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Background:  In South Africa, various treatment modalities from abroad have been implemented to treat patients with mood disorders. This article is based on a South African model that has been developed, implemented and evaluated for psychiatric nurses to use in facilitating constructive group therapy for patients with mood disorders., Objectives:  This study aimed to describe psychiatric nurses' experiences in implementation of a model to facilitate constructive group therapy for patients with mood disorders., Method:  A qualitative, exploratory, descriptive and contextual research design was used for this study. Participants were psychiatric nurses working in an inpatient unit for patients with mood disorders in a public psychiatric hospital., Results:  The study revealed that psychiatric nurses experienced the model as a supportive tool to facilitate constructive interaction among patients with mood disorders. The model was beneficial in creating a safe space for patients to share and deal with their challenges, promoting optimal functioning outside the hospital setting. The model's implementation also fostered improvement in psychiatric nurses' personal and professional skills., Conclusion:  The model emphasised psychiatric nurses' importance in treating patients with mood disorders and ensuring positive patient experiences and outcomes.Contribution: This study contributes to the theory of clinical psychiatric nursing practice and the empowerment of psychiatric nurses, creating self-awareness related to working with patients with mood disorders.

Abstract: Although reminiscence therapy alleviates mental illness and improves quality of life in neurocognitive disorders patients, little study reports its clinical application in cancer patients. Thus, this study aimed to explore the effect of reminiscence therapy on anxiety, depression, quality of life, and survival profile in postoperative gastric cancer patients.One hundred sixty surgical gastric cancer patients were enrolled in this randomized, controlled study, then randomly assigned to Reminiscence therapy group (N = 80) and Control group (N = 80) as 1:1 ratio. The evaluation was carried at baseline (M0), month 3 (M3), month 6 (M6), month 9 (M9), and month 12 (M12) after intervention by Hospital Anxiety and Depression Scale and European Organization for Research and Treatment of Cancer quality of life Questionnaire-Core 30 (QLQ-C30). Furthermore, disease-free survival and overall survival were analyzed using follow-up data.Reminiscence therapy decreased HADS for anxiety score at M6, M9, and M12, decreased anxiety rate at M9 and M12 compared to control care; while it did not affect HADS for depression score or depression rate at any time-point. Also, reminiscence therapy raised QLQ-C30 global health status score at M12, reduced QLQ-C30 symptoms score at M6, while did not affect QLQ-C30 function score at any time-point compared to control care. Reminiscence therapy did not affect disease-free survival and overall survival, either. Further subgroup analyses (divided by age and gender) observed that the effect of reminiscence therapy seemed more obvious in patients with age ≤60 years and male patients.Reminiscence therapy exhibits alleviation of anxiety and improvement of quality of life in postoperative gastric cancer patients., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Little is known about which personality traits determine the effectiveness of various types of cognitive-behavioral therapy (CBT) on animal phobia. The objective of the present study was to investigate a possible association between personality traits and the outcome of single- and multi-session CBT., Methods: The present randomized clinical trial was conducted from November 2018 to May 2019 in Shiraz, Iran. Forty female students with rat phobia, who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria, were systematically allocated into a single- and a multi-session therapy group (odd numbers one-session treatment, even numbers multi-session treatment). In both groups, the students were gradually exposed to rats as part of the treatment. Psychological measures (state-anxiety, rat phobia, and disgust questionnaires) were used to compare pre- and post-intervention outcomes. Multivariate analysis of covariance was used to assess which personality traits influenced the intervention outcome. The statistical analysis was performed using SPSS (version 20.0) and P values<0.05 were considered statistically significant., Results: Rat phobia was positively and significantly affected by conscientiousness (P=0.001) and agreeableness (P=0.003). Of these personality traits, only a higher degree of conscientiousness resulted in a further reduction of state anxiety after the intervention (P=0.005). There were no significant differences between the pre- and post-intervention outcomes., Conclusion: The outcome of single- and multi-session rat phobia therapies was associated with specific personality traits of the participants, namely conscientiousness and agreeableness. Both intervention methods had an equal effect on reducing rat phobia., (Copyright: © Iranian Journal of Medical Sciences.)

Background: According to the World Health Organization (WHO), up to 25% of people worldwide will develop mental health disorders during their lifetime. Patients admitted to acute inpatient units for mood disorders experience emotional distress. Group therapy has the potential to foster the therapeutic change through specific therapeutic mechanisms. Psychiatric nurses working in inpatient units are in a unique position to offer group therapy., Objectives: Explore and describe stabilised acute psychiatric patients with mood disorders' lived experiences of group therapy facilitated by psychiatric nurses. Make specific recommendations for psychiatric nurses to facilitate constructive group therapy for stabilised acute psychiatric patients with mood disorders in an inpatient unit., Method: A qualitative, exploratory, descriptive and contextual design was used in the study. A purposive sample of all patients with mood disorders older than 18 years admitted to inpatient units who participated in group therapy was made. Data were collected through conducting phenomenological interviews, observation and field notes. Interviews focussed on the following open question: 'How did you experience group therapy facilitated by the psychiatric nurses?' An independent coder analysed the data by using thematic coding. Measures to ensure trustworthiness were applied. The following four ethical principles were adhered to: autonomy, non-maleficence, beneficence and justice., Results: Three themes emerged from this study. Theme 1 entailed the psychological experiences of patients attending group therapy. Theme 2 highlighted the interpersonal experiences of patients. Theme 3 evolved around patients' experiences outside group therapy. Patients initially experienced attending group therapy as anxiety provoking. However, negative psychological experiences soon transformed into positive psychological experiences., Conclusion: The findings of this study were used to make specific recommendations to facilitate constructive group therapy for patients with mood disorders.

Background: Group-Based Opioid Treatment (GBOT) has recently emerged as a mechanism for treating patients with opioid use disorder (OUD) in the outpatient setting. However, the more practical "how to" components of successfully delivering GBOT has received little attention in the medical literature, potentially limiting its widespread implementation and utilization. Building on a previous case series, this paper delineates the key components to implementing GBOT by asking: (a) What are the core components to GBOT implementation, and how are they defined? (b) What are the malleable components to GBOT implementation, and what conceptual framework should providers use in determining how to apply these components for effective delivery in their unique clinical environment?, Methods: To create a blueprint delineating GBOT implementation, we integrated findings from a previously conducted and separately published systematic review of existing GBOT studies, conducted additional literature review, reviewed best practice recommendations and policies related to GBOT and organizational frameworks for implementing health systems change. We triangulated this data with a qualitative thematic analysis from 5 individual interviews and 2 focus groups representing leaders from 5 different GBOT programs across our institution to identify the key components to GBOT implementation, distinguish "core" and "malleable" components, and provide a conceptual framework for considering various options for implementing the malleable components., Results: We identified 6 core components to GBOT implementation that optimize clinical outcomes, comply with mandatory policies and regulations, ensure patient and staff safety, and promote sustainability in delivery. These included consistent group expectations, team-based approach to care, safe and confidential space, billing compliance, regular monitoring, and regular patient participation. We identified 14 malleable components and developed a novel conceptual framework that providers can apply when deciding how to employ each malleable component that considers empirical, theoretical and practical dimensions., Conclusion: While further research on the effectiveness of GBOT and its individual implementation components is needed, the blueprint outlined here provides an initial framework to help office-based opioid treatment sites implement a successful GBOT approach and hence potentially serve as future study sites to establish efficacy of the model. This blueprint can also be used to continuously monitor how components of GBOT influence treatment outcomes, providing an empirical framework for the ongoing process of refining implementation strategies.

Background: STEPWISE is a theory-informed self-management education programme that was co-produced with service users, healthcare professionals and interventionists to support weight loss for people with schizophrenia. We report the process evaluation to inform understanding about the intervention and its effectiveness in a randomised controlled trial (RCT) that evaluated its efficacy., Methods: Following the UK Medical Research Council (MRC) Guidelines for developing and evaluating complex interventions, we explored implementation quality. We considered causal mechanisms, unanticipated consequences and contextual factors associated with variation in actual and intended outcomes, and integrated treatment fidelity, using the programme theory and a pipeline logic model. We followed a modified version of Linnan and Steckler's framework and single case design. Qualitative data from semi-structured telephone interviews with service-users (n = 24), healthcare professionals delivering the intervention (n = 20) and interventionists (n = 7) were triangulated with quantitative process and RCT outcome data and with observations by interventionists, to examine convergence within logic model components., Results: Training and course materials were available although lacked co-ordination in some trusts. Healthcare professionals gained knowledge and some contemplated changing their practice to reflect the (facilitative) 'style' of delivery. They were often responsible for administrative activities increasing the burden of delivery. Healthcare professionals recognised the need to address antipsychotic-induced weight gain and reported potential value from the intervention (subject to the RCT results). However, some doubted senior management commitment and sustainability post-trial. Service-users found the intervention highly acceptable, especially being in a group of people with similar experiences. Service-users perceived weight loss and lifestyle benefits; however, session attendance varied with 23% (n = 47) attending all group-sessions and 17% (n = 36) attending none. Service-users who lost weight wanted closer monitoring and many healthcare professionals wanted to monitor outcomes (e.g. weight) but it was outside the intervention design. No clinical or cost benefit was demonstrated from the intermediate outcomes (RCT) and any changes in RCT outcomes were not due to the intervention., Conclusions: This process evaluation provides a greater understanding of why STEPWISE was unsuccessful in promoting weight loss during the clinical trial. Further research is required to evaluate whether different levels of contact and objective monitoring can support people with schizophrenia to lose weight., Trial Registration: ISRCTN, ISRCTN19447796. Registered 20 March 2014.

Introduction: Depression and anxiety disorders are highly prevalent among primary care patients. Group visits provide a way of delivering interventions to multiple patients at the same time. Group visits for depression and anxiety present an opportunity to expand the reach of behavioral health services for primary care patients. The goal of the current study was to evaluate the implementation of an acceptance and mindfulness-based group for primary care patients with depression and anxiety., Methods: Adult family medicine patients with Patient Health Questionnaire-9 (PHQ-9) and/or Generalized Anxiety Disorder Scale-7 (GAD-7) scores > 5 were eligible for the group. The group was held biweekly in the family medicine practice with rolling enrollment. The PHQ-9 and GAD-7 were administered at every visit, and changes in depression and anxiety symptoms were analyzed using multilevel modeling. We evaluated feasibility, acceptability/satisfaction, penetration, and sustainability., Results: Over the course of 19 months, 50 patients were referred to the group, and 29 enrolled. The median number of visits attended was four among those who attended more than one group visit. Results revealed that depression and anxiety symptoms decreased significantly over the first four visits attended (d = -.26 and -.19, respectively). Patients who attended more than one group reported high satisfaction. The group was sustainable after the research funding ended; however, penetration was low., Discussion: A rolling enrollment group for patients with depression and anxiety that utilized mindfulness- and acceptance-based treatment principles is feasible to implement in a primary care setting but is not without challenges. Recommendations for ways to enhance implementation and future research are provided. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Background: Breast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder. In contrast, growing evidence has shown that posttraumatic growth can occur as a result of coping with breast cancer. Challenging the assumptive world, deliberate rumination, and emotional disclosure are recognized as strong predictors of posttraumatic growth. Group interventions may also increase social support, distress disclosure, and posttraumatic growth. The aim of this study is to evaluate how group-based interventions can facilitate posttraumatic growth and promote improved psychosocial adjustment to breast cancer. This article describes the study protocol and the applied research methods., Methods: To measure the impact of a group-based intervention on posttraumatic growth, a multi-center randomized control trial was developed for Portuguese breast cancer patients. 205 women with nonmetastatic breast cancer (stages 1 to 3) were recruited for the study and were randomly assigned either to the experimental group, which participated in an 8-session group intervention, or to the control group. Psychosocial variables, which consisted of posttraumatic growth, illness perception, stressfulness of the event, Posttraumatic Stress Disorder, core beliefs, rumination, social support, and distress disclosure were measured at three time points. The designated points in time for the assessments were baseline, 6 months post-intervention, and follow-up (12 months after baseline)., Discussion: This study is the first trial to assess the efficacy of a group-based intervention designed to facilitate posttraumatic growth following a breast cancer diagnosis. If proven to be effective, group-based intervention could be recommended as a complementary program to be included in hospital health-care and clinical practice., Trial Registration: The trial was registered on 28/10/2013 at the Current Controlled Trials ( ISRCTN02221709 ).

Background: There are no randomised clinical trials comparing the outcomes of short- with long-term psychodynamic group psychotherapy., Aims: To compare differences in outcome during and after short- and long-term group psychotherapy., Method: In total, 167 out-patients with mood, anxiety and personality disorders were randomised to short- or long-term group therapy (20 or 80 weekly, 90 min sessions). Outcome measures were: symptoms (Symptom Checklist 90 - Revised), interpersonal problems (Inventory of Interpersonal Problems - Circumplex) and psychosocial functioning (Global Assessment of Functioning (GAF) split version: GAF-Symptom and GAF-Function). Change over the 3-year study period was assessed using linear mixed models. The study was registered in clinicalTrials.gov as NCT00521417., Results: Patients in both groups made significant gains. A significantly larger symptomatic change over time was found for long-term compared with short-term therapy, but no significant differences were detected for the three remaining outcome variables. There was a higher number of premature terminations in the long-term (33.3%) compared with the short-term group (8.6%)., Conclusions: Short- and long-term therapy seem equally effective for typical out-patients seeking group psychotherapy, except for symptomatic distress.

Background: Hemodialysis patients face numerous physical and psychological stresses that result in reduced health. The aim of this study is to determine the impact of an empowerment program on self-efficacy, quality of life, clinical indicators of blood pressure and interdialytic weight gain, and laboratory results in these patients., Methods: This randomized, controlled trial was conducted at Boo Ali Sina Dialysis Center, Shiraz, Iran. A total of 48 hemodialysis patients participated in this study. After acquisition of informed consent, eligible patients were randomly divided into two groups, control and experimental. Pre-test data were obtained by using a demographic data form and two questionnaires for self-efficacy and quality of life. Blood pressure and interdialytic weight gain were measured. We extracted laboratory data from patients' charts. A six-week empowerment intervention that included four individual and two group counselling sessions was performed for the experimental group. Six weeks after intervention, post-test data were obtained from both groups in the same manner as the pre-test. Data were analyzed by ANCOVA using SPSS v11.5., Results: There were no statistically significant differences in demographic variables between the groups. Pre-test mean scores for self-efficacy, quality of life, blood pressure, interdialytic weight gain and laboratory results did not differ between the groups. There was a significant difference between the experimental and control groups in terms of pre-to post-intervention changes in overall self-efficacy scores, stress reduction, and decision making, in addition to overall quality of life and all dimensions included within quality of life based on this questionnaire. Additionally, the pre- to post-intervention changes in systolic/diastolic blood pressures, interdialytic weight gain, hemoglobin and hematocrit levels significantly differed between the groups., Conclusion: Our study demonstrates that a combination of individual and group empowerment counselling sessions improves self-efficacy, quality of life, clinical signs, and hemoglobin and hematocrit levels in hemodialysis patients. Empowerment of hemodialysis patients should be considered in hemodialysis centers to assist patients with the management of their health-related problems., Trial Registration: Irct ID: IRCT138901172621N4.

Over the past 25 years, group analysis has been much influenced by new developments in psychoanalysis, developmental psychology, evolutionary neurobiology, and evolutionary psychology. Basic group-analytic concepts are now being validated and reinforced by new knowledge of developmental processes in infancy and childhood. The development of both our brain as the organ of sociality and our personality begins as early as in utero. A child first learns how and whether to trust others and how to manage its emotions through empathy and sensitive responsiveness of its parents. Infant mental and emotional development is indebted to good enough environmental responses. Understanding these early influences is important because, among other things, it makes us aware how difficult it may be to influence such early factors by psychotherapy.

In the last few decades, group psychotherapy has deserved considerable attention from researchers. Based on recent publications, the authors of this work make considerations concerning the indication, the need to adopt a selection criteria, expected results and prognoses as well as the change process. Literature review shows a tendency to recognize the client as an agent for his own change. The particular shape which is taken by this process in group psychotherapy is pointed out.

Objective: Empirical support for the effectiveness of group therapies for women with a history of childhood sexual abuse is scant. This study examined the feasibility of conducting abuse-focused research and group treatment on a short-term unit and evaluated the effectiveness of the Women's Safety in Recovery group., Methods: Eighty-six women with a history of childhood sexual abuse participated in treatment as usual (N=38) or in the Women's Safety in Recovery group (N=48). The latter group met three times weekly for one hour, focusing on patients' current safety and self-care. Participants completed the Symptom Checklist-Revised at baseline, discharge, and six-month follow-up. Patients rated their experience in treatment at discharge and six-month follow-up, and therapists rated patients' treatment experiences at discharge. The feasibility of the treatment group was measured by enrollment rates, group attendance, and attrition., Results: Eighty-two percent of eligible patients agreed to enroll in the study. Women's Safety in Recovery participants attended an average of ten group meetings. Seventy percent of enrollees completed discharge assessments, and of these, 82 percent completed the six-month follow-up. Compared with treatment-as-usual patients, Women's Safety in Recovery participants reported greater symptom improvement and reported that their childhood sexual abuse issues had been more thoroughly addressed. These differences were present at discharge and at six-month follow-up. Therapists also perceived that abuse issues of these participants had been more thoroughly addressed., Conclusions: Women's Safety in Recovery participants reported significant reductions in distress compared with those receiving treatment as usual. The abuse-focused research program and the Women's Safety in Recovery group proved feasible, despite attrition.

People with schizophrenia smoke more than the general population and more than other psychiatric diagnostic groups. The rate of smoking in the general population is 30 percent, and reported rates for people with schizophrenia range between 62 percent and 81 percent. The author briefly reviews evidence that nicotine's augmentation of dopamine release may account for the high prevalence of smoking in this group. The affective, cognitive, and social difficulties and the symptoms experienced by many patients with schizophrenia indicate that existing smoking cessation programs may not be appropriate for them. The author describes three programs developed for use with this population and reviews evidence of their effectiveness. Preliminary evidence suggests that transdermal nicotine patches are effective and that patients do not misuse them. The author concludes that stopping smoking is possible for individuals with schizophrenia, especially if the treatment is specifically designed for them.

The combined problems of substance abuse, mental illness, and homelessness among the urban poor represent a major public health issue. The study evaluated 340 patients attending a cocaine day treatment program that integrates peer leadership and professional supervision. Thirty-six percent of the sample had a major mental illness, and 39 percent were homeless. Sixty-nine percent achieved an acceptable final urine toxicology status, and the median number of program visits was 46. Homelessness, a longer history of cocaine use, and a diagnosis of schizophrenia were associated with positive treatment outcomes. The results support the feasibility of a cocaine abuse treatment model combining professional and peer leadership.