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Choi H, Shin S, Lee G. Effects of Positive Psychotherapy for People with Psychosis: A Systematic Review and Meta-Analysis. Issues Ment Health Nurs 2023; 44:180-193. [PMID: 36920274 DOI: 10.1080/01612840.2023.2174218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
This study evaluates positive psychotherapy's effects on the well-being and psychiatric symptoms of people with psychosis. A systematic search was conducted using 10 electronic databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was performed using the R 4.2.0 program to estimate the effect size. Seventeen studies were included in the systematic review and 14 in meta-analysis. Positive psychotherapy for people with psychosis had significant effects on subjective and psychological well-being and psychiatric symptoms. Further, country, age, and session were significant moderators. Thus, positive psychotherapy improves the well-being and psychiatric symptoms of people with psychosis.
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Affiliation(s)
- Heeseung Choi
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Soyoun Shin
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Gumhee Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
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2
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Lim YJ. Psychometric Properties of the Mental Health Continuum-Short Form (MHC-SF): A Study With Individuals With Schizophrenia Living in the Community. Psychiatry Investig 2022; 19:1021-1026. [PMID: 36588436 PMCID: PMC9806510 DOI: 10.30773/pi.2022.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/03/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The Mental Health Continuum-Short Form (MHC-SF) is widely used to measure positive mental health. This study is the first to examine the psychometric properties of the MHC-SF in persons with schizophrenia living in the community. METHODS Two hundred thirty-one individuals with schizophrenia living in the community in South Korea filled out the MHC-SF. Confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM were undertaken to examine the factor structure of the MHC-SF. RESULTS Results showed that a three-factor bifactor ESEM model yielded better fit than the other alternative models. Indices of internal consistency reliability were acceptable. CONCLUSION The results suggest that bifactor ESEM is an appropriate analysis for examining the factor structure of the MHC-SF in individuals with schizophrenia. The findings support the use of the overall MHC-SF scale rather than the use of the subscales in people with schizophrenia.
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Affiliation(s)
- Young-Jin Lim
- Department of Psychology, Daegu University, Gyeongsan, Republic of Korea
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Kouvaras S, Guiotto M, Schrank B, Slade M, Riches S. Character Strength-Focused Positive Psychotherapy on Acute Psychiatric Wards: A Feasibility and Acceptability Study. Psychiatr Serv 2022; 73:1051-1055. [PMID: 35378993 DOI: 10.1176/appi.ps.202100316] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A manualized single-session positive psychotherapy intervention was developed and tested on acute psychiatric wards. METHODS Participants were invited in 2018-2019 to identify positive experiences, link them to a personal character strength, and plan a strengths-based activity. The intervention's feasibility was evaluated through fidelity to session components, character strengths identification, and activity completion. Acceptability was evaluated with self-reported pre- and postsession mood ratings, a postsession helpfulness rating, and narrative feedback. RESULTS Participants (N=70) had complex and severe mental health conditions. In 18 group sessions, 89% of components were delivered with fidelity; 80% of the participants identified a character strength, of whom 71% identified a strengths-based activity, and 58% completed the activity. The mean±SD helpfulness rating (N=23) was 8.5±1.5 (on a 10-point Likert scale), and positive mood significantly increased postsession (5.9 presession vs. 7.2 postsession). CONCLUSIONS Positive psychotherapy is feasible in challenging inpatient settings, and service users with severe and complex mental health conditions find it helpful.
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Affiliation(s)
- Stef Kouvaras
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Martina Guiotto
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Beate Schrank
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Mike Slade
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Simon Riches
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
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Chan K, Wong FKY, Tam SL, Kwok CP, Fung YP, Wong PN. Effectiveness of a brief hope intervention for chronic kidney disease patients on the decisional conflict and quality of life: a pilot randomized controlled trial. BMC Nephrol 2022; 23:209. [PMID: 35701732 PMCID: PMC9195369 DOI: 10.1186/s12882-022-02830-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
Background Stage 5 chronic kidney disease (CKD) patients often experience decisional conflict when faced with the selection between the initiation of dialysis and conservative care. The study examined the effects of a brief hope intervention (BHI) on the levels of hope, decisional conflict and the quality of life for stage 5 CKD patients. Methods This is a single-blinded, randomized controlled trial (ClinicalTrials.gov identifier: NCT03378700). Eligible patients were recruited from the outpatient department renal clinic of a regional hospital. They were randomly assigned to either the intervention or the control group (intervention: n = 35; control: n = 37). All participants underwent a customized pre-dialysis education class, while the intervention group received also BHI. Data were collected prior to the intervention, immediately afterwards, and one month following the intervention. The Generalized Estimating Equation was used to measure the effects in the level of hope, decisional conflict scores (DCS) and Kidney Disease Quality of life (KDQOL-36) scores. Estimated marginal means and standard errors with 95% confidence intervals of these scores were also reported to examine the within group and between group changes. Results An increase of the hope score was found from time 1 (29.7, 1.64) to time 3 (34.4, 1.27) in the intervention group. The intervention had a significant effect on the KDQOL-36 sub-scores Mental Component Summary (MCS) (Wald χ2 = 6.763, P = 0.009) and effects of kidney disease (Wald χ2 = 3.617, P = 0.004). There was a reduction in decisional conflict in both arms on the DCS total score (Wald χ2 = 7.885, P = 0.005), but the reduction was significantly greater in the control group (effect size 0.64). Conclusions The BHI appeared to increase the level of hope within the intervention arm. Nonetheless, differences across the intervention and control arms were not significant. The KDQOL-36 sub-scores on MCS and Effects of kidney disease were found to have increased and be higher in the intervention group. The DCS total score also showed that hope was associated with reducing decisional conflict. Trial Registration ClinicalTrials.gov Protocol Registration, NCT03378700. Registered July 12 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02830-7.
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Affiliation(s)
- Kitty Chan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, People's Republic of China.
| | - Frances Kam Yuet Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, People's Republic of China
| | - Suet Lai Tam
- Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong SAR, People's Republic of China
| | - Ching Ping Kwok
- Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong SAR, People's Republic of China
| | - Yuen Ping Fung
- Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong SAR, People's Republic of China
| | - Ping Nam Wong
- Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong SAR, People's Republic of China
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Chu MHW, Lau B, Leung J, Chan SC, Tang B, Lau C, Newby C, Chiu R, Lo WTL, Schrank B, Slade M. Positive psychotherapy for psychosis in Hong Kong: A randomized controlled trial. Schizophr Res 2022; 240:175-183. [PMID: 35030447 DOI: 10.1016/j.schres.2021.12.044] [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: 04/22/2021] [Revised: 11/21/2021] [Accepted: 12/25/2021] [Indexed: 10/19/2022]
Abstract
Recovery-oriented practice has been advocated in mental health services in Hong Kong since 2009. Well-being has become an important area of focus for mental health services. Positive Psychotherapy for Psychosis (PPP) is a well-being-focused intervention for use in psychosis, with preliminary evidence from a randomized controlled trial in the United Kingdom of impact on well-being and symptomatology. The aim of this study was to test the effectiveness of PPP on the well-being of people with psychosis in Hong Kong. The study was a randomized controlled trial with two-arm parallel groups. Both groups received treatments as usual, and in addition the intervention group received a 13-session intervention based on a Cantonese Chinese translation of the PPP manual. Intention-to-treat analysis was used. The trial was registered (ANZCTR: ACTRN12620000464965). A total of 154 participants (78 intervention, 76 control) were recruited. As compared to control group, intervention group participants showed significant changes over time on the primary outcome of well-being assessed using the Chinese Short Warwick-Edinburgh Mental Well-being Scale (p = 0.001) and on secondary outcomes of hope (Agency subscale: p = 0.029) and self-efficacy (p = 0.001). Positive Psychotherapy for Psychosis was found to be an effective treatment in improving the well-being and other mental health outcomes for people with psychosis. It can be recommended for use in mental health services to promote recovery.
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Affiliation(s)
- Menza Hon-Wai Chu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China.
| | - Bien Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Joey Leung
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Sheung Chun Chan
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Betty Tang
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Charles Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | | | - Rose Chiu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - William Tak-Lam Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Beate Schrank
- Karl Landsteiner University of Health Sciences, Department of Psychiatry, Krems, Austria
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, United Kingdom
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6
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Kasperek‐Zimowska B, Bednarek A, Giguere M, Parnowska D, Żochowska A, Malewicz‐Sawicka M. The impact of positive psychotherapy of psychoses on the subjective well‐being of people suffering from chronic schizophrenia—Preliminary report. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Agata Bednarek
- Daily Psychiatric Ward Institute of Psychiatry and Neurology Warsaw Poland
| | - Marta Giguere
- Daily Psychiatric Ward Institute of Psychiatry and Neurology Warsaw Poland
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Pina I, Braga CDM, de Oliveira TFR, de Santana CN, Marques RC, Machado L. Positive psychology interventions to improve well-being and symptoms in people on the schizophrenia spectrum: a systematic review and meta-analysis. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:430-437. [PMID: 33331497 PMCID: PMC8352741 DOI: 10.1590/1516-4446-2020-1164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/18/2020] [Indexed: 01/07/2023]
Abstract
Objective: Positive psychology interventions (PPIs) incorporate principles of personal strengths with the view that mental health recovery transcends symptom relief. Severe psychiatric conditions, such as schizophrenia, may benefit from such interventions. This study aims to gather the current evidence on the impact of PPIs on increasing well-being in patients on the schizophrenia spectrum and assess reductions in negative or positive symptoms. Methods: A systematic review of PPI studies with schizophrenia-spectrum patients was carried out following PRISMA recommendations. The PubMed, PsycINFO, Web of Science, and Scopus databases were searched for relevant publications in order to understand the possible effects of these interventions on well-being measures and psychotic symptoms in this population. Results: Nine studies (four controlled) were included. Meta-analysis of the controlled studies showed a significant effect (p = 0.04) for improvement of well-being (Z = 2.01). Overall, the reviewed evidence suggests well-being improvement. The effect on reduction of negative symptoms was unclear. Conclusion: Used as an adjunctive therapy, PPIs appear to be a promising resource for patients on the schizophrenia spectrum, with possible effects on well-being and symptom reduction.
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Affiliation(s)
- Isabela Pina
- Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Catarina de M Braga
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
| | | | - Camila N de Santana
- Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Rodrigo C Marques
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
| | - Leonardo Machado
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
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Chan K, Wong F, Tam SL, Kwok CP, Fung YP, Wong PN. The effects of a brief hope intervention on decision-making in chronic kidney disease patients: A study protocol for a randomized controlled trial. J Adv Nurs 2020; 76:3631-3640. [PMID: 33038022 DOI: 10.1111/jan.14520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/15/2020] [Accepted: 07/15/2020] [Indexed: 11/26/2022]
Abstract
AIMS This study describes the study protocol of a manualized brief hope intervention that is based on the theoretical proposition - hope theory. BACKGROUND Patients with stage 5 chronic kidney disease often had decisional regret when facing the tension of treatment alternatives between dialysis initiation and palliative care. Hope has been found to account for therapeutic changes in clients with depressive symptoms, heightens positive expectations, and striving to accomplish chosen goals. Nevertheless, little is known about the effect of hope on decisional conflict and its influences to the quality of life in these chronic kidney disease patients. DESIGN This study is a single-blinded, randomized controlled trial. METHODS Participants will be recruited from a regional hospital (approved in April 2018). They will be randomly assigned in equal numbers to either the brief hope intervention or the control arm on completion of the baseline assessment on the possible need of dialysis initiation. Participants in the intervention group will receive the pre-dialysis education and a 4-week Brief Hope Intervention [consisting of four sessions at weekly intervals (two face-to-face sessions and two telephone follow-up sessions in between)], while those allocated to the control arm will receive the renal education and social chats. Outcome measures will be carried out prior to the intervention (baseline), immediately, and 1 month after the intervention. These consist of the hope level, decisional conflict, and quality of life. Healthcare resources use data will be reported. IMPACT The study results have the potential to add scientific evidence to the research-tested programme when developing renal services integral to multimodal care management to optimize decision-making and attain better health outcomes.
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Affiliation(s)
- Kitty Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Frances Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Suet Lai Tam
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
| | - Ching Ping Kwok
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
| | - Yuen Ping Fung
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
| | - Ping Nam Wong
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
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Positive intervention for depression and teacher-student relationship in Iranian high school girl students with moderate/mild depression: a pilot randomized controlled trial. Child Adolesc Psychiatry Ment Health 2020; 14:25. [PMID: 32518587 PMCID: PMC7271528 DOI: 10.1186/s13034-020-00331-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 05/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Positive intervention (PI) is a modern and therapeutic approach broadly based on the principles of positive psychology (Rashid in J Posit Psychol 1:25-40, 2014). PI effects at schools have received little attention to date. However, since PI offers a focus on the positive aspects of human experience (Seligman and Csikszentmihalyi in Am Psychol 55:5-14, 2000), we hypothesized that it could exert positive changes in the teacher-student relationship (TSR) and depression symptoms. Therefore, the mentioned pilot study conducted in this article aimed at evaluating PI effects on depression and TSR among Iranian high school girl students with moderate/mild depression. METHOD In this research, 60 eligible female students (aged 15-18) with a Beck Depression Inventory-II (BDI-II) mild-moderate depression diagnosis, were randomly divided into PI (n = 30) and control groups (n = 30) at the time of entering the study and 2 months later following their assessments through the Inventory of TSR (IT-SR) and BDI-II. The intervention group participated in 8-week 2 h group sessions of PI and the control group was evaluated without any intervention. RESULTS The study was completed with a total number of 49 girls [PI group (n = 24), and control group (n = 25)] and everybody participate in 8 sessions. The intervention group was effective on the variables of BDI-II and IT-SR in a way that the involved girls increased their communication (p = 0.001, d = 0.17), trust (p = 0.001 d = 0.14) after PI training and decreased alienation (p = 0.012, d = 0.11) and depression (p = 0.001, d = 0.15) among other high school students. CONCLUSION This intervention could function as an unspecific component of a stepped care approach for teenage girls suffering from depression. This study recommends more RCT with large sample sizes among high school boys students and follow-up.
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Ibrahim N, Thompson D, Nixdorf R, Kalha J, Mpango R, Moran G, Mueller-Stierlin A, Ryan G, Mahlke C, Shamba D, Puschner B, Repper J, Slade M. A systematic review of influences on implementation of peer support work for adults with mental health problems. Soc Psychiatry Psychiatr Epidemiol 2020; 55:285-293. [PMID: 31177310 DOI: 10.1007/s00127-019-01739-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/03/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE The evidence base for peer support work in mental health is established, yet implementation remains a challenge. The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work. METHODS Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measure based on the strongest influences was conducted. The review protocol was pre-registered (Prospero: CRD42018094838). RESULTS The search strategy identified 5813 publications, of which 53 were included. Fourteen implementation influences were identified, notably organisational culture (reported by 53% of papers), training (42%) and role definition (40%). Ratings on a measure using these influences demonstrated preliminary evidence for the convergent and discriminant validity of the identified influences. CONCLUSION The identified influences provide a guide to implementation of peer support. For services developing a peer support service, organisational culture including role support (training, role clarity, resourcing and access to a peer network) and staff attitudes need to be considered. The identified influences provide a theory base to prepare research sites for implementing peer support worker interventions.
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Affiliation(s)
- Nashwa Ibrahim
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK.,Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Dean Thompson
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK
| | - Rebecca Nixdorf
- Department of Psychiatry, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Jasmine Kalha
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | | | - Galia Moran
- Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | - Grace Ryan
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Julie Repper
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK.
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Coates R, Ayers S, de Visser R, Thornton A. Evaluation of the CORE-10 to assess psychological distress in pregnancy. J Reprod Infant Psychol 2019; 38:311-323. [PMID: 31870174 DOI: 10.1080/02646838.2019.1702631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Women experience diverse symptoms of mental ill-health in pregnancy, yet measures usually only assess depression or anxiety. Measures may, therefore, miss out on identifying women experiencing distress. OBJECTIVE We aimed to examine the validity and reliability of the CORE-10: a short measure with broad coverage of symptoms of distress and associated functioning, in pregnant women. METHODS 366 women 26-38 weeks pregnant completed online measures of distress (CORE-10), depression (Whooley questions), anxiety (Generalised Anxiety Disorder-2), and a single item measuring worry about psychological health. We examined convergent and factorial validity and concordance rates of the measures. RESULTS Levels of distress were high, with anxiety the most reported symptom. The CORE-10 showed good convergent validity. A two-factor structure representing 'symptoms' and 'ways of coping' best fit this sample. Internal reliability of the symptoms' factor was good. DISCUSSION The self-selected online sample may not be representative of pregnant women in the third trimester and a diagnostic interview was not used. Based on this validation study, the CORE-10 potentially offers an assessment of a broad range of symptoms of postnatal distress within the confines of a measure brief enough to be usable in clinical settings. Further validation is needed.
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Affiliation(s)
- Rose Coates
- School of Psychology, University of Sussex , Brighton, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City University London , London, UK
| | | | - Alexandra Thornton
- Centre for Maternal and Child Health Research, School of Health Sciences, City University London , London, UK
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12
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Slade M, Rennick-Egglestone S, Blackie L, Llewellyn-Beardsley J, Franklin D, Hui A, Thornicroft G, McGranahan R, Pollock K, Priebe S, Ramsay A, Roe D, Deakin E. Post-traumatic growth in mental health recovery: qualitative study of narratives. BMJ Open 2019; 9:e029342. [PMID: 31256037 PMCID: PMC6609070 DOI: 10.1136/bmjopen-2019-029342] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/12/2019] [Accepted: 05/31/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Post-traumatic growth, defined as positive psychological change experienced as a result of the struggle with challenging life circumstances, is under-researched in people with mental health problems. The aim of this study was to develop a conceptual framework for post-traumatic growth in the context of recovery for people with psychosis and other severe mental health problems. DESIGN Qualitative thematic analysis of cross-sectional semi-structured interviews about personal experiences of mental health recovery. SETTING England. PARTICIPANTS Participants were adults aged over 18 and: (1) living with psychosis and not using mental health services (n=21); (2) using mental health services and from black and minority ethnic communities (n=21); (3) underserved, operationalised as lesbian, gay, bisexual and transgender community or complex needs or rural community (n=19); or (4) employed in peer roles using their lived experience with others (n=16). The 77 participants comprised 42 (55%) female and 44 (57%) white British. RESULTS Components of post-traumatic growth were present in 64 (83%) of recovery narratives. Six superordinate categories were identified, consistent with a view that post-traumatic growth involves learning about oneself (self-discovery) leading to a new sense of who one is (sense of self) and appreciation of life (life perspective). Observable positively valued changes comprise a greater focus on self-management (well-being) and more importance being attached to relationships (relationships) and spiritual or religious engagement (spirituality). Categories are non-ordered and individuals may start from any point in this process. CONCLUSIONS Post-traumatic growth is often part of mental health recovery. Changes are compatible with research about growth following trauma, but with more emphasis on self-discovery, integration of illness-related experiences and active self-management of well-being. Trauma-related growth may be a preferable term for participants who identify as having experienced trauma. Trauma-informed mental healthcare could use the six identified categories as a basis for new approaches to supporting recovery. TRIAL REGISTRATION NUMBER ISRCTN11152837.
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Affiliation(s)
- Mike Slade
- Institute of Mental Health, University of Nottingham School of Health Sciences, Nottingham, UK
| | | | - Laura Blackie
- Department of Psychology, University of Nottingham, Nottingham, UK
| | - Joy Llewellyn-Beardsley
- Institute of Mental Health, University of Nottingham School of Health Sciences, Nottingham, UK
| | - Donna Franklin
- Institute of Mental Health, NEON Lived Experience Advisory Panel, Nottingham, UK
| | - Ada Hui
- Institute of Mental Health, University of Nottingham School of Health Sciences, Nottingham, UK
| | - Graham Thornicroft
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rose McGranahan
- Unit of Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Stefan Priebe
- Unit of Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Amy Ramsay
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - David Roe
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Emilia Deakin
- Institute of Mental Health, University of Nottingham School of Health Sciences, Nottingham, UK
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13
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The challenge of well-being and quality of life: A meta-analysis of psychological interventions in schizophrenia. Schizophr Res 2019; 208:16-24. [PMID: 30833133 DOI: 10.1016/j.schres.2019.01.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 11/08/2018] [Accepted: 01/27/2019] [Indexed: 02/03/2023]
Abstract
Well-being is a critical outcome in the recovery from psychosis and the prevention of symptoms. Previous reviews of the effectiveness of psychological interventions have focused on psychotic symptoms and general psychopathology, not recognising well-being as an essential outcome. This study conducted a meta-analysis of the effects of psychological interventions on the well-being and quality of life (QoL) of people with schizophrenia and analysed some critical moderating factors. A systematic literature search was conducted yielding 12986 published reports, 2043 of which were clinical trials. After a detailed review, 36 articles were included in the analyses. Measures of related concepts, well-being and quality of life were included in the present meta-analysis to reflect the current state of the literature and to ensure the representativeness of RCTs that have evaluated the effect of psychological interventions on the extent to which people with schizophrenia experience a good life. Our findings reflect a significant, small, treatment effect on the outcomes of well-being. Subgroup analysis also suggested a significant moderating effect when the primary aim of the intervention was well-being. These findings suggest that symptom or functional improvement does not necessarily lead to an improvement in well-being and would imply the need to focus specifically on those. We recommend psychological interventions that target well-being as a complementary strategy in mental health promotion and treatment. In addition, we stress the need to include well-being outcome measure in RCT as well as to clearly identify the different domains of well-being being measured.
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Chan K, Wong FKY, Lee PH. A Brief Hope Intervention to Increase Hope Level and Improve Well-Being in Rehabilitating Cancer Patients: A Feasibility Test. SAGE Open Nurs 2019; 5:2377960819844381. [PMID: 33415238 PMCID: PMC7774404 DOI: 10.1177/2377960819844381] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/23/2019] [Indexed: 12/22/2022] Open
Abstract
This article reports on the feasibility and effect of the brief hope intervention (BHI) in terms of increasing the hope level and psychological and physical health outcomes of rehabilitating cancer patients (RCP). Chinese RCP living in the community were invited to join the study. The BHI consisted of four one-on-one sessions: two (1-hour) face-to-face sessions and two (30-minute) telephone follow-up sessions in between. There were three core features in the hope therapy: (a) goal thoughts: finding workable goals, (b) pathway thoughts: finding ways to reach the targets, and (c) agency thoughts: positive self-talk to optimize their motivation to accomplish the set goals. A one-group pre- and postintervention design was used. Outcome measures included the Memorial Symptom Assessment Scale, the Center for Epidemiological Studies Depression Scale (CES-D), and the State Hope Scale. Recruitment, attrition, and qualitative feedback were collected to understand their comments on BHI. A total of 40 participants were recruited (female 92.3%). The mean age was 57.2 years (SD = 6.7). The participants had significant improvement in all aspects of the Memorial Symptom Assessment Scale, with moderate-to-large effect sizes (d = 0.49-0.74). The changes in present hope and depression scores were insignificant, with small effect sizes (d = 0.17-0.34). The BHI seemed to be promising in producing both physical and psychological benefits in RCP.
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Affiliation(s)
- Kitty Chan
- School of Nursing, The Hong Kong Polytechnic University, People's Republic of China
| | - Frances K Y Wong
- School of Nursing, The Hong Kong Polytechnic University, People's Republic of China
| | - Paul H Lee
- School of Nursing, The Hong Kong Polytechnic University, People's Republic of China
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15
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Abstract
Abstract
Positive psychology directs its research interests primarily to healthy people. The most important goal is to build a positive attitude towards yourself and the surrounding world. Recently, positive psychology has set a new area of research interest, which is clinical psychology. In recent years, several positive psychotherapy programs have been developed for people with schizophrenia experience. The article presents the latest trends in positive psychotherapy for people with schizophrenia. They involve taking into account the individual differences of each patient and the specificity of his / her psychopathology. As far as the therapeutic goals are concerned, there are interventions focused on strategies for enhancing positive emotions and wellbeing or the method of activating the strengths of character. Taking into account the methods of therapeutic work, they can be divided into training methods or those of the behavioral-cognitive psychotherapy as well as those that take into account the various aspects of meditation. The article presents the distribution of therapeutic programs in terms of the range of therapeutic goals in which the most important are: intensification of positive experiences, building of strengths of character and well-being. Therapeutic programs have been shown to focus not only on breaking down negative attitudes towards one’s own illness and life, but also on those that try to deal with the unsolved schizophrenia problem - negative symptoms.
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16
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Guo YF, Zhang X, Plummer V, Lam L, Cross W, Zhang JP. Positive psychotherapy for depression and self-efficacy in undergraduate nursing students: A randomized, controlled trial. Int J Ment Health Nurs 2017; 26:375-383. [PMID: 27633932 DOI: 10.1111/inm.12255] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 11/28/2022]
Abstract
Nursing students across the globe experience depressive symptoms, and many interventions have been used to alleviate their depression. However, few interventions focus on students' personal strengths and advantages. The aim of the present study was to explore the effects of an 8-week group positive psychotherapy (PPT) programme on depression and self-efficacy in full-time undergraduate nursing students. A randomized, controlled trial was conducted for 76 nursing students (34 in the experimental group, 42 in the control group). The Beck Depression Inventory-II and the General Self-Efficacy Scale were used to collect data prior to, immediately after PPT, 3 months', and 6 months' post-PPT. Repeated-measures analysis of variance indicated that the intervention significantly alleviated depression and improved self-efficacy (each P < 0.05); the effect of time and time-group interaction was also significant (each P < 0.05). The findings suggest that PPT could significantly relieve depressive symptoms and improve self-efficacy. We recommend that PPT is effective in alleviating depression and improving self-efficacy in undergraduate nursing students. Academic mental health nurses should appreciate the value of PPT and consider incorporating it in psychological support methods in order to facilitate nursing students' mental health.
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Affiliation(s)
- Yu-Fang Guo
- Nursing Psychology Research Center of Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Xia Zhang
- Nursing Psychology Research Center of Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Virginia Plummer
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Louisa Lam
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Wendy Cross
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Jing-Ping Zhang
- Nursing Psychology Research Center of Xiangya Nursing School, Central South University, Changsha, Hunan, China
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17
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Walsh S, Cassidy M, Priebe S. The Application of Positive Psychotherapy in Mental Health Care: A Systematic Review. J Clin Psychol 2016; 73:638-651. [PMID: 27482845 DOI: 10.1002/jclp.22368] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/31/2016] [Accepted: 06/19/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Positive psychotherapy (PPT) stems from the positive psychology movement and is a multicomponent model promoting therapeutic change by developing engagement, pleasure, and meaning. There is some evidence it is effective for depression. PPT is recommended as a flexible model that can be applied to other patient groups alongside other treatments approaches. However, it remains unclear which of the many components are applied. The study aimed to identify how PPT is applied in mental health care. METHOD We systematically searched online databases, including Medline, Embase, PsycINFO, British Nursing Index, Cumulative Index of Nursing and Applied Health, and Cochrane registers (CENTRAL), and completed complementary hand and citation searches. Narrative synthesis was used for analysis. RESULTS A total of 12 papers (from 9 studies) widely applied some PPT components (e.g., blessings journal, character strengths) and scarcely applied others (e.g., satisficing plan or family strengths tree). However, papers poorly described the intervention and rationale for applying components. CONCLUSION Given the lack of rationale for applying PPT, further research is needed to establish which components are acceptable and feasible for use in different patient groups and settings.
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Affiliation(s)
- Sophie Walsh
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London
| | - Megan Cassidy
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London
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18
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Schrank B, Brownell T, Jakaite Z, Larkin C, Pesola F, Riches S, Tylee A, Slade M. Evaluation of a positive psychotherapy group intervention for people with psychosis: pilot randomised controlled trial. Epidemiol Psychiatr Sci 2016; 25:235-46. [PMID: 25698298 PMCID: PMC6998731 DOI: 10.1017/s2045796015000141] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/18/2015] [Accepted: 01/19/2015] [Indexed: 12/13/2022] Open
Abstract
AIMS Third-wave psychological interventions have gained relevance in mental health service provision but their application to people with psychosis is in its infancy and interventions targeting wellbeing in psychosis are scarce. This study tested the feasibility and preliminary effectiveness of positive psychotherapy adapted for people with psychosis (WELLFOCUS PPT) to improve wellbeing. METHODS WELLFOCUS PPT was tested as an 11-week group intervention in a convenience sample of people with psychosis in a single centre randomised controlled trial (ISRCTN04199273) involving 94 people with psychosis. Patients were individually randomised in blocks to receive either WELLFOCUS PPT in addition to treatment as usual (TAU), or TAU only. Assessments took place before randomisation and after the therapy. The primary outcome was wellbeing (Warwick-Edinburgh Mental Well-Being Scale, WEMWBS). Secondary outcomes included symptoms (Brief Psychiatric Rating Scale), depression (Short Depression-Happiness Scale), self-esteem, empowerment, hope, sense of coherence, savouring beliefs and functioning, as well as two alternative measures of wellbeing (the Positive Psychotherapy Inventory and Quality of Life). Intention-to-treat analysis was performed. This involved calculating crude changes and paired-sample t-tests for all variables, as well as ANCOVA and Complier Average Causal Effect (CACE) Analysis to estimate the main effect of group on all outcomes. RESULTS The intervention and trial procedures proved feasible and well accepted. Crude changes between baseline and follow-up showed a significant improvement in the intervention group for wellbeing according to all three concepts assessed (i.e., WEMWBS, Positive Psychotherapy Inventory and Quality of Life), as well as for symptoms, depression, hope, self-esteem and sense of coherence. No significant changes were observed in the control group. ANCOVA showed no main effect on wellbeing according to the primary outcome scale (WEMWBS) but significant effects on symptoms (p = 0.006, ES = 0.42), depression (p = 0.03, ES = 0.38) and wellbeing according to the Positive Psychotherapy Inventory (p = 0.02, ES = 0.30). Secondary analysis adapting for therapy group further improved the results for symptom reduction (p = 0.004, ES = 0.43) and depression (p = 0.03, ES = 0.41) but did not lead to any more outcomes falling below the p = 0.05 significance level. CACE analysis showed a non-significant positive association between the intervention and WEMWBS scores at follow-up (b = 0.21, z = 0.9, p = 0.4). CONCLUSIONS This study provides initial evidence on the feasibility of WELLFOCUS PPT in people with psychosis, positively affecting symptoms and depression. However, more work is needed to optimise its effectiveness. Future research might evaluate positive psychotherapy as a treatment for comorbid depression in psychosis, and consider alternative measurements of wellbeing.
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Affiliation(s)
- Beate Schrank
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tamsin Brownell
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Zivile Jakaite
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Charley Larkin
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Francesca Pesola
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Simon Riches
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Andre Tylee
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mike Slade
- Institure of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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19
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Broyd A, Jolley S, Johns L. Determinants of subjective well-being in people with psychosis referred for psychological therapy in South London. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2016; 55:429-440. [DOI: 10.1111/bjc.12112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 03/31/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Annabel Broyd
- Department of Psychology; Institute of Psychiatry, Psychology and Neuroscience (IoPPN); King's College, London; UK
| | - Suzanne Jolley
- Department of Psychology; Institute of Psychiatry, Psychology and Neuroscience (IoPPN); King's College, London; UK
| | - Louise Johns
- Department of Psychology; Institute of Psychiatry, Psychology and Neuroscience (IoPPN); King's College, London; UK
- Department of Psychiatry; Oxford University; UK
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20
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Schrank B, Brownell T, Riches S, Chevalier A, Jakaite Z, Larkin C, Lawrence V, Slade M. Staff views on wellbeing for themselves and for service users. J Ment Health 2015; 24:48-53. [PMID: 25587818 DOI: 10.3109/09638237.2014.998804] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Wellbeing is an important outcome in the context of recovery from mental illness. The views of mental health professionals on wellbeing may influence their approach to supporting recovery. AIMS This study aims to explore views held by mental health staff about factors influencing their own wellbeing and that of service users with psychosis. METHODS Semi-structured interviews were conducted with 14 mental health staff in South London who had worked with people with psychosis. Thematic analysis was used to analyse the data and comparisons were made between staff views of wellbeing for themselves and service users. RESULTS Staff participants held similar conceptualisations of wellbeing for themselves and for service users. However, they suggested a differential impact on wellbeing for a number of factors, such as balance, goals and achievement, and work. Staff employed a more deficit-based perspective on wellbeing for service users and a more strengths-based view for themselves. CONCLUSIONS Staff stated a recovery orientation in principle, but struggled to focus on service user strengths in practice. A stronger emphasis in clinical practice on amplifying strengths to foster self-management is indicated, and staff may need support to achieve this emphasis, e.g. through specific interventions and involvement of peer support workers.
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Affiliation(s)
- Beate Schrank
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience (Box P029) , De Crespigny Park, London , UK and
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Brownell T, Schrank B, Jakaite Z, Larkin C, Slade M. Mental Health Service User Experience of Positive Psychotherapy. J Clin Psychol 2014; 71:85-92. [DOI: 10.1002/jclp.22118] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Beate Schrank
- King's College London; Institute of Psychiatry
- Medical University of Vienna
| | | | | | - Mike Slade
- King's College London; Institute of Psychiatry
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