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Papastylianou AD, Travasaros T. Patients' Perspective on the Important Therapeutic Factors in Integrated Systemic Group Therapy: A Phenomenological Approach. Int J Group Psychother 2024; 74:33-77. [PMID: 38451504 DOI: 10.1080/00207284.2024.2303087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
This qualitative research refers to the patients' perspective on the therapeutic factors operating in long-term group therapy of an integrated systemic orientation (ISO). Semi-structured interviews of members of two long-term ISO psychotherapy groups were conducted in three phases: the first, second, and third year of their group psychotherapy. The research sample consisted of 13 participants. The data was analyzed through an interpretative phenomenological analysis. The results confirmed the classification of Yalom's therapeutic factors. However, an additional therapeutic factor emerged, the "development of pluralistic perspectives" that appears more clearly from the second year of therapy onward. Moreover, from the second year onward, the categories "existential factors" and "interpersonal learning" get strengthened. Limitations and future directions are discussed.
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Nesbitt AE, Sabiston CM, deJonge ML, Barbic SP, Kozloff N, Nalder EJ. A scoping review of resilience among transition-age youth with serious mental illness: tensions, knowledge gaps, and future directions. BMC Psychiatry 2023; 23:660. [PMID: 37679708 PMCID: PMC10483804 DOI: 10.1186/s12888-023-05158-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION The study of resilience among transition-age youth (aged 16-29 years) living with serious mental illness (SMI) has provided a promising new direction for research with the capacity to explore individuals' strengths and resources. However, variability in how resilience is defined and measured has led to a lack of conceptual clarity. A comprehensive synthesis is needed to understand current trends and gaps in resilience research among this population. The purpose of the current study was to map how resilience has been conceptualized and operationalized among transition-age youth with SMI, explore resilience factors and outcomes that have been studied, and recommend areas for future research. METHODS A six-stage scoping review methodology was used to systematically identify relevant empirical literature across multiple databases (MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Scopus), addressing transition-age youth diagnosed with SMI and resilience. Topic consultation and reaction meetings were conducted to gather feedback from transition-age youth with SMI, researchers, and clinicians during the review process to enhance the applicability of the review findings. A meta-narrative approach was used to organize included studies into research traditions (i.e., paradigms of inquiry with similar storylines, theoretical and methodological orientations). Resilience factors and outcomes, and the consultative meetings, were analyzed using content analysis. RESULTS Twenty-four studies met inclusion criteria (14 quantitative, 9 qualitative, 1 mixed-method). Four research traditions were identified, each contributing a unique storyline which conceptualized and operationalized resilience in slightly different ways: Stress Adaptation, Person-Environment Interactions, Recovery-Focused, and Critical and Cultural Perspectives. Resilience factors and outcomes were most commonly evaluated at the individual-level or within the immediate environment (e.g., personal characteristics, social support networks). Limited research has explored the influence of macro-level systems and health inequalities on resilience processes. Results from the consultative meetings further demonstrated the importance of health services and sociocultural factors in shaping processes of resilience among youth. CONCLUSION The present results may be used to inform future work, as well as the development of age-appropriate, strengths-based, and resilience-oriented approaches to service delivery. Interdisciplinary and intersectional research that prioritizes community and youth engagement is needed to advance current understandings of resilience among transition-age youth with SMI.
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Affiliation(s)
- Amy E Nesbitt
- Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Melissa L deJonge
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Skye P Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Foundry, Vancouver, BC, Canada
- Providence Research, Vancouver, BC, Canada
| | - Nicole Kozloff
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Emily J Nalder
- Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Beckmann KM, Pepe B. Subacute voluntary care provision, what about Yalom? Australas Psychiatry 2023:10398562231158918. [PMID: 36825301 DOI: 10.1177/10398562231158918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Hauber K, Boon A. First-Session Therapeutic Relationship and Outcome in High Risk Adolescents Intensive Group Psychotherapeutic Programme. Front Psychol 2022; 13:916888. [PMID: 35783793 PMCID: PMC9245890 DOI: 10.3389/fpsyg.2022.916888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAn important determinant of therapy outcome is the quality of the therapeutic relationship. This study evaluated the association between the client’s assessment of first-session therapeutic relationship (FSTR) and outcome in an intensive treatment for adolescents with personality disorders.MethodPatients (N = 92) were measured weekly during intensive group treatment. The therapeutic relationship was measured with the Child version of the Session Rating Scale (C-SRS) that was completed after each group therapy session by the patient. Outcome was measured with the Child version of the Outcome Rating Scale (C-ORS). Reliable change index (RCI) was calculated for the both instruments to determine significant changes in therapeutic relationship and outcome.ResultsA good FRST gave twice as much chance of a significantly better outcome. Especially for those with moderate FSTR, establishing and maintaining a good working relationship during treatment could increase the chances of a good outcome considerably. In contrast, adolescents with low FSTR had little chance of positive outcome regardless of any improvement in the therapeutic relationship.ConclusionAdolescents assessment of FRST is indicative of the chance of a good outcome.
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Affiliation(s)
- Kirsten Hauber
- LUMC Curium, Child and Adolescent Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
- Parnassia Psychiatric Institute, Youz Child and Adolescent Psychiatry, The Hague, Netherlands
- *Correspondence: Kirsten Hauber,
| | - Albert Boon
- LUMC Curium, Child and Adolescent Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
- Parnassia Psychiatric Institute, Youz Child and Adolescent Psychiatry, The Hague, Netherlands
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Maheu C, Lok V, Galica J, Tse M, Maltus E, Giguère L, Tock WL, Lebel S. Motivation to Consent and Adhere to the FORT Randomized Controlled Trial. Curr Oncol 2022; 29:2848-2863. [PMID: 35448206 PMCID: PMC9025660 DOI: 10.3390/curroncol29040232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this qualitative study was to identify the motivational factors that influence cancer survivors to participate and adhere to the fear of cancer recurrence (FCR) FORT randomized controlled trial (RCT). Fifteen women diagnosed with breast and gynecological cancer who took part in the FORT RCT were interviewed about their experience to consent and adhere to the trial. The transcribed interviews were content analyzed within a relational autonomy framework. The analysis revealed that the participants’ motivation to consent and adhere to the FORT RCT was structured around thirteen subthemes grouped into four overarching themes: (1) Personal Influential Factors; (2) Societal Motivations; (3) Structural Influences; and (4) Gains in Emotional Support. The unique structures of the trial such as the group format, the friendships formed with other participants in their group and with the group leaders, and the right timing of the trial within their cancer survivorship trajectory all contributed to their motivation to consent and adhere to the FORT RCT. While their initial motivation to participate was mostly altruistic, it was their personal gains obtained over the course of the trial that contributed to their adherence. Potential gains in emotional and social support from psycho-oncology trials should be capitalized when approaching future participants as a mean to improve on motivations to consent and adhere.
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Affiliation(s)
- Christine Maheu
- Ingram School of Nursing, McGill University, Montreal, QC H3A 0G4, Canada;
- Correspondence:
| | - Valerie Lok
- Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Jacqueline Galica
- School of Nursing, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Mali Tse
- School of Nursing, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Emma Maltus
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Lauriane Giguère
- Faculty of Social Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Wing Lam Tock
- Ingram School of Nursing, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
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Clough B, Spriggens L, Stainer M, Casey L. Working together: An investigation of the impact of working alliance and cohesion on group psychotherapy attendance. Psychol Psychother 2022; 95:79-97. [PMID: 34480400 DOI: 10.1111/papt.12364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Group psychotherapy holds considerable potential for cost-effective treatment delivery. However, issues with client attendance can compromise the efficacy of such treatments. To date, client specific factors are amongst the most researched predictors of attendance in psychotherapy, with much less of a focus given to process factors, particularly in the group therapy context. This study aimed to determine which process factors influenced attendance in the context of a group therapy programme for adults with anxiety. It was hypothesized that (1) the working alliance and group cohesion would be moderately correlated, (2) both the working alliance and group cohesion would explain unique variance in session attendance, and (3) the working alliance would act as a moderator for attendance, when group cohesion was low. DESIGN The study utilized a within participants design. METHODS Participants were 91 adults (aged 18-74 years) who took part in a 9-week, transdiagnostic cognitive behavioural group therapy programme for the treatment of anxiety disorders. RESULTS Working alliance and group cohesion were significantly, but only moderately correlated (rs ranging .41 to .55). Together, working alliance and group cohesion significantly predicted total session attendance (17.70% variance explained). Working alliance did not moderate the relationship between group cohesion and session attendance. CONCLUSIONS The importance of individual and group processes in influencing group therapy engagement is highlighted, including the role of fostering bonds within the group and between clients and therapists. PRACTITIONER POINTS A complex array of process factors has been argued to influence treatment outcomes in group therapy The quality of the relationship between group therapy clients, as well as the relationship between a client and the therapist, predict session attendance. The quality of the relationship between the client and the therapist may be the most important predictor of session attendance. Therapists should foster positive relationships between each client and the therapist in group therapy, as well as assisting each client to foster positive relationships with other group members.
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Affiliation(s)
- Bonnie Clough
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Lauren Spriggens
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Matthew Stainer
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Leanne Casey
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
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Freeland L, O’Reilly M, Fleury J, Adams S, Vostanis P. Digital Social and Emotional Literacy Intervention for Vulnerable Children in Brazil: Participants’ Experiences. International Journal of Mental Health Promotion 2022. [DOI: 10.32604/ijmhp.2022.015706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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McKenzie RJ, Chambers TP, Nicholson-Perry K, Pilgrim J, Ward PB. "Feels Good to Get Wet": The Unique Affordances of Surf Therapy Among Australian Youth. Front Psychol 2021; 12:721238. [PMID: 34721176 PMCID: PMC8552065 DOI: 10.3389/fpsyg.2021.721238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022] Open
Abstract
Increasing prevalence rates of mental health problems among adolescents is an issue of growing concern. Surf therapy is a novel intervention that may provide tangible benefits to address this problem. Congruent with the ecological dynamics perspective (EDP), the existing research postulates that surf therapy yields psychological benefits in part due to the unique affordances of immersion in a blue space such as the ocean. Evidence worldwide has validated the use of surfing as a therapeutic mediator to achieve positive change, however, no such research has been conducted on Australian adolescents. The current study aimed to evaluate the impact of the Waves of Wellness (WOW) Foundation's 8 week surf therapy program on mental health outcomes in Australian at-risk youth. The study employed a mixed-methods design to examine the experiences of participants. Nine adolescents (Mage = 14.9; SD = 1.2; 8 female) participated in the quantitative stage, with four completing the qualitative interview. Results indicated positive changes in resilience, self-esteem, social connectedness, and depressive symptoms post-intervention, however, improvements were not maintained at follow-up. Participants unanimously agreed that the program normalised their experiences with mental health through the unique leaning environment and fostered personal growth through mastery experiences and the development of healthy relationships. The EDP provided the most compelling explanation of the results denoting that benefits arise from the reciprocal relationship between individual, task, and environment. Despite the small and heterogenous sample, the findings provided preliminary evidence of the efficacy of surf therapy among Australian youth and offer a potential starting point for further research utilising larger more diverse samples.
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Affiliation(s)
- Rebekah Jade McKenzie
- Discipline of Psychological Science, Australian College of Applied Psychology, Sydney, NSW, Australia
| | | | - Kathryn Nicholson-Perry
- Discipline of Psychological Science, Australian College of Applied Psychology, Sydney, NSW, Australia
| | - Joel Pilgrim
- Waves of Wellness Foundation, Sydney, NSW, Australia
| | - Philip B Ward
- Waves of Wellness Foundation, Sydney, NSW, Australia.,UNSW Sydney and Schizophrenia Research Unit, School of Psychiatry, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
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Lakeman R, Emeleus M. The process of recovery and change in a dialectical behaviour therapy programme for youth. Int J Ment Health Nurs 2020; 29:1092-1100. [PMID: 32535985 DOI: 10.1111/inm.12749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 01/08/2023]
Abstract
Dialectical behaviour therapy (DBT) is an effective treatment for borderline personality disorder and suicidal behaviour. However, it is a complex programme involving individual therapy, participation in skills training groups, and phone coaching aimed at improving emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Little is known about what elements contribute to its effectiveness, or the characteristics of those who complete the programme and achieve recovery. In this study, six participants in a dialectical behaviour therapy programme for youth were interviewed at three time points over their recovery journey. The transcribed narratives were analysed using inductive methods, and the core processes related to recovery were elucidated and described: 'Becoming a cheerleader for DBT' and 'Learning the language of DBT and consolidation of skills'. Indicators of recovery included having a sound working alliance with the primary therapist and others involved in the programme and noticing meaningful improvements in problem areas which they attributed to particular skills and improved capacity to regulate emotions. The rich narrative description provided by participants might inspire some to remain engaged in a dialectical behavioural therapy programme or clinicians to consider promoting a positive view of the prognosis for borderline personality disorder.
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Affiliation(s)
| | - Mary Emeleus
- Queensland Health, Brisbane, Queensland, Australia
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