Poor suitability for psychotherapy - a risk factor for treatment non-attendance?

Socioeconomic status, psychotherapy duration, and return to work from disability due to common mental disorders

Objective Low socioeconomic status (SES) is a risk factor for work disability due to common mental disorders (CMDs), one possible reason being inequal use of services. Psychotherapy is an evidence-based treatment for CMDs. This study examines socioeconomic and sociodemographic differences in psychotherapy attendance and an association of psychotherapy duration with return to work (RTW).Methods The study subjects (N = 12,263) were all Finnish citizens granted a disability pension (DP) due to CMDs in 2010-2012. Numbers of psychotherapy sessions (maximum 200) were collected from the nine-year interval around the DP grant. Socioeconomic and sociodemographic differences in psychotherapy duration (dependent variable) among DP recipients were studied using multinomial logistic regression models, likewise, the association between psychotherapy duration and RTW (dependent variable) among temporary DP recipients was examined.Results Higher SES, female gender, and younger age were positively associated with attending longer psychotherapies and surpassing the early treatment termination level (>10 sessions). Attending 11-60 psychotherapy sessions was positively associated with full RTW and partial RTW, whereas longer psychotherapies were not. Early termination was positively associated with partial RTW only.Conclusion This study demonstrates varying tendencies among CMD patients from different backgrounds to attend long rehabilitative psychotherapies, which may create inequalities in RTW.

Therapeutic comparison in psychological capital

Aim

This study aimed to investigate and compare the therapeutic outcomes of psychological capital between narrative therapy, cognitive-behavioral therapy, and play therapy in the context of hikikomori.

Methods

This study included 502 hikikomori. Correlation analysis was performed to investigate the relationship between the three forms of therapy and psychological capital, while one-way ANOVA and independent samples t-tests were performed to determine the differences in the outcomes of psychological capital between the three forms of therapies.

Results

Results indicated that all three forms of therapy were significantly positively related to psychological capital. Moreover, while cognitive-behavioral therapy performed better in psychological capital (overall score) than the other two, cognitive-behavioral therapy performed better in the subscales "self-efficacy" and "resilience," while narrative therapy performed better in the "hope" and "optimism" subscales. Also, combining features of play therapy helped enhance the outcomes of narrative therapy and cognitive-behavioral therapy on psychological capital.

Conclusion

Owing to the varied outcomes of psychological capital among different therapies, the differential use of therapies to deal with the unique needs resultant of hikikomori helps achieve optimal results.

Score für Psychotherapieeignung kann Prädiktor für Therapieabbrüche sein

Woran liegt es, wenn ein Patient eine Psychotherapie abbricht? Intuitiv einleuchtend erscheint, dass dabei persönliche Faktoren, Faktoren einer psychischen Erkrankung oder ihrer Folgen und nicht zuletzt auch das Stigma psychischer Erkrankungen eine wichtige Rolle spielen. Zu erfassen, welche zugrundeliegenden Faktoren es gibt kann die Voraussetzung sein, um diese Variablen zu ändern und damit Therapieabbrüche zu minimieren.