Counselling in primary care: a systematic review of the evidence

Primary objective: To undertake a systematic review which aimed to locate, appraise and synthesise evidence to obtain a reliable overview of the clinical effectiveness, cost‐effectiveness and user perspectives regarding counselling in primary care. Main results: Evidence from 26 studies was presented as a narrative synthesis and demonstrated that counselling is effective in the short term, is as effective as CBT with typical heterogeneous primary care populations and more effective than routine primary care for the treatment of non‐specific generic psychological problems, anxiety and depression. Counselling may reduce levels of referrals to psychiatric services, but does not appear to reduce medication, the number of GP consultations or overall costs. Patients are highly satisfied with the counselling they have received in primary care and prefer counselling to medication for depression. Conclusions and implications for future research: This review demonstrates the value of counselling as a valid choice for primary care patients and as a broadly effective therapeutic intervention for a wide range of generic psychological conditions presenting in the primary care setting. More rigorous clinical and cost‐effectiveness trials are needed together with surveys of more typical users of primary care services.     

Using Creative Writing Techniques to Enhance the Case Study Method in Research Integrity and Ethics Courses

The following article explores the use of creative writing techniques to teach research ethics, breathe life into case study preparation, and train students to think of their settings as complex organizational environments with multiple actors and stakeholders.     

Creativity Research Overlooks the Study of Resilience among Young Children: A Bibliometric Network Review

Creativity researchers are increasingly interested in understanding when, how, and for whom creativity can be beneficial. Previous reviews have demonstrated that creativity research largely ignores the study of its impact on factors that promote health, and well-being among populations of adults. It is unclear, in fact, whether this gap in research also extends to creativity research among young children. This paper addresses this issue. Early childhood is a crucial stage for the cognitive development of young children who remain highly sensitive to stress, and adversity. It is therefore essential to identify and promote factors that are beneficial to early childhood resilience, thereby contributing to documenting more of the effects of creative activities on positive outcomes. This paper presents a review with a bibliometric analysis of 1000 randomly selected articles from the Web of Science, without bias towards any specific peer-reviewed journal. The analysis of 454 included articles shows that approximately 80% of the included studies focus on creativity as an outcome (replicating previous findings with a larger sample), with only 3.78% investigating creative activities as predictors among young children. In this small percentage, most of the studies addressed creative activities in young children related to resilience outcomes.     

Caregiver involvement in applied behavior-analytic research: A scoping review and discussion

We conducted a scoping review to characterize the role of caregiver involvement in behavior-analytic research. We reviewed eight behavioral-learning journals from 2011–2022 for works that included children or caregivers as participants and characterized caregiver involvement as passive (implications for caregivers, input, social validity) and active (implementation, caregiver behavior, training, caregiver-collected data). The review identified 228 studies, and almost all (96.1%; n = 219) involved caregivers in some capacity; 94.3% (n = 215) had passive involvement (26.8% had only passive involvement; n = 61), 69.3% (n = 158) had active involvement (1.8% had only active involvement; n = 4), and 3.9% (n = 9) had neither passive nor active involvement. Involvement generally increased over publication years. The most common types of involvement were implications for caregivers, implementation, and input; caregiver-collected data were rare. We propose considerations when engaging caregivers in research and suggest new avenues of inquiry related to caregivers' treatment objectives and social validity, treatment implementers, and caregiver-collected data.     

Chatbot-Delivered Psychotherapy for Adults With Depressive and Anxiety Symptoms: A Systematic Review and Meta-Regression

Although psychotherapy is a well-established treatment for depression and anxiety, chatbot-delivered psychotherapy is an emerging field that has yet to be explored in depth. This review aims to (a) examine the effectiveness of chatbot-delivered psychotherapy in improving depressive symptoms among adults with depression or anxiety, and (b) evaluate the preferred features for the design of chatbot-delivered psychotherapy. Eight electronic databases were searched for relevant randomized controlled trials. Meta-analysis and random effects meta-regression was conducted using Comprehensive Meta-Analysis 3.0 software. Overall effect was measured using Hedges’s g and determined using z statistics at significance level p < .05. Assessment of heterogeneity was done using χ² and I² tests. A meta-analysis of 11 trials revealed that chatbot-delivered psychotherapy significantly improved depressive symptoms (g = 0.54, 95% confidence interval [−0.66, −0.42], p < .001). Although no significant subgroup differences were detected, results revealed larger effect sizes for samples of clinically diagnosed anxiety or depression, chatbots with an embodiment, a combination of types of input and output formats, less than 10 sessions, problem-solving therapy, off-line platforms, and in different regions of the United States than their counterparts. Meta-regression did not identify significant covariates that had an impact on depressive symptoms. Chatbot-delivered psychotherapy can be adopted in health care institutions as an alternative treatment for depression and anxiety. More high-quality trials are warranted to confirm the effectiveness of chatbot-delivered psychotherapy on depressive symptoms.PROSPERO registration number: CRD42020153332.     

Stigmatisation intériorisée et consommation de substances psychoactives : revue systématique de la littérature

IntroductionSubstance use is a very stigmatized condition all over the world. Moreover, lots of people who use drugs or alcohol tend to internalize these stigmas, which can lead to harmful consequences. Corrigan's progressive model of self-stigma suggest that individuals go through four stages to internalize the stigma (aware, agree, apply, harm) and then undergo a stage of resignation and lack of hope and energy called “why try”. Research seems to be increasingly interested in this phenomenon, so we wonder, where we stand in the comprehension of internalized stigma for substances users?ObjectiveThis work aims to systematically review ten-past years studies about self-stigma in substance addiction in order to assess the status of curr ent works in this area.MethodThis systematic review was led inspired by the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statements on the electronic databases PubMed, PsycInfo and PsycArticle. The inclusion criteria were: references published between 2010 and 2020, in French or English language which shows results about self-stigma for psychoactives substances users. A total of 39 studies met the eligibility criteria for inclusion in this review.ResultsSynthesizing findings across the studies revealed some important topics. First, the progressive model seems to be statistically valid among drug and/or alcohol users. Nevertheless, self-stigma of drugs and/or alcohol is not the only condition that entails users. A varieties of other factors (i.e. HIV, sex work) are to be considered in the understanding of stigmatization. In the studies, negative consequences due to self-stigma in substance use were observed such as depression or anxiety symptoms, lower self-esteem and negatives emotions as fear and shame.ConclusionAll these results are to be considered within their limits. In light of these findings, the knowledge acquired will allow professionals to develop new interventions to prevent and to reduce self-stigma of drug and/or alcohol users.     

Adding Silence to Stories: Narrative Therapy and Contemplation

A review of the literature reveals that one particular form of contemplation—mindfulness—has been integrated into cognitive-behavioral therapy. Built upon this background, this article raises the issue of combining contemplation and narrative therapy. It first examines the unique experiences that occur when one enters into silence. Then, it explores the implications of these experiences for narrative therapy. A contemplative-based approach to narrative therapy differs from traditional narrative therapy in that it utilizes: (a) contemplative skills, (b) contemplative and narrative metaphors, (c) modified interventions, and (d) broader views of reality and self. The outcome is an enlarged narrative approaches that possess numerous benefits and possibilities for future treatment models. P. Gregg Blanton is a Professor of Human Services at Montreat College. He is a Clinical Member and Approved Supervisor of AAMFT.     

Collaborative Helping: A Practice Framework for Family-Centered Services

This article offers a framework for collaborative family-centered practice that can reinvigorate our work with families who have not responded to more traditional approaches. Collaborative Helping is grounded in family-centered principles that include: striving for cultural curiosity, believing in resourcefulness, working in partnership, and making our work more accountable to the clients we serve. The article introduces collaborative inquiry as an organizing metaphor for clinical practice and offers a five-step practice framework with clinical illustrations and sample questions. The framework draws from appreciative inquiry, motivational interviewing, the signs of safety approach to child protection work, and solution-focused and narrative therapies.     

The many faces of the Still-Face Paradigm: A review and meta-analysis

The Still-Face Paradigm (SFP) designed by Tronick, Als, Adamson, Wise, and Brazelton (Tronick, E., Als, H., Adamson, L., Wise, S., & Brazelton, T. B. (1978). Infants response to entrapment between contradictory messages in face-to-face interaction. Journal of the American Academy of Child and Adolescent Psychiatry, 17, 1–13) has been used for many different purposes in over 80 empirical studies. In the current paper, the nature and correlates of infant behavior in the SFP were examined in a systematic narrative review and a series of meta-analyses. The results of the meta-analyses confirmed the classic still-face effect of reduced positive affect and gaze, and increased negative affect, as well as a partial carry-over effect into the reunion episode consisting of lower positive and higher negative affect compared to baseline. The still-face effect is very robust as it was found regardless of most sample variations such as infant gender and risk status, and regardless of most procedural variations, such as the length of the SFP episodes and the use of intervals between episodes. The few moderator effects that were found in the meta-analyses tended to put findings from the narrative review in a new perspective. Additional meta-analyses confirmed the narrative review in finding that higher maternal sensitivity predicted more infant positive affect during the still-face. Infants’ higher positive affect and lower negative affect during the still-face were predictive of secure attachment at age 1 year. The meta-analytic results for maternal depression were equivocal. Implications for future research include a need for studies testing the role of the adults’ identity (parent versus stranger, mother versus father) to elucidate the relationship-specificity of the still-face effect. Also, the role of maternal sensitivity and temperament as potential moderators of the still-face effect need to be examined further. On a procedural level, the effects of the timing of the still-face and of the duration of the reunion on infant responses deserve future research attention.