Psychology and Psychotherapy-Theory Research and Practice最新文献

Introduction: This study explores self-compassion as a mediator in the relationship between attachment and self-harm. Self-harm represents a maladaptive coping strategy, meanwhile suicidal self-harm is the third most common cause of premature death among young people worldwide. Therefore, it is necessary to expand research on self-harm and explore potential protective factors. Our main research hypothesis was that self-compassion mediates the relationship between attachment and self-harm based on the empirical and theoretical evidence presented.

Method: Four hundred and two participants recruited online completed a questionnaire consisting of scales measuring self-harming behaviour, adult attachment and self-compassion.

Results: We found that both attachment anxiety and attachment avoidance positively predict self-harm and negatively predict self-compassion. The results also revealed that self-compassion negatively predicts self-harm and mediates the relationship between self-harm and both anxious and avoidant attachment.

Conclusion: We believe that this paper creates further ground for future research on protective factors involved in the dynamics of self-harm and has the potential to provide interesting findings for professionals working with insecurely attached self-harming clients.

Objective: Research is required to better understand the experience and effectiveness of dyadic developmental psychotherapy (DDP), a promising intervention developed to meet the complex needs of developmental trauma-experienced children in substitute care. DDP is a systemic intervention, within which the child's carer plays a significant role. Given their significant role and the lack of existing research, this study aimed to explore how foster carers experience DDP.

Design: A qualitative design using semi-structured interviews with 10 foster carers was implemented.

Method: Interviews conducted via Microsoft Teams and telephone were recorded, transcribed and analysed using interpretative phenomenological analysis.

Results: Four group experiential themes and 11 subthemes were formed; 'from disbelief to clarity', 'scaffolded and safe', 'attuned and connected' and "It's worth it". From initial confusion and disappointment, came clarity of self-understanding and a more attuned, connected attachment relationship. DDP was experienced as both fulfilling and demanding.

Conclusions: Though the need to explore DDP's effectiveness remains, this study suggests foster carers experience DDP as a demanding yet worthwhile intervention. Implications for practice, especially an increased need for relational safety and carer support are explored, as well as avenues for future research.

Objectives: Disengagement from psychological therapies in first-episode psychosis (FEP) is a common occurrence, with personal costs associated with untreated problems. This study aimed to establish the barriers and facilitators of people experiencing FEP to engagement in psychological therapies by undertaking a meta-ethnography and Qualitative Comparative Analysis (QCA) of existing qualitative literature.

Methods: A systematic search was conducted in multiple databases including Psychinfo, Ovid Medline, Web of Science, EthOs, OPENgrey and Procrest in July 2021 (updated in July 2024). The search identified 6966 titles and 71 full texts that were reviewed for eligibility. Twenty-three studies were found to meet eligibility and were critically appraised. Data was systematically extracted and synthesized in a meta-ethnography and QCA.

Results: Seven themes were identified as barriers to engagement in psychological therapy (Ambivalence to therapy, Emotional distress, Fluctuating symptoms, Negative expectations, Physical capacity, Service limitations and Therapy preference unmet) and six themes were identified as facilitators (Destigmatizing, Accessibility of digital therapy, Positive expectations of therapy are met, Service factors, Therapists interpersonal approach and skills and Therapy preferences met). The QCA identified a model with the Therapists interpersonal approach and skills, as sufficient (i.e. whenever that condition is present, the outcome is also guaranteed to be present) for engagement in psychological therapy, while Emotional distress was a sufficient barrier to engagement.

Conclusions: Engagement is a multifaceted construct with many factors unique to an individual's experience, impacted by emotional, social, practical and service-level factors. Strengths, limitations and recommendations of the findings are discussed.

Objectives: This systematic review investigated the qualitative experiences of sexual abuse survivors in talking therapy treatments with respect to the helpful and hindering aspects of therapy.

Methods: Searches were conducted on five databases; PubMed, Web of Science, PyscInfo, PsycArticles and PsycExtra and through searching reference lists. Papers were included where they provided qualitative primary data of client experiences of therapy, did not involve specialist clinical populations and were written in English. Papers were included irrespective of whether study participants had experienced sexual abuse in childhood, adulthood or both. Studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Meta-study was used to analyse the results.

Results: Four themes were generated: (1) helpful therapy relies on choice, autonomy, and the freedom to choose when to speak and what to speak on, (2) engagement relies on considerations of the complexity of recovery from sexual abuse, (3) feeling cared for and connected with the therapist is important and (4) a sensitive and thoughtful end of therapy can bring positive holistic emotional and lifestyle changes.

Conclusions: This study provides clinical insights into the helpful aspects of therapy, facilitating a safe therapeutic engagement, and managing an effective and sensitive transition into recovery. These themes are considered in relation to understanding supportive factors in therapy.

Objectives: Loneliness in people who experience psychosis is common and associated with poor mental health. In this randomised trial, we tested the feasibility and acceptability of an adapted Groups for Health (G4H) intervention for loneliness, delivered in group or individual format.

Design: Mixed methods, two-arm feasibility randomised controlled trial.

Methods: Forty individuals who self-identified as having psychosis were recruited from UK mental health care services, recovery colleges and charities. G4H was modified for people with psychosis, with participants randomised to receive the intervention delivered via group (N = 20) or individual (N = 20) format. The primary outcomes related to trial acceptability and feasibility. Exploratory repeated measures ANOVAs and t-tests evaluated differences between formats over time in loneliness, wellbeing and possible mechanisms of change including social identification, identity integration and perceived in-group and out-group empathy. Measures were completed at baseline, end of treatment and 1- and 6-month follow-up.

Results: Recruitment, retention and trial acceptability ratings for both group and individual formats of G4H were acceptable to good. No participants reported experiencing a serious adverse event. Exploratory ANOVAs indicated no differences related to format but positive change in key variables of loneliness, wellbeing, social identification and identity integration over time. T-tests for loneliness indicated that this change was step-wise from baseline, through end of treatment to 1-month follow-up.

Conclusions: G4H is a feasible intervention for people with psychosis who identify as lonely and it can be delivered in either group or individual formats. This feasibility trial provides support for a future full randomised controlled trial.

Background: NICE guidelines advocate that healthcare professionals should aim to use non-pharmacological and person-centred approaches as primary strategies to reduce or prevent distress in people living with dementia who reside within care settings. However, despite these recommendations, recent studies have illustrated that there is still a requirement for healthcare professionals to have adequate opportunities to access training programmes and guidance on how to effectively use non-pharmacological approaches in dementia care settings. Communication and Interaction Training (CAIT) was developed to train healthcare professionals in dementia care on how to apply person-centred principles to effectively reduce or negate distress in people living with dementia in a non-invasive manner.

Aims: This paper provides an overview of current debates regarding the use of non-pharmacological approaches in dementia care, as initial care strategies, to reduce the primary use of pharmacological interventions that may have deleterious side effects for people living with dementia. Furthermore, this paper provides a summary of an evaluation that assessed the extent to which a 2-day CAIT programme could enhance healthcare professionals in their perceived ability to communicate therapeutically with and provide care for people living with dementia.

Materials & methods: In this evaluation, 35 healthcare professionals in dementia care engaged with the 2-day CAIT programme. The Confidence in Dementia Scale, Knowledge in Dementia Scale and Compassionate Competence Scale were administered for participants to complete pre and post training.

Results: A series of parametric paired samples t-tests were completed, and the results indicated that the 2-day CAIT course was effective in enhancing healthcare professionals' perceived confidence, communication skills, sensitivity, and ability to meet the care needs of people living with dementia. However, staff' knowledge of dementia did not significantly increase following the CAIT course, which could be due to participants already having high levels of knowledge on dementia prior to training.

Discussion & conclusion: These results indicated that engaging in CAIT could be beneficial in enhancing healthcare professionals' perceived ability to use therapeutic communication strategies in their interactions with people living with dementia. Discussion is provided on how the delivery of training programmes, such as CAIT, may assist in re-enforcing guidelines that advocate for the use of non-pharmacological and non-invasive approaches in dementia care.