Psychoeducational group interventions for adults diagnosed with attention-deficit/ hyperactivity disorder: a scoping review of feasibility, acceptability, and outcome measures.

INTRODUCTION: Although psychoeducational group interventions are increasingly used for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), a comprehensive review focused on the feasibility and acceptability indicators of these interventions remains lacking. Furthermore, although previous research has explored various aspects of psychoeducation for ADHD, such as its definition and approaches, limited research has focused on the synthesis for outcome measures and patients' experiences related to these interventions. Therefore, this scoping review aims to map the existing evidence reported on psychoeducational group interventions for adults diagnosed with ADHD. The objective is to provide a comprehensive overview of feasibility indicators, acceptability, and outcome measures used in psychoeducational group interventions. METHOD: A comprehensive structured literature search on the topic was performed in seven bibliographic databases, and the resulting records were independently screened, and their data extracted by two reviewers. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-S) to ensure the transparency and rigor of this scoping review. RESULTS: The searches yielded 7510 records. Eight studies met the inclusion criteria. These included studies were conducted in European countries and the United States. Among these, six studies used a randomized control design, one an open feasibility trial, and one a pre-post intervention design. All the studies reported some feasibility and acceptability indicators. While all the studies reported on the severity of symptoms of ADHD as an outcome measure, some also reported on outcomes related to psychological or mental-health problems, quality of life, changes in knowledge regarding ADHD, or the level of self-esteem, functioning, and impairment. CONCLUSION: This scoping review revealed that psychoeducational group interventions are generally acceptable for patients in terms of patient satisfaction with the group intervention. All included studies reported some feasibility indicators, with some reporting good attendance and relatively low dropout rates. Most studies reported positive effects on ADHD and mental health symptoms, suggesting that these interventions are beneficial for adults with ADHD. However, several gaps exist regarding the reporting on the feasibility indicators, acceptability, and outcome measures employed across studies.

The construct validity of an abridged version of the general self-efficacy scale for adults with attention-deficit/hyperactivity disorder.

Objectives: The General Self-Efficacy (GSE) scale is a validated self-rated questionnaire increasingly used in mental health research. However, despite several psychometric advantages of the GSE scale, its validity in those diagnosed with attention-deficit/hyperactivity disorder (ADHD) has not yet been examined. Moreover, a shorter version of the GSE scale would contribute to a more rational use of resources in extensive multivariate studies. Therefore, as self-rated scales to measure self-efficacy in this population are lacking, the current study aims to develop a condensed version of the GSE for adults with ADHD. Methods: A group of patient collaborators (user representatives) from an ADHD organization and health professionals shortened the original 10-item GSE scale to six items and evaluated the content validity of the revised scale. Second, 525 potential participants were invited to participate in a cross-sectional study conducted in 2021 (between January 19th and February 7th). Of them, 403 filled out the GSE-6 for ADHD and two scales measuring psychological well-being and mental health (the five-item World Health Organization Well-Being Index, WHO-5, and the four-item Patient Health Questionnaire, PHQ-4). The psychometric properties of the new scale were examined, testing a priori formulated hypotheses. Results: The brief GSE-6 for ADHD displayed good internal consistency with a Cronbach's α of 0.907. No floor or ceiling effect was detected. Exploratory and confirmatory factor analyses supported a one-factor structure. The GSE-6 also showed a moderate positive correlation with the WHO-5 (rs = 0.578) and a moderate negative correlation with the depression and anxiety rating scale PHQ-4 (rs = -0.595). Conclusion: The 6-item GSE for ADHD was evaluated to have good content validity. The scale demonstrated good psychometric properties. The results indicate that the GSE-6 may help assess self-efficacy in adults with ADHD.

Factor structure of the patient health questionnaire-4 in adults with attention-deficit/hyperactivity disorder.

Background: Persons with attention-deficit/hyperactivity disorder (ADHD) frequently experience symptoms of anxiety and depression. In this population, there is a need for validated brief self-report screening questionnaires to assess the severity of comorbid mental health problems. The Patient Health Questionnaire 4 (PHQ-4) is a self-report questionnaire that may contribute to this purpose as it can screen for both disorders efficiently. However, this will be the first study examining the factor structure of the PHQ-4 in samples of adults with ADHD, and also evaluating the validity of the Norwegian version of the PHQ-4. Objectives: The aim of the current cross-sectional study was to examine the factor structure and validity of the Norwegian version of the PHQ-4 in a sample of adults who reported having been diagnosed with ADHD. Methods: Of 496 invited, a total of 326 participants (66%) completed the PHQ-4, The World Health Organization Five Well-Being Index, the Oslo Social Support Scale and the 4-item Perceived Stress Scale electronically in a web-portal between the 9th and 30th of June 2020. Results: Confirmatory factor analysis of the PHQ-4 supported a two-factor structure [RMSEA = 0.038 (90% CI 0.000-0.159), CFI = 1.00, TLI = 0.999, SRMR = 0.004], consisting of a depression factor and an anxiety factor. Standardized factor loadings were 0.79 to 0.97. The PHQ-4 was negatively correlated with well-being and social support and positively correlated with perceived level of stress. Conclusion: This study indicates promising psychometric properties of the PHQ-4 as a measure of anxiety and depressive symptoms in adults with self-reported ADHD who are fluent in Norwegian. The questionnaire's brevity makes it a valuable resource in research and clinical settings. However, more studies are needed to test the instrument in a clinical sample.

Development of nurse-led videoconference-delivered cognitive behavioural therapy for domestic violence: Feasibility and acceptability.

AIMS: Because of the COVID-19 lockdown, an internet-based adaption of a nurse-led cognitive behavioural group therapy (CGBT) was provided for perpetrators of domestic violence. The aim of this study was to describe the development of the therapy, examine the initial feasibility and impact on patient satisfaction of the programme and evaluate the associated patient-reported experiences. DESIGN: Programme development as well as testing its feasibility and acceptability using cross-sectional survey data. METHODS: Anonymous data were collected at a university hospital in Norway between October and December 2021. Feasibility was examined by comparing the numbers of patients who agreed to participate, chose not to participate or dropped out during the intervention. There was a self-reporting scale that evaluated patient satisfaction, and the participants were invited to make suggestions for improvement of the intervention. The results of the study are reported in accordance with the STROBE checklist. RESULTS: The videoconference-delivered CGBT was feasible. Two of the 67 patients refused to attend therapy delivered in a remote manner (3.0%), and four patients (6.0%) were classified as non-completers. Overall, patients were satisfied with the therapy. CONCLUSIONS: This study described a promising nurse-led internet-based intervention for individuals who were domestically violent and had voluntarily sought healthcare help. The participants' satisfaction with the intervention indicates its acceptability and feasibility. However, research on internet-based cognitive behaviour therapy is still in its infancy. These results may guide the future development of internet-based cognitive behavioural therapy (CBT) for individuals who perpetrate domestic violence. Further research is needed on the pros and cons of this mode of service delivery. IMPACT: This study addressed the challenges of providing treatment for domestic violence during the COVID-19 pandemic by examining videoconference-delivered CBT for individuals who perpetrate domestic violence.

Validating the Five-Item World Health Organization Well-Being Index.

Purpose: Research on the psychological well-being of caregivers of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) suggests that the well-being of parents and caregivers has been negatively affected by the COVID-19 pandemic. Although the psychological well-being of caregivers is a major concern, few validated well-being measures exist for caregivers of children diagnosed with ADHD. Therefore, a valid self-report scale is needed to assess well-being during the pandemic. The brief Five-Item World Health Organization Well-Being Index (WHO-5) has previously been used in studies on caregivers. However, its validity in this population remains unknown. This study aimed to evaluate the reliability and construct validity of the WHO-5 with caregivers of children with ADHD. Methods: A cross-sectional anonymous online survey was conducted in Norway. The study recruited caregivers from a community sample during the COVID-19 pandemic. This was carried out to investigate the construct validity by exploring the relationship between well-being, quality of life, social support, self-reported psychological distress, and perceived stress. Results: The findings of unidimensionality and high internal consistency, together with the results from the hypothesis testing, demonstrate the reliability and construct validity of the Norwegian version of the WHO-5 in this population. Conclusions: This study provides the first empirical evidence of the validity and reliability of the WHO-5 from a sample of Norwegian caregivers of children diagnosed with ADHD, with excellent reliability and construct validity. The scale can be used to systematize the measurement of well-being in caregivers because of its brevity and good psychometric properties, making it a valuable resource in research settings and assisting healthcare professionals in their crucial work of caring for caregivers.

Psychometric Properties of the WHO-5 Well-Being Index among Nurses during the COVID-19 Pandemic: A Cross-Sectional Study in Three Countries.

Nurses' well-being has been increasingly recognised due to the ongoing pandemic. However, no validation scales measuring nurses' well-being currently exist. Thus, we aimed to validate the WHO-5 Well-Being Index (WHO-5) in a sample of nurses. A cross-sectional multinational study was conducted, and a total of 678 nurses who worked during the COVID-19 pandemic in Spain (36.9%), Chile (40.0%) and Norway (23.1%) participated in this study. The nurses completed the WHO-5, the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2) and three questions about the quality of life (QoL). The WHO-5 demonstrated good reliability and validity in the three countries. Cronbach's alphas ranged from 0.81 to 0.90. High correlations were found between the WHO-5 and the psychological well-being dimension of QoL, and negative correlations between the WHO-5 and PHQ-2. The unidimensional scale structure was confirmed in all the countries, explaining more than 68% of the variance. The item response theory likelihood ratio model did not show discernible differences in the WHO-5 across the countries. To conclude, the WHO-5 is a psychometrically sound scale for measuring nurses' well-being during a pandemic. The scale showed strong construct validity for cross-cultural comparisons; however, more research is required with larger sample sizes.

Fighting the waves; Covid-19 family life interference in a neurodevelopmental disorder-caregiver population.

INTRODUCTION: The current COVID-19 pandemic interferes with family lives across the world, particularly families of children with neurodevelopmental disorders (NDDs) are at a greater risk for being negatively impacted by the pandemic. Together with representatives from this caregiver population the aim was to explore the interference associated with normal family life caused by the COVID-19 pandemic. METHOD: This is a descriptive study using a cross-sectional design. Following a strategic network sampling strategy, a user-developed national survey was completed by a larger sample (N = 1,186) of parents and informal caregivers of children with NDDs. The survey utilized a combination of both closed and open-ended questions, and a logistic regression analysis was carried out to assess the association between family characteristics, characteristics of the child, and COVID-19 related family life interference. Before carrying out the regression an inductive content analysis of the open-ended question on `How has the isolation affected the family´ was carried out to construct the outcome variable. RESULTS: The initial analysis indicated that the COVID-19 pandemic induced a shift in everyday family life and a lack of guidance and support related to managing the challenges they were facing. Caregivers who reported that COVID-19 had significantly interfered with their family life, were more likely to report having anxious children, and to have experienced an increased number of conflicts at home. The logistic regression showed that both anxious children and increased conflicts considerably increased the risk for reporting family life interference compared to those that reported no increased conflicts or anxious children. DISCUSSION: Considering how the COVID-19 related increased conflicts at home and anxious children threaten the family life of the NDD caregiver population, as an external source of family stress, which might lead to negative impact on their mental and physical well-being, the need for further research in collaboration with user representatives is apparent. Our study suggests that more information should be provided to healthcare providers, social professionals, peers, people with NDDs, and caregivers of people with NDDs about the potential threats that a stressful life event such as the current pandemic can pose to their mental and physical health and their family life.

The duty to care and nurses' well-being during a pandemic.

BACKGROUND: The coronavirus disease 2019 pandemic is impacting the delivery of healthcare worldwide, creating dilemmas related to the duty to care. Although understanding the ethical dilemmas about the duty to care among nurses is necessary to allow effective preparation, few studies have explored these concerns. AIM: This study aimed to identify the ethical dilemmas among clinical nurses in Spain and Chile. It primarily aimed to (1) identify nurses' agreement with the duty to care despite high risks for themselves and/or their families, (2) describe nurses' well-being and (3) describe the associations between well-being and the duty to care. RESEARCH DESIGN: Cross-sectional self-reported anonymous data were collected between May and June 2020 via electronic survey distribution (snowball sampling). ETHICAL CONSIDERATIONS: The Institutional Ethical Review Committees in both countries approved the study (CHUC_2020_33 and 27/2020). FINDINGS: In total, 345 clinical nurses answered the primary question about the duty to care for the sick. Although in the total sample 77.4% agreed they have a duty to care for the sick, significant differences were found between the Spanish and Chilean samples. Overall, 53.6% of the nurses reported low levels of well-being; however, among those reporting low well-being, statistically significant differences were found between Spanish and Chilean nurses as 19.4% and 37.8%, respectively, disagreed with the statement regarding the duty to care. DISCUSSION: Participants in both countries reported several ethical dilemmas, safety fears, consequent stress and low well-being. These results suggest that prompt actions are required to address nurses' ethical concerns, as they might affect their willingness to work and psychological well-being. CONCLUSION: Our findings shed light on the ethical dilemmas nurses are facing related to the duty to care. Not only has the coronavirus disease 2019 pandemic given rise to ethical challenges, but it has also affected nurses' well-being and willingness to work during a pandemic.

The Mediating Role of Resilience in the Relationship between Perceived Stress and Mental Health.

The COVID-19 pandemic has created great uncertainty around the world, and due to the pandemic, nurses have been exposed to an increase in highly stressful clinical situations. This study examines the relationships between perceived stress and emotional disorders among nurses who have provided direct patient care during the COVID-19 pandemic and explores the mediating role of resilience in these relationships. In an online cross-sectional design, we asked Spanish nurses (N = 214) to complete self-reported scales, and we performed correlation and mediation analyses between perceived stress (Perceived Stress Scale, PSS-4), resilience (Wagnild Resilience Scale, RS-14), wellbeing (World Health Organization Wellbeing Index, five items, WHO-5), anxiety (PHQ-2) and depression (GAD-2). The nurses self-reported moderate levels of perceived stress, considerable psychological distress and high resilience. We found resilience to be significantly negatively correlated with the reported levels of perceived stress, anxiety and depression (p < 0.001). The mediating analysis revealed that resilience played a protective role in the direct relationships of stress with depression, anxiety, and psychological distress. To conclude, our findings supported the hypothesis that resilience mediated the relationship between stress and mental health.

Exploring patterns in psychiatric outpatients' preferences for involvement in decision-making: a latent class analysis approach.

BACKGROUND: Shared decision-making (SDM), a collaborative approach that includes and respects patients' preferences for involvement in decision-making about their treatment, is increasingly advocated. However, in the practice of clinical psychiatry, implementing SDM seems difficult to accomplish. Although the number of studies related to psychiatric patients' preferences for involvement is increasing, studies have largely focused on understanding patients in public mental healthcare settings. Thus, investigating patient preferences for involvement in both public and private settings is of particular importance in psychiatric research. The objectives of this study were to identify different latent class typologies of patient preferences for involvement in the decision-making process, and to investigate how patient characteristics predict these typologies in mental healthcare settings. METHODS: We conducted latent class analysis (LCA) to identify groups of psychiatric outpatients with similar preferences for involvement in decision-making to estimate the probability that each patient belonged to a certain class based on sociodemographic, clinical and health belief variables. RESULTS: The LCA included 224 consecutive psychiatric outpatients' preferences for involvement in treatment decisions in public and private psychiatric settings. The LCA identified three distinct preference typologies, two collaborative and one passive, accounting for 78% of the variance. Class 1 (26%) included collaborative men aged 34-44 years with an average level of education who were treated by public services for a depressive disorder, had high psychological reactance, believed they controlled their disease and had a pharmacophobic attitude. Class 2 (29%) included collaborative women younger than 33 years with an average level of education, who were treated by public services for an anxiety disorder, had low psychological reactance or health control belief and had an unconcerned attitude toward medication. Class 3 (45%) included passive women older than 55 years with lower education levels who had a depressive disorder, had low psychological reactance, attributed the control of their disease to their psychiatrists and had a pharmacophilic attitude. CONCLUSIONS: Our findings highlight how psychiatric patients vary in pattern of preferences for treatment involvement regarding demographic variables and health status, providing insight into understanding the pattern of preferences and comprising a significant advance in mental healthcare research.

Test-Retest Reliability of the Patient Activation Measure-13 in Adults with Substance Use Disorders and Schizophrenia Spectrum Disorders.

Patient Activation Measure-13 (PAM-13) is a valid and widely used questionnaire that assess an individual's knowledge, confidence, and skills for self-management of their chronic illness. Although there is some evidence regarding its reliability, the test-retest reliability has not been investigated among patients with substance use disorders (SUDs) or schizophrenia spectrum disorders. We investigated the internal consistency and test-retest reliability of PAM-13 in these populations. Test-retest reliability was analysed using data from 29 patients with SUDs and 28 with schizophrenia spectrum disorders. Cronbach's α and Intraclass Correlation Coefficient (ICC) scores were used to examine internal consistency and test-retest reliability, respectively. Of the 60 collected test-retest questionnaires, 57 were included in the analyses. No mean differences between time one (T1) and time two (T2) were observed in either patient group, except for item 12 in schizophrenia spectrum disorders patients (p < 0.05). Internal consistency for T1 and T2 was 0.75 and 0.84 in SUDs patients and 0.87 and 0.81 in schizophrenia spectrum disorders patients, respectively. The ICC was r = 0.86 in patients with SUDs and r = 0.93 in patients with schizophrenia spectrum disorders. To conclude, PAM-13 showed good internal consistency and test-retest reliability in SUDs and schizophrenia spectrum disorders patients.

Assessment of the Quality of Life in Parents of Children With ADHD: Validation of the Multicultural Quality of Life Index in Norwegian Pediatric Mental Health Settings.

Background: The brief generic Multicultural Quality of Life Index (MQLI) is a culturally informed self-report 10-item questionnaire used to measure health-related quality of life (QoL). QoL is an important outcome measure in guiding healthcare and is held as a substantial parameter to evaluate the effectiveness of healthcare. Attention Deficit Hyperactivity Disorder (ADHD) in children might negatively influence the parents' QoL. Having a validated questionnaire to measure QoL for this population will therefore be a vital first step in guiding healthcare for parents of children with ADHD. We aimed to examine the reliability and validity of the Norwegian version of the MQLI in a sample of parents of children with ADHD. Methods: In a cross-sectional study, 128 parents of children with ADHD were recruited from four outpatient clinics within the Child and Adolescents Mental Health Services (CAMHS) in Norway. They completed the MQLI along with an alternative well-being scale, the Five-item World Health Organization Well-being Index (WHO-5), and a form including demographic variables. Reliability and validity of the MQLI were examined. We conducted a factor analysis and calculated internal consistency and the correlation between the MQLI and the WHO-5. Results: Factor analysis of the parents reported MQLI yielded a one-factor solution. For the MQLI, Cronbach's alpha was 0.73. The correlation between the two measures of MQLI and WHO-5 was high (r = 0.84), reflecting convergent validity since the association between the two measures was strong. Conclusion: Results from this study support the reliability and validity of the Norwegian version of the MQLI for assessment of quality of life in parents of children with ADHD with good psychometric properties. Study findings support the use of the questionnaire in CAMHS.

Effects of a peer co-facilitated educational programme for parents of children with ADHD: a feasibility randomised controlled trial protocol.

INTRODUCTION: Significant numbers of children with attention deficit hyperactivity disorder (ADHD) display problems that cause multiple disabilities, deficits and handicaps that interfere with social relationships, development and school achievement. They may have multiple problems, which strain family dynamics and influence the child's treatment. Parent activation, described as parents' knowledge, skills and confidence in dealing with their child's health and healthcare, has been shown to be an important factor in improving health outcomes. Research suggests that parents need edification to learn skills crucial to the treatment and management of their children's healthcare. Promoting positive parenting techniques may reduce negative parenting factors in families. This study aims to assess the acceptability, feasibility and estimated sample size of a randomised controlled trial (RCT) comparing an ADHD peer co-led educational programme added to treatment as usual (TAU). METHODS AND ANALYSIS: Using a randomised waitlist controlled trial, parents of children aged 6-12 years newly diagnosed with ADHD, and referred to a child mental health outpatient clinic in Mid-Norway, will receive TAU concomitant with a peer co-facilitated parental engagement educational programme (n=25). Parents in the control group will receive TAU, and the educational programme treatment within a waitlist period of 3-6 months (n=25). Parent activation, satisfaction, well-being, quality of life and treatment adherence, will be assessed at baseline (T0), 2 weeks (T1) pre-post intervention (T2, T3) and at 3 months follow-up (T4). Shared decision making, parents preferred role in health-related decisions and involvement, parent-reported symptoms of ADHD and child's overall level of functioning will be assessed at T0 and T4. Such data will be used to calculate the required sample size for a full-scale RCT. ETHICS AND DISSEMINATION: Approval was obtained from the Regional Committee for Medicine and Health Research Ethics in Mid-Norway (ref: 2018/1196). The findings of this study are expected to provide valuable knowledge about how to optimise family education and management of ADHD and will be disseminated through presentations at conferences and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04010851.

Cognitive behavioural group therapy versus mindfulness-based stress reduction group therapy for intimate partner violence: a randomized controlled trial.

BACKGROUND: Violence in close relationships is a global public health problem and there is a need to implement therapeutic programs designed to help individuals who voluntarily seek help to reduce recurrent intimate partner violence. The effectiveness of such interventions in this population remains inconclusive. The aim of the present study was to compare the effectiveness of cognitive-behavioural group therapy (CBGT) vs mindfulness-based stress reduction (MBSR) group therapy in reducing violent behavior amongst individuals who are violent in intimate partnerships and who voluntarily seek help. METHODS: One hundred forty four participants were randomized using an internet-based computer system. Nineteen withdrew after randomization and 125 participants were randomly assigned to the intervention condition (CBGT, n = 67) or the comparator condition (MBSR, n = 58). The intervention condition involved two individual sessions followed by 15 cognitive-behavioural group therapy sessions. The comparator condition included one individual session before and after 8 mindfulness-based group sessions. Participants (N = 125) and their relationship partners (n = 56) completed assessments at baseline, and at three, six, nine and twelve months' follow-up. The pre-defined primary outcome was reported physical, psychological or sexual violence and physical injury as measured by the revised Conflict Tactics Scale (CTS2). RESULTS: The intent-to-treat analyses were based on 125 male participants (intervention group n = 67; comparator group n = 58). Fifty-six female partners provided collateral information. Baseline risk estimate in the CBGT-group was .85 (.74-.92), and .88 (.76-.94) in the MBSR-group for physical violence. At 12-months' follow-up a substantial reduction was found in both groups (CBGT: .08 (.03-.18); MBSR: .19 (.11-.32)). CONCLUSION: Results provide support for the efficacy of both the cognitive-behavioural group therapy and the mindfulness-based stress reduction group therapy in reducing intimate partner violent behavior in men voluntarily seeking treatment. TRIAL REGISTRATION: NCT01653860, registered July 2012.

Does the working alliance mediate the effect of routine outcome monitoring (ROM) and alliance feedback on psychotherapy outcomes? A secondary analysis from a randomized clinical trial.

Little is known about the mechanisms through which routine outcome monitoring (ROM) influences psychotherapy outcomes. In this secondary analysis of data from a randomized clinical trial (Brattland et al., 2018), we investigated whether the working alliance mediated the effect of the Partners for Change Outcome Monitoring System (PCOMS), a ROM system that provides session-by-session feedback on clients' well-being and the alliance. Adult individuals (N = 170) referred for hospital-based outpatient mental health treatment were randomized to individual psychotherapy either with the PCOMS ROM system, or without (treatment as usual [TAU]). Treatment was provided by the same therapists (N = 20) in both conditions. A multilevel mediation model was developed to test if there was a significant indirect effect of ROM on client impairment at posttreatment through the alliance at 2 months' treatment controlled for first-session alliance. Alliance ratings increased more from session 1 to 2 months' treatment in the ROM than TAU condition, and alliance increase was associated with less posttreatment impairment. A significant indirect effect of ROM on treatment outcomes through alliance increase (p = .043) explained an estimated 23.0% of the effect of ROM on outcomes. The results were consistent with a theory of the alliance as one mechanism through which ROM works. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cognitive behavioural group therapy for male perpetrators of intimate partner violence: a systematic review.

BACKGROUND: Violence against intimate partners is a worldwide public health problem. Cognitive behavioural therapy delivered in a group format is widely used for the treatment of men's violent behaviour towards their female partners. A Cochrane review about the effectiveness of this therapy from 2011 revealed a lack of controlled studies. Our aim is to update the current evidence on the effectiveness of cognitive behavioural group therapy on men's violent behaviour towards their female partner. METHODS: The Cochrane Library, the Campbell Collaboration Social, MEDLINE, PsychINFO, CINAHL, SCOPUS, Embase, Open Grey, Grey Literature Report, and Sociological Abstracts were searched for studies investigating the effectiveness of cognitive behavioural group therapy on intimate partner violence published in the period of January 1, 2010, to February 12, 2018. Manual searches were also performed to identify randomized and non-randomized controlled trials. Data extraction was done in duplicate. The primary outcome was the reduction in violent behaviour, and secondary outcomes were physical health, mental health, quality of life, emotion regulation, and substance use. Study quality was assessed with the Cochrane Collaboration's risk of bias tool and the Risk of Bias In Non-Randomized Studies of Interventions tool. A narrative summary was used to describe the review findings. RESULTS: We identified six new studies that met the inclusion criteria: four randomized controlled trials and two non-randomized trials. Three of the randomized controlled trials found a reduction in intimate partner violence after treatment. The fourth randomized trial found that a subsample of responding partners reported a reduction in violence but no changes in the men's self-reported violence after treatment. No effect could be detected in the two non-randomized studies. Analysis of risk of bias revealed mixed results, indicating both strengths and weaknesses. LIMITATIONS: Only a limited amount of studies which scored as "low quality" were available. CONCLUSIONS: There is still insufficient evidence to confirm that cognitive behavioural group therapy for perpetrators of intimate partner violence has a positive effect. Future research should focus on randomized controlled studies distinguishing between convicted and non-convicted populations where violent behaviour is the primary outcome. TRIAL REGISTRATION: CRD42016041493 .

The effects of routine outcome monitoring (ROM) on therapy outcomes in the course of an implementation process: A randomized clinical trial.

This study investigated the effects of the Partners for Change Outcome Management System (PCOMS) in adult outpatient treatment at a hospital-based mental health clinic. It also investigated whether the effects differed with the timing of the treatment within a 4-year implementation period, with clients' initial distress levels, and between therapists. Adult clients (N = 170) were randomized to treatment as usual (TAU) or routine outcome monitoring (ROM). Twenty therapists provided therapy in both conditions. Therapy outcome was measured by the Behavior and Symptoms Identification Scale (BASIS-32). Data were analyzed in a series of multilevel models (MLMs). Clients in the ROM condition were 2.5 times more likely to demonstrate improvement than those in the TAU condition. Controlling for therapist variability, the overall effect size (ES) in favor of ROM was small (d = 0.26, p = .037). The superiority for ROM over TAU increased significantly over the duration of the study. ROM effects were not moderated by clients' initial distress levels. Differences between therapists accounted for 9%-10% of the variability in outcomes, and there were no significant differences in ROM effects between therapists. ROM was associated with better treatment outcomes independent of clients' initial distress levels. Clients treated later in the study benefitted more from ROM than those treated earlier. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The effects of a pretreatment educational group programme on mental health treatment outcomes: a randomized controlled trial.

BACKGROUND: Patients dropping out of mental health treatment is considered a widespread and significant obstacle to providing effective treatment, thus reducing the probability of patients achieving the desired improvement. Here, relative to ordinary treatment, we investigate the effects of providing an educational group programme before mental health treatment on mental health symptomatology and the risk of patients dropping out or prematurely discontinuing treatment. METHODS: A randomized controlled trial in which adults referred to a community mental health center were randomized to either a Control Group (n = 46) or a pretreatment educational programme followed by treatment as usual (Intervention Group, n = 45). The primary outcome was self-reported mental health symptomatology assessed with BASIS-32. Data were analyzed by multilevel linear regression and Cox's regression. RESULTS: We recruited 93 patients during a 26-month period. Assessments were performed before (0 month, baseline) and after the intervention (1 month, before treatment initiation), and after 4 and 12 months. The net difference in BASIS-32 score between 0 and 1-month was - 0.27 (95% confidence interval CI] -0.45 to - 0.09) in favor of the intervention group. Although both groups had a significant and continuous decline in psychopathology during the treatment (from 1 month and throughout the 4- and 12-month follow-up assessments), the group difference detected before treatment (between 0 and 1 month) persisted throughout the study. Premature treatment discontinuation was partially prevented. The dropout risk was 74% lower in the Intervention Group than in the Control Group (hazard ratio 0.26, 95% CI = 0.07-0.93). CONCLUSIONS: A brief educational intervention provided before mental health treatment seems to have an immediate and long-lasting effect on psychopathology, supplementary to traditional treatment. Such an intervention might also have a promising effect on reducing treatment dropout. TRIAL REGISTRATION: NCT00967265 , clinicaltrials.gov . Registered August 27, 2009, retrospectively registered.