Group-based problem-solving therapy in self-poisoning females: A pilot study

Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed.     

Engaging multiproblem families in treatment: lessons learned throughout the development of multisystemic therapy.

Multisystemic therapy (MST) is a family-based treatment model that has achieved high rates of treatment completion with youths who present serious clinical problems, and their families. The success of MST in engaging challenging families in treatment is due to programmatic commitments to family collaboration and partnership as well as to a conceptual process that delineates barriers to family engagement, develops and implements strategies to overcome these barriers, and evaluates the success of these strategies. This article provides an overview of the nonspecific/universal engagement strategies used by MST therapists, frequently observed barriers to achieving therapist-family engagement, and specific strategies to overcome a sampling of these barriers.     

Engaging refugee families in therapy: exploring the benefits of including referring professionals in first family interviews

The possible benefits of including referring professionals in the first family interviews are being explored as a way to engage refugee families in therapy. Families in exile confront a number of problems related both to premigration traumatic exposures and to present adaptation processes. Refugee clients and the referring professionals in the larger system frequently see the problems and their solutions quite differently. This situation may often result in unclear working alliances in a context of therapy. We will describe first family interviews in which referring professionals are interviewed about their reasons for referrals, and where the families are invited to discuss these considerations. The conversations permit families, referrers, and therapists to reflect upon differences in positions and perspectives. Their experiences suggest that agreements or contracts based on these joint interviews are less ambiguous and more clearly formulated than contracts based on interviews with families alone. Finally, these experiences are discussed as a potentially valuable approach in a cross-cultural context.     

Engaging with change: a process study of family therapy

It is argued that current attempts to investigate the process of family therapy might benefit from the application of discursive and narrative analytic techniques. An example of such an analysis is given, taking the work of an experienced family therapist with one family seeking help in dealing with the aftermath of a marital separation.' The theme of how to deal with change'as it materializes in the discussions during therapy is selected for detailed examination in this paper. It is argued that there are two main discourses on this theme evident in the family's discussions, one being that the separation has occurred and its consequences should now he left to arise naturally; the other being that the effects of the separation need to be actively managed. It is suggested that this analytic procedure can dramatize the subtle changes in family discourses during therapy; its limitations in terms of generalizability, and the difficulties of dealing with huge amounts of complex material, are also noted.     

Engaging families as experts: collaborative family program development

This article presents the collaborative family program development (CFPD) model, a collaborative research-based approach to creating community-based programs for families. In this approach, families are viewed as experts on the nature of their challenges and on what they desire in a program. This approach is particularly useful in developing programs for families who have experienced social oppression and who may have been reluctant to participate in programs created for them by professionals without their consultation. In contrast, when professionals adopt the stance of respectful learners, families respond by actively engaging in the program development research and in the program created from it. This article describes the nature and complexities of a collaborative program development stance, the unique contribution to community-based program development offered by a family systems focus, and the 10 steps in the CFPD approach. These 10 steps guide movement from initiating the project and forming collaborative professional partnerships to engaging cultural consultants; conducting in-depth research to understand the problems, resources, contexts, and recommendations from the perspective of families who will receive the program and from the perspective of front-line professionals working with these families; transforming research findings into program contents and formats; and implementing, evaluating, revising, and replicating the program. The approach is illustrated by a program called Fresh Start for Families, developed and replicated for families in New York City who are homeless and attempting to move from welfare to work.     

Engaging high risk families in community based intervention services

Involving high risk families in community based intervention services constitutes a major challenge facing service delivery in the fields of mental health and substance abuse. Mental health and substance abuse programs typically experience high rates of failure to enroll families in services, as well as high rates of drop-outs from treatment. With family-based intervention programs, those involving all the members of the family or household participation by the entire family is a key to having a successful program. The NIDA funded Youth Support Project tests such a home and family based Family Empowerment Intervention in a randomized field trial which targets families of juvenile offenders. This intervention is delivered three times a week by paraprofessionals who are supervised by a licensed clinician. We discuss the guiding principles and success of our enrollment activities and discuss their implications for other family-based services.     

Family therapy with problem drinkers and drug takers: A pilot follow-up study

We report a retrospective outcome study of 36 problem drinkers and/or drug takers, treated with structural-strategic family therapy. The interval between treatment and follow-up varied from six months to two years. Follow-up data was available on 34 cases. Twenty had a pure alcohol problem and of these 18 had a good outcome at follow up. Five had a mixed drug/alcohol problem; of these all were free from problem drinking and four had become abstinent from drugs at follow-up. Of the nine patients with a pure drug problems, eight were abstinent from drugs at follow-up. Given the retrospective nature of this study and the lack of control data, these results must remain impressionistic but the implications of the findings are discussed.     

A pilot study of two-day cognitive-behavioral therapy for panic disorder

The present study investigated the short-term efficacy of brief, intensive cognitive-behavioral therapy (CBT) for panic disorder (PD). The treatment involved 9h of therapist contact over two consecutive days and was developed for the purpose of delivering CBT for PD to a largely rural patient population that must travel long distances to find a treatment provider. Ten patients who elected to participate in brief, intensive CBT instead of weekly CBT were recruited from routine clinical practice in a hospital-based anxiety disorders clinic. Patients were not excluded based on the presence of agoraphobia, diagnostic comorbidity, concurrent use of PRN benzodiazepine medications, or previous nonresponse to psychotherapy for PD. Assessments conducted at pre-treatment and 1-month follow-up revealed large, clinically significant reductions in PD symptoms, anxiety sensitivity, body vigilance, and anxiety and depressive symptoms. Most patients (60%) were panic-free after treatment and evidenced normative levels of symptomatology at follow-up. The present study suggests that brief, intensive treatment may be an effective means of delivering CBT for PD.     

Emotionally-focused therapy and treatment as usual comparison groups in decreasing depression: A clinical pilot study

Abstract

Decades of research have shown that depression can have deleterious effects on couple relationships. Emotionally-focused therapy (EFT; Johnson, 2004 Johnson, S. M. (2004). The practice of emotionally focused couple therapy: Creating connection. East Sussex, UK: Brunner-Routledge. [Google Scholar]) is an empirically validated form of couple therapy, which has shown effectiveness in reducing depressive symptoms in couples where the wife has depression. The aim of the current pilot study was to examine the extent to which EFT and the comparison treatment as usual (TAU) therapy group decrease depressive symptoms in distressed couples. Results show that both groups were effective in decreasing depressive symptoms, with EFT showing a clinically significant reduction. Clinical implications and future research are discussed.     

A pilot study of cognitive-behavioral therapy of insomnia in people with mild depression

In some cases, insomnia and depression may have a reciprocal relationship, in which each aggravates and maintains the other. To test the hypothesis that reduction of insomnia would result in reduction of depression in patients (N=10) with both disorders, a repeated-measures design was used comparing depression and insomnia levels before and after 6 sessions of cognitive-behavioral therapy of insomnia. Posttreatment, 100% of completers (n=8) had a normalized sleeping pattern, and 87.5% had normalized depression scores. Significant posttreatment improvement was seen in sleep onset latency (-31 min), wake time after sleep onset (-24 min), total sleep time (+65 min), sleep efficiency (+14%), and sleep quality (+19%), which was maintained at 3-month follow-up. A decreasing trend occurred in depression scores from pre- to posttreatment, which reached significance at 3-month follow-up. Intent-to-treat analyses showed similar results.     

Student mental health: A pilot study

In this country, little research has been undertaken into the difficulties faced by students and the contributory stressors. It is apparent that they have a lot with which to content. Identification of stressors, assessement of stress levels and consequences on mental health appear vital.A pilot study was undertaken of 40 studets: 10 males aged under 21 years, ten males 21–40 years, 10 females under the age of 21 and 10 females 21–40 years, The purpose was to identify the potential factors leading to student discontent, problems and stress. Students were in the professions allied to medicine. Oral semi-structured interviews and a written questionnaire were used. Results indicated that for students the major difficulties were coursework and emotional state. Finance was a recurring problem but not as troublesome to the students as the other two problems. What must be considered are ways to alleviate student unhappiness. Emphasis should be placed on prevention where possible. Ongoing counseling throughuot the educational years is desirable as are various programmes which address student concerns. Of particular value would be a Student Mental Health Service. ‘Unnecessary’ coursework could be an added burden.     

Child and parental outcomes of a group parenting intervention for Latino families: A pilot study of the CANNE program

Criando a Nuestros Ni?os hacia el éxito (CANNE) is the Spanish adaptation of Parenting Our Children to Excellence (PACE). A pilot study conducted with 124 parents of preschoolers (mostly recent Mexican immigrants) provides preliminary evidence for the community acceptability and efficacy of CANNE. Eighty-eight of the 124 parents who enrolled in the program attended one or more of the 8 sessions (17% attended 1 session, 11% attended 2-4 sessions, and 72% attended 5 or more sessions), participated actively in sessions, and expressed high degrees of program satisfaction. Over time, parents improved on measures of harsh-inconsistent discipline, and children improved on social competence and social-communication skills. When high-versus-low attenders were compared, high attenders (parents who attended 4 sessions or more) reported greater increases than low attenders in their appropriate-positive parenting practices and clear expectations, and in their children's social competence and communication skills, and they reported greater decreases in their harsh-inconsistent discipline and in their children's aggressiveness and hyperactivity. Some of these changes were evident by the end of the program, whereas others became apparent (or stronger) over a 3-month follow-up period. These encouraging results point to the need for an efficacy study that assesses how well CANNE can help larger numbers of Latino parents in the important task of bringing up their young children in the United States.