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Jubenville-Wood T, Nicholas DB, Weiss J, Cairns S. Mental Health Providers' Perspectives on What Helps and Hinders in Psychotherapy for Autistic Adults with Co-occurring Mental Health Problems. J Autism Dev Disord 2024; 54:4311-4324. [PMID: 37856002 DOI: 10.1007/s10803-023-06143-y] [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] [Accepted: 09/18/2023] [Indexed: 10/20/2023]
Abstract
Autistic adults experience disproportionate rates of co-occurring mental health problems. Psychotherapy has been recognized as an appropriate treatment approach, but evidence is limited. Researchers used a qualitative research paradigm to explore the experiences of mental health providers who provide psychotherapy to autistic adults. The Enhanced Critical Incident Technique was used to interview 13 mental health providers regarding perceptions of facilitating therapy with autistic adults. This research highlights challenges to providing psychotherapy to autistic adults while also illuminating ways that mental health providers have worked to ameliorate such challenges and create positive experiences in therapy. This research also contrasts therapy for autistic adults relative to the general population. Practice recommendations and suggestions for future research are offered.
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Flückiger C, Munder T, Schürmann-Vengels J. [Learning Evidence-Based Practice - Multi-Perspective Competence Development using the Example of Generalised Anxiety Disorder]. Psychother Psychosom Med Psychol 2024. [PMID: 39303744 DOI: 10.1055/a-2382-7598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
Within the framework of the evidence-based practice model of the American Psychological Association (APA, 2006), psychotherapeutic core competences are mostly formulated transdiagnostically and transtheoretically, but do not exclude the systematic consideration of symptom-specific aspects. This article provides an exemplary case study of a person suffering from a generalized anxiety disorder to illustrate how evidence-based practice can be implemented. Multi-perspective competence development can be stimulated in training through the following therapeutic areas: (1) through broad assessment and psychodiagnostics, (2) through joint development of an individual explanatory model, (3) through inclusion of symptom-specific models, (4) through broad consideration of stringent interventions, (5) through application of various treatment modalities, (6) through patient-centred treatment implementation. The article concludes with a list of study examples of how psychotherapeutic competence development can be researched within the framework of the evidence-based practice model.
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Bharadwaj SV, Rhoades EA, Perry H. Consideration of Demographic Variables in Behavioral Interventions Pertaining to Children With Hearing Loss: A Systematic Review. Am J Audiol 2024; 33:991-1007. [PMID: 38861427 DOI: 10.1044/2024_aja-23-00208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
PURPOSE Equitable representation of children with hearing loss who are members of marginalized or minority groups in behavioral intervention studies enhances inclusivity in the scientific process and generalizability of results. The goal of this systematic review was to ascertain the percentage of studies conducted in the United States in the past 2 decades that reported relevant demographic variables. METHOD Studies were searched across eight databases and clinical trial registries in October 2022. Variations of the following search strings were used to retrieve peer-reviewed published studies and unpublished clinical trials: children, hearing loss, and intervention. RESULTS Thirty-nine intervention studies met the inclusion criteria. The selected studies were reviewed and coded for the following demographic variables: area and type of intervention, participant age, hearing technology data, sample size, gender, race/skin color and ethnicity, primary/home language(s), additional disabilities, parental education, family income, and parental occupation. Results revealed that many demographic variables were remarkably underreported, with parental education, family income, and parental occupation variables being the least reported data. CONCLUSIONS Demographic data can be an important tool for changing disparities related to intervention outcomes. This systematic review suggests that inclusive research practices should be extended to low-literacy or low-economic resources, non-White, and non-English-speaking groups. Inclusion practices coupled with sufficient sample sizes will ultimately aid in identifying hearing health disparities.
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Affiliation(s)
- Sneha V Bharadwaj
- Department of Communication Sciences and Oral Health, Texas Woman's University, Denton
| | | | - Haley Perry
- Department of Communication Sciences and Oral Health, Texas Woman's University, Denton
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Lutz W, Schaffrath J, Eberhardt ST, Hehlmann MI, Schwartz B, Deisenhofer AK, Vehlen A, Schürmann SV, Uhl J, Moggia D. Precision Mental Health and Data-Informed Decision Support in Psychological Therapy: An Example. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:674-685. [PMID: 38099971 PMCID: PMC11379786 DOI: 10.1007/s10488-023-01330-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 09/08/2024]
Abstract
Outcome measurement including data-informed decision support for therapists in psychological therapy has developed impressively over the past two decades. New technological developments such as computerized data assessment, and feedback tools have facilitated advanced implementation in several seetings. Recent developments try to improve the clinical decision-making process by connecting clinical practice better with empirical data. For example, psychometric data can be used by clinicians to personalize the selection of therapeutic programs, strategies or modules and to monitor a patient's response to therapy in real time. Furthermore, clinical support tools can be used to improve the treatment for patients at risk for a negative outcome. Therefore, measurement-based care can be seen as an important and integral part of clinical competence, practice, and training. This is comparable to many other areas in the healthcare system, where continuous monitoring of health indicators is common in day-to-day clinical practice (e.g., fever, blood pressure). In this paper, we present the basic concepts of a data-informed decision support system for tailoring individual psychological interventions to specific patient needs, and discuss the implications for implementing this form of precision mental health in clinical practice.
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Affiliation(s)
- Wolfgang Lutz
- Department of Psychology, Trier University, Trier, 54296, Germany.
| | - Jana Schaffrath
- Department of Psychology, Trier University, Trier, 54296, Germany
| | | | | | - Brian Schwartz
- Department of Psychology, Trier University, Trier, 54296, Germany
| | | | - Antonia Vehlen
- Department of Psychology, Trier University, Trier, 54296, Germany
| | | | - Jessica Uhl
- Department of Psychology, Trier University, Trier, 54296, Germany
| | - Danilo Moggia
- Department of Psychology, Trier University, Trier, 54296, Germany
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Plasencia M, Farris SG, Wilson GT. Clinician Knowledge of and Attitudes Toward Guided Self-Help. Behav Ther 2024; 55:922-934. [PMID: 39174270 DOI: 10.1016/j.beth.2024.01.006] [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: 12/07/2022] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 08/24/2024]
Abstract
The current study evaluated knowledge of and attitudes toward guided self-help (GSH) among clinicians who use evidence-based practices to treat one or more of the following: panic disorder, major depressive disorder, bulimia nervosa, binge-eating disorder, and generalized anxiety disorder. A total of 153 of 256 individuals recruited online and at professional conferences were eligible. This study assessed prior experience with and knowledge of GSH, as well as hypothetical use with a mock patient. Less than 20% of clinicians had ever used GSH, and fewer had used it as a stand-alone treatment. Given a mock patient reporting moderate symptoms, clinicians indicated a 53.62% likelihood that they would use GSH. Exploratory analyses indicated that hypothetical use was predicted by prior use of GSH as well as the Openness subscale of the Evidence-Based Practice Attitude Scale. Study findings suggest that clinicians using evidence-based practices do not uniformly know of or endorse the use of GSH. Lack of training in GSH was one of the most frequently endorsed barriers to implementing GSH in clinical practice (n = 99, 64%). These findings have implications for the use of therapy formats that scale evidence-based treatments in the United States.
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Affiliation(s)
- Maribel Plasencia
- Rutgers University; Center for Quality, Effectiveness and Safety; Michael E. DeBakey VA Medical Center; Baylor College of Medicine; and South Central Mental Illness Research, Education and Clinical Center.
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Harnas SJ, Knoop H, Sprangers MAG, Braamse AMJ. Defining and operationalizing personalized psychological treatment - a systematic literature review. Cogn Behav Ther 2024; 53:467-489. [PMID: 38535891 DOI: 10.1080/16506073.2024.2333345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
This systematic literature review aimed to propose a definition of personalized psychological treatment and to suggest how the definition can be operationalized. PsycINFO, Cochrane Library, MEDLINE and EMBASE were searched up to 11 December 2023 for studies in which a definition of personalized psychological treatment was included or a systematic operationalization of personalized psychological treatment was described. Based on a narrative synthesis of the collected definitions, summary categories were developed that informed the proposed definition. Operationalizations were described according to what aspect of treatment, how and when treatment was personalized. The extent to which the operationalizations deviated from the proposed definition was assessed. Thirty-four studies with definitions and 200 with operationalizations were included. The following definition was proposed: personalized psychological treatment aims to optimize treatment outcome for the individual patient by tailoring treatment to unique or specific needs, preferences or other characteristics and includes a systematic adaptation of treatment or a differentiation between treatment strategies. Based on the operationalizations, timing of personalization, specification of the systematic approach and treatment elements that could be personalized were added to the proposed definition. Evidence-based personalization of psychological treatments can be enhanced by clear operationalization based on a comprehensive definition of personalization.
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Affiliation(s)
- Susan J Harnas
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annemarie M J Braamse
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
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Thakur H, Choi JW, Andrews AR, Temple JR, Cohen JR. Measurement of adolescent psychological wellbeing: A test of factor structure and measurement invariance. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:734-744. [PMID: 38561961 DOI: 10.1111/jora.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/15/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024]
Abstract
Gains in holistic approaches to adult mental health have been associated with increasing interest in understanding psychological wellbeing (PWB) among adolescents. Empirical examination of measurement models for PWB in adolescence is lacking. Thus, the current study examined PWB in a longitudinal, diverse sample of 433 adolescents (non-Latinx Black: 37.6%; non-Latinx White: 25.9%; Latinx: 36.5%; Male adolescents: 50.1%). A one-factor, correlated six-factor and hierarchical models were examined across racial/ethnic (White, Black, and Hispanic) and gender (female, male) identities, after which the best fitting model was selected to undergo invariance testing. A one-factor structure was superior, and exhibited strict invariance across racial/ethnic and gender identities at each wave of the study, as well as longitudinal invariance within the entire sample.
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Affiliation(s)
- Hena Thakur
- Department of Psychology, University of Illinois at Urbana - Champaign, Champaign, Illinois, USA
| | - Jae Wan Choi
- Department of Psychology, University of Illinois at Urbana - Champaign, Champaign, Illinois, USA
| | - Arthur R Andrews
- Department of Psychology and Institute for Ethnic Studies, University of Nebraska - Lincoln, Lincoln, Nebraska, USA
| | - Jeff R Temple
- School of Behavioral Health Sciences, UTHealth, Houston, Texas, USA
| | - Joseph R Cohen
- Department of Psychology, University of Illinois at Urbana - Champaign, Champaign, Illinois, USA
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Solberg Kleiven G, Hjeltnes A, Brattland H, Moltu C. Moments of change: Clients' immediate experiences when sharing emotions in psychotherapy. Psychother Res 2024; 34:872-884. [PMID: 37748195 DOI: 10.1080/10503307.2023.2260938] [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: 06/26/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE In-session processing of emotions is important in facilitating psychotherapeutic change. This study explores how clients in active treatment experience inner changes when sharing emotions in psychotherapy sessions. The aim was to retrieve in-depth knowledge about clients' moment-by-moment experiences of change in a naturalistic psychotherapy context. METHOD Two psychotherapy sessions (session 3 or 4 and session 7 or 8) were videotaped and immediately followed by semi-structured interviews with clients (n = 11) in the format of Interpersonal Process Recall (IPR). Interviews were analysed using thematic analysis. RESULTS Four themes resulted from analysis: (1) reaching a new clarity about inner struggles; (2) a shift in how I approach and experience my feelings; (3) grieving losses and gaining a more positive understanding of myself; (4) feeling relief and liberation when allowing difficult emotions. CONCLUSION The resulting themes took into account the importance of the felt quality of change experiences within sessions, which appears to be important in making micro-processes of change salient. Across themes, we found accounts of shifts in awareness and self-compassion, which we discuss as micro-outcomes that clients can ideally be guided to dwell with.
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Affiliation(s)
| | - Aslak Hjeltnes
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Heidi Brattland
- Nidelv Mental Health Center, St.Olavs University Hospital, Trondheim, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
- Department of Health and Caring Sciences, Western Norway University of Applied Science, Førde, Norway
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Henderson CE, Woodard GS, Simmonds-Buckley M, Christensen M, Jensen-Doss A, Douglas S, Delgadillo J. Prediction of adolescent psychotherapy outcomes using youth- and caregiver-reported symptoms data. Psychother Res 2024:1-13. [PMID: 39212169 DOI: 10.1080/10503307.2024.2394187] [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] [Received: 12/02/2023] [Revised: 08/01/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE We used longitudinal youth- and caregiver-reports of adolescent psychological symptoms from three samples of youth receiving mental health services in routine treatment settings to derive expected change trajectories and identify cases at risk for treatment failure. METHOD Participants were 1906 youth (1053 caregivers) receiving treatment in community mental health settings, merged across three samples. The Symptoms and Functioning Severity Scale (SFSS) was used as an indicator of weekly clinical change. Multilevel modeling methods were used to develop expected change trajectories and identify cases at risk for treatment failure (not on track; NOT). Logistic regression was used to predict client improvement as a function of NOT status. RESULTS The SFSS was a reliable indicator of therapeutic change according to youth-reported symptoms. Caregiver reports were not as robust. Whereas predictive accuracy of NOT status yielded moderately high sensitivity in detecting improvement according to youth report, caregiver reports were not as predictive. CONCLUSIONS The youth-reported version of the SFSS-based algorithm seems appropriate for implementation in clinical care. Future studies should search for similarly predictive measures for caregivers.
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Affiliation(s)
- Craig E Henderson
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, USA
| | - Grace S Woodard
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Maxwell Christensen
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Susan Douglas
- Department of Leadership, Policy and Organizations, Vanderbilt University, Nashville, TN, USA
| | - Jaime Delgadillo
- Department of Psychology, Clinical Psychology Unit, University of Sheffield, Sheffield, UK
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Becker KD, Wu EG, Westman JG, Boyd MR, Guan K, Lakind D, Chu W, Knudsen KS, Bradley WJ, Park AL, Kenworthy LaMarca T, Lang E, Chorpita BF. The Interrater Reliability of a Coding System for Measuring Mental Health Professionals' Decisions and Actions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-17. [PMID: 39137271 DOI: 10.1080/15374416.2024.2384027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
OBJECTIVE The clinical decisions and actions of evidence-based practice in psychology (EBPP) are largely underspecified and poorly understood, in part due to the lack of measurement methods. We tested the reliability of a behavioral coding system that characterizes a flow of interrelated activities that includes problem detection and prioritization, intervention selection and implementation, and review of intervention integrity and impact. METHOD The context included two publicly funded youth mental health service organizations located in geographically distinct and underresourced communities in the U.S. where service inequities are common. We sampled 84 digitally recorded and transcribed supervision events that included a sample of professionals who were mostly women (93.02%) and BIPOC (86.04%) whose self-reported race/ethnicity matched the youth populations they served. We coded these events for activities (e.g., considering) and their predicate content (i.e., problems or practices) and examined reliability of these codes applied to excerpts (i.e., small contiguous units of dialogue) as well as to complete events. RESULTS Interrater reliability estimates showed that, overall, coders reliably rated the occurrence and extensiveness of activities and content. Excerpt coding was generally more reliable than event coding. However, mathematical aggregation of excerpt coding offered a superior method for estimating event codes reliably, reducing individual subjectivity while providing event level synthesis of activities that are grounded in excerpt level details. CONCLUSIONS The assessment of clinical decisions and actions has the potential to unpack the black box of EBPP, with different methods best suited to different research questions and resource considerations.
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Affiliation(s)
| | - Eleanor G Wu
- Department of Psychology, University of South Carolina
| | | | | | - Karen Guan
- Department of Psychology, University of California
| | | | - Wendy Chu
- Department of Psychology, University of South Carolina
| | | | | | | | | | - Emily Lang
- Department of Psychology, University of California
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Lyons GA, Zettle RD, Petts RA. Investigating Determinants of Client Psychotherapy Preference: An Analog Study. J Cogn Psychother 2024; 38:227-242. [PMID: 38991741 DOI: 10.1891/jcp-2022-0041] [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] [Indexed: 07/13/2024]
Abstract
Increased emphasis has been placed on elucidating the contribution of client variables, such as treatment preference, to optimize evidence-based practice. This analog study sought to better understand variables associated with treatment preference using a convenience sample of college students (n = 54) who read brief descriptions of three interventions for negative thoughts-defusion, noticing, and restructuring. They rated each on acceptability and practicality and completed measures of cognitive fusion, emotional distress, and experiential avoidance as possible moderating variables. Restructuring was overwhelmingly preferred and rated as more acceptable than the two alternatives by both the overall sample and a distressed subsample. Preference for defusion or noticing was not predicted by ratings of acceptability or practicality but by elevated levels of cognitive fusion and emotional distress consistent with a compensation model. Limitations of the study and its implications for further research on psychotherapy preference and its integration within evidence-based practice are discussed.
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Affiliation(s)
- Grace A Lyons
- Department of Psychology, Wichita State University, Wichita, KS, USA
| | - Robert D Zettle
- Department of Psychology, Wichita State University, Wichita, KS, USA
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Coronado-Montoya S, Abdel-Baki A, Crockford D, Côté J, Dubreucq S, Dyachenko A, Fischer B, Lecomte T, L’Heureux S, Ouellet-Plamondon C, Roy MA, Tibbo P, Villeneuve M, Jutras-Aswad D. Preferences of Young Adults With Psychosis for Cannabis-Focused Harm Reduction Interventions: A Cross-Sectional Study: Préférences des jeunes adultes souffrant de psychose pour les interventions de réduction des méfaits axées sur le cannabis : une étude transversale. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:524-535. [PMID: 38571478 PMCID: PMC11168346 DOI: 10.1177/07067437241242395] [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: 04/05/2024]
Abstract
OBJECTIVES Cannabis use is common in people with early-phase psychosis (EP) and is associated with worse treatment outcomes. Few targeted interventions for cannabis use behaviour in this population exist, most focusing on abstinence, none focusing on harm reduction. Many people with EP will not seek treatment for their cannabis use with current therapeutic options. Understanding preferences for cannabis-focused harm reduction interventions may be key to improving outcomes. This study aimed to determine preferences of young adults with EP who use cannabis for cannabis-focused harm reduction interventions. METHODS Eighty-nine young adults across Canada with EP interested in reducing cannabis-related harms were recruited. An online questionnaire combining conventional survey methodology and two unique discrete choice experiments (DCEs) was administered. One DCE focused on attributes of core harm reduction interventions (DCE 1) and the second on attributes of boosters (DCE 2). We analysed these using mixed ranked-ordered logistic regression models. Preference questions using conventional survey methodology were analysed using summary statistics. RESULTS Preferred characteristics for cannabis-focused harm reduction interventions (DCE 1) were: shorter sessions (60 min vs. 10 min, odds ratio (OR): 0.72; P < 0.001); less frequent sessions (daily vs. monthly, OR: 0.68; P < 0.001); shorter interventions (3 months vs. 1 month, OR: 0.80; P < 0.01); technology-based interventions (vs. in-person, OR: 1.17; P < 0.05). Preferences for post-intervention boosters (DCE 2) included opting into boosters (vs. opting out, OR: 3.53; P < 0.001) and having shorter boosters (3 months vs. 1 month, OR: 0.79; P < 0.01). Nearly half of the participants preferred to reduce cannabis use as a principal intervention goal (vs. using in less harmful ways or avoiding risky situations). CONCLUSIONS Further research is required to see if technology-based harm reduction interventions for cannabis featuring these preferences translate into greater engagement and improved outcomes in EP patients.
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Affiliation(s)
- Stephanie Coronado-Montoya
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Department of Psychiatry, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - David Crockford
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - José Côté
- Research Centre, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Simon Dubreucq
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Alina Dyachenko
- Research Centre, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Benedikt Fischer
- Centre for Applied Research in Addiction and Mental Health, Simon Fraser University, Vancouver, Canada
- Research & Graduate Studies Division, University of the Fraser Valley, Abbotsford, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- School of Population Health, University of Auckland, Auckland, New Zealand
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Tania Lecomte
- Department of Psychology, University of Montréal, Montréal, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | - Sophie L’Heureux
- Clinique Notre-Dame des Victoires, Institut Universitaire en Santé Mentale, Centre Intégré Universitaire de Soins et Services Sociaux de la Capitale Nationale, Québec, Canada
- Department of Psychiatry and Neurosciences, Laval University, Québec, Canada
| | - Clairélaine Ouellet-Plamondon
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Department of Psychiatry, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Marc-André Roy
- Department of Psychiatry and Neurosciences, Laval University, Québec, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Québec, Québec, Canada
- Centre de Recherche CERVO, Québec, Canada
| | - Philip Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Marie Villeneuve
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Department of Psychiatry, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- University Institute on Addictions, Montréal, Canada
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Di Malta G, Cooper M, Bond J, Raymond-Barker B, Oza M, Pauli R. The Patient-Perceived Helpfulness of Measures Scale: Development and Validation of a Scale to Assess the Helpfulness of Using Measures in Psychological Treatment. Assessment 2024; 31:994-1010. [PMID: 37767908 PMCID: PMC11134981 DOI: 10.1177/10731911231195837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
In response to the increase in Routine Outcome Monitoring and Clinical Feedback, the Patient-Perceived Helpfulness of Measures Scale (ppHMS) was developed to assess the helpfulness-as perceived by patients-of using measures in psychological treatment. Study 1: The construct of patient-perceived helpfulness of measures was explored using thematic analysis with 15 patients. Six helpful and three unhelpful themes were identified and informed item development. Study 2: 28 items were formulated and rated by experts. Ten items were taken forward for psychometric shortening in a sample of 76 patients. Confirmatory factor analysis (CFA) led to an adequately fitting six-item model with excellent internal consistency, and convergence with the Delighted-Terrible single item of product satisfaction and a single item of measure helpfulness. Study 3: In a stratified online sample of 514 U.K. psychotherapy patients, a five-item model constituted the best fit. The final ppHMS had excellent internal consistency (McDonald's ω = .90), convergent validity with psychotherapy satisfaction (r = .5; p < .001), divergence from social desirability (r = .1), and metric and scalar invariance across measures. Study 4: Analyses were replicated and confirmed in a stratified U.S. sample (n = 602). The ppHMS is a reliable and valid scale that can be used to assess and compare patients' perceptions of the helpfulness of different measures as part of their psychological treatment.
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14
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Vázquez Morejón AJ, Felipe González C, Muñoz Caracuel MA, Vázquez-Morejón R. Psychosocial factors associated with treatment preference in mental health. Int J Soc Psychiatry 2024; 70:818-827. [PMID: 38439521 DOI: 10.1177/00207640241236105] [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] [Indexed: 03/06/2024]
Abstract
BACKGROUND Studies examining the effects of incorporating patients' preferences into treatment outcomes highlight their impact on crucial aspects such as reduced dropout rates and enhanced effectiveness. Recognizing individuals' rights to participate in decisions about their treatments underscores the importance of studying treatment preferences and the factors influencing these choices. AIM This study aims to identify treatment preferences (psychological, pharmacological, or combined) among a sample of patients and to discern the psychosocial and clinical factors influencing these preferences. METHODS A total of 2,133 individuals receiving care at a community mental health unit completed assessments on anxious-depressive symptoms, social and occupational adjustment, and their treatment preference. Data analysis was conducted using SPSS, with descriptive statistics, Chi-square tests, and one-way ANOVA applied. RESULTS Preferences for treatments were distributed as follows: Combined (49.8%), psychological (33%), and pharmacological (10.6%). Factors such as diagnosis, severity of depressive and anxious symptoms, and functional impact were related to treatment preference with a moderate effect size. Meanwhile, various sociodemographic factors correlated with the selected treatment, though with a weak effect size. CONCLUSIONS There is a pronounced preference for combined treatments. The significance of psychological treatments is evident, as four out of five participants favored them in their choices. Addressing these preferences calls for an exploration within the broader context of prescription freedom in mental health.
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Affiliation(s)
- Antonio J Vázquez Morejón
- Hospital Universitario Virgen del Rocío, Seville, Andalucía, Spain
- University of Seville, Seville, Spain
| | | | | | - Raquel Vázquez-Morejón
- Grupo de Investigación Comportamientos Sociales y Salud, University of Seville, Seville, Spain
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Hadjistavropoulos HD, McCall HC, Dear BF, Beahm JD, Carleton RN, Titov N. Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study. J Anxiety Disord 2024; 104:102861. [PMID: 38640867 DOI: 10.1016/j.janxdis.2024.102861] [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: 05/17/2023] [Revised: 01/07/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment for various mental health concerns. Canadian PSP report favorable attitudes toward ICBT, and preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted of a longitudinal observational study of 560 Canadian PSP who participated in ICBT. It was designed to assess the longer term effectiveness of ICBT and moderators of outcomes by gender, linguistic and occupational group, and years of occupational experience. We evaluated symptom change at 8, 26, and 52 weeks post-enrollment, and results among PSP who had elevated clinical scores, showed large reductions (Hedges' g) in symptoms of depression (g = 1.3), anxiety (g =1.48), posttraumatic stress (g =1.24), panic (g =1.19), and anger (g =1.07) and moderate reductions in symptoms of social anxiety (g =.48-.56). Moderator analyses revealed modest differences in pre-treatment symptoms among certain groups but no group differences in symptom change over time. Clients showed good completion of treatment materials and reported high treatment satisfaction. The results suggest further study of ICBT tailored to PSP is warranted, including evaluating ICBT tailored for PSP in other countries.
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Affiliation(s)
- Heather D Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada.
| | - Hugh C McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Blake F Dear
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - Janine D Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nickolai Titov
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
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16
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Rief W, Asmundson GJG, Bryant RA, Clark DM, Ehlers A, Holmes EA, McNally RJ, Neufeld CB, Wilhelm S, Jaroszewski AC, Berg M, Haberkamp A, Hofmann SG. The future of psychological treatments: The Marburg Declaration. Clin Psychol Rev 2024; 110:102417. [PMID: 38688158 DOI: 10.1016/j.cpr.2024.102417] [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: 09/28/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Abstract
Although psychological treatments are broadly recognized as evidence-based interventions for various mental disorders, challenges remain. For example, a substantial proportion of patients receiving such treatments do not fully recover, and many obstacles hinder the dissemination, implementation, and training of psychological treatments. These problems require those in our field to rethink some of our basic models of mental disorders and their treatments, and question how research and practice in clinical psychology should progress. To answer these questions, a group of experts of clinical psychology convened at a Think-Tank in Marburg, Germany, in August 2022 to review the evidence and analyze barriers for current and future developments. After this event, an overview of the current state-of-the-art was drafted and suggestions for improvements and specific recommendations for research and practice were integrated. Recommendations arising from our meeting cover further improving psychological interventions through translational approaches, improving clinical research methodology, bridging the gap between more nomothetic (group-oriented) studies and idiographic (person-centered) decisions, using network approaches in addition to selecting single mechanisms to embrace the complexity of clinical reality, making use of scalable digital options for assessments and interventions, improving the training and education of future psychotherapists, and accepting the societal responsibilities that clinical psychology has in improving national and global health care. The objective of the Marburg Declaration is to stimulate a significant change regarding our understanding of mental disorders and their treatments, with the aim to trigger a new era of evidence-based psychological interventions.
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Affiliation(s)
- Winfried Rief
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany.
| | | | - Richard A Bryant
- University of New South Wales, School of Psychology, Sydney, New South Wales, Australia
| | - David M Clark
- University of Oxford, Department of Experimental Psychology, Oxford, UK
| | - Anke Ehlers
- University of Oxford, Department of Experimental Psychology, Oxford, UK
| | - Emily A Holmes
- Uppsala University, Department of Women's and Children's Health, Uppsala, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Solna, Sweden
| | | | - Carmem B Neufeld
- University of São Paulo, Department of Psychology, Ribeirão Preto, SP, Brazil
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard School of Medicine, Boston, USA
| | - Adam C Jaroszewski
- Massachusetts General Hospital and Harvard School of Medicine, Boston, USA
| | - Max Berg
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany
| | - Anke Haberkamp
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany
| | - Stefan G Hofmann
- Philipps-University of Marburg, Department of Psychology, Translational Clinical Psychology Group, Marburg, Germany
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17
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Ogle LN, Garman-McClaine BA, Ruble LA. Intervention Plan Quality Matters: Using COMPASS to Collaboratively Develop Student-Centered, Evidence-based Intervention Plans using an EBPP Approach. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2024; 34:265-289. [PMID: 39072267 PMCID: PMC11280249 DOI: 10.1080/10474412.2024.2352464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/03/2024] [Indexed: 07/30/2024]
Abstract
The quality of interventions for children with autism has improved thanks in part to the widespread dissemination of evidence-based practices (EBPs); however, teachers still report challenges developing focused interventions targeting the core challenges of students with autism. Tested in three randomized trials, COMPASS is a consultation-based implementation strategy that prioritizes shared decision-making in the development of goals and intervention plans using an evidence-based practice in psychology approach. To successfully train COMPASS consultants, a 16-item Intervention Plan Quality Scale (IPQS) was developed and tested with a set of nine school-based COMPASS-trained consultants who provided a total of 28 consultations. Results revealed that the IPQS had acceptable reliability and concurrent validity and was successful in helping consultant trainees develop high-quality plans over four feedback sessions. Overall, the IPQS was helpful for fidelity monitoring and appears to partially mediate child goal attainment outcomes through teacher adherence implementing the intervention plans.
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Affiliation(s)
| | | | - Lisa A Ruble
- Ball State University, Department of Special Education
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18
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Srivastava R, Choudhury PK, Dev SK, Rathore V. Alpha-pine self-emulsifying nano formulation attenuates rotenone and trichloroethylene-induced dopaminergic loss. Int J Neurosci 2024:1-18. [PMID: 38598315 DOI: 10.1080/00207454.2024.2341916] [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: 03/12/2022] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
AIM The current investigation's goals are to pharmacologically evaluate the neurotherapeutic role of the bioactive compound Alpha Pinene (ALP)-loaded Self-emulsifying nano-formulation (SENF) in neurotoxin (Rotenone and the Industrial Solvent Trichloroethylene)- induced dopaminergic loss. It is believed that these models simulate important aspects of the molecular pathogenesis of Parkinson's disease. MATERIAL AND METHODS The ALP-nano-formulation's anti-Parkinson's activity was compared to ALP suspension in Wistar rats after rotenone and trichloro ethylene-induced dopaminergic loss. Neurobehavioral and motor performances were measured on the 14th, 21st, and 28th day in the rotenone model. However, in the trichloroethylene model, it was measured from the 4th to the 8th week. RESULTS Significant neurobehavioral improvement has been found in ALP-SENF treated animals then untreated and animals treated with plain ALP suspension. Furthermore, biochemical tests reveal marked expression of catalase, glutathione, and superoxide dismutase, which significantly combat the (Oxidative stress) OS-induced neurodegeneration. CONCLUSION The antioxidant effect of ALP-SENF likely includes free radicals neutralization and the activation of enzymes associated with antioxidant activity, leading to the enhancement of neurobehavioral abnormalities caused by rotenone and trichloroethylene.
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Affiliation(s)
- Rajnish Srivastava
- Chitkara University School of Pharmacy, Chitkara University, Himachal Pradesh, India
| | - Pratim Kumar Choudhury
- Department of Pharmacy, Pacific Academy of Higher Education and Research University, Rajasthan, India
| | - Suresh Kumar Dev
- Department of Pharmacy, Pacific Academy of Higher Education and Research University, Rajasthan, India
| | - Vaibhav Rathore
- Department of Pharmaceutical Sciences, Mohanlal Sukhadia University, Udaipur, India
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19
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Sapkota RP, Lozinski T, Wilhems A, Nugent M, Schaub MP, Keough MT, Sundström C, Hadjistavropoulos HD. Internet-delivered therapy for alcohol misuse: engagement, satisfaction, and outcomes when patients select their preference for therapist- or self-guided treatment. Addict Sci Clin Pract 2024; 19:30. [PMID: 38643242 PMCID: PMC11032586 DOI: 10.1186/s13722-024-00456-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/19/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Alcohol misuse is common and causes substantial harm. Internet-delivered cognitive behaviour therapy (ICBT) is effective in reducing alcohol misuse; however, the literature investigating how treatment outcomes are impacted by patients' preferences for therapist- versus self-guided ICBT for alcohol misuse is sparse. METHODS In this preference trial, 74 eligible patients (who reported ≥ 14 drinks in the previous week and obtained scores suggesting hazardous or harmful drinking) chose between enrolling in either therapist- or self-guided ICBT for alcohol misuse. We investigated whether those who chose therapist- versus self-guided ICBT differed in their (a) drinking outcomes-as measured by Timeline Follow-Back (TLFB) and heavy drinking days (HDD) at post-treatment and 3-month follow-up-and (b) post-treatment ICBT engagement and satisfaction. RESULTS The majority (81.1%) of eligible patients chose therapist-guided ICBT. These patients reported higher psychotropic medication use, drinking difficulties, and anxiety symptoms. For both the therapist- and self-guided patients, a modified intention-to-treat analysis revealed large within-group treatment effects for TLFB (β = - 2.64, SE 0.66; p < 0.001) and HDD (β = - 0.34, SE 0.07; p < 0.001), with large pre-to-post-treatment Cohen's effect sizes of d = 0.97 (95% CI [0.49, 1.45]) for TLFB and d = 1.19 (95% CI [0.69, 1.68]) for HDD. The interaction comparing the effects of therapist- to self-guided ICBT over time was not significant for TLFB (p = 0.34) or HDD (p = 0.06). With treatment, for both therapist- and self-guided patients, there was a significant improvement in drinking difficulties, cravings, and confidence with controlling cravings, as well as in anxiety, depression, and functional impairment. Further, the majority (75.7%) of patients completed five or more lessons, as well as reported overall satisfaction with the treatment (88.9%) and increased confidence in managing their symptoms (86.7%); these outcomes also did not differ between therapist- and self-guided patients. CONCLUSIONS The current study shows that ICBT for alcohol misuse is associated with reduced drinking and comorbid mental health difficulties over time, irrespective of whether patients chose to complete the course on their own or with therapist guidance. TRIAL REGISTRATION NUMBER NCT04611854 ( https://clinicaltrials.gov/ct2/show/NCT04611854 ).
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Affiliation(s)
- Ram P Sapkota
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Tristen Lozinski
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Andrew Wilhems
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Marcie Nugent
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christopher Sundström
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Norra Stationsgatan 69, 113 64, Stockholm, Sweden
| | - Heather D Hadjistavropoulos
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada.
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20
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Bernardi R, Eidlin M. Clinical Evidence, Triangulation of Perspectives and Contextualization. Part 1: The Beginning of Carla's Treatment. THE PSYCHOANALYTIC QUARTERLY 2024; 93:33-76. [PMID: 38578265 DOI: 10.1080/00332828.2024.2316218] [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: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 04/06/2024]
Abstract
We propose to critically evaluate and strengthen the level of clinical evidence in psychoanalysis, using a strategy of triangulating clinical phenomena from different perspectives and increasing contextual knowledge. Insufficient discussion of alternative hypotheses and limited contextual information are two Achilles heels of psychoanalytic case presentations. We examine the concept and quality standards of clinical evidence in psychoanalysis and related disciplines, with particular attention to the contribution of the three-level model (3-LM). We analyze the case of a patient treated with transference-focused psychotherapy (TFP), making explicit the theoretical-clinical agreements and disagreements of the authors. We discuss the strengths and limitations of triangulation and contextualization, concluding that they make clinical work and psychoanalytic writing more reliable, transparent, auditable, and replicable.
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Affiliation(s)
| | - Monica Eidlin
- Ricardo Bernardi Juan Benito Blanco 1285 Apto. 602 11 300 Montevideo Uruguay
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21
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Řiháček T, Elliott R, Owen J, Ladmanová M, Coleman JJ, Bugatti M. Session Reactions Scale-3: Initial psychometric evidence. Psychother Res 2024; 34:434-448. [PMID: 37549107 DOI: 10.1080/10503307.2023.2241983] [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: 10/31/2022] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/09/2023] Open
Abstract
Objective: This study aimed to develop an updated brief self-report post-session measure, suitable for collecting systematic feedback on clients' session reactions in the context of measurement-based care (MBC). Method: The Session Reactions Scale-3 (SRS-3; 33 items) was developed by extending and adjusting the Revised Session Reactions Scale. In Study 1, the psychometric properties of the SRS-3 were tested on N = 242 clients. In Study 2, a brief version of the SRS-3 (SRS-3-B; 15 items) was developed using a combination of conceptual, empirical, and pragmatic criteria. In Study 3, the psychometric properties of the SRS-3-B were tested on a new sample of N = 265 clients. Results: Exploratory factor analysis supported the use of the SRS-3-B as a two-factor (helpful reactions, hindering reactions) or unidimensional (overall session evaluation) instrument. The SRS-3-B was meaningfully related to another process measure (Individual Therapy Process Questionnaire) both on the item and factor levels. Conclusions: The SRS-3-B is a reliable process measure to elicit rich and clinically meaningful feedback from clients within the MBC context and as a research instrument to assess the helpful and hindering aspects of therapy sessions.
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Affiliation(s)
- Tomáš Řiháček
- Faculty of Social Studies, Department of Psychology, Masaryk University, Brno, Czech Republic
| | - Robert Elliott
- Counselling Unit, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Jesse Owen
- Counseling Psychology Department, Morgridge College of Education, University of Denver, Denver, CO, USA
| | - Michaela Ladmanová
- Faculty of Social Studies, Department of Psychology, Masaryk University, Brno, Czech Republic
| | - Jeremy J Coleman
- Department of Psychological Sciences, College of Science and Mathematics, Augusta University, Augusta, GA, USA
| | - Matteo Bugatti
- Counseling Psychology Department, Morgridge College of Education, University of Denver, Denver, CO, USA
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22
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Warwar S. The use of homework in emotion-focused therapy for depression. J Clin Psychol 2024; 80:744-761. [PMID: 38111154 DOI: 10.1002/jclp.23618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/20/2023] [Accepted: 10/24/2023] [Indexed: 12/20/2023]
Abstract
Emotion-focused therapy (EFT) is an empirically supported treatment of depression, and an integrative, transdiagnostic therapy approach focusing on transforming emotions that are the cause of a person's emotional pain and suffering. In-session experiential work and two-chair interventions are consolidated and expanded by between-session homework which is viewed as a natural extension of in-session work. As the focus on emotion in EFT necessitates the provision of a safe, attuned, empathic relationship and a good collaboration on the tasks and goals of therapy the use of homework is very well-suited to this approach. An EFT case example is discussed to illustrate how homework can be an important ingredient to strengthen and facilitate change in treating a depressed client with a core underlying feeling of shame related to unresolved childhood trauma.
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Affiliation(s)
- Serine Warwar
- Centre for Psychology and Emotional Health, Toronto, Ontario, Canada
- Greenberg Institute of Emotion-Focused Therapy, Toronto, Ontario, Canada
- Emotion-Focused Therapy Clinic, York University, Toronto, Ontario, Canada
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23
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Ghosh NR, Esmaeilinezhad Z, Zając J, Creasy RA, Lorenz SG, Klatt KC, Bala MM, Beathard KM, Johnston BC. Evidence-Based Practice Competencies among Nutrition Professionals and Students: A Systematic Review. J Nutr 2024; 154:1414-1427. [PMID: 38159813 PMCID: PMC11347811 DOI: 10.1016/j.tjnut.2023.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Evidence-based practice (EBP) promotes shared decision-making between clinicians and patients. OBJECTIVE The aim was to determine EBP competencies among nutrition professionals and students reported in the literature. METHODS We conducted a systematic review by searching Medline, Embase, CINAHL, ERIC, CENTRAL, ProQuest Dissertations and Theses Global, BIOSIS Citation Index, and clinicaltrials.gov up to March 2023. Eligible primary studies had to assess one of the 6 predefined EBP competencies: formulating clinical questions; searching literature for best evidence; assessing studies for methodological quality; effect size; certainty of evidence for effects; and determining the applicability of study results considering patient values and preferences. Two reviewers independently screened articles and extracted data, and results were summarized for each EBP competency. RESULTS We identified 12 eligible cross-sectional survey studies, comprising 1065 participants, primarily registered dietitians, across 6 countries, with the majority assessed in the United States (n = 470). The reporting quality of the survey studies was poor overall, with 43% of items not reported. Only 1 study (8%) explicitly used an objective questionnaire to assess EBP competencies. In general, the 6 competencies were incompletely defined or reported (e.g., it was unclear what applicability and critical appraisal referred to and what study designs were appraised by the participants). Two core competencies, interpreting effect size and certainty of evidence for effects, were not assessed. CONCLUSIONS The overall quality of study reports was poor, and the questionnaires were predominantly self-perceived, as opposed to objective assessments. No studies reported on competencies in interpreting effect size or certainty of evidence, competencies essential for optimizing clinical nutrition decision-making. Future surveys should objectively assess core EBP competencies using sensible, specific questionnaires. Furthermore, EBP competencies need to be standardized across dietetic programs to minimize heterogeneity in the training, understanding, evaluation, and application among dietetics practitioners. This study was registered at PROSPERO as CRD42022311916.
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Affiliation(s)
- Nirjhar R Ghosh
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Zahra Esmaeilinezhad
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Joanna Zając
- Department of Hygiene and Dietetics, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Rebecca A Creasy
- Department of Food Science and Technology, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Saundra G Lorenz
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Kevin C Klatt
- Department of Nutrition Sciences and Toxicology, University of California, Berkeley, CA, United States
| | - Malgorzata M Bala
- Department of Hygiene and Dietetics, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Karen M Beathard
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Bradley C Johnston
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States; Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, USA.
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Bertolín Guillén JM. Psychotherapies in current clinical psychology and psychiatry in Spain. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:59-63. [PMID: 32340885 DOI: 10.1016/j.rpsm.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 01/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The practice of psychotherapy in Spain (Europe) continues being a reason for doubts, uncertainty, controversy or confusion. The access to psychotherapy is also controversial. To contribute to clarify all this in order to improve quality and minimise risks is the aim of our work. METHOD Update of the regulations and legal rules which are applicable in psychotherapy to those graduated in both psychology and medicine. RESULTS AND DISCUSSION Neuroscience, clinical psychology and psychiatry develop in a parallel and convergent way. It is necessary to emphasise the risks of pseudotherapies, including pseudopsychotherapies, and pseudosciences in general. The practice of psychotherapy as a psychological treatment necessarily implies the healthcare field both for the private and public sectors. In order to practice as a psychotherapist in Spain, it is necessary to be a psychologist specialised in clinical psychology or a doctor specialised in psychiatry. The figure of the sanitary general psychologist is a regulated profession in Spain at present, but that is not equivalent to be a specialist. The former psychologists who have the required legal qualification are also allowed to act for the public sector in the healthcare field. Other doctors who are not psychiatrists, other psychologists or the nurses specialised in mental health are not allowed to name themselves or act as psychotherapists in any field or sector.
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Affiliation(s)
- José Manuel Bertolín Guillén
- Servicio de Psiquiatría y Salud Mental, Departamento de Salud Valencia-Arnau de Vilanova-Llíria, Valencia, Spain; Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain.
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25
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Aydin O. Rise of single-case experimental designs: A historical overview of the necessity of single-case methodology. Neuropsychol Rehabil 2024; 34:301-334. [PMID: 36811612 DOI: 10.1080/09602011.2023.2181191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
ABSTRACTWindelband ([1894]1980) advocated that two approaches are used for accumulating scientific knowledge. The first is the idiographic approach that derives knowledge from a single unit, and the second is the nomothetic approach that accumulates knowledge of a group. Given these two approaches, the former matches case studies while the latter is more appropriate with experimental group studies. Scientists have criticized both methodologies for their various limitations. Later, the single-case methodology emerged as an alternative that potentially allays these limitations. In this context, this narrative review aims to describe the historical roots of single-case experimental designs (SCEDs) that have emerged to eliminate the tension of nomothetic and idiographic approaches over time. First, the review focuses on the emergence of SCEDs. Second, the strengths and challenges of SCEDs are reviewed, including those to address the limitations of group experimental and case studies. Third, the use and analyses of SCEDs are outlined, considering their current status. Fourth, this narrative review continues to delineate the dissemination of SCEDs in the modern scientific world. As a result, SCEDs can be evaluated as a method that has the potential to overcome the issues encountered in case description and group experimental research. Thus, that helps accumulate nomothetic and idiographic knowledge in determining evidence-based practices.
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Affiliation(s)
- Orhan Aydin
- Faculty of Education, Erzincan Binali Yildirim University, Erzincan, Türkiye
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Bifano SM, Szeglin CJ, Garbers S, Gold MA. Emotional Freedom Techniques (EFT) Tapping for Pediatric Emergency Department Staff During the COVID-19 Pandemic: Evaluation of a Pilot Intervention. Med Acupunct 2024; 36:70-78. [PMID: 38665925 PMCID: PMC11040184 DOI: 10.1089/acu.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Objective Emergency-department (ED) staff may experience psychologic distress due to the stressful nature of their work. The COVID-19 pandemic exacerbated this distress. Emotional Freedom Techniques (EFT) tapping, a somatic psychophysiologic intervention combining vibratory acupressure with elements of cognitive-behavioral and exposure therapies, can reduce psychologic distress. This study tested the short-term effect of 10-minute EFT tapping on the psychologic distress of pediatric ED staff responding to COVID-19. Materials and Methods During the COVID-19 pandemic, diverse staff in the pediatric ED of a New York City teaching hospital participated in this single-group study. A licensed creative arts therapist led participants in 10-minute EFT tapping sessions. A self-report questionnaire with 7 items based on the Trauma Exposure Response framework was administered immediately pre- and postintervention. Standardized mean differences between both timepoints were calculated. Results There were statistically significant reductions for 6 of the 7 items studied, including stress (3.32-2.14), obsessive and intrusive thoughts (2.50-1.85), feelings of pressure (3.20-2.17), loneliness (1.84-1.44), and emotional and physical pain (2.28-1.70); all P < 0.001. No significant changes in professional satisfaction were reported following the intervention. Conclusions Despite the limitations of a single-arm study design, a 10-minute brief EFT tapping session was a promising way to reduce short-term psychologic distress in pediatric ED health care workers. Future studies, including rigorous randomized controlled trials, are needed to evaluate the effectiveness of brief EFT tapping interventions in other settings.
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Affiliation(s)
- Susanne M. Bifano
- Creative Arts Therapy, New York–Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | | | - Samantha Garbers
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melanie A. Gold
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Pediatric, Columbia University Irving Medical Center, New York, NY, USA
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de Moura JQ, Saratt MM, da Silva SCS, Silva VC, Murta SG, Habigzang LF. Adaptation and feasibility assessment of a dating violence prevention program for girls in foster care. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:9. [PMID: 38483652 PMCID: PMC10940555 DOI: 10.1186/s41155-024-00292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Dating violence in adolescence is a serious public health issue due to its significant impact on mental health and its significant predictive value for intimate partner violence in adulthood. Universal and selective programs can contribute to the prevention of this issue. Nonetheless, there are few selective programs with evidence of feasibility in contexts of social vulnerability. OBJECTIVE The present study examined evidence of the feasibility of a dating violence selective prevention program for girls in foster care by monitoring process indicators during the implementation phase of a pilot study. METHODS The program, originally designed for adolescents in the general population, was adapted to the context of girls at risk. The pilot study was conducted in the southern region of Brazil and involved the participation of six girls aged between 15 and 17. Both quantitative and qualitative measures were used, and the data were explored through frequency analysis, the Jacobson and Truax test, and content analysis. RESULTS The study identified favorable evidence regarding demand, acceptability, and adaptation of the intervention. On the other hand, contextual and institutional barriers hindered recruitment and restricted the reach of the intervention. CONCLUSION Although there are changes to be made to improve the program's applicability in its specific context, it should be emphasized that this study provides evidence to maintain the methods and content of the intervention.
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Affiliation(s)
- Julliane Quevedo de Moura
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil.
| | - Manoela Mosena Saratt
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil
| | | | - Victória Caroline Silva
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil
| | - Sheila Giardini Murta
- Departamento de Psicologia Clínica, Universidade de Brasília, SQN 606, Campus Universitário Darcy Ribeiro, ICC Sul, IP-PCL Asa Norte, Brasília, DF, 70910900, Brazil
| | - Luísa Fernanda Habigzang
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil
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Levenson JS, Grady MD, Lasoski H, Collins KT. Learning From Consumers of Mandated Sex-Offending Programs: "It's Not Treatment, I Wish It Was.". SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2024; 36:203-232. [PMID: 37078579 DOI: 10.1177/10790632231172158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The purpose of this qualitative study was to explore clients' perceptions of sex-offending treatment. The sample included 291 people required to register as sex offenders in the U.S. who answered an open-ended question in an online survey asking them to describe their positive and negative experiences in mandated treatment. Using qualitative analysis, three overarching themes (with several subthemes) were identified: (1) positive and (2) negative treatment experiences and (3) the affiliation between the criminal justice system and clinical services. Experiences in sex offending treatment were viewed as positive when clients had opportunities to learn about themselves, experience group cohesion, build a positive alliance with a caring therapist, learn tools and skills for emotional health, explore the roots of offense behavior, and create healthy life plans to reduce risk for re-offending. Negative themes emerged when treatments were viewed as coercive, confrontational, or demeaning; when therapists seemed inexperienced or unqualified; and when seemingly outdated or unscientific methods were emphasized without explanation or dialogue. The entanglement between court-mandated treatment providers and the criminal justice system led to concerns about confidentiality, conflicts of interest, and role ambiguity. Drawing upon literature related to therapeutic alliance, trauma-informed care, and Risk-Need-Responsivity models, we offer suggestions for integrating client feedback to improve treatment responsivity and prevent re-offending.
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Affiliation(s)
| | - Melissa D Grady
- National School of Social Service, The Catholic University of America, Washington, DC, USA
| | - Heike Lasoski
- National School of Social Service, The Catholic University of America, Washington, DC, USA
| | - Kyle T Collins
- National School of Social Service, The Catholic University of America, Washington, DC, USA
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Özer Ö, Köksal B, Altinok A. Understanding university students' attitudes and preferences for internet-based mental health interventions. Internet Interv 2024; 35:100722. [PMID: 38356613 PMCID: PMC10864831 DOI: 10.1016/j.invent.2024.100722] [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] [Received: 09/13/2023] [Revised: 01/04/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
Internet-based interventions are recognised as a practical approach to address mental health issues. The acceptance and utilisation of such interventions are closely linked to user attitudes and preferences. This study aims to examine the predictors of university students' attitudes towards internet-based interventions. Additionally, it seeks to elucidate students' preferences regarding crucial features of these interventions, such as the format, delivery mode, content type, and structural components, to understand better what makes these interventions appealing and practical for university students. A total of 273 university students (comprising 68 % females and 32 % males) participated in the study. The data collection instruments employed were the Personal Information Form, Internet-Based Intervention Preference Survey, E-therapy Attitude Measure (ETAM), Digital Literacy Scale, Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 (GAD-7). The data were analysed utilising descriptive statistics, Pearson correlation analysis, and multiple linear regression analysis. The multiple regression analysis revealed digital literacy as a predictive factor for attitudes towards internet-based interventions. Demographic variables, such as age and gender, and psychological variables, such as depression and anxiety levels, were found not to be associated with attitudes towards these interventions. While students are actively seeking mental health information online, a significant majority remain unaware of internet-based interventions. They show a preference for interventions offering greater human interaction, including face-to-face guidance and video content featuring people. Participants favour completing one or two sessions of the intervention weekly. Desired features of internet-based interventions include self-assessment scales, relatable characters, voice relaxation exercises, practical daily life activity tasks, and weekly reminders throughout the process. In conclusion, initiatives aimed at enhancing digital literacy levels could foster more positive attitudes towards internet-based interventions among students. Developers creating Internet-Based Interventions (IBI) for university students should consider these preferences.
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Affiliation(s)
- Ömer Özer
- Department of Social Work and Consultancy, Open Education Faculty, Anadolu University, Eskisehir, Turkiye
| | - Burak Köksal
- Counseling and Guidance Center, Gaziosmanpaşa University, Tokat, Turkiye
| | - Ahmet Altinok
- Department of Psychology, Experimental Psychology, University of Groningen, Groningen, the Netherlands
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De Vincenzo C, Stocco N, Modugno R. A Critical Sociocultural Understanding of Evidence-Based Research and Practice Paradigm in Contemporary Psychology. Integr Psychol Behav Sci 2024; 58:160-177. [PMID: 37553500 DOI: 10.1007/s12124-023-09798-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2023] [Indexed: 08/10/2023]
Abstract
The paper aims to develop a critical sociocultural understanding on the epistemological and historical analysis of evidence-based (EB) paradigm in contemporary psychological knowledge-production (research) and knowledge-application (practice). It firstly retraces the emergence of EB in medical disciplines, its paradigmatic status, and its subsequent adoption by mainstream psychological sciences. The description of EB historical roots and key concepts leads to the second part, where the paper reflects on key epistemological criticalities scholars have raised toward the EB paradigm. Then, we develop our sociocultural perspective to enrich the epistemological analysis and critique of EB. Specifically, we propose a hermeneutic and interpretative understanding which frames EB as a re-enactment of the positivist scientific research ambition to reach for a complete formalization of biological/psychological phenomena (endo-genetical dynamics), and of new socioeconomic, political, and individual needs posed by contemporary Western societal institutions to scientific knowledge (exo-genetical dynamics). Furthermore, building on such understanding, we suggest that EB works as a contemporary epistemic indicator and threshold, serving two functions: selective filtering and exclusion. Finally, we speculate that EB endo-genetical and exo-genetical developmental dynamics can be interpreted as an expression of the contemporary presentist regime of temporality and as a shift towards the regime of performative techniques instead of context-specific and future-oriented relational competences, also tracing a determining factor that has directed, directs and will continue to direct scientific research in psychology.
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Affiliation(s)
| | | | - Raffaele Modugno
- IBEF-International Centre of Excellence on Innovative Learning, Teaching Environments and Practices, Shanghai, China.
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31
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Låver J, McAleavey A, Valaker I, Castonguay LG, Moltu C. Therapists' and patients' experiences of using patients' self-reported data in ongoing psychotherapy processes-A systematic review and meta-analysis of qualitative studies. Psychother Res 2024; 34:293-310. [PMID: 37322037 DOI: 10.1080/10503307.2023.2222896] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE Using patient-generated quantitative data in psychotherapy (feedback) appears to enhance treatment outcome, but there is variability in its effect. Different ways and reasons to implement routine outcome measurement might explain such variability. The goal of this review is to address the insufficient knowledge on how these data are used by therapists and patients. METHODS The present study is a systematic review and meta-analysis of qualitative reports of therapists' and patients' experiences using patient-generated quantitative data during ongoing psychotherapy. RESULTS Four main categories of use were identified: (1) uses of patients' self-reported data as nomothetic/objective markers for assessment, process monitoring, and treatment planning; (2) intrapersonal uses that enhance self-awareness, initiate reflection, and influence patients' mood or responses; (3) uses that prompt interactional processes by facilitating communication, supporting exploration, creating ownership in patients, changing treatment focus, enhancing therapeutic alliance, or disturbing the psychotherapy process; and (4) patients responding for specific purposes due to uncertainty and interpersonal motives, or strategic responding to achieve a desired result. CONCLUSION These results demonstrate that patient-reported data, when used in active psychotherapy, is very clearly not just an objective measurement of client functioning: the inclusion of patient-data has the potential to influence psychotherapy in numerous ways.
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Affiliation(s)
- J Låver
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - A McAleavey
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- District General Hospital of Førde, Førde, Norway
| | - I Valaker
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - L G Castonguay
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | - C Moltu
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- District General Hospital of Førde, Førde, Norway
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Wucherpfennig F, Schwartz B, Rubel J. Towards a taxonomy of mechanisms of change? Findings from an expert survey on the association between common factors and specific techniques in psychotherapy. Psychother Res 2024; 34:398-411. [PMID: 37127943 DOI: 10.1080/10503307.2023.2206051] [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: 01/12/2023] [Accepted: 04/19/2023] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVE In the present study, we used structural equation modeling (SEM) to investigate the complex relationship between common factors, i.e., mechanisms of change, and specific factors, i.e., therapeutic techniques. METHOD N = 256 psychotherapy experts were asked to rate the appropriateness of 14 techniques commonly used in psychotherapy to facilitate five different common factors - resource activation, motivational clarification, self-management & emotion regulation, social competence, and therapeutic relationship. Using SEM, we defined techniques as indicators and common factors as latent variables. Data were split randomly into two subsets. Indicators were selected if three a priori defined criteria were met based on training data (n = 128). Subsequently, the goodness of model fit was assessed in the test data (n = 128). RESULTS The proposed model revealed adequate fit. All factor loadings were theoretically sound and significant in magnitude. Findings suggest that psychotherapy experts discriminate between common factors by their various associations with therapeutic techniques. CONCLUSION Suggestions are made, how therapeutic techniques are to be used to facilitate desirable change in the patient. Our model is a step towards a taxonomy of mechanisms of change that may help to improve research-informed decision-making.
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Affiliation(s)
| | - Brian Schwartz
- Department of Psychology, University of Trier, Trier, Germany
| | - Julian Rubel
- Department of Psychology, University of Giessen, Giessen, Germany
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Keenan EG, Gurba AN, Mahaffey B, Kappenberg CF, Lerner MD. Leveling Up Dialectical Behavior Therapy for Autistic Individuals with Emotion Dysregulation: Clinical and Personal Insights. AUTISM IN ADULTHOOD 2024; 6:1-8. [PMID: 38435330 PMCID: PMC10902278 DOI: 10.1089/aut.2022.0011] [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: 03/05/2024]
Abstract
Autistic people may experience high emotion and sensory sensitivities and a slow return to baseline emotional state. Dialectical behavior therapy (DBT) was developed to address reactivity, impulsivity, and mood dysregulation in individuals with mood and personality disorders. DBT may be therapeutically beneficial to autistic individuals struggling with these or similar emotional and sensory challenges. This article is a synthesis of the first author's experiences of DBT as an autistic person and professional insights from all authors. We provide an overview of the development of DBT, its foundational components, and adaptations. Using this basis, the first author describes the benefits DBT has had, the modifications that have helped him, and how those modifications may enhance DBT for autistic people. Modifications include visuals, graphics, and a gaming format that target the client's personal interests. The essence of these alterations is to transform life skills and DBT skills into something meaningful and functional. Receptivity of the therapist to the modifications and neurodivergent problem solving may be foundational to therapeutic success. Client-initiated contributions in collaborative therapy may improve autistic participants' understanding, validation, and adherence with DBT. The authors suggest expanding work on DBT modifications for autism in the areas of daily self-monitoring, assessing for preferred visual and gaming formats, and utilizing personal interests.
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Affiliation(s)
| | - Ava N. Gurba
- Stony Brook University, Stony Brook, New York, USA
| | | | - Catherine Faith Kappenberg
- University of California, Los Angeles, Los Angeles, California, USA
- Stony Brook University, Stony Brook, New York, USA
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Pfund RA, Boness CL, Tolin DF. Commentary: Emotional freedom techniques for treating post traumatic stress disorder: an updated systematic review and meta-analysis. Front Psychol 2024; 15:1308687. [PMID: 38464621 PMCID: PMC10921559 DOI: 10.3389/fpsyg.2024.1308687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Rory A. Pfund
- Department of Psychology, Tennessee Institute for Gambling Education & Research, Memphis, TN, United States
- Department of Psychology, The University of Memphis, Memphis, TN, United States
| | - Cassandra L. Boness
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, United States
| | - David F. Tolin
- Anxiety Disorders Center, Institute of Living, Hartford, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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von der Warth R, Rudolph M, Bengel J, Glattacker M. The association of early response with the outcome of psychosomatic rehabilitation in patients with mental disorders and its link to treatment and illness beliefs-A prospective longitudinal cohort study. Psychother Res 2024:1-16. [PMID: 38381978 DOI: 10.1080/10503307.2024.2316014] [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] [Received: 09/25/2023] [Accepted: 02/02/2024] [Indexed: 02/23/2024] Open
Abstract
Early response is considered to be an important predictor for therapy outcomes; yet little is known about its relevance in psychosomatic rehabilitation. This paper aims to describe the association of early response in psychosomatic rehabilitation, as well as the associations of early response with pre-rehabilitative factors such as illness and treatment beliefs. A longitudinal study with three measurement points was applied. Early response was defined using the percent improvement method after two weeks of treatment. Its association with therapy outcome and with illness and treatment beliefs was analyzed using multiple regression analyses. A total of 264 participants took part. Early response was a significant predictor of psychosomatic rehabilitation outcome, explaining an incremental variance of 1-30% after controlling for initial symptom burden. Illness and treatment beliefs predicted 6-20% variance in early response. Important illness beliefs referred to perceived symptoms, consequences and comprehensibility of the illness. Important treatment beliefs referred to expectations about rehabilitation structure, processes and concerns. Early response is associated with the therapy outcome of psychosomatic rehabilitation, with illness and treatment beliefs found to be associated with early response. Further research on the predictors of early response in psychosomatic rehabilitation is needed.
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Affiliation(s)
- Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Rudolph
- Deutsche Rentenversicherung Rheinland-Pfalz (German Statutory Pension Insurance Rhineland Palatinate), Mittelrhein-Klinik (Clinic for Psychosomatic Rehabilitation), Boppard-Bad Salzig, Germany
| | - Jürgen Bengel
- Section of Rehabilitation Psychology and Psychotherapy, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Blause S, Tirelli E, Wauquiez G, Raffard S, Didone V, Willems S. What Information Do Neuropsychologists Use to Guide their Clinical Decisions? A Survey on Knowledge and Application of Evidence-Based Practice in a French-Speaking Population. Arch Clin Neuropsychol 2024; 39:140-156. [PMID: 37551122 DOI: 10.1093/arclin/acad057] [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: 01/26/2023] [Revised: 06/01/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVE Evidence-based practice (EBP) is an approach that encourages clinicians to base their practice on evidence to improve the quality of patient care and reduce uncertainty in their clinical decisions. However, the state of knowledge and practice of neuropsychologists in French-speaking countries is still unknown. This study aimed to find out what these neuropsychologists know about EBP and whether they use it. METHOD A questionnaire with 39 questions for French-speaking neuropsychologists was distributed. The questions focused on neuropsychologists' knowledge and use of EBP and information that guide their clinical decisions. RESULTS A total of 392 respondents started the survey. The data show that only 35% correctly defined EBP and there was confusion between this practice and the strict use of research data. In practice, their decisions are influenced by multiple factors, including the patient's difficulties and advice from peers. Regarding the research, a significant proportion of the sample stated that they did not search the scientific literature frequently. Barriers to accessing scientific information and ineffective article-reading behavior were highlighted. CONCLUSION A lack of knowledge of EBP among French-speaking neuropsychologists was observed. Furthermore, the factors influencing their decision-making do not clearly fit the definitions of EBP. Information-seeking behaviors show several weaknesses and barriers to the integration of scientific evidence into practice. These results are like those of other studies conducted among psychologists or in other health professions. We will discuss possible courses of action that could be implemented to improve the knowledge and use of EBP.
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Affiliation(s)
- Sacha Blause
- Department of Psychology, University of Liège, Liège, Belgium
| | - Ezio Tirelli
- Department of Psychology, University of Liège, Liège, Belgium
| | - Grégoire Wauquiez
- Rehabilitation Centre, University Hospital Centre Dijon, Dijon, France
| | - Stéphane Raffard
- Department of Psychology, University of Montpellier, Montpellier, France
| | - Vincent Didone
- Department of Psychology, University of Liège, Liège, Belgium
| | - Sylvie Willems
- Department of Psychology, University of Liège, Liège, Belgium
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Jensen-Doss A, Casline E, Woodard GS, Phillips DA, Lane E, Palafu T, Waye C, Ramirez V, Cheron DM, Okamura K. Provider Use of, Attitudes Towards, and Self-efficacy with Key Measurement-based Care Practices in Youth Mental Health Treatment: A Multi-site Examination. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01354-6. [PMID: 38334881 DOI: 10.1007/s10488-024-01354-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 02/10/2024]
Abstract
Measurement-based care (MBC) is an underutilized evidence-based practice, and current implementation efforts demonstrate limited success in increasing MBC use. A better understanding of MBC implementation determinants is needed to improve these efforts, particularly from studies examining the full range of MBC practices and that span multiple samples of diverse providers using different MBC systems. This study addressed these limitations by conducting a multi-site survey examining MBC predictors and use in youth treatment. Participants were 159 clinicians and care coordinators working in youth mental health care settings across the United States. Participants were drawn from three program evaluations of MBC implementation. Providers completed measures assessing use of five MBC practices (administering measures, viewing feedback, reviewing feedback in supervision, sharing feedback with clients in session, and using feedback to plan treatment), MBC self-efficacy, and MBC attitudes. Despite expectations that MBC should be standard care for all clients, providers reported only administering measures to 40-60% of clients on average, with practices related to the use of feedback falling in the 1-39% range. Higher MBC self-efficacy and more positive views of MBC practicality predicted higher MBC use, although other attitude measures were not significant predictors. Effects of predictors were not moderated by site, suggesting consistent predictors across implementation settings. Implications of study findings for future research and for the implementation of MBC are discussed.
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Affiliation(s)
| | - Elizabeth Casline
- Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, Chicago, IL, US
| | - Grace S Woodard
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Elizabeth Lane
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Tessa Palafu
- The Baker Center for Children and Families, Boston, MA, USA
| | - Catherine Waye
- The Baker Center for Children and Families, Boston, MA, USA
| | | | | | - Kelsie Okamura
- The Baker Center for Children and Families, Boston, MA, USA
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Way N, Mikl J, Cataldo M, Erensen JG, Martin A, Li V, Pliszka SR. Drivers and Barriers to Tolerable and Effective Treatment for ADHD: The Importance of Treatment Perseverance and Duration of Effect. J Atten Disord 2024; 28:310-320. [PMID: 38243741 DOI: 10.1177/10870547231217088] [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] [Indexed: 01/21/2024]
Abstract
OBJECTIVE To examine treatment outcomes for classes of ADHD drugs in conjunction with physicians' prescribing rationales and the utility of treatment perseverance in treatment effectiveness. METHODS A retrospective non-interventional study using physician-provided chart data for treated adolescent and adult ADHD patients in the United States (April-June 2019). Multivariable analyses compared the effectiveness and tolerability of drug classes. RESULTS Among the 1,232 ADHD patients included in this study, 37.7% experienced one, 11.8% two, and 6.7% three treatment changes post their first prescribed regimen. These changes were mostly attributed to lack of rapid onset and duration of effect. Achieving best response correlated with the number of previous treatments for adolescents, but not adults. Maintaining full response correlated with the length of current treatment for adolescents and adults. CONCLUSION Physicians' prescribing rationales targeted duration of effect and tolerability. ER monotherapy demonstrated potential advantages over other regimens. Treatment perseverance is integral to effective ADHD management.
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Affiliation(s)
- Nate Way
- Real World Evidence, Cerner Enviza, Malvern, PA, USA
| | | | | | | | - Ashley Martin
- Real World Evidence, Cerner Enviza, Malvern, PA, USA
| | - Vicky Li
- Real World Evidence, Cerner Enviza, Malvern, PA, USA
| | - Steven R Pliszka
- The University of Texas Health Science Center at San Antonio, USA
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Thomson-Casey C, McIntyre E, Rogers K, Adams J. Practice recommendations and referrals, perceptions of efficacy and risk, and self-rated knowledge regarding complementary medicine: a survey of Australian psychologists. BMC Complement Med Ther 2024; 24:13. [PMID: 38166841 PMCID: PMC10759583 DOI: 10.1186/s12906-023-04288-y] [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: 07/22/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Many people with mental health problems use a range of complementary medicine (CM), including over the counter products, practices, and utilise the services of CM practitioners. Psychologists are likely to consult with clients using CM, in some form, as part of their broader mental health care. The aim of this research was to determine the number of types of CM products, practices, and practitioners are recommended and/or referred by Australian psychologists as part of their clinical practice, as well as explore the relationship between psychologists' perspectives on the risk and relevance of engaging with CM in psychology. METHODS Survey data was collected from psychologists in clinical practice who self-selected to participate in the study via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice. RESULTS Amongst the 201 psychologists, 5% reported not recommending any type of CM, with 63% recommending four or more types of CM. Further, 25% had not referred to a CM practitioner, while 33% had referred to four or more types of CM practitioner. Psychologists are recommending and referring to CM even when they perceive their knowledge of CM to be poor, and that engaging with CM was a risk. CONCLUSION This study provides insights into psychologist perceptions of CM within psychology practice and how these perceptions are associated with rates of recommending and referring to CM as part of their clinical practice. These findings may inform the development of CM relevant education and guidelines for psychologists.
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Affiliation(s)
- Carrie Thomson-Casey
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
- Faculty of Health, Southern Cross University, Gold Coast, Australia.
| | - Erica McIntyre
- Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
| | - Kris Rogers
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Vize CE, G C Wright A. Translating the Transdiagnostic: Aligning Assessment Practices With Research Advances. Assessment 2024; 31:199-215. [PMID: 37706296 DOI: 10.1177/10731911231194996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Researchers and clinicians working within the Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition, Text Rev (DSM-5-TR) framework face a difficult question: what does it mean to have an evidence-based assessment of a nonevidence-based diagnostic construct? Alternative nosological approaches conceptualize psychopathology as (a) hierarchical, allowing researchers to move between levels of description and (b) dimensional, eliminating artificial dichotomies between disorders and the dichotomy between mental illness and mental well-being. In this article, we provide an overview of ongoing efforts to develop validated measures of transdiagnostic nosologies (i.e., the Hierarchical Taxonomy of Psychopathology; HiTOP) with applications for measurement-based care. However, descriptive models like HiTOP, which summarize patterns of covariation among psychopathology symptoms, do not address dynamic processes underlying the problems associated with psychopathology. Ambulatory assessment, well-suited to examine such dynamic processes, has also developed rapidly in recent decades. Thus, the goal of the current article is twofold. First, we provide a brief overview of developments in constructing valid measures of the HiTOP model as well as developments in ambulatory assessment practices. Second, we outline how these parallel developments can be integrated to advance measurement-based treatment. We end with a discussion of some major challenges for future research to address to integrate advances more fully in transdiagnostic and ambulatory assessment practices.
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41
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Dobler VB, Nestler J, Konzelmann M, Kennerley H. Mapping evidence-based interventions to the care of unaccompanied minor refugees using a group formulation approach. Behav Cogn Psychother 2024; 52:14-32. [PMID: 37974439 DOI: 10.1017/s1352465823000437] [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] [Indexed: 11/19/2023]
Abstract
BACKGROUND How we adapt treatment algorithms to complex, clinically untested, difficult-to-engage patient groups without losing evidence base in everyday practice is a clinical challenge. Here we describe process and reasoning for fast, pragmatic, context-relevant and service-based adaptations of a group intervention for unaccompanied minor asylum seekers (UASC) arriving in Europe. We employed a distillation-matching model and deployment-focused process in a mixed-method, top-down (theory-driven) and bottom-up (participant-informed) approach. Prevalence of mental disorders amongst UASC is extremely high. They also represent a marginalised and hard-to-engage group with limited evidence for effective treatments. METHOD Content and process adaptations followed four steps: (1) descriptive local group characterisation and theoretical formulation of problems; (2) initial adaptation of evidenced treatment, based on problem-to-component grid; (3) iterative adaptation using triangulated feedback; and (4) small-scale pilot evaluation. RESULTS Based on evidence and participant feedback, adaptations included minimising verbal demands, facilitating in-session inductive learning, fostering social connectedness via games, enhancing problem-solving skills, accounting for multi-traumatisation, uncertainty and deportation. Quantitative evaluation suggested improved feasibility, with increased attendance, low drop-out and symptom improvement on depression and trauma scores. CONCLUSIONS By describing the principles under-pinning development of a group intervention for severely traumatised UASC, we contribute to the literature supporting dynamic adaptations of psychological interventions, without losing reference to evidence base. Complex and difficult-to-reach clinical groups are often those in most need of care, yet least researched and most affected by inequality of care. Pragmatic adaptations of proven programs are often necessary to increase feasibility.
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Affiliation(s)
- V B Dobler
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridge, UK
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, D-89075Ulm, Germany
| | - Judith Nestler
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, D-89075Ulm, Germany
| | | | - Helen Kennerley
- Oxford Cognitive Therapy Centre, Warneford Hospital, Oxford, UK
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Reinosa Segovia FA, Benuto LT. Venciendo la Depresión: A Pilot Study of Telehealth-Delivered Behavioral Activation for Depressed Spanish-Speaking Latinxs. Behav Ther 2024; 55:164-176. [PMID: 38216230 DOI: 10.1016/j.beth.2023.05.011] [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: 06/10/2022] [Revised: 02/26/2023] [Accepted: 05/27/2023] [Indexed: 01/14/2024]
Abstract
Latinxs are substantially impacted by depression. The research literature has documented barriers (e.g., stigma, limited English proficiency, and lack of transportation) contributing to the underutilization of behavioral health services among Spanish-speaking Latinxs (SSLs). Telehealth can be broadly defined as the provision of healthcare information and services through the use of telecommunications technology. Behavioral Activation (BA) has well established empirical support for reducing symptoms of depression among ethnic minority groups. The unprecedent challenges associated with accessing in-person behavioral health services during the COVID-19 pandemic have underscored the need to examine alternate methods for treatment delivery. Thus, the proposed study aimed to conduct a feasibility study to determine the viability of telehealth-delivered BA for SSLs. Twenty-five SSL participants met eligibility criteria and were enrolled in the intervention and 17 participants completed treatment. The majority of participants experienced significant improvements in depressive symptoms and positive affect. These treatment gains were sustained at one-month follow-up. The present study offers promising preliminary data to support the acceptability and feasibility of telehealth-delivered BA, with the potential to lessen barriers to care by offering readily accessible behavioral health services for depressed individuals in underserved communities.
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Crowther ME, Saunders WJ, Sletten TL, Drummond SPA, Bei B. Tailoring cognitive behavioural therapy for insomnia across contexts, conditions, and individuals: What do we know, where do we go? J Sleep Res 2023; 32:e14023. [PMID: 37641983 DOI: 10.1111/jsr.14023] [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: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Cognitive behavioural therapy for insomnia (CBT-I) is considered the front-line treatment for insomnia. Despite the demonstrated effectiveness of CBT-I, it is necessary to consider how CBT-I may be tailored to different individuals. The purpose of the present review is to provide a summary of literature on tailoring CBT-I to different individuals and provide directions for future research. This review focused on the following domains of adaptation: (i) tailoring CBT-I components to individuals with comorbid mental or physical health conditions such as comorbid depression and pain; (ii) adapting CBT-I delivery for different contexts in which individuals exist, such as inpatient, educational, and different social/cultural settings, (iii) adapting CBT-I to specific individuals via case-formulation in clinical settings. We highlight current gaps in the exploration of tailored CBT-I, including a lack of research methodology to evaluate tailored interventions, a need for the integration of ongoing individualised assessment to inform treatment, and the necessary involvement of consumers and stakeholders throughout the research and treatment development process. Together, this review showed abundant adaptations in CBT-I already exist in the literature. Future research is needed in understanding when and how to apply adaptations in CBT-I and evaluate the benefits of these adaptations.
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Affiliation(s)
- Meagan E Crowther
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - William J Saunders
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Tracey L Sletten
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Bei Bei
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
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Yin Q, Hughes CD, Rizvi SL. Using GIMME to model the emotional context of suicidal ideation based on clinical data: From research to clinical practice. Behav Res Ther 2023; 171:104427. [PMID: 37980875 DOI: 10.1016/j.brat.2023.104427] [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: 01/31/2023] [Revised: 10/15/2023] [Accepted: 11/03/2023] [Indexed: 11/21/2023]
Abstract
Research and clinical experience highlight the variability of suicidal ideation (SI) within and between individuals. Although the idiographic emotional contexts in which SI occurs may offer explanations for its dynamic nature, most statistical methods focus on nomothetic patterns, making it difficult to advance our understanding of SI. Furthermore, the gap between nomothetic methods and a need for idiographic understanding of SI poses challenges to translating empirical knowledge into individualized clinical treatment. Group iterative multiple model estimation (GIMME) is a method that may bridge the idiographic-nomothetic divide by analyzing temporal relationships among a network of variables at both group- and individual-levels. This study explored the feasibility and clinical utility of GIMME applied to examine the relationships between various emotions and SI among individuals with borderline personality disorder who underwent Dialectical Behavior Therapy. We present graphic outputs that emerged throughout treatment and discuss how they could aid clinical assessment and case formulation (ClinicalTrials.gov Identifier: NCT03123198.).
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Affiliation(s)
- Qingqing Yin
- Department of Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ, 08854, United States.
| | - Christopher D Hughes
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, United States; Department of Psychosocial Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, United States
| | - Shireen L Rizvi
- Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ, 08854, United States
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Cooper M, Di Malta G, Knox S, Oddli HW, Swift JK. Patient perspectives on working with preferences in psychotherapy: A consensual qualitative research study. Psychother Res 2023; 33:1117-1131. [PMID: 36669123 DOI: 10.1080/10503307.2022.2161967] [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: 06/30/2022] [Accepted: 12/17/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Assessing and accommodating patient preferences is integral to evidence-based practice. This qualitative study sought to explore patient perspectives and experiences of preference work in psychotherapy. METHODS Participants were 13 UK-based patients who had completed up to 24 sessions of a collaborative-integrative psychotherapy. Ten participants identified as female and three as male. Interviews were conducted at endpoint and analyzed using a team-based, consensual qualitative research approach. RESULTS Three superordinate domains were developed: Preferences Themselves, Process of Working with Preferences in Psychotherapy, and Effect of Preference Work (or its Absence). Patients typically wanted leadership, challenge, and input from their psychotherapist, and an affirming style. Patients attributed the origin of their preferences to personal history, characteristics, or circumstances; the present psychotherapy; or past episodes of psychotherapy. Some preferences changed over time. Preference work was described as having positive effects on the therapeutic relationship and patients' intrapersonal worlds; however, variantly, non-accommodation of preferences was also experienced as beneficial. CONCLUSION Our findings provide in-depth answers to a range of novel questions on preference work-potential mechanisms by which preference work impacts outcomes, factors that may facilitate preference work, and origins of preferences-as well as nuancing previously-established quantitative findings. Implications for clinical training and practice are discussed.
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Affiliation(s)
- Mick Cooper
- Department of Psychology, University of Roehampton, London, UK
| | - Gina Di Malta
- Department of Psychology, University of Roehampton, London, UK
- School of Psychology and Counselling, University of Roehampton, The Open University, London, UK
| | - Sarah Knox
- College of Education, Marquette University, Milwaukee, WI, USA
| | | | - Joshua K Swift
- Department of Psychology, Idaho State University, Pocatello, ID, USA
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Dimic T, Farrell A, Ahern E, Houghton S. Young people's experience of the therapeutic alliance: A systematic review. Clin Psychol Psychother 2023; 30:1482-1511. [PMID: 37537723 DOI: 10.1002/cpp.2885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE The aim of this systematic review was to synthesise qualitative evidence on young people's conceptualisation, utilisation and experiences of the therapeutic alliance in individual psychotherapy or counselling and its role in bringing about change. METHOD The thematic synthesis method was used to synthesise data. The methodological quality of included studies was assessed using the CASP checklist for qualitative research. RESULTS Four superordinate analytical themes were generated: (1) valuable therapist qualities, (2) conditions for the development and maintenance of the therapeutic alliance, (3) therapeutic processes and (4) barriers to the development of the therapeutic alliance. Findings indicate that young people appreciated the uniqueness of the therapeutic relationship that provided a sense of safety, choice and autonomy. Flexibility and accessibility were noted as important elements of therapeutic alliance building as they elicited a sense of agency. Young people emphasised the non-linear nature of therapy and prioritised process variables such as improvement in self-understanding, self-efficacy and self-worth. CONCLUSION The current systematic review is a comprehensive overview of qualitative studies of experiences of therapy from young people's perspectives. Important practical implications derived from this review as the role of autonomy in the change process and the formation and maintenance of the therapeutic relationship were outlined as important elements in youth therapy.
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Affiliation(s)
- Tamara Dimic
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Aoife Farrell
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Elayne Ahern
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Sharon Houghton
- Department of Psychology, University of Limerick, Limerick, Ireland
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Pfund RA, Ginley MK, Kim HS, Boness CL, Horn TL, Whelan JP. Cognitive-behavioral treatment for gambling harm: Umbrella review and meta-analysis. Clin Psychol Rev 2023; 105:102336. [PMID: 37717456 PMCID: PMC11059187 DOI: 10.1016/j.cpr.2023.102336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/16/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
The aim of the current umbrella review and meta-analysis was to evaluate the methodological rigor of existing meta-analyses on cognitive-behavioral treatment (CBT) for gambling harm. The Cochrane Database of Systematic Reviews, PsycINFO, and PubMed were searched for meta-analyses of CBT for gambling harm among individuals aged 18 years and older. The search yielded five meta-analyses that met inclusion criteria, representing 56 unique studies and 5389 participants. The methodological rigor for one meta-analyses was rated high, two were moderate, and two were critically low. Including only moderate- to high-quality meta-analyses, a robust variance estimation meta-analysis indicated that CBT significantly reduced gambling disorder severity (g = -0.91), gambling frequency (g = -0.52), and gambling intensity (g = -0.32) relative to minimal and no treatment control at posttreatment, suggesting 65%-82% of participants receiving CBT will show greater reductions in these outcomes than minimal or no treatment controls. Overall, there is strong evidence for CBT in reducing gambling harm and gambling behavior, and this evidence provides individuals, clinicians, managed care companies, and policymakers with clear recommendations about treatment selection.
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Affiliation(s)
- Rory A Pfund
- Tennessee Institute for Gambling Education & Research, USA; Department of Psychology, University of Memphis, USA.
| | - Meredith K Ginley
- Tennessee Institute for Gambling Education & Research, USA; Department of Psychology, East Tennessee State University, USA
| | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University, Canada
| | - Cassandra L Boness
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, USA
| | - Tori L Horn
- Tennessee Institute for Gambling Education & Research, USA; Department of Psychology, University of Memphis, USA
| | - James P Whelan
- Tennessee Institute for Gambling Education & Research, USA; Department of Psychology, University of Memphis, USA
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Oddli HW, Stänicke E, Halvorsen MS, Lindstad TG. Causality in psychotherapy research: Towards evidential pluralism. Psychother Res 2023; 33:1004-1018. [PMID: 36585952 DOI: 10.1080/10503307.2022.2161433] [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: 06/15/2022] [Accepted: 12/17/2022] [Indexed: 01/01/2023] Open
Abstract
Identifying causal relationships is at the heart of all scientific inquiry, and a means to evidence base practices and to guide policymaking. However, being aware of the complexities of interactions and relationships, scientists and academics are cautious about claiming causality. Researchers applying methods that deviate from the experimental design generally abstain from causal claims, reserving them for designs that adhere to the evidential ideals of empiricism (e.g., RCTs), motivated by the Humean conceptions of causality. Accordingly, results from other designs are ascribed lower explanatory power and scientific status. We discuss the relevance of also other perspectives of causality, such as dispositionalism and the power perspectives of various realist approaches, which emphasize intrinsic properties and contextual variations, as well as an inferentialist/epistemic approach that advocates causal explanations in terms of inferences and linguistic interaction. The discussion will be illustrated by the current situation within psychotherapy research and the APA Policy Statement on Evidence-Based Practice. The distinction between difference-making and causal production will be proposed as a possible means to evaluate the relevance of designs. We conclude that clarifying causal relationships is an ongoing process that requires the use of various designs and methods and advocate a stance of evidential pluralism.
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Affiliation(s)
- Hanne W Oddli
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Erik Stänicke
- Department of Psychology, University of Oslo, Oslo, Norway
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Havnen A, Zotcheva E, Bjerkeset O, Sui X, Ernstsen L. Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database. J Affect Disord 2023; 339:111-117. [PMID: 37437717 DOI: 10.1016/j.jad.2023.07.029] [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: 01/11/2023] [Revised: 06/11/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND We investigated the association between cardiorespiratory fitness (CRF) and incident use of antidepressants or anxiolytics in the general adult population. METHODS A non-exercise prediction model was used to estimate CRF in 32,603 participants in the third wave of the Trøndelag Health Study (HUNT3; 2006-08). Data on first purchase of antidepressants and anxiolytics were obtained from the Norwegian Prescription Database. Cox regression was used to estimate hazard ratios (HRs). RESULTS Each 1- metabolic equivalent of task (MET) increase in CRF was associated with 4 % reduced risk of purchasing antidepressant or anxiolytic medication during follow-up (HR 0.96, 95 % Confidence interval [CI] 0.94-0.98). Compared to the low CRF tertile, participants in intermediate (HR 0.93, 95 % CI 0.87-0.98) and high (HR 0.92, 95 % CI 0.86-0.98) CRF tertiles had reduced risk of medication purchase. Men in intermediate and high CRF tertile had lower risk of medication purchase (intermediate HR 0.87, 95 % CI 0.79-0.96; high HR 0.87, 95 % CI 0.78-0.96). Intermediate and high CRF tertiles were associated with reduced risk of medication use for younger adults (20 to <30 years old; intermediate HR 0.74, 95 % CI 0.61-0.91, high HR 0.78, 95 % CI 0.64-0.95) and middle-aged adults (30 to <65 years old; intermediate HR 0.90, 95 % CI 0.83-0.97, high HR 0.90, 95 % CI 0.84-0.98), but not in older adults (≥65 years old). LIMITATIONS Only information about medication purchase and not actual use was available. CONCLUSION Increased CRF is associated with reduced risk of anxiolytics and antidepressants purchase, with stronger effects for men and younger adults.
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Affiliation(s)
- Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Norway; Division of Psychiatry, St. Olavs Hospital, Trondheim, Norway.
| | - Ekaterina Zotcheva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway; Department of Physical Health and Ageing, Norwegian Institute of Public Health, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norway
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Linda Ernstsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway
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Clarke AT, Grassetti SN, Brumley L, Ross KY, Erdly C, Richter S, Brown ER, Pole M. Integrating trauma-informed services in out-of-school time programs to mitigate the impact of community gun violence on youth mental health. J Prev Interv Community 2023; 51:332-351. [PMID: 38349066 DOI: 10.1080/10852352.2024.2313382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Community gun violence disproportionately impacts youth in low-income urban neighborhoods. Integrating trauma-informed mental health care in community-based out-of-school time (OST) programs is an innovative method of service delivery for these youth. This article provides justification for integrating evidence-based, trauma-informed services in OST programs within communities characterized by high rates of violent crime to minimize the impact of violence exposure on youth mental health. We describe the initial feasibility of a model program, the Violence Intervention and Prevention (VIP) Initiative, implemented in a small city in southeastern Pennsylvania. Within the first six months of the VIP Initiative, 95 community residents (90% under age 18; 51% Hispanic) received intervention services, primarily through single-session and short-term weekly group intervention in OST programs, and 80% of OST youth development staff participated in at least one trauma-informed professional development training. Recommendations to enhance and expand the delivery of trauma-informed services in the novel setting of OST programs are provided.
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Affiliation(s)
- Angela T Clarke
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Stevie N Grassetti
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Lauren Brumley
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Kyle Y Ross
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Courtney Erdly
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Sarah Richter
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Emily R Brown
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Michele Pole
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
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