Psychology and Psychotherapy-Theory Research and Practice最新文献_第8页

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。

{"title":"First do no harm: Client and staff experiences of negative effects from dialectical behaviour therapy","authors":"Zazie Lawson, Lorna Farquharson","doi":"10.1111/papt.12578","DOIUrl":"10.1111/papt.12578","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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”’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"570-589"},"PeriodicalIF":2.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"Developing a psychosocial competency framework for adult and older adult acute mental health inpatient care","authors":"Lisa Wood, Claire Williams, Leah Luxon, Ajvir Kumary, Anthony Roth","doi":"10.1111/papt.12575","DOIUrl":"10.1111/papt.12575","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 3","pages":"553-569"},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"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","authors":"Yang Liu, Pengfei Wang, Liangfan Duan, Qingxin Shen, Lei Xu, Tiancheng Zhang","doi":"10.1111/papt.12580","DOIUrl":"10.1111/papt.12580","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Child psychological abuse was positively associated with depression (<i>r</i> = .507, <i>p</i> < .001) and SNSA (<i>r</i> = .208, <i>p</i> < .001) in college students and negatively associated with psychological flexibility (<i>r</i> = −.293, <i>p</i> < .001). SNSA played a mediating role between childhood psychological abuse and depression (<i>β</i> = .170, <i>SE</i> = 0.035, <i>p</i> < .001) in college students, while psychological flexibility attenuated the strength of the relationship between the latter two (<i>β</i> = −.095, <i>SE</i> = 0.031, <i>p</i> < .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"534-548"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"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","authors":"Petra Lichvárová, Bronislava Šoková, Nina Linderová","doi":"10.1111/papt.12577","DOIUrl":"10.1111/papt.12577","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Four hundred and two participants recruited online completed a questionnaire consisting of scales measuring self-harming behaviour, adult attachment and self-compassion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"520-533"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"Exposed, scaffolded and connected – Foster carers' experiences of dyadic developmental psychotherapy: An interpretative phenomenological analysis","authors":"Amy Murphy, Yvonne Melia, Gabija Srejic","doi":"10.1111/papt.12572","DOIUrl":"10.1111/papt.12572","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative design using semi-structured interviews with 10 foster carers was implemented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Interviews conducted via Microsoft Teams and telephone were recorded, transcribed and analysed using interpretative phenomenological analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"501-519"},"PeriodicalIF":2.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"Barriers and facilitators to engagement in psychological therapy in first episode psychosis: A meta-ethnography and qualitative comparative analysis","authors":"Leanne Fahy, Linda Lee, Liberty Newlove, Lisa Wood, Ciarán O'Driscoll","doi":"10.1111/papt.12576","DOIUrl":"10.1111/papt.12576","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"232-255"},"PeriodicalIF":2.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"How do people with a history of sexual abuse experience talking therapies for sexual trauma? A systematic review of qualitative findings","authors":"Runa Dawood, Jane Vosper, Stuart Gibson, Chris Irons","doi":"10.1111/papt.12571","DOIUrl":"10.1111/papt.12571","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"211-231"},"PeriodicalIF":2.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12571","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A randomised feasibility trial comparing group and individual format GROUPS FOR HEALTH interventions for loneliness in people who experience psychosis 一项随机可行性试验，比较群体和个人形式的群体健康干预对精神病患者孤独感的影响。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-01-29 DOI: 10.1111/papt.12574

Lorna I. Hogg, Laura G. E. Smith, Catherine Haslam, Lyndsay Coxhill, Tim Kurz, Georgina Hobden, Anthony P. Morrison

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.

目的：精神病患者的孤独感很常见，并与心理健康状况不佳有关。在这项随机试验中，我们测试了以群体或个人形式提供的针对孤独的适应性健康团体（G4H）干预的可行性和可接受性。设计：混合方法，两组可行性随机对照试验。方法：从英国精神卫生保健服务机构、康复学院和慈善机构招募了40名自认为患有精神病的人。对精神病患者的G4H进行了修改，参与者被随机分为小组（N = 20）或个人（N = 20）形式接受干预。主要结果与试验的可接受性和可行性有关。探索性重复测量方差分析和t检验评估了不同格式在孤独感、幸福感和可能的变化机制方面的差异，包括社会认同、身份整合和感知的群体内和群体外共情。测量在基线、治疗结束和1个月和6个月的随访时完成。结果：G4H的群体和个体形式的招募、保留和试验可接受性评分均为可接受至良好。没有参与者报告出现严重的不良事件。探索性方差分析显示，孤独感、幸福感、社会认同和身份整合等关键变量随时间变化呈正相关。孤独感的t检验表明，从基线到治疗结束到1个月的随访，这种变化是逐步发生的。结论：G4H对孤独精神病患者是一种可行的干预措施，可以采用群体或个体形式实施。这项可行性试验为未来的完全随机对照试验提供了支持。

{"title":"A randomised feasibility trial comparing group and individual format GROUPS FOR HEALTH interventions for loneliness in people who experience psychosis","authors":"Lorna I. Hogg, Laura G. E. Smith, Catherine Haslam, Lyndsay Coxhill, Tim Kurz, Georgina Hobden, Anthony P. Morrison","doi":"10.1111/papt.12574","DOIUrl":"10.1111/papt.12574","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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 <span>Groups for Health</span> (G4H) intervention for loneliness, delivered in group or individual format.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Mixed methods, two-arm feasibility randomised controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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 (<i>N</i> = 20) or individual (<i>N</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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. <i>T</i>-tests for loneliness indicated that this change was step-wise from baseline, through end of treatment to 1-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"478-500"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12574","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A qualitative exploration of change processes relevant to compassion-focused therapy that occurs when people view both soothing and non-soothing images 当人们同时观看抚慰性和非抚慰性图像时，对以同情为中心的治疗相关的变化过程进行定性探索。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-01-20 DOI: 10.1111/papt.12566

Stephanie Allan, Chris Morea, Keren MacLennan, Matthias Schwannauer, Angela L. McLaughlin, Netta Weinstein, Stella W. Y. Chan

Objective

Using soothing imagery within psychotherapy may support people to undertake positive visualisation exercises. However, little is known about what processes happen when people view images they find to be soothing or non-soothing.

Design

Exploratory qualitative methods were used.

Method

Responses from 644 participants who had written about images they found to be soothing or non-soothing were analysed using thematic analysis.

Results

Two key themes were developed that related to the importance of the image content (such as it being a natural scene or artificial) and the internal cognitive and psychological processes that it triggered within participants as being key drivers for an image being perceived as soothing or non-soothing. This included recall of positive autobiographical memories and liking the image content. Conversely, negative autobiographical memories and disliking image content were associated when people viewed images they considered to be non-soothing.

Conclusions

Experiences of feeling soothed when viewing an image appear to be maintained by imagining positive sensory experiences that were associated with the image or linking the image to positive experiences from the participant's autobiographical memory. This has implications for the delivery of therapy using pre-existing image sets and suggests there is a need to find out what images are most suited for people accessing services.

目的：在心理治疗中使用舒缓意象可以支持人们进行积极的观想练习。然而，当人们看到他们认为舒缓或不舒缓的图像时，会发生什么过程，我们知之甚少。设计：采用探索性定性方法。方法：对644名参与者的回答进行主题分析，这些参与者写下了他们认为舒缓或不舒缓的图像。结果：两个关键主题的发展，涉及到图像内容的重要性（如它是一个自然的场景或人工）和内部的认知和心理过程，它触发了参与者作为关键驱动因素的图像被认为是抚慰或非抚慰。这包括回忆积极的自传体记忆和喜欢图像内容。相反，当人们看到他们认为不舒缓的图像时，负面的自传式记忆和不喜欢的图像内容是相关的。结论：通过想象与图像相关的积极感官体验，或将图像与参与者自传体记忆中的积极体验联系起来，观看图像时感到舒缓的体验似乎得以维持。这对使用预先存在的图像集提供治疗有影响，并表明有必要找出最适合人们获得服务的图像。

{"title":"A qualitative exploration of change processes relevant to compassion-focused therapy that occurs when people view both soothing and non-soothing images","authors":"Stephanie Allan, Chris Morea, Keren MacLennan, Matthias Schwannauer, Angela L. McLaughlin, Netta Weinstein, Stella W. Y. Chan","doi":"10.1111/papt.12566","DOIUrl":"10.1111/papt.12566","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Using soothing imagery within psychotherapy may support people to undertake positive visualisation exercises. However, little is known about what processes happen when people view images they find to be soothing or non-soothing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Exploratory qualitative methods were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Responses from 644 participants who had written about images they found to be soothing or non-soothing were analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two key themes were developed that related to the importance of the image content (such as it being a natural scene or artificial) and the internal cognitive and psychological processes that it triggered within participants as being key drivers for an image being perceived as soothing or non-soothing. This included recall of positive autobiographical memories and liking the image content. Conversely, negative autobiographical memories and disliking image content were associated when people viewed images they considered to be non-soothing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Experiences of feeling soothed when viewing an image appear to be maintained by imagining positive sensory experiences that were associated with the image or linking the image to positive experiences from the participant's autobiographical memory. This has implications for the delivery of therapy using pre-existing image sets and suggests there is a need to find out what images are most suited for people accessing services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 1","pages":"193-204"},"PeriodicalIF":2.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Veterans' experiences of somatic experiencing and prolonged exposure therapies for post-traumatic stress disorder: A qualitative analysis 退伍军人的躯体体验与长时间暴露治疗创伤后应激障碍：一项定性分析。

IF 2.7 3区医学 Q2 PSYCHIATRY

Psychology and Psychotherapy-Theory Research and Practice

Pub Date : 2025-01-14 DOI: 10.1111/papt.12570

Anna Harwood-Gross, Shir Elias, Karen Lerner, Nitsa Nacasch, Cathy Lawi, Danny Brom, Adi Barak

Purpose

Despite the proliferation of research into evidence based treatment for military PTSD there is little evidence for treatment assignment criterion and military based PTSD still demonstrates low remission rates.

Method

Thirty participants in a randomized control trial comparing Prolonged Exposure (PE) and Somatic Experiencing (SE) were interviewed on their experiences in therapy and their responses assessed using a descriptive phenomenological analysis approach to delineate the central tenets of the two therapeutic approaches.

Results

Results indicated that participants from both therapies covered themes of the experience of change, the experience of the therapeutic relationship and the therapeutic process. Within these themes, SE and PE participants reported both similar experiences, such as the predominance of physiological or bodily experiences and also described nuanced differences, specifically pertaining to therapy characteristics. SE participants described the process in terms of learning a language, applicable to alternative scenarios and PE participants described the process in terms of conquering exposures in order to achieve respite from symptoms.

Conclusion

The current findings have relevance in terms of presenting the key elements of the distinct trauma therapies and determining treatment appropriateness based on desired outcomes. They highlight the commonalities and differences between the patient experience in PE and SE, specifically the relevance of the bodily response, treatment expertise and therapist characteristics in both treatments. Understanding the unique elements of PE, a gold-standard PTSD treatment and SE, a novel somatic-based psychotherapy, will allow for better treatment preparation for participants and potentially aid treatment assignment.

目的：尽管针对军事创伤后应激障碍的循证治疗研究层出不穷，但治疗分配标准的证据却很少，而且军事创伤后应激障碍的缓解率仍然很低：方法：在一项比较长期暴露疗法（PE）和躯体体验疗法（SE）的随机对照试验中，对 30 名参与者进行了访谈，了解他们在治疗中的经历，并采用描述性现象学分析方法对他们的回答进行评估，以确定两种治疗方法的核心原则：结果表明，两种疗法的参与者都涉及到了改变的体验、治疗关系的体验和治疗过程等主题。在这些主题中，SE 和 PE 参与者既报告了相似的体验，如生理或身体体验占主导地位，也描述了细微的差异，特别是与治疗特点有关的差异。SE 参与者从学习一种语言的角度描述了这一过程，这种语言适用于其他情景，而 PE 参与者则从克服暴露以获得症状缓解的角度描述了这一过程：目前的研究结果对于介绍不同创伤疗法的关键要素以及根据预期结果确定治疗的适当性具有现实意义。研究结果强调了 PE 和 SE 患者体验的共性和差异，特别是身体反应、治疗专长和治疗师特征在两种疗法中的相关性。了解创伤后应激障碍治疗的黄金标准 PE 和基于躯体的新型心理疗法 SE 的独特要素，将有助于为参与者提供更好的治疗准备，并有可能帮助分配治疗方案。

{"title":"Veterans' experiences of somatic experiencing and prolonged exposure therapies for post-traumatic stress disorder: A qualitative analysis","authors":"Anna Harwood-Gross, Shir Elias, Karen Lerner, Nitsa Nacasch, Cathy Lawi, Danny Brom, Adi Barak","doi":"10.1111/papt.12570","DOIUrl":"10.1111/papt.12570","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Despite the proliferation of research into evidence based treatment for military PTSD there is little evidence for treatment assignment criterion and military based PTSD still demonstrates low remission rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Thirty participants in a randomized control trial comparing Prolonged Exposure (PE) and Somatic Experiencing (SE) were interviewed on their experiences in therapy and their responses assessed using a descriptive phenomenological analysis approach to delineate the central tenets of the two therapeutic approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results indicated that participants from both therapies covered themes of the experience of change, the experience of the therapeutic relationship and the therapeutic process. Within these themes, SE and PE participants reported both similar experiences, such as the predominance of physiological or bodily experiences and also described nuanced differences, specifically pertaining to therapy characteristics. SE participants described the process in terms of learning a language, applicable to alternative scenarios and PE participants described the process in terms of conquering exposures in order to achieve respite from symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current findings have relevance in terms of presenting the key elements of the distinct trauma therapies and determining treatment appropriateness based on desired outcomes. They highlight the commonalities and differences between the patient experience in PE and SE, specifically the relevance of the bodily response, treatment expertise and therapist characteristics in both treatments. Understanding the unique elements of PE, a gold-standard PTSD treatment and SE, a novel somatic-based psychotherapy, will allow for better treatment preparation for participants and potentially aid treatment assignment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 1","pages":"175-192"},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12570","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0