Psychology and Psychotherapy-Theory Research and Practice最新文献_第7页

“What I share is not the same as therapy”: Psychologist experiences of Instagram use as a mental health influencer “我分享的与治疗不一样”：心理学家将Instagram用作心理健康影响者的经历。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-21 DOI: 10.1111/papt.12585

Ella White, Terry Hanley

Introduction

Psychologists are increasingly using social media to share their therapeutic knowledge. Despite this, social media guidelines devised by professional bodies remain limited in content, with the focus typically on personal use rather than professional use as a mental health influencer. Therefore, this study aimed to explore practitioner psychologists' experiences of Instagram use with an influencer presence.

Methods

Twelve UK-based practitioner psychologists were interviewed who had an Instagram account that they used as a mental health influencer. The semi-structured interview transcripts were analysed using reflexive thematic analysis.

Results

Three themes were developed, each with four subthemes. The first theme ‘“I'm a psychologist, but I'm not your psychologist” explored psychologists’ experiences of trying to input boundaries on Instagram around self-disclosure, risk management, time management, and client work. The second theme ‘“anxiety about not wanting to do the wrong thing” highlighted the impact of an influencer presence on psychologists’ own mental health. The third theme ‘“I share what I think is going to be helpful for other people and myself” considered the psychologists’ motivations for Instagram use for social justice advocacy and business promotion, and the contradictions between these.

Conclusion

Psychologists can use their training to share evidence-based research as a free widely accessible form of psychoeducation potentially acting as a first step into therapy. However, there are still many ethical ambiguities thus updated guidance specifically for an influencer presence can reduce psychologists' anxieties and potential risks.

心理学家越来越多地使用社交媒体来分享他们的治疗知识。尽管如此，专业机构制定的社交媒体指南在内容上仍然有限，通常侧重于个人使用，而不是作为心理健康影响者的专业使用。因此，本研究旨在探讨从业心理学家在有网红存在的情况下使用Instagram的体验。方法：对12名英国执业心理学家进行了采访，他们都有一个Instagram账户，并将其用作心理健康影响者。采用反身性主题分析对半结构化访谈记录进行分析。结果：开发了三个主题，每个主题有四个子主题。第一个主题是“我是一名心理学家，但我不是你的心理学家”，探讨了心理学家试图在Instagram上围绕自我披露、风险管理、时间管理和客户工作设定界限的经历。第二个主题是“不想做错事的焦虑”，强调了网红对心理学家自身心理健康的影响。第三个主题“我分享我认为对别人和我有帮助的东西”，考虑了心理学家使用Instagram来倡导社会正义和商业推广的动机，以及两者之间的矛盾。结论：心理学家可以利用他们的培训来分享基于证据的研究，作为一种免费的、广泛可及的心理教育形式，有可能作为进入治疗的第一步。然而，仍然存在许多道德上的歧义，因此专门针对影响者的最新指导可以减少心理学家的焦虑和潜在风险。

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引用次数: 0

Associations between psychological inflexibility processes, pre-sleep arousal and sleep quality 心理不灵活性过程，睡前觉醒和睡眠质量之间的联系。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-20 DOI: 10.1111/papt.12584

Lisa Mastin-Purcell, Amanda L. Richdale, Lauren P. Lawson, Eric M. J. Morris

Objectives

Psychological inflexibility, the model of psychopathology underlying Acceptance and Commitment Therapy (ACT), has been linked to a broad range of psychological problems, but its link with sleep quality is not well understood. This study aimed to identify relationships between psychological inflexibility processes (cognitive fusion, experiential avoidance, limited perspective-taking, lack of present moment awareness and inaction) and sleep quality, investigating pre-sleep arousal and anxiety symptomatology as mechanisms mediating these relationships.

Design

A correlational, cross-sectional design was used to test two statistical models.

Methods

Participants (N = 704) from a general population sample completed an online survey, reporting on sleep quality, pre-sleep arousal, anxiety and measures of psychological inflexibility. Data were analysed using correlations and path analyses.

Results

All psychological inflexibility processes were moderate to strongly correlated with sleep quality. Path analysis showed cognitive fusion, lack of present moment awareness and experiential avoidance, mediated by pre-sleep cognitive and somatic arousal, explained 49% of the variance in sleep quality (Model 1). Cognitive fusion via pre-sleep cognitive arousal had the largest effect. Anxiety preceding pre-sleep arousal (Model 2) explained no additional variance, and model fit was poorer than Model 1.

Conclusions

These findings highlight the role of psychological inflexibility processes in disrupting the de-arousal process needed for healthy sleep, supporting evidence for ACT as a treatment for sleep disturbance.

目的：心理不灵活性是接受与承诺疗法（ACT）背后的精神病理学模型，它与一系列心理问题有关，但它与睡眠质量的关系尚不清楚。本研究旨在确定心理不灵活性过程（认知融合、经验回避、有限的换位思考、缺乏当下意识和不作为）与睡眠质量之间的关系，并研究睡眠前唤醒和焦虑症状作为调节这些关系的机制。设计：采用相关的横断面设计来检验两个统计模型。方法：来自普通人群样本的参与者（N = 704）完成了一项在线调查，报告了睡眠质量、睡前唤醒、焦虑和心理不灵活性的测量。数据分析采用相关性和路径分析。结果：所有心理不灵活性过程与睡眠质量均有中强相关。通径分析显示，由睡眠前认知唤醒和躯体唤醒介导的认知融合、当下意识缺失和经验回避解释了49%的睡眠质量差异（模型1）。通过睡眠前认知唤醒介导的认知融合的影响最大。睡眠前唤醒前的焦虑（模型2）不能解释额外的方差，模型拟合比模型1差。结论：这些发现强调了心理不灵活性过程在破坏健康睡眠所需的去唤醒过程中的作用，支持ACT作为治疗睡眠障碍的证据。

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引用次数: 0

Changes in the predictive effects of family function and depressive symptoms of suicide-related behaviours in Chinese adolescents during COVID-19 COVID-19期间家庭功能和抑郁症状对中国青少年自杀相关行为预测作用的变化

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-17 DOI: 10.1111/papt.12573

Rui Hu, Sisi Ma, Yuan-jie Lin, Yi-wei Feng, Xiang Li, Wei Shi, Li Zhao, Daniel T. L. Shek

Background

The COVID-19 pandemic has led to a global mental health crisis, with increased rates of depression among adolescents, exacerbated by interventions such as social distancing and school closures. While widespread anti-epidemic experiences may have strengthened social cohesion and improved adolescents' mental health, the long-term impact of the pandemic on mental health remains a concern, particularly regarding suicide-related behaviours.

Method

This study explored changes in suicide-related behaviours among adolescents with depressive symptoms during the pandemic. A cohort of 4245 students aged 10–19 participated in a school-based survey in 2020, followed by a follow-up in 2021. Cross-lagged panel analysis was used to examine associations between depressive symptoms, suicide-related behaviours and family functioning over time.

Results

Depressive symptoms increased from 2020 to 2021, with a significant rise in mild symptoms (95% CI: 15.53%, 17.78%), whereas severe symptoms decreased (95% CI: 10.24%, 12.14%) (p < .05). Suicide-related behaviours, except suicidal plans, showed a decreasing trend (p < .05). Significant correlations were found between family functioning, depressive symptoms and suicide-related behaviours.

Conclusions

While some aspects of adolescent mental health, such as depressive symptoms, showed improvement during the pandemic, depressive symptoms remained a strong predictor of suicide-related behaviours. The findings underscore the importance of addressing depressive symptoms as a key risk factor for suicide and highlight the role of family functioning in mitigating these risks. Continued attention to adolescent mental health, especially in the context of prolonged pandemic-related stressors, is essential.

背景：2019冠状病毒病大流行导致全球精神卫生危机，青少年抑郁症发病率上升，保持社交距离和关闭学校等干预措施加剧了这一危机。虽然广泛的抗流行病经验可能加强了社会凝聚力，改善了青少年的心理健康，但大流行病对心理健康的长期影响仍然令人关切，特别是在与自杀有关的行为方面。方法：本研究探讨大流行期间有抑郁症状的青少年自杀相关行为的变化。2020年，4245名10-19岁的学生参加了一项以学校为基础的调查，随后在2021年进行了随访。交叉滞后面板分析用于检查抑郁症状、自杀相关行为和家庭功能之间的关系。结果：从2020年到2021年，抑郁症状有所增加，轻度症状显著增加（95% CI: 15.53%, 17.78%），而重度症状减少（95% CI: 10.24%, 12.14%） (p结论：虽然青少年心理健康的某些方面，如抑郁症状在大流行期间有所改善，但抑郁症状仍然是自杀相关行为的有力预测因素。研究结果强调了将抑郁症状作为自杀的关键风险因素的重要性，并强调了家庭功能在减轻这些风险方面的作用。必须继续关注青少年的心理健康，特别是在与大流行病有关的压力因素长期存在的情况下。

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引用次数: 0

First do no harm: Client and staff experiences of negative effects from dialectical behaviour therapy 第一，不伤害：客户和员工体验辩证行为疗法的负面影响。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-15 DOI: 10.1111/papt.12578

Zazie Lawson, Lorna Farquharson

Objectives

Research has shown that dialectical behaviour therapy (DBT) is effective in reducing self-harm and suicidal ideation, but there is also some evidence of negative effects with differences in the reports from clients and staff. However, no research has focused on both groups' understandings of negative effects. This study aimed to explore client and staff experiences of the negative effects from DBT, investigate how their understandings compare, and how staff address any negative effects that arise.

Methods

Eight client participants and seven staff participants, who had experienced or witnessed negative experiences from DBT, engaged in semi-structured interviews, the transcripts of which were analysed using reflexive thematic analysis.

Results

Four themes relating to client experiences were generated: ‘I'm the problem’, ‘DBT can do no wrong’, ‘No understanding of trauma’ and ‘An unhealthy “blueprint for relationships”’. Five themes relating to staff experiences were generated: ‘It's not me, it's the client’, ‘DBT or nothing’, ‘We don't do ‘why’ in DBT’, ‘We did make some changes’ and ‘Organisational “restrictions”’.

Conclusions

Both staff and clients understood negative effects from DBT to include pathologisation and re-traumatisation. However, whilst clients related negative effects to the therapeutic relationship, staff highlighted the impact of organisational restrictions. The findings support a number of changes to practice, particularly the need to recognise potential negative effects and provide meaningful informed consent procedures.

目的：研究表明，辩证行为疗法（DBT）在减少自我伤害和自杀意念方面是有效的，但也有一些负面影响的证据，在来访者和工作人员的报告中存在差异。然而，没有研究关注这两组人对负面影响的理解。本研究旨在探讨客户和员工对DBT负面影响的体验，调查他们的理解比较，以及员工如何应对出现的负面影响。方法：采用半结构化访谈法对8名曾经历或目睹过行为行为负面体验的来访者和7名工作人员进行访谈，并采用自反性主题分析对访谈文本进行分析。结果：产生了与客户体验相关的四个主题：“我是问题”，“DBT不会做错”，“不理解创伤”和“不健康的“关系蓝图”。与员工体验相关的五个主题是：“不是我的问题，是客户的问题”、“要么做DBT，要么什么都不做”、“我们在DBT中不做‘为什么’”、“我们确实做了一些改变”和“组织的“限制”。结论：工作人员和来访者都理解DBT的负面影响包括病理化和再创伤。然而，当客户提到治疗关系的负面影响时，工作人员强调了组织限制的影响。研究结果支持对实践进行一些改变，特别是需要认识到潜在的负面影响并提供有意义的知情同意程序。

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引用次数: 0

Developing a psychosocial competency framework for adult and older adult acute mental health inpatient care 制定成人和老年人急性精神健康住院治疗的社会心理能力框架。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-14 DOI: 10.1111/papt.12575

Lisa Wood, Claire Williams, Leah Luxon, Ajvir Kumary, Anthony Roth

Objectives

Acute mental health inpatient settings care for those with acute and complex mental health needs. This study aimed to develop a psychosocial competency framework for use by multidisciplinary professional practitioners working in adult and older adult acute mental health inpatient settings.

Methods

The competence framework was developed through an iterative developmental process. Initially, the relevant literature was reviewed to draft the framework. A multidisciplinary Expert Reference Group provided their expertise to refine and develop the framework and provide professional advice on areas with a weaker evidence base.

Results

A competency framework was produced and nine key areas of competency were developed; ‘Basic knowledge of issues related to acute mental health inpatient care’, ‘Communication skills’, ‘Professional competences for all healthcare workers’, ‘Generic relationship competences’, ‘Assessment, formulation and planning’, ‘Structured care and intervention’, ‘Psychosocial interventions’, ‘Meta-competences’, and ‘Professional competences for organisations’.

Conclusions

This competency framework will enable stakeholders to understand which competences are needed for high-quality acute mental health inpatient care provision. It can be used to underpin training packages in this field. Our framework has been recommended as a best-practice resource in the NHS England Acute Inpatient Mental Health Care guidance for adults and older adults.

目的：急性心理健康住院设置护理那些急性和复杂的心理健康需求。本研究旨在开发一个心理社会能力框架，供在成人和老年人急性心理健康住院环境中工作的多学科专业从业者使用。方法：采用迭代开发的方法开发胜任力框架。首先，对相关文献进行了审查，以起草框架。一个多学科专家参考小组提供了他们的专门知识，以完善和发展框架，并就证据基础较弱的领域提供专业咨询意见。结果：构建了胜任力框架，开发了九个关键胜任力领域；“与急性精神健康住院治疗有关的问题的基本知识”、“沟通技巧”、“所有医护人员的专业能力”、“一般关系能力”、“评估、制定和规划”、“结构化护理和干预”、“社会心理干预”、“元能力”和“组织的专业能力”。结论：这个能力框架将使利益相关者了解哪些能力是高质量急性精神卫生住院护理所需要的。它可以用来支持这一领域的培训包。我们的框架已被推荐为成人和老年人的NHS英格兰急性住院精神卫生保健指导的最佳实践资源。

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引用次数: 0

The mediating effect of social network sites addiction on the relationship between childhood psychological abuse and depression in college students and the moderating effect of psychological flexibility 社交网站成瘾在大学生童年心理虐待与抑郁关系中的中介作用及心理灵活性的调节作用。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-10 DOI: 10.1111/papt.12580

Yang Liu, Pengfei Wang, Liangfan Duan, Qingxin Shen, Lei Xu, Tiancheng Zhang

Background

Experience of child psychological abuse in college students is likely to increase their risk of depression, but the potential psychological mechanisms between the two require further exploration. This study supplemented the risk and protective factors between child psychological abuse and depression in college students by introducing social network sites addiction (SNSA) as a mediating factor and psychological flexibility as a moderating factor.

Methods

A cross-sectional survey was conducted on 655 college students from two universities in Hunan Province, China. Self-reported measures included childhood psychological abuse, depression, SNSA, and psychological flexibility. Descriptive and correlational analyses were performed on these variables, followed by the establishment of a structural equation model.

Results

Child psychological abuse was positively associated with depression (r = .507, p < .001) and SNSA (r = .208, p < .001) in college students and negatively associated with psychological flexibility (r = −.293, p < .001). SNSA played a mediating role between childhood psychological abuse and depression (β = .170, SE = 0.035, p < .001) in college students, while psychological flexibility attenuated the strength of the relationship between the latter two (β = −.095, SE = 0.031, p < .01).

Conclusion

The study further elucidates the psychological mechanisms underlying the relationship between childhood psychological abuse and depression in college students. SNSA may mediate the relationship between the two, while psychological flexibility may buffer the strength of the relationship between them. Future research should explore interventions enhancing college students' psychological flexibility after childhood psychological abuse to cut the risk of depression.

背景：经历过儿童心理虐待的大学生有可能增加其患抑郁症的风险，但两者之间潜在的心理机制有待进一步探讨。本研究通过引入社交网站成瘾（social network sites addiction， SNSA）作为中介因素和心理灵活性作为调节因素，补充了儿童心理虐待与大学生抑郁之间的风险和保护因素。方法：对湖南省两所高校655名大学生进行横断面调查。自我报告的测量包括童年心理虐待、抑郁、SNSA和心理灵活性。对这些变量进行了描述性和相关性分析，建立了结构方程模型。结果：儿童心理虐待与抑郁症呈正相关(r =。507, p < .001)和SNSA (r =。208, p < .001)，且心理弹性呈负相关（r = -）。293, p < 0.001)。SNSA在儿童心理虐待与抑郁之间起中介作用(β =。170, SE = 0.035, p < .001)，而心理灵活性减弱了后两者之间的关系强度（β = -）。095, SE = 0.031, p < 0.01)。结论：本研究进一步阐明了童年心理虐待与大学生抑郁关系的心理机制。SNSA可能是两者关系的中介，而心理灵活性可能缓冲两者关系的强度。未来的研究应探索提高童年心理虐待后大学生心理弹性的干预措施，以降低抑郁风险。

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引用次数: 0

Can self-compassion mitigate the negative consequences of insecure attachment on the incidence of self-harm in young adults? The relationship between self-harm, attachment and self-compassion 自我同情能减轻不安全依恋对年轻人自残发生率的负面影响吗？自我伤害，依恋和自我同情之间的关系。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-06 DOI: 10.1111/papt.12577

Petra Lichvárová, Bronislava Šoková, Nina Linderová

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.

前言：本研究探讨自我同情在依恋与自我伤害之间的中介作用。自残是一种适应不良的应对策略，而自杀式自残是全球年轻人过早死亡的第三大常见原因。因此，有必要扩大对自我伤害的研究，探索潜在的保护因素。我们的主要研究假设是自我同情在依恋和自我伤害之间起到中介作用。方法：在网上招募的402名参与者完成了一份自残行为、成人依恋和自我同情量表组成的调查问卷。结果：依恋焦虑和依恋回避对自我伤害有正向预测，对自我同情有负向预测。结果还显示，自我同情负向预测自我伤害，并在自我伤害与焦虑依恋和回避依恋的关系中起中介作用。结论：我们相信这篇论文为未来关于自我伤害动力学中涉及的保护因素的研究创造了进一步的基础，并且有可能为那些研究不安全依恋的自我伤害客户的专业人员提供有趣的发现。

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引用次数: 0

Exposed, scaffolded and connected – Foster carers' experiences of dyadic developmental psychotherapy: An interpretative phenomenological analysis 暴露，搭建和连接——寄养照顾者的二元发展心理治疗经验：解释性现象学分析。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-04 DOI: 10.1111/papt.12572

Amy Murphy, Yvonne Melia, Gabija Srejic

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.

目的：我们需要开展研究，以更好地了解 "伴侣式发展心理疗法"（Dyadic Development Psychal Therapy，DDP）的经验和效果，这是一种很有前途的干预措施，旨在满足替代照料机构中经历过发展创伤的儿童的复杂需求。DDP 是一种系统性干预措施，儿童的照料者在其中扮演着重要角色。鉴于寄养照护者的重要作用和现有研究的缺乏，本研究旨在探讨寄养照护者如何体验 DDP：设计：采用定性设计，对 10 名寄养照料者进行了半结构化访谈：方法：通过 Microsoft Teams 和电话进行访谈，并使用解释性现象分析法对访谈进行记录、转录和分析：结果：形成了四个小组经验主题和 11 个次主题："从不以为然到豁然开朗"、"支架和安全"、"适应和联系 "以及 "值得"。从最初的困惑和失望，到后来的清晰的自我认识，以及更加贴合和联系的依恋关系。对 DDP 的体验既充实又苛刻：尽管仍有必要对 DDP 的有效性进行探讨，但本研究表明，寄养照护者认为 DDP 是一种要求很高但却很有价值的干预措施。本研究探讨了对实践的影响，特别是对关系安全和照顾者支持的更大需求，以及未来研究的途径。

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引用次数: 0

Barriers and facilitators to engagement in psychological therapy in first episode psychosis: A meta-ethnography and qualitative comparative analysis 首次精神病患者参与心理治疗的障碍和促进因素：一种元民族志和定性比较分析。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-02-03 DOI: 10.1111/papt.12576

Leanne Fahy, Linda Lee, Liberty Newlove, Lisa Wood, Ciarán O'Driscoll

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.

目的：首次发病的精神病患者（FEP）脱离心理治疗是一种常见现象，未治疗的问题会造成个人损失。本研究旨在通过对现有定性文献进行元民族志和定性比较分析（QCA），确定 FEP 患者参与心理治疗的障碍和促进因素：2021 年 7 月（2024 年 7 月更新），在多个数据库中进行了系统检索，包括 Psychinfo、Ovid Medline、Web of Science、EthOs、OPENgrey 和 Procrest。搜索共发现 6966 个标题和 71 篇全文，并对其进行了资格审查。发现 23 项研究符合资格要求，并对其进行了严格评估。通过元人种学和 QCA 系统地提取和综合了数据：结果：有七个主题被确定为参与心理治疗的障碍（对治疗的矛盾心理、情绪困扰、症状波动、消极期望、身体能力、服务限制和未满足的治疗偏好），六个主题被确定为促进因素（去污名化、数字治疗的可及性、满足对治疗的积极期望、服务因素、治疗师的人际交往方法和技能以及满足的治疗偏好）。QCA确定了治疗师的人际交往方法和技巧模型，该模型足以促进心理治疗的参与（即只要具备该条件，就能保证治疗结果的出现），而情绪困扰则足以阻碍参与心理治疗：参与是一个多层面的概念，个人经历中存在许多独特的因素，并受到情感、社会、实践和服务层面因素的影响。本文讨论了研究结果的优势、局限性和建议。

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引用次数: 0

How do people with a history of sexual abuse experience talking therapies for sexual trauma? A systematic review of qualitative findings 有性虐待史的人如何接受性创伤的谈话治疗？对定性发现的系统回顾。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-01-31 DOI: 10.1111/papt.12571

Runa Dawood, Jane Vosper, Stuart Gibson, Chris Irons

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.

目的：本系统综述调查了性虐待幸存者在谈话治疗中的定性经验，涉及治疗的帮助和阻碍方面。方法：对5个数据库进行检索；PubMed, Web of Science, PyscInfo， PsycArticles和PsycExtra，并通过搜索参考文献列表。论文包括提供治疗的客户体验的定性主要数据，不涉及专家临床人群，并以英文撰写。无论研究参与者是否在童年、成年或两者都经历过性虐待，论文都被纳入其中。使用关键评估技能计划（CASP）定性检查表对研究进行评估。采用元研究对结果进行分析。结果：产生了四个主题：(1)有益的治疗依赖于选择，自主和自由选择何时说话和谈论什么；(2)参与依赖于考虑性虐待恢复的复杂性；(3)感觉被治疗师关心和联系是重要的；(4)敏感和周到的治疗结束可以带来积极的整体情绪和生活方式的改变。结论：本研究为治疗的有益方面提供了临床见解，促进了安全的治疗参与，并管理了有效和敏感的过渡到康复。这些主题被认为与理解治疗中的支持因素有关。

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引用次数: 0