Women's experiences of the therapeutic value of writing about pregnancy sickness

Background

There is evidence of the beneficial effects of writing therapy in relation to a range of disorders. This is the first study to evaluate those effects in the field of pregnancy sickness.

Aim

To analyse the experiences of women using writing therapy to address issues associated with pregnancy sickness.

Method

Ten women with an age range of 32–48 years participated in this research study. All had been hospitalised at least once with severe pregnancy sickness symptoms in the form of hyperemesis gravidarum. Participants were invited to write reflectively about their former pregnancy sickness, at home, and then take part in a qualitative, semi‐structured telephone interview of approximately one hour to talk about how they experienced this writing process.

Findings

Thematic analysis identified several themes relating to the beneficial effects and uses of writing therapy and women's relational need to be heard and supported.

Discussion

This study supports previous findings about the beneficial effects of writing therapy and contributes new knowledge to the field of pregnancy sickness vis‐à‐vis the importance of emotional expression, emotional care and emotional recovery. The findings have important implications for healthcare professional practice.     

团体咨询成员的相互共情及其与效果的关系——社会关系模型在团体咨询研究中的应用

研究旨在探讨团体成员的相互共情及其与团体效果的关系。共收集10个团体,53名成员的数据,运用社会关系模型分析。结果发现：1.成员自评相互共情得分较高,但互评相关不显著;2.共情水平与会谈效果正相关,与团体反治疗性因素负相关;3.被共情水平与不信任负相关;4.共情准确性与团体治疗性因素正相关。结论：成员自评相互共情水平较高,但互评不匹配。成员自评共情水平越高,会谈效果越好,受团体反治疗性因素阻碍更少。越被准确评估情绪效价的成员,从治疗性因素中获益更多。     

The Effect of PTSD Symptom Change on Suicidal Ideation in a Combined Military and Civilian Sample Engaged in Cognitive Processing Therapy

In light of the well-established relationship between posttraumatic stress disorder (PTSD) and suicidal ideation (SI), there has been a push for treatments that simultaneously improve symptoms of PTSD and decrease SI. Using data from a randomized controlled hybrid implementation-effectiveness trial, the current study investigated the effectiveness of Cognitive Processing Therapy (CPT; Resick, Monson, & Chard, 2016) on PTSD and SI. The patient sample (N = 188) was diverse in military and veteran status, gender, and comorbidity, and 73% of the sample endorsed SI at one or more points during CPT. Participants demonstrated significant improvement in SI over the course of CPT. Multilevel growth curve modeling revealed a significant association between PTSD symptom change and change in SI. Results from cross-lagged multilevel regressions indicated that PTSD symptoms predicted SI in the next session, yet SI in a given session did not predict PTSD symptoms in the next session. Potentially relevant clinical factors (i.e., military status, gender, depression diagnosis, baseline SI, study consultation condition) were not associated with the relationship between PTSD symptoms and SI. These results add to the burgeoning literature suggesting that evidence-based treatments for PTSD, like CPT, reduce suicidality in a range of individuals with PTSD, and that this reduction is predicted by improvements in PTSD symptoms.     

Testing Clinical Intuitions About Barriers to Improvement in Cognitive-Behavioral Therapy for Panic Disorder

Although clinical intuitions influence psychotherapeutic practice and are a rich source of novel hypotheses for research, many remain to be empirically tested. This study evaluates whether clinicians’ beliefs about barriers to progress in cognitive-behavioral therapy (CBT) for panic disorder are supported by data. Data from a randomized-controlled trial comparing CBT to panic-focused psychodynamic psychotherapy (PFPP) for adults with primary panic disorder (N = 161) were used to evaluate 15 factors endorsed by clinicians as impediments to CBT in a recent survey. Panic severity was assessed before, during (at Weeks 1, 5, and 9), and at termination of treatment (Week 12) using the Panic Disorder Severity Scale. Hierarchical linear modeling revealed that none of the perceived barriers were predictive of poor outcome. Contrary to clinicians’ intuitions, dissociation during panic attacks was associated with greater symptomatic improvement in both treatment arms (β = ?0.69, p < .05), above the effect of established predictors. Moderation analyses revealed that when patients had PTSD diagnosed with the Anxiety Disorders Interview Schedule (β = 1.71, p < .05) or less severe panic disorder (β = 0.45, p = .04), they changed more rapidly in CBT than in PFPP. Overall, clinician agreement was inversely related to the strength of a predictor (r = ?.24, p = .39). Although clinical intuitions can be useful as clinical and empirical signals, such beliefs should be critically examined before informing practice. Dialogue between academics and clinicians might be enhanced through research that incorporates input from front-line practitioners.     

Cultural Dimensions of Early Pregnancy Loss: Spiritual and Religious Issues

Nearly one in five clinically confirmed pregnancies ends in a loss before 20 weeks (Bardos et al., 2015). Despite the prevalence of miscarriage, many women and partners experience a lack of acknowledgment and support while also encountering complicated concerns related to the intersection of perinatal loss, culture, religious and spiritual issues, medical treatment, their reproductive stories, and grief (Randolph et al., 2015). Counselors working with these clients must address complex cultural considerations. As such, we review key cultural and religious/spiritual issues related to early pregnancy loss and offer recommendations for practice based on the current literature in the context of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009) counseling competencies.     

The effects of a program to enhance self-compassion in Japanese individuals: A randomized controlled pilot study

To date, there is no evidence suggesting that a program aimed at increasing self-compassion is effective in interdependent cultures such as Japan. The aim of this study was to examine the effects of an Enhancing Self-Compassion Program (ESP) among Japanese individuals in a randomized controlled study. Individuals reporting low self-compassion (N = 40) were randomly assigned to an ESP or wait-list control group. Participants completed self-report questionnaires at pre-treatment, post-treatment, and a three-month follow-up. In the post-treatment and follow-up, ANOVAs revealed that the ESP group (N = 16) had significant improvements in each of the subscales of self-compassion (Cohen’s ds: .91–1.51) except for mindfulness, whereas the control group (N = 12) did not. Greater reductions in negative thoughts and emotions in the ESP group were also found. These gains remained at follow-up. These findings suggest that an ESP may be an effective and acceptable adjunct intervention for Japanese individuals with low self-compassion.     

Adolescent Report of Interparental Conflict: The Role of Threat and Self-blame Appraisal on Adaptive Outcome

Research consistently shows that children exposed to interparental conflict are at-risk for experiencing psychopathology. Establishing a link, however, between interparental conflict and maladjustment is not the same as understanding how specific outcomes manifest. Therefore, we examined the relation of interparental conflict and appraisal with adolescent outcome with 169 high school students (ages 14–19 years). Specifically, threat and self-blame appraisals were hypothesized to mediate the relation between interparental conflict and both adaptive and maladaptive outcomes. Results suggest that threat partially mediated the relation between interparental conflict and externalizing problems, interparental conflict and internalizing problems, and interparental conflict and adaptive behaviors. Additionally, self-blame appears to partially mediate the relation between interparental conflict and internalizing problems. Implications of the current findings are discussed.     

心理咨询过程-效果研究现状及展望

心理咨询过程-效果研究考察咨询过程变量对咨询效果的影响。以人为中心流派、认知流派、行为流派、精神分析流派等都为该研究领域提供了理论基础。主要研究内容有咨询师的反应方式、会谈中的当事人行为、工作同盟、会谈中的重要内容等过程变量与效果的关系。该领域积累的成果还不多,这可能与过程-效果关系本身的复杂性有关,同时研究方法尚有许多欠缺,如考察复杂关系时使用的研究设计过于简单、测量工具不统一导致结果难以比较,有些测量工具不成熟信效度不高。未来的研究除了努力克服这些问题外,还应多考虑理论构建、内隐变量的调节和中介作用、当事人变量,在研究方法上应更为综合和多样化