A personal narrative intervention combined with self-monitoring strategies: Outcomes for Mandarin-speaking adolescents with Down syndrome.

BACKGROUND: Personal narratives play an essential role in children's social and academic development. However, children with Down syndrome have ongoing challenges with constructing and communicating personal narratives. METHODS: Using a single-case multiple-probe across participants design, we examined whether a targeted intervention could improve both micro- and macro-structural aspects of personal narratives from Chinese adolescents with Down syndrome. RESULTS: All three participants demonstrated high treatment effects in two macrostructural narrative outcomes (i.e., narrative element complexity and narrative coherence) in response to the intervention and moderate to high treatment effects in the microstructural narrative outcomes (i.e., the mean length of utterance in words and the number of different words). However, all participants demonstrated limited improvements in narrative cohesion. These effects were maintained and generalised in a different narrative condition. CONCLUSIONS: The preliminary findings support the feasibility and effectiveness of the personal narrative intervention incorporated with self-monitoring strategies for adolescents with Down syndrome.

Constructing and Preliminary Testing a Narrative Therapy Programme for Posttraumatic Growth in Chinese Patients With Inflammatory Bowel Disease-A Pilot Study.

BACKGROUND: The research on posttraumatic growth (PTG) promotion programmes, particularly narrative therapy (NT), for patients with inflammatory bowel disease (IBD) remains limited. This pilot study aims to develop an NT programme to promote PTG and evaluate its feasibility, preliminary effectiveness, participants' experiences and improvement suggestions. METHODS: The NT programme was initially developed through literature review, interviews with IBD patients and expert panel discussions. A randomized controlled pilot trial was conducted to assess the feasibility and preliminary effectiveness of the programme. Participants in the NT group received five consecutive weekly sessions of the programme, while the control group received standard care. Outcomes including PTG, anxiety, depression and quality of life were measured. Qualitative interviews were conducted to explore participants' experiences and suggestions for programme modifications. RESULTS: The NT programme was developed with scientific rigour. The recruitment rate and retention rate were 62.5% and 96.7%, respectively. A significant reduction in anxiety levels was observed, and manifestations of PTG were reported in the NT group. Suggestions for improvement of the NT programme were received from the participants. CONCLUSION: The NT programme was constructed to promote PTG in IBD patients in this study, further offering preliminary evidence for its feasibility and potential positive psychological change. However, large-scale research is needed to validate its effectiveness for broader applications.

Making meaning of one's own life story in words and images: A narrative case report of personal recovery from personality disorder through the interventions "An Empowering Story" and art therapy.

Understanding and processing life experiences are essential in the treatment of personality disorders to promote personal recovery and psychological wellbeing. In this qualitative case report, drafted in co-creation between the client, clinical psychologist, and art therapist, individual treatment consisted of two psychotherapeutic interventions, "An Empowering Story" and life-story-focused art therapy, in 12 parallel sessions for 24 weeks. Hilda, 68 years of age, had been diagnosed with an unspecified personality disorder and various traits of borderline personality disorder. She experienced emotional exhaustion following long-term mental health problems rooted in a traumatic early childhood. This affected her ability to manage her emotions and social relations, resulting in the sense that her life had no meaning. Hilda was invited to reconstruct her life experiences, divided into the past, turning point, and present/future, in a written and a painted life story. This allowed for the integration of traumatic as well as positive memories, enhanced self-compassion, and meaning making. She developed self-reflection and integration of internal conflicts leading to a better emotional balance and self-understanding. Art therapy emphasizes bottom-up regulatory processes, while narrative psychology supports top-down regulatory processes. The combined approach effectively integrated bottom-up, experiential, sensory experiences with top-down, cognitive emotion-regulation processes. The results suggest that psychotherapeutic interventions involving a multi-pronged, complementary, and thus more holistic approach can support personal recovery in personality disorders.

Effectiveness of a narrative nursing intervention on reproductive concerns in women of childbearing age undergoing cervical cancer surgery: A randomized controlled trial.

OBJECTIVE: This study aims to explore the intervention effects of narrative nursing on the reproductive concerns of cervical cancer patients of childbearing age undergoing surgical treatment. METHODS: Patients undergoing cervical cancer surgery with moderate to severe levels of reproductive concerns, treated between January and December 2023 at a tertiary Grade-A oncology hospital in China, were selected as the research subjects. Patients were randomized into an intervention group and a control group, each consisting of 33 patients. The control group received standard nursing care, while the intervention group received a narrative nursing intervention in addition to standard care. The changes in the levels of reproductive concerns, post-traumatic growth, and quality of life scores before and after the intervention were compared between the two groups. RESULTS: After the intervention, the reproductive concerns scores of the cervical cancer patients in the intervention group (32.53 ± 4.77) were significantly lower than those in the control group (59.29 ± 3.24), with a statistically significant difference (t = 26.143, p < 0.001). The post-traumatic growth scores in the intervention group (86.78 ± 3.52) were significantly higher than those in the control group (68.06 ± 6.24), with a statistically significant difference (t = -14.595, p < 0.001). The quality of life scores in the intervention group (149.00 [IQR = 8.75]) were significantly higher than those in the control group (129.00 [IQR = 13.00]), with a statistically significant difference (z = -5.799, p < 0.001). CONCLUSION: Narrative nursing can effectively alleviate reproductive concerns in cervical cancer patients undergoing surgical treatment, promote positive psychological changes post-trauma, and improve patients' quality of life.

Asylee perspectives on psychotherapies for posttraumatic stress.

Asylees (i.e., asylum seekers) have a higher prevalence of mental health concerns, particularly posttraumatic distress, than the general population due to both their exposure to traumatic experiences and prolonged uncertain status in a new country. Meta-analyses of randomized controlled trials with asylees have found that culturally adapted cognitive behavioral therapy (CA-CBT), eye movement desensitization and reprocessing (EMDR), and narrative exposure therapy (NET) are efficacious in treating trauma-related symptoms and posttraumatic stress disorder (PTSD); however, treatment utilization remains low. Thus, it is imperative to determine what PTSD interventions are effective, credible, and acceptable for asylees. We employed structured virtual interviews with 40 U.S. asylees from diverse countries living with one or more symptoms of PTSD. Participants were asked about treatment engagement, perceived barriers to treatment, goals for psychotherapy, and perceptions of the effectiveness and difficulty of engaging in CA-CBT, EMDR, NET, and (non-exposure-based) interpersonal therapy (IPT) for PTSD. Participants perceived IPT to be significantly less difficult than all exposure-based treatments, with medium effect sizes, ds = 0.55-0.71. A qualitative analysis of asylees' comments provided valuable insights into how they think about these treatments. Ways in which these results can be considered when informing recommendations for improving interventions for asylees are discussed.

La terapia narrativa como intervención en jóvenes víctimas de abuso sexual infantil / Narrative therapy as an intervention in young victims of child sexual abuse

La terapia narrativa surge como una propuesta de intervención, debido a que este modelo permite que las personas puedan generar un proceso donde se desarrolle de manera integral lo que han padecido, y, de esa manera, poder resignificarlo; consiguientemente, cada paciente puede, así, superar la experiencia traumática (Ihl y Diaz, 2021). Método: Este trabajo de integración final de diseño teórico de revisión bibliográfica se propuso analizar la posible eficacia de la terapia narrativa como intervención clínica con jóvenes que han sido víctimas del abuso sexual infantil. Síntesis y conclusiones: La terapia narrativa propone un espacio respetuoso, flexible y de contención; se establece un entorno en el que el paciente tiene la oportunidad de contar su experiencia traumática, sin estar obligado a relatarla. Es decir, este abordaje no se enfoca en la exposición del trauma, ni exige que la persona relate la situación de abuso en un momento específico; la terapia narrativa propone trabajar con los efectos y las consecuencias del trauma AU

Narrative therapy emerges as an intervention proposal because this model allows people to generate a process where what they have suffered is developed in an integral way, and, in this way, to resignify it; consequently, each patient can thus overcome the traumatic experience (Ihl & Diaz, 2021). Method: This work offinal integration of theoretical design of bibliographic review was proposed to analyze the possible effectiveness of narrative therapy as a clinical intervention with young people who have been victims of child sexual abuse. Synthesis and conclusions: Narrative therapy proposes a respectful, flexible, and supportive space; an environment is established in which the patient has the opportunity to recount his traumatic experience, without being obliged to recount it. In other words, this approach does not focus on the exposure of the trauma, nor does it require the person to report the situation of abuse at a specific time; Narrative therapy proposes working with the effects and consequences of trauma AU

Treating trauma and aggression with narrative exposure therapy in former child and adult soldiers: A randomized controlled trial in Eastern DR Congo.

OBJECTIVE: Individuals who return from armed groups present with a history of traumatic events including perpetration. Subsequent severe mental stress and heightened levels of reactive and appetitive aggression may persist and if left untreated, frequently impede peacebuilding and societal stability. In this study, we tested a revised adaptation of Narrative Exposure Therapy (NET; Schauer et al., 2011) for Forensic Offender Rehabilitation (FORNET) implemented in a sample of male former combatants in war-torn regions of the DR Congo. METHOD: We applied a longitudinal parallel-group randomized controlled design with treatment as usual (TAU) as control condition and 3-5 and 6-9 months follow-up assessments. The effect of treatment over time on clinical and social outcomes was tested with GLMMs; appetitive aggression and current violent behavior (CVB) were specified as primary and posttraumatic stress as secondary outcomes. RESULTS: FORNET decreased appetitive aggression (within group Cohen's dz = 2.00), CVB (dz = .90) and posttraumatic stress (dz = 1.48) significantly more than treatment as usual. Clinical significance was obtained for all outcomes. Remarkably, NET clients also reduced their substance abuse (dz = .68) even though this was not targeted within the intervention. Depression, perceived social acknowledgement and subjective solidarity with (para)military life decreased. CONCLUSION: FORNET is a compact and scalable psychotherapeutic intervention that effectively reduces current aggressive behavior including physical abuse against children, intimate partner violence (IPV), and community violence. FORNET further decreases appetitive aggression, posttraumatic stress symptoms, and other clinical and social problems that commonly hinder demobilization, reintegration, and post-conflict peacebuilding. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Promoting community reintegration using narratives and skills building for young adults with stroke: a protocol for a randomised controlled trial.

BACKGROUND: Stroke in adults aged between 18 and 64 years old is increasing significantly worldwide. Studies have reported that this group of young stroke survivors encounters enormous difficulties reintegrating into their social roles. Individualised discussions with healthcare professionals and learning from other survivors are imperative for them to reconstruct their identities after stroke. There is also great demand for community support during their chronic stage of recovery to help them rebuild life skills to promote reintegration. METHODS/DESIGN: This is a randomised controlled trial to investigate the effects of a 24-week Narrative and Skills-building Intervention (NSI) on young stroke survivors' community reintegration and psychosocial outcomes. A total of 208 adults aged 18-64 years old with a first-ever or recurrent ischaemic or haemorrhagic stroke and have been discharged home will be recruited and randomly assigned to receive usual care or usual care with NSI. The NSI is grounded in Narrative Theory and Bandura's principles of Self-efficacy and Outcome Expectation, consisting of successive eight individual sessions over six months delivered by a trained facilitator (a registered nurse). Participants will be facilitated to narrate their survival experiences and rebuild core life skills. Videos of peer young stroke survivors' experiences of recovery will be provided. Outcomes including community reintegration, depressive symptoms, health-related quality of life, self-efficacy, outcome expectation and satisfaction with performance of self-management behaviours will be measured before (T0) and immediately after NSI (T1), then six (T2) and 12 months after NSI (T3). Generalised estimating equations models will be used to compare the differential changes in outcomes across time between the two groups. Focus group interviews will be conducted with the facilitator at T1 and with the participants in the intervention group at T1 and T3. DISCUSSION: This study will evaluate the short and long-term effects of a theory-based NSI on young stroke survivors' community reintegration and establish a new model of community reintegration after stroke to inform future research. The results will also provide valuable evidence to develop clinical guidelines for young stroke survivors' community reintegration. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04560140 , registered on 23 September, 2020.

Generativity and Social Well-Being in Older Women: Expectations Regarding Aging Matter.

OBJECTIVES: Beliefs about aging can contribute to health and well-being in older adults. Feeling generative, or that one is caring for and contributing to the well-being of others, can also impact health and well-being. In this study, we hypothesized that those with more positive expectations regarding aging (ERA) in the mental health domain would report greater levels of perceived social support (PSS) and lower levels of loneliness in response to a generativity intervention (vs control condition). METHOD: Participants in this study (n = 73, 100% female) were randomly assigned to a 6-week generativity condition, which involved writing about life experiences and sharing advice with others, or to a control condition, which involved writing about neutral topics. Pre- and postintervention, PSS, and feelings of loneliness were measured. RESULTS: Those in the generativity condition with more positive ERA in the mental health domain reported greater PSS and lower loneliness postintervention. DISCUSSION: These results highlight the importance of psychological factors, such as ERA, in moderating the efficacy of interventions to promote social well-being in older adults.

Radical Pleasure: Feminist Digital Storytelling by, with, and for Women Living with HIV.

Despite the fact that HIV can be controlled with medication to undetectable levels where it cannot be passed on, stigmatization of women living with HIV persists. Such stigmatization pivots on stereotypes around sex and sexism and has force in women's lives. Our aim was to create an inspirational resource for women living with HIV regarding sex, relationships, and sexuality: www.lifeandlovewithhiv.ca (launched in July 2018). This paper describes the development and mixed-method evaluation of our first year and a half activities. We situated our work within a participatory arts-based knowledge translation planning framework and used multiple data sources (Google Analytics, stories and comments on the website, team reflections over multiple meetings) to report on interim outcomes and impacts. In our first 1.5 years, we recruited and mentored 12 women living with HIV from around the world (Canada, Australia, New Zealand, Kenya, South Africa, Spain, Nigeria, and the U.S.) to write their own stories, with the support of a mentor/editor, as a way of regaining control of HIV narratives and asserting their right to have pleasurable, fulfilling, and safer sexual lives. Writers published 43 stories about pleasure, orgasm, bodies, identities, trauma, resilience, dating, disclosure, self-love, and motherhood. Our social media community grew to 1600, and our website received approximately 300 visits per month, most by women (70%) and people aged 25-44 years (65%), from more than 50 cities globally, with shifts in use and demographics over time. Qualitative data indicated the power of feminist digital storytelling for opportunity, access, validation, and healing, though not without risks. We offer recommendations to others interested in using arts-based digital methods to advance social equity in sexual health.

Prevención del tabaquismo con mensajes narrativos. Estudio experimental sobre el efecto conjunto de la similitud con el protagonista y la voz narrativa / Smoking prevention with narrative messages. An experimental study on the joint effect of audiencecharacter similarity and narrative voice

El presente trabajo se centra en la prevención del tabaquismo utilizando mensajes narrativos. En particular, se analiza el papel de doscaracterísticas de los mensajes narrativos que pueden influir, de manera indirecta, en la intención de dejar de fumar, las expectativas deauto-eficacia y la percepción de la eficacia de la respuesta preventiva.Para ello, se llevó a cabo una investigación experimental (N = 680,50% mujeres y rango de edad 18-55 años) con un diseño factorial 2(voz narrativa: mensaje en primera vs. tercera persona) x 2 (similitudcon el protagonista: baja vs. alta). Los resultados mostraron que lacondición óptima de recepción (narración en primera persona protagonizada por un personaje similar a la audiencia) indujo niveles máselevados de identificación con el protagonista (un exfumador describía el proceso de abandono del tabaco y las mejoras que ha experimentado desde entonces). Los análisis mediacionales mostraron quela condición óptima de recepción ejercía efectos indirectos significativos sobre las variables dependientes que se debían al aumento de laidentificación y la reducción de la reactancia. Además, la condiciónóptima de recepción también ejerció un efecto indirecto significativosobre la eficacia percibida de la respuesta preventiva que se explicabapor el incremento de la identificación y la reducción de la contra-argumentación. El presente trabajo abre una línea de estudio sobre laconstrucción de mensajes narrativos para la prevención del tabaquismo. Se pone de manifiesto la relevancia de las características que dichos mensajes deben tener para que se activen procesos mediadoresque faciliten la persuasión. (AU)

This study focuses on smoking prevention using narrative messages.In particular, the role of two narrative attributes that can indirectlyinfluence the intention to quit smoking, self-efficacy expectations andthe perceived effectiveness of the preventive response were analysed.An experimental study was carried out (N = 680, 50% women and agerange 18-55 years) with a 2 (narrative voice: first- vs. third-person message) x 2 (audience-protagonist similarity: low vs. high) between-subjects factorial design. Results showed that the optimal reception condition (first-person narrative with a highly similar protagonist to theaudience) induced the highest levels of identification with the protagonist (a former smoker who described the process of quitting smokingand subsequent the improvements he has experienced). Mediationalanalyses showed that the optimal reception condition exerted significant indirect effects on the dependent variables, due to the increasein identification and reactance reduction. In addition, the optimalreception condition also exerted a significant indirect effect on theperceived effectiveness of the preventive response that was explainedby stronger identification and weaker counterarguing. The presentstudy opens an innovative line of research on the construction of narrative messages for smoking prevention. The relevance of the characteristics of these messages is highlighted in order to activate mediatingprocesses that facilitate persuasion. (AU)

El construccionismo social en la conducta suicida: conversaciones narrativas con estudiantes universitarios / Social constructionism in suicidal behavior: narrative conversations with college students

En este artículo presentamos los resultados de una investigación que tuvo como objetivo com-prender los significados que los estudiantes de la Universidad Católica Luis Amigó de Manizales (Colombia) les dan a sus experiencias relacionales, en el contexto familiar y social, identifican-do aquellos aspectos de las relaciones que pueden ser factores protectores del riesgo suicida. Es una investigación de corte cualitativo con un diseño hermenéutico, siendo la narrativa la es-trategia para la producción dialógica. Tomamos como categorías de análisis los significados atribuidos a las relaciones con la familia, con los amigos y en el propio contexto investigativo. Encontramos que son factores protectores del riesgo suicida: la aceptación, la confianza y la posibilidad de ser auténtico y de expresarse libremente. Consideramos el potencial preventivo de las conversaciones narrativas basadas en el reconocimiento y el diálogo en las relaciones in-terpersonales. (AU)

In this paper we present the results of a research that aimed to understand the meanings that the students of the Luis Amigó Catholic University of Manizales (Colombia) give to their rela-tional experiences, in the familiar and social contexts, identifying those aspects of the rela-tionships that can be protective factors for suicide risk. It is a qualitative research with a hermeneutic design, being narrative approach the strategy for dialogic production. We took as categories of analysis the meanings attributed to relationships with family, friends, partners and in the research context itself. We found that acceptance, trust, the possibility of being authentic and of expressing oneself freely are protective factors for suicidal risk. Finally, we acknowledge the preventive potential of narrative conversations based on recognition and dia-logue in interpersonal relationships. (AU)

Effects of social stories intervention for children and adolescents with autism spectrum disorders: A protocol for a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Autism spectrum disorder (ASD) is a common neurodevelopmental disorder, which lacks specific medical treatment. Intervention is the key point of rehabilitation training for ASD. Social stories (SS) are a commonly used intervention practice in individuals with ASD. However, there is mixed evidence on the effectiveness of SS. Thus, the objective of this systematic review and meta-analysis is to assess studies of the effects of SS for children and adolescents with ASD. METHODS: To identify relevant studies, we will search PubMed, EMBASE, Cochrane Library, Web of Science, Google Scholar and trials registers (the World Health Organization International Clinical Trial Registration Platform, ClinicalTrials.gov, and Chinese Clinical Trial Register) from inception to May 2020. In addition, we will also perform handsearching of grey literature, such as conference proceedings and academic degree dissertations. Only the randomized control trials will be accepted, no matter what the languages they were reported. We will first focus on the effectiveness of the intervention on the behavior of the targets. Then we will do further analysis of the study design, including the length and intensity of intervention, the characteristics of participants and interveners, the methods of assessment, the place, the medium, and the economic feasibility. Two independent reviewers will carry out literature identification, data collection, and study quality assessment. Discrepancies will be resolved by a third reviewer. The Cochrane Risk of Bias Tool will be used to evaluate the risk of bias of the randomized controlled trials. Data analysis will be calculated using the STATA 13.0 software. RESULT: This study will offer new evidence whether the SS is an appropriate intervention of benefiting the children and adolescents with ASD, and to determine which factors affect the effectiveness of SS. CONCLUSION: The conclusion drawn from this systematic review will benefit the children and adolescents with ASD.

Contribution of community-based sociotherapy interventions for the psychological well-being of Rwandan youths born to genocide perpetrators and survivors: analysis of the stories telling of a sociotherapy approach.

BACKGROUND: Psychological well-being (PWB) refers to inter- and intra-individual levels of positive functioning that include one's relatedness with others and self-referent attitudes that include one's sense of mastery and personal growth. PWB consists of hedonism and eudaimonia building on thoughts, feelings, and behaviors. Sociotherapy is a community-based health intervention that contributes to the promotion of PWB worldwide. Starting from an analysis of trauma transmitted from the perpetrators and survivors of the Rwandan genocide to their descendants, this article is aimed at exploring the contribution of therapeutic sessions to PWB among youth. METHOD: A qualitative study design based on shared testimonies was carried out. Field reports from the sociotherapists, written texts, and testimonies of changes presented in the conviviality meetings were analyzed using transactional analysis. We included 24 reflexive texts upon completion of 8 months of the therapeutic program. RESULTS: Results indicated that before sociotherapy sessions, youth born to genocide survivors and perpetrators had psychosocial distress, including low self-esteem, hopelessness, anxiety, stigma, thoughts of revenge, shame, depression, and antisocial behaviors. Sociotherapy significantly contributed to the reduction of these psychosocial problems. Participating youth reported feeling safe, trusted, respected, and healthier than before the sociotherapy. This intervention created inner healing, social cohesion, alleviated their sufferings of trauma, restored their families and contributed to community resilience. Results revealed that youth developed PWB, helping them to what appeared to be psychosocial problems as being potentially healthy, enhancing self-acceptance, and respecting humanity. Youth also became the vector for the reconciliation and reconstruction of their humanity. CONCLUSION: Sociotherapy is a community health intervention that has an effective outcome on the personal well-being of of youth. This therapy impacted the individual, social, and familial resilience of youth who developed their capacity to regain and maintain health. The intervention restored their PWB, characterized by increased positive functioning specifically in the areas of autonomy, ecological mastery, individual growth, purpose in life, good relationships with others, and improved self-esteem.

¿Cómo han vivido los niños el confinamiento por el coronavirus? / How have children experienced the confinement due to coronavirus?

INTRODUCCIÓN: los niños muestran sentimientos y vivencias que no saben o no se atreven a expresar y que se pueden conocer a través de sus dibujos e imaginación. La Asociación Española de Pediatría de Atención Primaria (AEPap) se ha propuesto conocer cómo han vivido los niños el confinamiento. MATERIAL Y MÉTODOS: se ha organizado un concurso en la página web Familia y Salud. Sujetos: niños o niñas de todo el territorio nacional con edades comprendidas entre los 3 y 16 años. Trabajos: dibujos, cuentos y vídeos breves. RESULTADOS: hemos recibido 53 trabajos procedentes de diferentes comunidades autónomas y entregado cinco premios. Los elementos que más se repiten son: el coronavirus, figuras de niños dentro de las casas, el arco iris entre las nubes y los sanitarios. El aburrimiento, la tristeza de no poder ver a abuelos y amigos, la confianza en los sanitarios, la valoración positiva del cambio de vida en la familia, la mejora en la contaminación ambiental y el mensaje positivo de que todo va a salir bien son algunos de los temas expresados. CONCLUSIONES: los resultados obtenidos en el presente estudio denotan optimismo en general, y permiten concluir que los dibujos, los relatos y los vídeos son herramientas útiles para analizar la percepción de esta población ante situaciones de riesgo. Además, destaca el interés de los pediatras de Atención Primaria por conocer cómo han vivido los niños el confinamiento a causa de la infección por coronavirus y crear la inquietud de que el dibujo infantil debe ser estudiado de manera rigurosa

INTRODUCTION: children have feelings and experiences that they cannot or will not express and that may manifest through their drawings and imagination. The Asociación Española de Pediatría de Atención Primaria (Spanish Association of Primary Care Pediatrics, AEPap) wanted to explore how children have experienced the confinement. MATERIAL AND METHODS: we organized a contest through the Family and Health website. The study population consisted of children residing anywhere in Spain aged 3 to 16 years. The works submitted were drawings, micro stories or micro videos. RESULTS: we received 53 works from children in different autonomous communities and gave 5 awards. The elements featured most frequently were the coronavirus, figures of children indoors, a rainbow in the clouds and health care professionals. Some of the subjects expressed in the works were boredom, missing grandparents and friends, trust in health care professionals, a positive perception of the change in life in the family, the improvement in environmental pollution and a positive view that everything will turn out well. CONCLUSIONS: the results obtained in this study suggest a generalized optimism and allow us to conclude that drawings, stories and videos are a useful tool to analyze the perception of this population in risk situations. We also ought to highlight the interest of primary care paediatricians in how children have experienced the confinement imposed due to the coronavirus pandemic and raise awareness that children's drawings should be carefully studied

"Slowed Down but Not Stopped": A Spiritual Life Review Intervention in Patients with Neurodegenerative Disease.

Spiritual health is important in managing and coping with chronic and debilitating illnesses, such as neurodegenerative diseases. However, few spiritual interventions have addressed this population. This article quantitatively and qualitatively evaluates outcomes of a spiritual life review in neurodegenerative diseases patients. The majority of participants improved or maintained quality of life and spiritual/emotional well-being following the intervention. Spiritual life review may be an important intervention in the comprehensive care of patients with neurodegenerative diseases.

The Warrior's Journey Intervention: A Chaplain-Led Motivational, Preparatory Exercise for Enhancing Treatment Success.

Outcome literature has shown poor treatment engagement in efficacious, evidence-based post-traumatic stress disorder (PTSD) programs among returning veterans with combat-related psychological symptoms and calls for the development of motivational, preparatory exercises that circumvent stigma-related barriers and are delivered before or during the orientation phase of treatment. The psychological states of hope, meaning, and guilt have been found to impact motivation for treatment and the development and maintenance of post-trauma pathology and symptom severity. Given a chaplain's less stigmatized role, as compared to mental health providers, and proficiency in assessing these states and providing interventions that mediate change, often before a veteran is enrolled in a PTSD treatment program, this paper introduces a brief, chaplain-led, preparatory exercise called the "Warrior's Journey Intervention" (WJI). This narrative based, meaning-making exercise is designed to improve motivation for treatment and mitigate post-trauma symptoms by impacting hope, meaning, and guilt through use of a universally shared, metaphoric story of trauma recovery. A case study will demonstrate use of the intervention, observe its effects, and analyze mechanisms of change. Research is recommended at the end of the article to test the hypothesis that the intervention promotes motivation for treatment and reduces symptoms of PTSD and Moral Injury (MI). A standardized manual for the exercise is available from author.

Visual stimuli in narrative-based interventions for adult anxiety: a systematic review.

Background: Visual stimuli are frequently incorporated into interventions that use narratives to meet counseling, therapy, education, and clinical needs. However, the treatment efficacy of visual stimuli is unclear. This systematic review synthesizes and evaluates visual narrative interventions addressing anxiety.Methods: Databases (n = 9) and extended reference searches identified 13 original studies using visual artifacts in narrative interventions for adult anxiety. The visual stimulations were analyzed based on artifact origin, user interactivity, and functions of the stimuli.Results: Three types of visual artifacts- virtual reality (VR) (n = 4), videos (n = 4), and drawings (n = 5) were found. Dichotomous patterns of artifact origin (native vs. foreign) and interactivity (participatory vs. non-participatory) characterized the applications. A hierarchy of functions- engage, externalize, internalize, and rescript was observed. Most studies confirmed the positive effects on the varied anxiety conditions; however, unclear risk of bias and extraneous factors was present.Conclusions: Future visual narrative studies addressing adult anxiety are recommended to strengthen the current body of knowledge by using double-blinded randomized control trials with robust anxiety measures, incorporating artifact origin and user interactivity in intervention designs, considering alternative stimuli with high accessibility, such as images, and including employment-related anxiety conditions.

UK speech and language therapists' views and reported practices of discourse analysis in aphasia rehabilitation.

BACKGROUND: Discourse assessment and treatment in aphasia rehabilitation is a priority focus for a range of stakeholder groups. However, a significant majority of speech and language therapists (SLTs) infrequently conduct discourse analysis, and do not feel competent in doing so. Known barriers identified in other countries, specifically a lack of time, training, expertise and resources, affect use of discourse analysis in clinical practice. AIMS: To investigate UK SLTs' reported practices and views of discourse analysis, barriers and facilitators, and clinical feasibility in aphasia rehabilitation. METHODS & PROCEDURES: An online survey of 52 questions adapted from existing research and incorporating behaviour change literature was created for the study and piloted. UK SLTs working in aphasia rehabilitation for at least 6 months were invited to participate. Potential participants were contacted through national and local clinical excellence networks, a National Health Service (NHS) bespoke e-mail list, and national magazine advertisement, and the study was also advertised on social media (Twitter). Therapists read an online participant information sheet and submitted individual electronic consent online; then progressed to the Qualtrics survey. Descriptive, correlational and inferential statistical analyses were conducted, and content analysis was carried out on the questions requiring text. OUTCOMES & RESULTS: A total of 211 valid responses were received from primarily female SLTs, aged 20-40 years, working full-time in the NHS in England, in community, inpatient and acute/subacute multidisciplinary settings. A total of 30% SLTs collected discourse analysis often, were mostly very experienced, and working part-time in community settings. Years of experience was predictive of use. Discourse was most often collected using standardized picture descriptions and recounts during initial assessment. Samples were infrequently recorded, and typically transcribed in real-time. Most SLTs (53-95%) reported making clinical judgements or manually counted words, sentences, communication of ideas and errors, and were confident in doing so. Barriers included time constraints; lack of expertise, confidence, training, resources and equipment; and patient severity. Discourse 'super-users' were distinguished by significantly higher professional motivation for discourse and workplace opportunity than other SLTs, and 'non-users' were distinguished by significantly less knowledge and skills in discourse analysis than other SLTs. SLTs reported a desire and need for training, new/assistive tools and time to do more discourse analysis in practice. CONCLUSIONS & IMPLICATIONS: Clinicians were highly engaged and relatively active in at least some aspects of discourse analysis practice. Interventions that target individual clinicians as well as organizations and systems are needed to improve the uptake of discourse analysis in practice. What this paper adds What is already known on the subject? Discourse in aphasia rehabilitation is a priority in clinical practice and research. However, the majority of clinicians infrequently collect and analyse discourse. Research in Australia and the United States indicated that lack of time, assessment resources and relevant knowledge and skills are the main barriers to use. What this paper adds to existing knowledge Compared with existing research, UK SLTs were more likely to see discourse analysis as part of their role and experienced fewer barriers, and more SLTs did it at least sometimes in clinic. However, practices were limited by lack of training, giving rise to challenges in selecting and interpreting findings for clients. More use was predicted by more experience and commitment to discourse analysis, particularly where workplaces supported this approach. Less use was associated with less knowledge and skills in discourse analysis. Practice and decision-making were influenced by client factors and constrained to a lesser degree by logistical challenges. What are the potential or actual clinical implications of this study? Education and training in discourse analyses and in specific procedures are needed to improve individual clinicians' knowledge, skills and confidence in using discourse analysis for clients' rehabilitation. Equally, organizational and systems changes are needed to promote, support and reinforce discourse analysis in the workplace.

The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: study protocol for a multi-center randomized controlled trial (YOURTREAT).

BACKGROUND: Germany hosts a large number of refugees from war-affected countries. The integration of refugees, in particular young refugees from the Middle East, is one of the major current social challenges in Germany. Mental disorders, first of all post-traumatic stress disorder (PTSD) that results from war experiences, are common among young refugees and interfere with quality of life as well as functional integration. Evidence regarding effective treatment options for this population is scarce. In this trial, we aim to evaluate the pragmatic, short-term psychotherapy Narrative Exposure Therapy for Children (KIDNET) for the treatment of young refugees in Germany. METHODS: In a rater-blinded, multi-center, randomized-controlled trial, KIDNET is compared to treatment as usual (TAU) within the general health care system. A total number of 80 young refugees who fulfill the diagnostic criteria of PTSD will be randomized to either KIDNET or TAU. Diagnostic interviews will take place at baseline before treatment as well as 6 and 12 months thereafter. They will assess exposure to traumatic events, PTSD and comorbid symptoms, as well as parameters of integration. DISCUSSION: The results of this study should provide evidence regarding effective treatment options for young refugees in Germany, a population that has been understudied and received only limited access to mental health care so far. Next to the effects of treatment on mental health outcomes, integration parameters will be investigated. Therefore, this study should provide broad insights into treatment options for young refugees and their potential implications on successful integration. TRIAL REGISTRATION: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS), ID: DRKS00017222. Registered on 15 May 2019.