Treating systemic issues in families affected by cystic fibrosis: A solution-focused approach.

Cystic fibrosis (CF) presents with various symptoms that impair day-to-day functioning and require lifelong treatment. Due to the chronic and severe nature of this disease, families are often impacted by the stress associated with treatment, complications of the disease, and the understanding that their loved one will one day die from CF. This article seeks to address a perceived gap in the literature for providing a model-specific approach to address psychosocial stress in families affected by CF. We provide a rationale for using solution-focused brief therapy (SFBT) to work with this population based on its empirically supported effectiveness, versatility, and capacity to be brief in nature. We describe how SFBT interventions can be used by practitioners working with this population, present a fictitious case illustration depicting the clinical use of specific SFBT interventions, and offer suggestions for future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Changes in the number of suicide re-attempts in a French region since the inception of VigilanS, a regionwide program combining brief contact interventions (BCI).

BACKGROUND: Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. They are easier to generalize to an entire population than other forms of intervention. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and mailings, according to a predefined algorithm. It was implemented gradually in the Nord-Pas-de-Calais (NPC), France, between 2015 and 2018. Here, we evaluate the effectiveness of VigilanS, in terms of SA reduction, using annual data collected by participating centers. Hypothesis tested: the higher the VigilanS implementation in a center (measured by penetrance), the greater the decrease in the number of SA observed in this center. METHODS: The study period was from 2014 to 2018, across all of NPC centers. We performed a series of linear regressions, each center representing a statistical unit. The outcome was the change in the number of SA, relative to the initial number, and the predictive variable was VigilanS' penetrance: number of patients included in VigilanS over the total number of SA. Search for influential points (points beyond threshold values of 3 influence criteria) and weighted least squares estimations were performed. RESULTS: Twenty-one centers were running VigilanS in 2018, with an average penetrance of 32%. A significant relationship was identified, showing a sharp decrease in SA as a function of penetrance (slope = - 1.13; p = 3*10- 5). The model suggested that a 25% of penetrance would yield a SA decrease of 41%. CONCLUSION: VigilanS has the potential to reduce SA. Subgroup analyzes are needed to further evaluate its effectiveness. Subgroup analyses remain to be done, in order to evaluate the specific variations of SA by group.

Effectiveness of psychoanalysis and long-term psychodynamic psychotherapy on personality and social functioning 10 years after start of treatment.

The evidence on potentially greater benefits of psychoanalysis (PA) vs. long-term psychodynamic psychotherapy (LPP) is scarce. This study compared the effectiveness of PA and LPP on personality and social functioning during a 10-year follow-up from the beginning of the treatments. The eligible patients, 41 self-selected for PA and 128 assigned to LPP, were 20-45 years of age and had anxiety or mood disorder. Outcomes were analyzed using ten standard measures of personality and social functioning, carried out 5-9 times during the follow-up. Different change patterns by time in PA and LPP emerged, suggesting less benefit of PA during the first years of follow-up and more benefit in most outcomes thereafter. Greater post-treatment improvement in PA than in LPP was seen up to 1-2 years after PA had ended in more mature defense style (DSQ), level of personality organization (LPO), more positive self-concept (SASB), more improved social adjustment (SAS-SR) and sense of coherence (SOC). However, at the 10-year follow-up the differences were non-significant. In conclusion, PA may give some additional benefits when long-term aims are linked to personality and social functioning. The relatively small differences and higher costs in comparison to LPP may restrict the feasibility of PA.

["VigilanSeu.r.se": A new profession?] / « VigilanSeu.r.se ¼ : un nouveau métier ?

In January 2015, in accordance with decades of scientific work based on maintaining contact, was born an innovative device for suicide prevention: VigilanS. To ensure this link, the choice was made to build a team with an equal number of nurses and psychologists, all located within the medical regulation. Nowadays, they are named "VigilanSeur": an original entity that highlights the emergence of this new profession, at the crossroads of several disciplines.

Advances in Motivational Interviewing for Pediatric Obesity: Results of the Brief Motivational Interviewing to Reduce Body Mass Index Trial and Future Directions.

Rates of childhood obesity in the United States remain at historic highs. The pediatric primary care office represents an important yet underused setting to intervene with families. One factor contributing to underuse of the primary care setting is lack of effective available interventions. One evidence-based method to help engage and motivate patients is motivational interviewing, a client-centered and goal-oriented style of counseling used extensively to increase autonomous motivation and modify health behaviors. This article summarizes the methods and results from a large trial implemented in primary care pediatric office and concludes with recommendations for improving the intervention and increasing its dissemination.

Sustained reduction in health care costs after adjunctive treatment of graded intensive short-term dynamic psychotherapy in patients with psychotic disorders.

The aim of this pilot study was to evaluate the changes in symptom severity and long-term health care cost after intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with psychotic disorders undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average of 13 one-hour sessions of graded ISTDP to 38 patients with psychotic disorders. Costs for health care services were compiled for a one-year period prior to the start of ISTDP (baseline) along with four one-year periods after termination. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination of ISTDP. Results revealed that health care cost reductions were significant for the one-year post-treatment period relative to baseline year, for both physician costs and hospital costs, and the reductions were sustained for the follow-up period of four post-treatment years. Furthermore, at treatment termination self-reported symptoms and interpersonal problems were significantly reduced. These preliminary findings suggest that this brief adjunctive psychotherapy may be beneficial and reduce costs in selected patients with psychotic disorders, and that gains are sustained in long-term follow-up. Future research directions are discussed.

Intelligence as a predictor of outcome in short- and long-term psychotherapy.

Intelligence has been suggested as a suitability factor for short-term therapy whereas its possible effect on short-term versus long-term therapy still is unknown. The aim of this study was to compare the prediction of intelligence on the level of psychiatric symptoms and psychosocial functioning in psychotherapies of different lengths. A total of 251 outpatients from the Helsinki Psychotherapy Study, aged 20­46 years, and suffering from mood or anxiety disorders were allocated to two long-term and two short-term therapies. Intelligence was assessed at baseline with the Wechsler Adult Intelligence Scale (WAIS-R). Psychiatric symptoms and psychosocial functioning were assessed 5­10 times during a 5-year follow-up using two primary symptom measures (HDRS and HARS) and one primary measure of psychosocial functioning (GAF). Short-term therapy was more effective than long-term therapy during the first year of follow-up. During the second to fourth follow-up year no differences between short- and long-term therapies or the intelligence groups were found. At the fifth follow-up year, however, long-term psychotherapy showed a statistically significantly larger change in all three primary measures compared to short-term therapy among those with higher intelligence. No differences between therapy groups were noted in those with lower intelligence. People with higher intelligence may benefit more from long-term than from short-term psychotherapy. These findings should be confirmed.

Benchmarking routine psychological services: a discussion of challenges and methods.

BACKGROUND: Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. AIMS: To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. METHOD: High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. RESULTS: High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. CONCLUSIONS: The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

Interpersonal psychotherapy: past, present and future.

The authors briefly describe the origins, theory, and development of interpersonal psychotherapy: its roots in clinical outcome research, its spread from major depression to other psychiatric disorders and its increasing dissemination as an empirically validated clinical intervention included in treatment guidelines. They attempt to forecast research, organizational and training issues the growing interpersonal psychotherapy community may face in the future.

Predictors of outcome in patients with common mental disorders receiving a brief psychological treatment: an exploratory analysis of a randomized controlled trial from Goa, India.

OBJECTIVE: A randomized placebo-controlled trial of treatment for common mental disorders in Goa, India found that psychological treatment (problem-solving) was no more effective than placebo. The study aimed to identify factors predicting outcome amongst participants receiving the psychological treatment, as measured by score on the Revised Clinical Interview Schedule (CISR). METHOD: The CISR scores at 2 months, 6 months and 12 months were modelled using multiple linear regression with a random effect for patients. Two types of variables were examined. Patient variables were age; sex; religion; education; marital status; severity of psychiatric morbidity at recruitment; and severity of social and life problems faced by the subject. Treatment variables were number of sessions attended and the hospital site. RESULTS: About half the participants had a depressive disorder; most of the remainder had mixed anxiety-depression. Overall adherence with the intervention was low; more than a third of patients attended only one session. Attending a greater number of sessions and facing a severe life problem were significantly associated with a worse outcome (p<0.005). CONCLUSION: The severe nature of life problems faced by some patients with common mental disorders may limit the efficacy of clinic-based psychological treatments in low income countries.

Brief intervention for problem drinkers in a Chinese population: a randomized controlled trial in a hospital setting.

BACKGROUND: Alcohol is a legal and accessible substance in Taiwan. As excessive alcohol has been linked to health and social problems, it is necessary to develop a brief, rapid, and low-cost tool to help health care providers deal with persons in Taiwan whose alcohol consumption has become hazardous or harmful to their health. METHODS: A randomized controlled clinical trial with 6- and 12-month follow-ups was designed. Eighteen medical/surgical units at a medical center in northern Taiwan were randomly assigned to 2 groups: experimental (n = 9) and control (n = 9). Inpatients on the units were enrolled if they met the following criteria: were older than 18 years, had no severe psychiatric illness, and were not pregnant. The experimental group (n = 138) received the intervention, a 15-minute counseling visit in which nurses screened participants using the Alcohol Use Disorders Identification Test (AUDIT), provided a health promotion booklet for adults, and individually discussed the booklet contents with patients based on their drinking level (AUDIT score). The control group (n = 137) received no treatment. Patterns of alcohol consumption were determined by AUDIT scores at baseline, 6, and 12 months later. RESULTS: Alcohol use disorders identification test scores decreased significantly in both groups at 6 months after the intervention, but did not differ significantly between the 2 groups. However, 12 months after the brief alcohol intervention, experimental subjects' AUDIT scores were significantly better than those of the control group. CONCLUSIONS: Our brief alcohol intervention provided a 12-month benefit for problem drinkers in Taiwan.

The future orientation of constructive memory: an evolutionary perspective on therapeutic hypnosis and brief psychotherapy.

We explore a new distinction between the future, prospective memory system being investigated in current neuroscience and the past, retrospective memory system, which was the original theoretical foundation of therapeutic hypnosis, classical psychoanalysis, and psychotherapy. We then generalize a current evolutionary theory of sleep and dreaming, which focuses on the future, prospective memory system, to conceptualize a new evolutionary perspective on therapeutic hypnosis and brief psychotherapy. The implication of current neuroscience research is that activity-dependent gene expression and brain plasticity are the psychobiological basis of adaptive behavior, consciousness, and creativity in everyday life as well as psychotherapy. We summarize a case illustrating how this evolutionary perspective can be used to quickly resolve problems with past obstructive procrastination in school to facilitate current and future academic success.

Brief alcohol interventions: do counsellors' and patients' communication characteristics predict change?

AIMS: To identify communication characteristics of patients and counsellors during brief alcohol intervention (BAI) which predict changes in alcohol consumption 12 months later. METHODS: Tape-recordings of 97 BAI sessions with hazardous drinkers were analysed using the Motivational Interviewing Skill Code (MISC). Outcome measures were (i) baseline to a 12-month difference in the weekly drinking quantity, and (ii) baseline to a 12-month difference in heavy drinking episodes per month. Bivariate analyses were conducted for all MISC measures, and significant variables were included in multiple linear regression models. RESULTS: Patient communication characteristics (ability to change) during BAI significantly predicted the weekly drinking quantity in the multiple linear regression model. There were significant differences for some of the counsellor skills in bivariate analyses but not in the multiple regression model adjusting for patients' talk characteristics. Changes in heavy drinking showed no significant association with patient or counsellor skills in the multiple linear regression model. CONCLUSION: Findings indicate that the more the patient expresses ability to change during the intervention, the more weekly alcohol use decreases. The role of the counsellor during the interaction, and influence on the outcomes was not clearly established. Implications for BAI and related research are discussed.

Thought field therapy. Interview by Denise Rankin-Box.

Thought field therapy (TFT), one of the new 'power therapies' uses the body's meridian system to facilitate emotional and psychological change. Developed by clinical psychologist Dr Roger Callahan over the last 22 years,TFT is now used internationally. Recent developments indicate that TFT has the potential to be used more widely in the field of health care. The editor recently interviewed Jo Cooper to find out more about this therapy,

Recommendations for the future of training in brief dynamic psychotherapy.

The results of 2 large surveys (of practitioners and graduate school/internship training directors) indicate that there is a considerable amount of brief therapy being conducted by psychodynamically trained therapists. However, their training in this specialization does not appear to be adequate. Eleven recommendations (e.g., addressing therapists' attitudes toward brief therapy, studying training processes and outcomes, using videotapes for teaching and supervision) are set forth to foster improvements in such training. We conclude that it is critical that the sizeable number of psychodynamic therapists conducting brief therapy receive continuing in-depth training in this challenging and demanding field.