[Food addictions]

Addictions are invading our daily lives. Eating and body image have become major preoccupations. Anorexia nervosa and bulimia nervosa are eating disorders with a high risk of chronicity and death. Curing them and preventing their recurrence requires a solid therapeutic alliance that aims to work around individual symptoms. The low self-esteem associated with these disorders may contribute to their maintenance, despite their negative impact on quality of life. One of the challenges of treating these disorders is to help patients find the motivation to seek treatment.

Parenting the parent without losing sight of the child. A qualitative study of therapists' experiences with intergenerational adversities in perinatal psychotherapy

The complex work of addressing intergenerational adversities, like violence, abuse, and neglect through perinatal psychotherapy, is understudied. Especially noticeable is the paucity of studies giving voice to the therapists. This study explored therapeutic processes through the perspectives of seven Norwegian therapists. A qualitative approach was chosen with individual interviews and a follow-up focus group. Data were analyzed using reflexive thematic analysis. We identified one overarching theme: To maintain a reflective therapeutic capacity, and two main themes with associated subthemes: 1) Alliance work when a caring system comes to therapy to fight generations of adversities and 2) The complex therapeutic work of addressing generational adversities in perinatal psychotherapy. Findings from the present study indicate that maintaining a reflective stance is essential yet challenging when addressing intergenerational adversities, requiring a holding environment for the therapists. The primary vehicle of change was perceived as a safe enough therapeutic alliance to explore new ways of being together, contrasting earlier experiences. A key question raised was how to give caregivers enough time to trust the therapist without compromising the safety and development of the child. The essence of the therapeutic work was to reduce risk factors and increase protective factors through multiple ports of entry.

[An information booklet on psychotropic treatments for child psychiatry patients]

In the child psychiatry hospital setting, educational approaches and the therapeutic alliance are fundamental principles on which professionals rely on a daily basis. Therapeutic acts, including the administration of psychotropic drugs, are carried out in a specific care area. What about the child's or adolescent's compliance with medication outside this setting? A booklet dedicated to psychotropic treatments, intended for patients and their relatives, has been designed with an informative objective.

[Therapeutic alliance between sectorial psychiatry inpatients and nurses and aides: A prospective, observational and cross-sectional study]

BACKGROUND

Therapeutic alliance represents a rarely studied object when it relates to nurses and care provided by a nursing team in acute care hospitalization.

OBJECTIVE

The objective was to study how factors might influence the therapeutic alliance built between nurses and aides and adult inpatients in an acute care unit of sectorial general psychiatry.

METHOD

This is a prospective, observational and cross-sectional study using a therapeutic alliance measurement scale. Therapeutic alliance (TA) score was measured with a STAR-P scale in a sample of 240 patients.

RESULTS

The median score found is 33.4 (±7.8) out of a maximum theoretical score of 48. The global score of TA in patients aged 60 years old or more is significantly higher than the score of patients between 18 and 29 years old (p=0.021). The lack of external follow-up in the three months after hospital release is not associated with TA global score (p=0.73). If inpatients, no matter what their diseases or types of care are, under legal obligation or not, consider their TA is rather good after their hospital stay. Only sociodemographic factors like age, housing conditions (insecure or sustainable), having a job or not, living alone or with a partner affect TA and follow-up.

CONCLUSION

Results evoke concepts of anomie and attachment, that seem to play an important role in the lack of follow-up after hospital stay, and indicate the mandatory global approach to care and an involvement of health professionals as well as social beings, where empathy must find its place.

[Body care in anorexia nervosa]

Therapeutic touch body care in the management of eating disorders, particularly anorexia nervosa, aims to deepen the relationship of trust and the therapeutic alliance. Nursing research and the development of clinical nursing care, with nursing diagnoses as a support, have made it possible to provide new responses adapted to the patient's needs. This reassuring helping relationship favors the work around the patient's psychic and physical perceptions. The notion of the gender of the caregiver in the body approach care is a dimension to be taken into consideration.

[Multidisciplinary care of an adolescent with somatic disorders]

Theo's clinical observation illustrates the management of a 14-year-old adolescent with unexplained somatic symptoms. His symptoms can be integrated into what the classification of mental illnesses calls a somatic symptom disorder, with a depressive comorbidity. The description of the care pathway shows the gradual acceptance of psychological suffering by the adolescent and his parents in a service where different professionals are involved, with sufficient time for a good therapeutic alliance to be built.

Working online due to the COVID-19 pandemic: a research and literature review

Given the contemporary situation of many analysts in the world now being forced to work online due to the effects of the COVID‐19 pandemic, it is important to review the working online issue. Substantial debate over previous years has questioned whether a genuine analytic process can unfold through online work. This debate is reviewed with the conclusion that such a process is not necessarily precluded. Research outcomes are then reviewed to highlight those things that can facilitate positive outcomes when working online. These cover the ‘online disinhibition effect’, the therapeutic alliance, particular ways of using the screen, focussing on trauma, the importance of self‐awareness, knowing the predictors of mental health, certain potential positives of isolation/quarantine and psychotherapy interventions that may be currently needed. Final recommendations and suggestions are then presented as in the diagnosis issue, professional development and guidelines to do with practical and ethical considerations.

[Psychology in therapeutic patient education]

In an effort to improve the quality of life of people with chronic diseases, care practices have been enriched by therapeutic patient education (TPE). This aims at the acquisition of plural knowledge and skills by patients, which promotes optimal management of the disease on a daily basis and of the resulting changes, limiting their negative repercussions on their autonomy and well-being. The subject is placed at the heart of the system, in a position of decision and responsibility, and collaborates actively with the various healthcare stakeholders. TPE therefore involves taking into account the patient's psychological dimension, using psychology and fundamental concepts for its implementation.

[Towards ending compulsory community treatment in recovery approaches]

Psychiatric compulsory community treatment programmes are widely and heterogeneously used measures of coercion. The recovery oriented mental health service 59G21 used them to minimize violating the rights of persons under compulsory care. Based on a clinical situation of failing this objective, we discuss their place in the health system and the reasons why we chose to move towards a "zero recourse" objective.

[From personal experience to the implementation of a in-home nursing consultation]

With 54,000 new cases per year, breast cancer is most frequently observed among women in France. It is the leading cause of death among women due to cancer: nearly 12,000 deaths per year. Based on her own experience with this disease and the heavy treatments that result from it, a free-lance nurse has developed a home-based consultation to accompany women during their care journey. Sharing of experience.

[Educating patients with chronic conditions cared for at home, a nursing initiative in Marseille]

Drawing on her hospital expertise in pulmonology, a currently private practice nurse describes her work supporting patients with chronic obstructive pulmonary disease in their home. In collaboration with hospital- and community-based teams, she uses a support tool to formalise therapeutic education sessions.

[The group connected bike to help fight addiction]

As part of the individualised management of patients with an addiction, a relapse prevention strategy for people dependent on alcohol or with bulimia has been developed by Sainte-Anne general hospital. Nursing support based on the use of a connected bike with virtual riding software recreates an environment which is considerably enriched on a social, motor and cognitive level.

[Therapeutic touch and anorexia nervosa]

An innovative practice, therapeutic touch has been used for around ten years in the treatment of eating disorders. Delivered by nurse clinicians having received specific training, this approach is based on nursing diagnoses which identify the major symptoms of this pathology. The support is built around the body and its perceptions. Through the helping relationship, it mobilises the patient's resources to favour a relationship of trust, a letting-go, physical, psychological and emotional relaxation, and improves the therapeutic alliance.

["Family groups" for relatives of patients with anorexia nervosa]

Anorexia nervosa affects mainly young adults. During care, caregivers seek alliance with patients' friends and family to be able to relate to the patients' symptoms and also their environment. Collaborative work with families helps build confidence. The "family group" is an example of well-intended partnership.

[The family therapeutic alliance]

The therapeutic alliance should be sought between the family and the therapist. Over time, it has experienced a significant evolution from the Freudian concept of the early 20th century to that of "potential competence" nowadays. Families now play an active role in the care of their hospitalised relatives.

[Supporting family carers in psychiatry]

The families of patients with psychiatric disorders are often ill-informed of the consequences of the condition of their loved one. The therapeutic alliance between the family and caregiving team enables the patient to derive the maximum possible benefit from remaining longer at home.