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“All the horrible emotions have passed, I still remained, and I was safe”: A qualitative study of Lesbian and Gay people's lived experience of completing a full Dialectical Behaviour Therapy programme "所有可怕的情绪都已过去,我依然存在,我很安全":女同性恋和男同性恋在完成完整的辩证行为疗法课程后的生活体验定性研究。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-30 DOI: 10.1111/papt.12555
Charlotte Harding, Daniel Pratt, James Lea

Objectives

Lesbian and Gay people (LGP) experience higher rates of mental health difficulties, including self-harm, suicidal behaviours, as well as inequalities in health care, than their heterosexual peers. Dialectical Behaviour Therapy (DBT) is an evidence-based treatment for self-harm and suicidal behaviours, though there is little research on LGP's experiences of DBT. This research aims to explore LGP's experiences of completing a full DBT programme.

Design

A qualitative design with semi-structured individual interviews was utilised. The results were analysed using Interpretative Phenomenological Analysis.

Methods

Six lesbian and two gay adults, aged between 22 and 47 years, living in the United Kingdom took part. All participants had completed a full programme of DBT within the 2 years prior to the interview.

Results

Four superordinate themes emerged from the data: (1) The DBT journey; (2) Connections and Sense of Community during DBT; (3) Sexuality both visible and invisible in DBT and (4) A Gender, Sexuality and Relationship Diverse (GSRD) affirmative future for DBT.

Conclusions

Several clinical implications are suggested to improve DBT for LGP, for example to consider having other LGP within DBT groups, to create a more GSRD-affirming DBT (changes to the DBT manual, DBT therapists, DBT programme and physical DBT space), to adapt DBT techniques to manage sexuality-related difficulties and to adopt a GSRD-centric framework. Overall, DBT appears to be beneficial for LGP.

研究目的与异性恋同龄人相比,女同性恋和男同性恋(LGP)在心理健康方面遇到困难的比例更高,包括自残、自杀行为以及医疗保健方面的不平等。辩证行为疗法(DBT)是一种以证据为基础的治疗自残和自杀行为的方法,但有关 LGP 对 DBT 的体验的研究却很少。本研究旨在探讨轻度自闭症患者在完成完整的 DBT 项目后的体验:设计:采用半结构化个人访谈的定性设计。方法:对六名成年女同性恋和两名成年男同性恋进行半结构式个人访谈,并采用解释性现象学分析法对访谈结果进行分析:六名女同性恋者和两名男同性恋者参加了访谈,他们都居住在英国,年龄在 22 岁至 47 岁之间。所有参与者都在访谈前两年内完成了一个完整的 DBT 项目:结果:数据中出现了四个首要主题:(1) DBT 之旅;(2) DBT 期间的联系和社区感;(3) DBT 中可见和不可见的性行为;(4) DBT 的性别、性取向和关系多元化(GSRD)平权未来:结论:为改善针对 LGP 的 DBT 提出了几项临床建议,例如考虑在 DBT 小组中加入其他 LGP,创建更能肯定 GSRD 的 DBT(改变 DBT 手册、DBT 治疗师、DBT 计划和 DBT 物理空间),调整 DBT 技术以管理与性有关的困难,以及采用以 GSRD 为中心的框架。总体而言,DBT 似乎对 LGP 有益。
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引用次数: 0
A systematic review and meta-ethnography exploring personal perspectives of recovery among those with lived experience of non-suicidal self-injury 系统性回顾和荟萃人种学研究,探索有非自杀性自残经历的人对康复的个人看法。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-28 DOI: 10.1111/papt.12552
Emily Hudson, Bali Hemmings, Samantha Hartley, Peter Taylor

Background

Non-suicidal self-injury (NSSI) is a significant public health concern. Research and treatment interventions largely focus on stopping self-injury. People who self-injure do not necessarily equate recovery to cessation. Qualitative accounts allow greater understanding of personal recovery narratives. This study aimed to synthesise personal conceptualisations of NSSI recovery.

Methods

Participants had lived experience of NSSI and discussed their recovery. Papers not written in English or had a quantitative design were excluded. Four databases (PsycInfo, CINAHL, Medline and Web of Science) were systematically searched. The quality of each paper was assessed using the CASP quality assessment tool. Data were synthesised using a meta-ethnographic approach.

Results

Thirteen studies comprising 159 participants were included. Three overarching themes were developed. While ceasing NSSI was an important aspect of recovery for some, recovery was typically viewed more holistically, encompassing developments within the self and relationships. Recovery was regarded an ongoing non-linear journey. The personal and multifaceted nature of the recovery process emerged through a line of argument synthesis.

Conclusions

This was the first qualitative synthesis of personal conceptualisations of NSSI recovery. The findings highlighted the personal and multifaceted nature of NSSI recovery and supported person-centred models of self-injury recovery. Clinical implications include the importance of expanding self-injury recovery beyond cessation within research and clinical practice, and for collaborative and person-centred approaches to be embraced when supporting those who self-injure.

背景:非自杀性自残(NSSI)是一个重大的公共卫生问题。研究和治疗干预主要集中在停止自我伤害上。自我伤害者并不一定将康复等同于停止自我伤害。通过定性叙述可以更好地理解个人康复叙述。本研究旨在总结关于 NSSI 康复的个人概念:方法:参与者都有 NSSI 的亲身经历,并讨论了他们的康复情况。非英语撰写或定量设计的论文被排除在外。系统检索了四个数据库(PsycInfo、CINAHL、Medline 和 Web of Science)。采用 CASP 质量评估工具对每篇论文的质量进行了评估。采用元人种学方法对数据进行综合:结果:纳入了 13 项研究,共有 159 名参与者。形成了三大主题。对一些人来说,停止非自愿性自杀是康复的一个重要方面,但康复通常被更全面地看待,包括自我和人际关系的发展。康复被视为一个持续的非线性旅程。康复过程的个人性和多面性是通过论证综合得出的:这是首次对新社会性行为(NSSI)康复的个人概念进行定性综合。研究结果强调了 NSSI 康复的个人性和多面性,并支持以人为本的自伤康复模式。临床意义包括:在研究和临床实践中将自我伤害康复扩展到停止自我伤害之外的重要性,以及在支持自我伤害者时采用合作和以人为本的方法的重要性。
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引用次数: 0
What is helpful and unhelpful when people try to withdraw from antipsychotics: An international survey 当人们试图停用抗精神病药物时,什么是有用的,什么是无用的:一项国际调查。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-24 DOI: 10.1111/papt.12551
John Read

Objective

Antipsychotics remain the first-line treatment for people diagnosed with psychotic disorders despite adverse effects which lead many people to stop their medication. Many stop without the support of the prescriber, who may fear relapse. The objective of this study is to better understand the process of withdrawal from antipsychotics, from the perspective of people taking antipsychotics.

Design

Online survey.

Methods

An international online survey elicited quantitative responses about pre-withdrawal planning (560) and qualitative responses about what was helpful and unhelpful when withdrawing from antipsychotics (443). Responses came from users of antipsychotics in 29 countries.

Results

Forty-seven per cent did not consult their psychiatrist before discontinuing. Only 40% made preparations, most commonly making a plan, gathering information and informing family. The most frequently reported helpful factors were focussing on the benefits of getting off the drugs (including ending adverse effects and feeling more alive), information about withdrawal symptoms and how to withdraw safely, withdrawing slowly, and support from psychologists, counsellors and psychotherapists. The most common unhelpful factor was the psychiatrist/doctor, largely because of their lack of knowledge, refusal to support the patient's wishes and the threat or use of coercion.

Conclusions

Evidence-based, respectful, collaborative responses to patients' concerns about adverse effects and desires to withdraw would probably reduce relapse rates and improve long-term outcomes. It would definitely help end pervasive breaching of the principle of informed consent and human rights legislation.

目的:尽管抗精神病药物的不良反应导致许多人停药,但抗精神病药物仍然是诊断出患有精神障碍的患者的一线治疗药物。许多人停药时没有得到处方医生的支持,因为处方医生可能会担心复发。本研究旨在从服用抗精神病药物者的角度出发,更好地了解抗精神病药物的停药过程:设计:在线调查:一项国际在线调查收集了有关停药前计划的定量回复(560 份),以及有关停用抗精神病药物时有帮助和无帮助的定性回复(443 份)。答复来自 29 个国家的抗精神病药物使用者:结果:47%的人在停药前没有咨询过精神科医生。只有 40% 的人做了准备,最常见的是制定计划、收集信息和通知家人。据报告,最常见的有益因素是关注停药的益处(包括结束不良反应和感觉更有活力)、关于停药症状和如何安全停药的信息、缓慢停药以及心理学家、辅导员和心理治疗师的支持。最常见的不利因素是精神科医师/医生,主要是因为他们缺乏知识、拒绝支持病人的意愿以及威胁或使用胁迫手段:结论:以证据为基础,以尊重为前提,以合作为方式来应对患者对不良反应的担忧和退出治疗的愿望,很可能会降低复发率并改善长期疗效。这无疑将有助于终止普遍存在的违反知情同意原则和人权法律的行为。
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引用次数: 0
What do they look for and what do they find? A coproduced qualitative study on young people's experiences of searching for mental health information online 他们在找什么,又找到了什么?关于年轻人在网上搜索心理健康信息的经历的共同定性研究。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-14 DOI: 10.1111/papt.12550
M. E. Loades, N. Higson-Sweeney, B. Teague, J. Leas, C. Payne-Cook, A. V. Slastikova, H. Peel, G. Chamberlain, L. Ferguson, K. Janes, T. Rhodes, E. C. Roupa, L. Biddle

Background

Many young people (YP) struggle with their mental health and look online for help. To capitalise on their digital presence, we need to better understand how and where they seek information online and what they think of what they find.

Method

We recruited 24 YP (aged 13–18 years). Online interviews were co-conducted by research team members and trained young researchers. We presented a persona with depression symptoms and asked about potential sources of information/support they might seek. They were also asked to think aloud while searching online and reviewing mental health resources (NHS, Young Minds). We used reflexive thematic analysis.

Results

Analysis generated four themes: (1) the online help-seeking process, showcasing where YP look for information and why; (2) the mismatch between the information YP expected to find and the reality; (3) the strategies YP employed to determine a source's trust and credibility and (4) individual differences that can influence help-seeking.

Conclusion

Participants initiated their online search by Googling symptoms. They trusted NHS websites for basic medical information, while charities provided detailed content. Despite scepticism about content, social media offered validation. Online resources should prioritise visual appeal, user-friendliness, age-appropriate and personalised content and peer insights. Codesign is imperative to ensure high-quality, impactful research.

背景:许多年轻人(YP)在心理健康问题上挣扎,并在网上寻求帮助。为了利用他们的数字影响力,我们需要更好地了解他们如何以及在哪里上网寻求信息,以及他们对所找到的信息的看法:我们招募了 24 名青少年(13-18 岁)。在线访谈由研究小组成员和经过培训的青年研究人员共同进行。我们向他们展示了一个有抑郁症状的角色,并询问他们可能寻求的信息/支持来源。我们还要求他们在网上搜索和查看心理健康资源(国家医疗服务系统、青年心灵)时大声思考。我们采用了反思性主题分析法:分析产生了四个主题:(1) 网上寻求帮助的过程,展示了青年在哪里以及为什么要寻找信息;(2) 青年期望找到的信息与现实之间的不匹配;(3) 青年为确定信息来源的信任度和可信度而采取的策略;(4) 可能影响寻求帮助的个体差异:参与者通过谷歌搜索症状开始在线搜索。他们信任国家医疗服务体系网站提供的基本医疗信息,而慈善机构则提供详细的内容。尽管他们对网站内容持怀疑态度,但社交媒体提供了验证。在线资源应优先考虑视觉吸引力、用户友好性、适合年龄和个性化的内容以及同龄人的见解。要确保高质量、有影响力的研究,规范设计是必不可少的。
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引用次数: 0
‘I'm ruined’: Young people's and their mothers' experiences of living with, and receiving a diagnosis of, borderline personality disorder: An interpretative phenomenological analysis 我被毁了年轻人及其母亲与边缘型人格障碍患者共同生活以及被诊断为边缘型人格障碍的经历:一种解释性现象学分析。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-07 DOI: 10.1111/papt.12549
L. Marriner, M. Larkin, G. Urquhart Law, S. Kaur Bhogal

Background

The adolescent borderline personality disorder (BPD) diagnosis has been widely debated for many years. Strikingly, young people's experiences of both receiving a diagnosis of BPD, and of living with BPD, are largely under-explored. The current study seeks to address these gaps in the literature in a multi-perspectival design utilising young people–parent dyads.

Methods

Young people (aged 16–18 years) with a diagnosis of BPD (n = 5) and their mothers (n = 5) were recruited from two NHS Community Mental Health Services in the West Midlands and participated in semi-structured interviews. Data were analysed using interpretative phenomenological analysis [IPA].

Findings

Analysis identified two superordinate themes with five subthemes: (1) The “ugly” reality of living with BPD (providing a stark insight into what it is like to live with the unpredictable nature of experiences labelled as BPD), and (2) The diagnosis that dare not speak its name (highlighting the complexities of how the diagnosis itself is experienced by participants as a symbol of personal and permanent defectiveness and danger).

Discussion

Findings highlight a clear commonality of experience centred around the intensity of the young people's emotional distress and the accompanying pressure on parents to keep young people safe, both of which services must strive to do more to contain. Ultimately, the costs of receiving a BPD diagnosis appear to outweigh the benefits, and this paper adds support to calls for change in respect to how we conceptualise difficulties labelled as BPD and how we communicate about these difficulties, in order to avoid causing harm.

背景:多年来,青少年边缘型人格障碍(BPD)的诊断一直备受争议。令人震惊的是,青少年在接受 BPD 诊断和与 BPD 共同生活时的经历在很大程度上未得到充分探讨。本研究试图通过一项多视角设计,利用青少年与父母的二元对立关系来填补这些文献空白:方法:研究人员从西米德兰兹郡的两家国家医疗服务系统社区心理健康服务机构招募了被诊断为 BPD 的青少年(16-18 岁)(5 人)及其母亲(5 人),并对他们进行了半结构化访谈。采用解释现象学分析法(IPA)对数据进行了分析:分析确定了两个上位主题和五个次主题:(1) 患有 BPD 的 "丑陋 "现实(提供了对被贴上 BPD 标签的经历的不可预知性的严酷洞察),以及 (2) 不敢说出自己名字的诊断(强调了参与者如何将诊断本身作为个人和永久缺陷和危险的象征的复杂性):讨论:研究结果凸显了一种明显的共同体验,其核心是青少年情绪困扰的强度以及随之而来的父母为保证青少年安全所承受的压力,而这两方面的服务都必须努力加以控制。归根结底,接受 BPD 诊断的成本似乎大于收益,本文进一步支持了关于改变我们如何看待被贴上 BPD 标签的困难以及我们如何就这些困难进行沟通的呼吁,以避免造成伤害。
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引用次数: 0
Adult stakeholders' perspectives on supporting or undermining the mental health of sexual and gender minoritised adolescents 成人利益相关者对支持或破坏性与性别少数青少年心理健康的看法。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-05 DOI: 10.1111/papt.12548
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.

目的探讨成年利益相关者对日常生活中支持或破坏性与性别少数群体青少年(SGMA)心理健康的观点,以便更好地了解如何为性与性别少数群体青少年营造有利的社会心理环境:设计:描述性定性研究设计,采用框架分析法:对 16 名英国成人利益相关者进行了半结构化远程访谈,其中包括 SGMA 的父母、医疗和社会护理专业人员、社区专业人员以及委托提供青少年健康和福祉相关服务的专业人员:结果:共确定了九个主题,分别代表了营造有利于 SGMA 心理健康的社会心理环境的障碍和促进因素。障碍主题示例包括 SGMA "面临长期和严重的安全威胁和压力"、"对社会联系缺失和疏远的心理反应"、"数字暴露和在线风险与脆弱性 "以及 "冲突信息、由此导致的分歧和成人疏远"。促进因素的例子包括 "探索、拥有和改变(个人)身份"、"与青少年并肩作战,同时保持自己作为成年人的身份 "以及 "亲自促进青少年的心理安全和融入":成人利益相关者报告说,圣基茨和尼维斯青少年心理健康和情感障碍者经常暴露在对其身份的关键方面有敌意的环境中,进而损害了他们的心理健康。这些经历会威胁到他们的安全感和不断发展的身份认同。从业人员尤其应该意识到与 SGMA 身份和未成年化经历有关的压力因素,以培养 SGMA 所需的心理安全感和融入感,使他们信任关系和所提供的支持。
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引用次数: 0
A qualitative study exploring participants experiences of the Mental Imagery for Suicidality in Students Trial 一项定性研究,探索参与者在 "心理想象治疗学生自杀倾向试验 "中的体验。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-27 DOI: 10.1111/papt.12547
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.

目的:高校学生的自杀意念水平较高,但在获得支持方面往往面临障碍。针对学生自杀倾向的心理想象试验(MISST;ISRCTN13621293;NCT05296538)测试了一种名为 "广义情感应对"(BMAC)的基于想象的六节课方法的可行性和可接受性。本定性评估探讨了 MISST 参与者和工作人员的经历:设计:一项定性研究,采用一对一定性访谈的方式,对从 MISST 招募的参与者和员工进行访谈。采用反思性主题分析法探讨参与者和工作人员的体验,为未来的确定性试验提供参考:方法:对学生参与者(n = 16)、研究助理(n = 4)和试验治疗师(n = 1)进行访谈,并使用反思性主题分析法对访谈记录进行分析:结果:确定了四个关键主题。第一个主题强调了学生谈论自杀的价值和挑战。主题 2 探讨了如何建立沟通和融洽关系,以促进这种谈话。主题 3 解释了与 BMAC 治疗师的合作如何提高参与者对其当前情绪的认识,吸引他们关注生活中的积极时刻,并帮助他们积极回忆这些时刻,以打断反刍和自杀意念的消极循环。主题4概述了BMAC的 "适用性",并对未来干预的发展提出了具体建议:BMAC提供了一种积极的、有时间限制的结构化干预,非常适合满足有自杀意念的高校学生的需求。还需要进一步的研究来检验其对心理健康和自杀相关结果的有效性。
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引用次数: 0
Lost in translation? Qualitative interviews with Australian psychedelic-assisted therapy trial clinicians 翻译中的迷失?对澳大利亚迷幻药辅助治疗试验临床医生的定性访谈。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-16 DOI: 10.1111/papt.12545
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。
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引用次数: 0
‘Cheering on from the side-lines’: The perceived impact of romantic partner's commentary and behaviour on maintaining women's appearance anxiety 从旁加油":恋爱伴侣的评论和行为对维持女性外貌焦虑的感知影响
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-13 DOI: 10.1111/papt.12546
Gemma Stephanie Lumsdale, Hannah Frith, Lucy Hale

Objectives

Appearance 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.

Design

Qualitative semi-structured interview study.

Methods

Semi-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.

Results

Four 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.

Conclusions

Romantic 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.

研究目的:外貌焦虑(AA)可能是导致身体畸形障碍的一个危险因素,也是一种普遍存在的令人沮丧的问题。现有文献表明,恋爱伴侣的评论和迁就行为可能会导致女性的外貌焦虑。本研究旨在探讨女性如何体验和理解恋爱伴侣对其外貌的反馈。方法对 13 名顺式性别女性进行半结构化访谈,探讨她们如何在恋爱关系中理解外貌焦虑。研究采用了归纳-演绎混合编码的反思性主题分析方法,并将认知行为理论(CBT)作为解释数据的理论视角。结果从数据中产生了四个主题:(1) "然后他对我说......你也许可以调高一点":维持周期;(2) "我认为这些评论最终会有帮助":走出维持周期;(3) "他们就像在用外语交谈";信念是过滤器;(4) "在一旁为我加油";浪漫伴侣是支持我的教练。这些主题凸显了恋爱伴侣的行为和评论对参与者戒酒的无益(如对行为的迁就)和有益(如感情)影响。临床实践的意义包括让恋爱伴侣参与治疗,临床医生利用他们的配方和 CBT 技能(如苏格拉底式提问)来了解并针对这些可能的夫妻维持过程。
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引用次数: 0
‘Like walking with someone as opposed to trying to catch up to them’—Dynamics at play when clinicians and young people formulate together 就像与人同行,而不是试图追上他们"--临床医生和年轻人一起制定方案时的动力。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-06 DOI: 10.1111/papt.12543
Laura J. Douglas, Cian Aherne, Patrick Ryan, Barry Coughlan, Donal G. Fortune

Objective

The aim of the present study was to explore the social process of formulation in talk therapy between young people and clinicians.

Design

Qualitative semi-structured interview study.

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.

研究目的本研究旨在探索青少年与临床医生在谈话治疗中制定治疗方案的社会过程:设计:半结构式定性访谈研究:方法:对 10 名青少年(男性 6 人,女性 4 人,年龄 16-23 岁)和 9 名来自青少年心理健康服务机构不同专业的临床医生进行了访谈。采用建构主义基础理论进行分析:从数据中构建了四个主题:青少年和临床医生之间的 "公平竞争环境 "有助于制定治疗方案;制定治疗方案是一个不断正确和错误的过程;情感表达和调适使我们更接近彼此和理解;"制定治疗方案与诊断 "会在治疗室中造成紧张气氛。所设计的建构主义基础理论展示了权力、合作、开放性和治疗关系的动态如何在配制过程中不断变化:本文提出了一种建构主义基础理论,其中包含了与权力、协作和开放性有关的动态因素。治疗关系的重要性也得到了强调。该理论鼓励治疗师进行持续的、递归的个人反思,以了解他们如何才能与年轻人的权力、合作和开放性动态保持最佳的一致。
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引用次数: 0
期刊
Psychology and Psychotherapy-Theory Research and Practice
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