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From psychotic perceptual aberration to dissociative part of the self: An historical and personal overview of changing perspectives on voice hearing. 从精神病性知觉失常到自我的分离部分:对声音听力变化观点的历史和个人概述。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-10-10 DOI: 10.1111/papt.70014
Andrew Moskowitz, Dirk Corstens

Relational approaches to voice hearing (VH), which emphasize changing a person's attitude towards and relationship with their voices, challenge the medical view of VH as a psychotic symptom that can only be managed, typically through medication. In this paper, we review historical perspectives on VH, exploring factors that led VH to be classified as a core symptom of schizophrenia in the late 20th century. Around the same time, an alternative paradigm emerged through the Hearing Voices Movement, which argued that VH was a variation of normal human consciousness that should be accepted and explored without stigma. Dirk Corstens, a psychiatrist working within that perspective, joined forces with Andrew Moskowitz, a clinical psychologist with experience with dissociative disorders, to publish a paper entitled 'Auditory Hallucinations: Psychotic Symptom or Dissociative Experience'? In that seminal paper, Moskowitz and Corstens (2007) argued-after reviewing research on VH in the general population, similarities in VH between clinical and non-clinical populations, and the relationship between dissociation and voice hearing-that VH was better understood as essentially normal and dissociative in nature, rather than pathological and psychotic. They further argued that voice hearers would benefit from dialogical approaches seeking to understand the purpose of their voices and change the voice hearer's relationship to them. Since then, research and clinical trials have strongly supported all the tenets of the 2007 paper, to the point that relational or dialogical approaches to VH are now rapidly becoming an acceptable complement or even alternative to medical treatment for hearing voices.

语音听力(VH)的关系方法强调改变一个人对声音的态度和与他们的声音的关系,挑战了VH作为一种只能通过药物治疗来控制的精神病症状的医学观点。在本文中,我们回顾了VH的历史观点,探索导致VH在20世纪后期被归类为精神分裂症的核心症状的因素。大约在同一时间,另一种范式通过“听声运动”出现了,该运动认为,VH是正常人类意识的一种变化,应该被接受和探索,而不是耻辱。精神科医生Dirk Corstens与临床心理学家Andrew Moskowitz合作,发表了一篇名为《幻听:精神病症状还是分离体验》的论文。在那篇开创性的论文中,Moskowitz和Corstens(2007)在回顾了对普通人群中VH的研究、临床和非临床人群中VH的相似性以及分离和语音听力之间的关系之后,认为VH本质上是正常的和分离的,而不是病态的和精神病性的。他们进一步认为,声音听众将受益于寻求理解其声音目的的对话方法,并改变声音听众与他们的关系。从那时起,研究和临床试验强烈支持2007年论文的所有原则,以至于关系或对话方法治疗VH现在正迅速成为一种可接受的补充,甚至替代听力声音的医学治疗。
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引用次数: 0
A network analysis of gender differences in unresolved attachment, post-traumatic stress following COVID-19, psychiatric comorbidity, and contamination fear in adolescents: Implications for psychotherapy 未解决依恋、COVID-19后创伤后应激、精神共病和青少年污染恐惧的性别差异网络分析:对心理治疗的影响
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-09-05 DOI: 10.1111/papt.70013
Man Cheung Chung, Fangsong Liu, Na Wang, Mengge Zhang, Yabing Wang

Objectives

This study used a network approach to examine gender differences in adolescents regarding unresolved attachment styles, COVID-19 PTSD symptoms, comorbid psychiatric symptoms, and contamination fear. The rationale for the study stems from the suggestion that parents‘ relationships with adolescents (i.e., attachment) can influence how adolescents cope with distress during COVID-19. Since attachment is linked to gender differences, these differences should also be considered. Furthermore, while much has been documented on secure or insecure attachment, little is known about whether the impact of unresolved attachment can influence psychological distress in adolescents.

Methods

Adolescents (n = 1715; 803 females, 912 males) from five Hong Kong secondary schools completed measures assessing unresolved attachment, contamination-related fears, PTSD symptoms, and general psychological disorders.

Results

No significant gender differences were observed in network density or global strength. However, network structure analysis revealed weaker connections among males compared to females. For males, all unresolved attachment aspects were linked to COVID-19 PTSD and comorbid psychiatric symptoms, while for females, only perceived failed protection correlated with depression. Both genders showed associations between PTSD, comorbid symptoms, and contamination fear.

Conclusions

While trauma and psychological reactions were shared, gender differences emerged in how unresolved attachment influenced distress. Males exhibited broader attachment-related distress links, whereas females showed more specific associations. These findings enhance understanding of adolescent psychotherapy needs during crises.

目的:本研究采用网络方法研究青少年在未解决依恋类型、COVID-19创伤后应激障碍症状、共病精神症状和污染恐惧方面的性别差异。这项研究的基本原理源于这样一种建议,即父母与青少年的关系(即依恋)会影响青少年在COVID-19期间应对痛苦的方式。由于依恋与性别差异有关,因此也应考虑到这些差异。此外,虽然有很多关于安全或不安全依恋的文献记载,但关于未解决的依恋是否会影响青少年的心理困扰,我们知之甚少。方法:来自香港五所中学的青少年(n = 1715; 803名女性,912名男性)完成了未解决依恋、污染相关恐惧、创伤后应激障碍症状和一般心理障碍的评估。结果:在网络密度和整体强度上没有观察到显著的性别差异。然而,网络结构分析显示,与女性相比,男性之间的连接较弱。对于男性来说,所有未解决的依恋方面都与COVID-19创伤后应激障碍和共病精神症状有关,而对于女性来说,只有感知到的保护失败与抑郁症有关。男女均表现出创伤后应激障碍、共病症状和污染恐惧之间的关联。结论:虽然创伤和心理反应是相同的,但在未解决的依恋如何影响痛苦方面,性别差异出现了。男性表现出更广泛的依恋相关的痛苦联系,而女性则表现出更具体的联系。这些发现加强了对危机期间青少年心理治疗需求的理解。
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引用次数: 0
CBT, parent training, and combined approaches for children with ADHD: A randomized study 儿童多动症的CBT、父母训练和联合治疗:一项随机研究。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-09-04 DOI: 10.1111/papt.70011
Burcu Hafiz Ahmet, Alperen Bıkmazer, Vahdet Gormez

Objective

This study aimed to evaluate the effectiveness of cognitive behavioural therapy (CBT), parent training programm (PTPs), and their combination as adjunctive interventions to medication in reducing core ADHD symptoms and functional difficulties in children aged 7–11 who had been receiving pharmacological treatment. The goal was to examine whether these psychosocial approaches could enhance treatment outcomes beyond medication alone.

Method

Forty-two mother–child dyads were randomly assigned to one of four groups: (1) medication (M) plus cognitive behavioural therapy (CBT), (2) M plus parent training programme (PTP), (3) M plus both CBT and PTP (combined), and (4) M only (control). Families completed the sociodemographic data form, the Turgay DSM-IV ADHD Assessment Scale, and the Strengths and Difficulties Questionnaire (SDQ) before and after the intervention period. Data were analysed using Kruskal–Wallis H, Mann–Whitney U, Bonferroni correction, Wilcoxon signed-rank, and Chi-square tests, with a significance level set at p < .05.

Results

Significant reductions in attention deficit, hyperactivity, and impulsivity were observed in the M + CBT, M + PTP, and combined groups, as measured by the Turgay DSM-IV ADHD Assessment Scale. According to the SDQ, all three groups also showed significant decreases in SDQ impact scores, suggesting improved functional outcomes. In contrast, the control group showed improvement only in attention deficit, despite a notable increase in SDQ impact scores, indicating worsened overall functioning.

Conclusion

Adjunctive CBT, parent training, and their combination were more effective than medication alone in reducing core ADHD symptoms and improving children's functioning. These findings support the integration of psychosocial interventions into routine ADHD treatment, especially in school and family settings where behavioural support is essential. However, the small sample size limits generalizability, and further research with larger samples, extended follow-up, and placebo-controlled designs is needed to confirm these results and guide evidence-based policy and practice.

目的:本研究旨在评估认知行为疗法(CBT)、家长培训计划(PTPs)及其联合作为药物辅助干预措施在减少7-11岁接受药物治疗的儿童核心ADHD症状和功能困难方面的有效性。目的是检查这些社会心理方法是否可以提高治疗效果,而不仅仅是药物治疗。方法:将42对母子随机分为四组:(1)药物治疗加认知行为疗法(CBT),(2)药物治疗加家长培训计划(PTP),(3)药物治疗加认知行为疗法和认知行为疗法(CBT和PTP)(联合),(4)药物治疗组(对照组)。家庭在干预前后分别填写社会人口学数据表、Turgay DSM-IV ADHD评估量表和优势与困难问卷(SDQ)。采用Kruskal-Wallis H、Mann-Whitney U、Bonferroni校正、Wilcoxon sign -rank和卡方检验对数据进行分析,显著性水平设置为p。结果:根据Turgay DSM-IV ADHD评估量表测量,M + CBT、M + PTP和联合组的注意缺陷、多动和冲动显著减少。根据SDQ,三组患者的SDQ影响评分均显著下降,表明功能预后得到改善。相比之下,对照组仅在注意力缺陷方面有所改善,尽管SDQ影响得分显著提高,表明整体功能恶化。结论:辅助CBT、家长训练及其联合治疗在减轻ADHD核心症状和改善儿童功能方面比单独用药更有效。这些发现支持将社会心理干预纳入ADHD的常规治疗,特别是在行为支持至关重要的学校和家庭环境中。然而,小样本量限制了普遍性,需要进一步研究更大的样本,延长随访和安慰剂对照设计来证实这些结果并指导循证政策和实践。
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引用次数: 0
Does remote match reality? Comparing the effectiveness of a self-help app for panic disorder and agoraphobia to face-to-face CBT 远程与现实相符吗?比较恐慌症和广场恐惧症的自助应用程序与面对面CBT的有效性。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-09-01 DOI: 10.1111/papt.70012
Justine Spies, Thomas Lang, Alexander L. Gerlach, Tilo Kircher, Alfons Hamm, Georg W. Alpers, Thomas Fydrich, Volker Arolt, Jürgen Deckert, Andreas Ströhle, Hans-Ulrich Wittchen, Sylvia Helbig-Lang

Background

Exposure-based CBT is highly effective in treating patients with panic disorder and agoraphobia; however, access to such treatments is often limited. Smartphone-based self-management apps offer a promising low-threshold treatment alternative to face-to-face therapy. Although such health apps have shown to be effective in reducing anxiety symptoms, comparisons to active treatments are still scarce. Therefore, this study compared the effectiveness of a self-help app to an established face-to-face CBT intervention for panic and agoraphobia.

Method

The present study conducts a post hoc comparison of two independent RCTs examining participants with panic disorder and/or agoraphobia. Interventions in both studies were based on the same CBT manual. Study 1 (n = 138) included face-to-face CBT; Study 2 addressed the effects of a digital self-help intervention (n = 57). Main outcomes comprised symptoms of both panic disorder and agoraphobia, depressive symptoms and agoraphobic avoidance. Data were analysed using linear mixed models in intent-to-treat and completer data sets.

Results

Linear mixed models showed that face-to-face treatment was superior to app treatment in reducing panic and agoraphobic symptoms (R2 = 0.32), depressive symptoms (R2 = 0.24) and agoraphobic avoidance (R2 = 0.12 and 0.15). Dropout rates did not differ significantly, and both interventions demonstrated high levels of adherence.

Discussion

Although a smartphone-based CBT intervention was effective in reducing symptoms of panic and agoraphobia, its efficacy was significantly below the effects of the same intervention delivered in face-to-face format. Thus, digital interventions might be most suitable within a stepped-care approach or to bridge waiting times for psychotherapy.

背景:基于暴露的CBT在治疗惊恐障碍和广场恐惧症患者中非常有效;然而,获得这种治疗的机会往往有限。基于智能手机的自我管理应用程序为面对面治疗提供了一种有前景的低门槛治疗方案。尽管这类健康应用程序已被证明在减轻焦虑症状方面有效,但与积极治疗的比较仍然很少。因此,本研究比较了自助应用程序与已建立的面对面CBT干预恐慌和广场恐惧症的有效性。方法:本研究对两个独立的随机对照试验进行了事后比较,这些随机对照试验检查了惊恐障碍和/或广场恐惧症的参与者。两项研究的干预措施均基于相同的CBT手册。研究1 (n = 138)包括面对面CBT;研究2探讨了数字自助干预的效果(n = 57)。主要结果包括惊恐障碍和广场恐怖症的症状,抑郁症状和广场恐怖症回避。使用意向治疗和完成率数据集的线性混合模型对数据进行分析。结果:线性混合模型显示,面对面治疗在减轻恐慌和广场恐惧症症状(R2 = 0.32)、抑郁症状(R2 = 0.24)和广场恐惧症回避(R2 = 0.12和0.15)方面优于应用程序治疗。辍学率没有显著差异,两种干预措施都表现出高水平的依从性。讨论:尽管基于智能手机的CBT干预在减少恐慌和广场恐怖症症状方面是有效的,但其效果明显低于面对面的相同干预的效果。因此,数字干预可能最适合于阶梯式护理方法或缩短心理治疗的等待时间。
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引用次数: 0
Transition to online psychological support – Barriers, stereotypes and challenges from the perspective of service providers 过渡到在线心理支持-从服务提供者的角度来看障碍,刻板印象和挑战。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-08-27 DOI: 10.1111/papt.70010
Miroslav Charvát, Leona Jochmannová, Petra Zia Sluková, Lucie Viktorová

Objectives

This qualitative study, which provides practical insights for the field, described the transition process of psychological service providers towards online care provision. We aimed to describe the process of professionals' adaptation to new methods of distant psychological care, including its main facilitating and complicating elements.

Methods

We used a qualitative approach, specifically evaluation design, employing reflexive thematic analyses conducted by the software ATLAS.ti. Semi-structured interviews were conducted with 51 professionals, and 14 focus groups with 44 experts. We worked with 95 experienced professionals specializing in clinical psychology, psychological counseling, and counseling those affected by domestic violence. All of them have had practical exposure to delivering care online.

Results

The results show that after first-hand involvement, most of the providers have moved from being cautious experimenters to being regular practitioners of online remote psychological care in cases where it is appropriate. Technical difficulties and negative stereotypes receded, with many respondents striving to provide online services for their clients' benefit. However, some negative aspects persist, including the lack of timely support from key institutions.

Conclusions

Logistical barriers stem from poor management and insufficient political, legislative and financial support. Ethical and legal challenges require serious attention from key system players. The question of embodiment, involving new therapeutic cues and compensating for absent ones, warrants thorough follow-up research. Bias and stereotype-related barriers, often shaped by providers' attitudes, can be addressed through targeted training and shared professional experiences.

目的:本定性研究描述了心理服务提供者向在线护理提供的转变过程,为该领域提供了实践见解。我们旨在描述专业人员对远程心理护理新方法的适应过程,包括其主要的促进因素和复杂因素。方法:采用定性方法,具体评价设计,利用ATLAS.ti软件进行反身性专题分析。我们对51位专业人士进行了半结构化访谈,并对14个焦点小组进行了44位专家访谈。我们与95名经验丰富的专业人士合作,他们专门从事临床心理学、心理咨询和家庭暴力受害者咨询。他们都有过提供在线护理的实际经验。结果:结果表明,在直接参与后,大多数提供者在适当的情况下从谨慎的实验者转变为在线远程心理护理的常规实践者。技术上的困难和负面的刻板印象逐渐消失,许多受访者努力为客户的利益提供在线服务。然而,一些消极的方面仍然存在,包括缺乏关键机构的及时支持。结论:后勤障碍源于管理不善和政治、立法和财政支持不足。道德和法律方面的挑战需要关键系统参与者的认真关注。体现的问题,涉及新的治疗线索和补偿缺失的线索,值得深入的后续研究。与偏见和陈规定型观念有关的障碍往往是由提供者的态度形成的,可以通过有针对性的培训和分享专业经验来解决。
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引用次数: 0
Cognitive analytic therapy-guided self-help for depression: A mixed methods evaluation 认知分析疗法引导的抑郁症自助:一种混合方法评价。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-08-18 DOI: 10.1111/papt.70008
Rebecca Kelly, Stephen Kellett, Mel Simmonds-Buckley, Niall Power

Objectives

To evaluate cognitive analytic therapy-guided self-help (CAT-GSH) for depression in terms of outcomes and acceptability.

Design

A parallel mixed methods case series with session-by-session outcome measurement supplemented by patient and staff interviewing.

Methods

Four psychological well-being practitioners (PWPs) delivered CAT-GSH to N = 11 patients in an NHS talking therapies service, and these patients were followed up at 1 month. Acceptability of CAT-GSH was assessed via treatment refusal and dropout rates, sessional attendance and qualitative interviewing of PWPs and patients. Outcomes were assessed by comparing group means at screening, termination and follow-up on sessional measures, calculating the case-by-case recovery rate and benchmarking against relevant research.

Results

All 11 patients offered CAT-GSH accepted; one patient dropped out, all completers attended the full 6 sessions, and 7/10 were in reliable recovery at follow-up. Treatment gains were maintained over the follow-up period, and outcomes appeared equivalent when benchmarked against the evidence base. Patients found CAT-GSH to be a mostly acceptable intervention, and this was due to mood improvements, better recognition skills and implementation of ‘exits’. CAT-GSH improved the diversity of the treatment offer for PWPs and provided professional development opportunities.

Conclusions

CAT-GSH holds promise as a low-intensity treatment for depression, but clearly more controlled research is needed.

目的:评价认知分析治疗引导自助(CAT-GSH)治疗抑郁症的疗效和可接受性。设计:一个平行的混合方法的病例系列,每个疗程的结果测量,辅以病人和工作人员的访谈。方法:4名心理健康从业者(PWPs)对11例NHS谈话治疗患者进行CAT-GSH治疗,随访1个月。CAT-GSH的可接受性通过治疗拒绝率和辍学率、会期出勤率以及对pwp和患者的定性访谈来评估。通过比较筛查、终止和随访期间措施的组均值,计算个案恢复率和对照相关研究的基准来评估结果。结果:11例患者均接受CAT-GSH治疗;1名患者退出,所有完成者参加了完整的6个疗程,7/10在随访中可靠恢复。在随访期间,治疗效果保持不变,当与证据基础基准比较时,结果似乎相同。患者发现CAT-GSH是一种可接受的干预措施,这是由于情绪改善,更好的识别技能和“退出”的实施。CAT-GSH改善了为工务人员提供的治疗方案的多样性,并提供了专业发展机会。结论:CAT-GSH有望作为抑郁症的低强度治疗,但显然需要更多的对照研究。
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引用次数: 0
Activation of the inner critic increases speech illusions and negative emotional valence of perceived speech 内部批评的激活增加了言语错觉和被感知言语的负性情绪效价。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-08-18 DOI: 10.1111/papt.70007
June Engeland, Andrew Allen, Rachel Brand

Objectives

Research consistently reports an association between auditory hallucinations and traumatic experiences, yet the psychological mechanisms underpinning this relationship remain poorly understood. Empirical evidence suggests that enduring dispositions, including early maladaptive schemas, interact with immediate stressors to elicit auditory hallucinations. The inner critic represents the activation of such enduring dispositions and concurs with common themes in auditory hallucinations. This study aimed to investigate the effect of the inner critic on speech illusions and the emotional valence of perceived words.

Design

A quasi-experimental design was utilised.

Methods

Forty-two non-clinical participants (67.40% female, Mage = 29.63) completed self-report questionnaires measuring predisposition to hallucination-like experiences, self-criticism and demanding and punitive parent schema modes. Participants then completed an auditory perception task, the Babble Task, inducing speech illusions before and after an inner critic imagery manipulation.

Results

A mixed factorial analysis of variance revealed a significant main effect of the inner critic manipulation on speech illusions, with participants reporting more speech illusions after the manipulation. Participants scoring high on the demanding parent mode reported more speech illusions overall. Linguistic analysis of speech illusions demonstrated an increase in negative tone across groups following the inner critic manipulation.

Conclusions

While acknowledging concerns regarding the convergent validity of the Babble Task, these findings add nuance to existing theories by suggesting that an activated inner critic impairs source monitoring and shapes the content of ensuing auditory intrusions. Additionally, the findings indicate the inner critic as a potential target for treatment in distressing auditory hallucinations.

目的:研究不断报道幻听和创伤经历之间的联系,然而支撑这种关系的心理机制仍然知之甚少。经验证据表明,持久的倾向,包括早期的适应不良图式,与直接的压力源相互作用,引起幻听。内心的批评代表了这种持久倾向的激活,并与幻听中的常见主题一致。本研究旨在探讨内在批评对言语错觉和感知词的情绪效价的影响。设计:采用准实验设计。方法:42名非临床被试(67.40%为女性,年龄29.63岁)完成幻觉样体验倾向、自我批评倾向、苛求性和惩罚性父母图式模式倾向的自我报告问卷。然后,参与者完成了一项听觉感知任务,即“胡言乱语任务”,在进行内心批评想象操作之前和之后诱导语言幻觉。结果:混合因子方差分析显示,内批评操纵对言语错觉有显著的主效应,被试在操纵后报告了更多的言语错觉。在要求型父母模式中得分高的参与者报告了更多的语言错觉。语言错觉的语言分析表明,在内部批评操纵后,各组的消极语调有所增加。结论:虽然承认了对胡言乱语任务的趋同有效性的关注,但这些发现通过表明激活的内部批评削弱了源监控并塑造了随后的听觉入侵的内容,从而为现有理论增加了细微差别。此外,研究结果表明,内在批评是治疗痛苦幻听的潜在目标。
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引用次数: 0
What works? A grounded theory investigation of training non-psychology staff in using Solution-Focused Brief Therapy 工作什么?以解决方案为中心的简短疗法培训非心理学人员的扎根理论研究。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-08-17 DOI: 10.1111/papt.70009
Haakon Juul, Dominic Bray, Ian C. Smith

Objective

As part of a task-sharing strategy, clinical psychologists are becoming increasingly expected to offer therapy training for staff in health care services to develop psychological mindedness to increase access and provision of psychological support for clients. The current study explored how 10 staff working in health care settings experienced Solution-Focused Brief Therapy (SFBT) training and how they subsequently used it.

Methods

One-to-one semi-structured interviews were conducted with 10 participants; a constructivist grounded theory (GT) approach was used to generate a model based on the participants' reflections after the training.

Results

Staff shared how they felt they needed evidence of SFBT effectiveness in order to believe that learning a new model would be worth the required investment. They also found realistic role modelling that was relevant to their context to be particularly convincing as well as regular support from their peers and multidisciplinary meetings. Participants also shared some barriers to using SFBT in practice, including time-restricted clinics, service pressures and challenging clients.

Conclusion

The model describes a complex dynamic between personal, interpersonal and systemic factors that influenced the staff members' individual decision to abandon the more familiar medical model that represented a sense of comfort and safety. The study includes recommendations for how clinical psychologists can address the identified facilitators and barriers to facilitate more effective training programmes and training transfer.

目的:作为任务分担战略的一部分,越来越多的人期望临床心理学家为卫生保健服务部门的工作人员提供治疗培训,以培养心理意识,增加为客户提供心理支持的机会。目前的研究探讨了在卫生保健机构工作的10名工作人员如何经历以解决方案为重点的简短治疗(SFBT)培训,以及他们随后如何使用它。方法:采用一对一半结构化访谈法,共10人;运用建构主义扎根理论(GT)方法,根据参与者在培训后的反思来生成模型。结果:员工们分享了他们如何认为他们需要SFBT有效性的证据,以便相信学习一个新的模式是值得投资的。他们还发现,与他们的背景相关的现实角色建模特别令人信服,以及来自同龄人和多学科会议的定期支持。与会者还分享了在实践中使用SFBT的一些障碍,包括时间限制、服务压力和客户挑战。结论:该模型描述了个人、人际和系统因素之间的复杂动态关系,这些因素影响了工作人员放弃代表舒适和安全感的更熟悉的医疗模式的个人决定。该研究包括临床心理学家如何解决已确定的促进因素和障碍,以促进更有效的培训计划和培训转移的建议。
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引用次数: 0
Barriers and accessibility-improving strategies in mental health services for persons with hearing or vision impairments: Perspectives from professionals and clients—A qualitative interview study 听力或视力障碍者心理健康服务中的障碍和可及性改善策略:来自专业人员和客户的观点-一项定性访谈研究。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-08-13 DOI: 10.1111/papt.70006
Bastian Hardt, Thomas Heidenreich, Christina Hunger-Schoppe, Nele Adam, Julia Heinen, Joana Hopf, Axel Röhlig, Johannes Michalak

Objectives

Despite studies showing that persons with hearing impairments (HI) or vision impairments (VI) have an increased risk of developing mental health disorders, mental health services frequently are not accessible and suited to the specific needs of both populations. However, there is limited research addressing how mental health services can be improved to meet these needs.

Design

This qualitative interview study explores barriers and strategies to improve accessibility in mental health services for persons with HI or VI in Germany, as viewed with a multi-perspective approach.

Methods

Using problem-centred interviews, which combine a flexible interview guide with a focus on specific issues, we applied a participatory research approach to gather insights from 58 participants, including mental health professionals specialised in treating persons with HI or VI and persons with HI or VI with lived experience as clients in mental health services.

Results

The qualitative content analysis yielded 44 inductive subcategories within a category system of seven deductive main categories. Key barriers included communication, limited visual accessibility and environmental challenges, while improvement strategies focused on tailored therapeutic adaptations as well as proactive and collaborative practices between therapists and clients.

Conclusions

Our findings highlight the need for structural changes and expanded mental health services that cater to the specific needs of persons with sensory impairments. These insights should contribute to improving mental health services, training programs for professionals and emphasise the importance of including persons with HI or VI, both professionals and clients, in the participatory development of accessible care.

目标:尽管研究表明,有听力障碍(HI)或视力障碍(VI)的人患精神健康障碍的风险更高,但精神健康服务往往无法获得,也无法满足这两类人群的具体需求。然而,关于如何改善精神卫生服务以满足这些需求的研究有限。设计:本质性访谈研究从多视角探讨了提高德国HI或VI患者获得精神卫生服务的障碍和策略。方法:采用以问题为中心的访谈,结合灵活的访谈指南和对具体问题的关注,我们采用参与式研究方法收集了58名参与者的见解,其中包括专门治疗HI或VI患者的精神卫生专业人员,以及作为精神卫生服务客户的有生活经验的HI或VI患者。结果:定性内容分析在7个演绎主范畴的范畴体系中产生了44个归纳子范畴。主要障碍包括沟通,有限的视觉可及性和环境挑战,而改善策略侧重于量身定制的治疗适应以及治疗师和客户之间的主动和协作实践。结论:我们的研究结果强调了结构改变和扩大心理健康服务的必要性,以满足感觉障碍患者的特殊需求。这些见解应有助于改善精神卫生服务、专业人员培训方案,并强调将高智力障碍患者(专业人员和患者)纳入无障碍保健参与性发展的重要性。
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引用次数: 0
Gendered dynamics in outpatient psychotherapy: An interpretative phenomenological analysis of female patients' and male therapists' experiences 门诊心理治疗中的性别动态:对女性患者和男性治疗师经验的解释性现象学分析。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-08-12 DOI: 10.1111/papt.70005
Erwin Schweitzer, Yvonne Schaffler, Thomas Probst, Elke Humer, Christoph Pieh, Brigitte Schigl

Objectives

Gender dynamics within the patient–therapist relationship can influence the therapeutic process in meaningful ways. However, the female patient–male therapist dyad has received limited attention in recent psychotherapy research. This article explores how female patients and their male therapists experience the role of gender in outpatient psychotherapy.

Design

This study is a qualitative subproject within a larger research initiative involving psychotherapists in private practice and their patients in Austria. Interviews with patients and therapists were conducted using a comprehensive, semi-structured interview guide.

Method

Interviews were conducted with ten participants from female patient–male therapist dyads. The data were analyzed using dyadic interpretative phenomenological analysis and interpreted through the theoretical lens of relational phenomenology.

Results

The analysis identified four themes that illustrate participants' recognition of gender as an important factor influencing psychotherapy: (1) gender shapes the topics and interventions in psychotherapy, (2) the male therapist's gender as valuable for the female patient, (3) the female patient's gender as valuable for the male therapist and (4) attraction between male therapist and female patient. A contrasting fifth theme reflects perspectives suggesting that (5) gender plays a lesser role in psychotherapy.

Conclusion

Participants offered varied and sometimes conflicting views on gender's role in outpatient psychotherapy. While they acknowledged its influence, some felt other factors held greater significance. These differing perspectives reflect diverse experiences of gender, which, if not adequately addressed in therapy, may hinder the therapeutic process.

目的:患者-治疗师关系中的性别动态可以以有意义的方式影响治疗过程。然而,在最近的心理治疗研究中,女性患者-男性治疗师二元关系受到的关注有限。本文探讨女性患者及其男性治疗师在门诊心理治疗中如何体验性别角色。设计:本研究是一个大型研究项目中的一个定性子项目,该研究涉及奥地利私人执业的心理治疗师及其患者。对患者和治疗师的访谈采用了全面的、半结构化的访谈指南。方法:对10名女性患者和男性治疗师进行访谈。数据分析采用二元解释现象学分析,并通过关系现象学的理论镜头解释。结果:分析确定了四个主题,说明参与者认为性别是影响心理治疗的重要因素:(1)性别塑造了心理治疗的主题和干预措施,(2)男性治疗师的性别对女性患者有价值,(3)女性患者的性别对男性治疗师有价值,(4)男性治疗师与女性患者之间的吸引力。对比鲜明的第五个主题反映的观点表明(5)性别在心理治疗中起的作用较小。结论:参与者对门诊心理治疗中性别角色的看法各不相同,有时甚至相互矛盾。虽然他们承认其影响,但一些人认为其他因素更为重要。这些不同的观点反映了不同的性别经验,如果在治疗中没有充分解决,可能会阻碍治疗过程。
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引用次数: 0
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Psychology and Psychotherapy-Theory Research and Practice
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