1
|
Sheikh A, Jacob J, Vostanis P, Ruby F, Spuerck I, Stankovic M, Morgan N, Mota CP, Ferreira R, Eruyar Ş, Yılmaz EA, Fatima SZ, Edbrooke-Childs J. What Should Personalised Mental Health Support Involve? Views of Young People with Lived Experience and Professionals from Eight Countries. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01382-2. [PMID: 38907740 DOI: 10.1007/s10488-024-01382-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 06/24/2024]
Abstract
Research demonstrates that young people value mental health support that is tailored to their needs and preferences, rather than a "one size fits all" offer, which is often not equitably accessible (National Children's Bureau, 2021). Understanding young people's lived experiences across different sociocultural contexts is important. The aim of this research was to conduct an international qualitative study on the views of young people with lived experience and professionals, on proposed aspects of personalised support for anxiety and/or depression. Participatory action focus groups were conducted with N = 120 young people with lived experience of anxiety and/or depression (14-24 years) and with N = 63 professionals in Brazil, India, Kenya, Pakistan, Portugal, South Africa, Turkey, and the United Kingdom. Data were analysed using the rigorous and accelerated data reduction (RADaR) technique. Overall, although some country-specific differences were found in terms of what aspects of support young people found to be most important, individual preferences were considered stronger, furthering the view that support should be personalised to the needs of the individual young person. Young people experiencing anxiety and/or depression should be able to choose for themselves which aspects of support they would prefer in their own care and support plans, with families and mental health professionals providing guidance where appropriate, rather than removing the young person from the decision-making process altogether. It should also be ensured that the aspects of personalised support can be understood by young people and professionals from different contexts, including marginalised and minoritised groups and communities.
Collapse
Affiliation(s)
| | - Jenna Jacob
- Anna Freud, 4-8 Rodney Street, London, N1 9JH, UK.
- Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Panos Vostanis
- School of Media, Communication and Sociology, University of Leicester, University Road, Leicester, UK
| | | | - Inga Spuerck
- Euro Youth Mental Health, The Carling Building, Coopers Yard, Off, Market Pl, Hitchin, SG5 1AR, UK
| | - Milos Stankovic
- Euro Youth Mental Health, The Carling Building, Coopers Yard, Off, Market Pl, Hitchin, SG5 1AR, UK
| | - Nicholas Morgan
- Euro Youth Mental Health, The Carling Building, Coopers Yard, Off, Market Pl, Hitchin, SG5 1AR, UK
| | - Catarina Pinheiro Mota
- University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal
- Center for Psychology, University of Porto, Porto, Portugal
| | - Rúben Ferreira
- University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal
| | - Şeyda Eruyar
- Department of Psychology, Necmettin Erbakan University, Köyceğiz, Meram, Konya, 42140, Turkey
| | - Elmas Aybike Yılmaz
- Department of Psychology, Necmettin Erbakan University, Köyceğiz, Meram, Konya, 42140, Turkey
| | - Syeda Zeenat Fatima
- Hussaini Foundation-Child and Adolescent Development Program, Karachi, Pakistan
| | - Julian Edbrooke-Childs
- Anna Freud, 4-8 Rodney Street, London, N1 9JH, UK
- Clinical, Educational and Health Psychology, University College London, London, UK
| |
Collapse
|
2
|
Graf D, Sigrist C, Boege I, Cavelti M, Koenig J, Kaess M. Effectiveness of home treatment in children and adolescents with psychiatric disorders-systematic review and meta-analysis. BMC Med 2024; 22:241. [PMID: 38867231 PMCID: PMC11170798 DOI: 10.1186/s12916-024-03448-2] [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] [Received: 09/28/2023] [Accepted: 05/24/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Home treatment in child and adolescent psychiatry offers an alternative to conventional inpatient treatment by involving the patient's family, school, and peers more directly in therapy. Although several reviews have summarised existing home treatment programmes, evidence of their effectiveness remains limited and data synthesis is lacking. METHODS We conducted a meta-analysis on the effectiveness of home treatment compared with inpatient treatment in child and adolescent psychiatry, based on a systematic search of four databases (PubMed, CINAHL, PsychINFO, Embase). Primary outcomes were psychosocial functioning and psychopathology. Additional outcomes included treatment satisfaction, duration, costs, and readmission rates. Group differences were expressed as standardised mean differences (SMD) in change scores. We used three-level random-effects meta-analysis and meta-regression and conducted both superiority and non-inferiority testing. RESULTS We included 30 studies from 13 non-overlapping samples, providing data from 1795 individuals (mean age: 11.95 ± 2.33 years; 42.5% female). We found no significant differences between home and inpatient treatment for postline psychosocial functioning (SMD = 0.05 [- 0.18; 0.30], p = 0.68, I2 = 98.0%) and psychopathology (SMD = 0.10 [- 0.17; 0.37], p = 0.44, I2 = 98.3%). Similar results were observed from follow-up data and non-inferiority testing. Meta-regression showed better outcomes for patient groups with higher levels of psychopathology at baseline and favoured home treatment over inpatient treatment when only randomised controlled trials were considered. CONCLUSIONS This meta-analysis found no evidence that home treatment is less effective than conventional inpatient treatment, highlighting its potential as an effective alternative in child and adolescent psychiatry. The generalisability of these findings is reduced by limitations in the existing literature, and further research is needed to better understand which patients benefit most from home treatment. TRIAL REGISTRATION Registered at PROSPERO (CRD42020177558), July 5, 2020.
Collapse
Affiliation(s)
- Daniel Graf
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christine Sigrist
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Isabel Boege
- Department of Child and Adolescent Psychiatry, ZfP Suedwuerttemberg, Ravensburg, Germany
| | - Marialuisa Cavelti
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
| |
Collapse
|
3
|
Viduani A, Arenas DL, Benetti S, Wahid SS, Kohrt BA, Kieling C. Systematic Review and Meta-Synthesis: How Is Depression Experienced by Adolescents? A Synthesis of the Qualitative Literature. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00061-3. [PMID: 38340896 DOI: 10.1016/j.jaac.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/29/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To systematically investigate how youth with lived experience report their experience of depression in terms of features of depression and in relation to themselves and their environment. METHOD We conducted a systematic review of qualitative research around the world that explored the subjective experience of depression among youth (age range, 10-24 years) who had self-reported, screened positive for, or received a formal diagnosis of the disorder. We used multiple databases to search for relevant studies published in any language up until March 2023. Studies were coded regarding features of depression reported by adolescents. We also used thematic synthesis to extract and synthesize descriptions of the lived experience of depression, and to develop analytic themes. The study was registered with PROSPERO, CRD42021218300. RESULTS We identified a total of 23,424 unique records, and included 39 studies in the final review, representing the views of 884 adolescents with lived experience of depression. Most of the studies were conducted in high-income countries (72.8%), and the majority of participants were female (65%). The most frequently reported features of depression were sadness (present in 92.3% of the studies), social withdrawal (76.9%), and loneliness (69.2%). In addition, we constructed 3 themes that aimed to synthesize youths' accounts of their perceptions and experiences of depression: (1) making sense; (2) factoring in culture and contextual influences; and (3) accessing support and care. CONCLUSION Some of the more commonly reported features of depression among youth are not explicitly included in the DSM/ICD diagnostic criteria but are highly relevant and closely connected to the experiences of adolescents. Moreover, contextual interpretations of depression may be more sensitive to capture representations and narratives of depression among youth. Thus, incorporating features of depression reported by adolescents could potentially increase accuracy of detection, promote collaborative work, and enhance therapeutic and care outcomes. STUDY PREREGISTRATION INFORMATION The lived experience of depression in adolescence: a systematic review of the qualitative literature; https://www.crd.york.ac.uk/prospero/; CRD42021218300.
Collapse
Affiliation(s)
- Anna Viduani
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Daniel Luccas Arenas
- Hospital Materno-Infantil Presidente Vargas and Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Silvia Benetti
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | | | - Christian Kieling
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
| |
Collapse
|
4
|
Krause KR, Calderón A, Pino VG, Edbrooke-Childs J, Moltrecht B, Wolpert M. What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile. Eur Child Adolesc Psychiatry 2024; 33:151-166. [PMID: 36719524 PMCID: PMC10806045 DOI: 10.1007/s00787-023-02140-9] [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] [Received: 05/23/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Abstract
Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed.
Collapse
Affiliation(s)
- Karolin Rose Krause
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK.
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
| | - Ana Calderón
- Facultad de Psicología y Humanidades, Universidad San Sebastián, Sede Santiago, Chile
| | - Victor Gomez Pino
- Facultad de Medicina, Departamento de Psiquiatría Norte, Hospital Clínico, Clínica Psiquiátrica Universitaria, Universidad de Chile, Avenida La Paz 1003, Recoleta, Chile
| | - Julian Edbrooke-Childs
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK
- Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4-8 Rodney Street, London, N1 9JH, UK
| | - Bettina Moltrecht
- Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4-8 Rodney Street, London, N1 9JH, UK
- Centre for Longitudinal Studies, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK
| | - Miranda Wolpert
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK
- Wellcome Trust, 215 Euston Rd, Bloomsbury, London, NW1 2BE, UK
| |
Collapse
|
5
|
McCaffrey J, Terao M, McCaffrey C, Igoe A, Loughran O, McDonagh K, McDonogh S, Shackleton E, Whooley E, Jelovac A, McLoughlin DM, Hunter A. Protocol Development for a Qualitative Methodological Study Within a Trial (Qual-SWAT): The KARMA-Dep-2 Trial. HRB Open Res 2023; 6:29. [PMID: 37361338 PMCID: PMC10285324 DOI: 10.12688/hrbopenres.13721.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 06/28/2023] Open
Abstract
Background Despite methodological improvements in clinical trial design and conduct more generally, methodological limitations persist in trials concerning mental health care. A qualitative Study Within A Trial (Qual-SWAT), embedded in the KARMA-Dep-2 host trial, will be undertaken to explore and gain an understanding of two methodological questions in randomised trials specific to mental health care: (1) what are the key barriers and enablers of participation in randomised trials in mental health; and (2) how can randomised trials become part of routine mental health care. These issues will be examined from patient-participant and clinician- / researcher-participant perspectives, in alignment with PRioRiTy research themes. Methods A descriptive qualitative study design will be used. Data will be collected via one-to-one semi-structured interviews, conducted via Microsoft Teams. The interview data will be analysed using Braun and Clarke's Thematic Analysis approach. One-to-one interviews will be conducted with three participant groups ( N = 30): 1) host trial patient-participants ( n = 10); 2) potentially eligible host trial patient-participants who refused enrolment in the host trial ( n = 10); and 3) clinician- / researcher-participants who are associated with work on the host trial ( n = 10). Ethics and dissemination Ethical approval has been granted by St. Patrick's Mental Health Services Research Ethics Committee, Ireland (Ref: Protocol 09/20). When the study is completed, a report will be prepared and submitted to the Health Research Board (HRB). Findings will be shared with the host trial team and study participants, and submitted for publication. Host trial registration ClinicalTrials.gov ( NCT04939649); EudraCT ( 2019-003109-92). Official title: Ketamine as an Adjunctive Therapy for Major Depression - A Randomised Controlled Trial: [KARMA-Dep (2)].
Collapse
Affiliation(s)
- John McCaffrey
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Masashi Terao
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Cathal McCaffrey
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Anna Igoe
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Orlaith Loughran
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Kelly McDonagh
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Sarah McDonogh
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Ellie Shackleton
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Emma Whooley
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Ana Jelovac
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Declan M. McLoughlin
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Andrew Hunter
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Qualitative Research in Trials Centre (QUESTS), University of Galway, Galway, Ireland
| |
Collapse
|
6
|
Calderon A, Storeide KAH, Elvejord C, Nissen-Lie HA, Ulberg R, Dahl HSJ. Examining Psychotherapeutic Processes with Depressed Adolescents: A Comparative Study of Two Psychodynamic Therapies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16939. [PMID: 36554820 PMCID: PMC9779625 DOI: 10.3390/ijerph192416939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
To understand processes associated with better or poorer psychotherapy outcomes is vital. This study examined and contrasted interaction patterns between one therapist and two depressed 17-year-old girls, Johanna (good outcome) and Sonja (poor outcome), in short-term psychoanalytic therapies selected from an RCT. Outcome data were collected regarding level of inter- and intra-personal functioning and symptoms of depression. Process data were obtained using the Adolescent Psychotherapy Q-Set on all available sessions. Analyses yielded five relational patterns or "interaction structures" in the two therapy processes; Three explained most of the variance in sessions with Johanna (i.e., 'positive working alliance', 'therapist's active use of psychodynamic techniques', and 'a receptive patient') and two explained more of the variance in sessions with Sonja (i.e., 'therapist using a more problem-solving and symptom-oriented approach' and 'patient displaying limited capacity for mentalization'). The processes in the two cases presented differences related to mentalization, psychological mindedness, and attachment style of the patients. The therapist used different therapeutic approaches, favouring more psychodynamic interventions in the good outcome case and a more problem-solving and symptom-oriented approach with the poor outcome case. In the latter case, the relationship seemed to be more of a struggle.
Collapse
Affiliation(s)
- Ana Calderon
- Escuela de Psicología, Universidad Gabriela Mistral, Santiago 7500533, Chile
| | | | - Cecilie Elvejord
- Department of Psychology, University of Oslo, Forskningsveien 3, 0370 Oslo, Norway
| | | | - Randi Ulberg
- Faculty of Medicine, University of Oslo, 0372 Oslo, Norway
- Research Unit, Division of Mental Health, Vestfold Hospital Trust, 3103 Tønsberg, Norway
- Department of Psychiatry, Diakonhjemmet Hospital, Forskningsveien 7, 0370 Oslo, Norway
| | - Hanne-Sofie Johnsen Dahl
- Department of Psychology, University of Oslo, Forskningsveien 3, 0370 Oslo, Norway
- Research Unit, Division of Mental Health, Vestfold Hospital Trust, 3103 Tønsberg, Norway
| |
Collapse
|
7
|
Krause KR, Hetrick SE, Courtney DB, Cost KT, Butcher NJ, Offringa M, Monga S, Henderson J, Szatmari P. How much is enough? Considering minimally important change in youth mental health outcomes. Lancet Psychiatry 2022; 9:992-998. [PMID: 36403601 DOI: 10.1016/s2215-0366(22)00338-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/19/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022]
Abstract
To make decisions in mental health care, service users, clinicians, and administrators need to make sense of research findings. Unfortunately, study results are often presented as raw questionnaire scores at different time points and regression coefficients, which are difficult to interpret with regards to their clinical meaning. Other commonly reported treatment outcome indicators in clinical trials or meta-analyses do not convey whether a given change score would make a noticeable difference to service users. There is an urgent need to improve the interpretability and relevance of outcome indicators in youth mental health (aged 12-24 years), in which shared decision making and person-centred care are cornerstones of an ongoing global transformation of care. In this Personal View, we make a case for considering minimally important change (MIC) as a meaningful, accessible, and user-centred outcome indicator. We discuss what the MIC represents, how it is calculated, and how it can be implemented in dialogues between clinician and researcher, and between youth and clinician. We outline how use of the MIC could enhance reporting in clinical trials, meta-analyses, clinical practice guidelines, and measurement-based care. Finally, we identify current methodological challenges around estimating the MIC and areas for future research. Efforts to select outcome domains and valid measurement instruments that resonate with youth, families, and clinicians have increased in the past 5 years. In this context, now is the time to define demarcations of changes in outcome scores that are clinically relevant, and meaningful to youth and families. Through the use of MIC, youth-centred outcome measurement, analysis, and reporting would support youth-centred therapeutic decision making.
Collapse
Affiliation(s)
- Karolin R Krause
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Sarah E Hetrick
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Darren B Courtney
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Suneeta Monga
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joanna Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
8
|
Kuzmičová A, Supa M, Nekola M. Children's perspectives on being absorbed when reading fiction: A Q methodology study. Front Psychol 2022; 13:966820. [PMID: 36275222 PMCID: PMC9583005 DOI: 10.3389/fpsyg.2022.966820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/15/2022] [Indexed: 11/29/2022] Open
Abstract
Research in the intersections of literature, media, and psychology increasingly examines the absorbing story experiences of adult readers, typically relying on quantitative self-report questionnaires. Meanwhile, little work has been done to explore how being "lost in a book" is experienced by children, despite the phenomenon's importance for literacy education. Such work requires tools that are more inductive and child-centered than questionnaires. We have conducted a Q methodology study with participants aged 9-12 (n = 28), exploring how it feels for them when the mind and body are attuned to a story and how different facets of absorption (e.g., mental imagery, emotional engagement) inform the experience. Participants numerically sorted 24 cards expressing inner states and expectations relating to book-length fiction reading and were subsequently interviewed regarding their sorting choices. The cards were generated inductively based on preliminary research (focus groups, individual interviews, observations). By-person factor analysis of the sortings combined with reflective thematic analysis of the post-sorting interviews revealed four distinct reader subjectivities, or perspectives: Growth, Confirmation, Attachment and Mental Shift. Crucially, the children in these groups differed as to prominent dimensions of absorption but also as to the overall place of reading in their inner and everyday lives. Based on the four perspectives, we demonstrate that children have varied ways of being absorbed when reading fiction, and reflect on the affordances of Q methodology as a suitable child-centered approach to studying the subjective experiences of reading.
Collapse
Affiliation(s)
- Anežka Kuzmičová
- Institute of Czech Language and Theory of Communication, Faculty of Arts, Charles University, Prague, Czechia
| | - Markéta Supa
- Institute of Communication Studies and Journalism, Faculty of Social Sciences, Charles University, Prague, Czechia
| | - Martin Nekola
- Institute of Sociological Studies, Faculty of Social Sciences, Charles University, Prague, Czechia
| |
Collapse
|
9
|
Smith K, McLeod J, Blunden N, Cooper M, Gabriel L, Kupfer C, McLeod J, Murphie MC, Oddli HW, Thurston M, Winter LA. A Pluralistic Perspective on Research in Psychotherapy: Harnessing Passion, Difference and Dialogue to Promote Justice and Relevance. Front Psychol 2021; 12:742676. [PMID: 34552542 PMCID: PMC8450328 DOI: 10.3389/fpsyg.2021.742676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/05/2021] [Indexed: 11/23/2022] Open
Abstract
The adoption of a pluralistic perspective on research design, processes of data collection and analysis and dissemination of findings, has the potential to enable psychotherapy research to make a more effective contribution to building a just society. A review of the key features of the concept of pluralism is followed by a historical analysis of the ways in which research in counselling, psychotherapy and related disciplines has moved in the direction of a pluralistic position around knowledge creation. Core principles of a pluralistic approach to research are identified and explored in the context of a critical case study of contemporary research into psychotherapy for depression, examples of pluralistically oriented research practices, and analysis of a pluralistic conceptualisation of the nature of evidence. Implications of a pluralistic perspective for research training and practice are discussed. Pluralistic inquiry that emphasises dialogue, collaboration, epistemic justice and the co-existence of multiple truths, creates opportunities for individuals, families and communities from a wide range of backgrounds to co-produce knowledge in ways that support their capacities for active citizenship and involvement in open democratic decision-making. To fulfil these possibilities, it is necessary for psychotherapy research to be oriented towards social goals that are sufficiently relevant to both researchers and co-participants to harness their passion and work together for a common good.
Collapse
Affiliation(s)
- Kate Smith
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - John McLeod
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | | | - Mick Cooper
- Department of Psychology, Roehampton University, London, United Kingdom
| | - Lynne Gabriel
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Christine Kupfer
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Julia McLeod
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | | | - Hanne Weie Oddli
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Mhairi Thurston
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Laura Anne Winter
- Manchester Institute of Education, Schools of Environment, Education, and Development, University of Manchester, Manchester, United Kingdom
| |
Collapse
|