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This paper reports follow-up findings for an Mentalization based treatment (MBT) parenting intervention delivered to a community mental health sample. Parents completed the 12-week version of the Lighthouse Parenting Program (LPP) and were evaluated on parenting practices, parent-child relationships, parental mental health indicators, and child problem behaviour levels. We evaluated the extent to which improvements in mentalizing at follow-up mediated changes in parenting, parental adjustment, mental health, and child outcomes. Results included a reduction in parental coercive behaviours and child problems, improved parent-child relationship, and better parental psychological adjustment and mental health. Improvement in self-focused mentalizing were observed. Self-focused mentalizing mediated the changes in most outcomes from baseline to 3-month follow-up. These results provide strong preliminary evidence that the LPP improves parent and child outcomes. [ABSTRACT FROM AUTHOR]

Emotionally-based school avoidance (EBSA) is an important driver of persistent school absenteeism and may have worsened in the context of COVID-19. This paper describes the development of a brief parent-focused psychosocial intervention with the goal to address the lack of accessible early interventions for EBSA. The developmental process used a person-based approach with two phases. In Phase 1, qualitative data were collected about intervention preferences and priorities from N = 10 parents and N = 7 practitioners in a series of co-design workshops. Phase 2 refined an intervention blueprint based on iterative consultations with N = 4 parents and N = 3 practitioners. Framework analysis was used to organise findings around key intervention parameters, including relevant mechanisms, content, and delivery methods needed to provide effective, acceptable and feasible support for families affected by EBSA. The resulting blueprint incorporates three online modules to be delivered over three weeks with each module consisting of psychoeducational videos, self-completed learning tasks and a corresponding coaching session. Respective module content includes: (i) self-care strategies to increase parent wellbeing and self-efficacy; (ii) parenting strategies to change behavioural patterns that maintain child distress and avoidance of school; and (iii) strategic communication strategies to increase the quality of home-school relationships. The blueprint has been developed into a full prototype for a forthcoming feasibility study. Plain language summary: Since the onset of the Covid-19 pandemic, there has been a noticeable increase in children missing school. One significant contributor to this rise in absences is Emotionally-Based School Avoidance (EBSA). EBSA refers to a situation where a child stays home from school due to feelings of anxiety and distress about attending. Accessing timely support for children with EBSA can be difficult due to lengthy waiting lists for child and adolescent mental health services. This paper outlines the creation of a new, brief psychosocial intervention aimed at helping parents support their child experiencing EBSA. The development process involved two phases. In the first phase, we collaborated with 10 parents and 7 practitioners to gather ideas about the kind of support families require, what should be included in the intervention, and how to make it practical for families to use. Based on these discussions, we formulated a plan for the new intervention. The second phase refined this plan of the intervention to ensure its suitability for families. The intervention is called ISAAC: Intervention for School Anxiety and Absenteeism in Children. ISAAC consists of three online modules to be completed by parents over a three-week period. Each module includes videos, reflection activities and homework tasks which help the parent learn a new skill or try a different way of responding to their child's anxiety about attending school. Parents are also supported by a coach. The first module encourages parents to take care of their own wellbeing and manage stress. The second module helps parents to learn new ways to respond to their child's distress related to school attendance, while the third module provides guidance on effective communication with the child's school. The next step for this intervention is to see whether it is agreeable to parents and practical to deliver in the real-world. [ABSTRACT FROM AUTHOR]

Introduction: Innovative moments (IMs) pinpoint new and more adaptative meanings that emerge in clients' discourse during psychotherapy. Studies with adult clients have found a greater proportion of IMs in recovered compared to unchanged cases, but similar studies have yet to be conducted with adolescents. Aims: The paper aims (1) to study retrospectively the emergence of IMs in therapy, using a post‐therapy interview, in adolescents that underwent psychotherapy for depression, and (2) to characterize the themes present in IMs identified retrospectively in the interviews. Method: Semi‐structured post‐treatment interviews conducted with 24 adolescents on the experience of taking part in a clinical trial of youth depression, were coded using the Innovative Moments Coding System. After identifying IMs, a thematic analysis identified the prominent themes within them. Results: Higher presence of IMs were found in recovered compared to unchanged cases. Two main themes emerged in the IMs, changes that occurred with therapy and attributions of changes. Recovered cases presented more IMs centred on the self, whereas unchanged cases identified more non‐specific changes. Conclusion: This study suggests that it is possible to code IMs, identified retrospectively, based on post‐therapy interviews with adolescents. Meaningful differences were found between recovered compared to unchanged cases. Therapeutic recovery was associated with a higher focus on the self and more specificity in clients' representations of the change process. [ABSTRACT FROM AUTHOR]

Background: During neoadjuvant therapy (NAT), patients with locally advanced breast cancer (LABC) experience psychological distress (PD) and adopt appropriate coping strategies. Objective: This systematic review aimed to examine the prevalence and changes in PD and coping strategies in patients with LABC during NAT and to evaluate effective interventions to reduce their PD. Design: Quantitative (cross-sectional, longitudinal, and interventional) and qualitative studies reporting PD and coping strategies related to NAT during LABC were included. Data sources and methods: PubMed, Cochrane Library, Scopus, ScienceDirect, Wiley Online Library, and Web of Science databases were consulted to gather relevant literature from the first publications until July 25, 2023. Selection was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 41 articles were included, of which four were qualitative. The main results showed that the prevalence of depression before NAT ranged from 0% to 46% and that of anxiety from 5.5% to 54%. After NAT, the prevalence of depression ranged from 40% to 78.5% and anxiety accounted for 27%. Additionally, PD decreased during NAT. The main determinants of PD were perceived social support, living in joint families, being affected by COVID-19 infection, delays in diagnosis, and starting neoadjuvant treatment. For coping strategies, after NAT, "resigned coping" decreased, whereas "social support" increased, and active coping strategies were correlated with better PD. Some interventions found a reduction in PD, such as a mobile health application, fasting-mimicking diet, relaxation training, and guided imaging. Conclusion: These findings highlight the importance of considering PD and coping strategies in patients with LABC from diagnosis to the end of NAT. The results suggest that effective psychological interventions should be implemented. [ABSTRACT FROM AUTHOR]

Aims: To describe the changes in moderate‐to‐late preterm infants' (MLPIs) growth during 12 months of corrected age (CA) and to examine the predictive role of NICU‐related stress, postpartum depression trajectory and family coping ability on the physical developmental trajectory of MLPIs. Design: A prospective longitudinal study. Methods: There were 237 mother–infant dyads with at least two follow‐up data records included. General characteristics and NICU‐related stress were recorded from medical records at baseline. Infants' physical growth was measured at 40 weeks, 1, 3, 6, 9 and 12 months CA during outpatient follow‐up. Maternal postpartum depressive symptoms and family coping ability were assessed by questionnaires at 1, 3, 6, 9 and 12 months CA and 1 month CA respectively. We investigated the modifiable factors inside and outside of NICU on the trajectories of physical growth in the first year in MLPIs, mainly by using latent growth curve models with time‐varying covariates. Results: The curved trajectories of weight, length and head circumference in the first year in MLPIs demonstrated gradually slowed growth rates and these infants were above the WHO growth standards for the same age and sex. The latent growth curve models indicated that more NICU‐related stress was negatively associated with the weight and length at 40 weeks CA, and family coping ability (parent–child relationship) at 1 month CA was associated with the growth rate of weight. Besides, more NICU‐related stress predicted faster length growth rate. The infants of mothers who were in the group of high‐level postpartum depression trajectory had a slower growth rate of head circumference. Conclusions: Our study identified the modifiable factors along the care continuum influencing the trajectory of MLPIs' physical growth. Nurses should receive more training about infant stress measurement and family‐centred care to work in partnership with parents so that MLPIs can reach their full developmental potential. Also, multidisciplinary interventions including stress reduction strategies, close psychological monitoring and education improving parent–infant relationships should be further developed to achieve optimizing growth in the first year of MLPIs. Implications for the Profession and/or Patient Care: It is recommended that nurses pay attention to the long‐term physical growth status of MLPIs, and closely support their families. Quantifying NICU‐related stress and developing reduction strategies should be the priority for clinical staff during hospitalization. After discharge, persistent screening of depressive symptoms, psychological intervention and education about the parent–child relationship need to be included in the follow‐up visits. Patient or Public Contribution: No patient or public contribution. The study only included patients who were research participants. [ABSTRACT FROM AUTHOR]

The Supporting Transitions and Relationships (STAR Mums) program was developed in response to the clinical need for psychological intervention in pregnancy where mothers have risk factors for difficulties in the transition to parenthood. The program focuses on the developing relationship between the mother and the unborn child and aims to facilitate the normal psychological processes that are known to occur in pregnancy to prepare for the relationship with the infant and to reduce risk factors that may negatively impact this relationship. This article reports on interview data from the final follow-up of 12 high-risk participants at 12 to 14 weeks postpartum regarding their transition to parenthood and aspects of parental reflective function. These women presented with issues in developing their maternal identity and representation in the context of difficulties processing their own difficult childhood experiences. They also demonstrated some issues with limited reflective capacity in their understanding of their infant's emotional world and experiences. Though there are ongoing issues for these women, they provided feedback that the STAR Mums program included valued discussion around the changes in both self and relationships involved in parenting that helped them to prepare for their experiences of early parenthood by supporting their wondering about the baby and the changes that this new relationship may bring for them as a parent. [ABSTRACT FROM AUTHOR]

Aims: The clinical significance of cancer‐related stigma on patients' well‐being has been widely established. Stigma can be perceived and internalised by cancer patients or implemented by the general population and healthcare workers. Various interventions have been carried out to reduce cancer‐related stigma, but their effectiveness is not well‐understood. This review aims to synthesise evidence on the effectiveness of interventions to reduce cancer‐related stigma. Design: An integrative review. Methods: This integrative review combined both qualitative and quantitative studies and followed five steps to identify problems, search for the literature, appraise the literature quality, analyse data, and present data. Mixed Methods Appraisal Tool (version 2018) was applied to evaluate the quality of the included studies. Data Sources: Databases included Web of Science, MEDLINE, SpringerLink, Wiley Online Journals, Cochrane Library, ScienceDirect, OVID, and China National Knowledge Infrastructure (from the inception of each database to 30 April 2021). Results: Eighteen quantitative, six qualitative, and five mixed‐methods studies were included in this review. Cultural factors should be considered when conducting interventions to reduce cancer‐related stigma. For cancer patients, multi‐component interventions have demonstrated a positive effect on their perceived stigma. For general population, interactive interventions show promise to reduce their implemented stigma towards cancer patients. For healthcare workers, there is a paucity of studies to reduce their implemented stigma. Existing studies reported inconclusive evidence, partially due to the lack of a robust study design with an adequate sample size. Conclusions: Multi‐component and interactive interventions show promise to relieve cancer‐related stigma. More methodologically robust studies should be conducted in different cultures to elucidate the most appropriate interventions for different populations to reduce cancer‐related stigma. Implication for the Profession and Patient Care: These findings will facilitate healthcare workers to design and implement interventions to reduce cancer‐related stigma, thus improving the quality of life for cancer patients. Patient and Public Contribution: No patient and public contribution. [ABSTRACT FROM AUTHOR]

Objective: Feasibility test a co-developed intervention based on Acceptance and Commitment Therapy to support psychological adjustment post-stroke, delivered by a workforce with community in-reach. Design: Observational feasibility study utilising patient, carer, public involvement. Setting: Online. UK. Participants: Stroke survivors with self-reported psychological distress 4 + months post-stroke. Interventions: The co-developed Wellbeing After Stroke (WAterS) intervention includes: 9-weekly, structured, online, group sessions for stroke survivors, delivered via a training programme to upskill staff without Acceptance and Commitment Therapy experience, under Clinical Psychology supervision. Main measures: Feasibility of recruitment and retention; data quality from candidate measures; safety. Clinical and demographic information at baseline; patient-reported outcome measures (PROMs) via online surveys (baseline, pre- and post-intervention, 3 and 6 months after intervention end) including Mood (hospital anxiety and depression scale (HADS)), Wellbeing (ONS4), Health-Related Quality of Life (EQ5D5L), Psychological Flexibility (AAQ-ABI) and Values-Based Living (VQ). Results: We trained eight staff and recruited 17 stroke survivors with mild-to-moderate cognitive and communication difficulties. 12/17 (71%) joined three intervention groups with 98% attendance and no related adverse events. PROMS data were well-completed. The HADS is a possible future primary outcome (self-reported depression lower on average by 1.3 points: 8.5 pre-group to 7.1 at 3-month follow-up; 95% CI 0.4 to 3.2). Conclusion: The WAterS intervention warrants further research evaluation. Staff can be trained and upskilled to deliver. It appears safe and feasible to deliver online to groups, and study recruitment and data collection are feasible. Funding has been secured to further develop the intervention, considering implementation and health equality. [ABSTRACT FROM AUTHOR]

After the unexpected death of a child, bereaved parents require prompt access to helpful support systems. Online therapeutic writing courses can make such support accessible. Because few studies have included bereaved fathers as participants, we explored the experiences of fathers whose children died unexpectedly and who were part of an online course of therapeutic writing in Norway. We piloted two courses (group 1, six weeks, n = 9 ; group 2, 5 weeks, n = 5). We describe our methodological considerations for using poetic representations in qualitative health research and present four poetic representations based on fieldwork notes written by the principal investigator. Then, we triangulate and narratively analyze them together with two collective poems written by participants from each group; excerpts of the writings from two fathers, one per group; evaluation surveys (n = 4; n = 3); and, anonymous check-out journaling from the second group (n = 3). Resistance was a salient feature of our participants' grief, and writing enabled them to both be in contact with their emotional world and process difficult emotions as they looked for meaning despite the death of their children. Those who attended the most classes perceived the course as transformative, being part of an ongoing self-exploration, and a possibility to continue and strengthen the bond with their children. Our findings mirror the complexities of the grief experiences of fathers, giving account of their need to find a rhythm to dive into their emotional world, the importance of peer support, and the value of diversifying intervention techniques to meet individual needs and preferences. [ABSTRACT FROM AUTHOR]

Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed. [ABSTRACT FROM AUTHOR]