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This paper presents the hypothesis that psychotherapy seeks to produce changes in attitudes and behaviour through transformation of meanings. Patients come to psychotherapy because they are demoralized by the menacing meanings of their symptoms. The psychotherapist collaborates with the patient in formulating a plausible story that makes the meanings of the symptoms more benign and provides procedures for combating them, thereby enabling the patient to regain his morale. As a result, he feels better and functions more effectively, leading to progressive improvement. Various implications and limitations of this hypothesis are explored. [ABSTRACT FROM AUTHOR]

Provides guidelines for clinical care related to the practice of psychotherapies. Reflection on the clinical experiences of Canadian psychiatrists; Differentiation between psychiatric management and formal psychotherapies; Ethical guidelines for psychotherapies; Factors for effective therapeutic bond between the patient and the psychiatrist.

The author comments on the article by Friedhelm Roder and Petar Opalic which was published in the June 1, 1997 issue of "Group Analysis: The Journal of Group Analytic Psychotherapy." The author questions the therapeutic validity of Turkish therapist who runs groups for Turkish immigrants in Great Britain and the issue of cultural differences. The author emphasizes that the boundaries and the deepening communication are the backbone of any therapeutic approach. The author believes that running groups with people from different cultures is a very delicate subject.

Objective: This opinion paper discusses certain recommendations of the House of Representatives Select Committee on Mental Health and Suicide Prevention pertaining to psychology, GP and psychiatric professions. Conclusions: The Committee's recommendations may compromise patient care by undermining the ability of private sector medical specialists in providing direct clinical treatment and their role in the coordination of multidisciplinary teams. Expanding private psychological therapies without GP and private psychiatry support might increase the reliance on public hospital emergency departments and public sector mental health services for severe disorders and suicidal crises. Psychiatrists and GPs need to engage in more effective policy advocacy with the Australian Government, in order to maintain their roles in leading private sector collaborative multidisciplinary care. [ABSTRACT FROM AUTHOR]

Objective: This paper reports the capabilities of mental health nurse (MHN) psychotherapists in Australia and their perceptions on how to best utilize their skills.Method: An MHN is a registered nurse with recognized specialist qualifications in mental health nursing. One hundred and fifty three MHNs completed an online survey; 12 were interviewed.Results: Three themes were derived from a qualitative analysis of the aggregated data: psychotherapy skills of MHN psychotherapists are under-utilized; these nurses bridge gaps between biomedical and psychosocial service provision; and equitable access to rebates in the primary care sector is an obstacle to enabling access to services.Conclusions: MHN psychotherapists are a potentially valuable resource to patients in tertiary and primary health care. They offer capacity to increase access to specialist psychotherapy services for complex and high risk groups, while being additionally capable of meeting patients' physical and social needs. Equitable access to current funding streams including Medicare rebates can enable these outcomes. [ABSTRACT FROM AUTHOR]

The article reconstructs postpsychiatry's core propositions and briefly describes its theoretical background and assumptions. It also presents chosen aspects of postmodern psychotherapy, which seem to be in many ways similar to postpsychiatry's ideas. Although they are drawn from different inspiration, postpsychiatry and postmodern psychotherapy seem to come to similar conclusions, especially regarding the role of the patient in the therapeutic process, the meaning of psychiatric diagnosis, and the importance of the institutional, cultural, and social contexts in mental health practice and research. The paper also aims to place postpsychiatry and postmodern psychotherapy in a Polish context, focusing on the ethical challenges faced by psychiatry and showing that some of postpsychiatry's ideas and solutions to contemporary problems were already present in the Polish psychiatric literature of the 20th century. It also contains a brief description of the Polish social and historical context of psychiatry, as well as key aspects of the Polish legal system that relate to mental health and seem to reflect the nature of biomedical explanations of mental distress. It concludes that the model of psychiatric care postulated by "postmodern" approaches seems more ethical and scientifically and philosophically grounded and promises better treatment results than the "traditional" biomedical model. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Reports of low staff morale and high levels of patient complaints suggest that acute psychiatric wards are not achieving their full therapeutic potential. Aims: This paper reviews some of the 'therapeutic milieu' literature to identify ways of construing ward functioning so as to maximise therapeutic and minimise destructive processes within inpatient units. Method: Relevant papers are reviewed, providing an understanding that permits the inpatient clinician to consider and apply the pertinent concepts. Results: Five key therapeutic functions of the ward environment are identified--containment, support, structure, involvement and validation. Four destructive processes are described, relating to: the isolated patient; group phenomena; the contribution of staff; and structural manifestations in the ward. Conclusions: The inpatient ward can be construed as a 'whole', embodying a range of therapeutic functions, which may need rapid deployment and dismantling, as dictated by changes in ward conditions. The 'ward-as-a-whole' construct complements individualised models of patient care and the practical implications of such thinking could engender a greater sense of agency and job satisfaction in staff. [ABSTRACT FROM AUTHOR]

This paper examines the process of psychiatric diagnosis in a community mental health center walk-in clinic. The results indicate a great deal of conflict and contradiction in the psychiatric evaluation. This is discussed in light of several tensions: (1) mixed agendas surrounding diagnosis; (2) conflict between training and professional practice; (3) conflict created when a public facility is staffed by an elite medical school; (4) conflict between providing mental health services while serving the needs of other public agencies and mandates; and (5) conflict between an ascendant biopsychiatric model and the daily work of clinical therapeutic service. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article explores the need for innovative approaches to psychotherapy in India, specifically in terms of adapting existing models and introducing new ones that are culturally and socially responsive. It introduces Cognitive Analytic Therapy (CAT) as a potential model that can be used in the Indian context, emphasizing its transdiagnostic and whole-person approach. The article provides case examples to illustrate how CAT can be applied in therapy sessions, highlighting the importance of a collaborative and authentic therapeutic relationship. It also acknowledges the challenges of implementing psychotherapy in a system with limited access to trained professionals and calls for further research on the effectiveness of CAT in the Indian population. [Extracted from the article]

Objectives: This paper describes the role forensic psychotherapy has in the assessment and treatment of mentally disordered offender patients, and its role in the supervision of individual therapists, staff groups or whole organisations which contain and manage this patient population.Conclusions: Forensic psychotherapy has a valuable role to play in the management of mentally disordered forensic patients. As forensic services continue to develop in Australia and New Zealand and interest in this field continues to grow, then the future of forensic psychotherapy looks bright. [ABSTRACT FROM AUTHOR]

The article presents the study which examined the introduction of a Conversational Model of Short Term Intensive Psychodynamic Psychotherapy in a public mental health service in Australia. The model was introduced in 10 multidisciplinary mental health clinicians at the Western Sydney Health District in New South Wales. In the study, papers published in the Royal Australian & New Zealand College of Psychiatrists journals since 1980 as of October 2014 were analyzed.

In this paper, we describe the use of an aim-based outcome measure used in routine outcome monitoring of child and adolescent psychotherapy within a child and adolescent mental health service. We aim to explore the clinical feasibility and implications of the routine use of this measure. We argue that use of the measure provides a simple and useful way of clarifying the focus of the clinical work and reflecting its progress, while also having the potential to illuminate the clinical picture by contributing an additional source of clinical information from a collaborative process with the patient, parents or both. We argue that while there are some cases where use of the measure may be impossible, or even perverse, in general it enhances rather than detracts from clinical work. [ABSTRACT FROM PUBLISHER]

This paper examines the impact of World War II and its aftermath on the mental health sector, and traces the resulting transformations in US psychiatry and psychology. Focusing on the years between 1940 and 1970, it analyses the growing federal role in funding training and research in the mental health sector, the dominance of psychoanalysis within psychiatry in these years, and the parallel changes that occurred in both academic and clinical psychology. [ABSTRACT FROM PUBLISHER]

Introduction: Impaired self-awareness is a significant barrier to successful rehabilitation. This paper presents a new guideline for practice, entitled Self-awareness Enhancement through Learning and Function (SELF). Description: The SELF is a newly developed guideline for practice, which incorporates the latest theoretical information from neuroscience, psychology and computer science regarding self-awareness, learning, cognition and care giving, with evidence of the importance of participation in occupation. The SELF provides clear evaluation and treatment postulates using therapeutic alliance, occupation, belief perspectives, brain education and compensatory strategies to improve self-awareness. Discussion: The current approach to the treatment of impaired self-awareness focuses on testing and performance feedback. This approach does not have evidence to support its effectiveness and there is some evidence that the approach actually contributes to emotional distress and increased denial of deficits. Conclusion: The SELF integrates the art and the science of occupational therapy to foster self-awareness in an empathetic and dignified manner. Occupational therapists are uniquely qualified, and should be leaders, in the integration of personal factors, environmental elements and occupations to improve self-awareness. The SELF provides occupational therapists with guidelines for using these interrelationships to restore self-awareness in a manner that builds confidence and skills. [ABSTRACT FROM AUTHOR]

In this paper, I underline the challenges for group-analytic research by demonstrating the immense difference in the amount of research done in group psychotherapy in general as compared to group analysis. After presenting an overview of findings from empirical, quantitative outcome studies in group psychotherapy at large, I will discuss some trends in contemporary group psychotherapy research, and finally, I will give a rough sketch of group-analytic research. I will focus on quantitative research and I will see group analysis as a clinical enterprise — a theory, model, art and craft that has been developed and can be used to treat psychiatric disorders, and to ameliorate psychological problems. [ABSTRACT FROM AUTHOR]

Objective: This paper, composed by an interest group of clinicians and researchers based in Melbourne, presents some background to the practice of mindfulness-based therapies as relevant to the general professional reader. We address the empirical evidence for these therapies, the principles through which they might operate, some practical questions facing those wishing to commence practice in this area or to refer patients into mindfulness-based therapies, and some considerations relevant to the conduct and interpretation of research into the therapeutic application of mindfulness. Method: Databases (e.g. PsycINFO, MEDLINE) were searched for literature on the impact of mindfulness interventions, and the psychological and biological mechanisms that underpin the effects of mindfulness practice. This paper also draws upon the clinical experience of the author group. Results: Mindfulness practice and principles have their origins in many contemplative and philosophical traditions but individuals can effectively adopt the training and practice of mindfulness in the absence of such traditions or vocabulary. A recent surge of interest regarding mindfulness in therapeutic techniques can be attributed to the publication of some well-designed empirical evaluations of mindfulness-based cognitive therapy. Arising from this as well as a broader history of clinical integration of mindfulness and Western psychotherapies, a growing number of clinicians have interest and enthusiasm to learn the techniques of mindfulness and to integrate them into their therapeutic work. This review highlights the importance of accurate professional awareness and understanding of mindfulness and its therapeutic applications. Conclusions: The theoretical and empirical literatures on therapeutic applications of mindfulness are in states of significant growth and development. This group suggests, based on this review, that the combination of some well-developed conceptual models for the therapeutic action of mindfulness and a developing empirical base, justifies a degree of optimism that mindfulness-based approaches will become helpful strategies to offer in the care of patients with a wide range of mental and physical health problems. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper is to examine strategies that may facilitate the successful implementation of service-wide outcome measures in public mental health services. Conclusions: The available evidence suggests that a top-down approach to the introduction of state-wide routine outcome measurement across all public mental health services is likely to have only limited success. A centrally co-ordinated but locally directed bottom-up approach may be a more successful long-term strategy. Such an approach could make optimum use of a small team of “outcome experts”, while the use of strategies such as the development of local clinical guidelines would increase the co-operation and participation of the wider clinical community. An initial collection of clinical and social demographics could provide important contextual information on service populations and would initiate the administrative and communication networks that would need to be developed for later routine, multi-site data collection. [ABSTRACT FROM AUTHOR]

Mental health providers often have little to no training on working with disabled people, and may hold negative biases toward disability (American Psychological Association [APA], 2022). Given these conditions, this study fills a gap in knowledge about the experiences of people with physical disabilities in psychotherapy, and data-driven disability-affirmative approaches. Purposive sampling was used to recruit people with physical disabilities (N = 24) through social media, who participated in semi-structured individual interviews about their psychotherapy experiences. Consensual qualitative research methods revealed four overarching domains with multiple underlying themes. The four domains were: (a) positive therapeutic interventions and interactions, (b) negative therapeutic interventions and interactions, (c) in/accessibility of services, and (d) suggestions for improving mental health services. The results inform affirmative practices for psychotherapy with a stigmatized population. Implications for culturally-responsive clinical practice and training are discussed, as well as study limitations and directions for future research. [ABSTRACT FROM AUTHOR]

In focusing on eating disorders patients as a special application for group-analytic therapy, this paper first examines four central concepts of Foulkes in order to establish the effectiveness of group analysis. The role of the conductor is observed and discussed with particular reference to establishing a good-enough containing environment for group members. Phases of development within the group are documented as well as relationships between group members and how these affect the group's approach to a new conductor and the prospect of future challenges. [ABSTRACT FROM AUTHOR]

Blended Psychotherapy: Treatment concept and case report for the integration of Internet- and mobile-based interventions into brief psychotherapy of depressive disorders. Depression is among the commonest mental health disorders, affecting over 322 million people worldwide, and is the single largest contributor to health loss.[1] In India, depression affects one in every 20 individuals, and most of the affected neither seek nor have access to treatment.[2] Technology-driven self-help and guided psychological interventions have shown promising results and could be a low-intensity and low-cost strategy to cater to a larger number of individuals seeking mental health care.[3] This assumes great importance in the context of scarcity of trained professionals to offer psychological interventions and observations that a significant proportion of individuals seeking treatment for common mental health concerns may receive only pharmacological interventions, despite voluminous literature suggesting the utility of psychological interventions.[4] Graph Internet-based interventions have been assessed in substantial research in the last 20 years, and several meta-analyses demonstrate their effectiveness in treating various psychiatric disorders, including depression and anxiety.[5], [6] Different formats of internet-based interventions have been studied. Blending online therapy into regular face-to-face therapy for depression: Content, ratio and preconditions according to patients and therapists using a Delphi study. [Extracted from the article]

No.ComponentWestern CounsellingYogic Counselling1Paradigm of counsellingThe modern psychotherapy and counseling techniques are based out of a reductionist paradigm which attempt at explaining the entire system in terms of individual parts and their interactions.The Indian psychology is based on the holistic paradigm. The origin of concepts of yoga-based philosophical counselling can be derived from the traditional Vedic and Upanishadic literature from 2700 bc, also known as the preclassical period[1] of yoga. With increased focus on well-being and increased scientific research in the field of yogic sciences, the modern context views yoga as a complementary and alternative therapy in combating metabolic, psychosomatic, and mental health disorders, by addressing the root stressor.[8] Components of Yoga Yoga traditionally has eight limbs ( I Ashtanga Yoga i by Patanjali). [Extracted from the article]

But Zeavin's treatment of Freud intends to show not only that he practiced and therefore validated psychoanalytic therapy at a distance, challenging the misguided orthodoxy of later psychoanalysts who insist - in Freud's name - on the purity of two bodies present to each other in a room. On the other hand, psychoanalysis, as the original talking cure, inaugurates the lineage of mediated therapies Zeavin analyzes, and she often appeals to structural similarities between psychoanalysis and later technologically mediated therapies to substantiate and motivate the potential efficacy of those distanced treatments. Zeavin demarcates the differences between mediated therapies and Freudian psychoanalysis, both to demonstrate the march of history as change - a change that institutional psychoanalysis regards with suspicion and hostility - but also to evoke continuities that serve as partial assurance that "distanced" therapies remain potentially effective. Zeavin's third chapter focuses on two parallel histories of telephonic therapy, the suicide hotline that began as a direct response to the widespread depression and suicidality in the gay community in San Francisco, and the Christian church counseling helpline, which mixed the healing treatment of psychotherapy with the healing power of Jesus to provide a combination of proselytizing and counseling. [Extracted from the article]

The second is the building of stronger partnerships between all mental health and addictions services and their primary care colleagues, to both improve access to care and support and assist primary care to deliver effective mental health care. The Impact and Benefits of Collaborative Care The preponderance of research evidence for CMHC is based on studies of the model developed by Katon and colleagues over the past 25 years.[13],[29] This emphasizes: (a) team-based care, (b) measurement-based care and treatment-to-target, (c) evidence-informed treatment algorithms, and (d) population-oriented care using patient registries and proactive outreach. The first sees family physicians and other primary care professionals playing a growing role in delivering mental health care, even without the addition of new resources, by increasing the skills and capacity of the primary care sector to deliver "primary mental health care", supported by the local mental health system. Integration of Physical Health Care into Mental Health Settings In many parts of Canada, individuals living with a mental health and addiction problem, particularly those with severe and persistent mental illnesses, face difficulties in accessing regular, comprehensive, and continuing care. The third element is the integration of mental health-care providers within primary care settings to improve access to high-quality mental health and addiction assessment and treatment and enhance the patient experience. [Extracted from the article]

Background: The prevalence of mental disorders is increased among people of low socioeconomic status or educational level, but it remains unclear whether their access to treatment matches their increased need. Aims: Our objective was to examine whether educational level as an indicator of socioeconomic status is associated with use of mental health services, psychotropic medication and psychotherapy in Finland. Method: Cross-sectional data from a follow-up survey of a longitudinal, population-based cohort study were used to form a sample of 3,053 men and women aged 24 to 68 with a current or previous physician diagnosed mental disorder. The prevalence of mental disorders, mental health service use and educational level were assessed with self-report questionnaire. Educational level was determined by the highest educational attainment and grouped into three levels: high, intermediate and low. The associations between educational level and mental health service -related outcomes were assessed with binary logistic regression. Covariates in the fully adjusted model were age, gender and number of somatic diseases. Results: Compared to high educational level, low educational level was associated with higher odds of using antidepressants (OR 1.35, 95% CI [1.09, 1.66]), hypnotics (OR 1.33, 95% CI [1.07, 1.66]) and sedatives (OR 2.17, 95% CI [1.69, 2.78]), and lower odds of using mental health services (OR 0.80, 95% CI [0.65, 0.98]). No associations were found between educational level and use of psychotherapy. Conclusions: The results do not suggest a general socioeconomic status related mismatch. A pharmacological emphasis was observed in the treatment of low educational background participants, whereas overall mental health service use was emphasized among high educational background participants. [ABSTRACT FROM AUTHOR]

The article presents a discussion on forensic psychotherapy, group therapy and group-analytical therapy. Forensic psychotherapy always involves a tripartite relationship. There are three interested parties--the therapist, the patient and society's criminal justice system. The setting is of utmost importance for both therapist and patients whose problems involve acts against society. Group therapy through a process of minoring a social microcosm is able to provide a much better understanding of problems deeply related to antisocial actions. The group situation provides patients with a much wanner and less threatening setting than they could usually find in one-to-one therapy, in which their experiences of authority can be intense. Group-analytical therapy breaks through patterns of self-deception, fraud, secrecy and collusion, which are invariably present in these cases. The amount of fear, rejection and humiliation, which such patients experience when confronted in a group therapy session with their secrets and shame, is difficult to convey.

The World Health Organization (WHO), in its world health assembly (WHA), 2012, resolved that "there is need of a comprehensive, coordinated response from the health and social sectors at the community level to address the issue of burden of the mental illness."[1] India being a signatory to it, launched her national mental health policy (NMHPolicy) in 2014.[2] The policy was in concordance with WHO's mental health (MH) policy, plan, and program (2005), and the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD, 2007). 11 Mental health policy, plans, and programmes (updated version 2) (Mental Health Policy and Service Guidance Package), https://www.who.int/mental%5fhealth/policy/services/2%5fpolicy%20plans%20prog%5fWEB%5f07.pdf?ua=1 (2005, accessed December15,. For instance, universal access to MH care can be realized through effective implementation of the provisions of MHCA (2017), particularly early setting-up of the MHRB across the country (requiring a collaborative effort from both the state and center), which will ensure right-based MH services. [Extracted from the article]

The application of these counseling techniques derived out from the Ramayana in a clinical population would be the next step toward developing an evidence base and an indigenous counseling framework. In counseling psychology/psychotherapy, most often, the counsellor is in a position of power to deliver the counseling to clients and not vice versa (e.g., psychoanalytic psychotherapy and behavior therapy). Thus, there is a distinction between the counseling delivered in the epics and that conducted in counseling psychology, based on the theoretical background under which the counseling method is delivered. [Extracted from the article]

Most adults on the autism spectrum have co-occurring mental health conditions, creating a high demand for mental health services – including psychotherapy – in autistic adults. However, autistic adults have difficulties accessing mental health services. The most-reported barriers to accessing treatment are therapists’ lack of knowledge and expertise surrounding autism, as well as unwillingness to treat autistic individuals. This study was conducted by a participatory autism research group and examined 498 adult-patient psychotherapists on knowledge about autism and self-perceived competency to diagnose and treat autistic patients without intellectual disability compared to patients with other diagnoses. Psychotherapists rated their education about autism in formal training, and competency in the diagnosis and treatment of patients with autism, lowest compared to patients with all other diagnoses surveyed in the study, including those with comparable prevalence rates. Many therapists had misconceptions and outdated beliefs about autism. Few had completed additional training on autism, but the majority were interested in receiving it. Greater knowledge about autism was positively linked to openness to accept autistic patients. The results point to an alarming gap in knowledge necessary for adequate mental health care for individuals with autism. [ABSTRACT FROM AUTHOR]

Objective: We aimed to explore young peoples' lived experiences of multidisciplinary mental health assessment in an intensive mental health day program. Method: Interpretative phenomenological analysis (IPA) was applied to data from semi-structured interviews with six males, aged 13–16 years. Member-checking interviews were conducted to ensure the trustworthiness of findings. Results: Analysis revealed three themes, 'therapy fatigue', '360 supports' and 'experiential assessment'. Participants had either attended many years of psychological therapy without significant change or had failed to engage with therapy. Participants' attitudes changed at the day program with intensive support and their own determination. Participants valued experiential elements of assessment such as music therapy and art therapy which helped them understand the service, get to know others and experience positive emotions. Conclusions: Unsuccessful psychological treatment can leave young people feeling jaded and reluctant to engage with services. The potential for iatrogenic harm should be monitored and alternative approaches, such as intensive, multidisciplinary treatment including music therapy and art therapy considered to help young people overcome therapy fatigue, regain hope and reengage with mental health services. [ABSTRACT FROM AUTHOR]

Background: Classic psychedelics show promise in the treatment of mental health conditions; however, more scalable intervention protocols are needed to maximize access to these novel therapeutics. In this proof-of-concept study, perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide (LSD) were evaluated among healthy participants (N = 31) administered 50 to 100 µg LSD in a treatment paradigm conceptualized as more scalable than traditional approaches to administering classic psychedelics.Methods: Semi-structured interviews assessed participants' expectations, experience, and thoughts on the safety and efficacy of the study design. These interviews were transcribed for thematic analysis relating to perceptions of safety, subjective effects, and beliefs about the clinical utility of LSD.Results: Most participants felt safe throughout the study, with a minority reporting concerns related to having a challenging experience that diminished over time. Participants attributed their feelings of safety to the study structure and support of their attendants, which allowed them to "let go" and immerse themselves in the experience without pre-occupation. Furthermore, participants reported transcendent, mystical-type experiences characteristic of classic psychedelics, with almost half highlighting the prominent role played by music during the acute period of drug action. Finally, participants endorsed support for the clinical utility of LSD in controlled environments, expressing the belief that LSD is safe and has the potential to help others.Conclusion: Findings provide preliminary support for the feasibility of this scalable interventional paradigm and set the stage for future critical research with clinical populations. [ABSTRACT FROM AUTHOR]

Anorexia Nervosa (AN) is a lethal psychiatric disorder and the most common cause of psychiatric hospital admission amongst adolescents in the West. This paper is a systematic review to assess the clinical effectiveness of psychotherapies in the management of AN. Four specific online databases - EMBASE, PubMed, MEDLINE and the Cochrane Database were searched and selected articles were reviewed. Reviewed studies demonstrated clinical effectiveness of various types of interventions including psychotherapy in terms of Body Mass Index (BMI), weight gain, psychological functioning, social adjustment and 'recovery at follow-up'.The best recovery rates were with Family Therapy (FT). Effectiveness of Cognitive Behavioral Therapy (CBT) was not established by the review. Other types of psychotherapies and non-psychotherapeutic management strategies like Behavioural Family Therapy (BFT) or interpersonal therapy (IPT), cognitive analytical therapy or dietary advice (TAU) or non-specific supportive clinical management (NSSCM) were equally effective. [ABSTRACT FROM AUTHOR]

Objective: Little is known about the predictors of symptom change or the methods that might increase user ‘compliance’ on websites designed to improve mental health outcomes. The present paper: (i) examines predictors of expected final depression and anxiety scores on the MoodGYM website as a function of user characteristics; and (ii) compares the compliance rates of the original site with the new public version of the site (MoodGYM Mark II). The latter site requires compulsory completion of ‘core’ online assessments and may increase completion of site questionnaires. Method: MoodGYM Mark I participants were 19 607 visitors (public registrants) between April 2001 and September 2003 plus 182 participants who had been randomly assigned to MoodGYM in an earlier trial (The BlueMood Trial). MoodGYM Mark II participants were 38 791 public registrants of the MoodGYM Mark II site collected between September 2003 and October 2004. Symptom assessments are repeated within the website intervention to allow the examination of change in symptoms. Outcome variables were gender, initial depression severity scores, number of assessments completed and final anxiety and depression scores. Results: Men are predicted to be 0.19 units (SE = 0.095) higher than women on depression, controlling for the initial depression level and number of modules completed. For initial depression scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. For initial anxiety scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. Mark II registrants were more likely than to Mark I registrants to complete onsite assessments. Conclusions: Visitors to the MoodGYM site are likely to have better psychological outcomes if they complete more of the site material. Compulsory completion of core sections increases assessment completion. There is a need to examine further the significance of attrition from online interventions, to develop methods of handling missing data, and to investigate strategies to improve visitor dropout. [ABSTRACT FROM AUTHOR]

Objective: This paper outlines a rationale for expanding research and clinical innovations focused upon relapse prevention following a first episode of psychosis. Some general principles for further progress are extracted from an overview of the first-episode psychosis (FEP) relapse literature. A cognitive behaviour therapy intervention for relapse prevention for FEP, that has been developed at the Early Psychosis Prevention and Intervention Centre, is described to illustrate these principles. Conclusions: Further progress is needed in refining interventions specific to the prevention of relapse following FEP. Future progress is dependent upon improved understanding of the interaction of biological, interpersonal and psychological processes underpinning relapse. [ABSTRACT FROM AUTHOR]

Psychoanalytic disagreements are famously heated, polarized, and prolonged. These controversies are often the reflection of a shared agreement by the participants to engage in debate at an abstract level far removed from the clinical context in which the disagreement first arose. As a specimen example of such disputes, a case report by Patrick Casement is examined, together with a series of polemical discussions it inspired concerning physical contact suddenly demanded by an analysand in session. Over two dozen authors were almost evenly divided on whether to agree with Casement's technical conclusions, but showed a disquieting indifference to the detailed information available in his report regarding how this clinical crisis developed. The substantive merits of the contending arguments are not at issue; rather, the point is to demonstrate the crucial need to refine a methodology of contextualization to clarify inferential assumptions in clinical discussions. Premature truth claims might then give way to a more rational comparison of the clinical sources of divergent opinions. The term contextual horizon is introduced to facilitate an understanding of how the psychoanalyst makes inferences from the patient's associations. [ABSTRACT FROM AUTHOR]

Discusses the use of psychotherapeutic intervention in response to critiques by Sidney Blatt and Peter Fonagy to the article "On Analytic Process." Problem with the lack of empirical foundation in psychoanalysis; Limits of controlled clinical trials when studying psychotherapeutic intervention; Measurement of patient contributions to analytic process; Advantage of using a general prototype of analytic process in empirical studies and validation of psychoanalytic methods.

Discusses the definition of psychoanalytic process in response to Stuart Ablon's and Enrico Jones' article "On Analytic Process." Methodology used by Jones and Ablon; Ways in which psychotherapy Q-methodology was used in the article; Description of a prototype to define the psychoanalytic process.

NA-CC-D3.3 - Women's Experiences of Their First Pelvic Exam: Arts-Informed Narrative Inquiry Ms. Emma MacGregor, I Ryerson University, Toronto, Canada i Dr. Jasna Schwind, I Ryerson University, Toronto, Canada i Dr. Louela Manankil-Rankin Dr. Lori Schindel Martin, I Ryerson University, Toronto, Canada i NA-CC-D3 - Experience of Health and Illness 1, July 5, 2021, 3:00 PM - 4:00 PM B Introduction: b Canadian women usually have their first pelvic exam by the age of twenty-one, and then every three years until older adulthood. NA-CC-A1.2 - COVID-19 Pandemic Mental Health Challenges: Patients and Providers Dr. Carole Myers, I University Of Tennessee, Knoxville, United States i Ms. Lauren Munoz Ms Tracey Stansberry Dr. Mavis Schorn NA-CC-A1 - COVID-19 1, July 5, 2021, 9:00 AM - 10:00 AM B Introduction: b Interviews with 15 Tennessee Advanced Practice Registered Nurses (APRNs) early in the pandemic revealed a major theme unrelated to the primary study purpose. Oral Abstracts AME-CC-B3.2 - The Power of Metaphor as a Qualitative Tool for Understanding a Complex Experie... Dr. Matthew McCoy, I Department Of Veterans Affairs Greater Los Angeles, Los Angeles, United States i Dr. Ippolytos Kalofonos, I UCLA/VA Center of Excellence on Veteran Resilience and Recovery, Los Angeles, United States i Dr. Sonya Gabrielian, I UCLA/VA Center of Excellence on Veteran Resilience and Recovery, Los Angeles, United States i Dr. Lisa Altman, I UCLA/VA Center of Excellence on Veteran Resilience and Recovery, Los Angeles, United States i NA-CC-E4 - Experiences of Health and Illness 3, July 5, 2021, 4:00 PM - 5:00 PM B Introduction: b To mitigate risk for COVID-19 among Veterans experiencing homelessness (VEHs), the VA Greater Los Angeles created the Care, Treatment, and Rehabilitation Service (CTRS), an outdoor transitional housing program on VA grounds that provides a protected environment ("safe camping"). [Extracted from the article]

While on a waiting list for treatment by therapist-guided exposure and ritual prevention (ERP), patients with obsessive-compulsive disorder (OCD) did self-treatment at home guided by a manual plus a computer-driven telephone interview system (BT STEPS). Of 21 patients who used the system for at least three weeks while on the waiting list, one improved so much that subsequent therapist-guided ERP was unnecessary. Progress of the rest with the system predicted later progress with therapist-guided ERP. Improvement after using the system was similar to that of 20 matched historical controls who had had therapist-guided ERP without the prior use of BT STEPS. Outpatient users of BT STEPS needed less subsequent clinician-guided time than did their matched controls. In this pilot study, patients with OCD improved nearly as much with home self-treatment guided by a manual plus computer, as with treatment guided by a behaviour therapist. [ABSTRACT FROM AUTHOR]

Public policy in Ireland recognises that people living with early-stage dementia are likely to require considerable emotional support following diagnosis; anxiety and depression are very common within this population. Yet psychosocial interventions to support emotional health of people who receive a diagnosis of dementia are sparse; there is no mention of counselling and psychotherapy for people living with early dementia in national guidelines, despite a promising evidence base that has amassed internationally in recent decades. This article explores the psychological impact of receiving a diagnosis and the scant offering of emotional and psychological post-diagnostic support that is available for people living with early-stage dementia in Ireland. The author draws attention to the curious tension between the widely recognised psychological benefits of early diagnosis of dementia and the jarring delay in disclosure that continues to prevail across Irish healthcare delivery. The evidence base for counselling and psychotherapy for people living with mild to moderate dementia in regard to anxiety and depression is discussed. Recommendations are made for further research into specialist counselling and psychotherapy interventions with a strong involvement from people living with dementia embedded in both research and design. The author also calls for public policy to reflect the preference of people living with dementia for earlier diagnosis and to highlight the appetite and ability of people living with dementia to engage in psychotherapeutic interventions. [ABSTRACT FROM AUTHOR]

This paper presents a socio-cultural critique of contemporary American and Foulkesian traditions of group psychotherapy. It is argued that the American ethos of individualism has had an impact upon group psychotherapy, promoting an ideology of the autonomous individual, and the Foulkesian view, which gives primacy to the social dimension, is compared to certain American contemporary group approaches. [ABSTRACT FROM AUTHOR]

Research on countertransference within groups run on psychoanalytical- psychotherapy principles with chronically psychotic inpatients showed a consistency of counrertransference feelings in different facilitators at different phases of the groups. The phases resembled those encountered in bereavement. The strength of the countertransference in facilitators of groups may hinder the sharing of the experience and may result in unwanted effects on the staff, including physical illness. This paper emphasizes the importance of dealing adequately with countertransference in staff treating severely psychotic patients. [ABSTRACT FROM AUTHOR]

This paper concentrates on the impact that the group analyst's pregnancy had on a therapeutic group, highlighting the themes evoked, the transference issues that emerged and the countertransference feelings that impinged on the therapist's analytical thinking. The case material and group process is understood in relation to published literature on the subject, establishing the common ground between the individual and group reactions to the interruption of the reality of the therapist's life into the therapeutic setting. The general belief that this material can be usefully analysed and employed to the overall benefit of the patients' therapy in the group is confirmed. [ABSTRACT FROM AUTHOR]

In response to the demise of positivist rationality, different theoretical traditions have proposed alternative formulations of the way in which human beings construct their realities: discourse (social constructionism), self-interventions (critical realism), and the potentials of human consciousness (the humanist tradition). The notion of a "practical order" is introduced to conceptualize the practical context in which self-intervention takes place. Qualitative accounts of client experience of psychotherapy (Dinnage, 1988) provide examples of all three modes of reality construction. It is argued that a multimode perspective is consequently needed to provide an integrative framework that identifies in a systematic manner the different facets of client experience. The three modes correspond to three different sorts of questions that need to be addressed when researching client experience of psychotherapy. The multimode perspective advocated in this paper is used to highlight neglected research topics in this domain. [ABSTRACT FROM AUTHOR]

Living in a world affected by the COVID-19 (coronavirus disease 2019) pandemic presents unique challenges to the therapeutic endeavor. One such challenge is mutual sharing in the collective anxieties and stressors befalling communities globally. This article will seek to explore and understand these shared concerns through a Jasperian framework of limit experiences, particularly explicating the impact on therapeutic practice. Concepts such as emotional comportment and dwelling will be explored and recontextualized as possible responses to such limit situations. [ABSTRACT FROM AUTHOR]

This qualitative research sought to establish the impact of an 8-week program combining football and one-to-one psychotherapy on young males’ mental health, determining the factors that predict help-seeking behaviors in this group of men. Pre- and post-participation focus groups were used as the method of data collection. Six males (19–35 years old; M = 25.5) completed both pre-intervention and follow-up focus groups. Help-seeking behaviors were influenced by the appeal of football and the perception of the counselor being accessible. Barriers included gender norms, socialization, financial difficulties, and challenging social landscapes. Post-participation focus groups revealed that positive social and counseling relationships facilitated improved mental health. Sport was deemed an acceptable medium to deliver a mental health intervention as it increased social connections and facilitated help-seeking. Findings support previous research indicating that combining sports and psychotherapy positively impacts young males’ mental health. [ABSTRACT FROM AUTHOR]