Mapping the journey from epistemic mistrust in depressed adolescents receiving psychotherapy.

Although the theory of epistemic trust has started informing research in clinical populations and psychotherapy, no study has yet explored the phenomenon of epistemic trust and mistrust in depressed adolescents receiving psychotherapy. The present study aims to address this gap by creating a typology of depressed adolescents' experiences regarding their different journeys through the course of psychotherapy in relation to issues of epistemic trust and mistrust over a 2-year period. This study is based on a post hoc analysis of interview data collected for a broader purpose. A total of 45 semistructured interviews at three time points were conducted with 15 adolescents (80% female; Mage = 15.28, SD = 1.79) who entered treatment with indications of epistemic mistrust or hypervigilance. These interviews were qualitatively analyzed using ideal type analysis. Three distinct journeys of adolescents' experiences were identified. Some experienced a shift from epistemic mistrust to epistemic trust which seemed to be associated with the experience of therapy; other adolescents also showed a shift but did not consider it as an outcome of therapy; and finally, some adolescents reported continued mistrust over the 2-year period. An interpersonal component within or beyond therapy may be the key to breaking the vicious cycle of epistemic mistrust and generating epistemic trust; but not all depressed adolescents in therapy achieve this. Particular attention should be drawn to depressed adolescents who have difficulty making use of therapy and/or their broader social environment. Psychological interventions may need to openly address their issues of mistrust in early sessions as epistemic mistrust or hypervigilance may hinder paths to learning both within and beyond therapy. Treatments that intervene at the level of the wider social system are encouraged. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Reflective Fostering Programme-Adapting a group parenting programme for online delivery in response to the COVID-19 pandemic in the United Kingdom.

OBJECTIVE: In the context of the Covid-19 pandemic and subsequent lockdown restrictions, service providers faced significant challenges in delivering programmes to support their vulnerable service users. Foster carers-an already often isolated group of caregivers - were offered an adapted remote-delivery model of the Reflective Fostering Programme (Redfern et al., Adopt. Foster., 42, 2018, 234) from March 2020. METHOD: This paper outlines the adaptation process of the original programme to online-remote delivery and describes the feedback from participants in the programme. RESULTS: The adaptation of the Reflective Fostering programme to online, remote delivery had both strengths and weaknesses - including wider access to foster carers who might struggle to attend in person and challenge a to maintaining a Mentalizing space online and ensuring confidentiality within a therapeutic space. The programme was overwhelmingly well received by foster carers in this format. CONCLUSIONS: There are opportunities and challenges in the delivery of online therapeutic services, particularly those with a group format. This paper contributes initial reflections to what we hope will be a rapidly developing literature on best practice of supporting group services in an online format.