Clinical Psychology in Europe最新文献

Background: The transtheoretical conceptualization of the working alliance and the resultant evaluation tools often overestimate the collaboration between therapist and client, while neglecting the negotiation process. The degree to which therapists and clients can negotiate disagreements regarding goals and tasks is an important indicator in establishing and maintaining the alliance. Even though the negotiation concept is not new, there is still a lack of reliable and parsimonious self-report measures of the construct. The purpose of this study was to translate, execute the cultural adaptation and, also, to perform a preliminary psychometric analysis of the Portuguese form of the therapist version of the Alliance Negotiation Scale (ANS-T_Pt).

Method: Data were collected online from 100 Portuguese psychologists. Two random sub-samples were used to conduct both exploratory factorial analysis and confirmatory factorial analysis. Convergent validity was assessed through comparison with the Portuguese version of the Working Alliance Inventory.

Results: The ANS-T_Pt showed a one-factorial structure, consistent with previous versions, and demonstrated adequate internal consistency. Evidence supporting criterion-related validity was found based on the correlations between ANS-T_Pt and WAI-T scores. The results showed moderate to large associations between the instruments. These results support the usefulness of the scale, construct's relevance and its transtheoretical nature.

Conclusion: These results are a step forward for Portuguese therapists' and researchers' ability to evaluate the bond between client and therapist and to compare results from different countries.

Background: Research on cultural adaptation of psychological interventions indicates that a higher level of adaptation is associated with a higher effect size of the intervention. However, direct comparisons of different levels of adaptations are scarce.

Aims: This study used a smartphone-based self-help programme called Step-by-Step (Albanian: Hap-pas-Hapi) for the treatment of psychological distress among Albanian-speaking immigrants in Switzerland and Germany. Two levels of cultural adaptation (i.e., surface vs. deep structure adaptation) were compared. We hypothesised that the deep structure adaptation would enhance the acceptance and efficacy of the intervention.

Method: We conducted a two-arm, single-blind randomised controlled trial. Inclusion criteria were good command of the Albanian language, age above 18, and elevated psychological distress (Kessler Psychological Distress Scale score above 15). Primary outcome measures were the total score of the Hopkins Symptom Checklist and the number of participants who completed at least three (out of five) sessions. Secondary outcomes were global functioning, well-being, post-traumatic stress, and self-defined problems.

Results: Two-hundred-twenty-two participants were included, of which 18 (8%) completed the post-assessments. The number of participants who completed the third session was equal in both conditions, with N = 5 (5%) and N = 6 (6%) respectively.

Discussion: Drop-out rates were high in both conditions, and no group difference was found regarding the acceptance of the intervention. The high drop-out rate stands in contrast with other trials testing Step-by-Step. Future research should examine cultural factors impacting recruitment strategies, as insights could help to reduce participant drop-out rates in clinical trials.

Background: An online self-help programme for the treatment of depression called Hap-pas-Hapi was tested among Albanian-speaking immigrants in Switzerland and Germany, and two different levels of cultural adaptation were compared. Despite a massive recruitment effort, an insufficient number of participants could be recruited, and the drop-out rate was over 90%.

Aims: We conducted a qualitative study to better understand the reasons for the non-use of Hap-pas-Hapi.

Method: Eleven interviews were conducted with 17 Albanian-speaking participants aged 19-59. Participants were recruited for the purpose of this study and were not participants from the trial. They went through the recruitment material and the Hap-pas-Hapi introduction module, commented on the graphic design, usability, content, and shared their views about mental health and self-help.

Results: Participants criticised the lack of a "design system" (i.e., a clearly identifiable and consistent graphic design) on social media for Hap-pas-Hapi, and the recruitment messages were unclear. The programme itself was perceived to be important and helpful for the community at large, but most participants said that they would not use it for themselves. The younger generation would have preferred an application in German or French, while the older generation did not see a benefit in using an online self-help programme to manage their psychological distress. Negative beliefs about mental disorders and psychological interventions were perceived to be common in this target group.

Discussion: A professional recruitment strategy, a more careful selection of the target population (e.g., age groups) and different kinds of adaptations might have resulted in a better acceptance of the intervention. At the same time, anti-stigma campaigns and psychoeducation are needed to enhance treatment motivation.

Background: Behavioral activation (BA) is an effective and efficacious treatment for depression. Activity scheduling is the central treatment component of BA and involves planning of potentially enjoyable and rewarding activities. Evidence from non-clinical studies suggests that mental imagery simulations of planned activities can increase motivation and anticipated pleasure for these activities.

Method: We describe a randomized controlled trial testing a mental imagery activity scheduling training delivered online in four weekly sessions (total training duration approximately 90 minutes) in a sample meeting diagnostic criteria of a major depressive episode, as indicated by the Diagnostic Short-Interview for Mental Disorders (Mini-DIPS), and not currently receiving treatment. Participants (N = 140) will be randomized to either mental imagery activity scheduling or a wait-list control condition. Depressive symptoms (BDI-II) and behavioral activation (BADS) are the primary outcomes; BDI-II will be measured at Session 1, Session 4, and at two-week follow-up, BADS at Sessions 1-4 and at two-week follow-up.

Discussion: It is discussed how the expected results may reflect mechanisms and effects of a mental imagery activity scheduling training delivered online in a sample of individuals with depression. Concluding we outline next steps for future research and highlight the potential of this novel treatment for dissemination in the wider community and integration into routine care.

Background: Adjustment Disorder (AjD) is a frequent diagnosis in psychological and psychiatric consultations. Recently, the ICD-11 has introduced preoccupation and failure to adapt as core symptoms of AjD. However, empirical research that explores the various possible manifestations of preoccupation and failure to adapt in AjD patients is sparse. Therefore, the study aimed to explore patients' experiences of the core symptoms of AjD in a qualitative study.

Method: We recruited 16 patients suffering from ICD-11 AjD who filled in self-report questionnaires to assess sociodemographic information, adjustment disorder symptoms, anxiety and depression. Then, they participated in a semi-structured interview with a trained psychologist to explore the determinants and characteristics of their preoccupation and failure to adapt symptoms. Thematic analysis was applied to analyze the responses.

Results: Six themes were identified in our analysis 1) Preoccupation triggers, 2) Preoccupations and negative emotions, 3) Strategies to stop preoccupation, 4) Consequences of preoccupation, 5) Manifestation of difficulties/failure to adapt and 6) Strategies to address difficulties/failure to adapt.

Conclusion: We found partial congruence between our data and previous conceptualizations of AjD. Preoccupations seem to be time-consuming, center around stressors and their consequences, and be associated with negative emotions. Some preoccupations reported by the patients could also be labeled as ruminations or worries. The failure to adapt symptoms seemed to be broader than the exemplary symptoms highlighted in current measures of AjD.