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2.
Eur. j. psychol. appl. legal context (Internet) ; 12(2): 77-84, jul.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190652

RESUMO

Motivational strategies are among the most promising approaches to improve the effectiveness of batterer intervention programs (BIPs). An individualized motivational plan (IMP) is one of these motivational strategies. The present study aimed to explore whether adding an IMP to a standard BIP improved the participant-facilitator working alliance and participants' protherapeutic behaviors. To this end a randomized controlled trial was conducted. One hundred fifty-three men convicted of intimate partner violence were randomly assigned to either a standard BIP (control condition, n = 79) or a standard BIP plus IMP (experimental condition, n = 74). Working alliance (i.e., general working alliance, agreement, and bond) was assessed with the Working Alliance Inventory-Observer, short version. Protherapeutic behaviors (i.e., assumption of responsibility, participant role behavior, and group value) were assessed with the Observational Coding of Protherapeutic Group Behavior. Both working alliance and protherapeutic behaviors were assessed by an external observer early and late in intervention. Our results showed that both general working alliance and agreement and bond, were significantly higher in the standard BIP plus IMP intervention condition, both early and late in intervention. All protherapeutic behaviors were significantly higher in the standard BIP plus IMP early in intervention, and also late in intervention for assumption of responsibility and group value. Our findings have important practical implications as our results clearly showed that a motivational strategy tool such as the IMP improves key intervention processes (i.e., working alliance and protherapeutic behaviors) in BIPs, therefore increasing their effectiveness


Las estrategias motivacionales se encuentran entre los enfoques más prometedores para mejorar la eficacia de los programas de intervención con maltratadores. El plan motivacional individualizado (PMI) es una de estas estrategias motivacionales. El presente estudio tiene como objetivo explorar si añadir un plan motivacional individualizado a un programa estándar de intervención con maltratadores mejora la alianza de trabajo facilitador-participante y la conducta proterapéutica de los participantes. Para ello se realizó un ensayo clínico aleatorizado. Ciento cincuenta y tres hombres condenados por violencia de género fueron asignados aleatoriamente bien a un programa estándar de intervención con maltratadores (condición control, n = 79) o bien a un programa estándar de intervención con maltratadores más PMI (condición experimental, n = 74). La alianza de trabajo (i.e., alianza general, acuerdo y vínculo) se evaluó con la versión breve del Working Alliance Inventory-Observer. Las conductas proterapéuticas (i.e., asunción de responsabilidad, rol conductual del participante y valoración del grupo) fueron evaluadas con el Observational Coding of Protherapeutic Group Behavior. Tanto la alianza de trabajo como las conductas proterapéuticas fueron evaluadas por un observador externo al principio y al final de la intervención. Los resultados mostraron que tanto la alianza de trabajo general como el acuerdo y el vínculo fueron significativamente mayores en la condición experimental, tanto al principio como al final de la intervención. La expresión de todas las conductas proterapéuticas al inicio de la intervención fue significativamente mayor en la condición experimental, así como al final de la intervención para la asunción de responsabilidad y la valoración del grupo. Los resultados tienen importantes implicaciones prácticas, puesto que muestran con claridad que una estrategia motivacional como el PMI mejora procesos clave de la intervención con maltratadores (i.e., la alianza de trabajo y las conductas proterapéuticas), mejorando por lo tanto la efectividad de estos programas


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Violência de Gênero/prevenção & controle , Psicoterapia de Grupo , Processos Grupais , Motivação , Estudos de Casos e Controles , Fatores Socioeconômicos
3.
Medicine (Baltimore) ; 99(50): e23272, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327250

RESUMO

School sandplay group therapy is a useful clinical treatment method for adolescents who cannot adapt to school due to various emotional and behavioral problems. In this study, we conducted 10 weeks of group therapy in 70 adolescents referred to as maladjustment behavior problem in the school. The purpose of this study was to evaluate the clinical effects of sandplay therapy on the emotions and behaviors objectively through minnesota multiphasic personality test -2. There was a statistically significant difference in clinical scales such as depression, masculinity- femininity, social introversion, anger, subjective depression, need for affection, somatic complaint, and internal/external alienation after school sandplay group therapy. Sandplay therapy is estimated to have clinical effects not only on the emotional problems of maladapted high school students but also on physical problems.


Assuntos
Transtornos do Comportamento Infantil/terapia , MMPI , Ludoterapia , Psicoterapia de Grupo , Adolescente , Transtornos do Comportamento Infantil/psicologia , Feminino , Humanos , Masculino , Ludoterapia/métodos , Psicoterapia de Grupo/métodos , República da Coreia , Instituições Acadêmicas , Inquéritos e Questionários , Resultado do Tratamento
4.
Mayo Clin Proc ; 95(12): 2709-2718, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33276843

RESUMO

During the current coronavirus disease 2019 epidemic, many outpatient chemical dependency treatment programs and clinics are decreasing their number of in-person patient contacts. This has widened an already large gap between patients with substance use disorders (SUDs) who need treatment and those who have actually received treatment. For a disorder where group therapy has been the mainstay treatment option for decades, social distancing, shelter in place, and treatment discontinuation have created an urgent need for alternative approaches to addiction treatment. In an attempt to continue some care for patients in need, many medical institutions have transitioned to a virtual environment to promote safe social distancing. Although there is ample evidence to support telemedical interventions, these can be difficult to implement, especially in the SUD population. This article reviews current literature for the use of telehealth interventions in the treatment of SUDs and offers recommendations on safe and effective implementation strategies based on the current literature.


Assuntos
Transtornos Relacionados ao Uso de Substâncias/terapia , Telemedicina/métodos , Humanos , Pandemias , Psicoterapia de Grupo/instrumentação
5.
PLoS One ; 15(11): e0241704, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33180798

RESUMO

BACKGROUND: Emergency responders are routinely exposed to traumatic critical incidents and other occupational stressors that place them at higher risk of mental ill health compared to the general population. There is some evidence to suggest that resilience training may improve emergency responders' wellbeing and related health outcomes. The aim of this study was to evaluate the effectiveness of a tertiary service resilience intervention compared to psychoeducation for improving psychological outcomes among emergency workers. METHODS: We conducted a multicentre, parallel-group, randomised controlled trial. Minim software was used to randomly allocate police, ambulance, fire, and search and rescue services personnel, who were not suffering from depression or post-traumatic stress disorder, to Mind's group intervention or to online psychoeducation on a 3:1 basis. The resilience intervention was group-based and included stress management and mindfulness tools for reducing stress. It was delivered by trained staff at nine centres across England in six sessions, one per week for six weeks. The comparison intervention was psychoeducation about stress and mental health delivered online, one module per week for six weeks. Primary outcomes were assessed by self-report and included wellbeing, resilience, self-efficacy, problem-solving, social capital, confidence in managing mental health, and number of days off work due to illness. Follow-up was conducted at three months. Blinding of participants, researchers and outcome assessment was not possible due to the type of interventions. RESULTS: A total of 430 participants (resilience intervention N = 317; psychoeducation N = 113) were randomised and included in intent-to-treat analyses. Linear Mixed-Effects Models did not show a significant difference between the interventions, at either the post-intervention or follow-up time points, on any outcome measure. CONCLUSIONS: The limited success of this intervention is consistent with the wider literature. Future refinements to the intervention may benefit from targeting predictors of resilience and mental ill health. TRIAL REGISTRATION: ISRCTN registry, ISRCTN79407277.


Assuntos
Socorristas/psicologia , Técnicas Psicológicas , Psicoterapia de Grupo/métodos , Psicoterapia/métodos , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Adulto , Feminino , Educação em Saúde/métodos , Humanos , Masculino
6.
Rev Infirm ; 69(264): 26-28, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33129473

RESUMO

The perfume workshop is one of the therapeutic groups offered to young patients in the day hospital of the "Maison des adolescents" in Paris (14th arrondissement). None of them having learned to smell, this workshop allows these young people to discover a new field of experiences. Thanks to this particular mediation mobilizing this unexplored fifth sense, they connect to their sensations, access their memories and communicate them, open their imagination and discover a new medium to express themselves, share and regain self-confidence.


Assuntos
Psicoterapia de Grupo , Olfato , Adolescente , Humanos , Paris
7.
Lancet Child Adolesc Health ; 4(12): 889-898, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33217358

RESUMO

Death of a parent in childhood and adolescence is a distressing life event. Childhood grief reactions are distinct from those in adults, and are affected by developmental and contextual factors such as age of the child and changes in caregiving environments. Following parental bereavement, children and adolescents face unique emotional and behavioural challenges, and are susceptible to several adverse biopsychosocial outcomes. Empirically supported interventions can help young people to navigate the many grief-related challenges, and the core treatment components include grief psychoeducation, building emotion identification and regulation skills, cognitive coping and restructuring, grief and trauma processing, memorialising and continuing bonds, meaning making, involvement of caregivers in grief treatment, and future planning. Health-care professionals often interact with children and adolescents following bereavement; therefore, it is important they have the foundational knowledge and skills to communicate effectively about the death, recognise and normalise different ways grief can manifest across development, and support surviving caregivers in facilitating adaptive grief in their children.


Assuntos
Pesar , Morte Parental/psicologia , Adaptação Psicológica , Adolescente , Cuidadores/psicologia , Criança , Terapia Cognitivo-Comportamental/métodos , Humanos , Psicoterapia de Grupo/métodos , Apoio Social
8.
Artigo em Inglês | MEDLINE | ID: mdl-33166098

RESUMO

Objective: To report the clinical characteristics and transmission rate of coronavirus disease 2019 (COVID-19) in a community inpatient long-term care psychiatric rehabilitation facility designed for persons with serious mental illness to provide insight into transmission and symptom patterns and emerging testing protocols, as well as medical complications and prognosis. Methods: This study examined a cohort of 54 residents of a long-term care psychiatric rehabilitation program from March to April 2020. Baseline demographics, clinical diagnoses, and vital signs were examined to look for statistical differences between positive versus negative severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) groups. During the early phase of the pandemic, the facility closely followed the local shelter-in-place order (starting March 19, 2020) and symptom-based testing. Results: Of the residents, the primary psychiatric diagnoses were schizoaffective disorder: 28 (51.9%), schizophrenia: 21 (38.9%), bipolar I disorder: 3 (5.5%), and unspecified psychotic disorder: 2 (3.7%). Forty (74%) of 54 residents tested positive for SARS-COV-2, with a doubling time of 3.9 days. There were no statistical differences between the positive SARS-COV-2 versus negative groups for age or race/ethnicity. Psychiatric and medical conditions were not significantly associated with contracting SARS-COV-2, with the exception of obesity (n = 17 [43%] positive vs n = 12 [86%] negative, P = .01). Medical monitoring of vital signs and symptoms did not lead to earlier detection. All of the residents completely recovered, with the last resident no longer showing any symptoms 24 days from the index case. Conclusion: Research is needed to determine optimal strategies for long-term care mental health settings that incorporate frequent testing and personal protective equipment use to prevent rapid transmission of SARS-COV-2.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Transtornos Psicóticos/reabilitação , Centros de Reabilitação , Esquizofrenia/reabilitação , Adulto , Afro-Americanos , Americanos Asiáticos , Betacoronavirus , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/reabilitação , California/epidemiologia , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/transmissão , Diabetes Mellitus/epidemiologia , Grupo com Ancestrais do Continente Europeu , Refluxo Gastroesofágico/epidemiologia , Hispano-Americanos , Humanos , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Hipotireoidismo/epidemiologia , Controle de Infecções , Assistência de Longa Duração , Programas de Rastreamento , Pessoa de Meia-Idade , Obesidade/epidemiologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/transmissão , Reabilitação Psiquiátrica , Psicoterapia de Grupo , Transtornos Psicóticos/epidemiologia , Recreação , Reabilitação Vocacional , Esquizofrenia/epidemiologia , Fumar/epidemiologia , Visitas a Pacientes
9.
An. psicol ; 36(2): 188-199, mayo 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192055

RESUMO

El objetivo de este trabajo es evaluar empíricamente la eficacia de un programa de intervención con mujeres víctimas de violencia de género. El programa en conjunto se enmarca dentro de las Terapias Contextuales, específicamente se ha utilizado la Psicoterapia Analítica Funcional, combinada con la Terapia de Aceptación y Compromiso y la Activación Conductual. Se ha llevado a cabo en formato grupal, durante 11 sesiones de 2 horas cada una. Participaron un total de 21 mujeres (de una media de edad de 45 años), que habían sufrido violencia física y/o abuso emocional por parte de sus parejas, en diferente grado e intensidad, y en diferentes momentos en sus vidas. Se ha utilizado un diseño intragrupo con medidas pre-post. Se realizaron tres grupos de tratamiento en diferentes ciudades con 6 a 8 mujeres cada uno. Para medir la intervención se ha aplicado el cuestionario Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM). Los resultados han mostrado una disminución estadísticamente significativa en la severidad del malestar, han disminuido los indicadores de riesgo de suicidio, y han mejorado las conductas problemáticas dentro y fuera de las sesiones, además de incrementarse la apertura hacia los demás. Se discute la utilidad de las terapias contextual es para mejorar la calidad de vida de mujeres maltratadas, y su utilidad de aplicación en grupos en las instituciones públicas


The goal of this study is to empirically evaluate the efficacy of an intervention program with women victims of gender violence. Specifically, Functional Analytical Psychotherapy has been used, combined with Acceptance and Commitment Therapy, and Behavioral Activation. It has been carried out in group format, during 11 sessions of 2 hours each. A total of 21 women participated (an average of 45 years-old), who had suffered physical violence and/or emotional abuse by their partners, with different degrees and intensity, and at different moments of their lives. An intra-group design with pre-post measures was used. Three treatment groups were carried out in different cities with 6 to 8 women each one. To measure the intervention, the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) questionnaire was applied. The results has shown a statistically significant decrease in the severity of discomfort, decreased suicide risk indicators, improved problem behavior inside and outside sessions, and increased openness to others. The usefulness of contextual therapies to improve the quality of life of battered women and their usefulness for application in groups in public institutions are discussed


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Violência de Gênero/psicologia , Resultado do Tratamento , Psicoterapia de Grupo/métodos , Psicometria/instrumentação , Inquéritos e Questionários , Abuso Físico/psicologia , Qualidade de Vida/psicologia , Apoio Social , Escalas de Graduação Psiquiátrica/normas , Análise de Variância , Maus-Tratos Conjugais/psicologia
10.
PLoS One ; 15(9): e0239715, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970784

RESUMO

About a third of strokes cause aphasia, or language loss, with profound consequences for the person's social participation and quality of life. These problems may be mitigated by group social support. But this intervention is not available to all individuals. This study investigated whether it is feasible to deliver group social support to people with aphasia via a multi-user, virtual reality platform. It also explored the indicative effects of intervention and the costs. Intervention aimed to promote wellbeing and communicative success. It enabled participants to form new social connections and share experiences of living with aphasia. It comprised 14 sessions delivered over 6 months and was led by community based co-ordinators and volunteers. Feasibility measures comprised: recruitment and retention rates, compliance with intervention and assessment of treatment fidelity. Effects of intervention were explored using a waitlist randomised controlled design, with outcome measures of wellbeing, communication, social connectedness and quality of life. Two intervention groups were randomised to an immediate condition and two were randomised to a delayed condition. The main analysis explored scores on the measures between two time points, between which those in the immediate condition had received intervention, but those in the delayed group had not (yet). A comprehensive approach to economic data collection ensured that all costs of treatment delivery were recorded. Feasibility findings showed that the recruitment target was met (N = 34) and 85.3% (29/34) of participants completed intervention. All groups ran the 14 sessions as planned, and participants attended a mean of 11.4 sessions (s.d. 2.8), which was 81.6% of the intended dose. Fidelity checking showed minimal drift from the manualised intervention. No significant change was observed on any of the outcome measures, although the study was not powered to detect these. Costs varied across the four groups, from £7,483 - £12,562 British Pounds Sterling ($10,972 - $18,419 US dollars), depending on travel costs, the relative contributions of volunteers and the number of hardware loans that were needed. The results suggest that a larger trial of remote group support, using virtual reality, would be merited. However the treatment content and regime, and the selection of outcome measures should be reviewed before conducting the trial. Trail registration: Study registered with ClinicalTrials.gov; Identifier: https://www.ncbi.nlm.nih.gov/NCT03115268.


Assuntos
Afasia/terapia , Psicoterapia de Grupo/métodos , Apoio Social , Reabilitação do Acidente Vascular Cerebral/métodos , Realidade Virtual , Adulto , Afasia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações
11.
Br J Clin Psychol ; 59(4): 552-564, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32920864

RESUMO

BACKGROUND: Cognitive behavioural analysis system of psychotherapy (CBASP) is an effective individual treatment for persistent depressive disorder (PDD), but evidence on group treatment (Group-CBASP) is limited. Our aim was to review the effect of Group-CBASP on self-report depression severity in outpatients with PDD, overall and by age of depression-onset. METHODS: A retrospective chart review study (November 2011-March 2017) in 54 patients with PDD (29 late-onset, 25 early-onset). Patients were previously treated by pharmacotherapy (92.6%), psychotherapy (98.1%) and/or electroconvulsive therapy (11.1%). Group-CBASP involved 24 weekly sessions during 6 months, followed by individual appointments over 6 months. The Inventory of Depressive Symptoms -self rating(IDS-SR) was used at baseline and after 3, 6, 9 and 12 months, computing mean differences and response rates. RESULTS: The mean IDS-SR score decreased significantly from 39.83 at baseline to 33.78 at 6 months: a decrease from severe to moderate depression after 24 weeks of Group-CBASP, with a medium effect size (Cohen's d = .49). At 12 months, the mean IDS-SR score was 32.81, indicating moderate symptom levels remained. At 6 and 12 months, mean IDS-SR scores were similar among late- versus early-onset patients, but at 12 months response rates were higher among late-onset patients. LIMITATIONS: Although results of our study provide valuable input for future prospective studies, limitations were the use of a retrospective design and the small group size. CONCLUSION: Group-CBASP offered to an outpatient population with PDD was associated with clinically relevant decrease in self-reported symptom severity, and with sustained response particularly in patients with late onset of depression. PRACTITIONER POINTS: Group-CBASP seems to be a good alternative for CBASP in individual setting. Patients with late age of depression-onset seem to benefit more from Group-CBASP. This study shows that clinical relevant effects of Group-CBASP, followed by individual contacts, remain at least for 6 months. Research on personalizing treatment strategies is needed to improve patient assignment for Group-CBASP.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Depressão/terapia , Psicoterapia de Grupo/métodos , Adulto , Doença Crônica , Cognição , Depressão/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
12.
J Pediatr Psychol ; 45(9): 983-989, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32940702

RESUMO

OBJECTIVE: We recently transitioned from in-person delivery of a brief behavioral parent intervention to telepsychology delivery to meet families' needs during the COVID-19 pandemic. In this topical review, we describe how we used treatment fidelity as a guiding principle to orient adaptations for telepsychology, as well as preliminary findings and early lessons learned in this implementation. Methods: Using rapid-cycle quality improvement methods, we adapted a brief parent training group (Bootcamp for Attention-Deficit/Hyperactivity Disorder; BC-ADHD) to three groups of caregivers (i.e., 5-7 families) of school-aged children with ADHD (n = 20; 85% males). Families were from the following ethnic backgrounds: 75% White non-Hispanic, 15% White Hispanic, and 10% Black. Clinicians completed measures on their implementation experience. Observers completed measures on content/process fidelity and attendance. Caregivers completed measures on demographics, treatment satisfaction, and telepsychology experience. RESULTS: Telepsychology BC-ADHD can be implemented with comparably high levels of content and process fidelity and treatment satisfaction to in-person groups; and it appears to be feasible and acceptable to caregivers. Caregiver and clinician qualitative feedback revealed themes of appreciating the convenience of telepsychology, while experiencing some challenges in relating to others and sharing over video. CONCLUSIONS: When treatment fidelity is used as a guiding tool, telepsychology parent training groups can be delivered with high fidelity and appear to be acceptable and feasible to caregivers and clinicians. Future research using larger and more diverse samples, multimethod and multi-informant measurement approaches, and controlled designs is needed to further assess the generalizability and efficacy of telepsychology parent training groups.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Terapia Comportamental/métodos , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pais/psicologia , Pneumonia Viral/prevenção & controle , Psicoterapia de Grupo/métodos , Telemedicina/métodos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Cuidadores/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino
13.
Br J Clin Psychol ; 59(4): 524-551, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32944971

RESUMO

OBJECTIVE: Psychological interventions reduce the impact of psychosis, but widescale implementation is problematic. We tested the feasibility of group acceptance and commitment therapy for Psychosis (G-ACTp), delivered by frontline staff, and co-facilitated by service-user experts-by-experience (SU-EbyE), for service-users and informal caregivers (ISRCTN: 68540929). We estimated recruitment/retention rates and outcome variability for future evaluation. METHODS: Staff and SU-EbyE facilitators completed 1-day workshops, then delivered closely supervised G-ACTp, comprising four sessions (weeks 1-4) and two boosters (10 and 12 weeks). Participants recruited from adult community psychosis services were randomized to receive G-ACTp immediately or after 12 weeks, completing outcome assessments at 0, 4, and 12 weeks. Service-use/month was calculated for 1-year pre-randomization, weeks 0-12, and 5-year uncontrolled follow-up. RESULTS: Of 41 facilitators trained (29 staff, 12 SU-EbyE), 29 (71%; 17 staff, 12 SU-EbyE) delivered 18 G-ACTp courses. Participant refusal rates were low (9% of service-users [10/112]; 5% of caregivers [4/79]); 60% of those invited to participate attended ≥1 G-ACTp session (64% of service-users [39/61]; 56% of caregivers [35/63]). Randomization of facilitators and participants proved problematic and participant follow-up was incomplete (78% [66/85]; 82% of service-users [36/44]; 73% of caregivers [30/41]). Effect sizes ranged from very small to large mostly favouring treatment. Service-use reductions require cautious interpretation, as very few participants incurred costs. CONCLUSIONS: Implementation appears feasible for service-users; for caregivers, retention needs improving. Outcome variability indicated n = 100-300/arm followed up (α = 0.05, 90% power). Methodological limitations' mean replication is needed: identified sources of potential bias may be reduced in a cluster randomized design with sessional outcome completion. PRACTITIONER POINTS: Group acceptance and commitment therapy can be successfully adapted for people with psychosis and their caregivers. Implementation (training and delivery) is possible in routine community mental health care settings. Clinical and economic outcomes are promising, but replication is needed. Recommendations are made for future studies.


Assuntos
Terapia de Aceitação e Compromisso , Cuidadores/psicologia , Transtornos Psicóticos/terapia , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicoterapia de Grupo , Transtornos Psicóticos/psicologia , Resultado do Tratamento
15.
Semin Perinatol ; 44(7): 151279, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32972778

RESUMO

The pandemic, and the associated changes to pregnancy and postpartum experiences, can lead to profound psychological reactions including panic, hyperarousal, sleep disturbance, anxiety, depression, and traumatic stress disorders. Providers face compassion fatigue and shared trauma. In this article, we describe the mental health outcomes known to date in regard to the novel coronavirus disease 2019 pandemic for obstetric patients and their providers as well as therapeutic approaches, including our novel embedded mental health service, to address these mental health needs.


Assuntos
Fadiga por Compaixão/psicologia , Obstetrícia , Médicos/psicologia , Complicações na Gravidez/psicologia , Gestantes/psicologia , Trauma Psicológico/psicologia , Ansiedade/psicologia , Ansiedade/terapia , Fadiga por Compaixão/terapia , Depressão/psicologia , Depressão/terapia , Feminino , Humanos , Saúde Mental , Serviços de Saúde Mental , Política Organizacional , Gravidez , Complicações na Gravidez/terapia , Trauma Psicológico/terapia , Psicoterapia , Psicoterapia de Grupo , Transtornos do Sono-Vigília , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Traumático Agudo/psicologia , Transtornos de Estresse Traumático Agudo/terapia , Telemedicina , Visitas a Pacientes
16.
Syst Rev ; 9(1): 217, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967717

RESUMO

BACKGROUND: COVID-19 has resulted in an increased demand for eHealth services globally. There is emerging evidence for the efficacy for group eHealth interventions that support population-based mental health and wellbeing, but a systematic review is lacking. The primary objective of this systematic review is to summarize the evidence for eHealth group counseling and coaching programs for adults. A second objective is to assess, within studies selected for our primary objective, the impact of programs that encourage PA on outcomes compared to those that do not. METHODS: Randomized controlled trials that assess the impact of eHealth group counseling or coaching programs on mental health, health behavior, or physical health activity among community-dwelling adults will be included. We will search the following electronic databases (from January 2005 onwards): MEDLINE, PsycINFO, CINHAL, and the Central Register of Controlled Trials. The primary outcomes will be changes in mental health conditions (e.g., depression, anxiety, stress, quality of life), behavioral health conditions (e.g., substance use, smoking, sexual behavior, eating behavior, medication adherence), and physical health conditions (e.g., coping with cancer, menopausal symptoms, arthritis pain). Secondary outcomes will be changes in physical activity. Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion with a third reviewer. A narrative synthesis without meta-analysis will be conducted. The strength of the body of evidence will be assessed using GRADE. The risk of bias in individual studies will be appraised using the Cochrane Risk of Bias 2.0 tool. Potential sources of gender bias in included studies will be considered at all stages of the planned review. DISCUSSION: This review will contribute to the literature by providing evidence on the effectiveness of eHealth counseling and coaching programs delivered to adults in a group format. SYSTEMATIC REVIEW REGISTRATION: The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020187551 ).


Assuntos
Assistência à Saúde , Exercício Físico , Nível de Saúde , Saúde Mental , Telemedicina/métodos , Adulto , Betacoronavirus , Infecções por Coronavirus , Aconselhamento/métodos , Humanos , Tutoria/métodos , Pandemias , Pneumonia Viral , Psicoterapia de Grupo/métodos
17.
Artigo em Inglês | MEDLINE | ID: mdl-32858791

RESUMO

BACKGROUND: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia. METHODS: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (n = 150) or no further intervention (n = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat. RESULTS: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI -1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect p < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing. CONCLUSION: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Osteoartrite do Joelho/psicologia , Osteoartrite do Joelho/terapia , Manejo da Dor/métodos , Medição da Dor/métodos , Dor/psicologia , Psicoterapia de Grupo/métodos , Atividades Cotidianas , Adulto , Idoso , Cognição , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/epidemiologia , Dor/epidemiologia , Resultado do Tratamento
18.
Arch Phys Med Rehabil ; 101(11): 1849-1856.e1, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32795562

RESUMO

OBJECTIVES: The aims of this study were to analyze the effects of a dual-task group program, to compare it with the effects of a single-task group program, and to analyze the effects of functional secondary tasks. DESIGN: Single-blind randomized controlled trial. SETTING: University laboratory and a rehabilitation gym at a health center. PARTICIPANTS: Patients (N=40) with a diagnosis of Parkinson disease (mean age, 66.72y; age range, 44-79y) with Hoehn and Yahr stage I to III who were on medication were randomized to either a group with dual-task training or a group with single-task training (only gait). INTERVENTION: Both interventions involved 20 sessions lasting 1 hour each and conducted twice a week. Dual-task training included walking exercises and cognitive or motor tasks carried out separately, then later performed together as a dual-task according to a progressive protocol in the same training session. MAIN OUTCOME MEASURES: Velocity and spatiotemporal parameters of gait were measured without a secondary task and during dual-task gait combined with a visual, verbal, auditory, and motor task. In addition, executive cognitive function and quality of life were measured. Assessments were conducted at baseline, postrehabilitation, and at the 8-week follow-up. RESULTS: The dual-task group demonstrated improved velocity and stride length time in all assessment conditions after training (P<.05), as well as perceived quality of life (P<.05). The single-task group experienced improvements in the same outcomes for only the motor condition (P<.05) after training, but failed to improve perceived quality of life (P>.05). Likewise, the dual-task group showed higher velocity and stride length after treatment than the single-task group across conditions. No significant changes were observed in cognitive performance (P>.05), although the dual-task group tended to improve performance during the executive function test. CONCLUSIONS: Dual-task training in functional contexts is associated with greater improvements in velocity and stride length in patients with PD compared with regular physiotherapy without secondary tasks. Dual-task training also improves perceived quality of life.


Assuntos
Função Executiva , Terapia por Exercício/métodos , Marcha , Doença de Parkinson/reabilitação , Psicoterapia de Grupo/métodos , Qualidade de Vida , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Doença de Parkinson/psicologia , Método Simples-Cego , Análise e Desempenho de Tarefas , Resultado do Tratamento
19.
Lancet Psychiatry ; 7(9): 775-787, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32828167

RESUMO

BACKGROUND: Maternal depression has a recurring course that can influence offspring outcomes. Evidence on how to treat maternal depression to improve longer-term maternal outcomes and reduce intergenerational transmission of psychopathology is scarce, particularly for task-shifted, low-intensity, and scalable psychosocial interventions. We evaluated the effects of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal. METHODS: 40 village clusters in Pakistan were randomly allocated using a computerised randomisation sequence to receive a group-based, psychosocial intervention and enhanced usual care for 36 months, or enhanced usual care alone. Pregnant women (≥18 years) were screened for moderate or severe symptoms of depression (patient health questionnaire-9 [PHQ-9] score ≥10) and were recruited into the trial (570 participants), and a cohort without depression (PHQ-9 score <10) was also enrolled (584 participants). Including the non-depressed dyads enabled us to determine how much of the excess risk due to maternal depression exposure the intervention could mitigate. Research teams responsible for identifying, obtaining consent, and recruiting trial participants were blind to the allocation status throughout the duration of the study, and principal investigators, site coordinators, statisticians, and members of the trial steering committee were also blinded to the allocation status until the analysis of 6-month data for the intervention. Primary outcomes were maternal depression symptoms and remission (PHQ-9 score <10) and child socioemotional skills (strengths and difficulties questionnaire [SDQ-TD]) at 36-months postnatal. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, NCT02658994. FINDINGS: From Oct 15, 2014 to Feb 25, 2016 46 village clusters were assessed for eligibility, of which 40 (including 1910 mothers were enrolled. After exclusions, 288 women were randomly assigned to the enhanced usual care group and 284 to the intervention group, and 1159 women were included in a group without prenatal depression. At 36-months postnatal, complete data were available from 889 mother-child dyads: 206 (72·5%) in the intervention group, 216 (75·3%) in the enhanced usual care group, and 467 (80·0%) women who did not have prenatal-depression. We did not observe significant outcome differences between the intervention group and the enhanced usual care group for the primary outcomes. The standardised mean difference of PHQ-9 total score was -0·13 (95% CI -0·33 to 0·07), relative risk of patient health questionnaire-9 remission was 1·00 (95% CI 0·88 to 1·14), and the SDQ-TD treatment estimate was -0·10 (95% CI -1·39 to 1·19). INTERPRETATION: Reduced symptom severity and high remission rates were seen across both the intervention and enhanced usual care groups, possibly masking any effects of the intervention. A multi-year, psychosocial intervention can be task-shifted via peers but might be susceptible to reductions in fidelity and dosage over time (which were not among the outcomes of this trial). Early intervention efforts might need to rely on multiple models (eg, collaborative care), be of greater intensity, and potentially targeted at mothers who are at high risk for depression to reduce the intergenerational transmission of psychopathology from mothers to children. FUNDING: National Institutes of Health.


Assuntos
Desenvolvimento Infantil , Depressão Pós-Parto/terapia , Relações Mãe-Filho , Mães/psicologia , Grupo Associado , Psicoterapia de Grupo/métodos , Adolescente , Adulto , Comportamento Infantil , Pré-Escolar , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/psicologia , Feminino , Humanos , Paquistão , Escalas de Graduação Psiquiátrica , Resultado do Tratamento , Adulto Jovem
20.
PLoS One ; 15(8): e0238321, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853261

RESUMO

BACKGROUND: Psychological treatments improve depressive symptoms in people living with HIV/AIDS (PLWHA). Adaptation of treatments should be based on explanatory models of depression and other elements within the given context. AIM: This study aimed to examine explanatory models of depression and acceptable approaches for implementation of group IPT in Northwest Ethiopia. METHODS: Qualitative data were collected from April to May 2019 from case managers, adherence supporters and service users using focus group discussion and analysed thematically. RESULTS: PLWHA attributed depression to psychosocial problems, spiritual factors and biological factors. Depression had several impacts at individual and family level. Group-based interpersonal therapy (IPT) was acceptable if provided by trained peer counselors. CONCLUSION: The current study findings informed how to conduct feasibility and acceptability trials of group IPT in the HIV population in Ethiopia.


Assuntos
Adaptação Psicológica/fisiologia , Infecções por HIV/psicologia , Adolescente , Adulto , Depressão/psicologia , Etiópia , Feminino , Grupos Focais , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Psicoterapia de Grupo/métodos , Pesquisa Qualitativa , Organização Mundial da Saúde , Adulto Jovem
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