Rajvinder Samra, Mathijs F G Lucassen, Alicia Núñez-García, Katherine E Brown, Katharine A Rimes, Louise M Wallace
Objectives: To explore adult stakeholders' perspectives on what supports or undermines the mental health of sexual and gender minoritised adolescents (SGMA) in everyday life in order to better understand how to foster supportive psychosocial environments for SGMA.
Design: Descriptive qualitative study design, using framework analysis.
Methods: Semi-structured interviews were conducted remotely with 16 UK-based adult stakeholders which included parents of SGMA, health and social care professionals, community-based professionals, and professionals who commission services related to adolescent health and well-being.
Results: Nine themes were identified that represented barriers and enablers of fostering psychosocial environments that are supportive of SGMA mental health. Example barrier themes include SGMA 'facing chronic and acute safety threats and stress', 'psychological responses to social connection losses and navigating alienation', 'digital exposure and online risk and vulnerability' and 'conflicting messages, resulting divisions and adult distancing'. Example enablers include 'exploring, owning, and changing (personal) identities', 'advocating alongside adolescents whilst containing oneself as the adult in the situation' and 'personally fostering adolescents' psychological safety and inclusion'.
Conclusions: Adult stakeholders report that SGMA are often exposed to environments hostile to key aspects of their identity which then by extension undermines their mental health. These experiences can threaten their sense of safety and evolving identity. Practitioners in particular should be aware of the stressors relating to SGMA identity and minoritisation experiences in order to develop the psychological safety and sense of inclusion needed for SGMA to trust in the relationship and the support offered.
{"title":"Adult stakeholders' perspectives on supporting or undermining the mental health of sexual and gender minoritised adolescents.","authors":"Rajvinder Samra, Mathijs F G Lucassen, Alicia Núñez-García, Katherine E Brown, Katharine A Rimes, Louise M Wallace","doi":"10.1111/papt.12548","DOIUrl":"https://doi.org/10.1111/papt.12548","url":null,"abstract":"<p><strong>Objectives: </strong>To explore adult stakeholders' perspectives on what supports or undermines the mental health of sexual and gender minoritised adolescents (SGMA) in everyday life in order to better understand how to foster supportive psychosocial environments for SGMA.</p><p><strong>Design: </strong>Descriptive qualitative study design, using framework analysis.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted remotely with 16 UK-based adult stakeholders which included parents of SGMA, health and social care professionals, community-based professionals, and professionals who commission services related to adolescent health and well-being.</p><p><strong>Results: </strong>Nine themes were identified that represented barriers and enablers of fostering psychosocial environments that are supportive of SGMA mental health. Example barrier themes include SGMA 'facing chronic and acute safety threats and stress', 'psychological responses to social connection losses and navigating alienation', 'digital exposure and online risk and vulnerability' and 'conflicting messages, resulting divisions and adult distancing'. Example enablers include 'exploring, owning, and changing (personal) identities', 'advocating alongside adolescents whilst containing oneself as the adult in the situation' and 'personally fostering adolescents' psychological safety and inclusion'.</p><p><strong>Conclusions: </strong>Adult stakeholders report that SGMA are often exposed to environments hostile to key aspects of their identity which then by extension undermines their mental health. These experiences can threaten their sense of safety and evolving identity. Practitioners in particular should be aware of the stressors relating to SGMA identity and minoritisation experiences in order to develop the psychological safety and sense of inclusion needed for SGMA to trust in the relationship and the support offered.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paula Duxbury, Peter James Taylor, Jasper Palmier-Claus, Bradley Boardman, Daniel Pratt, Sophie Parker, Fiona Lobban
Objectives: Higher education students experience elevated levels of suicidal ideation, but often face barriers in accessing support. The Mental Imagery for Suicidality in Students Trial (MISST; ISRCTN13621293; NCT05296538) tested the feasibility and acceptability of a six-session imagery-based approach called Broad-Minded Affective Coping (BMAC). This qualitative evaluation explored the experiences of MISST participants and staff.
Design: A qualitative study using one-to-one qualitative interviews with participants and staff recruited from MISST. Reflexive thematic analysis was used to explore trial participant and staff experiences to inform a future definitive trial.
Methods: Student participants (n = 16), research assistants (n = 4) and the trial therapist (n = 1) were interviewed and transcripts analysed using reflexive thematic analysis.
Results: Four key themes were identified. The first theme highlights the value and challenges for students in talking about suicide. The ways in which communication and rapport can be built to facilitate this conversation are explored in theme 2. Theme 3 explains how working with the BMAC therapist increased participants' awareness of their current mood, drew their attention to positive moments in their lives and helped them to actively recall these moments to interrupt negative cycles of rumination and suicidal ideation. The extent to which the BMAC is 'fit for purpose' is outlined in theme 4, generating specific recommendations for future intervention development.
Conclusions: The BMAC offers a positive, time-limited, structured intervention that is well suited to meet the needs of higher education students experiencing suicidal ideation. Further research is needed to test the effectiveness on mental health and suicide-related outcomes.
{"title":"A qualitative study exploring participants experiences of the Mental Imagery for Suicidality in Students Trial.","authors":"Paula Duxbury, Peter James Taylor, Jasper Palmier-Claus, Bradley Boardman, Daniel Pratt, Sophie Parker, Fiona Lobban","doi":"10.1111/papt.12547","DOIUrl":"https://doi.org/10.1111/papt.12547","url":null,"abstract":"<p><strong>Objectives: </strong>Higher education students experience elevated levels of suicidal ideation, but often face barriers in accessing support. The Mental Imagery for Suicidality in Students Trial (MISST; ISRCTN13621293; NCT05296538) tested the feasibility and acceptability of a six-session imagery-based approach called Broad-Minded Affective Coping (BMAC). This qualitative evaluation explored the experiences of MISST participants and staff.</p><p><strong>Design: </strong>A qualitative study using one-to-one qualitative interviews with participants and staff recruited from MISST. Reflexive thematic analysis was used to explore trial participant and staff experiences to inform a future definitive trial.</p><p><strong>Methods: </strong>Student participants (n = 16), research assistants (n = 4) and the trial therapist (n = 1) were interviewed and transcripts analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Four key themes were identified. The first theme highlights the value and challenges for students in talking about suicide. The ways in which communication and rapport can be built to facilitate this conversation are explored in theme 2. Theme 3 explains how working with the BMAC therapist increased participants' awareness of their current mood, drew their attention to positive moments in their lives and helped them to actively recall these moments to interrupt negative cycles of rumination and suicidal ideation. The extent to which the BMAC is 'fit for purpose' is outlined in theme 4, generating specific recommendations for future intervention development.</p><p><strong>Conclusions: </strong>The BMAC offers a positive, time-limited, structured intervention that is well suited to meet the needs of higher education students experiencing suicidal ideation. Further research is needed to test the effectiveness on mental health and suicide-related outcomes.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michaela Barber, John Gardner, Paul Liknaitzky, Adrian Carter
Background: Policy changes in Australia mean that psychedelic-assisted therapy (PAT) is now available to consumers outside of clinical trials. Yet, the regulatory frameworks guiding the practice of PAT are underdeveloped, and the evidence base for guiding clinical practice is diverse and emerging, resulting in anticipated challenges in translation to community practice. Mental health clinicians who have experience delivering PAT in clinical trials are likely to be at the forefront of community practice and training, and influential in discussions about implementation. Yet little is known of their perspectives, preferences, and practices associated with the implementation of PAT.
Method: Interviews with 11 clinicians working on clinical trials of PAT were thematically analysed.
Results: Four themes were identified, describing the therapeutic frames that interviewees used to understand PAT and shaped their views on its interface with the mental health system: (1) therapeutic eclecticism, (2) enhanced reflexivity for PAT providers, (3) legitimisation of extra-medical perspectives in mental health, and (4) what might be lost in translation?
Conclusion: We argue that clinicians' perspectives on PAT are reflective of existing tensions between a medical model of mental health care and other psychosocial, relational models. Therapists' ideals for the delivery of PAT can be conceptualised as a sort of 'enhanced care' approach, but workforce development and economic constraints are likely to challenge the accessible and impactful translation of this vision.
背景:澳大利亚的政策变化意味着消费者现在可以在临床试验之外使用迷幻辅助疗法(PAT)。然而,指导迷幻辅助疗法实践的监管框架尚不完善,指导临床实践的证据基础也是多种多样、层出不穷,因此在转化为社区实践时预计会面临挑战。在临床试验中具有实施 PAT 经验的心理健康临床医生很可能处于社区实践和培训的最前沿,并在有关实施的讨论中具有影响力。然而,人们对他们的观点、偏好以及与实施 PAT 相关的实践却知之甚少:方法:对 11 位从事 PAT 临床试验的临床医生的访谈进行了主题分析:结果:确定了四个主题,描述了受访者用于理解 PAT 的治疗框架,并形成了他们对 PAT 与精神卫生系统衔接的看法:(1)治疗折衷主义;(2)增强 PAT 提供者的反思能力;(3)精神卫生领域医学外观点的合法化;以及(4)翻译中可能丢失的内容:我们认为,临床医生对 "可视化治疗 "的看法反映了心理健康医疗模式与其他社会心理、关系模式之间的紧张关系。治疗师们对提供 "可视化治疗 "的理想可以概念化为一种 "强化护理 "方法,但劳动力的发展和经济上的限制很可能会对这一理想的可及性和影响力构成挑战。
{"title":"Lost in translation? Qualitative interviews with Australian psychedelic-assisted therapy trial clinicians.","authors":"Michaela Barber, John Gardner, Paul Liknaitzky, Adrian Carter","doi":"10.1111/papt.12545","DOIUrl":"https://doi.org/10.1111/papt.12545","url":null,"abstract":"<p><strong>Background: </strong>Policy changes in Australia mean that psychedelic-assisted therapy (PAT) is now available to consumers outside of clinical trials. Yet, the regulatory frameworks guiding the practice of PAT are underdeveloped, and the evidence base for guiding clinical practice is diverse and emerging, resulting in anticipated challenges in translation to community practice. Mental health clinicians who have experience delivering PAT in clinical trials are likely to be at the forefront of community practice and training, and influential in discussions about implementation. Yet little is known of their perspectives, preferences, and practices associated with the implementation of PAT.</p><p><strong>Method: </strong>Interviews with 11 clinicians working on clinical trials of PAT were thematically analysed.</p><p><strong>Results: </strong>Four themes were identified, describing the therapeutic frames that interviewees used to understand PAT and shaped their views on its interface with the mental health system: (1) therapeutic eclecticism, (2) enhanced reflexivity for PAT providers, (3) legitimisation of extra-medical perspectives in mental health, and (4) what might be lost in translation?</p><p><strong>Conclusion: </strong>We argue that clinicians' perspectives on PAT are reflective of existing tensions between a medical model of mental health care and other psychosocial, relational models. Therapists' ideals for the delivery of PAT can be conceptualised as a sort of 'enhanced care' approach, but workforce development and economic constraints are likely to challenge the accessible and impactful translation of this vision.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectivesAppearance anxiety (AA) is a probable risk factor for body dysmorphic disorder and a prevalent and debilitating concern. Extant literature suggests that romantic partners’ commentary and accommodation behaviour may contribute to women's appearance concerns. The aim of this study is to explore how women experience and make sense of romantic partner feedback about their appearance.DesignQualitative semi‐structured interview study.MethodsSemi‐structured interviews with 13 cis‐gender women explored how they make sense of appearance anxiety in the context of romantic relationships. Reflexive thematic analysis with a hybrid inductive‐deductive coding approach was utilised, drawing on cognitive behavioural theory (CBT) as a theoretical lens to interpret the data.ResultsFour themes were created from the data: (1) ‘Then he said to me … you could probably tone up a bit’: Maintaining cycles; (2) ‘I think those comments down the line do eventually help’: breaking out of maintenance cycles, (3) ‘It's like they're talking in a foreign language’; beliefs as a filter and (4) ‘Cheering me on from the side‐lines’; romantic partner a supportive coach. These themes highlight the perceived unhelpful (e.g. accommodation of behaviours) and helpful (e.g. affection) impact of romantic partners' behaviours and commentary on participants’ AA.ConclusionsRomantic partners are perceived by women to have a potent impact on their AA. Clinical practice implications include involving romantic partners in treatment, and clinicians using their formulation and CBT skills (e.g. Socratic questioning), to understand and target these possible maintenance processes within couples.
{"title":"‘Cheering on from the side‐lines’: The perceived impact of romantic partner's commentary and behaviour on maintaining women's appearance anxiety","authors":"Gemma Stephanie Lumsdale, Hannah Frith, Lucy Hale","doi":"10.1111/papt.12546","DOIUrl":"https://doi.org/10.1111/papt.12546","url":null,"abstract":"ObjectivesAppearance anxiety (AA) is a probable risk factor for body dysmorphic disorder and a prevalent and debilitating concern. Extant literature suggests that romantic partners’ commentary and accommodation behaviour may contribute to women's appearance concerns. The aim of this study is to explore how women experience and make sense of romantic partner feedback about their appearance.DesignQualitative semi‐structured interview study.MethodsSemi‐structured interviews with 13 cis‐gender women explored how they make sense of appearance anxiety in the context of romantic relationships. Reflexive thematic analysis with a hybrid inductive‐deductive coding approach was utilised, drawing on cognitive behavioural theory (CBT) as a theoretical lens to interpret the data.ResultsFour themes were created from the data: (1) ‘Then he said to me … you could probably tone up a bit’: Maintaining cycles; (2) ‘I think those comments down the line do eventually help’: breaking out of maintenance cycles, (3) ‘It's like they're talking in a foreign language’; beliefs as a filter and (4) ‘Cheering me on from the side‐lines’; romantic partner a supportive coach. These themes highlight the perceived unhelpful (e.g. accommodation of behaviours) and helpful (e.g. affection) impact of romantic partners' behaviours and commentary on participants’ AA.ConclusionsRomantic partners are perceived by women to have a potent impact on their AA. Clinical practice implications include involving romantic partners in treatment, and clinicians using their formulation and CBT skills (e.g. Socratic questioning), to understand and target these possible maintenance processes within couples.","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Method: Ten young people (male = 6, female = 4, age range = 16-23 years) and nine clinicians from various disciplines within a youth mental health service were interviewed. Constructivist grounded theory was used for the analysis.
Results: Four themes were constructed from the data; a 'level playing field' between young person and clinician enables formulation, formulating is a constant process of getting it right and getting it wrong, emotional expression and attunement get us closer to each other and to understanding, and 'formulation versus diagnosis' can create tension in the therapy room. The constructivist grounded theory devised demonstrated how the dynamics of power, collaboration, openness, and the therapeutic relationship are constantly in flux during the process of formulation.
Conclusion: The paper presents a constructivist grounded theory which incorporates dynamics relating to power, collaboration, and openness. The importance of the therapeutic relationship is also emphasised. The theory encourages continuous and recursive personal reflection by the therapist as to how they can be optimally attuned to the dynamics of power, collaboration, and openness with young people.
{"title":"'Like walking with someone as opposed to trying to catch up to them'-Dynamics at play when clinicians and young people formulate together.","authors":"Laura J Douglas, Cian Aherne, Patrick Ryan, Barry Coughlan, Donal G Fortune","doi":"10.1111/papt.12543","DOIUrl":"https://doi.org/10.1111/papt.12543","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present study was to explore the social process of formulation in talk therapy between young people and clinicians.</p><p><strong>Design: </strong>Qualitative semi-structured interview study.</p><p><strong>Method: </strong>Ten young people (male = 6, female = 4, age range = 16-23 years) and nine clinicians from various disciplines within a youth mental health service were interviewed. Constructivist grounded theory was used for the analysis.</p><p><strong>Results: </strong>Four themes were constructed from the data; a 'level playing field' between young person and clinician enables formulation, formulating is a constant process of getting it right and getting it wrong, emotional expression and attunement get us closer to each other and to understanding, and 'formulation versus diagnosis' can create tension in the therapy room. The constructivist grounded theory devised demonstrated how the dynamics of power, collaboration, openness, and the therapeutic relationship are constantly in flux during the process of formulation.</p><p><strong>Conclusion: </strong>The paper presents a constructivist grounded theory which incorporates dynamics relating to power, collaboration, and openness. The importance of the therapeutic relationship is also emphasised. The theory encourages continuous and recursive personal reflection by the therapist as to how they can be optimally attuned to the dynamics of power, collaboration, and openness with young people.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick Luyten, Saskia Malcorps, Anthony Bateman, Peter Fonagy
Mentalization-based treatment (MBT) is a spectrum of interventions that share a central focus on improving the capacity for mentalizing. Although MBT was originally developed as a treatment for individuals with borderline personality disorder, its scope and focus have been broadened to become a socioecological approach that stresses the role of broader sociocultural factors in determining the closely related capacities for mentalizing and epistemic trust. This special issue brings together some of the newest developments in MBT that illustrate this shift. These contributions also highlight several current limitations in mentalization-based approaches, providing important pointers for further research. In this editorial, we first outline the broadening scope of the mentalizing approach, and then provide a discussion of each of the contributions to this special issue in the context of the need for further research concerning some of the key assumptions of mentalization-based approaches and their implementation in clinical practice. We close this editorial with considerations concerning future research.
{"title":"Mentalizing individuals, families and systems: Towards a translational socioecological approach.","authors":"Patrick Luyten, Saskia Malcorps, Anthony Bateman, Peter Fonagy","doi":"10.1111/papt.12544","DOIUrl":"https://doi.org/10.1111/papt.12544","url":null,"abstract":"<p><p>Mentalization-based treatment (MBT) is a spectrum of interventions that share a central focus on improving the capacity for mentalizing. Although MBT was originally developed as a treatment for individuals with borderline personality disorder, its scope and focus have been broadened to become a socioecological approach that stresses the role of broader sociocultural factors in determining the closely related capacities for mentalizing and epistemic trust. This special issue brings together some of the newest developments in MBT that illustrate this shift. These contributions also highlight several current limitations in mentalization-based approaches, providing important pointers for further research. In this editorial, we first outline the broadening scope of the mentalizing approach, and then provide a discussion of each of the contributions to this special issue in the context of the need for further research concerning some of the key assumptions of mentalization-based approaches and their implementation in clinical practice. We close this editorial with considerations concerning future research.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sofie Heidenheim Christensen, Michella Heinrichsen, Bo Møhl, Lotte Rubæk, Katherine Krage Byrialsen, Olivia Ojala, Clara Hellner, Anne Katrine Pagsberg, Johan Bjureberg, Britt Morthorst
Objectives: We explore adolescents' and their parents' experiences of internet-based emotion regulation therapy for non-suicidal self-injury (NSSI).
Design: A qualitative study nested within a controlled feasibility trial.
Methods: Online, semi-structured focus group interviews were conducted with outpatient adolescents with NSSI aged 13-17 years (n = 9) and their parents (n = 8) who had received therapist-guided Internet-delivered Emotion Regulation Individual Therapy for Adolescents (IERITA). Transcripts were analysed using reflexive thematic analysis.
Results: Three main themes were generated: (1) Fatigue - barriers to and during treatment, comprised of two sub-themes 'Arriving to services exhausted, needing motivation, and leaving feeling abandoned' and 'the burden of IERITA and the consequences of fatigue', (2) inter- and intrapersonal insights as facilitators of change and (3) Online, written contact with the therapist is beneficial and contributes with less pressure, comprised of three sub-themes 'the therapist behind the screen is essential', 'less pressure sitting alone: the physical absence of a therapist' and 'engaging on your own terms, in your own tempo'. Themes were consistent among adolescents and parents.
Conclusion: Fatigue due to therapeutic engagement and previous help-seeking processes created barriers for engagement. Emotion regulation therapy was experienced as beneficial leading to inter- and intra-personal insights, facilitating change of maladaptive patterns. Therapists were regarded as indispensable, and the internet-based format did not hinder therapeutic alliance. The written format allowed for reflection and alleviated the pressure of relating to the therapist. Further research should explore experiences of other online treatment formats (e.g. synchronous or video-based) with regard to benefits, fatigue and therapist interaction.
{"title":"Internet-delivered emotion regulation therapy for adolescents engaging in non-suicidal self-injury and their parents: A qualitative, online focus group study.","authors":"Sofie Heidenheim Christensen, Michella Heinrichsen, Bo Møhl, Lotte Rubæk, Katherine Krage Byrialsen, Olivia Ojala, Clara Hellner, Anne Katrine Pagsberg, Johan Bjureberg, Britt Morthorst","doi":"10.1111/papt.12541","DOIUrl":"https://doi.org/10.1111/papt.12541","url":null,"abstract":"<p><strong>Objectives: </strong>We explore adolescents' and their parents' experiences of internet-based emotion regulation therapy for non-suicidal self-injury (NSSI).</p><p><strong>Design: </strong>A qualitative study nested within a controlled feasibility trial.</p><p><strong>Methods: </strong>Online, semi-structured focus group interviews were conducted with outpatient adolescents with NSSI aged 13-17 years (n = 9) and their parents (n = 8) who had received therapist-guided Internet-delivered Emotion Regulation Individual Therapy for Adolescents (IERITA). Transcripts were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three main themes were generated: (1) Fatigue - barriers to and during treatment, comprised of two sub-themes 'Arriving to services exhausted, needing motivation, and leaving feeling abandoned' and 'the burden of IERITA and the consequences of fatigue', (2) inter- and intrapersonal insights as facilitators of change and (3) Online, written contact with the therapist is beneficial and contributes with less pressure, comprised of three sub-themes 'the therapist behind the screen is essential', 'less pressure sitting alone: the physical absence of a therapist' and 'engaging on your own terms, in your own tempo'. Themes were consistent among adolescents and parents.</p><p><strong>Conclusion: </strong>Fatigue due to therapeutic engagement and previous help-seeking processes created barriers for engagement. Emotion regulation therapy was experienced as beneficial leading to inter- and intra-personal insights, facilitating change of maladaptive patterns. Therapists were regarded as indispensable, and the internet-based format did not hinder therapeutic alliance. The written format allowed for reflection and alleviated the pressure of relating to the therapist. Further research should explore experiences of other online treatment formats (e.g. synchronous or video-based) with regard to benefits, fatigue and therapist interaction.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent times there has been increasing acknowledgement of the importance of attending to the agenda of people with lived experience in psychotherapy research. In particular, young people's voices have been recognised as central to the design and development of psychotherapies that work for them. It is important to recognise the limits of professional agendas and make sure that young people's own priorities are represented in the indicators against which we measure change in research evaluations of psychotherapy. This requires an extension of evaluation research indicators from psychiatric symptomatology, to include aspects of wellbeing that matter to young people themselves. This article joins others in calling for a shift from the focus on symptom change in the evaluation of psychotherapy with youth, to acknowledge subjective indicators identified through research conducted with young people. New indicators might, for example, be centred on the degree to which young people experience increased capacity for acceptance of their emotions, a comfortable sense of identity, improved relational trust, and a stronger sense of their own agency. If psychotherapy is to be meaningful to young people, it is vital that we tailor it to young people's own needs and priorities and evaluate it against the aspects of change that matter to them.
{"title":"Commentary: What young people want from psychotherapy.","authors":"Kerry Gibson, Jessica Stubbing","doi":"10.1111/papt.12542","DOIUrl":"https://doi.org/10.1111/papt.12542","url":null,"abstract":"<p><p>In recent times there has been increasing acknowledgement of the importance of attending to the agenda of people with lived experience in psychotherapy research. In particular, young people's voices have been recognised as central to the design and development of psychotherapies that work for them. It is important to recognise the limits of professional agendas and make sure that young people's own priorities are represented in the indicators against which we measure change in research evaluations of psychotherapy. This requires an extension of evaluation research indicators from psychiatric symptomatology, to include aspects of wellbeing that matter to young people themselves. This article joins others in calling for a shift from the focus on symptom change in the evaluation of psychotherapy with youth, to acknowledge subjective indicators identified through research conducted with young people. New indicators might, for example, be centred on the degree to which young people experience increased capacity for acceptance of their emotions, a comfortable sense of identity, improved relational trust, and a stronger sense of their own agency. If psychotherapy is to be meaningful to young people, it is vital that we tailor it to young people's own needs and priorities and evaluate it against the aspects of change that matter to them.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Skrobinska, Katherine Newman-Taylor, Katherine Carnelley
Purpose: Many people with psychosis do not seek help which delays access to recommended treatments. Duration of untreated psychosis is associated with poor healthcare outcomes and increased risk of relapse. The reasons why people delay accessing treatment remain unclear. This is the first systematic review to synthesise the literature examining professional and non-professional help-seeking in psychosis across clinical and subclinical populations.
Methods: We searched four databases (APA PsycINFO, APA PsycArticles, Medline and British Library EThOS) to generate a comprehensive account of the quantitative literature. Heterogeneity of measures precluded a meta-analysis.
Results: We identified 19 articles (including 9686 participants) that met criteria for the review. Help-seeking in psychosis is associated with being female, having a higher level of education, and experiencing more than one symptom. People with psychosis report stigma, poor mental health literacy and lack of family support as key barriers. Clinicians report childhood physical abuse, insecure attachment and severity of psychosis as additional barriers. We also found differences in preferred sources of help across cultures. There is currently no consensus on reliable help-seeking measures.
Conclusions: This is the first systematic review to examine help-seeking behaviour in psychosis. Assertive and culturally sensitive engagement efforts should be targeted towards people with a history of early adversity, poor mental health literacy, limited social support and more severe psychosis.
{"title":"Psychosis and help-seeking behaviour-A systematic review of the literature.","authors":"Laura Skrobinska, Katherine Newman-Taylor, Katherine Carnelley","doi":"10.1111/papt.12531","DOIUrl":"https://doi.org/10.1111/papt.12531","url":null,"abstract":"<p><strong>Purpose: </strong>Many people with psychosis do not seek help which delays access to recommended treatments. Duration of untreated psychosis is associated with poor healthcare outcomes and increased risk of relapse. The reasons why people delay accessing treatment remain unclear. This is the first systematic review to synthesise the literature examining professional and non-professional help-seeking in psychosis across clinical and subclinical populations.</p><p><strong>Methods: </strong>We searched four databases (APA PsycINFO, APA PsycArticles, Medline and British Library EThOS) to generate a comprehensive account of the quantitative literature. Heterogeneity of measures precluded a meta-analysis.</p><p><strong>Results: </strong>We identified 19 articles (including 9686 participants) that met criteria for the review. Help-seeking in psychosis is associated with being female, having a higher level of education, and experiencing more than one symptom. People with psychosis report stigma, poor mental health literacy and lack of family support as key barriers. Clinicians report childhood physical abuse, insecure attachment and severity of psychosis as additional barriers. We also found differences in preferred sources of help across cultures. There is currently no consensus on reliable help-seeking measures.</p><p><strong>Conclusions: </strong>This is the first systematic review to examine help-seeking behaviour in psychosis. Assertive and culturally sensitive engagement efforts should be targeted towards people with a history of early adversity, poor mental health literacy, limited social support and more severe psychosis.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}