Service users' first accounts of experiencing endings from a psychological service or therapy: A systematic review and meta-ethnographic synthesis.

PURPOSE: To review and synthesize the qualitative literature on service users' experiences of endings from a psychological service or therapy. METHODS: A systematic search of the peer-reviewed literature identified qualitative studies meeting specific inclusion criteria. A modified CASP tool was used to critically appraise their quality, and a meta-ethnographic approach was used to synthesize their findings. RESULTS: Twelve papers met the inclusion criteria. The interpretation of findings suggested three key themes: anticipation of ending, service user control, and sense of responsibility. Although studies varied in geographical location and type of service, they were consistently of high quality. CONCLUSIONS: The review highlights the importance of service users' perspectives in understanding the experiences of endings. The findings complement existing literature and provide new interpretations. Considerations for practice were limited; however, the review provides useful directions for future research. PRACTITIONER POINTS: When ending therapy, clinicians should consider the dyadic nature of the therapeutic relationship and the emotional impact this may have upon both service users and staff. Further consideration should be given to how staff manage their responses to the ending. The time-limited structure of therapy may aid the ending process by relieving staff and service users of responsibility.

The effectiveness and acceptability of a guided self-help Acceptance and Commitment Therapy (ACT) intervention for psychogenic nonepileptic seizures.

This study utilized a nonconcurrent case-series design to examine the effectiveness and acceptability of a guided self-help Acceptance and Commitment Therapy (ACT) intervention for people with psychogenic nonepileptic seizures. A key aim of the study was to investigate the relationship between psychological flexibility (a key process within ACT), psychological health, quality of life, and seizure frequency. Six participants completed the study, with reliable and clinically significant changes in psychological flexibility, quality of life, and psychological health observed in the majority of participants. Notable reductions in self-reported seizure frequency were also observed. The implications of these findings for clinical practice are discussed and recommendations for future research suggested.

The impact of receiving a diagnosis of Non-Epileptic Attack Disorder (NEAD): A systematic review.

BACKGROUND: Clinicians have reported observations of the immediate cessation of non-epileptic attacks after the diagnosis of NEAD is presented. OBJECTIVE: The purpose of this systematic review was to examine the impact of receiving a diagnosis of NEAD. SEARCH STRATEGY: A literature search across the databases Medline, PsycINFO, EMBASE, and CINAHL, and additional hand searching, identified six original studies meeting criteria for the review. SELECTION CRITERIA: Included studies were original peer-reviewed articles investigating the impact of receiving a diagnosis of NEAD on adult populations with at least one outcome measured pre- and post-diagnosis. ANALYSIS: The studies were assessed for methodological quality, including biases. This assessment was developed to include criteria specific to research regarding NEAD and diagnosis. RESULTS: Six identified studies, with a total of 153 NEAD participants, examined the impact of receiving a diagnosis on seizure frequency. Two of the six also examined the impact on health-related quality of life. The findings were inconsistent, with approximately half the participants experiencing seizure reduction or cessation post-diagnosis. Diagnosis appeared to have no significant impact on health-related quality of life. The overall evidence lacked quality, particularly in study design and statistical rigour. CONCLUSIONS: Mixed results and a lack of high quality evidence were found. Concerns are considered regarding the appropriateness of seizure frequency as the primary outcome measure and the use of epilepsy control groups. Indications for future research include: measuring more meaningful outcomes, using larger samples and power calculations, and ensuring consistent and standard methods for communicating the diagnosis and recording outcomes.

Female-perpetrated intimate partner violence: an examination of three cases using multiple sequential functional analysis.

BACKGROUND: Recent empirical evidence suggests that women assault their intimate partners at approximately the same rate as men. However, a general historical reluctance to acknowledge women as significant perpetrators of intimate partner violence (IPV) has limited clinical understanding of this phenomenon and the processes by which such behaviour may develop. AIM: The following paper uses multiple sequential functional analysis (MSFA), an idiographic case formulation method based on functional analysis, to explore the development and functional value of IPV in the case histories of three women. METHOD: Data from comprehensive clinical interviews, file review and collateral professional interviews are synthesised using MSFA to examine the development and maintenance of IPV across each participant's lifespan. RESULTS: Although there appeared to be important differences between participants, the analyses broadly indicated that all three participants used violence instrumentally to achieve some aspect of control or coercion over their intimate partners, and to meet their primary intimacy needs. CONCLUSIONS: The MSFA appears to be a useful methodology for understanding female-perpetrated IPV and, importantly, may lend itself more readily to effective formulation-informed interventions than other qualitative-narrative case methods. The strengths and limitations of MSFA as a pragmatic case formulation method are discussed.

Assessing the implicit beliefs of sexual offenders using the implicit relational assessment procedure: a first study.

Researchers have proposed that the cognitive distortions of sexual offenders are underpinned by a number of implicit cognitive processes termed implicit theories. Until recently, however, the implicit theory hypothesis has received little empirical support due to broader limitations with standard forensic assessment procedures. The current research aimed to determine whether a new assessment methodology, the Implicit Relational Assessment Procedure (IRAP), could provide further evidence for Ward and Keenan's (1999) children as sexual beings implicit theory. The results indicated that the IRAP was significantly more effective at identifying core implicit differences between sexual offenders against children and nonoffenders than a cognitive distortion questionnaire. Furthermore, although both groups demonstrated an overall response bias towards adults as sexual and children as nonsexual, this bias was significantly impaired in the sexual offender group. The findings are discussed in relation to previous implicit theory research and recommendations for the development of implicit methodologies are made.