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Douglas S, Page AC, Moltu C, Kyron M, Satterthwaite T. The Connections Matter: Bi-Directional Learning in Program Evaluation and Practice-Oriented Research. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:318-335. [PMID: 37768486 DOI: 10.1007/s10488-023-01304-8] [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: 09/17/2023] [Indexed: 09/29/2023]
Abstract
Intended for researchers and clinical leaders, this article suggests that embedded program evaluation is a good fit with the desired features of practice-oriented research. The systematic nature of evaluation that is built into the operational workflow of a practice setting may increase the diversity of methods available to explore processes and outcomes of interest. We propose a novel conceptual framework that uses a human-centered systems lens to foster such embedded evaluation in clinical routine. This approach emphasizes the evaluator-practitioner partnership to build confidence in the bi-directional learning of practice-based evidence with evidence-based practice. The iterative cycles inherent to design thinking are aimed at developing better evaluation questions. The attention to structure and context inherent to systems thinking is intended to support meaningful perspectives in the naturally complex world of health care. Importantly, the combined human-centered systems lens can create greater awareness of the influence of individual and systemic biases that exist in any endeavor or institution that involves people. Recommended tools and strategies include systems mapping, program theory development, and visual facilitation using a logic model to represent the complexity of mental health treatment for communication, shared understanding, and connection to the broader evidence base. To illustrate elements of the proposed conceptual framework, two case examples are drawn from routine outcome monitoring (ROM) and progress feedback. We conclude with questions for future collaboration and research that may strengthen the partnership of evaluators and practitioners as a community of learners in service of local and system-level improvement.
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Affiliation(s)
- Susan Douglas
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA.
| | - Andrew C Page
- School of Psychological Science and WA Mental Health Research Centre, University of Western Australia, Perth, Australia
| | - Christian Moltu
- District General Hospital of Førde, Førde, Norway
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway
| | - Michael Kyron
- School of Psychological Science and WA Mental Health Research Centre, University of Western Australia, Perth, Australia
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Cooper M, Xu D. Goals Form: Reliability, validity, and clinical utility of an idiographic goal-focused measure for routine outcome monitoring in psychotherapy. J Clin Psychol 2023; 79:641-666. [PMID: 35366375 PMCID: PMC10084194 DOI: 10.1002/jclp.23344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/12/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aimed to assess the reliability, validity, and clinical utility of an idiographic, goal-focused patient-reported outcome measure: The Goals Form. METHODS Data were analyzed from 88 participants, across three samples, who had participated in collaborative-integrative psychotherapy at university-based clinics in the UK. The samples were approximately 70% female with mean age of 30 years old. RESULTS The psychometric properties of the Goals Form were generally good. Noncompletion of individual items was low, temporal stability tended to be at target levels, and mean change scores showed moderate to good convergent validity against measures of psychological distress. The measure appeared sensitive to change in psychotherapy and was experienced by most patients as helpful. CONCLUSIONS The Goals Form shows acceptable psychometric and clinical properties for routine outcome monitoring in psychotherapy.
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Affiliation(s)
- Mick Cooper
- School of Psychology, University of Roehampton, London, UK
| | - Dan Xu
- School of Psychology, University of Roehampton, London, UK.,Department of Psychology, Zhejiang University of Technology, Hangzhou, Zhejiang, China
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3
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Kalsås ØR, Dyregrov K, Fadnes LT, Titlestad KB. The social health domain of people bereaved by a drug-related death and associations with professional help: A cross-sectional study. DEATH STUDIES 2022; 47:926-937. [PMID: 36347016 DOI: 10.1080/07481187.2022.2142329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
People bereaved by traumatic deaths are vulnerable to long-lasting impairments in social health, including the quality of social relationships and the capacity to manage their social lives. In this Norwegian study involving 255 participants bereaved by a drug-related death, we aimed to investigate their social health and associations with professional help. The results of a cross-sectional survey showed that participants on average rated their social health as poor, though with large variations within the group. Participants who reported high satisfaction with professional help reported significantly higher scores on most social health-related variables. More research is needed on professional help focusing on the social health of traumatically bereaved people.
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Affiliation(s)
- Øyvind R Kalsås
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, Vestland, Norway
| | - Kari Dyregrov
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, Vestland, Norway
| | - Lars Thore Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kristine B Titlestad
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, Vestland, Norway
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Tamayo N, Lane A. Effective Nursing Recovery-Oriented Interventions for Individuals With Substance Use Disorder: A Literature Review. J Addict Nurs 2022; 33:233-246. [PMID: 37140411 DOI: 10.1097/jan.0000000000000489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
ABSTRACT Nurses support the recovery of individuals with substance use disorder. How they support individuals, however, may impact the effectiveness of their work. For example, there are various paradigms of recovery that alter interventions. In addition, negative attitudes adopted by clinicians discourage individuals who use substances from accessing healthcare services, experiencing further health deterioration. Alternatively, nurses can enact interventions that promote positive experiences, further supporting the recovery of individuals. Hence, it is beneficial to increase nurses' awareness of effective interventions that promote recovery. The purpose of this literature review is to examine effective nursing interventions that promoted recovery of those with substance use disorders from the perspective of nurses and individuals who received nursing care. The review identified that effective interventions were based on three major themes: person-centered care, empowerment, and maintaining supports and capability enhancement. In addition, literature revealed that some interventions were perceived to be more effective; this depended on whose viewpoint was examined-nurses or individuals with substance use disorders. Finally, there are interventions based on spirituality, culture, advocacy, and self-disclosure that are often disregarded but may be effective. Nurses should utilize the more prominent interventions as they offer the most benefit and integrate interventions that are often overlooked.
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Weir B, Struthers R, Reid L, Wild C, Robinson L. Psychological recovery in a step 4 service: a qualitative study exploring the views of service users and clinicians. JOURNAL OF MENTAL HEALTH (ABINGDON, ENGLAND) 2021; 31:220-226. [PMID: 33978537 DOI: 10.1080/09638237.2021.1922640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Psychological recovery is typically measured in improving access to psychological therapies (IAPT) services as the reduction of symptoms on routine outcome measures (ROMs). However, conceptualisations of psychological recovery vary, and there are concerns that ROMs may not be suitable for measuring recovery from complex mental health difficulties. AIM To gain insight into psychological recovery and measurement in clinical practice. METHOD A qualitative study at a step-4 IAPT service in the North of England. Eight clinicians contributed to focus groups, and 10 service users were later interviewed individually. RESULTS Factors that informed four congruent and interacting themes of recovery were identified among participants as an ongoing personal process, of intra-therapeutic and extra-therapeutic factors impacting on recovery in helpful and unhelpful ways, and the need for idiographic long-term recovery measures. The functional and long-term nature of recovery and the socio-economic context for recovery were considered particularly crucial. CONCLUSIONS The need for idiographic long-term recovery measures to support the ongoing process of recovery was reported in the majority of instances. Study findings mirrored existing recovery and outcome measurement literature, provided new evidence in relation to recovery from complex mental health difficulties, and made recommendations for future research and clinical practice.
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Affiliation(s)
- Bronagh Weir
- North Tyneside Talking Therapies, Wallsend Health Centre, Newcastle Upon Tyne, UK
| | - Ruth Struthers
- North Glasgow Child and Adolescent Mental Health Service, Glasgow, UK
| | - Lucy Reid
- North Tyneside Talking Therapies, Wallsend Health Centre, Newcastle Upon Tyne, UK
| | - Celia Wild
- North Tyneside Talking Therapies, Wallsend Health Centre, Newcastle Upon Tyne, UK
| | - Lucy Robinson
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
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Moltu C, McAleavey AA, Helleseth MM, Møller GH, Nordberg SS. How therapists and patients need to develop a clinical feedback system after 18 months of use in a practice-research network: a qualitative study. Int J Ment Health Syst 2021; 15:43. [PMID: 33975630 PMCID: PMC8111973 DOI: 10.1186/s13033-021-00465-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A personalized computer-adaptive system for clinical feedback and routine outcome monitoring in mental health, Norse Feedback aims to bridge the needs for standardized and idiographic measures in ordinary practice. METHODS Item response theory analyses of completed treatment processes (n = 800) informed a qualitative study comprising individual in-depth interviews and focus groups with patients (n = 9) and clinicians (n = 10). The research question was: How do clinicians and patients contribute to developing a clinical feedback system in a continuous process aimed at refining its clinical usefulness? RESULTS We conducted thematic analyses and found five themes: 1. Added clinical needs, 2. Needs for re-organizing the clinician report, 3.Needs for differentiation of clinical content, 4. User-interface needs, and 5. Item level suggestions. CONCLUSION In this article, we detail resulting needs for continuous adaptation to practice, and discuss implications of the concrete experiences with the Norse action research program for the larger field of ROM/CFS implementation.
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Affiliation(s)
- Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway. .,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway.
| | - Andrew A McAleavey
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,Weill Cornell Medical College, New York, NY, USA
| | | | - Geir Helge Møller
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Sam S Nordberg
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
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Continuous quality improvement in measure development: Lessons from building a novel clinical feedback system. Qual Life Res 2021; 30:3085-3096. [PMID: 33591432 PMCID: PMC8528746 DOI: 10.1007/s11136-021-02768-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/03/2022]
Abstract
Purpose While the use of clinical feedback systems has become commonplace in psychological treatment, many of the most common instruments used for this purpose have not changed in decades. This paper describes the first four cycles of a measure development method designed to embrace continuous quality improvement. Methods Using techniques and philosophies developed in business management and academia—lean continuous quality improvement, action research, and practice research networks—we iterated through multiple cycles of development with the goal of creating an optimal clinical feedback system. These cycles emphasize building capacity to receive and implement feedback from a variety of stakeholders, especially patients and providers of behavioral health services, while also being responsive to quantitative findings from measure development. Results Iterating measure development with stakeholder feedback over the course of 5 years has resulted in a novel measurement system with 19 subscales administered via branching logic, and a supporting practice research network to sustain development. Conclusion In developing a new clinical feedback system, the less-frequently-discussed practical aspects of measure development require close attention. Specifically, being willing to embrace change, planning for iteration, and systematically seeking stakeholder feedback are identified as central methods for improving clinical feedback systems.
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Vera San Juan N, Gronholm PC, Heslin M, Lawrence V, Bain M, Okuma A, Evans-Lacko S. Recovery From Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives. Front Psychiatry 2021; 12:712026. [PMID: 34539464 PMCID: PMC8440827 DOI: 10.3389/fpsyt.2021.712026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/14/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised. Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems. Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods. Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence. Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention. Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.
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Affiliation(s)
- Norha Vera San Juan
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Petra C Gronholm
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Margaret Heslin
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Vanessa Lawrence
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matthew Bain
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Ayako Okuma
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
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9
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Oedegaard CH, Davidson L, Stige B, Veseth M, Blindheim A, Garvik L, Sørensen JM, Søraa Ø, Engebretsen IMS. "It means so much for me to have a choice": a qualitative study providing first-person perspectives on medication-free treatment in mental health care. BMC Psychiatry 2020; 20:399. [PMID: 32770965 PMCID: PMC7414551 DOI: 10.1186/s12888-020-02770-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 06/29/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In 2016, the Western Norway Regional Health Authority started to integrate more evidence-based psychosocial interventions into the existing mental health care, emphasizing the right for persons with psychosis to choose medication-free treatment. This change emerged from the debate on the effectiveness and adverse effects of the use of antipsychotic medication. Aspects beyond symptom reduction, such as interpersonal relationships, increased understanding of one's own pattern of suffering, hope and motivation, are all considered important for the personal recovery process. METHODS This study explores whether these aspects were present in users' descriptions of their recovery processes within the medication-free treatment programme in Bergen, Western Norway. We interviewed ten patients diagnosed with psychosis who were eligible for medication-free services about their treatment experiences. Data were analysed using Attride-Stirling's thematic network approach. RESULTS The findings show a global theme relating to personal recovery processes facilitated by the provision of more psychosocial treatment options, with three organizing subthemes: interpersonal relationships between patients and therapists, the patient's understanding of personal patterns of suffering, and personal motivation for self-agency in the recovery process. Participants described an improved relationship with therapists compared to previous experiences. Integrating more evidence-based psychosocial interventions into existing mental health services facilitated learning experiences regarding the choice of treatment, particularly the discontinuation of medication, and appeared to support participants' increased self-agency and motivation in their personal recovery processes. CONCLUSION Health care in Norway is perhaps one step closer to optimizing care for people with psychosis, allowing for more patient choice and improving the dialogue and hence the interpersonal relationship between the patient and the therapist. Personal patterns of suffering can be explored within a system aiming to support and have a higher level of acceptance for the discontinuation of medication. Such a system requires personal agency in the treatment regimen, with more focus on personal coping strategies and more personal responsibility for the recovery process.
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Affiliation(s)
- Christine H. Oedegaard
- grid.412008.f0000 0000 9753 1393Haukeland University Hospital, Kronstad DPS, Pb 1400, 5021 Bergen, Norway ,grid.7914.b0000 0004 1936 7443Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Pb. 7804, 5020 Bergen, Norway
| | - Larry Davidson
- grid.47100.320000000419368710Department of Psychiatry, Yale Medical School, New Haven, Connecticut USA
| | - Brynjulf Stige
- grid.7914.b0000 0004 1936 7443The Grieg Academy, University of Bergen, Pb. 7800, 5020 Bergen, Norway
| | - Marius Veseth
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, University of Bergen, Pb. 7807, 5020 Bergen, Norway
| | - Anne Blindheim
- grid.412008.f0000 0000 9753 1393Haukeland University Hospital, Kronstad DPS, Pb 1400, 5021 Bergen, Norway
| | - Linda Garvik
- Hvite Ørn User Organisation, Thomles gt. 4, 0270 Oslo, Norway
| | | | - Øystein Søraa
- Hvite Ørn User Organisation, Thomles gt. 4, 0270 Oslo, Norway
| | - Ingunn Marie Stadskleiv Engebretsen
- grid.7914.b0000 0004 1936 7443Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Pb. 7804, 5020 Bergen, Norway
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Leibert TW, Powell RN, Fonseca FD. Client descriptions of outcomes compared with quantitative data: A mixed‐methods investigation of a quantitative outcome measure. COUNSELLING & PSYCHOTHERAPY RESEARCH 2019. [DOI: 10.1002/capr.12260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Todd W. Leibert
- Department of Counseling Oakland University Rochester MI USA
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11
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Eldal K, Veseth M, Natvik E, Davidson L, Skjølberg Å, Gytri D, Moltu C. Contradictory experiences of safety and shame in inpatient mental health practice – a qualitative study. Scand J Caring Sci 2019; 33:791-800. [DOI: 10.1111/scs.12674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 02/03/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Kari Eldal
- Department of Health and Care Sciences Western Norway University of Applied Sciences Førde Norway
| | - Marius Veseth
- Department of Clinical Psychology University of Bergen Bergen Norway
| | - Eli Natvik
- Department of Health and Care Sciences Western Norway University of Applied Sciences Førde Norway
| | - Larry Davidson
- Program for Recovery and Community Health School of Medicine and Institution for Social and Policy Studies Yale University New Haven CT USA
| | - Åse Skjølberg
- Department of Health and Care Sciences Western Norway University of Applied Sciences Førde Norway
- Center for Health Research in Sogn og Fjordane District General Hospital of Førde Førde Norway
| | - Dorte Gytri
- Center for Health Research in Sogn og Fjordane District General Hospital of Førde Førde Norway
| | - Christian Moltu
- Department of Health and Care Sciences Western Norway University of Applied Sciences Førde Norway
- Department of Psychiatry District General Hospital of Førde Førde Norway
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12
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Kverme B, Natvik E, Veseth M, Moltu C. Moving Toward Connectedness - A Qualitative Study of Recovery Processes for People With Borderline Personality Disorder. Front Psychol 2019; 10:430. [PMID: 30873097 PMCID: PMC6403141 DOI: 10.3389/fpsyg.2019.00430] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/12/2019] [Indexed: 11/29/2022] Open
Abstract
Borderline personality disorder (BPD) is a mental health disorder estimated to affect 1–2% of the general population. As a group, people with BPD endure a high degree of suffering, often leading to suicide attempts, self-harm, and suicide. Comparatively few studies explore the first person perspective of the person suffering from any mental health disorder. This might be especially problematic for people diagnosed with BPD, as this particular diagnosis is followed by stigma potentially making help seeking harder and helping relationships more vulnerable. We interviewed 12 female participants recently diagnosed with BPD in-depth about their experiences with recovery and treatment, and used a stepwise reflective approach to rigorously analyze the data. Results show an overarching theme of working toward connectedness, with four constituent sub-themes. We discuss the findings with regard to empirical work, recovery and autonomy, and the risk of epistemic injustice that people with BPD risk facing.
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Affiliation(s)
- Britt Kverme
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Eli Natvik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
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Review: What Outcomes Count? A Review of Outcomes Measured for Adolescent Depression Between 2007 and 2017. J Am Acad Child Adolesc Psychiatry 2019; 58:61-71. [PMID: 30577940 DOI: 10.1016/j.jaac.2018.07.893] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/03/2018] [Accepted: 08/15/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Measurement of treatment outcomes in childhood depression has traditionally focused on assessing symptoms from the clinician's perspective, without exploring other outcome domains or considering young people's perspectives. This systematic review explored the extent to which multidimensional and multi-informant outcome measurements have been used in clinical research for adolescent depression in the past decade and how patterns have evolved over time. METHOD Embase, Medline, and PsycINFO were searched, and studies that were published from 2007 through 2017 and assessed the effectiveness of treatments or service provision for adolescent depression were included. Of 7,483 studies screened, 95 met the inclusion criteria and were included for data extraction and analysis. RESULTS Ten outcomes domains were identified, 2 of which were assessed on average using 4 outcome measures. Most studies (94%) measured symptoms, followed by functioning (52%). Other domains such as personal growth, relationships, quality of life, and service satisfaction were each considered by less than 1 in 10 studies. Youth self-report was considered by 54% but tended to focus on secondary outcomes. Multidimensional and multi-informant measurements were more frequent in studies published since 2015. CONCLUSION Recent clinical research continues to prioritize symptoms measurement based on clinician report and has not yet fully embraced multidimensional and multi-informant approaches. In the context of significant policy shifts toward patient-centered and evidence-based care, measuring what matters most to patients has become a priority, but this is not yet widely reflected in clinical research.
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14
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Reichelt S, Skjerve J, McLeod J. Topic-focused analysis in a case of integrative psychotherapy with a father fearing his own anger. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2018. [DOI: 10.1080/13642537.2018.1459769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Jan Skjerve
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - John McLeod
- Department of Psychology, University of Oslo, Oslo, Norway
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15
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Lavik KO, Veseth M, Frøysa H, Binder PE, Moltu C. What are "good outcomes" for adolescents in public mental health settings? Int J Ment Health Syst 2018; 12:3. [PMID: 29387146 PMCID: PMC5775535 DOI: 10.1186/s13033-018-0183-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/15/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In line with the evidence-based paradigm, routine outcome monitoring and clinical feedback systems are now being recommended and implemented in youth mental health services. However, what constitutes a good outcome for young service users is not fully understood. In order to successfully monitor outcomes that are clinically and personally relevant for the service user that are to benefit from these systems, we need to gain more knowledge of what young service users value as meaningful outcomes of youth mental health services. AIM To contribute knowledge into what constitutes "good outcomes" from the experiences of adolescent service users in public mental health systems. METHODS A qualitative in-depth study of the experiences and reflections from 22 adolescents aged 14-19 years, currently or recently being in public mental health services. The data material was analyzed using a systematic step-wise consensual qualitative research framework for team-based analysis. RESULTS An overarching theme of outcome as having developed a stronger autonomy and safer identity emerged from the analysis, with the subsequent five constituent themes, named from the words of the adolescent clients: (1) I've discovered and given names to my emotions, (2) I've started to become the person that I truly am, (3) I've dared to open up and feel connected to others, (4) I've started saying yes where I used to say no, and, (5) I've learned how to cope with challenges in life. CONCLUSION "Good outcomes" in youth mental health services should be understood as recovery oriented, sensitive to developmental phases, and based on the personal goals and values of each adolescent client.
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Affiliation(s)
- Kristina O. Lavik
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Helga Frøysa
- Department of Community Mental Health Service, Askøy kommune, Bergen, Norway
| | - Per-Einar Binder
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
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Hansen H, Stige SH, Davidson L, Moltu C, Veseth M. How Do People Experience Early Intervention Services for Psychosis? A Meta-Synthesis. QUALITATIVE HEALTH RESEARCH 2018; 28:259-272. [PMID: 29039239 DOI: 10.1177/1049732317735080] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We conducted a study to explore how people diagnosed with first-episode psychosis experienced their contact with early intervention services for psychosis and the way these experiences relate to their recovery processes. Our aim was to integrate and describe the service users' experiences in a rigorous and comprehensive way. A broad literature search was performed in June and July 2016. After screening, 17 qualitative studies were included. We analyzed the findings in two main steps: (a) translating studies into one another and (b) synthesizing the findings from the studies. Through these interpretative processes, we found five new and overarching themes: (a) something is wrong, (b) do for myself, (c) it's about people, (d) a price to pay, and (e) ongoing vulnerability. We describe these themes as a process that service users' maneuver through in their contact with the services. Our findings are discussed in light of relevant research.
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Affiliation(s)
- Hege Hansen
- 1 Western Norway University of Applied Sciences, Bergen, Norway
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17
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Halvorsen MS, Benum K, Oddli HW, Stänicke E, McLeod J. How usual is treatment as usual? Experienced therapists’ reflections on participation in practice-based research. COUNSELLING PSYCHOLOGY QUARTERLY 2017. [DOI: 10.1080/09515070.2017.1397502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Kirsten Benum
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Erik Stänicke
- Department of Psychology, University of Oslo, Oslo, Norway
| | - John McLeod
- Department of Psychology, University of Oslo, Oslo, Norway
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18
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Veseth M, Binder PE, Stige SH. "If there's no stability around them": experienced therapists' view on the role of patients' social world in recovery in bipolar disorder. Int J Ment Health Syst 2017; 11:55. [PMID: 28943889 PMCID: PMC5607588 DOI: 10.1186/s13033-017-0166-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/18/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Recovery in severe mental illness has traditionally been described as a deeply personal process. At the same time, researchers are increasingly attending to the social nature of such processes. In this article, we aim to supplement the growing knowledge base regarding these social aspects by exploring the perspectives of experienced therapists: how do they view the role of the social world in processes of healing and growth for people with bipolar disorder? And in what ways can the social world impede recovery? METHODS We conducted 12 semi-structured individual interviews and analyzed the resulting transcripts using a team-based thematic analysis method. RESULTS We identified three themes: (a) establishing a sense of belonging; (b) backing ongoing therapy; and (c) relational ripple effects. CONCLUSIONS We relate our findings to existing theory and research, discuss clinical implications, and highlight study limitations. We argue that our findings underscore the need to integrate an understanding of recovery as a personal and social process in the mental health care services that we provide.
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Affiliation(s)
- Marius Veseth
- Department of Clinical Psychology, University of Bergen, Christies gate 12, 5012 Bergen, Norway
| | - Per-Einar Binder
- Department of Clinical Psychology, University of Bergen, Christies gate 12, 5012 Bergen, Norway
| | - Signe Hjelen Stige
- Department of Clinical Psychology, University of Bergen, Christies gate 12, 5012 Bergen, Norway
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19
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Råbu M, Haavind H. Coming to terms: Client subjective experience of ending psychotherapy. COUNSELLING PSYCHOLOGY QUARTERLY 2017. [DOI: 10.1080/09515070.2017.1296410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Marit Råbu
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Hanne Haavind
- Department of Psychology, University of Oslo, Oslo, Norway
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