A Brief Psychotherapeutic Intervention with Depressed Middle-Aged Portuguese Women

The line of research on middle-aged women's depression that we have been developing for over a decade has pointed to the frequency and severity of this disorder among Portuguese women, particularly less educated women. These women are more vulnerable and often receive a strictly medical response, which leaves little room for the elaboration of their complaints. We present a general overview of the results of this research line on depression in middle-aged women and the positive effect of a group intervention carried out in a health center where part of this research took place.     

A Mixed Methods Study of the Re-Animation Approach Within a Forensic Mental Health Setting

This mixed-methods study investigated the impact of the Re-Animation Approach, a creative occupational therapy, on the well-being and occupational performance of three male patients in a forensic mental health setting. Quantitative data were gathered through goal attainment scaling (GAS) and qualitative data using semi-structured interviews. GAS t-scores demonstrated an over-achievement of expected outcomes in goals related to improving skills, well-being, and time use. Issues emerging from thematic analysis of the interviews are consistent with the GAS results. The Re-Animation Approach had a positive impact on participants’ health and well-being, addressed a range of occupational needs, and can be graded.     

A Bibliometric Analysis of the Quantitative Mental Health Literature in Occupational Therapy

ABSTRACT

A bibliometric analysis was performed to examine the impact and use of the peer-reviewed occupational therapy intervention effectiveness literature addressing adults with mental illness, 2000–2016. Of 2,597 articles, 68 were quantitative studies assessing an intervention for adults with mental illness. These studies had a collective citation count of 1,455 and were published in 29 journals in 14 countries. The majority (n?=?36; 52.94%) were randomized controlled and two-group controlled studies. The most commonly assessed interventions were life skills and community reintegration (n?=?20, 29.41%) and supported employment (n?=?16, 23.52%). Sixty-five (95.58%) studies found statistically significant results on the primary or secondary outcomes.     

A Clinical Trial of In-Home CBT for Depressed Mothers in Home Visitation

Despite negative outcomes for depressed mothers and their children, no treatment specifically designed to address maternal depression in the context of home visitation has emerged. In-Home Cognitive Behavioral Therapy (IH-CBT) is an adapted treatment that is delivered in the home, focuses on the needs of new mothers, and leverages ongoing home visiting to optimize engagement and outcomes. This study examined the efficacy of IH-CBT using a randomized clinical trial. Subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3 months postpartum were randomized into IH-CBT and ongoing home visitation (n = 47) or standard home visitation (SHV; n = 46) in which they received home visitation alone and could obtain treatment in the community. Depression was measured at pre- and posttreatment, and 3-month follow-up using interviews, clinician ratings, and self-report. Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up. For example, 70.7% of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2% in the SHV group. These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs.     

Adapting Brief CBT-I for Depressed Adolescents: A Case Illustration of the Sleeping Better Program

Disturbed sleep is a common symptom of depression in adolescents, but this symptom is not often targeted in psychological therapies for depression. Although the causal relationship between sleep and depression is unclear, there is increasing evidence that in adults, Cognitive Behavioral Therapy for Insomnia (CBT-I) improves sleep problems and reduces symptoms of depression; however, there has been little investigation of using this approach with adolescents. This article describes the adaptation of brief CBT-I for adolescents with depression. A single case study is reported to illustrate the use of the Sleeping Better program. Adaptations for adolescents include increased emphasis on engagement of the young person and the inclusion of parents in treatment. The treatment program was acceptable to the adolescent and parent, and treatment outcome, as indicated by sleep diaries and standardized measures of depression and anxiety, was positive. Further evaluation of the Sleeping Better program is needed to establish if it is an effective low-intensity intervention for sleep problems in adolescents who have depression or anxiety.     

A Role for Occupational Therapy in Foster Care

The purpose of this publication is threefold. First, it is an attempt to document the need for occupational therapy services within the foster care population. Second, it describes methods that can be used by occupational therapists to provide appropriate interventions to people affected by foster care. And third, it highlights the need for and identifies specific assessments that can be used to evaluate individuals affected by foster care and to measure the effectiveness of occupational therapy services delivered to foster care agencies.     

One Parent-Child Activity Group

Abstract

The framework that the author developed for parent-child activity groups is described. This is followed by “snapshots” of a group session to enhance the readers' understanding of the framework. Excerpts of the author's logs from her participant observation of the parent-child activity group that she studied are organized sequentially to provide examples of each part of a parent-child activity group session.     

When a Skeptical Hypothesis Is Live

I’m going to argue for a set of restricted skeptical results: roughly put, we don’t know that fire engines are red, we don’t know that we sometimes have pains in our lower backs, we don’t know that John Rawls was kind, and we don’t even know that we believe any of those truths. However, people unfamiliar with philosophy and cognitive science do know all those things. The skeptical argument is traditional in form: here's a skeptical hypothesis; you can’t epistemically neutralize it, you have to be able to neutralize it to know P; so you don’t know P. But the skeptical hypotheses I plug into it are “real, live” scientific‐philosophical hypotheses often thought to be actually true, unlike any of the outrageous traditional skeptical hypotheses (e.g., ‘You’re a brain in a vat’). So I call the resulting skepticism Live Skepticism. Notably, the Live Skeptic's argument goes through even if we adopt the clever anti‐skeptical fixes thought up in recent years such as reliabilism, relevant alternatives theory, contextualism, and the rejection of epistemic closure. Furthermore, the scope of Live Skepticism is bizarre: although we don’t know the simple facts noted above, many of us do know that there are black holes and other amazing facts.     

Effectiveness of a Multiple Family Group Intervention for Juvenile First Offenders in Reducing Parent Stress

Parenting practices are major influences on incidents of juvenile delinquency. Stress experienced by parents of children with behavioral problems is a leading contributor to parenting practices. We investigated the extent to which parental stress was reduced by participation in an established multiple group family intervention, the Family Solutions Program, developed to reduce recidivism among juvenile offenders. We also examined parent stress by gender, ethnicity, dropout rates, intervention benefits at 3-month follow-up, single- versus two-parent households, and across dimensions of family functioning and parent-adolescent communication. Parents reported greater levels of parent stress than non-clinical parents prior to intervention. Parental stress did diminish in response to intervention, but not until follow-up to intervention completion. No differences were found on initial parent stress level between completers and non-completers of the intervention or between parent stress and gender or ethnicity of the parent; however, single-parent household was associated with significantly higher levels of parent stress. Family functioning was significantly negatively correlated with parental stress. Finally, open communication between juvenile first offenders and their parents improved significantly in response to the intervention both at post-intervention and at follow-up.     

不同抑郁状态个体对情绪面孔的评价研究

目的:为探讨不同抑郁状态个体对情绪面孔的效价评价情况。方法:以BDI、SDS、CCMD-3和汉密顿抑郁量表为工具筛选出42名正常对照组、54名抑郁情绪组、17名抑郁康复组和24名抑郁患者组成员,所有被试完成情绪面孔的效价评价任务。结果:发现抑郁患者组和抑郁情绪组对高兴面孔的评价分数显著低于其他两组(F=7.427,p=0.000);抑郁患者组和抑郁康复组对悲伤面孔的评价分数显著低于其他两组(F=4.956,p=0.003);抑郁患者组和抑郁康复组在情绪评价任务中对高兴和中性面孔的反应时显著长于其他两组(F=13.735,p=0.000;F=18.008,p=0.000),对悲伤面孔的反应时与其他两组无显著差异(p>0.05),抑郁患者组对中性面孔的反应时显著长于悲伤面孔(F=4.240,p=0.018)。结论:抑郁个体对正性刺激存在感知缺陷,对负性刺激存在夸大加工倾向和加工易化效应,其中前者是抑郁的状态特征,后两者是抑郁的特质特征。     

Be a Mom: Formative Evaluation of a Web-Based Psychological Intervention to Prevent Postpartum Depression

A formative evaluation (consisting of two phases: a scoping literature review and a focus group with mental health professionals) was conducted to inform the design of a web-based intervention to prevent postpartum depression, in terms of its characteristics and content: the Be a Mom program. The results showed that the web-based intervention should be short-term, delivered postnatally, and grounded in cognitive-behavior therapy principles. Moreover, the intervention should include weekly sessions targeting basic contents: motherhood changes, reorganizations and emotional experience; cognitions, self-criticism, and self-compassion; parenting values, social support, and assertive communication skills; couple relationship, negotiation and conflict resolution skills; and postpartum depression signs and professional help-seeking. These results may improve the Be a Mom’s adequacy, implementation success, and effectiveness.     

Effect of Training on Sensory Room and Cart Usage

In this study, the authors assess the effectiveness of education on the consistency of use of sensory rooms within a large mental health facility. Eleven staff and thirty-six clients received additional multimodal education in sensory strategies, the use of the sensory rooms on their assigned units, and the link between the rooms and clients' personal crisis intervention plans. Staff knowledge and room usage rates were analyzed pre- and post-training. The authors found statistically significant increases in staff knowledge post-training and increases in the use of the sensory rooms by study participants. The results support the effectiveness of training which uses hands-on, population-specific strategies.     

Uncovering the Value and Meaning of a Horticulture Therapy Program for Clients at a Long-Term Adult Inpatient Psychiatric Facility

This qualitative study investigated the value and meaning of the Greenhouse Program and its impact on recovery goals of residents with severe and persistent mental illness at an adult, long-term psychiatric facility. Eight participants and two occupational therapists were interviewed. Findings revealed two main themes, relating to the essence of the program and personal growth of the participants, supplemented by six sub-themes. The findings suggest that initiatives, such as the Greenhouse Program, are an appropriate intervention that occupational therapy professionals can use in adult inpatient psychiatric facilities.     

Depressed youth: treatment outcome and changes in family functioning in individual and family therapy

This study explores the role of family functioning in therapeutic change in focused individual psychodynamic psychotherapy (FIPP) and time‐limited systems integrative family therapy (SIFT) for depressed children and adolescents. After a screening process, 72 participants aged 8 to 15 were randomized to either FIPP or time‐limited SIFT. Assessments took place prior to, at the end of, and 6 months after treatment. Families in both SIFT and FIPP showed a small but significant and sustained improvement in family functioning by the end of treatment in both mothers' self‐reports and family therapists' assessments. Better family functioning at baseline in mothers' self‐reports and improved family functioning during SIFT, as assessed by family therapists, predicted a sustained decrease in self‐reported depressive symptoms. Results indicated that time‐limited SIFT may be more effective with younger children and in patients without a diagnosis of double depression than adolescents.     

抑郁症人群的心境一致性认知偏向

心境一致性认知偏向指的是抑郁病人的认知加工偏向负性情绪效价, 简称认知偏向。大量行为学、电生理学以及脑成像学的研究显示该认知偏向主要包括知觉偏向、注意偏向、记忆偏向以及解释偏向。该认知偏向以加工偏向负性、积极偏向缺失以及认知控制受损为特点, 且是杏仁核等边缘系统对负性信息过度激活、纹状体对正性信息激活不足以及额区激活模式异常三个相应脑机制协同作用的产物。目前此领域存在各认知偏向之间联系不清楚、认知偏向和抑郁症的因果关系难以确定以及各研究结果不一致等有待回答的问题, 这些重要问题值得引起该领域未来研究者的注意。     

Implementation of Expressive Physical Touch in Depressed Older Adults

Depression is a serious problem among older adults and there is limited research on the most effective way to implement and evaluate the effects of expressive touch, either alone or in combination with verbalization, on levels of depression. A convenience sample of 24 institutionalized depressed older adult subjects (15 females and 9 males), ages 67 to 91 years was used for this study. An interrupted time series with multiple replications design was employed with four measurements: Geriatric Depression Scale (GDS), Life-Satisfaction-A-Scale, Rosenburg Self-Esteem Scale, and Locus of Control Scale. Four interventions were implemented: expressive touch only, verbalization only, a combination of expressive touch and verbalization, and a control (presence). Significant differences were found between pretest and posttest scores on the GDS for the expressive touch/verbal intervention. The most comfortable locations to implement the expressive touch and combination interventions were in the dining room or at the subject's bedside. The most comfortable areas of the subjects' bodies touched were the arms, hands, shoulders, and back. Results of this study support an important link between depression, self-esteem, locus of control, and life satisfaction and expressive touch either alone or when combined with talk. Touch as a mode of effective social support may have a therapeutic effect for depressed older adults.     

Changes in Cognitions, Emotions, and Behaviors in Depressed Patients and Their Spouses Following Marital Cognitive Therapy, Traditional Cognitive Therapy, Pharmacotherapy, and No Intervention

This study evaluated specific influences of a cognitive marital treatment (CMT) for depression based on an integration of cognitive theory of depression and systems theory. The effects of CMT on variables representing cognitions, emotions, and behaviors were compared with the effects of traditional cognitive therapy (CT), pharmacotherapy (PT), and no treatment (NT). Subjects were Major Depression Disorder and Dysthymic outpatients and their spouses. The changes considered were for pre–post treatment and pre-treatment–follow-up. CMT affected a wider range of variables than other treatments. In most instances it was also superior to the NT condition. Most of the gains were manifested at termination and lasted through follow-up. The variables affected by CMT were patients' and spouses' cognitions and emotions. PT had best effects on patients' emotions. CT affected patients' cognitions, but did not achieve superiority on any of the compared variables. None of the treatments produced significant changes in behaviors.