A thematic analysis of the experience of UK mental health nurses who have trained in Solution Focused Brief Therapy

The effect of solution-focused approach on attitudes to violence against women in high school students

PURPOSE

This study was conducted to examine the Effect of Solution-Oriented Approach on Attitudes of Violence Against Women in High School Students.

MATERIALS AND METHODS

The research was designed as a pretest-posttest and repeated-measurement randomized controlled experimental study. The population of the research consisted of 1473 students studying at 5 high schools randomly selected from a city center. Out of these students, 166 students who did not accept the study or did not meet the research criteria were excluded, and the school numbers of the remaining 1307 students were numbered separately for girls and boys, and 90 (45 girls and 45 boys) students were included in the study by simple randomization method. Personal Information Form and Violence Against Women Attitude Scale (İSKEBE) were used to collect data.

RESULTS

Before the program, the personal characteristics of the control and experimental group students were similar in terms of İSKEBE and subscale scores. Significant differences were found between the groups in the Attitude Toward Identity, Attitude Toward Body sub-dimensions, and the total scores of İSKEBE of the scale used to collect data in the post-program and follow-up test (p < 0.05).

CONCLUSION

It was seen that the solution-oriented approach applied to high school students had positive effects on the students' attitudes toward violence against women. In this context, it is thought that this study will develop a new perspective in breaking the cycle of violence against women.

Application of the solution-focused brief strategies via telephone for family caregivers of persons with dementia: the Alzheimer's Association National Helpline

OBJECTIVES

Nearly 75% of persons living with dementia (PLWD) in the US live at home and are cared for by informal family members who have limited access to supportive and accessible services, indicating an increased need for these types of services (Alzheimer's Association, 2023). The Alzheimer's Association call centers offer free telephone care consultations, but it currently remains unclear which types of brief telephone support benefit caregivers. This study compares outcomes of participants who received traditional care consultation calls via the Alzheimer's Association National Helpline with care consultation calls from Helpline staff trained in Solution-Focused Brief Strategies (SFBS), a client-centered evidence- and resource-based approach.

METHOD

Sequential callers were randomly assigned to the "traditional" or "SFBS" care consultation groups and were assessed at the time of call (baseline) and post-call (T1). The outcomes of interest were general self-efficacy (GSE), self-efficacy in managing emotions (PROMIS), caregiver mastery, therapeutic alliance, and goal setting.

RESULTS

Of over 500 callers, callers receiving the SFBS scored higher on therapeutic alliance and goal-setting metrics, such as greater sense of collaboration on goals (effect size = 0.280, p = 0.0005, significant with Bonferroni correction), mutual agreement with care consultant on goals (effect size = 0.418, p < 0.0001, significant with Bonferroni correction), and believing the way the problem was resolved was correct (effect size = 0.286, p = 0.0007, significant with Bonferroni correction) than those receiving the traditional care consultation. Both groups reported improvements in the PROMIS measure, but there were no differences between groups. There were no significant differences in GSE or caregiver mastery scores between groups.

CONCLUSION

This study provides evidence for the effectiveness of the integration of SFBS in dementia care consultation calls as part of telephone-based supportive services for dementia caregivers.

A randomized controlled trial of a nurse-led psychological pain solution-focused intervention for depressed inpatients: study protocol

BACKGROUND

Depressed patients commonly experience psychological pain. Research pointed to positive psychological interventions as an effective means of ameliorating psychological pain, although the exact effect is unclear. Based on the hope theory and solution-focused brief therapy (SFBT), this study combines hope theory with solution-focused brief therapy to develop a nurse-led psychological pain solution-focused (PPSF) intervention in depressed patients.

METHODS

This is an assessor-blinded randomized controlled trial following the SPIRIT guidance. A total of 84 depressed patients will be recruited from the inpatient wards of a psychiatric hospital and randomly assigned to the control and experimental groups. Patients in the control group will be treated as usual. In contrast, patients in the experimental group will receive 6 sessions of the PPSF intervention for two weeks on top of the routine care. Primary outcomes are psychological pain, hope, cognitive distortions. Secondary outcomes are depression and suicidal ideation. Data will be collected at 5-time points: baseline, 1 and 2 weeks (post-intervention), 1 month (follow up), and 6 months after baseline. Generalized equation evaluation will be used to assess the effectiveness of the PPSF intervention.

DISCUSSION

From a positive psychology perspective, there remains much room for developing psychological pain interventions in depressed patients. SFBT and hope theory are both based on positive psychology. With hope theory as the general framework and SFBT questions as the practical guide, the PPSF intervention program is designed that nursing staff can implement. If the intervention is effective, it will advance the development of psychological pain interventions for patients with depression.

TRIAL REGISTRATION

ChiCTR2100048223.

The effect of solution-focused approach on anger management and violent behavior in adolescents: A randomized controlled trial

BACKGROUND

This study was carried out to evaluate the effect of a solution-focused approach on anger management and violent behavior in adolescents.

METHOD

The study was an experimental and randomized controlled trial including pre-test and post-test measurements and control group. The sample of experimental (n = 24) and control groups (n = 24) of the study consisted of 48 students. A 7-session program of anger management and prevention of violent behavior based on a solution focused approach was applied to the experimental group.

RESULTS

There were no statistically significant differences between trait anger, anger in, anger out, anger control sub-dimensions and VTS scores of the experimental and control groups before the intervention (p > 0.05). In post-test and follow-up test, trait anger (23.32 ± 2.83) (21.10 ± 3.51), anger-out (14.95 ± 4.16) (15.50 ± 3.49) and the mean scores of VTS (30.77 ± 4.01) (32.80 ± 4.53) of the individuals in the experimental group were significantly lower, whereas their mean score of anger control (24.86 ± 3.62) (23.65 ± 4.44) were significantly higher than the control group.

CONCLUSION

Solution-oriented approach programs should be used by psychiatric nurses to provide anger management and reduce violence tendencies in adolescents.

Utilizing the mental health nursing workforce: A scoping review of mental health nursing clinical roles and identities

Despite rising international needs for mental health practitioners, the mental health nursing workforce is underutilized. This is in part due to limited understandings of their roles, identities, and capabilities. This paper aimed to collate and synthesize published research on the clinical roles of mental health nurses in order to systematically clarify their professional identity and potential. We searched for eligible studies, published between 2001 and 2021, in five electronic databases. Abstracts of retrieved studies were independently screened against exclusion and inclusion criteria (primarily that studies reported on the outcomes associated with mental health nursing roles). Decisions of whether to include studies were through researcher consensus guided by the criteria. The search yielded 324 records, of which 47 were included. Retained papers primarily focused on three themes related to mental health nursing clinical roles and capabilities. Technical roles included those associated with psychotherapy, consumer safety, and diagnosis. Non-technical roles and capabilities were also described. These included emotional intelligence, advanced communication, and reduction of power differentials. Thirdly, the retained papers reported the generative contexts that influenced clinical roles. These included prolonged proximity with consumers with tensions between therapeutic and custodial roles. The results of this scoping review suggest the mental health nurses (MHNs) have a wide scope of technical skills which they employ in clinical practice. These roles are informed by a distinctive cluster of non-technical capabilities to promote the well-being of service users. They are an adaptable and underutilized component of the mental health workforce in a context of escalating unmet needs for expert mental health care.

The effect of a solution-oriented therapy on the depression levels and the perceived social support of depressive patients

BACKGROUND

This study was executed to evaluate the effect of the solution-oriented therapy programme on the depression levels and the perceived social support of depressive patients METHOD: The study was designed as a randomized controlled trial with a pre-test and post-test control group and repeated measures. The Solution-Oriented Therapy Programme was implemented in a total of 6 to 10 sessions with the patients of experimental group.

RESULTS

There were no statistically significant differences between the mean BDI and PSSI scores of the experimental and control groups before the programme. At one week after the programme (29.89 ± 4.15) and after 3 months (31.71 ± 3.72), the mean of the BDI grades of the individuals in the experimental group were significantly lower than was that of the individuals in the control group. In the study group, the mean PSSI scores significantly increased at one week after programme (50.79 ± 10.81) and decreased (46.61 ± 10.37) at after 3 months.

CONCLUSION

The execution of Solution-Oriented Therapy Programme with the depressive patients should be done by the psychiatric nurses within the scope of the services that psychiatric care units serve.

The effects of group counseling based on the solution-focused approach on anxiety and healthy lifestyle behaviors in individuals with eating disorders

PURPOSE

This study was conducted to determine the effects of group counseling based on the solution-focused approach (SFA) on anxiety and healthy lifestyle behaviors in individuals with eating disorders.

DESIGN AND METHODS

The study was implemented with a pretest-posttest experimental (n:31) randomized controlled (n:45) design. Adults aged 25 and older were included in the study.

FINDINGS

After the intervention, there was a decrease in the trait anxiety inventory scores, while there was an increase in the healthy lifestyle scores and subscale scores. Additionally, the mean weight of the individuals in the experiment group and their body mass indices decreased, and their weekly hours of exercise increased.

PRACTICAL IMPLICATIONS

SFA counseling provided to the individuals with eating disorders decreased the anxiety of the individuals and increased their healthy lifestyle behaviors.

A treatment strategy for meeting life as it is. Patients' and therapists' experiences of brief therapy in a district psychiatric centre: A qualitative study

BACKGROUND

Young adults increasingly seek help for mental health problems. In 2016, a district psychiatric centre in Norway started a brief treatment program to provide early and effective help for moderate depression and anxiety.

AIM

Exploring patients' and therapists' experiences of brief therapy, especially how the time limitation influences the treatment process.

METHODS

Individual interviews with 12 patients and focus group interviews with eight therapists analyzed using systematic text condensation.

RESULTS

The results constitute five themes: (1) Time-limit as a frame for targeted change, (2) Clarifying expectations and accountability, (3) Shared agreement on a defined treatment-project, (4) Providing tools instead of searching for causes, and (5) Learning to cope-not being cured.

CONCLUSION

Time-limitation in brief therapy appeared to play a positive role, helping the therapists to structure the therapeutic process and strengthening patients' motivation. Shared understanding and activation during brief therapy may reinforce patients' responsibility and expectations to achieve individual goals. Brief therapy can be viewed as the start of a personal process towards "mastering life as it is". More research is needed to investigate the patients' long-term outcomes after treatment and to shed light on the potential for, and limitations of, mastering everyday-life.

Solution Focused Brief Therapy Telemental Health Suicide Intervention

One of the innumerable impacts of the coronavirus has been the change in how individuals provide services. For mental health providers, the pandemic required a sudden shift from in person to online service delivery. As therapists learn and embrace a new modality for providing therapy, crisis situations may present with some anxiety. With the pandemic increasing crisis situations for so many individuals, and teletherapy as a mode of service delivery being unlikely to go away after the pandemic, therapists require support in navigating crises situations online, in a medium that feels like the therapist has less control with their clients due to being in different physical locations. The authors believe that regardless of the primary model(s) therapists utilize in session, solution-focused brief therapy is an integrative model that uniquely captures client's resources and reasons for living and when clients are in crisis. The purpose of this paper is to present recommendations for applying solution-focused language in teletherapy practice, to provide ethical, evidenced based care for clients in crisis. A clinical vignette is used to illustrate the application of solution focused brief therapy for working with clients in crisis. Future directions and limitations are discussed.

Overcoming barriers to implementing ward-based psychosocial interventions in acute inpatient mental health settings: A meta-synthesis

BACKGROUND

The culture of acute mental health wards is often dominated by medical models of care despite some patient dissatisfaction with care in these settings and a demand for increased access to psychosocial interventions. Research has found that psychosocial interventions can improve a number of patient and staff outcomes, however, implementation within these settings is often challenging.

OBJECTIVES

The aim of this review was to provide a comprehensive synthesis of the barriers and facilitators to implementing psychosocial interventions on acute wards, in order to develop a list of recommendations for embedding psychosocial interventions within the ward culture in acute settings.

METHODS

Databases were systematically searched using search terms related to acute mental health wards and psychosocial intervention implementation from inception to December 2019. Thirty-nine studies (forty-three papers) that explored the implementation of psychosocial interventions on adult acute mental health wards using qualitative methods met inclusion criteria. Data relating to barriers and facilitators to implementing psychosocial interventions extracted from the results sections of the papers were synthesised using the COM-B model.

RESULTS AND CONCLUSIONS

We conclude that to address barriers to the implementation of psychosocial interventions, services should provide clear information to patients regarding the benefits of engagement, and additional training for staff. A shift in ward culture is required and can be achieved through the recruitment of empathic implementers, together with providing staff with protected time for delivery of psychosocial interventions with clear accountability for intervention delivery through the provision of clearly defined roles.

Are current mental health assessment formats consistent with contemporary thinking and practice?

Conducting and documenting a mental health assessment is considered a central activity from a clinical and organizational perspective. In recent years, thinking and practice in mental health service delivery has changed considerably to embrace principles of recovery, trauma-informed care, and strengths-based approaches. The aim of the present study was to determine the degree to which these concepts are reflected in the content of assessment formats across mental health services in Australia and New Zealand. Copies of mental health assessments used in each state and territory in Australia, and three District Health Boards in New Zealand were obtained. Assessment formats were compared for similarities and differences, and to determine whether concepts of recovery, trauma-informed care, and strengths-based approaches were incorporated. The assessment formats analysed (n = 11) contained many traditional features targeted at identifying harms, problems, risks, and pathology. Some attempts to redress this discrepancy were evident. Overall, assessment formats did not adequately voice the individual's perspective or promote a truly comprehensive assessment through an exploration of individual strengths, skills and abilities, past successes, and future hopes. Assessment formats across Australia and New Zealand are not currently aligned with contemporary thinking and practice in mental health care. Given the heavy influence that mental health assessment has on clinical decision making in particular, a reappraisal of the focus and content of formats used is urgently required.

Implementation and evaluation of a follow-up programme after intensive care treatment: A practice development project

OBJECTIVES

This study aimed to measure the effects of a newly developed follow-up programme on intensive care unit patient quality of care, as perceived by their relatives, and the appropriateness of the programme according to nurses.

METHODS AND SETTING

This before and after implementation study was conducted in a level III intensive care unit for adult patients and related follow-up wards and included 135 intensive care nurses and 105 general ward nurses. The implemented programme included a personalised poster, a revised discharge protocol and follow-up visits on the ward. Eligible relatives of patients who had remained in the intensive care for a minimum of 48 hours were included.

MAIN OUTCOME MEASURES AND RESULTS

Total quality of care and communication were assessed by relatives as high according to the Quality Monitor. Most intensive care nurses evaluated the usefulness of the discharge protocol as positive (71.8% partly/totally agreed) and in accordance with the patients' needs (82.1% partly/totally agreed).

CONCLUSION

Communication and general support as perceived by patients' relatives improved; however, no influence on the total quality of care of the revised discharge protocol was shown. Nurses considered the programme as useful. The intervention might enable nurses to better respond to the instrumental and affective needs of patients and their relatives.