Psychology and Psychotherapy-Theory Research and Practice最新文献

Objectives

Intrusive mental imagery is associated with anxiety in bipolar disorder (BD) and presents a novel treatment target. Imagery-based treatments show promise in targeting anxiety and improving mood instability. This qualitative study explored experiences of receiving up to 12 sessions of a brief structured psychological intervention: Image-Based Emotion Regulation (IBER), which targets maladaptive mental imagery in the context of BD with an aim to modify the emotional impact of these images.

Design

A qualitative study embedded within the Image Based Emotion Regulation (IBER) feasibility randomised controlled trial.

Methods

Semi-structured interviews were conducted with 12 participants in the treatment arm of the trial who received IBER + treatment as usual. Data were analysed using thematic analysis.

Results

Despite some initial scepticism about imagery-focused treatment, all participants expressed broadly positive accounts of treatment experiences. High levels of engagement with imagery modification techniques, beneficial use of techniques post treatment and improvements in anxiety management and agency were described by some. Three sub-groups were identified: those who reported a powerful transformative impact of treatment; those who embedded some new techniques into their daily lives, and those who felt they had techniques to use when needed. No participants reported overall negative experiences of the IBER treatment.

Conclusions

Findings from this study highlight the value for treatment recipients of modifying the underlying meanings associated with maladaptive imagery, and the personalised skills development to manage anxiety within bipolar disorders. Findings can inform treatment refinements and further trial-based evaluations.

Objectives

Videoconference psychotherapy (VCP) is a crucial component of many health care systems, allowing for remote delivery of services. However, little is known about the mechanisms of change within VCP. Previous research has suggested that self-disclosure may be greater in VCP than face-to-face modalities and was investigated in the current study.

Design

Young adults aged 18–25 years (N = 57) were randomly allocated to face-to-face or VCP interview conditions, with measures completed pre- and post-interview.

Methods

Participants completed an autobiographical memory task, requiring them to describe specific memories in response to positive and negative valence cue words. Measures included self-reported self-disclosure, blind observer-rated self-disclosure, memory specificity, and mean number of words per response.

Results

No significant differences were found between conditions with regard to self-reported self-disclosure, capacity to recall specific memories, or words uttered per response. However, observer-rated depth of self-disclosure was significantly higher for participants in the face-to-face than VCP condition. Self-disclosure and memory specificity were also significantly greater for negative than positive valence cue words, regardless of condition.

Conclusions

The findings indicate that whilst participants may be able to draw on memories with equal ease regardless of interview modality, in VCP, emotional processing of these memories may require increased support and guidance from the therapist.

Objectives

To compare idiographic change during two formats of guided self-help (GSH); cognitive-behavioural therapy guided self-help (CBT-GSH) and cognitive analytic therapy guided self-help (CAT-GSH).

Design

Qualitative inductive thematic analysis.

Methods

Semi-structured interviews with N = 17 participants with a reliable change outcome on the GAD-7 after completing GSH for anxiety. Changes were categorised and themes extracted.

Results

No differences between CAT-GSH and CBT-GSH were found regarding types of change reported. The five overarching themes found were personal qualities of success, enlightenment through understanding, specific tools and techniques, changes to relationships and tailoring support. Four themes maximally differentiated between the two different types of GSH; CAT-GSH enabled relational insight and change whilst CBT-GSH enabled better understanding of anxiety, new coping techniques and supportive relationships.

Conclusions

Both common and model-specific factors contribute to patient change during GSH. Whilst all forms of GSH are grounded in the psychoeducational approach, separate theoretical foundations and associated methods facilitate different types of ideographic change.

Objectives

The current study aimed to examine: (1.1) causal beliefs about adolescent depression in a sample of adolescents with a clinical depression and their mothers and fathers; (1.2) within-family overlap of causal beliefs; (2.1) mothers' and fathers' reflected causal beliefs about their child's perspective; (2.2) the accuracy of mothers' and fathers' reflected causal beliefs as related to their child's causal beliefs.

Design

Qualitative study using a within-family approach.

Methods

Adolescents with a current clinical depression (MDD/dysthymia; N = 34) and their parents (N = 34 mothers, N = 26 fathers) were independently interviewed about their causal beliefs about the adolescents' depression. Parents were additionally interviewed about their perception of their child's causal beliefs (i.e., reflected causal beliefs).

Results

The causal beliefs most frequently mentioned by adolescents, mothers and fathers are: characteristics of the child, social factors, school and various stressful experiences. Parent–child overlap was relatively low, specifically for the themes of bewilderment, cumulative effect and stressful life events, whereas overlap was relatively high for themes of social factors, school and stressful experiences outside of the family. Parents were relatively accurate in their reflected causal beliefs, but tended to underestimate their child's insights into possible causes of their depression. Accuracy of parents' reflected causal beliefs was particularly low for the theme cumulative effect and high for social factors.

Conclusions

The various causal beliefs of adolescents and their parents could be used in therapeutic setting. Future research could examine whether (guided) conversations may promote alignment within families and treatment efficacy.

Objectives

This study aimed to explore the experiences of women with moderate-to-severe mental health difficulties during pregnancy, with a focus on establishing their psychological needs. Psychological distress caused by mental health difficulties during pregnancy is common and can significantly impact women and their babies. However, women's subjective experiences of difficulties with their mental health throughout pregnancy, alongside their experiences of staff, services and treatments are less well understood.

Design

In this qualitative study, an Interpretive Phenomenological Analysis (IPA) approach was used.

Methods

Semi-structured interviews were conducted with participants recruited via a regional Perinatal Mental Health Service. Interviews were transcribed and analysed following the IPA methodology.

Results

Five superordinate themes were identified which represented the lived experiences of the 11 participants on their journey through pregnancy whilst living with mental health difficulties and subsequent psychological distress: (i) Feeling the ‘wrong’ feelings, (ii) Societal pressures and a desire for greater acceptance, (iii) Searching for answers despite a lack of resources, (iv) What made a difference and (v) Experiences and expectations of service provision. Within these themes, 13 subordinate themes were also identified.

Conclusions

These themes highlight the need for greater awareness and acceptance of mental health difficulties during pregnancy as well as postnatally. While perinatal mental health services are evolving, there is still an urgent requirement for services to continue to develop to meet women's needs, as well as to develop the role of clinicians as facilitators of engagement with needs-matched care.

The raison d'être for psychotherapy¹ is to address individual suffering and distress. The sustainable development goals address suffering and distress on a global scale in the context of threats to the survival of our communities and planet.

Objective

We propose scaling up therapeutic principles for collective impact and nurturing therapist commitment beyond the therapy room, to activate and sustain compassion-in-action at the community system level.

Design

The SDGs represent the strength of collective human concern and action coming together. At the half-way point, we are falling dangerously short of our targets, requiring an urgent response. The tenet of this paper is that the weakest link in our journey is not technical capability or finances, or even the impact of multiple intersecting crises, but our ability to collaborate for sustained action—it is the human factor—hence, we need a psychologically informed response.

Method

Notably, least ‘visible’ is SDG17, the umbrella goal designated means of implementation, through partnership. Partnership has been treated as a transactional element of SDG projects, rather than the vital heartbeat connecting daily actions to the 2030 vision. Partnership is about investing in relationships and a commitment to working together with a common purpose—the bailiwick of psychological therapists.

Results

We propose an architecture to support the development of courageous partnerships and compassionate systems.

Conclusion

Compassion uniquely potentiates global action on wicked problems.

Objectives

Most lifetime mental health problems (MHP) start before the age of 25. Yet young people—particularly those of minority backgrounds—often do not seek or access professional help. In the UK, young people of Eastern European (EE) backgrounds represent a large minority group; however, little is known about their experiences of MHP and help-seeking. In this study, we aim to understand the help-seeking process from the perspectives of EE young people.

Design

We used a qualitative study design with semi-structured individual interviews. The results were analysed using reflexive thematic analysis.

Method

Twelve young people (18–25 years) of EE backgrounds, living in Oxfordshire, UK, took part. All participants had experienced a severe MHP and were identified in the community.

Results

EE young people's experiences of MHP and help-seeking were driven by a sense of being caught between different cultures and simultaneously needing to navigate the potentially contrasting expectations of both cultures. This process was reinforced or tempered by the perceived continuing influence of young people's families, that is, families with more open views about MHP made it easier for young people to navigate through the process of help-seeking. Young people's internalised cultural and familial beliefs about MHP affected their decision-making when experiencing difficulties, their levels of trust in services, and perceived sense of resourcefulness and ability to cope.

Conclusions

Recognising and responding to the cultural tension that young people of EE backgrounds may experience can help us to develop more accessible and inclusive mental health services.

Introduction

People who grew up under the care of children's social services are a highly vulnerable group, with 50% of this population meeting the criteria for a mental health problem at any one time. Emerging evidence suggests that there is a disparity between the number of people who require support, and those that receive it, and that they face several barriers to accessing timely and effective mental health support. We have a limited understanding of how to support the mental health of this group as they ‘age out’ of children's social services, and the transition to independence, which occurs around the age of 18. We aimed to explore how care-leavers understand their experiences of help-seeking from formal mental health services.

Methods

We used qualitative interviews, and Interpretative Phenomenological Analysis with 9 care-experienced young people aged between 18 and 25 years old. This work was co-produced by a team of care-experienced adults, from the conception of the study to write-up.

Results

Qualitative analysis revealed several themes which centred around: (1) taking reluctant steps towards recovery, (2) challenges with being understood and the importance of gaining an understanding of yourself, (3) navigating trust and (4) the legacy of not having your mental health needs met.

Conclusions

We identified several important implications for health and social care practice, across primary and secondary health care settings. This work highlights ways to better support this highly vulnerable group in accessing evidence-based mental health support, and how to maintain engagement.