure activities, and (iii) subjective well-being among Finnish young adults, and to determine the persistence of the intervention’s influence over time. A one-group pre- and post-test design with no control group was used. Thirty-seven participants were enrolled in the study. The inclusion criteria were being between the ages of 18 and 29; self-reported excessive gaming; a willingness to get support in monitoring one’s gaming behaviour; and a fluency in Finnish. Participants completed a 10-session group intervention designed to enhance conscious gaming behavior and well-being. Baseline, post-test, and six month follow-up measurements were conducted to gather data. Variables measured included background variables, gaming disorder tendencies (Problematic Online Gaming Questionnaire, POGQ), self-reported time spent on various leisure activities, and subjective well-being (Short Form of the Clinical Outcomes in Routine Evaluation Outcome Measure, CORE-SF/A). The time spent on gaming decreased from pre- to post-intervention measurement and further to the six month follow-up, and participants exhibited less severe GD symptoms during the post-intervention phase and six months after the intervention. Gradual improvements in subjective well-being were also observed. The group intervention was found to be particularly effective at reducing the severity of GD symptoms.
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28
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Messina I, Scottà F, Marchi A, Benelli E, Grecucci A, Sambin M. Case Report: Individualization of Intensive Transactional Analysis Psychotherapy on the Basis of Ego Strength. Front Psychol 2021; 12:618762. [PMID: 34177686 PMCID: PMC8219863 DOI: 10.3389/fpsyg.2021.618762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 04/01/2021] [Indexed: 11/21/2022] Open
Abstract
In intensive transactional analysis psychotherapy (ITAP), intensity is obtained with both technical expedients and the relational manner with the patient. In ITAP, the therapist modulates pressure and support commensurately to the patients' ego strength. In the present article, we contrast two clinical cases of young adults in which ego strength produced different therapy outcomes and processes. We present excerpts of the psychotherapy process that illustrates technical aspects of ITAP as well as the therapist's attitude that we describe as holding. We show quantitative therapy outcomes consisting of effects size values of changes in Clinical Outcome in Routine Evaluation—Outcome Measure scores in baseline, treatment, and follow-up phases and qualitative outcome evaluated with the Change Interview at the end of the therapy. In the patient with high ego strength, we observed a rapid improvement and a complete recovery at the end of the therapy, whereas the results of the patient with low ego strength were less consistent (more fluctuations in Clinical Outcome in Routine Evaluation—Outcome Measure scores including deterioration but good qualitative outcome). We conclude that quantitative and qualitative outcome data, together with process observations, are required to have a complete picture of therapy effectiveness. Moreover, we conclude that qualitative ego strength is not a limitation for the use of expressive therapy such as ITAP, but rather, it is an important variable that should be considered to dose confrontations and support.
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Affiliation(s)
- Irene Messina
- Universitas Mercatorum, Rome, Italy.,Centro Psicologia Dinamica, Padua, Italy
| | | | - Arianna Marchi
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Enrico Benelli
- Centro Psicologia Dinamica, Padua, Italy.,Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Alessandro Grecucci
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| | - Marco Sambin
- Centro Psicologia Dinamica, Padua, Italy.,Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
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Cornwall PL, Simpson S, Gibbs C, Morfee V. Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: effectiveness in people with autism spectrum disorders. BJPsych Bull 2021; 45:146-153. [PMID: 33261708 PMCID: PMC9059310 DOI: 10.1192/bjb.2020.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
AIMS AND METHOD Radically open dialectical behaviour therapy (RO DBT) is a transdiagnostic treatment designed to address disorders associated with overcontrol, including autism spectrum disorders (ASD). To date, no studies have reported on the effectiveness of RO DBT for people with ASD. Forty-eight patients were referred to a RO DBT programme, of whom 23 had a diagnosis of ASD. Outcome was measured using the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE) and the Questionnaire about the Process of Recovery. RESULTS The intervention was effective, with a medium effect size of 0.53 for improvement in CORE global distress. End-point CORE global distress score was predicted from initial severity and a diagnosis of ASD. Participants with a diagnosis of ASD who completed the therapy had significantly better outcomes than completing participants without an ASD diagnosis. CLINICAL IMPLICATIONS These findings provide preliminary support for RO DBT as an effective intervention for ASD in routine settings.
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Affiliation(s)
- Peter L Cornwall
- Redcar & Cleveland Mental Health Services, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Susan Simpson
- Redcar & Cleveland Mental Health Services, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Claire Gibbs
- Redcar & Cleveland Mental Health Services, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Valerie Morfee
- Redcar & Cleveland Mental Health Services, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
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30
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Grau Touriño A, Feixas G, Medina JC, Paz C, Evans C. Effectiveness of integrated treatment for eating disorders in Spain: protocol for a multicentre, naturalistic, observational study. BMJ Open 2021; 11:e043152. [PMID: 34006027 PMCID: PMC7942235 DOI: 10.1136/bmjopen-2020-043152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Eating disorders (EDs) are complex pathologies which require equally complex treatment strategies. These strategies should be multidisciplinary, personalised interventions, performed in appropriate settings along a healthcare continuum from inpatient to community care. Personalisation, and the complexity of levels of care and interventions make evaluation of treatments difficult. The present study aims to measure the effectiveness of a complex treatment programme for EDs which includes hospitalisation, day hospital and outpatient settings. Our purpose is to assess the complete therapeutic process of each patient through all these levels of care, capturing the multiplicity of trajectories that a programme of these characteristics involves. METHODS AND ANALYSIS This protocol describes a multicentre, naturalistic, observational study. All patients starting between November 2017 and October 2020 in a healthcare network for EDs in Spain are being invited to participate. The first phase of intensive change monitoring to November 2020 is followed by lower intensity follow-up until October 2025. In the first phase progress of all participants is assessed every 3 weeks using specific measures for ED and the Clinical Outcomes Routine Evaluation system, a family of instruments specifically designed to measure change in psychotherapy. In the second phase data collection will happen quarterly. Both cross-sectional and longitudinal analyses will be conducted, with a special focus on patterns and predictors of change studied through multilevel linear models. ETHICS AND DISSEMINATION The study has been approved by the Research Bioethics Committee of the University of Barcelona (no. IRB00003099) and the ethical committee of ITA Mental Health, the organisation to which all participating centres belong. Dissemination will be in papers for peer-reviewed research journals and to clinicians working with ED. TRIAL REGISTRATION NUMBER NCT04127214.
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Affiliation(s)
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Section of Personality, Evaluation and Psychological Treatment, Psychology Faculty, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Joan Carles Medina
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Clara Paz
- School of Psychology, Universidad de Las Americas, Quito, Ecuador
| | - Chris Evans
- Department of Psychology, The University of Sheffield, Sheffield, UK
- Department of Psychology, University of Roehampton, London, UK
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Renger S, Macaskill A. Simplifying the definition of the fully functioning person for client use. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Susan Renger
- Centre for Behavioural Science and Applied Psychology Sheffield Hallam University Sheffield UK
| | - Ann Macaskill
- Centre for Behavioural Science and Applied Psychology Sheffield Hallam University Sheffield UK
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32
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Riva Crugnola C, Preti E, Bottini M, Rosaria Fontana M, Sarno I, Ierardi E, Madeddu F. Effectiveness of a university counseling intervention based on a psychodynamic approach. Bull Menninger Clin 2020; 84:373-398. [PMID: 33779236 DOI: 10.1521/bumc.2020.84.4.373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The study examined the effectiveness of a brief psychodynamic counseling intervention on psychological distress and general life satisfaction in a sample of 124 students by comparing pre- and posttreatment data. The authors also tested the moderating role of pretreatment attachment styles. Results showed that most participants (57%) can be classified as a nonclinical population, whereas only a minority of participants belong to a clinical population (17%) and a subclinical population (26%) according to the Symptom Checklist 90 Revised (SCL-90-R). Psychodynamic counseling intervention was shown to be associated with a decrease in the Global Severity Index and the anxiety and depression subscales of the SCL-90-R. Clinical effectiveness was greater for participants belonging to the clinical group. General life satisfaction increased significantly for all students. The authors found no moderation effect of attachment styles. Brief psychodynamic counseling intervention was associated with a reduction of psychological distress and an increase in life satisfaction.
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Affiliation(s)
| | - Emanuele Preti
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marta Bottini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Irene Sarno
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Elena Ierardi
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Fabio Madeddu
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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33
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Hagen BI, Landrø NI, Lau B, Koster EHW, Stubberud J. Predictors of Long-Term Improvement Following Cognitive Remediation in a Sample With Elevated Depressive Symptoms. Front Psychol 2020; 11:2232. [PMID: 33013583 PMCID: PMC7516280 DOI: 10.3389/fpsyg.2020.02232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/10/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Cognitive remediation (CR) techniques (interventions to enhance cognitive functioning) have proven moderately effective in improving cognition and daily functioning in major depressive disorder (MDD). However, baseline predictors of treatment response are lacking. The present study aimed to identify factors influencing long-term CR outcomes in a sample with current or previous, mild or moderate MDD and with self-reported cognitive deficits. Methods Forty-two completers of group-based CR (strategy learning or drill-and-practice), were pooled into one sample. Based on change scores from baseline to 6-month follow-up, participants were categorized as “improvers” or “non-improvers” using reliable change index calculations. Measures included a questionnaire of everyday executive functioning and a neuropsychological test of attention. Finally, improvers and non-improvers were compared in terms of various sociodemographic, psychological, illness-related, and neuropsychological baseline variables. Results Seventeen participants improved reliably in everyday executive functioning, and fourteen demonstrated a reliable improvement in attention. No statistically significant differences emerged between improvers and non-improvers. Conclusion No major predictors of CR were identified. Importantly, the current findings are insufficient to guide clinical decision-making. Large-scale studies with a priori hypotheses are needed to make advances in the future.
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Affiliation(s)
| | | | - Bjørn Lau
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jan Stubberud
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
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34
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Keetharuth AD, Bjorner JB, Barkham M, Browne J, Croudace T, Brazier J. An item response theory analysis of an item pool for the recovering quality of life (ReQoL) measure. Qual Life Res 2020; 30:267-276. [PMID: 32909162 PMCID: PMC7847872 DOI: 10.1007/s11136-020-02622-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 02/06/2023]
Abstract
Purpose ReQoL-10 and ReQoL-20 have been developed for use as outcome measures with individuals aged 16 and over, experiencing mental health difficulties. This paper reports modelling results from the item response theory (IRT) analyses that were used for item reduction. Methods From several stages of preparatory work including focus groups and a previous psychometric survey, a pool of items was developed. After confirming that the ReQoL item pool was sufficiently unidimensional for scoring, IRT model parameters were estimated using Samejima’s Graded Response Model (GRM). All 39 mental health items were evaluated with respect to item fit and differential item function regarding age, gender, ethnicity, and diagnosis. Scales were evaluated regarding overall measurement precision and known-groups validity (by care setting type and self-rating of overall mental health). Results The study recruited 4266 participants with a wide range of mental health diagnoses from multiple settings. The IRT parameters demonstrated excellent coverage of the latent construct with the centres of item information functions ranging from − 0.98 to 0.21 and with discrimination slope parameters from 1.4 to 3.6. We identified only two poorly fitting items and no evidence of differential item functioning of concern. Scales showed excellent measurement precision and known-groups validity. Conclusion The results from the IRT analyses confirm the robust structure properties and internal construct validity of the ReQoL instruments. The strong psychometric evidence generated guided item selection for the final versions of the ReQoL measures. Electronic supplementary material The online version of this article (10.1007/s11136-020-02622-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Jakob Bue Bjorner
- Optum Patient Insights, Rhode Island, United States and University of Copenhagen, Copenhagen, Denmark
| | - Michael Barkham
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - John Browne
- School of Public Health, University College Cork, Cork, Ireland
| | - Tim Croudace
- School of Health Sciences, University of Dundee, Dundee, UK
| | - John Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Khalifa NR, Gibbon S, Völlm BA, Cheung NHY, McCarthy L. Pharmacological interventions for antisocial personality disorder. Cochrane Database Syst Rev 2020; 9:CD007667. [PMID: 32880105 PMCID: PMC8094881 DOI: 10.1002/14651858.cd007667.pub3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Antisocial personality disorder (AsPD) is associated with rule-breaking, criminality, substance use, unemployment, relationship difficulties, and premature death. Certain types of medication (drugs) may help people with AsPD. This review updates a previous Cochrane review, published in 2010. OBJECTIVES To assess the benefits and adverse effects of pharmacological interventions for adults with AsPD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 13 other databases and two trials registers up to 5 September 2019. We also checked reference lists and contacted study authors to identify studies. SELECTION CRITERIA Randomised controlled trials in which adults (age 18 years and over) with a diagnosis of AsPD or dissocial personality disorder were allocated to a pharmacological intervention or placebo control condition. DATA COLLECTION AND ANALYSIS Four authors independently selected studies and extracted data. We assessed risk of bias and created 'Summary of findings tables' and assessed the certainty of the evidence using the GRADE framework. The primary outcomes were: aggression; reconviction; global state/global functioning; social functioning; and adverse events. MAIN RESULTS We included 11 studies (three new to this update), involving 416 participants with AsPD. Most studies (10/11) were conducted in North America. Seven studies were conducted exclusively in an outpatient setting, one in an inpatient setting, and one in prison; two studies used multiple settings. The average age of participants ranged from 28.6 years to 45.1 years (overall mean age 39.6 years). Participants were predominantly (90%) male. Study duration ranged from 6 to 24 weeks, with no follow-up period. Data were available from only four studies involving 274 participants with AsPD. All the available data came from unreplicated, single reports, and did not allow independent statistical analysis to be conducted. Many review findings were limited to descriptive summaries based on analyses carried out and reported by the trial investigators. No study set out to recruit participants on the basis of having AsPD; many participants presented primarily with substance abuse problems. The studies reported on four primary outcomes and six secondary outcomes. Primary outcomes were aggression (six studies) global/state functioning (three studies), social functioning (one study), and adverse events (seven studies). Secondary outcomes were leaving the study early (eight studies), substance misuse (five studies), employment status (one study), impulsivity (one study), anger (three studies), and mental state (three studies). No study reported data on the primary outcome of reconviction or the secondary outcomes of quality of life, engagement with services, satisfaction with treatment, housing/accommodation status, economic outcomes or prison/service outcomes. Eleven different drugs were compared with placebo, but data for AsPD participants were only available for five comparisons. Three classes of drug were represented: antiepileptic; antidepressant; and dopamine agonist (anti-Parkinsonian) drugs. We considered selection bias to be unclear in 8/11 studies, attrition bias to be high in 7/11 studies, and performance bias to be low in 7/11 studies. Using GRADE, we rated the certainty of evidence for each outcome in this review as very low, meaning that we have very little confidence in the effect estimates reported. Phenytoin (antiepileptic) versus placebo One study (60 participants) reported very low-certainty evidence that phenytoin (300 mg/day), compared to placebo, may reduce the mean frequency of aggressive acts per week (phenytoin mean = 0.33, no standard deviation (SD) reported; placebo mean = 0.51, no SD reported) in male prisoners with aggression (skewed data) at endpoint (six weeks). The same study (60 participants) reported no evidence of difference between phenytoin and placebo in the number of participants reporting the adverse event of nausea during week one (odds ratio (OR) 1.00, 95% confidence interval (CI) 0.06 to 16.76; very low-certainty evidence). The study authors also reported that no important side effects were detectable via blood cell counts or liver enzyme tests (very low-certainty evidence). The study did not measure reconviction, global/state functioning or social functioning. Desipramine (antidepressant) versus placebo One study (29 participants) reported no evidence of a difference between desipramine (250 to 300 mg/day) and placebo on mean social functioning scores (desipramine = 0.19; placebo = 0.21), assessed with the family-social domain of the Addiction Severity Index (scores range from zero to one, with higher values indicating worse social functioning), at endpoint (12 weeks) (very low-certainty evidence). Neither of the studies included in this comparison measured the other primary outcomes: aggression; reconviction; global/state functioning; or adverse events. Nortriptyline (antidepressant) versus placebo One study (20 participants) reported no evidence of a difference between nortriptyline (25 to 75 mg/day) and placebo on mean global state/functioning scores (nortriptyline = 0.3; placebo = 0.7), assessed with the Symptom Check List-90 (SCL-90) Global Severity Index (GSI; mean of subscale scores, ranging from zero to four, with higher scores indicating greater severity of symptoms), at endpoint (six months) in men with alcohol dependency (very low-certainty evidence). The study measured side effects but did not report data on adverse events for the AsPD subgroup. The study did not measure aggression, reconviction or social functioning. Bromocriptine (dopamine agonist) versus placebo One study (18 participants) reported no evidence of difference between bromocriptine (15 mg/day) and placebo on mean global state/functioning scores (bromocriptine = 0.4; placebo = 0.7), measured with the GSI of the SCL-90 at endpoint (six months) (very low-certainty evidence). The study did not provide data on adverse effects, but reported that 12 patients randomised to the bromocriptine group experienced severe side effects, five of whom dropped out of the study in the first two days due to nausea and severe flu-like symptoms (very low-certainty evidence). The study did not measure aggression, reconviction and social functioning. Amantadine (dopamine agonist) versus placebo The study in this comparison did not measure any of the primary outcomes. AUTHORS' CONCLUSIONS The evidence summarised in this review is insufficient to draw any conclusion about the use of pharmacological interventions in the treatment of antisocial personality disorder. The evidence comes from single, unreplicated studies of mostly older medications. The studies also have methodological issues that severely limit the confidence we can draw from their results. Future studies should recruit participants on the basis of having AsPD, and use relevant outcome measures, including reconviction.
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Affiliation(s)
- Najat R Khalifa
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Simon Gibbon
- Arnold Lodge, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
| | - Birgit A Völlm
- Department of Forensic Psychiatry, Center for Neurology, University Rostock, Rostock, Germany
| | - Natalie H-Y Cheung
- Forensic Research, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
| | - Lucy McCarthy
- Arnold Lodge, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
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Gibbon S, Khalifa NR, Cheung NHY, Völlm BA, McCarthy L. Psychological interventions for antisocial personality disorder. Cochrane Database Syst Rev 2020; 9:CD007668. [PMID: 32880104 PMCID: PMC8094166 DOI: 10.1002/14651858.cd007668.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Antisocial personality disorder (AsPD) is associated with poor mental health, criminality, substance use and relationship difficulties. This review updates Gibbon 2010 (previous version of the review). OBJECTIVES To evaluate the potential benefits and adverse effects of psychological interventions for adults with AsPD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 13 other databases and two trials registers up to 5 September 2019. We also searched reference lists and contacted study authors to identify studies. SELECTION CRITERIA Randomised controlled trials of adults, where participants with an AsPD or dissocial personality disorder diagnosis comprised at least 75% of the sample randomly allocated to receive a psychological intervention, treatment-as-usual (TAU), waiting list or no treatment. The primary outcomes were aggression, reconviction, global state/functioning, social functioning and adverse events. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS This review includes 19 studies (eight new to this update), comparing a psychological intervention against TAU (also called 'standard Maintenance'(SM) in some studies). Eight of the 18 psychological interventions reported data on our primary outcomes. Four studies focussed exclusively on participants with AsPD, and 15 on subgroups of participants with AsPD. Data were available from only 10 studies involving 605 participants. Eight studies were conducted in the UK and North America, and one each in Iran, Denmark and the Netherlands. Study duration ranged from 4 to 156 weeks (median = 26 weeks). Most participants (75%) were male; the mean age was 35.5 years. Eleven studies (58%) were funded by research councils. Risk of bias was high for 13% of criteria, unclear for 54% and low for 33%. Cognitive behaviour therapy (CBT) + TAU versus TAU One study (52 participants) found no evidence of a difference between CBT + TAU and TAU for physical aggression (odds ratio (OR) 0.92, 95% CI 0.28 to 3.07; low-certainty evidence) for outpatients at 12 months post-intervention. One study (39 participants) found no evidence of a difference between CBT + TAU and TAU for social functioning (mean difference (MD) -1.60 points, 95% CI -5.21 to 2.01; very low-certainty evidence), measured by the Social Functioning Questionnaire (SFQ; range = 0-24), for outpatients at 12 months post-intervention. Impulsive lifestyle counselling (ILC) + TAU versus TAU One study (118 participants) found no evidence of a difference between ILC + TAU and TAU for trait aggression (assessed with Buss-Perry Aggression Questionnaire-Short Form) for outpatients at nine months (MD 0.07, CI -0.35 to 0.49; very low-certainty evidence). One study (142 participants) found no evidence of a difference between ILC + TAU and TAU alone for the adverse event of death (OR 0.40, 95% CI 0.04 to 4.54; very low-certainty evidence) or incarceration (OR 0.70, 95% CI 0.27 to 1.86; very low-certainty evidence) for outpatients between three and nine months follow-up. Contingency management (CM) + SM versus SM One study (83 participants) found evidence that, compared to SM alone, CM + SM may improve social functioning measured by family/social scores on the Addiction Severity Index (ASI; range = 0 (no problems) to 1 (severe problems); MD -0.08, 95% CI -0.14 to -0.02; low-certainty evidence) for outpatients at six months. 'Driving whilst intoxicated' programme (DWI) + incarceration versus incarceration One study (52 participants) found no evidence of a difference between DWI + incarceration and incarceration alone on reconviction rates (hazard ratio 0.56, CI -0.19 to 1.31; very low-certainty evidence) for prisoner participants at 24 months. Schema therapy (ST) versus TAU One study (30 participants in a secure psychiatric hospital, 87% had AsPD diagnosis) found no evidence of a difference between ST and TAU for the number of participants who were reconvicted (OR 2.81, 95% CI 0.11 to 74.56, P = 0.54) at three years. The same study found that ST may be more likely to improve social functioning (assessed by the mean number of days until patients gain unsupervised leave (MD -137.33, 95% CI -271.31 to -3.35) compared to TAU, and no evidence of a difference between the groups for overall adverse events, classified as the number of people experiencing a global negative outcome over a three-year period (OR 0.42, 95% CI 0.08 to 2.19). The certainty of the evidence for all outcomes was very low. Social problem-solving (SPS) + psychoeducation (PE) versus TAU One study (17 participants) found no evidence of a difference between SPS + PE and TAU for participants' level of social functioning (MD -1.60 points, 95% CI -5.43 to 2.23; very low-certainty evidence) assessed with the SFQ at six months post-intervention. Dialectical behaviour therapy versus TAU One study (skewed data, 14 participants) provided very low-certainty, narrative evidence that DBT may reduce the number of self-harm days for outpatients at two months post-intervention compared to TAU. Psychosocial risk management (PSRM; 'Resettle') versus TAU One study (skewed data, 35 participants) found no evidence of a difference between PSRM and TAU for a number of officially recorded offences at one year after release from prison. It also found no evidence of difference between the PSRM and TAU for the adverse event of death during the study period (OR 0.89, 95% CI 0.05 to 14.83, P = 0.94, 72 participants (90% had AsPD), 1 study, very low-certainty evidence). AUTHORS' CONCLUSIONS There is very limited evidence available on psychological interventions for adults with AsPD. Few interventions addressed the primary outcomes of this review and, of the eight that did, only three (CM + SM, ST and DBT) showed evidence that the intervention may be more effective than the control condition. No intervention reported compelling evidence of change in antisocial behaviour. Overall, the certainty of the evidence was low or very low, meaning that we have little confidence in the effect estimates reported. The conclusions of this update have not changed from those of the original review, despite the addition of eight new studies. This highlights the ongoing need for further methodologically rigorous studies to yield further data to guide the development and application of psychological interventions for AsPD and may suggest that a new approach is required.
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Affiliation(s)
- Simon Gibbon
- Arnold Lodge, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
| | - Najat R Khalifa
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Natalie H-Y Cheung
- Forensic Research, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
| | - Birgit A Völlm
- Department of Forensic Psychiatry, Center for Neurology, University Rostock, Rostock, Germany
| | - Lucy McCarthy
- Arnold Lodge, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
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Bossi MM, Tufoni M, Zaccherini G, Antognoli A, Domenicali M, Caraceni P. A web-based group treatment for patients with alcoholic liver diseases at the time of the COVID-19 pandemic. Dig Liver Dis 2020; 52:956-957. [PMID: 32513630 PMCID: PMC7200346 DOI: 10.1016/j.dld.2020.04.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | | | | | - Paolo Caraceni
- Coreesponding author at: U.O. Semeiotica Medica, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, Italy.
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Lorentzen V, Handegård BH, Moen CM, Solem K, Lillevoll K, Skre I. CORE-OM as a routine outcome measure for adolescents with emotional disorders: factor structure and psychometric properties. BMC Psychol 2020; 8:86. [PMID: 32819424 PMCID: PMC7439542 DOI: 10.1186/s40359-020-00459-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 08/06/2020] [Indexed: 11/30/2022] Open
Abstract
Background Instruments for monitoring the clinical status of adolescents with emotional problems are needed. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) according to theory measures problems/symptoms, well-being, functioning and risk. Documentation of whether the theoretical factor structure for CORE-OM is applicable for adolescents is lacking. Methods This study examined the factor structure and psychometric properties of the CORE-OM based on two samples of adolescents (age 14–18): youths seeking treatment for emotional problems (N = 140) and high school students (N = 531). A split half approach was chosen. An exploratory factor analysis (EFA) was performed on the first half of the stratified samples to establish the suitability of the model. A Confirmatory Factor Analysis (CFA) with the chosen model from the EFA was performed on the second half. Internal consistency and clinical cut-off scores of the CORE-OM were investigated. Results The best fitting model only partially confirmed the theoretical model for the CORE-OM. The model consisted of five factors: 1) General problems, 2) risk to self, 3) positive resources 4) risk to others and 5) problems with others. The clinical cut-off score based on the all-item total was higher than in an adult sample. Both the all-item total and general problems cut-off scores showed gender differences. Conclusion The factor analysis on CORE-OM for adolescents resulted in a five-factor solution, and opens up for new subscales concerning positive resources and problems with others. A 17-item solution for the general problems/symptoms scale is suggested. We advise developers of self-report instruments not to reverse items, if they do not intend to measure a separate factor, since these seem to affect the dimensionality of the scales. Comparing means for gender in non-clinical samples should not be done without modification of the general emotional problem and the positive resources scales. Slightly elevated CORE-OM scores (up to 1.3) in adolescents may be normal fluctuations.
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Affiliation(s)
- Veronica Lorentzen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway. .,Department of Child and Adolescent Mental Health, Divisions of Child and Adolescent Health, University Hospital of North Norway, 9038, Tromsø, Norway.
| | - Bjørn Helge Handegård
- The Regional Centre for Child and Adolescent Mental Health - North, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Connie Malén Moen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway.,The Norwegian Labour and Welfare Administration (NAV), Employment Advisory Services in Troms and Finnmark, 9811, Vadsø, Norway
| | - Kenth Solem
- Substance use and Psychiatry unit, Department of Substance Use and Addiction Medicine, Clinic for Mental Health and Substance Use, Nordland Hospital, 8076, Bodø, Norway
| | - Kjersti Lillevoll
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway.,Clinic for Mental Health and Substance Use, University Hospital of North Norway, 9291, Tromsø, Norway
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Waters CS, Annear B, Flockhart G, Jones I, Simmonds JR, Smith S, Traylor C, Williams JF. Acceptance and Commitment Therapy for perinatal mood and anxiety disorders: A feasibility and proof of concept study. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2020; 59:461-479. [PMID: 32715513 DOI: 10.1111/bjc.12261] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/26/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of the current study was to assess the feasibility, safety, and effectiveness of a newly developed Acceptance and Commitment Therapy (ACT) intervention developed specifically to address the unique context of pregnancy and parenthood. The intervention was delivered to women accessing a specialist Perinatal Community Mental Health Service (PCMHS). DESIGN An open-label pilot study was conducted of an 8-week, group-delivered ACT intervention targeting women with moderate-to-severe mood and/or anxiety disorders during pregnancy and/or postpartum. METHODS Outcomes included session attendance rates, dropout rates, crisis/inpatient service use, and standardized symptom scales. Participant's responses to open-ended questions contained in an end of therapy questionnaire were analysed using thematic analysis. RESULTS Seventy-four women were referred to the intervention with 65 (88%) completing treatment. The median number of sessions attended was 7. No women required input from crisis/inpatient services. All reported finding the intervention helpful. The implementation of ACT in daily life, therapist support, and group processes were cited as helpful aspects of the intervention. At post-treatment, there was a significant reduction in global distress (d = 0.99) and depressive symptoms (d = 1.05), and an increase in psychological flexibility (d = 0.93). On the secondary outcome of global distress, 38% of women were classified as recovered, 31% had reliably improved, 27% remained the same, and 4% had reliably deteriorated. CONCLUSIONS The delivery of ACT in a routine practice setting is feasible, safe, and effective. A randomized control trial (RCT) is needed to establish the efficacy and cost-effectiveness of this group-delivered ACT intervention. PRACTITIONER POINTS Group-delivered Acceptance and Commitment Therapy (ACT) is acceptable for women with moderate-to-severe perinatal mood and/or anxiety disorders and can be feasibly delivered in a routine practice setting. The trans-diagnostic nature of ACT enables the concurrent treatment of depressive and anxiety symptoms within the same intervention which is particularly helpful in the perinatal context given the comorbidity of mood and anxiety disorders. With training and supervision, mental health practitioners without extensive education in the delivery of psychological therapies can facilitate the ACT group programme. As this was a feasibility study, there was no control group, adherence to the manual was not assessed, and the absence of a follow-up period limits our knowledge of the longer-term benefits of the ACT group programme.
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Affiliation(s)
- Cerith S Waters
- Cardiff and Vale University Health Board, Perinatal Community Mental Health Service, Wales, UK.,School of Psychology, Cardiff University, Wales, UK
| | - Benjamin Annear
- Cardiff and Vale University Health Board, Perinatal Community Mental Health Service, Wales, UK
| | - Gillean Flockhart
- Cardiff and Vale University Health Board, Perinatal Community Mental Health Service, Wales, UK
| | - Ian Jones
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental Health, Cardiff University, Wales, UK
| | - Jessica R Simmonds
- Cardiff and Vale University Health Board, Perinatal Community Mental Health Service, Wales, UK
| | - Sue Smith
- Cardiff and Vale University Health Board, Perinatal Community Mental Health Service, Wales, UK
| | - Claire Traylor
- Cardiff and Vale University Health Board, Perinatal Community Mental Health Service, Wales, UK
| | - Jessica F Williams
- Cardiff and Vale University Health Board, Perinatal Community Mental Health Service, Wales, UK
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Messina I, Scottà F, Benelli E, Marchi A, Sambin M. Intensive Transactional Analysis Psychotherapy (ITAP): A case series study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | - Arianna Marchi
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA) University of Padua Padua Italy
| | - Marco Sambin
- Centro Psicologia Dinamica Padova Italy
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA) University of Padua Padua Italy
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Paz C, Mascialino G, Proaño K, Evans C. Psychological intervention change measurement in Latin America: Where from? Where to? Psychother Res 2020; 31:132-141. [PMID: 32297845 DOI: 10.1080/10503307.2020.1750728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: To conduct a scoping review of measure utilization in Latin America. We relate the findings to the needs of the region and give recommendations for measure usage in LA. Methods: Six electronic databases (PubMed, Web of Science, CINAHL, PsychInfo, SCOPUS, and SCIELO) were searched to identify peer-reviewed literature. In total, 207 studies using change and/or outcome measures were identified based on a priori inclusion criteria. Results: Production by country varied markedly; more than three quarters of the studies took place in just three of the 20 Latin American countries: Brazil, Chile, and Mexico. The most frequently used measures were the Outcome Questionnaire, Beck Depression Inventory-II, Hamilton Rating Scale, and Yale-Brown Obsessive-Compulsive Scale. The most common diagnosis was depression (n = 54). Conclusions: Outcome and change research in Latin America is growing rapidly but future efforts should focus more tightly on the needs of the region, as well as on forging collaborations with researchers from other regions. The use of change measures for serial assessment throughout interventions is recommended in view of its adaptability to highly diverse Latin American social realities. Dissemination of research findings and promotion of outcome and change measure use through implementation of public policy is recommended.
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Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Guido Mascialino
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Karen Proaño
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Chris Evans
- The University of Sheffield, Western Bank, Sheffield, UK
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Pourová M, Řiháček T, Žvelc G. Validation of the Czech Version of the Relational Needs Satisfaction Scale. Front Psychol 2020; 11:359. [PMID: 32210881 PMCID: PMC7067918 DOI: 10.3389/fpsyg.2020.00359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/17/2020] [Indexed: 11/17/2022] Open
Abstract
AIM If we want to understand people's satisfaction in their relationships, it is essential to have a valid and reliable measure of relational needs satisfaction. The aim of this study was to test the factor structure of the Czech version of the Relational Needs Satisfaction Scale (RNSS) as well as the scale's measurement invariance and convergent validity. METHOD In total, 419 adults answered a battery of measures, including the RNSS, in an online survey. Confirmatory factor analysis was conducted to test the factor structure and the measurement invariance of the RNSS across gender and age. A correlational analysis was conducted to assess the convergent validity. RESULTS The five-factor structure of the RNSS was confirmed. Furthermore, support for a second-order global relationship satisfaction factor was found. The hierarchical model was strictly invariant with respect to gender and age. Furthermore, the RNSS demonstrated an expected pattern of correlations with the reference instruments. CONCLUSION The Czech version of the RNSS can be considered a valid and reliable method.
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Affiliation(s)
- Martina Pourová
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czechia
| | - Tomáš Řiháček
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czechia
| | - Gregor Žvelc
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
- Department of Psychology, UP FAMNIT, University of Primorska, Koper, Slovenia
- Institute for Integrative Psychotherapy and Counselling, Ljubljana, Slovenia
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Espel-Huynh H, Thompson-Brenner H, Boswell JF, Zhang F, Juarascio AS, Lowe MR. Development and validation of a progress monitoring tool tailored for use in intensive eating disorder treatment. EUROPEAN EATING DISORDERS REVIEW 2020; 28:223-236. [PMID: 31994259 PMCID: PMC7086406 DOI: 10.1002/erv.2718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/16/2019] [Accepted: 12/23/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Despite calls for routine use of progress and outcome monitoring in private and intensive treatment centres for eating disorders (EDs), existing measures have limited relevance to these supervised treatment settings. This study sought to develop and validate the progress monitoring tool for eating disorders, a multidimensional measure for progress monitoring in the context of intensive ED treatment. METHOD Thirty-seven items were generated by a team of content experts, clinicians, and administrative staff from the target treatment setting. Adolescent and adult females (N = 531) seeking residential ED treatment completed the items at admission as part of the clinic's routine assessment battery; 83% were retained for repeat assessment at discharge. Exploratory factor analysis was conducted for preliminary measure development. RESULTS Results yielded a five-factor, 26-item structure explaining 50% of total variance. Final construct domains included weight and shape concern, ED behaviours and urges, emotion avoidance, adaptive coping, and relational connection. The measure demonstrated adequate internal consistency, sensitivity to change during treatment, and convergence with validated assessment measures. CONCLUSIONS Preliminary data support the progress monitoring tool for eating disorders as a novel and valid multidimensional measure of treatment-relevant constructs. This measure may have utility in measuring treatment progress for patients receiving intensive treatment for EDs.
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Affiliation(s)
| | | | | | | | | | - Michael R. Lowe
- Drexel University, Philadelphia, PA, USA
- The Renfrew Center, Philadelphia, PA, USA
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Aafjes-van Doorn K, Sweeney K. The effectiveness of initial therapy contact: A systematic review. Clin Psychol Rev 2019; 74:101786. [PMID: 31733564 DOI: 10.1016/j.cpr.2019.101786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/17/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
'Initial therapy contacts', defined as (the first) 3 h or less of face-to-face psychological treatment, encompassing both the early phase of a longer therapy and one-off single session therapies, are seen as a critical phase of treatment. However, little is known about the direct effect of initial therapy contacts on change in common symptoms typically presented by patients in psychological therapy services. Our systematic literature search resulted in 35 identified empirical studies on the effect of initial therapy contacts. These studies were analyzed in three stages: 1) A systematic comparison of study characteristics using the preferred reporting items for systematic reviews and meta-analyses; 2) A domain-based evaluation of methodological rigor of the studies, in line with Cochrane's guidelines on assessing risk of bias; 3) A narrative synthesis of reported findings. The considerable variability in therapy format (a stand-alone single session, 2 + 1 format, or initial session of multisession therapy) and study design (post/pre-post measurement, with/without control) limited comparability of studies. The quality assessment indicated that the majority of studies had relatively weak methodologies overall. Qualitative synthesis of the effectiveness results suggests that a significant proportion of patients reported benefits, including symptom change. This positive effect is especially clear when compared to no-treatment controls, and appears to be maintained at follow-up. The findings suggest that a broad range of initial therapy formats, could in itself be beneficial to patients in primary care treatment settings, and that further research is warranted.
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Warnecke AJ, Teng E. Measurement-Based Care in the Veteran's Health Administration: A Critique and Recommendations for Future Use in Mental Health Practice. J Clin Psychol Med Settings 2019; 27:795-804. [PMID: 31659593 DOI: 10.1007/s10880-019-09674-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Measurement-based care (MBC), a mechanism through which feedback is given to providers and patients, is increasingly being used in mental health care and has a number of benefits. These include providing information about treatment progress, encouraging a discussion around these topics, providing a method for shared decision-making and personalized treatment, and improving treatment outcomes. Although there are many benefits to using MBC, it is still not being used regularly. Barriers include time to administer measures and uncertainty regarding which measures to administer. This paper will briefly describe MBC and its use in mental health care and then will focus on the use and implementation of MBC within the Veteran's Health Administration (VHA). The VHA is a large healthcare system in which there have been ongoing efforts to implement MBC. Suggestions for successful implementation will be discussed.
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Affiliation(s)
- Ashlee J Warnecke
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA. .,Battle Creek VA Medical Center, Battle Creek, MI, 49037, USA.
| | - Ellen Teng
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA.,Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, USA.,South Central Mental Illness Research Education, and Clinical Center, Houston, USA
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Sales CMD, Ferreira S, Matos PM. How Routine Patient-Centered Monitoring Relates to Therapeutic Gains in Family Therapy: A Single-Case Study. JOURNAL OF MARITAL AND FAMILY THERAPY 2019; 45:606-620. [PMID: 30325525 DOI: 10.1111/jmft.12359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As routine outcome monitoring systems develop, questions emerge about how therapists incorporate feedback into their practice, and how this relates to therapeutic gains. A case of covert grief was monitored in each session with the Personal Questionnaire and the Helpful Aspects of Therapy instruments. At 4 months follow-up, the Change Interview was administered. Individualized items facilitated access to the private views and needs of each member, which was useful for case formulation and ongoing personalization of the intervention. Qualitative feedback of treatment experiences helped therapists confirm the impacts of interventions, monitor therapeutic alliance, reformulate clinical hypothesis, and plan sessions. Therapists followed a critical triangulation process to decide the clinical meaning of feedback, according to his/her intervention model, expertise, and case-specific context.
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Börjesson S, Boström PK. “I want to know what it is used for”: Clients’ perspectives on completing a routine outcome measure (ROM) while undergoing psychotherapy. Psychother Res 2019; 30:337-347. [PMID: 31198093 DOI: 10.1080/10503307.2019.1630780] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Sara Börjesson
- Psychiatry West, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Petra K. Boström
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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Lau B, Shiryaeva O, Ruud T, Victor M. What are they returning to? Psychosocial work environment as a predictor of returning to work among employees in treatment for common mental disorders: A prospective observational pre-post study. PLoS One 2019; 14:e0215354. [PMID: 31017935 PMCID: PMC6481810 DOI: 10.1371/journal.pone.0215354] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 04/02/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Long-term sick leave and disabilities due to common mental disorders are challenging for society, employers, and individuals. Hence, we wanted to investigate whether psychosocial work environments experienced by employees undergoing treatment for such disorders was associated with return to work. METHODS At the start of treatment, 164 patients responded to questionnaires concerning their psychosocial work environment (the Job Demand-Control-Support model and the Effort-Reward Imbalance model), symptoms (The Clinical Outcomes in Routine Evaluation Outcome Measure) and ability to work (Work Ability Index). In addition, the respondents reported whether they were working or on sick leave at the start and end of their courses of treatment. Their therapists provided information about diagnoses. RESULTS Return to work was associated with control of decisions, support from colleagues, esteem, and job promotion opportunities as measured at the start of treatment. In multivariate analyses, control over decisions and job promotion opportunities continued to predict return to work when adjusted for symptoms, current work ability, and expected future work ability. DISCUSSION The working conditions that predicted return to work are considered to facilitate work performance and to be sources of motivation, job satisfaction, and job commitment. Consequently, it is important to examine whether this patient group has a favorable working environment and consider changes in the workplace if the environment is not favorable.
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Affiliation(s)
- Bjørn Lau
- Lovisenberg Hospital, Nydalen, Oslo, Norway
- University of Oslo, Department of Psychology, Oslo, Norway
- * E-mail:
| | | | - Torleif Ruud
- Akershus University Hospital, Division Mental Health Services, Lørenskog, Norway
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
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Kontunen J, Weiste E, Liukkonen T, Timonen M, Aaltonen J. Predicting response to interpersonal counselling (IPC) from case formulation: a systematic comparison between recovered and unchanged depressive cases. COUNSELLING PSYCHOLOGY QUARTERLY 2019. [DOI: 10.1080/09515070.2019.1588101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jarmo Kontunen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Elina Weiste
- Department of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Timo Liukkonen
- Centre for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Markku Timonen
- Centre for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jukka Aaltonen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
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Curran J, Parry GD, Hardy GE, Darling J, Mason AM, Chambers E. How Does Therapy Harm? A Model of Adverse Process Using Task Analysis in the Meta-Synthesis of Service Users' Experience. Front Psychol 2019; 10:347. [PMID: 30930805 PMCID: PMC6425860 DOI: 10.3389/fpsyg.2019.00347] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 02/04/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Despite repeated discussion of treatment safety, there remains little quantitative research directly addressing the potential of therapy to harm. In contrast, there are numerous sources of qualitative evidence on clients' negative experience of psychotherapy, which they report as harmful. Objective: To derive a model of process factors potentially leading to negative or harmful effects of therapy, from the clients' perspective, based on a systematic narrative synthesis of evidence on negative experiences and effects of psychotherapy from (a) qualitative research findings and (b) participants' testimony. Method: We adapted Greenberg (2007) task analysis as a discovery-oriented method for the systematic synthesis of qualitative research and service user testimony. A rational model of adverse processes in psychotherapy was empirically refined in two separate analyses, which were then compared and incorporated into a rational-empirical model. This was then validated against an independent qualitative study of negative effects. Results: Over 90% of the themes in the rational-empirical model were supported in the validation study. Contextual issues, such as lack of cultural validity and therapy options together with unmet client expectations fed into negative therapeutic processes (e.g., unresolved alliance ruptures). These involved a range of unhelpful therapist behaviors (e.g., rigidity, over-control, lack of knowledge) associated with clients feeling disempowered, silenced, or devalued. These were coupled with issues of power and blame. Conclusions: Task analysis can be adapted to extract meaning from large quantities of qualitative data, in different formats. The service user perspective reveals there are potentially harmful factors at each stage of the therapy journey which require remedial action. Implications of these findings for practice improvement are discussed.
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Affiliation(s)
- Joe Curran
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, United Kingdom
| | - Glenys D Parry
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Gillian E Hardy
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Jennifer Darling
- Pennine Care NHS Foundation Trust, Ashton-under-Lyne, United Kingdom
| | - Ann-Marie Mason
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, United Kingdom
| | - Eleni Chambers
- School of Nursing and Midwifery, University of Sheffield, Sheffield, United Kingdom
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