As transformações psíquicas através do Rorschach: Juan, um adolescente e não um Don Juan! / Las transformaciones psíquicas en el Rorschach: Juan, un adolescente y no un Don Juan! / Psychic transformations through the Rorschach: Juan, an adolescent not a Don Juan!

RESUMO A adolescência é uma fase do desenvolvimento que se caracteriza pela presença de importantes transformações psíquicas que constituem a base dos processos de identidade e de identificação. No contexto social atual, a capacidade de integrar as diferenças culturais é um imperativo do ponto de vista social e emocional, não só para os adolescentes, mas para todos os que com eles se relacionam, sejam pais, professores e técnicos de saúde. Neste artigo, a autora procura realizar uma dupla análise: (1) Apresentar o trabalho psicoterapêutico realizado com Juan, um adolescente de 17 anos, durante o qual é possível observar as mudanças inerentes à construção da sua identidade e dos processos de identificação, inspirando-se num clássico literário espanhol, Don Juan; (2) A utilização do Rorschach, como instrumento de acesso privilegiado ao mundo interior do sujeito, que permite uma compreensão singular das transformações psíquicas presentes no processo de tornar-se adolescente. A utilização do Rorschach desta forma é uma abordagem inovadora para compreender os processos psíquicos envolvidos, melhorando a intervenção na clínica. No caso de Juan, foi possível ver além do seu diagnóstico clínico, lançando novos olhares sobre as suas capacidades psíquicas, favorecendo a construção de uma postura mais adulta, visível no seu desempenho académico, nas relações interpessoais e na dinâmica familiar. Esse trabalho clínico só foi possível graças aos referenciais teóricos que enfatizam os processos de comunicação e de simbolização.

RESUMEN. La adolescencia es un periodo de desarrollo que se caracteriza por la presencia de importantes transformaciones que están en la base de los procesos de identidad y de identificación. En el contexto social actual, la capacidad de integrar las diferencias culturales es un imperativo desde el punto de vista social y emocional, no solo para los adolescentes, sino para cualquier persona que tenga relación con ellos, ya sean padres, docentes y técnicos de salud. En este artículo, el autor busca realizar un doble análisis: (1) Presentar el trabajo psicoterapéutico realizado con Juan, un adolescente de 17 años, durante el cual es posible observar los cambios inherentes a la construcción de su identidad e identificación, presentada aquí con inspiración de un clásico literario español, Don Juan; (2) El empleo de la prueba de Rorschach, como instrumento de acceso privilegiado al mundo interior del sujeto, que permite una comprensión singular de las transformaciones psíquicas implicadas en el proceso de convertirse en adolescente. La utilización del Rorschach de esta manera es un enfoque innovador para comprender los procesos psíquicos involucrados, mejorando así la intervención clínica. En el caso de Juan, fue posible mirar más allá de su diagnóstico clínico, permitiendo que esta nueva lectura resalte sus habilidades psíquicas, favoreciendo la construcción de un nuevo posicionamiento, visible en su éxito académico, en las relaciones interpersonales y en su dinámica familiar. Este trabajo clínico solo fue posible dado el nuevo marco teórico que enfatiza los procesos de comunicación y simbolización.

ABSTRACT Adolescence is a stage of development that is characterized by the presence of important psychic transformations that form the base of the processes of identity and identification. In the current social context, the ability to integrate cultural differences is an imperative from a social and emotional standpoint, not only for adolescents, but anyone who has a relationship with them, be they parents, teachers and health technicians. In this article, the author seeks to carry out two-fold analysis: (1) Present the psychotherapeutic work conducted with Juan, a 17-year-old adolescent, during which it is possible to observe the changes inherent to the construction of his identity and identification, presented here with inspiration from a Spanish literary classic, Don Juan; (2) The employment of the Rorschach test, as an instrument granting privileged access to the subject's inner world, which allows for a singular understanding of the psychic transformations involved in the process of becoming an adolescent. Applying a Rorschach test in this fashion is an innovative approach to understanding the psychic underpinnings involved, thereby enhancing clinical intervention. In Juan's case, it was possible to look beyond his clinical diagnosis, shedding new light on his psychic abilities, favoring the construction of a new position, one more adult and one evidenced in improved academic performance, interpersonal relationships, and family dynamics. This clinical work was further enabled by theoretical frameworks that emphasize the processes of communication and symbolization.

Reflexões sobre a construção de uma pesquisa qualitativa em psicoterapia on-line / Reflexiones sobre la construcción de una investigación cualitativa en psicoterapia online / Reflections on the construction of a qualitative research in online psychotherapy

RESUMO. Os serviços mediados pela internet oferecem uma diversidade de formas de conexão e interatividade e, em decorrência, surgem novas intervenções em saúde mental, exigindo pesquisas que fundamentem e avaliem tais práticas. Entretanto, os estudos na área são escassos, especialmente diretrizes que auxiliem na condução de pesquisas que envolvam as intervenções baseadas na internet. Nesse sentido, o objetivo deste artigo é indicar orientações para o desenho de pesquisas de intervenção psicológica na internet, tendo como ilustração a construção de uma pesquisa interventiva em psicoterapia on-line, qualitativa, descritiva e longitudinal. São abordados seis aspectos significativos para pesquisas em intervenção digital, incluindo contato com colaboradores, critérios de participação, alcances da pesquisa, monitoramento e avaliação das intervenções, critérios tecnológicos e aspectos éticos no campo digital. São levantados aspectos técnicos, qualitativos e de cuidados necessários para manter a qualidade dos atendimentos e das pesquisas mediadas pelas tecnologias digitais. É urgente à psicologia consolidar um campo de saber que se ocupe tanto das influências das tecnologias nas subjetividades, também, delinear estudos que avaliem com rigor científico o uso da internet para o tratamento e cuidado em saúde mental.

RESUMEN. Los servicios mediados por Internet ofrecen una diversidad de formas de conexión e interactividad y, como resultado, surgen nuevas intervenciones en salud mental, que requieren investigaciones que corroboren y evalúen dichas prácticas. Sin embargo, los estudios en el área son escasos, especialmente las directrices que ayudan a realizar investigaciones que involucran intervenciones basadas en Internet. En este sentido, el objetivo de este artículo es indicar directrices para el diseño de investigación de intervención psicológica en Internet, teniendo como ilustración la construcción de una investigación intervencionista en psicoterapia online, cualitativa, descriptiva y longitudinal. Se abordan seis aspectos significativos para la investigación en intervención digital, incluyendo el contacto con colaboradores, los criterios de participación, el alcance de la investigación, el seguimiento y evaluación de las intervenciones, los criterios tecnológicos y los aspectos éticos en el campo digital. Se plantean aspectos técnicos, cualitativos y asistenciales necesarios para mantener la calidad asistencial y la investigación mediada por las tecnologías digitales. Es urgente que la Psicología consolide un campo de conocimiento que se ocupe tanto de las influencias de las tecnologías en las subjetividades como de esbozar estudios que evalúen con rigor científico el uso de Internet para el tratamiento y cuidado en salud mental.

ABSTRACT Internet-mediated services offer a variety form of connection and interactivity, from this, new mental health interventions emerge, requiring research to validate and evaluate such practices. However, studies in the area are scarce, especially guidelines that assist in conducting research involving Internet-based interventions. The purpose of this study was to indicate guidelines for the design of psychological intervention research mediated by the Internet, based on the construction of an interventional research in online, qualitative, descriptive and longitudinal psychotherapy. Six significant aspects for digital intervention. Six significant aspects for research in digital intervention are addressed, including contact with collaborators, criteria for participation, scope of research, monitoring and evaluation of interventions, technological criteria and ethical aspects in the digital field. Technical, qualitative and care aspects necessary to maintain the quality of care and research mediated by digital technologies are raised. It is urgent for Psychology to consolidate a field of knowledge that deals with the influence of technologies on subjectivities, as well as to design studies that scientifically assess the use of the internet for treatment and care in mental health.

A huggable device can reduce the stress of calling an unfamiliar person on the phone for individuals with ASD.

Individuals with autism spectrum disorders (ASD) are often not comfortable during mobile-phone conversations with unfamiliar people. "Hugvie" is a pillow with a human-like shape that has been designed to provide users with the tactile sensation of hugging another person during phone conversations to promote feelings of comfort and trust in the speaker toward their conversation partners. Our primary aim was to examine whether physical contact by hugging a Hugvie could reduce the stress of speaking with an unfamiliar person on the phone in individuals with ASD. We enrolled 24 individuals and requested them to carry out phone conversations either using only a mobile phone or using a mobile phone along with the Hugvie. All participants in both groups completed questionnaires designed to evaluate their self-confidence while talking on the phone, and also provided salivary cortisol samples four times each day. Our analysis revealed that the medium of communication was a significant factor, indicating that individuals with ASD who spoke with an unfamiliar person on the phone while hugging a Hugvie had stronger self-confidence and lower stress levels than those who did not use Hugvie. Hence, we recommend that huggable devices be used as adjunctive tools to support individuals with ASD during telephonic conversations with unfamiliar people.

El deseo del analista en la experiencia del análisis

Reflexión sobre los deseos del analista basada en los aportes de Jacques Lacan, partiendo de la concepción del psicoanálisis como praxis, y del inconsciente como concepto fundamental de la misma, y concibiéndolo como articulador de estas cuestiones.

Outcomes of a health informatics technology-supported behavioral activation training for care managers in a collaborative care program.

INTRODUCTION: Health informatics-supported strategies for training and ongoing support may aid the delivery of evidence-based psychotherapies. The objective of this study was to describe the development, implementation, and practice outcomes of a scalable health informatics-supported training program for behavioral activation for patients who screened positive for posttraumatic stress disorder and/or bipolar disorder. METHOD: We trained 34 care managers in 12 rural health centers. They used a registry checklist to document the delivery of 10 behavioral activation skills for 4,632 sessions with 455 patients. Care managers received performance feedback based on registry data. Using encounter-level data reported by care managers, we described the implementation outcomes of patient reach and care manager skill adoption. We used cross-classified multilevel modeling to explore variation in skill delivery accounting for patient characteristics, provider characteristics, and change over time. RESULTS: Care managers engaged 88% of patients in behavioral activation and completed a minimum course for 57%. The average patient received 5.9 skills during treatment, with substantial variation driven more by providers (63%) than patients (29%). Care managers significantly increased the range of skills offered to patients over time. DISCUSSION: The registry-based checklist was a feasible training and support tool for community-based providers to deliver behavioral activation. Providers received data-driven performance feedback and demonstrated skill improvement over time, promoting sustainment. Future research will examine patient-level outcomes. Results underscore the potential public health impact of a simple registry-based skills checklist coupled with a scalable remote training program for evidence-based psychotherapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Modelo conductual-contextual de las relaciones íntimas: aplicabilidad en psicoterapia / Behavioral-contextual model of intimate relationships: applicability in psychotherapy

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Intimate relationships matter for both human's physical and psychological health. Although many theories have been developed to study this topic, there is no consensus about the underlying processes in human relationships. The Interpersonal Process Model, which has well-established empirical support, aims to address the development of intimate relationships describing them as observed behaviors. This has important implications in psychotherapy, especially for those approaches that understand the interpersonal patient-therapist relationship as a tool for change. That is the case of Functional Analytic Psychotherapy. In this paper we articulate a model of intimate relationships based on Interpersonal Process Model and the principles of Functional Behavioral Analysis, connecting it with previous results on the field of intimate relationships. Likewise, a discussion about its implications in psychotherapy and its utility to solve some Functional Analytic Psychotherapy's limitations is presented

Feasibility and acceptability of a novel tool for the study of interpersonal processes in psychotherapy.

Psychotherapy process research methods often require extensive time and resources. Technology innovations, such as wearable sensors, have the potential to increase the efficiency of process data collection and processing. One such tool is the Sociometric Badge (SB), which is a portable, palm-sized device that can simultaneously record raw audio and data on social signals (e.g., speech patterns, body movement) in real-time and in varied contexts. In addition to describing the nature and implications of wearable sensing devices for psychotherapy research, this article reports results from a pilot study that examined the feasibility and acceptance of these assessment devices in comparison with traditional audio recording equipment. Undergraduate students (N = 306; Mage = 19.16 years, SD = 1.44; 50.3% female) were randomly placed into 153 dyads to mimic a psychotherapy dyad. Each dyad was randomly assigned to either a SB condition (n = 75 dyads) or a standard recording device condition (n = 78 dyads), and engaged in a conversation task. Participants completed self-report items assessing perceived relationship quality and experience with the respective recording device. Between-condition tests showed that perceived relationship quality did not differ between conditions. Participants in the audio recorder (vs. SB) condition reported more awareness of the device in the room. These findings reveal comparable acceptability and feasibility of SBs to traditional audio recorders in a simulated dyad, suggesting that wearable sensing devices may be suitable for research and practice in routine psychotherapy contexts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Attitudes of Therapists and Physicians on the Use of Sex Robots in Sexual Therapy: Online Survey and Interview Study.

BACKGROUND: Various types of robots have already been successfully used in medical care, and the use of new technologies is also playing an increasing role in the area of sexuality. Sex robots are marketed as advanced sex toys and sex dolls with artificial intelligence. Only a few considerations about the therapeutic use of sex robots in sexual therapy are debated in expert discussions. OBJECTIVE: The aim of this study was to conduct a first exploratory survey on the attitudes of sex therapists and physicians toward the therapeutic benefits of sex robots. METHODS: This study comprised a quantitative online survey and a qualitative interview study. A self-constructed questionnaire was used to survey the general attitudes of sex therapists and physicians regarding the benefits of sex robots in therapy. The qualitative study was designed to gain in-depth insight into the participants' beliefs and attitudes. Therefore, semistructured interviews were conducted. The quantitative data were evaluated by statistical analysis, and the interviews were transcribed and analyzed by using a grounded theory approach. RESULTS: A total of 72 sex therapists and physicians completed our self-constructed questionnaire (response rate 15%, 72/480). Only a few respondents (11%, 8/72) said that the use of sex robots was not conceivable for them, and almost half of all therapists and physicians could imagine recommending sex robots in therapy (45%, 33/72). The attitude toward sex robots as a therapeutic tool was very heterogeneous, with gender (P=.006), age (P=.03), and occupational differences (P=.05); female therapists, older therapists, and psychologists (in contrast to physicians) were more critical toward the therapeutic use of sex robots. The analysis of the 5 interviews identified 3 high-level core themes that were representative of the participants' responses: (1) the importance of the personal definition of sex robots for the assessment of their therapeutic benefits, (2) therapeutic benefits and dangers of sex robots, and (3) considerations on the quality of human-robot sexuality. Initial insights into the possible therapeutic use of sex robots in different disorders (eg, sexual dysfunction or pedophilia) and situations were gained from the perspective of sex therapists. CONCLUSIONS: The results of this study provide a first overview of the potential therapeutic use of sex robots. Moral, ethical, and treatment-related issues in this context are still unresolved and need to be further researched. We suggest integrating the topic into the training of sex therapists to form opinions beyond media images and to show therapy possibilities. Scientists engaged in sexual research should be involved in the development of sex robots to design robots with positive effects on sexual education, sexual therapy, sexual counseling, and sexual well-being for interested groups.

Effects of cyclic adjustment training delivered via a mobile device on psychological resilience, depression, and anxiety in Chinese post-surgical breast cancer patients.

PURPOSE: Psychological resilience is an important ability for women with breast cancer to cope effectively with depression and anxiety. However, the demands of long-term hospital-based psychological rehabilitation interventions are not met in mainland China, where shorter hospital stays and longer home rehabilitation are common. This study examines whether a cyclic adjustment training (CAT) intervention delivered via a mobile device can improve psychological resilience, and reduce depression and anxiety symptoms, in a population of post-surgical women with breast cancer. METHODS: Women with breast cancer were recruited through convenience sampling from a general hospital in Xi'an, and randomly allocated to an intervention group (n = 66), receiving CAT plus routine nursing care for 12 weeks, or a control group (n = 66), receiving only routine nursing care. The primary outcome was psychological resilience. Resilience, anxiety, and depression were measured using the Connor-Davidson Resilience Scale (CD-RISC), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS), respectively. A linear mixed model was applied to analyze the effects. RESULTS: Patients in the CAT group displayed significantly improved psychological resilience, anxiety, and depression scores (F = 19.53, P < 0.001; F = 31.85, P < 0.001; F = 26.32, P < 0.001), respectively, compared to the control group. CONCLUSIONS: The CAT had positive effects on improving psychological resilience and reducing the symptoms of anxiety and depression, supporting its use as an effective psychological management and intervention strategy in the early stages of long-term rehabilitation of post-surgical women with breast cancer. TRIAL REGISTRATION: Chictr.org.cn ChiCTR-IOR-16008253, registered 9 April 2016.

A virtual reality counterconditioning procedure to reduce methamphetamine cue-induced craving.

The present work developed a virtual reality (VR) counterconditioning procedure (VRCP), and investigated its efficacy in treatment of cue-induced craving in individuals with methamphetamine (METH) dependence. In study 1, thirty-one patients diagnosed with METH dependence received VRCP, while twenty-nine METH-dependent patients in waiting-list group did not. In study 2, the VRCP was computerized as a VR treatment system. Six-hundred and twelve abstinent individuals with a history of METH dependence received the computerized VRCP, while two-hundred seventy-six abstinent individuals with a history of METH dependence in waiting-list group did not. Patients with METH dependence who received VRCP showed a significantly larger decrease on the score of METH-craving and METH-liking from baseline to follow-up assessments, compared to those who did not received VRCP. Participants received VRCP showed a significantly larger decrease in HRV indexes on time domain and non-linear domain from baseline to follow-up assessments during exposure to VR cues, compared to those in waiting-list group. These findings indicate that the counterconditioning procedure under VR environment may be a useful strategy in suppressing cue-induced reactivity for patients with METH dependence.

Rationale and design of a systematic review: effectiveness and acceptance of technology-based psychological interventions in different clinical phases of depression management.

INTRODUCTION: Although many effective treatment options exist, depression is still undertreated indicating gaps in the healthcare system. The complementary provision of mental healthcare through technologies (eg, computer, smartphone) has the potential to fill treatment gaps and to overcome access barriers to mental healthcare. Until now, no systematic review integrates the evidence on different technology-based psychological interventions (TBIs) concerning their effectiveness and acceptance in different clinical phases of depression management (bridging waiting periods, acute treatment and aftercare). The aim of this project is to structure evidence on TBIs regarding different phases of depression management, and to determine effectiveness and acceptance for each clinical phase considering both active (eg, face-to-face treatment) and inactive (eg, waitlist) controls as comparators. METHODS AND ANALYSIS: We will include studies on adults with a formal diagnosis of unipolar depression. Treatments delivered by technologies based on scientific psychological theories will be considered as experimental interventions. The primary effectiveness outcome will be depressive symptoms at study endpoint measured by symptom severity rating scales, and the primary acceptance outcome will be dropping out of the study due to any reason. We will consider only randomised controlled trials, which will be identified by key database searches (including Cochrane Central Register of Controlled Trials, Medline, PsycINFO, PSYNDEX, CINAHL) complemented through searches in clinical trial registries (eg, clinicaltrials.gov) and grey literature searches (eg, Open Grey). Two review authors will independently conduct study selection, data extraction and quality assessment of included studies (using the Cochrane Collaboration's tool for assessing risk of bias). Meta-analyses applying random-effect models as well as subgroup, meta-regression and sensitivity analyses will be performed. ETHICS AND DISSEMINATION: Ethics approval is not required for this study, as we conduct research on secondary data. We will disseminate results via peer-reviewed journal publications, presentations on conferences and via plain language summaries. PROSPERO REGISTRATION NUMBER: CRD42016050413; Pre-results.

Testing an App-Assisted Treatment for Suicide Prevention in a Randomized Controlled Trial: Effects on Suicide Risk and Depression.

Suicide is a global public health problem and effective psychological interventions are needed. The objective of the present study was to evaluate the effect of an app-assisted suicide prevention treatment on suicide risk and depression. One hundred twenty-nine participants were randomized to treatment as usual (TAU), consisting of psychotherapy adhering to the framework of Collaborative Assessment and Management of Suicidality (CAMS), with (TAU+APP, N = 60) or without (TAU, N = 69) access to a mobile application (i.e., LifeApp'tite). Suicide risk and symptoms of depression were assessed pre- and posttherapy, and at 4-month follow-up. The TAU+APP group showed a smaller decrease on self-reported suicide risk at the end of treatment, corresponding to a medium between-group effect size (p = .008, d = 0.46). At the 4-month follow-up this was the case only at the trend level, where the effect size was also of a smaller magnitude (p = .057, d = 0.30). No differences between the treatment groups were observed on self-reported depressive symptoms, either immediately following treatment (p = .732, d = 0.05) or at follow-up (p = .467, d = 0.11). The unexpected negative effect concerning suicide risk points to crucial consideration of issues pertaining to timing, dosing, and content when adding new technology to existing treatments both in this and other populations.

Effectiveness of a Multimodal Digital Psychotherapy Platform for Adult Depression: A Naturalistic Feasibility Study.

BACKGROUND: Although psychotherapy is one of the most efficacious and effective treatments for depression, limited accessibility to trained providers markedly limits access to care. In an attempt to overcome this obstacle, several platforms seeking to provide these services using digital modalities (eg, video, text, and chat) have been developed. However, the use of these modalities individually poses barriers to intervention access and acceptability. Multimodal platforms, comprising those that allow users to select from a number of available modalities, may be able to provide a solution to these concerns. OBJECTIVE: We aimed to investigate the preliminary effectiveness of providing psychotherapy through a multimodal digital psychotherapy platform. In addition, we aimed to examine differential responses to intervention by gender, self-reported physical health status, and self-reported financial status, as well as how prior exposure to traditional face-to-face psychotherapy affected the effectiveness of a multimodal digital psychotherapy intervention. Finally, we aimed to examine the dose-response effect. METHODS: Data were collected from a total of 318 active users of BetterHelp, a multimodal digital psychotherapy platform. Data on physical health status, financial status, and prior exposure to psychotherapy were obtained using self-report measures. Effectiveness was determined by the extent of symptom severity change, which was measured using the Patient Health Questionnaire at Time 1 (time of enrollment) and Time 2 (3 months after enrollment). Intervention dosage was measured as the sum of individual therapist-user interactions across modalities. RESULTS: Depression symptom severity was significantly reduced after the use of the multimodal digital psychotherapy intervention (P<.001). Individuals without prior traditional psychotherapy experience revealed increased improvement after intervention (P=.006). We found no significant dose-response effect of therapy, nor significant differences in outcomes across gender, self-reported financial status, and self-reported physical health status. CONCLUSIONS: Users of BetterHelp experienced significantly reduced depression symptom severity after engaging with the platform. Study findings suggest that this intervention is equally effective across gender, self-reported financial status, and self-reported physical health status and particularly effective for individuals without a history of psychotherapy. Overall, study results suggest that multimodal digital psychotherapy is a potentially effective treatment for adult depression; nevertheless, experimental trials are needed. We discuss directions for future research.

An adaptive virtual reality system for the treatment of adjustment disorder and complicated grief: 1-year follow-up efficacy data.

Adjustment disorder (AD) and complicated grief (CG) are serious mental conditions that have a high prevalence and are associated with significant impairments in social and work functioning. Recently, these categories have been better specified in the new ICD-11 proposal. Empirical research on the efficacy of treatments for these problems is scarce. This study aims to offer long-term efficacy data from a between-groups controlled study that compares two treatment conditions (AD-protocol applied in a traditional way: N = 18 and the same protocol supported by virtual reality (VR); VR-protocol applied in a traditional way: N = 18) and a waiting list (WL) control group (N = 18). Both treatment conditions resulted in statistically significant improvements on both primary and secondary outcome measures, with large effect sizes, and this improvement did not occur in the WL. These changes were maintained in both treatment conditions in the medium (6-month) and long-term (12-month follow-up). Larger effect sizes were achieved in the VR condition in the long term. Furthermore, clinically significant change estimations on the primary outcome measures showed an advantage for the VR condition This is the first controlled study to compare a traditional face-to-face protocol for the treatment of stress-related disorders with the same protocol supported by VR and a WL control group.

Study Protocol for a Randomized Controlled Trial Evaluating the Efficacy of an Evidence-Based iPad-App for Cognitive Rehabilitation in Patients with Primary Brain Tumors.

BACKGROUND: Many patients with primary brain tumors suffer from cognitive deficits, which negatively impact their quality of life. However, cognitive rehabilitation programs for these patients are scarce. We developed an iPad-based cognitive rehabilitation program for brain tumor patients, which was based on our effective face-to-face cognitive rehabilitation program. After successful completion of a feasibility study, a randomized controlled trial has been started. OBJECTIVE: To evaluate the immediate and long-term effects of the iPad-based program on cognitive performance and patient-reported outcome measures (PROMs) in patients with primary brain tumors in an early stage of the disease. METHODS: Prior to surgery, patients with presumed low-grade glioma and meningioma are included. Before surgery and 3 mo after surgery, neuropsychological assessments are conducted. After the second neuropsychological assessment, patients are assigned to the intervention group or waiting-list control group. The intervention consists of psychoeducation, compensation training, and retraining. Patients are advised to spend 3 h per week on the program for 10 wk. Immediately after completion of the program and a half-year thereafter, postintervention assessments take place. Patients in the control group are offered the opportunity to follow the program after all study assessments. EXPECTED OUTCOMES: We expect that early cognitive rehabilitation has beneficial effects on cognitive performance and PROMs in brain tumor patients. DISCUSSION: The iPad-based program allows brain tumor patients to follow a cognitive rehabilitation program from their homes. Forthcoming results may contribute to further improvement of supportive care for brain tumor patients.

Neurostimulation for depression in epilepsy.

Epilepsy is often associated with comorbid psychiatric illnesses that can significantly impact its long-term course. The most frequent of these psychiatric comorbidities is major depressive disorder, which affects an estimated 40% of patients with epilepsy. Many patients are underdiagnosed or undertreated, yet managing their mood symptoms is critical to improving their outcomes. When conventional psychiatric treatments fail in the management of depression, neuromodulation techniques may offer promise, including electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), and repetitive transcranial magnetic stimulation (rTMS), as discussed in this review. "This article is part of the Supplement issue Neurostimulation for Epilepsy."