A systematic review of internet-delivered cognitive behavior therapy for alcohol misuse: study characteristics,program content and outcomes

ABSTRACT

Alcohol misuse is a common, disabling and costly issue worldwide. Internet-delivered cognitive behavior therapy (ICBT) has the potential to reduce the harms of alcohol misuse, particularly for individuals who are unable or unwilling to access face-to-face therapy. A systematic review was conducted using Medline, CINAHL, EMBASE and PsycINFO databases for all relevant articles published from 1980 to January 2019. Randomized controlled trials (RCTs) were included if (i) an ICBT intervention targeting alcohol misuse was delivered; (ii) participants were aged 18 years or older; and (iii) primary outcomes were quantity of drinking. A qualitative analysis was conducted on the content of the ICBT programs. Fourteen studies met inclusion criteria. Most studies included participants from the general population, while studies conducted within clinic settings with diagnosed individuals were rare. The programs were similar in terms of included modules. Small effects were seen in studies on self-guided ICBT, while therapist-guided ICBT rendered small to large effects. The current review indicates that ICBT has a significant effect in reducing alcohol consumption. Larger studies evaluating ICBT compared to active control groups especially within clinic settings are warranted.     

Solidarity and Community Engagement in Global Health Research

Abstract

Community engagement (CE) is gaining prominence in global health research. A number of ethical goals–spanning the instrumental, intrinsic, and transformative–have been ascribed to CE in global health research. This paper draws attention to an additional transformative value that CE is not typically linked to but that seems very relevant: solidarity. Both are concerned with building relationships and connecting parties that are distant from one another. This paper first argues that furthering solidarity should be recognized as another ethical goal for CE in global health research. It contends that, over time, CE can build the bases of solidaristic relationships—moral imagination, recognition, understanding, empathy—between researchers and community members. Applying concepts from existing accounts of solidarity, the paper develops preliminary ideas about who should be engaged and how to advance solidarity. The proposed approach is compared to current CE practice in global health research. Finally, the paper briefly considers how solidaristic CE could affect how global health research is performed.     

Family Therapy for Substance Use among Sexual Minority Youth: A Review of Treatment Options

Abstract

Substance use disorders are nearly twice as common among sexual minority youth (SMY) as among their heterosexual peers. Most applied literature about this population suggests interventions on either the individual or community level, and the benefits of family therapy for this population are often overlooked. The present literature review (a) outlines clinical knowledge related to sexual minority youth and substance use (e.g., prevalence rates, contributing factors), (b) discusses the importance of clinical self-awareness around these topics, and (c) outlines clinical behaviors and interventions from literature that may be employed when working with substance-using SMY and their families.     

Implementing Trauma-Informed Care in Primary Medical Settings: Evidence-Based Rationale and Approaches

ABSTRACT

Chronic stress stemming from trauma exposure and posttraumatic stress disorder (PTSD) leads to many health problems that are typically seen by primary care providers. Unfortunately, providers rarely identify trauma as the root cause of patient difficulties. The present paper provides an evidence-based rationale for implementing trauma-informed care principles and processes into medical primary care systems. Beginning with a review of prevalence of trauma exposure and PTSD in primary care clinics, this article elucidates relationships between trauma exposure and behavioral and medical health problems, as well as clinical and physiological pathways that lead from trauma exposure to illness. The article concludes with exposition of trauma-informed interventions that can be implemented in primary care clinics, and discussion of future directions.     

Supportive and interpretative interventions in fostering mentalisation during counselling

ABSTRACT

This work analysed which profiles of counsellors’ supportive and interpretative actions emerged in two group counselling interventions designed to promote mentalisation in underachieving university students. The Psychodynamic Intervention Rating Scale was used to analyse this and the level of depth of defence interpretations. Two outcome measures were administered to analyse student mentalisation and their academic achievements. Process findings showed that supportive actions were used for the most part in both counselling interventions; however, only one group improved in terms of mentalisation and academic performance. In the good-outcome group, there were more defence interpretations, especially during the early sessions, and with a deeper level of elaboration. The innovative relevance of these findings and their implications for practice among counsellors are discussed.     

The Latent Threat of Community Violence: Indirect Exposure to Local Homicides and Adolescents’ Mental Health in Colombia

This study examines the relation between adolescents’ indirect exposure to local homicides and mental health disorders and post‐traumatic stress disorder (PTSD) symptoms. We employ a sample of 300 adolescents ( representative for Bogotá, Colombia, and geocoded data on violent crimes recorded by the national police. Findings show that one SD increment in local homicides is associated with increments by 0.17 SD in the mental health disorder index and a 0.14 SD increase in the PTSD score index, even after accounting for adolescents’ direct exposure to violence. The estimated effect for PTSD was larger for adolescents’ who were directly exposed to violence and for those living in multidimensionally poor households, whereas no detectable effects were found for adolescents who perceived their residential neighborhood as relatively safe.