《Cognitive and behavioral practice》2023,30(3):384-396

This article addresses the barriers and facilitators associated with the implementation of PTSD Intensive Outpatient Programs (IOP) across three VHA Medical Centers. Each site developed programs that delivered EBPs in a massed or condensed format and relied on implementation science and the i-PARIHS model to help direct the innovation. Face-to-face, virtual, and combined platforms were used, demonstrating flexibility in design. While each site experienced unique challenges associated with local contextual factors, multiple themes emerged across sites that may help guide future IOP and massed EBP implementations. Common facilitators of the implementation process included: the availability or presence of a credible lead (i.e., champion) to guide the innovation, opportunities to consult with national or outside experts, strong team engagement, processes in place that allowed for ongoing review, clinic operations that are aligned with principles of PTSD specialty care (e.g., time-limited, evidence-based, utilization of measurement based care, willingness to treat complex cases), and leadership support. Alternately, shared barriers included limitations on available resources, options for provider coverage, early staff buy-in, and organizational factors. Solutions to address these barriers and recommendations for future direction are shared.  相似文献   

    

David A. Olson  Henny A. Westra  Serena Shukla  Alyssa A. Di Bartolomeo 《Counselling and Psychotherapy Research》2023,23(3):837-849

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Deborah Lane  Paula Reed 《Counselling and Psychotherapy Research》2023,23(2):432-445

Nature-based therapy is an emerging and rapidly developing field within counselling and psychotherapy, yet there is little published empirical research, or integrated models relating to its practice with Children and Young People (CYP). The present study aimed to explore therapists’ experiences of one-to-one nature-based counselling and psychotherapy with CYP, eliciting perspectives on the interaction between nature and the therapeutic process. A reflexive thematic analysis provides preliminary insights into possible mechanisms of action with the potential to inform a longer-term exploration of whether nature-based therapy is effective, for whom and why. The study highlights the need to better explore and understand how nature-based therapy supports relational and intrapsychic change in interaction with developmental processes, to inform construction of coherent and consolidated theory and models for practice.  相似文献   

    

Priyani Howell 《Counselling and Psychotherapy Research》2023,23(3):801-807

The purpose of this study was to understand the context of suicide in master's level counselling courses in Australia. The sample comprised courses accredited by the Australian Counselling Association (ACA) and the Psychotherapy and Counselling Federation of Australia (PACFA). A mixed methods content analysis was used to identify the explicitness of suicide in these courses and identify themes that emerged during the analysis. The sample consisted of 405 units of study contained in 26 courses. Suicide was explicit in 23 units in 17 courses. Suicide content was overshadowed by cultural diversity, ethics, morality and philosophy, research and self-awareness, which was explicit in all 26 courses.  相似文献   

    

Clara E. Hill  Kathryn V. Kline  Dennis M. Kivlighan Jr.  Zachariah Aaron  Shakeena King 《Counselling psychology quarterly》2019,32(1):1-17

Using the Meaning in Life Questionnaire (MLQ), we studied Presence and Search for meaning for 34 adult clients in psychodynamic psychotherapy. Clients completed the MLQ and Outcome Questionnaire (OQ) before intake and after every eight sessions. Variance in Presence scores was mostly attributable to clients; variance in Search scores was mostly attributable to clients and therapists. Clients initially high in Presence decreased and then increased back to initial levels; clients initially low in Presence increased and then decreased back to initial levels. Clients initially low in Search increased and then leveled off; clients initially high in Search decreased and then leveled off. In lagged cross panel analyses, when clients decreased in psychological distress during one eight-week time period, they increased in Presence during the next eight-week time period; when they increased in psychological distress during one eight-week time period, they increased in search in the next time period. Excerpts from post-therapy interviews illustrate the process of working with meaning in life in psychotherapy. Implications for practice and training are discussed.  相似文献   

    

Aisling McMahon  Kathryn Ledden 《Counselling and Psychotherapy Research》2019,19(3):241-251

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Helen Jane Florence  Barbara McKenzie‐Green  Keith Tudor 《Counselling and Psychotherapy Research》2019,19(3):329-337

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G. Nic Rider  Jennifer A. Vencill  Dianne R. Berg  Rachel Becker-Warner  Leonardo Candelario-Pérez  Katherine G. Spencer 《International Journal of Transgenderism》2019,20(2-3):275-288

Abstract

Background: The limited research on nonbinary individuals suggests that this community experiences significant health disparities. Compared to binary transgender individuals, research suggests that nonbinary individuals are at elevated risk for discrimination and negative mental health outcomes, including depression, anxiety, traumatic stress, and suicidality. Even mental health providers who work with binary transgender individuals often lack knowledge of and training to work competently with nonbinary individuals.

Methods: The authors of this conceptual article present the Gender Affirmative Lifespan Approach (GALA), a psychotherapy framework based in health disparities theory and research, which asserts that therapeutic interventions combating internalized oppression have the potential to improve mental health symptomatology resulting in improved overall health and well-being for gender diverse clients. GALA’s therapeutic interventions are designed to promote positive gender identity development through five core components: (1) building resiliency; (2) developing gender literacy; (3) moving beyond the binary; 4) promoting positive sexuality; and (5) facilitating empowering connections to medical interventions (if desired).

Results: The core components of the GALA model are individualized to each client’s unique needs, while taking into consideration age and acknowledging developmental shifts in, or fluidity of, gender across the lifespan. This model represents an inclusive, trans-affirmative approach to competent clinical care with nonbinary individuals.

Discussion: Application of the GALA model with nonbinary clients is discussed, including one clinical case vignette.  相似文献   

    

Arthur M. Nezu  Christine M. Nezu  Holly R. Gerber 《Australian psychologist》2019,54(5):361-371

Problem-solving therapy (PST) is a psychosocial intervention, typically considered to be a member of the cognitive and behaviour therapies family, and is based on a biopsychosocial, diathesis-stress model of psychopathology. The overarching goal of this approach is to promote the successful adoption of adaptive problem-solving attitudes and the effective implementation of certain behaviours as a means of coping with life stressors in order to attenuate the negative effects of such events on physical and mental well-being. Over the past several decades, in addition to accumulating strong support for its efficacy as a clinical intervention, similar to many other forms of psychotherapy, PST has undergone various evolutionary changes. Developed primarily as a more cognitive-based approach, due to the large body of literature in the field of affective neuroscience that underscores the importance of the impact of affect on problem solving, PST has evolved into emotion-centered problem-solving therapy (EC-PST). This article provides for a brief excursion into the historical roots of PST and why it has evolved into EC-PST, as well as providing support for its characterisation as a transdiagnostic approach. In addition, several meta-analyses that underscore its efficacy are described, as well as the most recent clinical guidelines that comprise EC-PST.  相似文献   

    

Begum Maitra 《The Journal of analytical psychology》2019,64(2):189-205

The basic assumptions of psychotherapy must necessarily reflect the cultural orientations and dilemmas of the western societies, and historical periods, in which these originated. This paper considers how the racialised biases of that period, namely, the era of European domination built upon the conquest, colonisation and enslavement of non‐European peoples, may linger in psychotherapeutic training and practice today. This not only limits the potential usefulness of the discipline in the multicultural populations of the west, but also risks it being read as covert neo‐colonialism in the ‘non‐west’. In a world that ever more clearly demonstrates the human costs of prejudice psychotherapists in general, and Jungians in particular, might wish to consider how, wittingly or otherwise, they maintain prejudiced ways of thinking. This paper examines material from the author's professional and personal experience, using literature that lies outside the specifically Jungian canon, to expose how such bias might work.  相似文献