Barriers and Facilitators to the Implementation of Intensive Treatments for PTSD: Early Lessons Learned From the Field

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.     

The nature space. A reflexive thematic analysis of therapists' experiences of 1:1 nature-based counselling and psychotherapy with children and young people: Exploring perspectives on the influence of nature within the therapeutic process

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.     

Context-dependent shifts in self-regulatory personality processes during COVID-19: Changes in control predict dynamic shifts in goal reengagement capacity

The ability to reengage with new attainable goals after major setbacks is a core self-regulatory trait linked to health and well-being. Yet little is known about the extent to which such goal reengagement capacities may shift over time in response to changing contextual circumstances. Using a nationally-representative sample of U.S. adults aged 18–80 (n = 293), the present 1-year study examined whether changes in opportunity to influence life circumstances (perceived control) were coupled with dynamic shifts in goal reengagement capacity for individuals who differed in their levels of control at pandemic onset. Results from multilevel models showed that within-person increases in perceived control during the pandemic predicted corresponding within-person increases in goal reengagement capacity. Moderation models showed that the positive within-person association between perceived control and goal reengagement was pronounced for individuals with lower levels of control at pandemic onset who may be particularly sensitive to periods of opportunity to pursue new attainable goals. Findings inform theories of personality and self-regulation in pointing to contextual circumstances under which goal reengagement capacity exhibits dynamic shifts in populations who differ in their perceived opportunities for control.     

Art in existential psychotherapy with couples and families

The authors describe and outline how art can be used in existential psychotherapy to help a couple or family uncover, discover, and make use of the meanings and meaning potentials to be found in marital and family life. In existential psychotherapy with couples and families, art can be used to help the members of the relationship notice meaning potentials in the future, honor meaning potentials that have been actualized and deposited in the past, and discover new ways to actualize meaning potentials in the here and now.     

Three years follow-up of panic disorder patients: A naturalistic study

Forty Danish panic disorder patients participating in a placebo controlled study of alprazolam and imipramine (The Cross National Collaborative Panic Study, Phase II) were followed up by a telephone interview three years later, with essentially the same battery of evaluation procedures applied at baseline, end of study, and follow-up. The main finding was that panic disorder is a chronic disorder, but fluctuating in form and severity in the course of time. Twenty-five percent of the patients no longer fulfilled the DSM-III criteria for panic disorder, but had substantial disability due to a variety of symptoms, including panic attacks at infrequent rate, generalized anxiety symptoms, affective symptoms, and phobic avoidance behavior. Nearly three fourths of the patients were under treatment at follow-up. Benzodiazepines were the drugs most often prescribed, usually in combination with supportive psychotherapy. It was concluded that the different types of treatment offered were insufficient. Variables predicting panic disorder or substantial disability at 3-years follow-up were few.     

Defaults in update semantics

The aim of this paper is twofold: (i) to introduce the framework of update semantics and to explain what kind of semantic phenomena may successfully be analysed in it: (ii) to give a detailed analysis of one such phenomenon: default reasoning.     

人格结构的动态分析

为了动态化地分析人格的结构。研究一采用个体性自由命名描述法考察人格的动态内容。１５０名大学生分别用１０个词描述实际的自我、理想的自我、应该的自我。词频统计反映了不同自我的内容特点。研究二采用常模化限定性描述法考察人格的结构特点,用研究珠高频词制成实际、理想、应该的自我词表。２００名大学生用７点量表分别评定各词表中的每个词适合描述相应的自我的程度。结果表明,实际的自我有５个因素,解释４７．１％的变异     

Aggression Observation Scale for Group Psychotherapy

An observational scale to record aggressive behaviors, defenses, and interventions that occur during a psychotherapy group has been developed. Content and process items were included. The content items focus on the spoken material and are on a continuum of increasing group members' awareness of and responsibility for their anger. The process items are directed to underlying psychodynamic issues on a continuum from avoiding anger, to indirect and then expression of anger. Leader interventions (responses) are also included. The development of the scale, the Aggression Observation Scale for Group Psychotherapy (AOSGP), is described including pilot testing and reliability and validity findings.     

Developing the matrix representation grid (MRG): A method for observing group processes. Findings from time-limited group psychotherapy for alcohol-dependent patients

The MRG was published 1988 in order to support developments in group psychotherapy methods as one of the all too few process observation research methods for studying group-as-a-whole. After 9 years of what pilot studies have labeled successful clinical trials, this study aims at validating the MRG against the established SAVI: Structural Analysis of Verbal Interaction (Agazarian & Simon 1989). Videotaped group sessions from short-term groups for alcohol dependent patients conducted along two therapy methods, one behaviorally oriented and the other group analytic, are used as material. The MRG is validated in the study, confirmed to be clinically valuable, and some interesting comparisons between the two treatment modalities are also made.