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}
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.
{"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}
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}
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.
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.
{"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}
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.
{"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}
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}
This systematic review aimed to evaluate and synthesise qualitative research on adult clients' experiences of psychotherapeutic interventions addressing trauma across multiple modalities.
Methods
Six databases (PsycINFO, MEDLINE, The Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and CINAHL) were systematically searched. Google Scholar and reference lists of included and other relevant reviews were also searched, and in total 37 studies met the inclusion criteria. Relevant data were extracted, quality assessed following the Critical Appraisal Skill Programme checklist, and data synthesised using thematic synthesis.
Results
The specific helpful factors and perceived impact of the interventions aligned with their theoretical bases. Certain factors were perceived to be helpful or challenging regardless of the modality used, such as relational factors between the client and the therapist, and within group settings. Towards the end of the interventions, feelings of ambivalence and emotional struggles which pervaded the process gradually resolved, as a majority of the clients expressed a sense of benefit from the whole experience. Most of the studies included in this review were published post-2020, underscoring research interest towards clients' psychotherapeutic experiences.
Conclusions
The review provides a comprehensive understanding of helpful and challenging factors of interventions addressing trauma, as perceived by clients. The analysis serves as a foundation for future intervention development. Also, it highlights the importance of therapist responsiveness and discussions with clients at various intervention stages to foster a sense of safety, prevent early drop-outs, and emphasise clients as agents of change in their therapeutic process.
目的：本系统综述旨在评估和综合对成人客户的心理治疗干预的经验进行定性研究，以解决多种模式的创伤。方法：系统检索PsycINFO、MEDLINE、Cochrane Central Register of Controlled Trials、Web of Science、Scopus和CINAHL 6个数据库。b谷歌我们还检索了纳入文献和其他相关综述的学者和参考文献列表，共有37篇研究符合纳入标准。提取相关数据，根据关键评估技能计划检查表评估质量，并使用主题综合方法对数据进行综合。结果：干预的具体帮助因素和感知影响与其理论基础一致。无论采用何种治疗方式，某些因素都被认为是有益的或具有挑战性的，比如来访者和治疗师之间的关系因素，以及群体环境。在干预结束时，弥漫在整个过程中的矛盾情绪和情感斗争逐渐得到解决，因为大多数客户都表达了从整个体验中获益的感觉。本综述中包含的大多数研究都是在2020年后发表的，强调了对客户心理治疗体验的研究兴趣。结论：这篇综述提供了一个全面的理解，帮助和挑战的因素干预解决创伤，作为客户的感知。该分析可作为未来干预发展的基础。此外，它强调了治疗师的反应和在不同干预阶段与客户讨论的重要性，以培养安全感，防止早期退出，并强调客户是治疗过程中变革的推动者。
{"title":"Clients' experiences of psychotherapeutic interventions addressing trauma","authors":"R. Lepistö, A. Ahmad, S. Kangaslampi, K. Peltonen","doi":"10.1111/papt.12569","DOIUrl":"10.1111/papt.12569","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This systematic review aimed to evaluate and synthesise qualitative research on adult clients' experiences of psychotherapeutic interventions addressing trauma across multiple modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six databases (PsycINFO, MEDLINE, The Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and CINAHL) were systematically searched. Google Scholar and reference lists of included and other relevant reviews were also searched, and in total 37 studies met the inclusion criteria. Relevant data were extracted, quality assessed following the Critical Appraisal Skill Programme checklist, and data synthesised using thematic synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The specific helpful factors and perceived impact of the interventions aligned with their theoretical bases. Certain factors were perceived to be helpful or challenging regardless of the modality used, such as relational factors between the client and the therapist, and within group settings. Towards the end of the interventions, feelings of ambivalence and emotional struggles which pervaded the process gradually resolved, as a majority of the clients expressed a sense of benefit from the whole experience. Most of the studies included in this review were published post-2020, underscoring research interest towards clients' psychotherapeutic experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The review provides a comprehensive understanding of helpful and challenging factors of interventions addressing trauma, as perceived by clients. The analysis serves as a foundation for future intervention development. Also, it highlights the importance of therapist responsiveness and discussions with clients at various intervention stages to foster a sense of safety, prevent early drop-outs, and emphasise clients as agents of change in their therapeutic process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 1","pages":"149-174"},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12569","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923852","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}
Sophie Trees, Ian Andrew James, Sally Stapleton, Daniel Rippon
<div> <section> <h3> Background</h3> <p>NICE guidelines advocate that healthcare professionals should aim to use non-pharmacological and person-centred approaches as primary strategies to reduce or prevent distress in people living with dementia who reside within care settings. However, despite these recommendations, recent studies have illustrated that there is still a requirement for healthcare professionals to have adequate opportunities to access training programmes and guidance on how to effectively use non-pharmacological approaches in dementia care settings. Communication and Interaction Training (CAIT) was developed to train healthcare professionals in dementia care on how to apply person-centred principles to effectively reduce or negate distress in people living with dementia in a non-invasive manner.</p> </section> <section> <h3> Aims</h3> <p>This paper provides an overview of current debates regarding the use of non-pharmacological approaches in dementia care, as initial care strategies, to reduce the primary use of pharmacological interventions that may have deleterious side effects for people living with dementia. Furthermore, this paper provides a summary of an evaluation that assessed the extent to which a 2-day CAIT programme could enhance healthcare professionals in their perceived ability to communicate therapeutically with and provide care for people living with dementia.</p> </section> <section> <h3> Materials & Methods</h3> <p>In this evaluation, 35 healthcare professionals in dementia care engaged with the 2-day CAIT programme. The Confidence in Dementia Scale, Knowledge in Dementia Scale and Compassionate Competence Scale were administered for participants to complete pre and post training.</p> </section> <section> <h3> Results</h3> <p>A series of parametric paired samples <i>t</i>-tests were completed, and the results indicated that the 2-day CAIT course was effective in enhancing healthcare professionals' perceived confidence, communication skills, sensitivity, and ability to meet the care needs of people living with dementia. However, staff’ knowledge of dementia did not significantly increase following the CAIT course, which could be due to participants already having high levels of knowledge on dementia prior to training.</p> </section> <section> <h3> Discussion & Conclusion</h3> <p>These results indicated that engaging in CAIT could be beneficial in enhancing healthcare professionals' perceived ability to use therapeutic communication strategies in their interactions with people living with dementia. Discussion is provided on how the delivery of training programmes, such as CAIT, may assist in re-enforcing guidelines that advocate for the use of non-ph
{"title":"A pre and post evaluation of the communication and interaction training programme for professionals in dementia care","authors":"Sophie Trees, Ian Andrew James, Sally Stapleton, Daniel Rippon","doi":"10.1111/papt.12568","DOIUrl":"10.1111/papt.12568","url":null,"abstract":"<div>\u0000 <section>\u0000 <h3> Background</h3>\u0000 <p>NICE guidelines advocate that healthcare professionals should aim to use non-pharmacological and person-centred approaches as primary strategies to reduce or prevent distress in people living with dementia who reside within care settings. However, despite these recommendations, recent studies have illustrated that there is still a requirement for healthcare professionals to have adequate opportunities to access training programmes and guidance on how to effectively use non-pharmacological approaches in dementia care settings. Communication and Interaction Training (CAIT) was developed to train healthcare professionals in dementia care on how to apply person-centred principles to effectively reduce or negate distress in people living with dementia in a non-invasive manner.</p>\u0000 </section> \u0000 <section>\u0000 <h3> Aims</h3>\u0000 <p>This paper provides an overview of current debates regarding the use of non-pharmacological approaches in dementia care, as initial care strategies, to reduce the primary use of pharmacological interventions that may have deleterious side effects for people living with dementia. Furthermore, this paper provides a summary of an evaluation that assessed the extent to which a 2-day CAIT programme could enhance healthcare professionals in their perceived ability to communicate therapeutically with and provide care for people living with dementia.</p>\u0000 </section> \u0000 <section>\u0000 <h3> Materials & Methods</h3>\u0000 <p>In this evaluation, 35 healthcare professionals in dementia care engaged with the 2-day CAIT programme. The Confidence in Dementia Scale, Knowledge in Dementia Scale and Compassionate Competence Scale were administered for participants to complete pre and post training.</p>\u0000 </section> \u0000 <section>\u0000 <h3> Results</h3>\u0000 <p>A series of parametric paired samples <i>t</i>-tests were completed, and the results indicated that the 2-day CAIT course was effective in enhancing healthcare professionals' perceived confidence, communication skills, sensitivity, and ability to meet the care needs of people living with dementia. However, staff’ knowledge of dementia did not significantly increase following the CAIT course, which could be due to participants already having high levels of knowledge on dementia prior to training.</p>\u0000 </section> \u0000 <section>\u0000 <h3> Discussion & Conclusion</h3>\u0000 <p>These results indicated that engaging in CAIT could be beneficial in enhancing healthcare professionals' perceived ability to use therapeutic communication strategies in their interactions with people living with dementia. Discussion is provided on how the delivery of training programmes, such as CAIT, may assist in re-enforcing guidelines that advocate for the use of non-ph","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 2","pages":"275-288"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12568","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856821","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}
Isabell Paetzold, Jessica Gugel, Anita Schick, Christian Rauschenberg, Dusan Hirjak, Benjamin Boecking, Lawrence Doi, Matthias Schwannauer, Ulrich Reininghaus
Objectives
Previous research indicates that the hybrid compassion-focused intervention EMIcompass may reduce stress reactivity and improve quality of life. Our aim was to investigate what components of the intervention work for whom, how, and under which circumstances to contribute to the enhancement of resilience.
Methods
We conducted a process evaluation using a realist framework. First, we developed initial programme theories using compassion-focused interventions and ecological momentary intervention documents, in addition to conducting a focus group and an interview with an individual expert. Second, we tested the initial programme theories based on qualitative data from 20 participants. Third, we refined the programme theories by analysing and interpreting the data.
Results
We identified four programme components experienced as enhancing the activation of the soothing system and the application of compassion-focused principles. EMIcompass was perceived as lowering the burden of and barriers to treatment and facilitating the translation into daily life. Intra- and interpersonal context factors interacted with the mechanisms, leading to improvement in well-being, which was identified as a main outcome.
Discussion
The intervention worked by strengthening participants' soothing system and facilitating ecological translation leading to improved well-being. Adaptions to improve the intervention may allow for more flexibility in individual intervention trajectories acknowledging different needs and preferences.
{"title":"Exploring the implementation of a novel, transdiagnostic, hybrid ecological momentary intervention for improving resilience in youth (EMIcompass): A process evaluation in the realist framework","authors":"Isabell Paetzold, Jessica Gugel, Anita Schick, Christian Rauschenberg, Dusan Hirjak, Benjamin Boecking, Lawrence Doi, Matthias Schwannauer, Ulrich Reininghaus","doi":"10.1111/papt.12565","DOIUrl":"10.1111/papt.12565","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Previous research indicates that the hybrid compassion-focused intervention EMIcompass may reduce stress reactivity and improve quality of life. Our aim was to investigate what components of the intervention work for whom, how, and under which circumstances to contribute to the enhancement of resilience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a process evaluation using a realist framework. First, we developed initial programme theories using compassion-focused interventions and ecological momentary intervention documents, in addition to conducting a focus group and an interview with an individual expert. Second, we tested the initial programme theories based on qualitative data from 20 participants. Third, we refined the programme theories by analysing and interpreting the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified four programme components experienced as enhancing the activation of the soothing system and the application of compassion-focused principles. EMIcompass was perceived as lowering the burden of and barriers to treatment and facilitating the translation into daily life. Intra- and interpersonal context factors interacted with the mechanisms, leading to improvement in well-being, which was identified as a main outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The intervention worked by strengthening participants' soothing system and facilitating ecological translation leading to improved well-being. Adaptions to improve the intervention may allow for more flexibility in individual intervention trajectories acknowledging different needs and preferences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 1","pages":"103-132"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856825","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}
Many people who engage in non-suicidal self-injury (NSSI) do not access support from health services, and evidence regarding the effectiveness of interventions is mixed. Despite this, NSSI prevalence rates decrease from adolescence into adulthood. Little is known about what helps alleviate difficulties with NSSI beyond psychological or medical intervention. This study sought to understand factors influencing naturalistic improvements in NSSI.
Methods
Semi-structured interviews were conducted over video call with 16 participants who believed their difficulties with NSSI had improved due to factors not attributed to psychological or medical intervention. Interviews were audio recorded and transcribed verbatim for analysis.
Results
A reflexive thematic analysis revealed four main themes. Increased insight into NSSI experiences promoted self-compassion and self-acceptance and enabled participants to reflect on the conflicting role of NSSI. Safe and supportive relationships helped alleviate loneliness, and developing alternative coping strategies enhanced feelings of control over self-injury. Creating a life guided by personal values promoted independence, choice, and self-esteem.
Conclusions
The findings of the study highlight several internal and external naturalistic processes deemed meaningful in improving difficulties with NSSI. Clinical implications include the importance of developing and embedding these approaches within services and interventions to improve outcomes for individuals who self-injure while promoting a person-centred approach.
{"title":"“It's like I used to share a room with self-injury, but now it lives next door”: Exploring experiences of naturalistic improvement in non-suicidal self-injury","authors":"E. Hudson, S. Hartley, P. J. Taylor","doi":"10.1111/papt.12567","DOIUrl":"10.1111/papt.12567","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many people who engage in non-suicidal self-injury (NSSI) do not access support from health services, and evidence regarding the effectiveness of interventions is mixed. Despite this, NSSI prevalence rates decrease from adolescence into adulthood. Little is known about what helps alleviate difficulties with NSSI beyond psychological or medical intervention. This study sought to understand factors influencing naturalistic improvements in NSSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted over video call with 16 participants who believed their difficulties with NSSI had improved due to factors not attributed to psychological or medical intervention. Interviews were audio recorded and transcribed verbatim for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A reflexive thematic analysis revealed four main themes. Increased insight into NSSI experiences promoted self-compassion and self-acceptance and enabled participants to reflect on the conflicting role of NSSI. Safe and supportive relationships helped alleviate loneliness, and developing alternative coping strategies enhanced feelings of control over self-injury. Creating a life guided by personal values promoted independence, choice, and self-esteem.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of the study highlight several internal and external naturalistic processes deemed meaningful in improving difficulties with NSSI. Clinical implications include the importance of developing and embedding these approaches within services and interventions to improve outcomes for individuals who self-injure while promoting a person-centred approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"98 1","pages":"133-148"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856810","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号