The Development and Feasibility of a Novel Group Intervention to Support Helping Professionals in Metabolizing Suffering and Engaging Strengths: The CHRYSALIS Program.

This feasibility study reports on the development and initial evaluation of a novel online intervention for helping professionals (HPs; i.e. mental health professionals, chaplains, clergy) designed to (a) address occupational hazards, such as burnout and vicarious traumatization, and (b) promote well-being and flourishing at work. In contrast with competency and self-care focused models, the CHRYSALIS (Catalyzing Helping Professionals' Resilience, VitalitY, Spirituality, Authentic Living, and Inner Strength) intervention centers the self of the provider, explores cultural and spiritual contexts, and attends to systemic challenges. As part of a larger randomized controlled trial evaluating two program formats, the group format entails eight online sessions exploring strengths that can promote well-being, including processing, relational, vitalizing, orienting, and agentic capacities. To pilot test this framework and establish proof of concept, this study analyzed data from 41 HPs who had been randomly assigned to the group condition and completed surveys at four time points. Quantitative results indicated significant reductions in vicarious traumatization and burnout as well as increased well-being and meaning in work. Qualitative results suggest the intervention fostered relational support, cultivated new perspectives, and increased engagement with strengths, positively impacting participants' work and navigation of caregiving systems. Feedback about cohesion and group dynamic challenges in an online format informed further program development. This study provides initial support for the feasibility and efficacy of the group format of the CHRYSALIS intervention as a creative means to address HPs' risk for occupational hazards and promote holistic formation in a relational context.

The Effect of Spiritual Group Therapy on the Quality of Life and Empowerment of Women with Breast Cancer: A Randomized Clinical Trial in Iran.

This randomized clinical trial was carried out on 74 women with breast cancer between May 2015 and April 2016 in the south of Iran. The patients were selected using a simple sampling method and randomly divided into an intervention (n = 30) and a control (n = 37) group. Five spiritual therapy sessions were conducted for the intervention group. Each session lasted one hour. The quality of life and empowerment of the patients were measured before and one month after the intervention. To collect data, four instruments were used, including a demographic information form, the European Organization for Research and Treatment of Cancer QOL questionnaire Cancer-30 (EORTC QLQ C-30), EORTC QLQ Breast-23 (EORTC QLQ-BR23), and the Cancer Empowerment Questionnaire (CEQ). After the intervention, a difference was observed between the groups concerning the mean score of general health (P = 0.016) and emotional function (P = 0.029), but there was no significant difference between the groups concerning the mean score of empowerment (P = 0.62). Thus, it appears that spiritual group therapy can improve the quality of life of this group of patients.IRCT registration number: IRCT 2014050417546N2.

A randomized comparison of online mindfulness-based group sex therapy vs supportive group sex education to address sexual dysfunction in breast cancer survivors.

BACKGROUND: Sexual difficulties and vaginal pain are common following treatment for breast cancer. AIM: The goal of this study was to evaluate an online mindfulness-based group sex therapy vs an online supportive sex education group therapy to address these sexual difficulties. METHODS: Breast cancer survivors (n = 118) were randomized to 1 of the 2 arms; 116 provided informed consent and completed the time 1 assessment. Treatment included 8 weekly 2-hour online group sessions. Those randomized to the mindfulness group completed daily mindfulness exercises, and those in the comparison arm read and completed exercises pertaining to sex education. OUTCOMES: Assessments were repeated at posttreatment and 6 months after the completion of the group. RESULTS: There was a main effect of treatment on primary endpoints of sexual desire, sexual distress, and vaginal pain, with all outcomes showing significant improvements, with no differential impact by treatment arm. Secondary endpoints of interoceptive awareness, mindfulness, and rumination about sex also significantly improved with both treatments, with no group-by-time interaction. CONCLUSION: Both mindfulness-based sex therapy and supportive sex education delivered in group format online are effective for improving many facets of sexual function, vaginal pain, rumination, mindfulness, and interoceptive awareness in breast cancer survivors. STRENGTHS AND LIMITATIONS: We used a randomized methodology. Future studies should seek to diversify participants. CLINICAL IMPLICATIONS: These findings highlight the need to offer similar treatments to more breast cancer survivors immediately after and in the years following cancer treatment as a means of improving survivorship quality of life.

The impact of group music therapy in ameliorating the depression among patients with dementia in care homes: A randomized control trial.

Despite the increasing use of music therapy to treat patients with dementia, studies focused on developing nations are still in their embryonic stages. In this view, this study examined the impact of group music therapy intervention in ameliorating depression levels among older people in two care homes. A randomized control trial (RCT) was carried out in which a total of 121 patients were randomly divided into control 61 and experimental group 60. After 6 weeks, 12-session experiment which involved passive and active music therapy, it was found that music group therapy intervention reduced the depression level of older persons in the experimental group, compared to those who were not exposed to the music therapy; control group. The music therapy session also influenced the salivary cortisol of the patients as it was shown to reduce their salivary cortisol levels. It was also observed that after three months of follow-up, participants in the experimental group still maintained a low level of depression and salivary cortisol level, but the control group's level was still high, thus, substantiating the effect of music in reducing depression among older people. We encouraged clinicians, nursing practitioners and care homes in Nigeria to incorporate music therapy as part of the treatment offered to patients with dementia.

The combination of oxytocin and mindfulness-based group therapy for empathy and negative symptoms in schizophrenia spectrum disorders - A double-blinded, randomized, placebo-controlled pilot study.

Treatment options for social cognition and negative symptoms in schizophrenia spectrum disorders (SSD) remain limited. Oxytocin could be a promising augmentation approach, but the social context influences the effect in humans. This pilot study hypothesized that oxytocin in a positive social setting through mindfulness-based group therapy (MBGT) would positively affect empathy and negative symptoms as well as affect and stress in an exploratory approach in SSD. An experimental, randomized, double-blinded (participants, psychotherapists), placebo-controlled pilot study with 41 individuals with SSD was conducted at the Charité - Universitätsmedizin Berlin. Oxytocin or placebo (24 I.U.) was administered intranasally 45 min before two sessions of MBGT each. A 2 × 2 mixed model ANCOVA design was calculated to assess empathy by the Interpersonal Reactivity Index and the Multifaceted Empathy Test and negative symptoms by the Self-Evaluation of Negative Symptoms. No benefit of oxytocin compared to placebo on empathy was observed, but significant between-group differences favoring oxytocin were found regarding the negative symptoms Diminished emotional range and Avolition. Negative affect and stress were significantly reduced compared to baseline. Mindfulness increased in both groups. Results indicated protocol adherence and retention rate of 91.1%, a drop-out rate of 8.9 % and a completion of 96 % of all sessions by the participants. No severe adverse events or side effects were reported. Our findings indicate proof-of-concept and suggest a potential role of oxytocin on negative symptoms and related variables in SSD in combination with MBGT. Future research should examine the stability of these effects with larger sample sizes.

Effect of traditional Chinese medicine combined group psychotherapy on psychological distress management and gut micro-biome regulation for colorectal cancer survivors: a single-arm phase I clinical trial.

OBJECTIVE: To evaluate the efficacy and feasibility of utilizing Traditional Chinese Medicine (TCM) combined group psychotherapy intervention on psychological distress management and gut micro-biome regulation for colorectal (CRC) survivors. METHODS: A single-arm phase I clinical trial was conducted between December 2020 and December 2021 in Xiyuan Hospital and Beijing Cancer Hospital in China. Inclusion criteria included stage I-III CRC survivors after radical surgery with age between 18 and 75. The intervention was a 6-week online TCM combined group psychotherapy intervention including 90-min communication, TCM lifestyle coaching, self-acupressure guidance, and mindfulness practice led by TCM oncologist and psychiatrist each week. Outcomes were measured by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Fear of Cancer Recurrence Inventor (FCRI), and Quality of Life Questionnaire (QLQ-C30). Fecal samples before and after intervention were collected for 16Sr RNA analysis. RESULTS: We recruited 40 CRC survivors and 38 of them finally completed all interventions with average age of 58±13 years' old. Paired t-test showed that SAS at week 2(35.4±5.8), week 4 (37.9±10.5) and week 6 (31.3±6.4) during the intervention was significantly lower than baseline (42.1±8.3, p<0.05 respectively). SDS score also declined substantially from baseline (38.8±10.7) to week 2 (28.3±8.8, p<0.001) and week 6 (25.4±7.7, p<0.001). FCRI decreased from 19.4±7.2 at baseline to 17.5±7.1 at week 4 (p=0.038) and 16.3±5.8 at week 6 (p=0.008). Although changes of QLQ-C30 were not statistically prominent, symptom burden of insomnia and fatigue significantly alleviated. The abundances of gut microbiota Intestinibacter, Terrisporobacter, Coprobacter, and Gordonibacter were all significantly elevated after intervention. CONCLUSIONS: TCM combined group psychotherapy intervention is feasible and effective to reduce CRC survivors' psychological distress and modulate certain gut bacteria which might be associated with brain-gut axis effect. It is necessary to carry out with phase II randomized controlled clinical trial.

Dance becomes therapeutic in the mid to late 20th century.

The convergence of dance art and therapeutic culture engendered the development of dance-movement therapy in the mid to late 20th century internationally. This article traces the sociopolitical, institutional, and aesthetic influences that coalesced in this process by contrasting histories of dance-movement therapy in Hungary and in the United States. The professionalization dance-movement therapy, through which it established its own theory, practice, and training institutions, occurred first in the United States in the late 1940s. Modern dancers in the United States began to conceptualize their activity as therapeutic, and the dancer as a (secular) healer, a therapist. The influx of therapeutic concepts into the field of dance is viewed as an example of therapeutic discourse permeating various areas of life in the 20th century. The Hungarian case provides a contrasting history of therapeutic culture, one that deviates from the predominant view of the phenomenon as a product of the global spread of Western modernization and the growth of free-market capitalism. Hungarian movement and dance therapy indeed developed independently from its American predecessor. Its history is intimately tied to the sociopolitical context of state-socialist period, particularly to the institutionalization of psychotherapy in public hospitals, and to the adaptation of Western group psychotherapies within the informal setting of the "second public sphere." The legacy of Michael Balint and the British object-relations school provided its theoretical framework. Its methodology was rooted in postmodern dance. The methodological differences between American dance-movement therapy and the Hungarian method reflects the shift in dance aesthetics that occurred internationally between 1940 and 1980s.

Effects of a biopsychosocial-spiritual group therapy on quality of life among institutionalized older adults with disabilities: A randomized controlled trial.

The traditional biomedical care approach has been unsatisfactory to meet the complex needs of seniors with long-term multimorbidity and irreversible disability, particularly for those living in residential LTC facilities. This study aimed to develop and evaluate the effectiveness of an 8-week biopsychosocial-spiritual (BPS-S) group intervention with the attempt to enhance quality of life (QoL) and meaning in life among senior residents with disability. This single-blind randomized controlled trail was conducted in eight residential LTC facilities. The primary outcome, 'participants' overall and subdomain QoL', and the secondary outcome, 'meaning in life', were repeatedly assessed, including four time points: before, mid- and post-intervention, and at a 1-month follow-up. A generalized linear mixed model (GLMM) was used to assess between-group differences over time. The post-intervention differences indicated significant higher improvement on senior residents' overall and all 4 domains of QoL, as well as their meaning in life, between the baseline and both times of post-intervention and 1-month follow-up. On the other hand, participants' family QoL have improved immediately in the midst of intervention. This study provides preliminary evidence to support the feasibility and effectiveness of an 8-week BPS-S group therapy. We recommend the BPS-S be integrated into routine institutional care activities to help maximize senior residents' own capacity for self-healing, achieve a state of harmonious balance between body, mind, social and spiritual relationships; and in turn, enhance holistic health of this group.

Effect of a long-term art-based group therapy with eating disorders.

Eating disorders (EDs) affect the physical, psychological, emotional and interpersonal areas of the individual and cause serious medical and mental consequences. Their treatment should be handled in a multidisciplinary manner.The objective of this study was to investigate potential benefits of long-term art-based group therapy (ABGT) as an adjunct to treatment for a variety of EDs. This study examined the effects of ABGT on disease symptoms, difficulty regulating emotions, depression, anxiety, targeted problems, functioning of individuals with EDs and therapeutic efficiency of the group. The study was carried out as a pre-test-post-test, quasi-experimental study with a control group, with a small sample diagnosed with an ED. In addition to their standard treatment at the outpatient centre, participants were included in a 30-week long-term semistructured ABGT focused on raising awareness of their psychological problems. Participants who received ABGT had significantly better functioning and lower severity of target problems compared with the control group. The severity of the three most important problems reported by patients post-ABGT compared with pre-ABGT and the effects of these problems on their social/private lives reduction was observed. The participants mostly benefited from catharsis, universality, self-understanding, existential factors and family re-enactment in the group process. Through the artwork, participants recognised the mental conflicts causing the symptoms of their ED. We found that art-based interventions are useful in the treatment of EDs, as they positively changed the functioning and symptoms of people with EDs. We recommend that clinicians keep these interventions in mind in formulating treatment protocols for these disorders.

Effects of school sandplay group therapy on children victims of cyberbullying.

Cyberbullying among children is increasing every year, leading to serious public health problems. Victims suffer serious aftereffects such as depression and suicidal ideation; therefore, early and appropriate psychological intervention and the role of schools are emphasized. This study investigated the effects of school sandplay group therapy (SSGT) on children affected by cyberbullying. This study was designed as a parallel-group non-randomized controlled trial. The study subjects were 139 elementary school students (mean age 11.35 years; standard deviation, 0.479; age range 12-13 years) residing in Cheonan City, Korea, who were assigned to the intervention and comparison groups. The intervention group received 10 sessions of therapy on a weekly basis, for 40 minutes per session. No therapy was administered in the control group. The effectiveness of the intervention was assessed using the Children Depression Inventory, Suicidal Ideation Questionnaire-Junior, and Rosenberg Self-Esteem Scale. The assessment for the comparison group was performed concurrently with that of the intervention group. Data were analyzed using multivariate analysis of variance. In this study, the SSGT group showed a significant decrease in depression and suicidal ideation compared to the control group after sandplay group therapy (SGT), and a significant increase in self-esteem. It was confirmed that SSGT can mitigate the negative consequences of cyberbullying and strengthen protective factors. This suggests that the SSGT can be successfully used for crisis counseling.

The effectiveness, acceptability, and sustainability of a 4-week DBT-informed group therapy in increasing psychological resilience for college students with mental health issues.

OBJECTIVE: An adapted, time-limited dialectical behavior therapy (DBT) skills training group therapy can prove to be an evidence-based treatment that can easily fit the needs, demands, and limitations of University Counseling Centers to serve college students with mental disorders. The present naturalistic study investigated the effectiveness, acceptability, and sustainability of a 4-week DBT-informed group therapy in enhancing psychological resilience. METHODS: Participants included 59 college students with heterogeneous mental health concerns. They attended weekly 1.5-hr DBT-informed, resilience-building group therapy for 4 weeks. Psychological resilience, mindfulness, emotional dysregulation, and overall distress were assessed at pretreatment and posttreatment, as well as at 1- and 3-month follow-ups. RESULTS: Findings showed increased psychological resilience among the participants at posttreatment and follow-ups, and provided preliminary evidence for the role of mindfulness as an important contributor to enhancing psychological resilience even after controlling for risk factors, treatment dosage, pregroup psychological resilience, and changes in emotion dysregulation and overall distress. CONCLUSION: A 4-week DBT-informed skills training group therapy can be utilized as a time-efficient, cost-effective, well-accepted preventative treatment with the potential longitudinal impact to boost psychological resilience for college students with mental health issues.

Stakeholder's experiences of living and caring in technology-rich supported living environments for tenants living with dementia.

BACKGROUND: Technology innovation provides an opportunity to support the rising number of people living with dementia globally. The present study examines experiences of people who have dementia and live in technology enriched supported care models. Additionally, it explores caregiver's attitudes towards technology use with the housing scheme. METHODS: A qualitative research design was adopted, and eight housing schemes consented to take part in the study. A technology audit was undertaken in addition to participant interviews and caregiver survey. Seven peer researchers conducted semi-structured interviews with 22 people living with dementia. Interviews were analysed using thematic analysis. Informal and formal caregivers were invited to complete a survey to capture their attitudes towards technology use. A total of 20 informal and 31 formal caregiver surveys were returned. All surveys were input into Survey Monkey and downloaded into excel for analysis. Closed questions were analysed using descriptive statistics and open-ended questions were organised into themes and described descriptively. RESULTS: The technology audit identified that technologies were in place from as early as 2002. Technology heterogeneity of, both passive and active devices, was found within the housing schemes. Technologies such as wearable devices were reportedly used according to need, and mobile phone use was widely adopted. The themes that developed out of the tenant interviews were: Attitudes and Engagement with Technology; Technology Enhancing Tenants Sense of Security; Seeking Support and Digital Literacy; and Technology Enabled Connection. A lack of awareness about living alongside technology was a major finding. Technologies enabled a sense of reassurance and facilitated connections with the wider community. The interaction with technology presented challenges, for example, remembering passwords, access to Wi-Fi and the identification of its use in an emergency. The caregiver survey reported a range of facilitators and barriers for the use of technology within care. Both types of caregivers held relatively similar views around the benefits of technology, however their views on issues such as privacy and consent varied. Safety was considered more important than right to privacy by family caregivers. CONCLUSIONS: The present study provides new insight into stakeholder's experiences of living, working and caregiving alongside technology in supported living environments. As the generation of people living with dementia become more tech savvy, harnessing everyday technologies to support care could enable holistic care and support the transition through the care continuum. Advance care planning and technology assessments are at the very core of future technology provision. It is evident that a paternalistic attitudes towards technology use could impact the multitude of benefits technology can play in both health and leisure for people living with dementia and their caregivers.

Concurrent and prospective associations between negative social-evaluative beliefs, safety behaviours, and symptoms during and following cognitive behavioural group therapy for social anxiety disorder.

BACKGROUND: Improving the delivery of cognitive-behavioural therapy (CBT) for social anxiety disorder (SAD) requires an in-depth understanding of which cognitive and behavioural mechanisms drive change in social anxiety symptoms (i.e., social interaction anxiety) during and after treatment. The current study explores the dynamic temporal associations between theory-driven cognitive and behavioural mechanisms of symptom change both during and following group CBT. METHODS: A randomized controlled trial of imagery-enhanced CBT (n = 51) versus traditional verbal CBT (n = 54) for social anxiety was completed in a community mental health clinic setting. This study included data collected from 12-weekly sessions and a 1-month follow-up session. Mixed models were used to assess magnitude of change over the course of treatment. Cross-lagged panel models were fit to the data to examine temporal relationships between mechanisms (social-evaluative beliefs, safety behaviours) and social interaction anxiety symptoms. RESULTS: Participants in both CBT groups experienced significant improvements across all cognitive, behavioural, and symptom measures, with no significant differences in the magnitude of changes between treatments. During treatment, greater social-evaluative beliefs (fear of negative evaluation, negative self-portrayals) at one time point (T) were predictive of more severe SAD symptoms and safety behaviours at T+1. Social-evaluative beliefs (fear of negative evaluation, probability and cost of social failure) and safety behaviours measured at post-treatment were positively associated with SAD symptoms at the 1-month follow-up. CONCLUSIONS: The current study identifies social-evaluative beliefs that may be important targets for symptom and avoidance reduction during and following CBT. Assessment of these social-evaluative beliefs throughout treatment may be useful for predicting future SAD symptoms and avoidance, and for adapting treatment to promote optimal change for patients.

Dropout from psychological treatment for borderline personality disorder: a multilevel survival meta-analysis.

BACKGROUND: Dropout from psychotherapy for borderline personality disorder (BPD) is a notorious problem. We investigated whether treatment, treatment format, treatment setting, substance use exclusion criteria, proportion males, mean age, country, and other variables influenced dropout. METHODS: From Pubmed, Embase, Cochrane, Psycinfo and other sources, 111 studies (159 treatment arms, N = 9100) of psychotherapy for non-forensic adult patients with BPD were included. Dropout per quarter during one year of treatment was analyzed on participant level with multilevel survival analysis, to deal with multiple predictors, nonconstant dropout chance over time, and censored data. Multiple imputation was used to estimate quarter of drop-out if unreported. Sensitivity analyses were done by excluding DBT-arms with deviating push-out rules. RESULTS: Dropout was highest in the first quarter of treatment. Schema therapy had the lowest dropout overall, and mentalization-based treatment in the first two quarters. Community treatment by experts had the highest dropout. Moreover, individual therapy had lowest dropout, group therapy highest, with combined formats in-between. Other variables such as age or substance-use exclusion criteria were not associated with dropout. CONCLUSION: The findings do not support claims that all treatments are equal, and indicate that efforts to reduce dropout should focus on early stages of treatment and on group treatment.

Mentalization-oriented psychodynamic group therapy for patients with personality disorders: a naturalistic prospective cohort study.

OBJECTIVES: Patients with personality disorders (PDs) are often treated with non-manualized psychodynamic group therapy (PDT) lasting for several years. Non-manualized PDT often combines a variety of therapeutic approaches from different PDT traditions, including mentalization-based therapy. Currently, little is known about the effect of this long-term, costly treatment. This study investigated the extent to which patients with different PDs benefit from mentalization-oriented PDT as it is implemented in clinical practice in terms of symptom severity, interpersonal problems, and general functioning. METHODS: The design was a naturalistic, prospective cohort study. Seventy-five consecutive PD patients were assessed before treatment with the Symptom Checklist-90 Revised (SCL-90-R) as the primary outcome measure and the Inventory of Interpersonal Problems (IIP) and Global Assessment of Functioning (GAF) as secondary outcome measures. The sample was repeatedly assessed every 12 months for up to 36 months. Paired t-tests were applied to examine the effectiveness of the intervention. RESULTS: Among completers (n = 42; 56%), improvement was observed on the SCL-90-R: Global Severity Index (mean change = -0.45 [95% CI = -0.72, -0.19]; Cohen's d = -0.55), Positive Symptom Distress Index (-0.40 [-0.63, -0.17]; -0.56); Positive Symptoms Total (-10.70 [-17.31, -4.09]; -0.52). Secondary outcomes also improved: IIP-total (mean change = -0.50 [95%CI = -0.74, -0.25]; Cohen's d = -0.66); GAF-Functioning (8.79 [6.32, 11.27]; 1.15); and GAF-Symptoms (10.67 [8.09, 13.25]; 1.34). CONCLUSIONS: Completers improved on symptom severity, interpersonal problems, and general functioning, with within-group effect sizes ranging from medium to large. Approximately half the sample dropped out, suggesting that mentalization-oriented PDT spanning several years may be unrealistic for many patients with PD. Significant outcomesThere are no clear guidelines for psychological interventions targeting personality disorders (PDs), and currently eclectic and non-manualized psychodynamic approaches lasting for up to 3 years are prevailing in some clinical practices.Although this treatment approach may have an effect on compliant patients, the high drop-out rate indicates that it may not be suitable for a large proportion of PD patients since it requires long-term commitment. Furthermore, it is difficult to identify the content of the non-manualized psychodynamic therapy and what helps the patients.More specific clinical guidelines emphasizing the application of evidence-based treatments or at least manualized treatments are warranted for the treatment of emotionally unstable PDs and other PDs. LimitationsThe naturalistic study design, without any control group, limits conclusions about mechanisms of action of the intervention.Since the intervention was not manualized, it is unknown exactly which treatment was actually administered, which reduces external validity.The outcomes are based on completer data of a relatively small sample size with high drop-out rate.

Using mindfulness-based stress reduction group therapy to reduce perceived stress of vulnerable women in south of Iran.

Provision of educational and health services to vulnerable women in drop-in centers can reduce their traumas. Mindfulness-Based Stress Reduction (MBSR) group therapy is a psychological intervention to reduce perceived stress these women. This quasi-experimental study aimed to evaluate the effectiveness of MBSR group therapy in the perceived stress of 63 vulnerable women who referred to two drop-in centers in southeastern Iran. The participants were assigned into the intervention (n = 30) and control (n = 33) groups. The intervention group members were required to attend the MBSR intervention held in eight 90-minute sessions. Perceived Stress Scale (PSS) was administered to collect data before and one month after the MBSR. Based on the findings, the pre-test scores of perceived stress were not significantly different between the intervention (38.16 ± 6.04) and control (39.06 ± 5.30) groups (t = -0.62, p = 0.53). However, the perceived stress scores reduced significantly in the intervention group (30.20 ± 2.89) than the control group scores (37.96 ± 4.18) in the posttest (t = -8.35, P = 0.001). Given the significant reduction of perceived stress in participants after attending the MBSR group therapy, expert counselors, psychologists, and psychiatrists are recommended to conduct this therapy to reduce perceived stress in vulnerable women.

Em busca das palavras: mediadores expressivos e expressão das emoções nos adolescentes / In search of words: expressive mediators and expression of emotions in adolescents

Possuir a capacidade de identificar as emoções e atribuir-lhes significado, é fundamental para a saúde mental dos adolescentes. Desta forma, facilitar o acesso às emoções e à sua expressão abre as portas à possibilidade dos adolescentes elaborarem as suas vivências, redifinirem significados e melhorarem a sua vida emocional, diminuindo os riscos para a sua saúde mental. Neste sentido, o projeto de investigação "Em busca das palavras ­ Mediadores expressivos e expressão das emoções nos adolescentes" é um projeto de investigação acção com abordagem mista (qualitativa e quantitativa), que pretende desenvolver uma intervenção terapêutica com um grupo de adolescentes, com recursos aos mediadores expressivos como facilitadores do acesso às emoções e à sua expressão. A intervenção desenvolveu-se com um grupo terapêutico de 6 adolescentes, em contexto de Hospital de Dia, com idades compreendidas entre os 14 e os 18 anos, mediado por dois Enfermeiros Especialistas em Enfermagem de Saúde Mental e Psiquiátrica. Foram planeadas 11 atividades para serem realizadas em 12 sessões, com a duração de 90 minutos cada, com recurso ao desenho, à pintura e à modelagem como mediadores expressivos, tendo por base o modelo do Continuum das Terapias Expressivas de Hinz (2009). A recolha e análise dos dados envolveu a observação participante, com recurso a notas de campo. Foi também aplicada a Escala da Expressividade Emocional (Kring, Smith, & Neale, 1994), validada para a população portuguesa, aplicada em dois momentos ­ antes do início do projeto e no final. A nível dos resultados, verificou-se que a utilização dos mediadores expressivos facilitou o acesso às emoções e a capacidade de expressão oral dos adolescentes, tendo melhorado a sua capacidade de exprimir as emoções e do reconhecimento destas pelo Outro.

Having the ability to identify emotions and attribute meaning to them is fundamental me adolescents' mental health. Thus, facilitating access to emotions and their expression opens the door to the possibility for adolescents to elaborate their experiences, redeem meanings and improve their emotional life, reducing the risks to their mental health. In this line of thought, the research project "Em busca das palavras ­ Mediadores expressivos e expressão das emoções nos adolescentes", is an action-research project with a mixed approach (qualitative and quantitative), which aims to develop a therapeutic intervention for groups of adolescents, with resources to expressive mediators as facilitators of access to emotions and their expression. The intervention was developed with a therapeutic group of 6 adolescents, in the context of Day Hospital, aged between 14 and 18 years, mediated by two Specialist Nurses in Mental and Psychiatric Health Nursing. Eleven activities were planned for twelve sessions, lasting 90 minutes each, using drawing, painting and modeling as expressive mediators, based on the Hinz Expressive Therapies Continuum model (2009). Data collection and analysis involved participant observation using field notes. The Emotional Expressiveness Scale (Kring, Smith, & Neale, 1994) was also applied, validated for the Portuguese population, applied in two moments ­ before the beginning of the project and at the end. As for the results, it was found that the use of expressive mediators facilitated access to emotions and the adolescents' ability of oral expression, which improved their ability to express emotions and their recognition by the Other.

Mediadores expressivos na prevenção da doença mental em crianças com long-COVID / Expressive mediators in the prevention of mental illness in children with long-COVID

O presente documento emerge do desenvolvimento do projeto de estágio, no âmbito da Especialização em Enfermagem de Saúde Mental e Psiquiátrica, com vista ao desenvolvimento e consolidação das competências específicas do Enfermeiro Especialista em Enfermagem de Saúde Mental e Psiquiátrica, em articulação com as competências do grau de Mestre. A componente comunitária do Estágio integrou um estudo de investigação alargado com o objetivo geral de avaliar o impacto a longo prazo da infeção por SARS-COV 2 na Saúde Mental da população pediátrica (dos 3 aos 12 anos e 364 dias). Avaliou-se o risco de psicopatologia através de uma triagem telefónica inicial, seguida de um questionário onde constavam questões relativas a três períodos distintos (antes, durante e após a infeção por SARS-COV 2) e um questionário SDQ (Strengths and Difficulties Questionnaire). Após a realização de uma consulta inicial de Enfermagem e de Psiquiatria da Infância e Adolescência às crianças, as crianças que se encontravam em risco de desenvolver psicopatologia iriam integrar uma intervenção terapêutica de prevenção em grupo. O desenvolvimento deste trabalho incidiu, sobretudo, na intervenção terapêutica de prevenção em grupo. Foi formado um grupo terapêutico de crianças com idades compreendidas entre os 4 e os 6 anos, que apresentavam risco de desenvolvimento de psicopatologia e/ou sintomas de Long COVID, em que se aplicou o desenho e a pintura como mediadores da relação e comunicação, entre outros mediadores, nomeadamente o de expressão dramática. Consoante os dados obtidos na primeira consulta médica e de enfermagem, estabeleceram-se os seguintes diagnósticos de enfermagem: comunicação (comprometida), interação social (prejudicada), ansiedade (presente), medo (presente), irritabilidade, inquietação, intolerância à frustração, comportamento de oposição. Assim, tendo em conta as necessidades em saúde mental de cada criança, procurou-se adequar a intervenção no sentido de promover a interação social, a comunicação, a expressão de emoções e sentimentos, e a diminuição dos níveis de inquietação e ansiedade. No final da intervenção, concluiu-se que a utilização do desenho e pintura enquanto mediador na comunicação e relação com crianças que estiveram infetadas por SARS-COV 2, quando mobilizado em terapia de grupo, pode apresentar benefício na prevenção do desenvolvimento de doença mental.

This paper presents the internship's project development, as part of the Mental Health and Psychiatry Nursing course, for the improvement and consolidation of specific capabilities of the specialised Nurse in Mental Health and Psychiatry nursing, to acquire competences and skills through the Master's degree. The internship's community component combined an extended investigation study with the purpose of evaluating the long-term impact of SARS-COV 2 infection in children's Mental Health (from 3 to 12 years-old and 364 days). The risk of psychopathology through an initial trial was evaluated, followed by a questionary that had questions regarding three distinctive periods (before, during and after the SARS-COV 2 infection) and a SDQ (Strengths and Difficulties Questionnaire) questionary. After the first medical and nursing appointment of child and adolescent psychiatry to children, it was identified the risk of having or had developed psychopathology. Considering its results, they were integrated in therapeutic groups. This work's development was mostly focused on its therapeutic group intervention phase. A children therapeutic group was formed (from 4 to 6 years old), that presented risk of developing symptoms of psychopathology and/or of Long-Covid; it was applied drawing and painting as a source of relationship and communication, as well as social drama. According to the acquired data from the first medical and nursing appointment, it was established the following nursing diagnosis: communication (compromised), social interaction (damaged), anxiety (present), fear (present), irritability, restlessness, impatience to frustration, opposition behaviour. Thereby, considering every child's Mental Health needs, it was sought to adequate the intervention in a way to promote social interaction, communication, expression of emotions and feelings, and to decrease the restlessness and anxiety levels. At the end of the intervention, it was concluded that the usage of drawing and painting as a guide in communication and establishing relationship with children that were infected with SARS-COV 2 may be beneficial in preventing Mental disorders.

Desenvolvimento das competências socioemocionais: Intervenção de enfermagem em grupo de adolescentes / Development of socio-emotional skills: Nursing intervention in a group of adolescents

O desenvolvimento de competências socioemocionais tem sido considerado como uma das componentes essenciais para uma educação de qualidade, possibilitando benefícios significativos no bem-estar e crescimento das crianças e adolescentes. A promoção destas competências permite a gestão das emoções, a promoção de relações interpessoais positivas, a aquisição de estratégias para a resolução de problemas, tomada de decisão de forma informada, o desenvolvimento de comportamentos sociais positivos e, consequentemente, a prevenção dos comportamentos de risco. Delinear projetos de intervenção que promovam o desenvolvimento destas competências desde a infância mostrou-se um tema prioritário e tem sido uma aposta frequente pelos vários profissionais no que toca à prevenção da doença mental. Quanto ao desenvolvimento de projetos sobre esta temática dirigido à fase da adolescência, a literatura encontra-se menos completa. Fez parte dos objetivos deste projeto de intervenção avaliar a importância e possível eficácia da implementação de intervenções que promovam o desenvolvimento de competências socioemocionais por meio de um grupo de adolescentes em situação de doença mental aguda, em contexto de internamento, com recurso a técnicas de dramatização. Pretendeu-se com isso compreender se este poderia constituir uma necessidade e ser parte integrante do projeto terapêutico individual de cada adolescente, como uma estratégia e um recurso facilitador bem como promotor de mudança de comportamento e de integração de novas estratégias para lidar com as várias questões que levam os adolescentes a adoecer mentalmente. Para este projeto de intervenção, procedeu-se à planificação e implementação de sessões de grupo onde se desenvolveram fundamentalmente intervenções no âmbito psicoterapêutico.

The development of socio-emotional skills has been considered an essential component for a quality education, enabling significant benefits in the well-being and growth of children and adolescents. The promotion of such skills allows the ability to manage emotions, the promotion of positive interpersonal relationships, the acquisition of strategies for solving problems, making informed decision, the development of positive social behaviors and, consequently, the prevention of risky behaviors. Outlining intervention projects that promote the development of these skills from childhood has proven to be a priority topic and has been a frequent priority by various professionals when it comes to the prevention of mental illness. However, for the development of projects on this theme aimed at adolescence, the literature is less complete. One of the main goals of this intervention project was to evaluate the importance and possible effectiveness of implementing interventions that promote the development of socio- emotional skills through a group of adolescents in a situation of acute mental illness, in a hospital context, using dramatization techniques. The aim was to understand if this could constitute a need and be an integral part of each adolescent's individual therapeutic project, as a strategy and resource that facilitates and promotes behavior change and the integration of new strategies to deal with the various issues that lead teenagers to become mentally ill. For this intervention project, group sessions were planned and implemented in which psychotherapeutic interventions were developed.