Psychotherapeutic Intervention for Adults With Acquired Brain Injury: A Case Study Using BackUp.

A moderate-to-severe acquired brain injury (ABI) can have tremendous lifelong consequences for ABI-survivors and their families. Despite rehabilitation practice since the 1980s aspiring to a dynamic, coherent and holistic approach, the psychological dimension still seems to be a challenge and research has revealed persisting psychosocial impairments after ABI. Therefore, we developed BackUp©, a manual based short term psychological intervention for adults with ABI. This study explores the effect of the intervention though a small feasibility study, employing a single case design. One client received the intervention. Self-report measures were collected, and a semi structured interview was conducted. While results from pre, post and follow-up measures do not show clear positive results, the interview reveals positive experiences and the participant reported achieving his therapy goal. This case study provides support for a psychological intervention to support the psychological rehabilitation after an ABI.

Defining Terms Used for Animals Working in Support Roles for People with Support Needs.

The nomenclature used to describe animals working in roles supporting people can be confusing. The same term may be used to describe different roles, or two terms may mean the same thing. This confusion is evident among researchers, practitioners, and end users. Because certain animal roles are provided with legal protections and/or government-funding support in some jurisdictions, it is necessary to clearly define the existing terms to avoid confusion. The aim of this paper is to provide operationalized definitions for nine terms, which would be useful in many world regions: "assistance animal", "companion animal", "educational/school support animal", "emotional support animal", "facility animal", "service animal", "skilled companion animal", "therapy animal", and "visiting/visitation animal". At the International Society for Anthrozoology (ISAZ) conferences in 2018 and 2020, over 100 delegates participated in workshops to define these terms, many of whom co-authored this paper. Through an iterative process, we have defined the nine terms and explained how they differ from each other. We recommend phasing out two terms (i.e., "skilled companion animal" and "service animal") due to overlap with other terms that could potentially exacerbate confusion. The implications for several regions of the world are discussed.

Dog visits in nursing homes - increase complexity or keep it simple? A randomised controlled study.

OBJECTIVE: To compare the immediate response of nursing home residents to dog visits with or without an activity, and the impact of cognitive ability. METHODS: In a randomly controlled trial, 174 nursing home residents were allocated to 12 bi-weekly 10-minute visits: either ordinary dog visits (D, n = 57, 49 analysed), dog visits with an activity (DA, n = 56, 48 analysed), or visits with activity but no dog (A, n = 61, 54 analysed). We recorded frequency and duration of residents' verbal and physical interactions with the dog and persons. Data were analysed in three periods of four visits (period 1-3) as binomial variables (generalised linear models) or durations (non-parametric statistics). RESULTS: Both visit type and impairment level affected the likelihood of interacting with the dog (D and DA). In some periods increased cognitive impairment lowered odds of touching the dog in DA visits (period 1: F1,85 = 5.17, P < 0.05) and talking to it directly (period 1: F1,90 = 4.60, P < 0.05; period 3: F1,87 = 5.34, P < 0.05). Throughout, residents talked less to persons during DA visits compared to D and A (P = 0.01-0.05), and level of cognitive impairment correlated negatively with talk duration (P < 0.001). Generally, high cognitive impairment level lowered odds of interacting with (period 1: F1,89 = 7.89, P < 0.01; period 2: F1,97 = 6.76, P = 0.01; period 3: F1,92 = 13.57, P < 0.001) and talking about the activities (period 1: F1,89 = 13.78, P <0.001; period 2: F1,88 = 3.27, P = 0.07; period 3: F1,86 = 3.88, P = 0.05). CONCLUSION: Visits without specific activities stimulated residents to interact with the dog, whereas increasing the complexity of dog visits by adding activities resulted in less interaction with the dog for severely impaired residents. The optimal dog visit for the less cognitively impaired residents could include activities and thereby a possibility to interact with the dog in different ways, whereas for severely impaired residents, just being with the dog seems more appropriate.

The relationship between sociocultural factors and autobiographical memories from childhood: the role of formal schooling.

Cross-cultural differences in autobiographical memory (AM) are associated with cultural variations. In models of the self and parental reminiscing style, but not many studies have analysed the relationship between AM and specific cultural practices such as formal schooling. Theoreticians like [Greenfield, P. M. (2009). Linking social change and developmental change: Shifting. pathways of human development. Developmental Psychology, 45, 401-418. doi: 10.1037/a0014726 ; Kagitçibasi, C. (2005). Autonomy and relatedness in cultural context. Implications for self and family. Journal of Cross-Cultural Psychology, 36, 403-422. doi: 10.1177/0022022105275959 ] and [Keller, H. (2007). Children development across cultures. New York: Lawrence Erlbaum Associates] have considered formal schooling as an engine towards the model of independence; however, the empirical evidence in this regard is inconclusive: while some studies found evidence of a relation between formal schooling and characteristics of AM, others did not. To solve this inconsistency, the present study compared orally narrated childhood memories of Mexican adults with three different levels of education (from rudimentary literacy to university). Results support a relationship between formal schooling and AM in the predicted direction: More educated participants reported longer, more specific and more self-oriented memories than those with less schooling experience did. Some gender differences were also observed, with males generally reporting more individually and less socially oriented memories than females, except for university level participants. We conclude that these results support Greenfield's theory about formal schooling as a sociocultural factor that promotes the cultural pathway to independence, as well as complexity and context-boundedness of gender differences in AM.

Investigating interdependent self in post-communist countries: A comparison of two Slovak and Danish generations.

Some evidence suggests prevalence of collectivist values and interdependent self in post-communist Europe. However, research on social representations identifies a possible divide between Eastern Europeans' appreciation of their immediate social environment on the one hand and their suspicion toward impersonal collectives on the other. The current study aimed to capture this divide by investigating two types of interdependent self, namely relational and collective. Specifically, we compared self-descriptions in two Slovak samples-"old" with a communist experience (n = 80) and "young" without it (n = 80)-and used a country that has never been communist (Denmark; n = 80 x 2) to control for age effects. Results showed predominance of independent self in all groups, higher relational self in both old groups, and highest collective self among the young Slovaks. This indicates no association between communist experience and interdependent self, but a possible post-communist effect is suggested. Theoretically, the study substantiated the importance of disentangling interdependence.

Does a short self-compassion intervention for students increase healthy self-regulation? A randomized control trial.

The primary aim of this study was to examine the effects of a two-week self-compassion course on healthy self-regulation (personal growth self-efficacy and healthy impulse control) and unhealthy self-regulation (self-judgment and habitual negative self-directed thinking) in university students. We also examined the effects on self-compassion, anxiety and depression. Students (N = 158, 85% women, mean age = 25 years) were randomized to an intervention group and a waiting-list control group in a multi-baseline randomized control trial. Healthy self-control was measured by the Personal Growth Initiative Scale (PGIS) and the Self-Control Scale; unhealthy self-control was measured by the Non-judgement subscale from the Five-Facet Mindfulness Questionnaire (reversed) and the Habit Index of Negative Thinking (HINT). Secondary outcomes were measured by the State-Trait Anxiety Inventory (STAI-trait), the Major Depression Inventory (MDI), and the Self-Compassion Scale (SCS). A 2 × 3 repeated measures analysis of variance (ANOVA) showed gains for the intervention-group in personal growth self-efficacy and healthy impulse-control and reductions in self-judgment and habitual negative self-directed thinking, as well as increases in self-compassion and reductions in anxiety and depression. After all participants had completed the course, the groups were combined and repeated measures ANOVAs showed that changes remained at six-month follow-up for personal growth self-efficacy, self-judgment and habitual negative self-directed thinking; as well as for self-compassion, anxiety and depression. Concluding, a short self-compassion course seems an effective method of increasing self-compassion and perceived control over one's life for university students, as well as increasing mental health.

How Are Service Dogs for Adults with Post Traumatic Stress Disorder Integrated with Rehabilitation in Denmark? A Case Study.

A severe mental illness like Post Traumatic Stress Disorder (PTSD) is known to have psychosocial consequences that can lead to a decreased quality of life. Research in Animal-Assisted Therapy (AAT) has revealed that the presence of a dog can have a positive effect on health, e.g., increase quality of life and lessen depression and anxiety. However, canine companionship is not a catch-all solution. Previous research has revealed methodological limitations that prohibit any clear conclusions, as well as a sparsity of critical reflection in anecdotal reports and case studies, which means that more research is needed to contextualize the findings. There has been an increasing interest in animal-assisted intervention in Denmark in recent years. Previously, authorities could only grant service dogs to adults with physical disabilities, but now this has been extended to adults with mental illnesses. Therefore, it has become important to explore how these service dogs are incorporated into rehabilitation practices in mental health, and how rehabilitation professionals react to the use of service dogs. This paper is a case study of a person who suffers from PTSD. This study examines how the person describes the significance of having a dog during her rehabilitation process, and how this is integrated with existing rehabilitation. The case study has been developed based on a semi-structured interview. A Thematic Content analysis was used to reveal dominant patterns and categories. This study revealed a lack of communication and collaboration between public administration (social service), service dog providers, health rehabilitation services, and providers of psychological treatment. It also revealed limited access for the dog to public services, limited success in incorporating the dog into goal-directed treatment and rehabilitation procedures, a strongly felt emotional support from the dog, and a perceived stigma by having the dog wearing a vest with he words "mentally ill" printed on it.

Bio-psycho-social effects of a coordinated neurorehabilitation programme: A naturalistic mixed methods study.

PURPOSE: Best practice guidelines for neurorehabilitation recommend coordinated rehabilitation programmes to ensure seamless service transitions and comprehensive rehabilitation practices. However, this recommendation for practice and the evidence informing its advancement is based on unexamined assumptions. Therefore, this study investigates bio-psycho-social outcomes and perceptions of a coordinated rehabilitation programme. METHOD: In a prospective, naturalistic mixed methods study, rehabilitation outcomes for 82 adults (18-66 years) with moderate to severe acquired brain injury were investigated. Clients who received the coordinated rehabilitation programme KORE (n = 27) were compared to clients from the same area who received standard rehabilitation prior to the implementation of the KORE programme (n = 37) and clients who received other coordinated efforts elsewhere (n = 18). The study employed quantitative data from standardized tests (Functional Independence Measure, Major Depression Inventory, Quality of life, and Impact on Participation and Autonomy Questionnaire, as well as information on return to work and qualitative interviews with clients (n = 82) and their relatives (n = 40). RESULTS: Outcomes did not improve from hospital discharge to two years later. Notably, physiological recovery had probably been achieved to the extent possible, but depression and reduced psychological well-being remained prevalent across groups. Qualitative interviews suggested several barriers to improvement, such as identity dilemmas and unmet needs for psychological support, while rehabilitation services focused on physical and practical training. CONCLUSION: Coordinated interventions do not guarantee comprehensive rehabilitation and better outcomes for clients with acquired brain injury. Psychological support seems to be important and largely unaddressed.