Comparing educational interventions: Correcting misperceived norms improves college students' mental health attitudes

This research targeted potential psychological contributors to college students' low levels of help‐seeking for mental distress using a field experiment. Researchers randomly assigned 520 undergraduates to 15‐min interventions: a novel, theory‐driven social norms intervention correcting misperceived distress, stigma, and help‐seeking norms; a general education intervention increasing mental health awareness; and a stress management active control condition. The norms intervention instilled more accurate perceptions of mental health norms and temporarily reduced perceived public stigma compared to other conditions. The norms and general education interventions improved attitudes toward seeking help for mental distress for at least 2 months, relative to the control. Effects on help‐seeking behavior were not observed in this timeframe. This research elucidates the robustness of brief social psychological mental health interventions on college campuses.     

A randomized controlled pilot trial of acceptance and commitment training (ACT) for preventing stress-related ill health among future nurses

Background: Levels of stress and burnout increase during nursing education. This development has consequences for nursing students' health, learning, competence, and interest in quality issues in health care. Design: In a randomized controlled pilot trial with a sample of 113 nursing students the effect of an intervention using techniques from acceptance and commitment training (ACT) to prevent the development of stress and burnout was evaluated. Method: The 6 × 2-hour program was compared to standard treatment (reflection seminars) post-intervention and at a three-month follow-up using longitudinal analysis of mean response profiles. Mechanisms of change were investigated using a baseline-post intervention two-mediator model. Results: The intervention resulted in increased mindful awareness and decreased experiential avoidance, as well as decreased perceived stress and burnout. Levels of mindful awareness and perceived stress were sustained at follow-up. The proposed mechanisms of change were partly supported by the data. Conclusion: This study shows that techniques from ACT might have the potential to contribute to preventing the development of stress and burnout during nursing education. However, additional studies are needed to validate these results.     

A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff

The mental health challenges of some vocations present a challenge for current intervention models. Bibliotherapy focused on transdiagnostic processes that might both prevent and alleviate a range of mental health distress could be an effective and practical approach. K-12 school personnel (N = 236; 91% female; 30-60 years old) responding to a wellness-oriented program announcement were randomized to receive an Acceptance and Commitment Therapy (ACT) self-help volume or to a waitlist. Three-fourths were above clinical cutoffs in general mental health, depression, anxiety, or stress. Participants read the book for two months, completed exercises and quizzes, and after post assessment were followed for 10 weeks; waitlist participants were then also given the book with two months to complete it. Overall, participants showed significant improvement in psychological health. Significant preventive effects for depression and anxiety were observed along with significant ameliorative effects for those in the clinical ranges of depression, anxiety and stress. Follow up general mental health, depression, and anxiety outcomes were related to the manner in which participants used the workbook and to post levels of psychological flexibility.     

Towards Working Life: Effects of an intervention on mental health and transition to post-basic education

The Towards Working Life group method was designed to promote the transition to the upper secondary level or vocational studies and to support mental health among young people finishing their basic education. This study examined the effects of the intervention during upper secondary and vocational studies in a randomized field experimental study among a total of 1034 students. At the one-year follow-up, the program had increased both education related social ties and the number of adults in these ties. The group intervention had interaction effects with baseline risk of depression and learning difficulties on symptoms of depression and school burnout. Among those initially at risk of depression, the intervention decreased symptoms of depression. For students who were at risk of depression and had learning difficulties, the intervention decreased school burnout.     

The relationships of change in work climate with changes in burnout and depression: a 2-year longitudinal study of Chinese mental health care workers

Mental health care workers face heavy emotional demand and are prone to work burnout. Work burnout has been associated with poor mental health and work climate, which refers to individual perceptions about work setting. The purpose of this study was to examine whether intra-individual changes in work climate were associated with intra-individual changes in burnout and depression over two years. The present sample included Chinese mental health care workers (N = 312; mean age = 38.6, SD = 9.9) working in a psychosocial rehabilitation institution. The participants completed questionnaires on work climate, work burnout and depression at seven time points across two years. Parallel process latent growth modeling was used to analyze the associations of change between work climate and burnout and depression. Work climate displayed a logarithmic decreasing trend while burnout and depression displayed logarithmic increasing trends over two years. Baseline levels of work climate were negatively and moderately associated with baseline levels of burnout and depression (r = ?.44 to ?.60, p < .01). Changes in work climate were negatively and moderately associated with change in burnout (r = ?.43, p < .01) and change in depression (r = ?.31, p < .05). Change in burnout was positively and strongly associated (r = .58, p < .01) with change in depression. The current results support temporal relationships among changes in work climate, burnout and depression across time. Practical implications for future preventive work in burnout interventions were discussed within this population.     

Physical activity in employees with differing occupational stress and mental health profiles: A latent profile analysis

ObjectivesTo examine whether employees with differing occupational stress and mental health profiles differ in their self-reported levels of physical activity.DesignCross-sectional survey data.MethodThe sample consisted of 2660 Swedish health care workers and social insurance officers (85% women, M = 46.3 years). Latent profile analysis was performed to identify classes. Between-class-differences in physical activity were tested via χ²-tests and multinominal logistic regression analyses using sex, age, BMI, marital status, children at home, caregiving, and smoking as covariates.ResultsLatent profile analysis resulted in a six-profile solution. Two pairs of classes had equal stress levels, one pair with high stress, one pair with moderate stress. Within each pair, one group showed some resilience (i.e. only moderate mental health problems despite high stress or good mental health despite moderate stress), whereas the other did not. The other two classes were characterized by either low stress and good mental health or moderate-to-high stress and elevated mental health problems. Participants who were resilient to high or moderate stress were more active than participants of the corresponding non-resilient classes. Participants with low stress and good mental health reported the highest physical activity levels, participants with high stress and high mental health problems reported the lowest physical activity levels.ConclusionsThe findings suggest that physical activity is associated with resilience to occupational stress, and that beyond primary prevention efforts to make work less stressful regular physical activity should be a target variable for health professionals working in the occupational setting.     

Is mindfulness associated with stress and burnout among mental health professionals in Singapore?

High levels of stress and burnout have been reported among mental health professionals worldwide, including Singapore, with concerning potential implications for the quality of patient care. Mindfulness has been associated with decreased stress and burnout; however, associations between mindfulness, stress, and burnout have not been examined in Singapore. The aim of this study was to investigate whether mindfulness is associated with stress and burnout among healthcare professionals working in a mental health setting in Singapore. A total of 224 Singaporean mental health professionals completed a cross-sectional survey which included measures of: mindfulness (observe, describe, act with awareness, non-judge, and non-react), stress, and burnout (exhaustion and disengagement). Using multiple regression, significant negative associations were found between each of the mindfulness facets and: stress, exhaustion, and disengagement, while controlling for years of experience. Of the five mindfulness facets, act with awareness demonstrated the strongest negative association with all three variables. This study showed that mental health professionals in Singapore who have higher levels of mindfulness also have lower levels stress and burnout (disengagement and exhaustion). Future longitudinal research is warranted to better understand the directionality of these associations, with implications for the development of interventions aimed to reduce stress and burnout within this population.     

A preliminary investigation of acceptance and commitment therapy as a treatment for marijuana dependence in adults

In this investigation, 3 adults who met criteria for marijuana dependence were treated using an abbreviated version of acceptance and commitment therapy (ACT). The treatment was delivered in eight weekly 90-min individual sessions. The effects of the intervention were assessed using a nonconcurrent multiple baseline across participants design. Self-reported marijuana use, confirmed through oral swabs, reached zero levels for all participants at posttreatment. At a 3-month follow-up, 1 participant was still abstinent and the other 2 were using but at a lower average level of consumption compared to baseline. Depression, anxiety, withdrawal symptoms, and general levels of experiential avoidance generally improved. This preliminary test suggests that additional development and testing of ACT for marijuana use are warranted.     

Improvements in Depression and Mental Health After Acceptance and Commitment Therapy are Related to Changes in Defusion and Values-Based Action

Acceptance and commitment therapy (ACT) has been found to be effective for various mental health disorders but the processes through which it affects change remain unclear. Much process research in the area is on physical rather than mental health, and focuses on the broad concept of psychological flexibility with little research on specific mechanisms identified in theory such as fusion and values. This study explored whether there was a relationship between two of the main ACT processes (cognitive defusion and values) and levels of depression and distress. Thirty-three participants completed questionnaires at the start and end of their treatment measuring general mental health and distress, depression, levels of cognitive fusion and how much they were living in line with their values and how important their values were to them. Results showed reductions in levels of fusion and increases in values-based action were significantly related to reductions in distress and depression. There was no correlation between changes in values importance and changes in distress or depression. This study therefore suggests decreased defusion and increased values-based action is an important mechanism in the efficacy of ACT in those with depression and mental health problems. The study is however limited by a small sample size and future research with a sample large enough for mediation analysis would be beneficial.     

Acceptance and Commitment Therapy for Posttraumatic Stress Disorder in Early Psychosis: A Case Series

Persons with psychosis often report high levels of posttraumatic stress disorder (PTSD) symptoms, which render them more vulnerable to relapse, symptom exacerbation, and reduced well-being. However, less is known about how to adequately accommodate the needs of persons recovering from a first episode of psychosis, presenting with PTSD. Further, the existing evidence-based interventions for PTSD seem less equipped to deal with serious mental disorder and comorbid conditions. This study aimed to assess the efficacy, acceptability, and safety of Acceptance and Commitment Therapy (ACT) for persons suffering from PTSD with comorbid trauma and psychosis. Three consecutively referred participants meeting ICD-10 criteria for PTSD and a first-episode nonaffective psychotic disorder were treated in an outpatient service within a case-series analysis. A manual-guided ACT intervention of 12 sessions showed clinically relevant improvement on self-report measures of PTSD symptoms and emotional distress. These initial findings are promising and appear to justify a more controlled evaluation of this brief intervention.     

A Test and Refinement of the Demand–Control–Support Model in the Construction Industry

This study aims at a test and further refinement of the Demand–Control–Support (DCS) model among construction workers (N = 210). On the basis of theory and empirical evidence, we hypothesized that mental or physical job demands, low job control, and lack of social support at work have direct and synergistic effects on burnout. The model was expanded by hypothesizing that burnout mediates the relationships between these potentially demanding working conditions on the one hand, and health complaints on the other. Results of a series of structural equation analyses partly supported these hypotheses. The proposed model fitted adequately to the data, although some variables in the DCS model did not make a unique contribution to explaining variance in burnout and (indirectly) health complaints. Interestingly, lack of social support was the most important determinant of burnout and health complaints among construction workers. In addition, a significant three-way interaction effect partly confirmed the synergism hypothesis: Physical demands were only related to burnout if participants had poor job control and reported high social support. The implications of these findings for research and practice are discussed.     

Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders

Acceptance and commitment therapy (ACT) has previously been shown to alter stigmatizing attitudes and to be relatively useful for psychologically inflexible participants. The present study is the first to bring those two findings together by comparing ACT to an education intervention for reducing stigma toward people with psychological disorders, and examining whether results differ for psychologically inflexible versus flexible individuals. A sample of college students (N =95) was randomly assigned to a 2(1)2h ACT or educational workshop. Measures were taken before and after the workshop and at a 1-month follow-up. ACT reduced mental health stigma significantly regardless of participants' pre-treatment levels of psychological flexibility, but education reduced stigma only among participants who were relatively flexible and non-avoidant to begin with. Acceptance could be an important avenue of exploration for stigma researchers.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.     

Intertransference: Transference Relationships between Members of the Psychotherapy Team

Abstract

There has been limited published research on the effectiveness of manualized psychoeducational approaches for the mental health and behavioral problems of child sexual abuse (CSA) survivors. The present study aims to add to the evidence base for the effectiveness and acceptability of such interventions. A total of 37 enrolled into a brief psychoeducation program (i.e., 10 sessions) aiming to help stabilize mental health and behavioral outcomes (e.g., self-harm), while on the waiting list for mental health services. Participants completed a set of self-rated measures at baseline, pre-intervention, post-intervention and 3-month follow-up. Although there was no change over time with regard to general distress, traumatic symptomatology, depression, anxiety, self-esteem, and life satisfaction, completers were less likely to report self-harm and presented with decreased rates of smoking, alcohol and substance misuse, and involvement in illegal and antisocial behaviors at post-treatment and follow-up. Qualitative data also suggested that overall the program is well tolerated by participants, despite the high attrition rate (43%). Although further research is required to establish the efficacy of this intervention, preliminary results indicate that the new intervention may be useful for stabilizing behavioral problems at post-treatment and follow-up. Strategies to improve attrition rates in future research and clinical practice are discussed.     

Efficacy of an internet-based intervention for burnout: a randomized controlled trial in the German working population

Background and Objectives: Internet-based interventions are a viable treatment option for various mental problems. However, their effects on the burnout syndrome yielded mixed results. In this paper, we examine the efficacy of a structured and therapist-guided internet intervention, based on solution-focused and cognitive-behavioral therapy, for individuals with symptoms of burnout.

Design: Two-arm, Internet-based, randomized, wait-list controlled trial (RCT).

Methods: Participants were recruited through in-house events and online advertising. They were randomly assigned to the intervention or a wait-list. Group comparison was conducted three months after randomization. Outcomes were the burnout level according to the Maslach Burnout Inventory (MBI-GS) and the levels of depression, anxiety and stress according to the DASS-21.

Results: Thirty-nine participants were included in the trial; 36 (92.3%) took part at the 3-months-follow-up. Intention-to-treat analyses revealed significant group differences in favor of the intervention group in depression (d?=?0.66), cynicism (d?=?0.87) and personal accomplishment (d?=?0.75).

Conclusions: The intervention helped ameliorate symptoms of work-related stress and burnout. Although limited by a small sample size, the study suggests that the program provides effective support for affected individuals. However, further studies with bigger sample sizes should be conducted to examine the effects of such programs more precisely.     

The Development,Pilot, and Process Evaluation of a Parent Mental Health Literacy Intervention Through Community Sports Clubs

The mental health literacy of parents may be critical in facilitating positive child and adolescent mental health outcomes. The purpose of this study was to develop, pilot, and evaluate a targeted parent mental health literacy intervention through community sports clubs. Sixty six parents (M_age?=?44.86?±?5.2 years) participated in either a brief mental health literacy intervention workshop delivered through community sporting clubs (n?=?42) or a community-matched control group (n?=?24). Participants’ mental health literacy was assessed at baseline, post-intervention and at 1 month follow-up. A mixed methods process evaluation was conducted with intervention participants to determine the acceptability and feasibility of the intervention. Participants in the experimental group showed greater increases in depression literacy, anxiety literacy, knowledge of help seeking options and confidence to assist an adolescent experiencing a mental health disorder, compared to those in the control group. Post-intervention changes in the experimental group were maintained at 1 month follow-up. A mixed methods process evaluation revealed that parents found the intervention content engaging, relevant to their needs, and practically useful in terms of actively supporting adolescent mental health. Findings provide evidence that a brief, targeted intervention through community sports clubs might be a particularly useful method of improving parental mental health literacy and facilitating positive youth mental health outcomes.     

Measuring the Effects of Stress and Social Networks on the Health of Canadians

We analyze the impact of networks and stress on the general and mental health of men and women aged 25 to 59 using data from the Canadian 2008 General Social Survey on Social Networks. Controlling for demographic and other variables, we examine the effects on health of social network types (family vs. friends), size, strength (frequency of contact) and diversity, and the interaction of these network variables with stress. We largely find the expected health benefits of network size, strength and diversity. Nonetheless, we also find diminishing health returns at higher levels of the network measures. The general health of men and women, for example, benefits from increasing size of family network, but such benefit decreases after a certain size. Likewise, increases in friend and family network sizes have positive but diminishing returns on men’s mental health. As expected, stress negatively impacts the general and mental health of men and women but social networks can buffer some of the negative effects. The negative effect of stress on men’s mental health is lessened with a more diverse network. Similarly, the negative effect of stress on women’s mental health decreases with larger network of friends. However, in the case of general health, men with higher stress have worsening health if they are in more diverse networks.     

Mindfulness-based stress reduction and self-compassion among mental healthcare professionals: a pilot study

The authors conducted a pilot study on the effects of a mindfulness-based stress reduction (MBSR) educational intervention on mental health professionals' self-compassion, perceived stress, burnout, and quality of life. Data were obtained from 22 female mental healthcare workers between the ages of 24 and 69 years who were enrolled in one of four separate 8-week MBSR courses. Pre- and post-assessment measures consisted of the Self-Compassion Scale (SCS), Maslach Burnout Inventory, and Quality of Life Inventory. The changes on the SCS total score proved significant with a p-value of .003. Within the SCS, changes were significant on four out of the six subscales. The study is unique in its use of the eight-week MBSR intervention to target mental health professionals currently working in the field, and in the examination of the specific facets of self-compassion enhanced by this type of intervention.     

Increasing Positive Health Behaviors in Adolescents with Nutritional Goals and Exercise

Research has documented that low-income urban youth are at risk for obesity and related health problems. Our goal was to develop a brief, developmentally informed intervention to increase positive health behaviors (e.g., diet and exercise) among low-income, minority adolescents. Our study was designed to examine the feasibility and potential impact of our single session intervention that was delivered in a primary care setting. The participants were 100 adolescents from an urban adolescent medicine clinic who were randomly assigned to one of two conditions: a) a 3–5?min goal-only session or b) a 15–20?min motivationally enhanced intervention. Health behaviors and individual characteristics (i.e., autonomous motivation, self-efficacy) were assessed at baseline and re-assessed at follow-up 1 month later with 53?% of the youth completing the follow-up assessment. Those in the enhanced intervention group were more likely to participate in the follow-up as were those who reported higher baseline motivation and self-efficacy. Both groups reported statistically significant health behavior improvements over time and older adolescents reported more improvements. The two conditions did not significantly differ in reported health improvements. Self-efficacy predicted improvements in self-reported fruit and vegetable intake at follow-up. Results support that a brief “chat” with adolescents about their personal goals and values appears to have the potential to increase their positive health behaviors and appears to be useful as a preparatory intervention for weight management efforts for urban teens. The study demonstrates the feasibility and potential efficacy of implementing this 20?min intervention into primary care settings, thereby helping urban youth focus on their individualized goals, values, and motivations for health.     

A brief cognitive behavioural therapy psychoeducational group for Chinese people with chronic illnesses: an evaluation study

This pilot study attempted to examine the effectiveness of a brief cognitive behavioural therapy (CBT) psychoeducational group for Chinese people with chronic illness in Hong Kong. It adopted a single group design, and 52 participants joined the group. A questionnaire with three outcome measures, measuring general mental health, quality of life and dysfunctional attitudes and beliefs, was administered to participants at pre-test, post-test and six month follow-up. Repeated measures ANOVAs were employed and revealed positive changes in most of the outcome measures across the three time points. Cohen’s d showed a moderate to large effect size for most outcome measures. From a step care perspective, a culturally attuned brief CBT psychoeducational group may serve as an early intervention and a triage to attract suitable people with chronic illness to engage in the treatment process.