Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.728
Filtrar
1.
BMC Psychiatry ; 24(1): 655, 2024 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-39367366

RESUMEN

BACKGROUND: Given the limited research focusing on psychotherapeutic interventions for suicide attempters, it is noteworthy that the Attempted Suicide Short Intervention Program (ASSIP) has demonstrated promising results in previous studies. In this investigation, we aim to evaluate the effectiveness of ASSIP across diverse healthcare settings, outlining the study design and planned evaluation. METHODS: Using a Randomized Controlled Trial (RCT) design with four assessment points (baseline, 3, 12- and 24-month follow-up), we aim to assess the effect of the 3-session psychotherapeutic intervention and hereafter brief contact via structured letters during 2 years in a clinical sample of recent suicide attempters (suicide attempts within three months before inclusion). Participants are randomly assigned to one of two groups; treatment as usual plus ASSIP or the control condition, treatment as usual. Assessments include measures of suicidal intent, coping, symptoms of depression, quality of life, self-stigma, and sick leave. The primary outcome is suicide attempt(s) within 3, 12, and 24 months and the secondary outcome is suicidal ideation within the same time frames after study inclusion. DISCUSSION: Findings from this study will provide novel insights regarding the effects of ASSIP on not only subsequent suicidal behavior but also other outcomes including self-stigma, quality of life, social network, sick leave, and symptoms of depression. TRIAL REGISTRATION: The trial was registered at ClinicalTrial.gov NCT04746261 on 2020-10-15.


Asunto(s)
Intento de Suicidio , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adaptación Psicológica , Depresión/terapia , Depresión/psicología , Psicoterapia Breve/métodos , Calidad de Vida/psicología , Ideación Suicida , Intento de Suicidio/psicología , Resultado del Tratamiento , Ensayos Clínicos Controlados Aleatorios como Asunto
2.
Int J Psychoanal ; 105(4): 496-520, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39230488

RESUMEN

In this paper, the author portrays the psychoanalytic therapy with a twelve-year-old refugee boy and his parents, prior to which the boy had been traumatised by the deaths of both his brothers in the civil war. In 2015 he had travelled with his father to Austria, where he was warmly received in a small community. The author examines how this child reacted to the traumatising experiences, as well as which resilience factors played a role in overcoming them. The psychoanalytic process is illuminated in a detailed analysis of the therapy sessions, which created a space for overcoming the helplessness, mourning the loss and furthering the integration process of the identity, disturbed after the traumatic experiences.


Asunto(s)
Terapia Psicoanalítica , Refugiados , Humanos , Refugiados/psicología , Masculino , Terapia Psicoanalítica/métodos , Niño , Trauma Psicológico/terapia , Trauma Psicológico/psicología , Psicoterapia Breve/métodos , Padres/psicología , Austria , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicología
3.
BMC Psychiatry ; 24(1): 628, 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39334120

RESUMEN

BACKGROUND: Suicide is a major public health problem, especially among individuals over 50 years old. Despite the suitability of this life stage for prevention, research on the efficacy of psychological interventions is scarce and methodologically limited, affecting their clinical utility and efficacy. Brief, flexible interventions that can be applied both in-person and remotely are needed. This study aims to evaluate the efficacy of a brief problem-solving-based suicide prevention program applied through various modalities to individuals over 50 years old. METHODS: A randomized controlled trial will be conducted. A sample of 212 adults aged 50 or older with suicidal ideation will be randomly assigned to a problem-solving-based psychological intervention administered face-to-face (PSPI-P; n = 53), by telephone multiconference (PSPI-M; n = 53), via a smartphone app (PSPI-A; n = 53), or to a usual care control group (UCCG; n = 53). The intervention will be delivered in 7 sessions or modules of 90 min each. Blind trained evaluators will conduct assessments at pre-intervention, post-intervention, and follow-ups at 3, 6, and 12 months. The primary outcome will be suicidal ideation evaluated using the Suicidal Ideation Scale (SSI) and the Columbia Suicide Severity Rating Scale (C-SSRS). Secondary outcomes will include hopelessness, anxiety and depression symptoms, reasons for living, impulsivity, problem-solving skills, social support, anger syndrome, gratitude, personality, dropouts, treatment adherence, and satisfaction with the intervention. DISCUSSION: This study will provide evidence of the efficacy of a brief problem-solving-based intervention for suicide prevention in individuals over 50 years old, administered face-to-face, by telephone multiconference, and via a smartphone app. If results are favorable, it will indicate that an effective, accessible, clinically and socially useful suicide prevention intervention has been developed for affected individuals, families, and communities. TRIAL REGISTRATION: ClinicalTrials.gov NCT06338904. Registered April 1, 2024.


Asunto(s)
Solución de Problemas , Prevención del Suicidio , Humanos , Persona de Mediana Edad , Masculino , Femenino , Ideación Suicida , Intervención Psicosocial/métodos , Psicoterapia Breve/métodos , Anciano , Aplicaciones Móviles
4.
Trials ; 25(1): 633, 2024 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-39342238

RESUMEN

BACKGROUND: Within England, children and young people entering police custody are referred to Liaison and Diversion (L&D) teams. These teams liaise with healthcare and other support services aiming to divert children and young people away from the criminal justice system. Although targeted psychological interventions are not typically offered to children and young people by L&D teams, evidence suggests that Solution Focused Brief Therapy (SFBT) leads to a reduction in internalising and externalising behaviour problems. METHODS: A two-arm individually randomised controlled trial (RCT) with internal pilot and process evaluation will be conducted with approximately 448 children and young people aged 10-17 years presenting at police custody suites who are referred to the L&D team or recruited via online routes if they have previously presented at any police custody suite in England. The primary outcome is the Self-Report Delinquency Measure (SRDM) at 6 months post-randomisation. Analyses will be performed using intention-to-treat. RESULTS: The statistical analysis plan (SAP) for the trial is described. The plan details of analyses to be undertaken which will be reported in the primary and any secondary publications. The plan was developed and published prior to locking our database and unblinding to treatment allocation. DISCUSSION: This RCT will evaluate the effectiveness of SFBT in reducing offending behaviours in CYP presenting at police custody suites including testing of moderating factors and sensitivity of the primary analyses. TRIAL REGISTRATION: ClinicalTrials.gov ISRCTN14195235. Registered on June 16, 2023.


Asunto(s)
Conducta del Adolescente , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Adolescente , Niño , Proyectos Piloto , Inglaterra , Delincuencia Juvenil , Psicoterapia Breve/métodos , Masculino , Policia , Resultado del Tratamiento , Femenino , Interpretación Estadística de Datos , Conducta Infantil , Factores de Tiempo
5.
BMC Prim Care ; 25(1): 313, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39179982

RESUMEN

BACKGROUND: Co-occurring physical and mental health conditions are common, but effective and sustainable interventions are needed for primary care settings. PURPOSE: Our paper analyzes the effectiveness of a Solution-Focused Brief Therapy (SFBT) intervention for treating depression and co-occurring health conditions in primary care. We hypothesized that individuals receiving the SFBT intervention would have statistically significant reductions in depressive and anxiety symptoms, systolic blood pressure (SBP), hemoglobin A1C (HbA1c), and body mass index (BMI) when compared to those in the control group. Additionally, we hypothesized that the SFBT group would have increased well-being scores compared to the control group. METHODS: A randomized clinical trial was conducted at a rural federally qualified health center. Eligible participants scored ≥ 10 on the Patient Health Questionnaire (PHQ-9) and met criteria for co-occurring health conditions (hypertension, obesity, diabetes) evidenced by chart review. SFBT participants (n = 40) received three SFBT interventions over three weeks in addition to treatment as usual (TAU). The control group (n = 40) received TAU over three weeks. Measures included depression (PHQ-9) and anxiety (GAD-7), well-being (Human Flourishing Index), and SFBT scores, along with physical health outcomes (blood pressure, body mass index, and hemoglobin A1c). RESULTS: Of 80 consented participants, 69 completed all measures and were included in the final analysis. 80% identified as female and the mean age was 38.1 years (SD = 14.5). Most participants were white (72%) followed by Hispanic (15%) and Black (13%). When compared to TAU, SFBT intervention participants had significantly greater reductions in depression (baseline: M = 18.17, SD = 3.97, outcome: M = 9.71, SD = 3.71) and anxiety (baseline: M = 14.69, SD = 4.9, outcome: M = 8.43, SD = 3.79). SFBT intervention participants also had significantly increased well-being scores (baseline: M = 58.37, SD = 16.36, outcome: M = 73.43, SD = 14.70) when compared to TAU. Changes in BMI and blood pressure were not statistically significant. CONCLUSION: The SFBT intervention demonstrated efficacy in reducing depressive and anxiety symptoms and increasing well-being but did not affect cardio-metabolic parameters over a short period of intervention. TRIAL REGISTRATION: The study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 4/20/2023. *M = Mean, SD = Standard deviation.


Asunto(s)
Ansiedad , Índice de Masa Corporal , Comorbilidad , Depresión , Hemoglobina Glucada , Humanos , Femenino , Masculino , Persona de Mediana Edad , Depresión/terapia , Depresión/epidemiología , Hemoglobina Glucada/análisis , Adulto , Ansiedad/terapia , Ansiedad/epidemiología , Hipertensión/terapia , Hipertensión/psicología , Presión Sanguínea , Obesidad/terapia , Obesidad/psicología , Psicoterapia Breve/métodos , Atención Primaria de Salud , Prestación Integrada de Atención de Salud , Diabetes Mellitus/terapia , Diabetes Mellitus/psicología , Resultado del Tratamiento
7.
Psychother Psychosom Med Psychol ; 74(8): 345-351, 2024 Aug.
Artículo en Alemán | MEDLINE | ID: mdl-38885656

RESUMEN

The diagnosis of a life-threatening illness may lead to a breakdown of psychological processing patterns and a reactualization of existential conflicts. The sudden loss of continuity, physical integrity and social roles can overwhelm patients' ability to cope psychologically. Psychosocial and medical care is likely compromised if patients suffer from affective disorders or symptoms of existential distress. Psychodynamic treatments may strengthen the experience of closeness and connectedness in order to cope with losses and enable farewell processes. ORPHYS describes a short-term psychodynamic psychotherapy (12-24 sessions) that aims to address the existential distress of seriously physically ill patients by taking into account relational conflicts at the end of life. The combination of supportive and expressive treatment techniques that focus on patients' subjective experience and illness situation may enable patients to integrate painful affective states and to explore their relationship and coping patterns. ORPHYS can thus facilitate a shared mourning process, in which the intense desire for connectedness at the end of life and the reality of dying can be reconciled.


Asunto(s)
Adaptación Psicológica , Psicoterapia Breve , Psicoterapia Psicodinámica , Humanos , Psicoterapia Psicodinámica/métodos , Psicoterapia Breve/métodos
8.
Psychodyn Psychiatry ; 52(2): 124-131, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38829225

RESUMEN

This article presents a frequent dilemma of treatment-seeking mothers suffering from complex posttraumatic stress disorder (PTSD) that is related to exposure to maltreatment and other forms of interpersonal violence. Namely, that complex PTSD symptoms, including dissociative states in mothers that are triggered by normative child emotion dysregulation, aggression, and distress during early childhood, hinder the development of a productive psychotherapeutic process in more traditional psychodynamic psychotherapies for mothers and children. The article thus presents clinician-assisted videofeedback exposure (CAVE) that characterizes a recently manualized brief psychotherapy for this population, called CAVE-approach therapy (CAVEAT). CAVEAT can be used on its own or to preface a deeper process using child-parent psychotherapy or other non-videofeedback-enhanced psychodynamic models. A clinical illustration is provided.


Asunto(s)
Atención Plena , Madres , Trastornos por Estrés Postraumático , Adulto , Preescolar , Femenino , Humanos , Exposición a la Violencia/psicología , Atención Plena/métodos , Relaciones Madre-Hijo/psicología , Madres/psicología , Responsabilidad Parental/psicología , Psicoterapia Breve/métodos , Trastornos por Estrés Postraumático/terapia , Masculino
9.
Am J Psychother ; 77(2): 88-94, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38764395

RESUMEN

Demand for mental health treatment surged after the COVID-19 pandemic intensified existing issues of limited access to care and long wait times. Programs that deliver high-quality treatment in a brief format are appealing in that they could reduce wait times for care and increase the number of patients served. The Rapid-Access Focused Treatment (RAFT) program was developed with the overarching goals of delivering brief, evidence-informed interventions in a timely and patient-centered manner, reducing wait times, and improving access to psychiatric specialty services. In this article, the authors describe the pilot implementation of the RAFT program in an outpatient psychiatry clinic, provide guidelines for identification of appropriate patients, and discuss lessons learned from two case examples that illustrate variations in the trajectory of brief treatment. Recommendations for the effective implementation of brief therapy models in an outpatient setting are provided.


Asunto(s)
Atención Ambulatoria , COVID-19 , Accesibilidad a los Servicios de Salud , Psicoterapia Breve , Adulto , Humanos , Persona de Mediana Edad , COVID-19/terapia , Trastornos Mentales/terapia , Pacientes Ambulatorios , Proyectos Piloto , Psicoterapia Breve/métodos , Listas de Espera
10.
Cogn Behav Ther ; 53(6): 608-620, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38721888

RESUMEN

People with eating disorders are often placed on lengthy waitlists for treatment. This is problematic, as increased time spent on waitlists has been shown to predict dropout. We examined whether providing brief interventions to people on a waitlist improved retention or outcomes in treatment. Participants (N = 85) were referred to a university training clinic for 10-session cognitive behavioural therapy for non-underweight patients with eating disorders (CBT-T). While waitlisted for CBT-T, participants were randomised to one of two waitlist interventions or a control condition. In one waitlist intervention (CRT-Brief), participants received a cognitive remediation therapy session at the start of the waitlist period. In the other waitlist intervention (brief contact), participants were sent a short supportive email and psychoeducation halfway through the waitlist period. The control condition was waitlist as usual. There was no evidence to suggest that the waitlist interventions improved symptoms during the waitlist period or CBT-T. However, participants who received a waitlist intervention were three times more likely to complete treatment. The present study suggests that providing even brief contact while people are waitlisted for eating disorder treatment significantly improves retention. However, replication in a more adequately powered study is required.


Asunto(s)
Terapia Cognitivo-Conductual , Trastornos de Alimentación y de la Ingestión de Alimentos , Listas de Espera , Humanos , Femenino , Adulto , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Masculino , Terapia Cognitivo-Conductual/métodos , Adulto Joven , Resultado del Tratamiento , Psicoterapia Breve/métodos , Adolescente , Remediación Cognitiva/métodos
11.
J Clin Psychol ; 80(8): 1876-1900, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38718273

RESUMEN

AIM: The primary aim of this study was to conduct an open pilot clinical trial of a brief mindfulness-based intervention for persistent postconcussion symptoms that occur after mild traumatic brain injury in military service members. For many service members, operational tempo and other time constraints may prevent them from completing a standard mindfulness-based stress reduction course. Thus, this study sought to examine the effectiveness of a five-session intervention called mindfulness-based stress, pain, emotion, and attention regulation (MSPEAR). METHODS: Participants were active duty service members with a history of mild traumatic brain injury (TBI) and persisting postconcussion symptoms, all of whom were recruited from an outpatient TBI rehabilitation program at a military treatment facility. Of the 38 service members that were initially enrolled, 25 completed the 5-session MSPEAR intervention, and 20 returned for a 5-week follow-up evaluation. Questionnaires assessing perceived stress, positive affect, pain interference and catastrophizing, sleep disturbances, perceived behavioral and attention regulation, self-efficacy and satisfaction with life were administered at preintervention, postintervention, and at 5-week follow-up intervals. Neuropsychological testing at preintervention and 5-week follow-up included performance validity measures, attention, working memory, and executive function measures. T-tests were run to compare for questionnaire measures at preintervention (Time 1) to postintervention (Time 2). Repeated analysis of variances were conducted to compare questionnaire and neuropsychological measures at Time 1, Time 2, and at Time 3 which is the 5-week follow-up. RESULTS: Improvements in perceived stress, positive affect, behavioral regulation, metacognition, sleep disturbance, self-efficacy, and satisfaction with life were found immediately after the MSPEAR intervention and were maintained at the 5-week follow-up. Magnification and helplessness aspects of pain catastrophizing improved when comparing preintervention to the 5-week follow-up. Pain interference was not significantly different across study assessment times. Neuropsychological testing revealed improvements in sustained attention, working memory, cognitive flexibility, and inhibitory control when comparing preintervention to the 5-week follow-up assessment. CONCLUSIONS: The MSPEAR intervention appears to show promise as a brief and effective therapy for specific postconcussion symptoms after mild traumatic brain injury in military service members. Each of the components of MSPEAR including stress, pain catastrophizing, emotion and attention regulation showed improvements in this study, and bears further investigation in a larger scale, preferably randomized controlled trial in those active duty military service members who experience persisting symptoms after a mild traumatic brain injury.


Asunto(s)
Conmoción Encefálica , Personal Militar , Atención Plena , Síndrome Posconmocional , Estrés Psicológico , Humanos , Atención Plena/métodos , Adulto , Masculino , Personal Militar/psicología , Femenino , Conmoción Encefálica/psicología , Conmoción Encefálica/terapia , Proyectos Piloto , Síndrome Posconmocional/terapia , Síndrome Posconmocional/psicología , Estrés Psicológico/terapia , Estrés Psicológico/psicología , Adulto Joven , Atención/fisiología , Regulación Emocional/fisiología , Persona de Mediana Edad , Psicoterapia Breve/métodos
12.
J Nerv Ment Dis ; 212(6): 347-351, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38810098

RESUMEN

ABSTRACT: Defense mechanisms (DMs) are strategies used by the individuals to protect the ego. Therefore, compulsive behaviors in obsessive-compulsive disorder (OCD) can be recognized as DMs. We analyzed how DMs changed in a brief cognitive behavioral therapy (CBT) for OCD. This was a quasi-experimental study with 92 OCD patients (aged 18-60 years). We used the Mini International Neuropsychiatric Interview to confirm OCD diagnosis, and we assessed the DMs with the Defense Style Questionnaire at three time points. Through a latent change score modeling, we found that the mature mechanism presented a constant change during the therapy. This mechanism increased in average 0.37 points at each measured moment of CBT, showing a linear trajectory. Neurotic and immature mechanisms showed no significant changes during therapy. The increased use of the mature mechanism can be an indicator of improvement in OCD treatment, showing that patients intensified their more adaptive responses to conflicts.


Asunto(s)
Terapia Cognitivo-Conductual , Mecanismos de Defensa , Trastorno Obsesivo Compulsivo , Humanos , Trastorno Obsesivo Compulsivo/terapia , Adulto , Terapia Cognitivo-Conductual/métodos , Masculino , Femenino , Persona de Mediana Edad , Adulto Joven , Adolescente , Psicoterapia Breve/métodos , Resultado del Tratamiento
13.
J Nerv Ment Dis ; 212(6): 352-357, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38810099

RESUMEN

ABSTRACT: Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain, fatigue, anxiety, depression, and sleep disturbances, significantly impairing quality of life and psychological well-being. Well-being therapy (WBT) is a brief psychotherapeutic intervention aimed at increasing well-being and optimizing functioning, which has proven effective in treating various conditions involving pain and psychological or psychiatric symptoms. We describe a case study of a 22-year-old university student experiencing FMS, highlighting the far-reaching effects of the condition on her quality of life. After eight sessions of WBT, there was a marked improvement in subjective well-being and euthymia, as well as a decrease in pain perception, improved ability to manage stress, reduced allostatic overload despite the presence of stressors, improved social relationships, and increased self-efficacy. The positive effects of WBT continued at 3-month follow-up, suggesting that WBT may represent a short-term effective intervention for patients with FMS.


Asunto(s)
Fibromialgia , Calidad de Vida , Humanos , Fibromialgia/terapia , Fibromialgia/psicología , Femenino , Adulto Joven , Adulto , Psicoterapia Breve/métodos , Resultado del Tratamiento
14.
J Affect Disord ; 358: 449-457, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38734242

RESUMEN

BACKGROUND: There is emerging literature regarding the efficacy of trauma-focussed writing therapies (TF-WTs) for posttraumatic stress. Such therapies have the potential to reduce posttraumatic stress symptoms (PTSS) in a brief time frame and can be delivered remotely. There remains a need for further research assessing the efficacy of different types of TF-WTs, as well comparing them to alternative control conditions not previously assessed. The present study assessed two TF-WTs that had differing writing instructions in comparison to an intervention that involved writing about positive experiences. METHODS: Adult community participants (n = 83) with subthreshold or clinical PTSD symptoms were randomized to one of three conditions (two of which involved trauma-focussed writing, and the other involved writing about positive experiences). All conditions involved three weekly telehealth-delivered writing appointments. Outcomes were measured using the PTSD Checklist (PCL-5) and the Depression, Anxiety and Stress Scales (DASS-21), and were evaluated at baseline, one-week post-intervention, and five-weeks post-intervention. This trial was registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR Protocol 12620001065987). RESULTS: There was no evidence that the two TF-WTs were more efficacious in reducing PTSS or producing clinically meaningful change in comparison to positive experiences writing. Instead, a significant reduction from baseline to follow-up in PTSS, depression, anxiety and stress was observed in all three conditions. LIMITATIONS: The results should be interpreted with consideration of the modest sample size and absence of longer-term follow-up. CONCLUSIONS: Three-session trauma-focussed writing delivered via telehealth may not be superior to writing about positive experiences.


Asunto(s)
Trastornos por Estrés Postraumático , Escritura , Humanos , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicología , Femenino , Masculino , Adulto , Persona de Mediana Edad , Resultado del Tratamiento , Psicoterapia Breve/métodos , Telemedicina , Adulto Joven , Escalas de Valoración Psiquiátrica
15.
Clin Psychol Psychother ; 31(3): e2976, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38757462

RESUMEN

BACKGROUND: Non-suicidal self-injury (NSSI) presents an increasingly prevalent problem for young people; however, there remains a scarce evidence base for effective, scalable treatments for adolescents. This study aimed to assess the feasibility and acceptability of a brief, cognitive analytic therapy (CAT)-informed intervention for young people who engage in NSSI (CATCH-Y). METHODS: A case series design recruited 13 young people who met the inclusion and exclusion criteria to participate in the five-session intervention. Eligible participants were aged 13-17 years (M = 15.15, SD = 1.28) and had engaged in NSSI at least once in the previous 6 months. Feasibility and acceptability were measured via recruitment, retention, qualitative feedback and missing data. The secondary outcome measures of personal recovery and motivation were administered pre- and post-assessment, with measures of depressive symptoms and urges to self-injure. RESULTS: The intervention was found to be largely feasible and acceptable with high rates of recruitment, retention and pre-/post-assessment data completeness. Measures showed preliminary support for positive change in rates of NSSI, urges to self-harm, low mood and personal recovery, although results were mixed. Completion rates for remote assessments were low. CONCLUSIONS: The findings of this study support further evaluation of the CATCH-Y intervention on a larger scale. In-person assessments may be preferable to remote to ensure good completion rates.


Asunto(s)
Terapia Cognitivo-Conductual , Conducta Autodestructiva , Humanos , Adolescente , Conducta Autodestructiva/psicología , Conducta Autodestructiva/terapia , Masculino , Femenino , Terapia Cognitivo-Conductual/métodos , Estudios de Factibilidad , Resultado del Tratamiento , Psicoterapia Breve/métodos
16.
Australas Psychiatry ; 32(4): 293-295, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38606612

RESUMEN

OBJECTIVE: Despite the known importance of regularly monitoring progress when delivering psychological interventions, this is not mandated or seemingly even common practice on Australian inpatient psychiatric wards. Barriers for why this might be the case are described, an argument made to rise above them, and a call for research in this area is made. CONCLUSIONS: Failure to find ways to collect, analyse and be transparent with data around brief inpatient psychological interventions can diminish treatment outcomes and leaves us open to criticism as a profession.


Asunto(s)
Hospitales Psiquiátricos , Trastornos Mentales , Humanos , Australia , Trastornos Mentales/terapia , Psicoterapia Breve/métodos , Pacientes Internos
17.
Br J Psychiatry ; 225(1): 274-281, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38602168

RESUMEN

BACKGROUND: Higher intensity of psychotherapy might improve treatment outcome in depression, especially in those with comorbid personality disorder. AIMS: To compare the effects of 25 individual sessions (weekly) of two forms of psychotherapy - short-term psychoanalytic supportive psychotherapy (SPSP) and schema therapy - with the same treatments given for 50 sessions (twice weekly) in people with depression and personality disorder. Trial registration: NTR5941. METHOD: We conducted a pragmatic, double-randomised clinical trial and, over 37 months, recruited 246 adult out-patients with comorbid depression/dysthymia and personality disorder. A 2 × 2 factorial design randomised participants to 25 or 50 sessions of SPSP or schema therapy. The primary outcome was change in depression severity over 1 year on the Beck Depression Inventory II (BDI-II). Secondary outcomes were remission both of depression and personality disorder. RESULTS: Compared with 25 sessions, participants who received 50 sessions showed a significantly greater decrease in depressive symptoms over time (time × session dosage, P < 0.001), with a mean difference of 5.6 BDI points after 1 year (d = -0.53, 95% CI -0.18 to 0.882, P = 0.003). Remission from depression was also greater in the 50-session group (74% v. 58%, P = 0.025), as was remission of personality disorder (74% v. 56%, P = 0.010). CONCLUSIONS: Greater intensity of psychotherapy leads to better outcomes of both depression and personality status in people with comorbid depression and personality disorder.


Asunto(s)
Trastornos de la Personalidad , Humanos , Masculino , Femenino , Adulto , Trastornos de la Personalidad/terapia , Trastornos de la Personalidad/epidemiología , Persona de Mediana Edad , Comorbilidad , Psicoterapia Psicodinámica/métodos , Resultado del Tratamiento , Terapia Psicoanalítica/métodos , Psicoterapia Breve/métodos , Trastorno Distímico/terapia , Trastorno Distímico/epidemiología
18.
Personal Disord ; 15(4): 226-240, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38573656

RESUMEN

Mentalization, that is the capacity to understand our and others' behaviors in terms of intentional mental states, represents one of the core features of personality disorders (PDs) and can be related to therapists' countertransference (CT) and interventions. AIMS: The aim of the present work was to study the relationship between therapists' technique, therapists' CT, and patients' mentalization, in a sample of patients with PDs undergoing a 40-session program of sequential brief-adlerian psychodynamic psychotherapy, a psychodynamic therapeutic model specifically developed for the treatment of PDs in public mental health services. METHOD: Eighty-seven patients with PD and their therapists completed ratings of mentalization (mentalization imbalances scale and reflective functioning questionnaire), CT (therapist response questionnaire), and therapists' intervention (comparative psychotherapy process scale) at five different time points (Sessions 5, 10, 20, 30, and 40). RESULTS: Results showed that patients' mentalizing problematics decreased over time. Moreover, we found a reduction of therapists' disengaged CT, and an increase in positive CT over time. Regarding therapists' techniques, psychodynamic-interpersonal interventions were on average higher than cognitive-behavioral, but both techniques were used increasingly over time. Our results also showed significant and clinically coherent interactions between therapist's CT and techniques and between patient's mentalization imbalance and therapist's response. Our results highlighted the importance of early stages in therapy, since the most significant relationships between the various process variables (patient's mentalizing imbalances, therapist's techniques, and emotional responses) are observed between t1 and t2, corresponding to the initial phases of the treatments. Clinical implications will be discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Contratransferencia , Mentalización , Trastornos de la Personalidad , Psicoterapia Breve , Psicoterapia Psicodinámica , Humanos , Adulto , Psicoterapia Psicodinámica/métodos , Femenino , Trastornos de la Personalidad/terapia , Masculino , Mentalización/fisiología , Persona de Mediana Edad , Psicoterapia Breve/métodos , Relaciones Profesional-Paciente , Adulto Joven
19.
J Psychiatr Res ; 174: 289-296, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38678686

RESUMEN

Hallucinations are a common feature of psychosis, yet access to effective psychological treatment is limited. The Managing Unusual Sensory Experiences for First-Episode-Psychosis (MUSE-FEP) trial aimed to establish the feasibility and acceptability of a brief, hallucination-specific, digitally provided treatment, delivered by a non-specialist workforce for people with psychosis. MUSE uses psychoeducation about the causal mechanisms of hallucinations and tailored interventions to help a person understand and manage their experiences. We undertook a two-site, single-blind (rater) Randomised Controlled Trial and recruited 82 participants who were allocated 1:1 to MUSE and treatment as usual (TAU) (n = 40) or TAU alone (n = 42). Participants completed assessments before and after treatment (2 months), and at follow up (3-4 months). Information on recruitment rates, adherence, and completion of outcome assessments was collected. Analyses focussed on feasibility outcomes and initial estimates of intervention effects to inform a future trial. The trial is registered with the ISRCTN registry 16793301. Criteria for the feasibility of trial methodology and intervention delivery were met. The trial exceeded the recruitment target, had high retention rates (87.8%) at end of treatment, and at follow up (86.6%), with good acceptability of treatment. There were 3 serious adverse events in the therapy group, and 5 in the TAU group. Improvements were evident in both groups at the end of treatment and follow up, with a particular benefit in perceived recovery in the MUSE group. We showed it was feasible to increase access to psychological intervention but a definitive trial requires further changes to the trial design or treatment.


Asunto(s)
Alucinaciones , Trastornos Psicóticos , Humanos , Alucinaciones/etiología , Alucinaciones/terapia , Trastornos Psicóticos/terapia , Femenino , Masculino , Adulto , Método Simple Ciego , Adulto Joven , Estudios de Factibilidad , Psicoterapia Breve/métodos , Adolescente , Persona de Mediana Edad , Estudios de Seguimiento , Evaluación de Resultado en la Atención de Salud
20.
Australas Psychiatry ; 32(4): 330-335, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38621694

RESUMEN

OBJECTIVE: This study evaluated the acceptance, feasibility and safety of a short-term group program for adults (18 years and older) and youth (16 to 18 years) with borderline personality disorder (BPD) symptoms. Termed Road Maps, the content and development were informed by common treatment factors identified from evidence-based therapies for BPD. METHOD: Two-hundred and eight people consented to participate in the research trial and completed baseline measures. Intervention participants rated the acceptability and subjective experience of the group. Attrition rates informed feasibility, and serious adverse events were tracked to identify potential harms. RESULTS: Participant post-group ratings of the group's acceptability and subjective experience were above average across both adult and youth populations. Attrition rate after commencement of group was 38% for adults and 27% among youth. The incidence rate of emergency department presentations was reduced by 41% in the 6 months post-group, relative to 6 months pre-group. CONCLUSIONS: The current study provides preliminary support for the acceptability and feasibility of a short-term group therapy program for people with a diagnosis of BPD. Road Maps may be a useful intermediate intervention in a broader model of stepped care. Australian New Zealand Clinical Trials Registry, https://www.anzctr.org.au/ACTRN12622000849796.aspx, (ACTRN12622000849796).


Asunto(s)
Trastorno de Personalidad Limítrofe , Estudios de Factibilidad , Aceptación de la Atención de Salud , Psicoterapia de Grupo , Humanos , Trastorno de Personalidad Limítrofe/terapia , Psicoterapia de Grupo/métodos , Femenino , Masculino , Adulto , Adolescente , Adulto Joven , Aceptación de la Atención de Salud/estadística & datos numéricos , Psicoterapia Breve/métodos , Persona de Mediana Edad
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...