Primary prevention of psychological difficulties in vulnerable mothers: pilot programme evaluation

This pilot study evaluated a primary prevention programme delivered to mothers who were considered to be vulnerable to the development of psychological difficulties (N = 11). Beneficial effects were noted in terms of mood and coping, as well as a reduction in the mothers' attendance at their general practitioners surgery. Copyright © 2001 John Wiley & Sons, Ltd.     

Improving access to psychological therapies: systemic therapy in the Newham pilot site

The improving access to psychological therapies (IAPT) programme, which started with two pilot sites, has dramatically changed the provision of mental health services for depression and anxiety disorders in the National Health Service. The IAPT initiative has focused on the provision of cognitive behaviour therapy but incorporated a small systemic therapy service in the Newham pilot site. The outcomes of this systemic service are presented in this article. Most clients seen by the service suffered from depression and anxiety disorders. The response rate for the evaluation questionnaires was high. For the depression and anxiety measures the recovery rate was above 50 per cent and the effect sizes were large. Most of the clients were satisfied with the service. A trend towards employment was identified. The outcomes are discussed in comparison with those of the cognitive behaviour therapy service and recommendations for the process of further studies are made.     

Dose response effects of cognitive-behavioral therapy in a school mental health program

ABSTRACT

School mental health (SMH) programs have been shown to be effective in providing evidence-based interventions to underserved youth. However, limitations of SMH programs are that they can entail holiday breaks, typically do not operate through summer, and often require pulling students from class to receive therapy. These limitations suggest that treatment must be expeditious and potent. Although researchers have investigated dose response to treatment, no studies were located that addressed dose response to treatment in SMH programs. The present study addressed this gap by evaluating the dose response to SMH treatment in a sample of 133 adolescents. Adolescents were assessed at baseline, post-treatment, and at multiple time points throughout treatment. An average treatment response of a 26.81-point decrease in Youth Outcome Questionnaire (YOQ-30) score was found across 14 sessions of cognitive-behavioral therapy (CBT). Further, adolescents exhibited reliable change in YOQ-30 score within an average of 2.91 sessions. Finally, it was found that baseline scores on the Depression and Hyperactivity subscales of the Behavior Assessment System for Children, 2nd Edition, along with YOQ-30 score, predicted treatment response. These findings advance our understanding of dose response to CBT in SMH settings, and create opportunities to better inform effective treatment strategies in similar contexts.     

Occupational Choices for People with Psychiatric Disabilities: Comparing Attendees and Non-Attendees at Community-Based Day Centers

Research has shown that people with psychiatric disabilities who attend a day center rate their satisfaction with daily occupations equally in comparison with non-attendees. The current study investigates which occupations the target group performs and also differences in occupational choices between attendees and non-attendees. Reported occupations were analyzed with content analysis. Day center attendees reported more productive occupations, while non-attendees reported more recreational occupations and a greater breadth of occupations. This implies that non-attendees might compensate a lack of work-like occupations at a day center with satisfying recreational occupations. The results can guide development of psychiatric occupational-based rehabilitation.     

Creating mother and baby therapy groups in prison: emotional valuation

Mothers in prison are at high risk of depression and other mental health issues and yet access to therapeutic services is limited. This paper describes the development by the author of two prison therapy groups: one for pregnant women, the other for mothers and their babies. Called the ‘Born Inside’ project, both groups are currently held in Bronzefield Prison, Surrey. The theory and principles behind the project are discussed, as well as the processes and practicalities involved in providing the therapy and specialised support to the women and their vulnerable infants. In addition, principles of forensic psychotherapy in relation to this specific prison population are described, and the situational and emotional challenges faced are illustrated through narratives of group members.     

The partnership between the Early Intervention Institute,St Petersburg,and the Anna Freud Centre,London

The authors describe study and teaching links between the Early Intervention Institute in St Petersburg and the Anna Freud Clinic in London. Some brief clinical examples from a variety of settings are given as well as a longer case presentation. The impact of widespread institutional care, alcoholism and terrible housing conditions on child mental health are illustrated. This raises questions about the role of child psychotherapy when social conditions are so harsh. The case material indicates that, despite this, children can be helped in some measure to feel more secure, by the therapist providing constancy and reliability within an often frightening and dangerous external world.     

Making the grade: a pilot investigation of an e-intervention to increase mental health literacy and help-seeking intentions among international university students

ABSTRACT

International students may have less understanding and awareness of mental health issues and appear unlikely to seek help. The purpose of the current study was to construct and evaluate a brief online educational intervention designed to increase mental health literacy (MHL) and help-seeking among international tertiary students studying in Australia. The intervention was tested among 45 international tertiary students (undergraduate and postgraduate), who were randomly allocated to control and intervention conditions. The intervention led to significant improvements in help-seeking attitudes, particularly in stigmatising attitudes. No significant effects were found for MHL or help-seeking intentions. A brief educational intervention can improve help-seeking attitudes among international tertiary students. Future research may focus on establishing optimal intervention dosage.     

Mental health and identity: the evaluation of a drop‐in centre

This paper is based on interviews with users of a drop‐in centre run by a voluntary group. Using a grounded theory approach the paper argues that individuals' use of the drop‐in is linked to the discursive strategies that they have developed to cope with stigma. Tajfel's Social Identity Theory is employed as a framework to examine how users manage the threat to their identity posed by the diagnosis and experience of mental illness. The implications of this research are examined within the context of the empowerment paradigm of mental health. Copyright © 2001 John Wiley & Sons, Ltd.     

Neuropsychological evaluation and rehabilitation in mental retardation

A discussion is provided of issues related to neuropsychological assessment of mentally retarded individuals. The first matters considered are test selection in relation to mental age and diagnostic issues. Various methods of evaluation are then considered, including assessment of orientation to sound and visual stimuli, language comprehension, right-left discrimination, and abstract and symbolic processes. Methods are also reviewed for detailed evaluation of language functions including testing for aphasia and for academic skills such as reading, writing, and calculation, as well as for spatial and constructional abilities. A section is devoted to use of neuropsychological assessment for rehabilitation of various disorders such as congenital aphasia, alexia, and spatial-constructional disorders.     

Addressing social determinants of mental health in therapy: A thematic synthesis

Background

The importance of addressing social determinants of mental health in therapy is well-documented. However, there appears to be limited research on what this actually involves in practice and how best to prepare therapists to work with individuals experiencing adverse social determinants.

Aims

The aim of this review was to draw implications for practice and training from reviewing research on addressing social determinants of mental health in therapy.

Methodology

A qualitative systematic review of the research on addressing social determinants of mental health in therapy was conducted, extracting papers from eight databases: Cochrane Library, ASSIA, CINAHL Plus, PsycInfo, Psychoanalytic Electronic Publishing, Science Direct, Scopus and Web of Science. Out of 127 papers found, five met the eligibility criteria and were quality-assessed and analysed thematically.

Findings

The thematic synthesis generated three main themes: “the therapeutic relationship,” “adapting to client context” and “community as a resource,” with eight subthemes.

Conclusion

This thematic synthesis highlights the importance of the therapeutic relationship and adapting mental health support to client frame of reference and context to address social determinants of mental health in therapy. It emphasises community as a helpful resource for informing training and therapeutic interventions, as well as a significant resource for people experiencing adverse social determinants.     

Cultural aspects of mental health and mental health service delivery with a focus on Nigeria within a global community

With an endless range of subgroups and individual variations, culture bears upon what all people bring to the clinical setting. Culture could account for health-seeking behaviour, type of services and support system and variations in how people communicate their health concerns. Culture may underlie presentation of sets of symptoms that are peculiar to certain societies – culture-bound syndromes. Culture also influences the meanings that people impart to their illness and also stigma associated with such illnesses. Culture must be viewed from the patients, clinicians and health system dimensions. Changes in mental health service delivery in last few decades have yielded culturally competent mental health services. The aim of this paper was to discuss culture and mental health with a focus on Nigeria and from a global perspective.     

A systematic review and meta-analysis of dropout rates from dialectical behaviour therapy in randomized controlled trials

ABSTRACT

Dropout is an important factor that may compromise the validity of findings from randomized controlled trials (RCTs) of dialectical behaviour therapy (DBT). We conducted a targeted meta-analytic review of dropout from RCTs of DBT, with the aims of (1) calculating average rates of dropout from DBT; (2) investigating factors that moderate dropout; (3) examining whether dropout rates from DBT differ to control interventions; (4) synthesising reasons for dropout. Forty RCTs of DBT met full inclusion criteria. The weighted mean dropout rate was 28.0% (95% CI = 23.6, 32.9). Dropout rates were not related to target disorder, dropout definition, delivery format, therapist experience, and therapist adherence. Unexpectedly, dropout rates were significantly higher in trials that offered telephone coaching and utilized a therapist consultation team. DBT dropout rates did not significantly differ to dropout rates from control interventions. Few trials reported reasons for dropout, and there was little consistency in the reported reasons. Findings suggest that over one in four patients drop out from DBT in RCTs. This review highlights the urgency for future trials to explicitly report detail pertaining to patient dropout, as this may assist in the development of strategies designed to prevent future dropouts in RCTs of DBT.     

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.     

Repentance and seeking forgiveness: the effects of spiritual therapy based on Islamic tenets to improve mental health

For years, spirituality has been utilised by many as an asset to improve mental and physical health. This study creates a valid argument that Islamic teachings specifically can have a notable effect on students’ overall health. This particular therapy originates from the Islamic concept of soul purification/cleansing (otherwise known as: tazkiyah al-nafs). The reason behind this was to evaluate the impact of tawba (meaning repentance) and istighfar (forgiveness) therapy for improving mental health in a selected group of Muslim college students. Participants were expected to attend eight consecutive sessions exploring both tawba and istighfar therapy. Both before they trialled the treatment and once they had completed it, all participants were also required to complete the ‘Social Emotional Health Survey-Higher Education’ (SEHS-HE). We concluded that in general this programme was in fact successful in improving the overall mental and even physical health in our select group of Islam practising students.