Relato de experiência de atendimentos em psicoterapia breve a partir da Abordagem Centrada na Pessoa: o cuidado ao processo de luto / Experience report of brief psychotherapy sessions from the person-centered approach: caring for the bereavement process of a family / Informe de experiencia de sesiones breves de psicoterapia desde el enfoque centrado en la persona: atención al proceso de duelo de un familiar

INTRODUÇÃO: A psicoterapia breve tem sido um importante recurso no atendimento aos casos de luto relacionados à perda de um familiar, de modo que estudos têm evidenciado a necessidade de aprofundamento nesta modalidade de atendimento. OBJETIVO: Este artigo tem como objetivo a apresentação e discussão de um relato de experiência de atendimento em psicoterapia breve a partir da Abordagem Centrada na Pessoa (ACP) e tem como tema central o processo de luto. METODOLOGIA: O relato de experiência se referiu a um processo de atendimento psicoterápico que ocorreu através do Projeto de Acolhimento da Universidade Federal da Bahia, entre setembro e dezembro de 2022, totalizando 10 encontros, sendo uma sessão semanal com duração de 50 minutos cada. Os atendimentos foram realizados remotamente. Através do relato de experiência, este trabalho buscou compreender o processo de luto de um familiar sob a luz do Modelo do Processo Dual do Luto, analisando a experiência da psicóloga no processo psicoterápico breve. RESULTADOS: Como resultados principais, observou-se que o processo de luto é um fenômeno natural e complexo e deve ser compreendido dentro das particularidades contextuais e culturais de cada indivíduo/família. CONCLUSÃO: Concluiu-se pontuando a importância da temática do luto na formação dos profissionais de saúde, em especial daqueles que lidam com essa demanda na sua prática profissional.

INTRODUCTION: Brief psychotherapy has been an important resource in the care of bereavement cases related to the loss of a family member, thus studies have shown the need to deepen this modality of care OBJECTIVE: This article aims to present and discuss an experience report of brief psychotherapy care from the person-centered approach, which has as its central theme the grieving process. METHODOLOGY: The experience report referred to a psychotherapeutic service that took place through the Projeto de Acolhimento da Universidade Federal da Bahia, between September and December 2022, totaling 10 meetings, with a weekly session lasting 50 minutes each. The consultations were carried out remotely. Through an experience report, this paper sought to understand the grieving process of a family member under the Dual Grief Process Model, analyzing the psychologist's experience in the brief psychotherapeutic process. RESULTS: As the main results, the study observed that the grieving process is a natural and complex phenomenon. In this sense, the necessary study points to understanding the grieving process within the contextual and cultural particularities of each individual/family. CONCLUSION: It was concluded by pointing out the importance of the theme of mourning in the training of health professionals, especially those who deal with this demand in their professional practice.

INTRODUCCIÓN: La psicoterapia breve ha sido un recurso importante en la atención de casos de duelo relacionados con la pérdida de un familiar, por lo que los estudios han mostrado la necesidad de profundizar en esta modalidad de atención. OBJETIVO: Este artículo tiene como objetivo presentar y discutir un relato de experiencia de atención psicoterapéutica breve desde el enfoque centrado en la persona, que tiene como tema central el proceso de duelo. METODOLOGÍA: El informe de la experiencia se refirió a un servicio psicoterapéutico que tuvo lugar a través del Projeto de Acolhimento da Universidade Federal da Bahia, entre septiembre y diciembre de 2022, con un total de 10 reuniones, con una sesión semanal de 50 minutos cada una. Las consultas se realizaron a distancia. A través del relato de la experiencia, este trabajo trató de comprender el proceso de duelo de un familiar a la luz del Modelo Dual de Proceso de Duelo, analizando la experiencia de la psicóloga en el proceso psicoterapéutico breve. RESULTADOS: Como principales resultados, se concluyó que el proceso de duelo es necesario, delicado y debe ser comprendido dentro de las particularidades contextuales y culturales de cada individuo/familia. CONCLUSIÓN: Se concluyó señalando la importancia del tema del duelo en la formación de los profesionales de la salud, especialmente de aquellos que atienden esta demanda en su práctica profesional.

Behavioral Health Workforce Development in Washington State: Addition of a Behavioral Health Support Specialist.

The mental and behavioral health workforce shortage has hindered access to care in the United States, resulting in long waitlists for persons who need behavioral health care. Global models for task sharing, combined with U.S.-led studies of nonspecialists delivering interventions for depression and anxiety, support the development of this workforce in a stepped care system. This Open Forum highlights an innovative effort in Washington State to initiate a bachelor's-level behavioral health support specialist curriculum leading to credentialing to expand the mental health workforce and improve access to care for people with depression and anxiety.

Value-Based Proposition of an Adapted Integrated Care Telehealth Service for Accountable Care Organization Members.

The authors describe a real-world application of virtually integrated primary and behavioral health care implemented within an accountable care organization (ACO) system. Cost-of-care data from before and after a 6-month intervention were analyzed for 121 Medicaid and Child Health Plan Plus ACO members. The intervention was associated with a significant shift in the distribution of health care costs, from inpatient and emergency care to outpatient and preventive care. The program demonstrates a flexible and replicable approach to integration that can help expand effective primary care.

Effects of Dignity Therapy on individuals with amyotrophic lateral sclerosis: Case studies.

OBJECTIVES: To analyze the effects of Dignity Therapy (DT) on the physical, existential, and psychosocial symptoms of individuals with amyotrophic lateral sclerosis (ALS). METHODS: This is a mixed-methods case study research that used the concurrent triangulation strategy to analyze the effects of DT on 3 individuals with ALS. Data collection included 3 instances of administering validated scales to assess multiple physical symptoms, anxiety, depression, spiritual well-being, and the Patient Dignity Inventory (PDI), followed by the implementation of DT and a semi-structured interview. RESULTS: The scale results indicate that DT led to an improvement in the assessment of physical, social, emotional, spiritual, and existential symptoms according to the score results. It is worth noting that the patient with a recent diagnosis showed higher scores for anxiety and depression after DT. Regarding the PDI, the scores indicate improvements in the sense of dignity in all 3 cases, which aligns with the positive verbal reports after the implementation of DT. SIGNIFICANCE OF RESULTS: This study allowed us to analyze the effects of DT on the physical, existential, and psychosocial symptoms of individuals with ALS, suggesting the potential benefits of this approach for this group of patients. Participants reported positive effects regarding pain and fatigue, could reflect on their life trajectories, and regained their value and meaning.

Design of a hybrid implementation effectiveness cluster randomized controlled trial of delivering written exposure therapy for PTSD in underserved primary care settings.

INTRODUCTION: Posttraumatic stress disorder (PTSD) results in substantial costs to society. Prevalence of PTSD among adults is high, especially among those presenting to primary care settings. Evidence-based psychotherapies (EBPs) for PTSD are available but dissemination and implementation within primary care settings is challenging. Building Experience for Treating Trauma and Enhancing Resilience (BETTER) examines the effectiveness of integrating Written Exposure Therapy (WET) within primary care collaborative care management (CoCM). WET is a brief exposure-based treatment that has the potential to address many challenges of delivering PTSD EBPs within primary care settings. METHODS: The study is a hybrid implementation effectiveness cluster-randomized controlled trial in which 12 Federally Qualified Health Centers (FQHCs) will be randomized to either CoCM plus WET (CoCM+WET) or CoCM only with 60 patients within each FQHC. The primary aim is to evaluate the effectiveness of CoCM+WET to improve PTSD and depression symptom severity. Secondary treatment outcomes are mental and physical health functioning. The second study aim is to examine implementation of WET within FQHCs using FQHC process data and staff interviews pre- and post-intervention. Exploratory aims are to examine potential moderators and mediators of the intervention. Assessments occur at baseline, and 3- and 12-month follow-up. CONCLUSION: The study has the potential to impact practice and improve clinical and public health outcomes. By establishing the effectiveness and feasibility of delivering a brief trauma-focused EBP embedded within CoCM in primary care, the study aims to improve PTSD outcomes for underserved patients. TRIAL REGISTRATION: (Clinicaltrials.govNCT05330442).

Brief Cognitive-Behavioral Therapy for Depression in Community Clinics: A Hybrid Effectiveness-Implementation Trial.

OBJECTIVE: The authors examined whether brief cognitive-behavioral therapy (bCBT) for depression, delivered by mental health providers in community-based outpatient clinics (CBOCs) of the Veterans Health Administration, improved depression outcomes and was feasible and acceptable in clinical settings. METHODS: The authors used a type-2 hybrid effectiveness-implementation, patient-randomized trial to compare bCBT with enhanced usual care. Participants (N=189) with moderate symptoms of depression (Patient Health Questionnaire-9 [PHQ-9] score ≥10) were enrolled from CBOCs in the southern United States. bCBT (N=109) consisted of three to six sessions, delivered by mental health providers (N=17) as part of routine clinic practices. Providers received comprehensive training and support to facilitate bCBT delivery. Recipients of enhanced usual care (N=80) were given educational materials and encouraged to discuss treatment options with their primary care provider. The primary effectiveness outcome was PHQ-9-assessed depression symptoms posttreatment (4 months after baseline) and at 8- and 12-month follow-ups. Implementation outcomes focused on bCBT dose received, provider fidelity, and satisfaction with bCBT training and support. RESULTS: bCBT improved depression symptoms (Cohen's d=0.55, p<0.01) relative to enhanced usual care posttreatment, and the improvement was maintained at 8- and 12-month follow-ups (p=0.004). bCBT participants received a mean±SD of 3.7±2.7 sessions (range 0-9), and 64% completed treatment (≥3 sessions). Providers delivered bCBT with fidelity and reported that bCBT training and support were feasible and effective. CONCLUSIONS: bCBT had a modest treatment footprint of approximately four sessions, was acceptable to participants and providers, was feasible for delivery in CBOCs, and produced meaningful sustained improvements in depression.

Anxiety and Depression in Family Members of Critically Ill Covid-19 Inpatients: Brief Psychological Interventions via Telephone, an Exploratory Study.

Purpose: This study aimed to assess the level of anxiety and depression in relatives of critically ill COVID-19 patients admitted to the intensive care unit (ICU), and to perform an exploratory pilot study on the implementation of telephone psychological interventions to reduce the initial levels of anxiety and depression in this population. Patients and Methods: Family members of COVID-19 inpatients at ICU answered GAD-7, PHQ-9 and questions on socio-demographic data. A brief psychological intervention was applied via telephone based on the needs of the participants (with adequate adaptation, with symptoms of anxiety, depression, or both). After intervention, participants completed the Patient Global Impression of Change Scale. Results: A total of 1307 relatives were included (66.5% female), 34% and 29% had anxiety and depressive symptoms, respectively. These symptoms were associated with female gender, unemployment, and being the parent or partner of the patient. After intervention, 57.9% reported felt better, 31.3% a little better and 6.6% much better; and with emotional regulation techniques and psychoeducation, higher percentages of feeling better or much better were reported. Conclusion: Brief interventions to reduce the psychological impact of inpatient family members could be effective but will need to be explored further in future studies.

Relato de Experiência: Escuta Clínica, HIV/AIDS e Covid-19 / Experience report: Clinical Listeling, HIV/AIDS and Covid-19 / Experience Report: Clinical Listening, HIV/AIDS and Covid-19

O artigo compartilha um relato de experiência de atendimento psicológico a pessoas que vivem com HIV/AIDS na pandemia causada pela covid-19, da Campanha Voluntariado pelas Américas Covid-19 e HIV/AIDS. A proposta busca colaborar com a tessitura de elaborações teóricas e técnicas sobre a escuta clínica, especialmente em sua forma remota. O atendimento psicológico virtual, de curta duração, foi realizado por 14 psicólogas voluntárias, a maioria ancorada na Psicanálise. A escuta orientou-se pela avaliação da angústia central a partir da queixa-sintoma, avaliando riscos, fatores estressantes e apoios. Amparou-se na noção de clínica ampliada, na articulação com as ações da campanha relacionadas à falta de medicamentos e à carência de alimentos, com encaminhamentos para a rede de atenção à saúde. Considerou o sofrimento psíquico associado a vulnerabilidades socioeconômicas a partir do dispositivo da necropolítica. O sofrimento emocional foi atravessado pelo adoecimento físico, por questões relativas à covid-19, e pela atualização de sentimentos vivenciados com o HIV, tais como: não aceitação do diagnóstico, medo da morte, abandono, isolamento e estigmas. Conclui-se que a escuta psicológica deu suporte emocional às pessoas em momento de intenso sofrimento psíquico. A empatia, o afeto e a solidariedade foram teias de resistência no momento de crise sanitária.

The article shares an experience report of psychological care for people living with HIV/AIDS in the pandemic caused by covid-19, from the Campaign Volunteering for the Americas Covid-19 and HIV/AIDS. The proposal seeks to collaborate with the fabric of theoretical and technical elaborations on clinical listening, especially in its remote form. The virtual psychological care, of short duration, was carried out by 14 volunteer psychologists, the majority referenced by Psychoanalysis. The listening was guided by the assessment of the central anguish based on the symptom-complaint, assessing risks, stressors and supports, based on the notion of an expanded clinic, in articulation with the actions of the campaign related to the lack of medication and the lack of food, with referrals to the health care network. It considered psychic suffering associated with socioeconomic vulnerabilities from the necropolitics device. Emotional suffering was crossed by physical illness, by issues related to covid-19, and by updating feelings experienced with HIV, such as non-acceptance of the diagnosis, fear of death, abandonment, isolation and stigma. In conclusion, psychological listening provided emotional support to people in times of intense psychic suffering. Empathy, affection and solidarity were webs of resistance in times of health crisis.

El artículo comparte un relato de experiencia de atención psicológica a personas viviendo con VIH/SIDA durante la pandemia de covid-19, de la Campaña Voluntariado por las Américas Covid-19 y VIH/SIDA. Busca colaborar con la construcción de elaboraciones teóricas y técnicas sobre la escucha clínica, especialmente en su modalidad a distancia. La atención psicológica virtual, de corta duración, estuvo a cargo de 14 psicólogas voluntarias, la mayoría ancladas en el Psicoanálisis. La escucha considerada la valoración de la angustia central a partir del síntoma-queja, valorando riesgos y soportes, sustentada en la noción de clínica ampliada, junto con el apoyo a la falta de alimentos e de medicamentos. Considerado el sufrimiento psíquico asociado a las vulnerabilidades socioeconómicas a partir del dispositivo de la necropolítica. El sufrimiento emocional estuvo atravesado por la enfermedad física, relacionadas con el covid-19, y por la actualización de sentimientos vividos con el VIH, como la no aceptación del diagnóstico, el miedo a la muerte, el abandono, el aislamiento y el estigma. Se concluye que la escucha psicológica brindó apoyo emocional a las personas en momentos de intenso sufrimiento psíquico. La empatía, el cariño y la solidaridad fueron redes de resistencia en momentos de crisis sanitaria.

Identificando las trayectorias de cambio terapéutico en psicoterapia breve en pacientes chilenos / Identifying trajectories of therapeutic change in brief psychotherapy in Chilean outpatients

Antecedentes: identificar subgrupos de pacientes que demuestren diferentes trayectorias de cambio terapéutico durante psicoterapia en contextos realistas es relevante para el desarrollo de procesos terapéuticos personalizados y efectivos. Objetivos: El presente estudio tuvo como objetivos (a) identificar trayectorias de cambios terapéutico en pacientes chilenos (b) explorar variables que puedan predecir la probabilidad de pertenecer a ciertas trayectorias y (c) examinar si estas diferentes trayectorias desembocan en distintos resultados terapéuticos. Método: se llevaron a cabo análisis de modelos de crecimientos mixto (Growth Mixture Modeling - GMM) y regresiones logísticas multinominales en una muestra de 400 pacientes chilenos recibiendo psicoterapia en un centro de salud mental privado. Resultados: se identificaron tres trayectorias de cambio terapéutico (a) disfunción inicial moderada con leve deterioro, (b) disfunción inicial leve con cambio favorable y (c) disfunción inicial severa con rápido cambio favorable. La edad de los pacientes fue considerada un factor predictor de trayectoria significativa, sugiriendo una peor prognosis para pacientes de mayor edad. Además, todas las trayectorias fueron predictoras del resultado terapéutico. Conclusiones: estos resultados pueden ser utilizados para desarrollar intervenciones enfocadas en el paciente, basadas en las trayectorias de cambio que exhiban.

Background: Identifying subgroups of patients that may show distinct trajectories of change during psychotherapy in realistic settings is relevant for the development of personalized therapeutic processes. Aims: The present study sought to (a) identify trajectories of change in Chilean patients; (b) explore variables that may predict the likelihood of belonging to certain trajectories; and (c) examine whether these different trajectories result in differences in treatment outcomes. Method: Growth mixture modeling (GMM) and multinomial logistic regression analysis were carried out on the data of 400 patients receiving psychotherapy at a private outpatient clinic in Chile. Results: Three trajectories of change were identified: (a) moderate initial dysfunction with slight deterioration, (b) mild initial dysfunction with favorable change, and (c) high initial dysfunction with rapid favorable change. Patient's age was found to be a significant predictor of trajectory assigned, suggesting a poorer prognosis for older patients. Moreover, the trajectories were significant predictors of treatment outcome. Conclusions: These results can be used to develop patient-specific therapeutic interventions based on the trajectories they exhibit.

The Acceptability of a Recovery Group Intervention in Acute Inpatient Mental Health Wards.

The aim of the present study was to evaluate the feasibility and explore the service user experience of a recovery-focused group intervention delivered in acute inpatient wards in a National Health Service (NHS) Trust in England, United Kingdom. Feedback from the Recovery Group Questionnaire given to patients who had attended the Recovery Group whilst admitted to acute inpatient wards was collated and analysed. The results suggest that patients found the group useful and supportive, as well as easy to follow. Themes which emerged from the content analysis included, value, challenges, support and understanding. The feedback also showed that patients found having an Expert by Experience co-facilitating was beneficial. The Recovery Group is an acceptable and feasible group intervention for those who are admitted to acute inpatient wards. Further research examining the clinical effectiveness of the intervention may be considered, however there are some barriers to doing so given the open-access format of the group.

Experience of application of the meaning-centered psychotherapy to Japanese bereaved family of patients with cancer - A mixed-method study.

OBJECTIVES: This study aimed to adapt the meaning-centered psychotherapy (MCP) to treat post-bereavement grief in Japanese bereaved families who lost their loved ones to cancer and to examine the feasibility of the intervention using both quantitative and qualitative methods. METHODS: A modified version of MCP was developed with cultural consideration. Bereaved individuals aged ≥18 years who had lost their family members to cancer at least 6 months before and had severe or persistent grief with a score of ≥26 on the Inventory of Complicated Grief (ICG-19) were included in the study. The participants received the modified version of MCP, which was provided in a 5-session monthly format. The levels of grief (ICG-19), depression (Center for Epidemiologic Studies Depression Scale [CES-D]), general health (General Health Questionnaire-12), and post-traumatic growth (Post-traumatic Growth Inventory -Short Form) were compared before and after the intervention. RESULTS: Five bereaved individuals were enrolled, and all the participants completed the program. The mean scores of the ICG-19. The participants' sense of regret, guilt, and being separated from the deceased person gradually shifted to the reappraisal of the experience, leading to a broadened view of the relationship with the deceased, and rediscovery of the core values, identity, and roles of the participants through the process of rediscovery of the meaning of life. SIGNIFICANCE OF RESULTS: A modified version of the MCP was well accepted by Japanese bereaved families. The intervention appears to promote the rediscovery of the meaning of life and appears to have the potential to alleviate the bereaved individuals' depression and grief-related symptoms and to facilitate their post-traumatic growth.

Risk factors for initial appointment non-attendance at Improving Access to Psychological Therapy (IAPT) services: A retrospective analysis.

BACKGROUND: Approximately 1.5 million referrals are made to Improving Access to Psychological Therapy (IAPT) services annually. However, treatment is received in less than half of cases due to ineligibility or non-attendance. The aim was to explore risk factors for non-attendance at the initial two IAPT appointments following referral. METHODS: An exploratory, retrospective analysis of referral and attendance data from five IAPT services in the North of England. Participants were 97,020 referrals received 2010-2014. Main outcome was attendance at the first two offered appointments (assessment and initial treatment). RESULTS: Based on data from two services, 66% of referrals resulted in assessment attendance. Across all five services 57% of patients who attended for assessment subsequently attended the first treatment appointment. The odds of attending an assessment appointment were more than 3 times higher for self-referrals than for GP referrals (OR 3.46, 95% CI 3.27-3.66, p < 0.001). Factors important to treatment appointment attendance following assessment were the service, referral source, presenting problem, and anxiety severity. CONCLUSION: Initial appointment non-attendance is a consistent problem for IAPT services. Specific factors that may support IAPT services to improve non-attendance rates are identified. IAPT indicators of success should take account of non-attendance at initial appointments.

Prevention of posttraumatic stress during inpatient rehabilitation post spinal cord injury: Study protocol for a randomized controlled trial of Brief Prolonged Exposure Therapy (Brief PE).

Background: Scant research has focused on posttraumatic stress disorder (PTSD) in the SCI population, despite high prevalence estimates. Fortunately, prolonged exposure therapy (PE) is a well-researched and highly effective treatment for PTSD. Our recent clinical trial showed that standard 12-session PE was effective for PTSD treatment among inpatients with SCI. Early intervention with brief PE (3-sessions) delivered in the emergency department has also been effective for PTSD prevention, but has not been tested among people post-SCI. Thus, we aim to conduct the first test of the Brief PE intervention to prevent PTSD among patients with SCI. Methods: Adults who have experienced a SCI (N = 200) will be randomly assigned during inpatient rehabilitation to either: (a) 3 60-min sessions of Brief PE (intervention group) or (b) treatment as usual (control group). Results: The primary outcome measure (PTSD symptoms measured by the PSSI-5) and secondary outcome measures (depression, anxiety, pain, quality of life, sleep disturbance, and resilience) will be assessed at baseline, 1-month, 3-months, and 6-months. Hierarchical linear modeling (HLM) will be used to evaluate the effectiveness of the PE intervention on PTSD and secondary outcomes. Descriptive statistics will examine feasibility and will include the number of participants enrolled, the number of sessions completed, fidelity of Brief PE delivery, and average scores for difficulty and helpfulness of the intervention scales for those randomized to intervention. Conclusions: Successful completion of this study will provide an evidence-based program to alleviate posttraumatic distress post spinal cord injury and prevent long-term development of PTSD.

Efeito de intervenções breves na redução do consumo de álcool em adultos: revisão sistemática / The effect of brief interventions on reducing alcohol consumption in adults: a systematic review / Efecto de las intervenciones breves en la reducción del consumo de alcohol en adultos: revisión sistemática

RESUMO Objetivo: sintetizar evidências sobre efeitos das intervenções breves na redução do consumo de bebidas alcóolicas entre adultos. Método: estudo de revisão sistemática, cadastrado protocolo na International Prospective Register of Systematic Reviews, registro nº CRD42020153034. A busca foi realizada em 2020, em bases de dados eletrônicas e foram incluídos ensaios clínicos randomizados que avaliavam os efeitos de Intervenções Breve em adultos bebedores de álcool. Resultados: foram avaliados 11 artigos. Todos os estudos realizaram, nos grupos controle e experimental, teste de identificação do padrão de consumo de álcool, com oferta de feedback para o usuário em seguida. As intervenções utilizam metodologias que incitam o usuário à tomada de decisão, bem como manter a decisão tomada e evitar recaídas. Conclusão: esta pesquisa contribui para o ensino e assistência em saúde, por meio de reflexões sobre a identificação do abuso de álcool e compilado sobre a aplicação e impacto das Intervenções Breves.

ABSTRACT Objective: to synthesize evidence on the effects of brief interventions on reducing alcohol consumption among adults. Method: systematic review study, protocol registered in the International Prospective Register of Systematic Reviews, registration no. CRD42020153034. The search was conducted in 2020, in electronic databases and randomized clinical trials that evaluated the effects of Brief Interventions in adult alcohol drinkers were included. Results: 11 articles were evaluated. All studies performed, in the control and experimental groups, a test to identify the pattern of alcohol consumption, with feedback offered to the user afterwards. The interventions use methodologies that encourage the user to make a decision, as well as maintain the decision made and avoid relapse. Conclusion: this research contributes to health care teaching and assistance, through reflections on the identification of alcohol abuse and compiled on the application and impact of Brief Interventions.

RESUMEN Objetivo: sintetizar las pruebas sobre los efectos de las intervenciones breves para reducir el consumo de alcohol entre los adultos. Método: estudio de revisión sistemática, protocolo registrado en el Registro Internacional Prospectivo de Revisiones Sistemáticas, número de registro CRD42020153034. La búsqueda se realizó en 2020, en bases de datos electrónicas y se incluyeron ensayos clínicos aleatorios que evaluaron los efectos de las Intervenciones Breves en bebedores de alcohol adultos. Resultados: Se evaluaron 11 artículos. Todos los estudios realizaron, en los grupos de control y experimental, una prueba para identificar el patrón de consumo de alcohol, con una retroalimentación ofrecida al usuario después. Las intervenciones utilizan metodologías que incitan al usuario a tomar una decisión, así como a mantener la decisión tomada y evitar recaídas. Conclusión: esta investigación contribuye a la docencia y a la atención sanitaria, a través de reflexiones sobre la identificación del abuso de alcohol y recopiladas sobre la aplicación y el impacto de las Intervenciones Breves.

A mixed methods study of an online intervention to reduce perfectionism.

Perfectionism is linked to a variety of mental health conditions in university students. Guided by the Perfectionism Social Disconnection Model, the purpose of the current mixed methods feasibility study was to evaluate the acceptability and potential effectiveness of a brief online intervention designed to reduce the negative consequences of perfectionism in university students. Seventy university students (83.9% female; M age = 19) reporting moderate to extreme levels of perfectionism completed the two hour 'Intentional Imperfection Program' (IIP). The IIP includes techniques to increase mindfulness, compassion for self and others, distress tolerance, and social skills. Participants completed self-report measures at baseline and at a two-week follow-up. Quantitative data showed statistically significant small to moderate reductions in self-oriented perfectionism (d = -0.48, p < .001), socially-prescribed perfectionism (d = 0.40, p < .001), hostility (r = 0.53, p < .001), rejection sensitivity (d = 0.37, p < .001), depression (r = -0.47, p < .001), and anxiety (r = -0.33, p = .010) and a small increase in perceived social support (r = -0.29, p = .023). Thematic analyses of qualitative data indicated that participants found the IIP feasible, enjoyable, and useful. A brief online intervention may be a feasible way of reducing the negative consequences of perfectionism among university students. A randomised control trial is warranted to further evaluate the efficacy of the IIP. This research was registered with the Australian New Zealand Clinical Trials Registry (no. ACTRN12620000574943).

Character Strength-Focused Positive Psychotherapy on Acute Psychiatric Wards: A Feasibility and Acceptability Study.

OBJECTIVE: A manualized single-session positive psychotherapy intervention was developed and tested on acute psychiatric wards. METHODS: Participants were invited in 2018-2019 to identify positive experiences, link them to a personal character strength, and plan a strengths-based activity. The intervention's feasibility was evaluated through fidelity to session components, character strengths identification, and activity completion. Acceptability was evaluated with self-reported pre- and postsession mood ratings, a postsession helpfulness rating, and narrative feedback. RESULTS: Participants (N=70) had complex and severe mental health conditions. In 18 group sessions, 89% of components were delivered with fidelity; 80% of the participants identified a character strength, of whom 71% identified a strengths-based activity, and 58% completed the activity. The mean±SD helpfulness rating (N=23) was 8.5±1.5 (on a 10-point Likert scale), and positive mood significantly increased postsession (5.9 presession vs. 7.2 postsession). CONCLUSIONS: Positive psychotherapy is feasible in challenging inpatient settings, and service users with severe and complex mental health conditions find it helpful.

Countertransference types and their relation to rupture and repair in the alliance.

Background Ruptures in the alliance are co-constructed by clients and therapists, reflecting an interaction between their respective personality configurations [Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. Guilford Press]. In order to work effectively with ruptures, therapists should be aware of their own feeling states, acknowledging the subjectivity of their perceptions [Safran, J. D. (2002). Brief relational psychoanalytic treatment. Psychoanalytic Dialogues, 12(2), 171-195. https://doi.org/10.1080/10481881209348661]. Lack of such awareness may be a product of countertransference (CT), which has been shown to be inversely related to outcome. However, when effectively managed, CT contributes to positive outcome [Hayes, J. A., Gelso, C. J., Goldberg, S., & Kivlighan, D. M. (2018). Countertransference management and effective psychotherapy: Meta-analytic findings. Psychotherapy, 55(4), 496-507. https://doi.org/10.1037/pst0000189]. Objectives: The present study examined the associations between types of CT and therapists' reports of ruptures and resolutions. Method: Data were collected from 27 therapists, who treated 67 clients in yearlong psychodynamic psychotherapy. CT patterns were assessed based on therapists' Core Conflictual Relationship Themes with their parents, which were repeated in narratives about their clients [Tishby, O., & Wiseman, H. (2014). Types of countertransference dynamics and their impact on the client-therapist relationship. Psychotherapy Research, 24(3), 360-375. https://doi.org/10.1080/10503307.2014.893068]. Results: Negative CT patterns were associated with more ruptures and less resolution. Positive patterns predicted resolution when the therapists repeated positive patterns with parents, but predicted ruptures when they tried to "repair" negative patterns with the parents. These results point to the importance of therapists' awareness of their CT in order to deal effectively with ruptures and facilitate resolution.

Effectiveness of brief group transdiagnostic therapy for emotional disorders in primary care: A randomized controlled trial identifying predictors of outcome.

AbstractBrief transdiagnostic psychotherapy is a possible approach for emotional disorders in primary care. The objective of the present randomized controlled trial was to determine its effectiveness compared with the treatment as usual based on pharmacological interventions in patients with mild/moderate symptoms. In addition, emotional regulation strategies and cognitive factors were studied as potential predictors. Participants (N = 105) were assigned to brief group therapy based on the Unified Protocol (n = 53) or treatment as usual (n = 52). They were assessed before and after the interventions. Mean differences and stepwise regression analyses were performed. Brief group transdiagnostic psychotherapy was more effective than medication in reducing all clinical symptoms (p = .007 for generalized anxiety; p = .000 for somatization; p = .000 for panic disorder; and p = .041 for depression) and in modifying emotional regulation strategies and cognitive processes (p = .000 for cognitive reappraisal, expressive suppression, worry, rumination, and metacognition) with moderate/high effect sizes. Besides, it was found that these variables acted as predictors of the therapeutic change. It is concluded that brief therapies could be an accurate treatment for mild/moderate emotional disorders in primary care due to their cost-effective characteristics.

Outcomes of brief versions of Dialectical Behaviour Therapy for diagnostically heterogeneous groups in a routine care setting.

INTRODUCTION: Brief versions of Dialectical Behaviour Therapy (DBT) may enhance patient outcomes in diverse service settings. This study examined the effectiveness of two DBT-informed treatments for diagnostically heterogeneous groups in routine practice: 5-day group training in DBT skills (DBT-5) and a 12-week DBT program (DBT-12). METHODS: : Depression, anxiety, stress, borderline symptoms, self-esteem, and general mental wellbeing were measured at pre-and post-treatment in a sample of inpatients and outpatients (N=395). Rates of clinically significant change on these measures were calculated and effect sizes benchmarked against prior DBT outcome studies. Readmission rates were used to measure treatment response maintenance. RESULTS: : Scores on all measures improved significantly from pre- to post-treatment. DBT-5 and DBT-12 yielded similar effect sizes compared to prior DBT outcome studies. At least 43.5% of patients were classified as recovered or improved regarding borderline symptoms at the end of both DBT-5 and DBT-12. Readmission rates were also low (5%-6.8%). CONCLUSIONS: Brief DBT-informed treatments may offer a fast reduction in symptoms and quicker return to functioning.

Barriers to Increasing Access to Brief Pediatric Mental Health Treatment From Primary Care.

A quality improvement process targeted mental health care uptake and system capacity in an underserved region. The pediatric program created pathways for rapid referral from primary care and schools to four sessions of evidence-based treatments for disruptive behavior and depression with community clinicians. Of 250 referrals, 46 families enrolled in treatments for disruptive behavior and 21 for depression. Many families did not respond or required more intensive treatment. Acceptability of the program was high for participating families, referrers, and clinicians. Brief treatment met most participating families' needs. The process demonstrated barriers to mental health care access and delivery and the need for integrated and multitiered care delivery.