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Complex and enduring mental health problems require greater treatment resources, usually in the form of multidisciplinary support, including providing psychological therapies. This paper reports on an NHS, tertiary-level specialist psychotherapy service offering Psychodynamic therapies with longer-term, exploratory transdiagnostic approaches to support complexity and sustained personality functioning. This paper adopts a naturalistic study design evaluating the effectiveness of Psychodynamic therapy using pre- and post-outcomes across a 10-year period. A total of n = 474 participants self-report pre- and post-outcome measures were used as the marker of effectiveness along with therapist assessments during intake and engagement. The findings showed that Psychodynamic therapy was effective in reducing psychological distress based on service-user self-report and therapist assessments. While intake scores varied by socio-demographic factors, the rate of change across most groups was similar. There were several limitations relating to data quality and completeness which reflect the naturalistic design. Despite the limits of a naturalistic design, this study provides evidence of support for the place of Psychodynamic therapies within NHS mental health care, catering to those with complex and enduring mental health problems. [ABSTRACT FROM AUTHOR]

Psychotherapy is widely used to treat different mental health disorders and emotional difficulties. The main objective of psychotherapy is to help clients become aware of and have control over their thoughts, moods, feelings and behaviours, as well as create healthy strategies to respond to challenging situations. Since the existing psychotherapy approaches and other methods of treatment are not always effective in treating mental health disorders, there is still space for new approaches to fill this gap. In this paper, we provide information about internal cohesion psychotherapy, which is a new integrative approach. This paper presents a new approach to eclectic psychotherapy, focussing on four detrimental aspects of human functioning through different time perspectives. [ABSTRACT FROM AUTHOR]

This document introduces a special issue on technological applications in mental health and mental health services research. The advancements in computer technology have allowed for innovative applications in collecting and analyzing data related to mental health. The use of personal electronic devices and the internet provides a rich stream of data that can offer insights into individuals' mental health. The special issue includes papers on topics such as video therapy, measurements in daily life, and automated coding of psychotherapy sessions. These papers highlight the potential of technology in improving mental health outcomes and expanding the accessibility of mental health services. [Extracted from the article]

This paper argues that the process of modeling in science and the process of encountering and working with a client in clinical psychotherapy overlap. In briefer terms: what makes a good therapist is much like what makes a good scientific modeler. Both modeling and psychotherapy are iterative processes, requiring careful observation, generation and testing of hypotheses. Both processes also face similar epistemic and pragmatic trade-offs. Heuristics and biases can shape both practices, for better and worse. Implications are considered for both training in clinical psychotherapy, and for larger debates concerning evidence-based methods in assessment of mental health care, and categorical v. dimensional approaches to diagnosis. [ABSTRACT FROM AUTHOR]

Aim: Routine outcome monitoring (ROM), including the use of feedback, has become a much vaunted method in psychological therapies but is little used in university/college counselling and mental health services, perhaps because its adoption raises questions for many practitioners and service leaders. There is a need for both clinical‐ and research‐based statements to clarify the reasoning and rationale for ROM. This paper aims to present and respond to common challenges of and reservations about using ROM in student counselling and/or mental health services. Method: The article poses 15 questions and issues about the adoption of ROM drawn from the literature on this topic and further refined by practitioner‐ and researcher‐members of a consortium comprising service leads, practitioners, and researchers working in the field of student counselling in the UK. The questions address nine themes: (1) the purpose and yield of ROM; (2) the burden of measurement; (3) the impact on clients and process of therapy; (4) consistency with therapeutic theory; (5) client groups and settings; (6) concern from practitioners; (7) equality, diversity, and inclusion; (8) implementation; and (9) relationship with the paradigm of practice‐based evidence. Findings: Responses to each of the 15 questions are provided from a methodological, evidence‐based, and clinical perspective. Conclusions: The responses provide practitioners with the necessary information to enable them to make informed decisions as to the value, or otherwise, of adopting ROM, including feedback, in the delivery of counselling interventions, and generating evidence created from clinical practice. [ABSTRACT FROM AUTHOR]

Aimed at understanding and improving psychological therapies as they are conducted in clinical routine, practice-oriented research (POR) is now a well-established approach to the scientific foundations of mental health care services. Resting on the accumulation of a wide range of practice-based evidence related to treatment outcome and process, as well as factors associated with the participants of psychotherapy and its context, POR is ripe for new developments – regarding what to investigate and how to investigate it. This paper is the introduction of a series devoted to recent advances and future directions of POR as their pertained to routine outcome monitoring, technologies and artificial intelligence, the integration of constructs and methods from program evaluation and implementation science, and the investigation of populations with limited financial resources across various regions of the world. The series also includes commentaries from two leaders of POR. [ABSTRACT FROM AUTHOR]

Case study can be adopted when aiming to understand an individual's lived experience. Such experience produces rich and complex qualitative data for analysis, conducive to counselling and psychotherapy research. Furthermore, grounded theory (GT) can be adopted to produce a theory from qualitative data, fitting well with case study research that explores complex experiences regarding social, psychological and phenomenological processes. This paper aims to guide the counselling researcher to incorporate Strauss and Corbin's model into the main arena of qualitative counselling research. In addition, this paper draws on a multiple case study that adopted Strauss and Corbin's method and identified various phases in the GT process. The aim is to inform the reader how to put the iterative process and pragmatic theoretical sampling into practice to produce a robust theory from clinical case study data. [ABSTRACT FROM AUTHOR]

Background: This commentary offers a critical reflection on the current status of evidence‐based psychological treatments for psychological distress in dementia, with a particular emphasis on acceptance and commitment therapy (ACT). Purpose: The paper hypothesises several explanations, such as ethical dilemmas with recruitment and consent, and possible preconceptions surrounding the nature, scope and likelihood of therapeutic change in this population, for a lack of interventional research on people with dementia. Implications: We highlight some recent developments in psychological therapy with people with dementia that are raising more questions and generating new outcome research. [ABSTRACT FROM AUTHOR]

Pathological narcissism is a personality constellation comprising distorted self‐image, maladaptive self‐esteem regulation, and difficulties in intimate relationships. Patients with elevated pathological narcissism may not necessarily meet criteria for narcissistic personality disorder, and may seek treatment for a range of mental health concerns across various clinical settings. An understanding of key principles of control‐mastery theory (CMT) can help clinicians understand the specific goals and challenges of the individual patient with pathological narcissism, and can illuminate ways in which the patient may work in psychotherapy. This paper outlines how patients with pathological narcissism may engage in testing of their pathogenic beliefs, and how therapists can respond in ways that facilitate the patient's sense of safety and foster psychological work. The role of the therapist's attitude is highlighted as a means for countering pathogenic beliefs associated with pathological narcissism. Clinical material from a single case of time‐limited supportive psychotherapy will be used to illustrate these principles and associated therapeutic processes. Insights from CMT regarding pathogenic beliefs and the patient's plan for addressing them can help to explain how therapy works or does not work for patients with pathological narcissism. [ABSTRACT FROM AUTHOR]

Preparing the future mental health workforce requires clinicians to be able to adapt their clinical work to different mental and medical healthcare settings to meet the growing need for mental health services. Medical Family Therapists (MedFTs) are specifically trained to provide care for patients from a biopsychosocial-spiritual perspective in diverse clinical settings. Having a theoretical foundation is a necessity for MedFTs to be able to adapt their clinical work to different contexts. Solution-focused therapy provides such a foundation. This paper provides examples of how MedFTs can use solution-focused therapy in traditional psychotherapy, integrated primary care, and integrated psychiatric care. [ABSTRACT FROM AUTHOR]

In recent years, social assistive robots have gained significant acceptance in healthcare settings, particularly for tasks such as patient care and monitoring. This paper offers a comprehensive overview of the expressive humanoid robot, Qhali, with a focus on its industrial design, essential components, and validation in a controlled environment. The industrial design phase encompasses research, ideation, design, manufacturing, and implementation. Subsequently, the mechatronic system is detailed, covering sensing, actuation, control, energy, and software interface. Qhali's capabilities include autonomous execution of routines for mental health promotion and psychological testing. The software platform enables therapist-directed interventions, allowing the robot to convey emotional gestures through joint and head movements and simulate various facial expressions for more engaging interactions. Finally, with the robot fully operational, an initial behavioral experiment was conducted to validate Qhali's capability to deliver telepsychological interventions. The findings from this preliminary study indicate that participants reported enhancements in their emotional well-being, along with positive outcomes in their perception of the psychological intervention conducted with the humanoid robot. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mentalizing is the capacity to understand both one's own and other people's behaviour in terms of mental states, such as, for example, desires, feelings and beliefs.The mentalizing capacities of healthcare professionals help to establish effective therapeutic relationships and, in turn, lead to better patient outcomes. What this paper adds to existing knowledge?: The personal factors positively associated with the mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. There is limited evidence that training programmes can improve mentalizing capacities.Although the mentalization field is gaining importance and research is expanding, the implications for mental health nursing have not been previously reviewed. Mental health nurses are underrepresented in research on the mentalizing capacities of healthcare professionals. This is significant given that mental health nurses work closest to patients and thus are more often confronted with patients' behaviour compared to other health care professionals, and constitute a large part of the workforce in mental healthcare for patients with mental illness. What are the implications for practice?: Given the importance of mentalizing capacity of both the patient and the nurse for a constructive working relationship, it is important that mental health nurses are trained in the basic principles of mentalization. Mental health nurses should be able to recognize situations where patients' lack of ability to mentalize creates difficulties in the interaction. They should also be able to recognize their own difficulties with mentalizing and be sensitive to the communicative implications this may have. Introduction: Mentalizing capacities of clinicians help to build effective therapeutic relationships and lead to better patient outcomes. Few studies have focused on factors associated with clinicians' mentalizing capacities and the intervention strategies to improve them. Aim: Present a systematic review of empirical studies on factors associated with healthcare professionals' mentalizing capacities and the effectiveness of intervention programmes designed to improve these capacities. Method: Following PRISMA‐guidelines, a systematic literature search was conducted in PubMed, PsycINFO, Cochrane Library and CINAHL. Results: Out of a systematic search with 1537 hits, 22 studies were included. Personal factors positively associated with mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. Evidence that training programmes improve mentalizing capacities is limited. Discussion: Mental health nurses are underrepresented in research on mentalizing capacities of healthcare professionals and training programs to improve these capacities are practically absent. Implications for Practice: For mental health nurses, training in basic mentalizing theory and skills will improve their capacities in building effective working relationships with patients. [ABSTRACT FROM AUTHOR]

This paper highlights the limitations of narrative logic in mental health care, and in particular of "narrative vigilance"—the tendency to watch over experience via narrativisation, and to tether the concrete particulars of experience to the hypothetical structure of a narrative signification. Narrative logic is grounded in hypotaxis—the syntactic structuring whereby a discourse is characterised by different levels of subordination using linking words that connect, especially in terms of temporal and explanatory consequentiality. I offer an alternative approach based on parataxis—the practice of placing phrases or parts of speech next to each other without subordinating conjunctions. Sentences are juxtaposed without a clear connection; the contrast may generate novel and unexpected combinations between these dissimilar fragments. After distinguishing between parataxis and psychopathological phenomena like disturbances of association, I take inspiration from the work and life of a poet, Johann Christian Friedrich Hölderlin (1770–1843), considered among the greatest. He suffered for half his life from a severe form of mental illness that would perhaps, today, be diagnosed as schizophrenia. In the poems written during his illness, hypotaxis and narrative vigilance seem to blur, and parataxis takes centre stage. The fading of narrative structure in no way coincides with the absence of meaningfulness. Rather, meaningfulness is left to parataxis itself, that is, to the recombining power of words, sentences, and images. Parataxis itself can provide meaningfulness or, at least, provide the soil in which it can germinate. The void of narration opens the door for the fullness of "emergent" connections. In the final part of the paper, with the help of Freud's ideas on the relationship between "analysis" and "synthesis" in psychoanalytic treatment, some implications are derived about the relevance of parataxis to the logics of discovery in psychotherapeutic care, especially that of persons with severe mental conditions. [ABSTRACT FROM AUTHOR]

The article focuses on the activity of making paper bag books as a creative intervention for elementary school children experiencing high-conflict parental divorce. Research shows that school-based interventions for children can help counter the adverse effects of divorce. It states that the paper bag book activity aims to offer a compassionate environment for meaningful connections and perceived commonality among students with similar traumatic experiences. Furthermore, the child-made paper bag books can help empower the child to express his or her innermost feelings.

In this paper I argue that close attention should be paid to thechanges that have been taking place in the National HealthService over the last 15 years as a result of governmentalinitiatives. The identification of the direction that the recenthealth reforms have been taking should allow us to drawsignificant conclusions regarding the possible fate that the NHSis facing in the not-too-distant future. The introduction of theinternal market in health care, the Private Finance Initiative,private Diagnostic & Treatment Centres and FoundationTrusts may indicate that the privatization of the NHS hasbegun in earnest. The relevance of such considerations to allNHS workers and users needs to be appreciated, as it may gosome way towards answering the important question of whatkind of NHS we will be having and using in the future. Theimplications for the NHS in general, and for psychotherapyservices in particular, of the insidious but invasive process ofprivatization inherent in the ongoing changes in the structureand funding of the NHS are discussed. [ABSTRACT FROM AUTHOR]

Aim: Suicidal behavior is a serious public health problem and a major cause of death among adolescents. Three categories of major risk factors have been identified: psychological factors, stressful life events, and personality traits. Severe and objective stressful life events (SLEs), such as childhood mistreatment or abuse, have been clearly associated with higher rates of suicide risk. However, the relationship between suicide risk and adolescents' perceptions of the SLE impact is not as clear. This paper studies the relationship between SLE impact perception and suicide risk and the possible mediating role of perceived family functioning in this relationship. The need for longer-term or more intense psychological or psychiatric treatment in relation to SLE impact perception is also addressed. Method: One hundred forty-seven adolescents aged 11–17 were consecutively recruited from the Child and Adolescent Mental Health Outpatient Services Department of a general hospital in Madrid, Spain. Self-informed questionnaires were used to assess suicide risk, SLEs, and family functioning. In addition, the clinical records of the participants were consulted to collect information about their treatment histories, including the number of appointments and the duration of follow-up. Results: SLE impact perception correlates significantly with suicide risk, the number of clinical appointments, the duration of treatment, and the perceived level of family functioning. The mediation model of the family functioning perception variable in the relationship between SLE impact perception and suicide risk is significant. The linear regression model of SLE impact perception and family functioning perception on suicide risk is also significant, accounting for 25.7% of the variance. Conclusions: Beyond the clear and proven effect of serious and objective SLEs, the perceived impact of SLEs reported by adolescents is related to an increased risk of suicide and more intense psychological and/or psychiatric follow-up. This relationship is mediated by the perceived level of family functioning. Adolescents' perceptions of their life experiences and perceived family support may be key determinants of suicide risk prevention. [ABSTRACT FROM AUTHOR]

The rapid development of cultural tourism in recent years refers to a process of cultural experience of tourist objects with cultural characteristics. It can not only vigorously carry forward the rich and colorful history and cultural deposits, but also combine the huge economic and cultural benefits generated by tourism, and promote the rapid development of cultural construction. Cultural tourism is a kind of way that all kinds of social groups enjoy, and it is a deep and lasting way of communication, which can promote the communication between people of different social strata. The existing literature has explored the influence of tourists' psychological carrying capacity, but failed to explain the process and degree of influence. Based on behavioral and experience theories, this paper proposes that culture has a positive impact on tourists' psychological carrying capacity through tourist experience, and tests relevant hypotheses. The primary psychological traits of historical and cultural tourists include curiosity about historical mysteries, the desire for historical knowledge, motivation to collect spiritual enrichment, academic interest in cultural heritage exploration, and an aesthetic appreciation for classical history. Key determinants include the scale and conservation of historical and cultural resources, their combination with natural attractions, and the personal qualities of tourists and the cultural competence of tour guides. The mental health care model combines tourism and psychology to facilitate both physical and mental well-being through professional psychological counseling services, aiding tourists in their recovery and self-healing. This integrated approach offers a broad scope and potential as an effective tool for addressing negative emotions, with demonstrated therapeutic effects focusing on psychological and social factors. [ABSTRACT FROM AUTHOR]

As the press for services at university counseling centers increases, so does the need to provide optimal therapeutic services. Ethnic glossing in previous research has combined rather disaggregated the mental health treatment experiences of American Latinx (AL) students and International Latinx (IL) students. The purpose of this paper was to examine potential differences in (1) the number of attended sessions, (2) symptom severity, and (3) treatment improvement rates. We used a nationwide dataset including 13,156 AL students and 911 IL students. Results indicated that (1) there was no significant difference in attendance rates, (2) AL students had significantly worse initial symptom severity (d = 0.24), and (3) there were no significant differences in improvement rates. We discuss the importance of understanding the different clinical presentations of AL and IL students, as well as the importance of addressing ethnic glossing in future research and clinical work. [ABSTRACT FROM AUTHOR]

There is a growing body of global research demonstrating the significance of mental health to individuals' overall happiness and productivity. The research evidence has encouraged governmental agencies in the United Arab Emirates (UAE) to divert more attention toward the provision and development of mental health services. As the sector grows, one of the first issues of concern is the adherence to a unified set of ethics of practice. The purpose of this paper is to present and discuss the existing ethical codes of conduct relevant to the mental health profession in the unique context of the UAE. Specifically, this discussion will focus on the interaction of cultural factors with the ethical standards of confidentiality, informed consent, and multiple relationships. This paper provides an initial reference for researchers and practitioners to explore regional issues of ethical standards in mental health services. [ABSTRACT FROM AUTHOR]

This contribution aims to highlight the theoretical and epistemological premises of the co‐writing experience, a practice where a clinician and a patient are mutually engaged in jointly or collaboratively writing a narrative related to the patient's experience. Unlike a typical set of therapeutic techniques, co‐writing is based on sharing perspectives and meanings about the experience of crisis, recovery, and the therapeutic process. The paper identifies and briefly describes four non‐clinical epistemological paradigms on which it is grounded: ethnography, values‐based practice, narrative care, and phenomenology. Although they differ in several ways, at the same time, they seem to share some common features that the paper investigates and comments. For clinicians, nurses, researchers and Mental Health Service managers, attention to the users and to the improvement of their active roles represents not only a strategy for the empowerment of results, but also the access door to a different perspective which relies on a renewed conceptualization of the mental disease nature that may lead to overcoming the epistemic asymmetry between the 'expert' and the 'other' in favor of intersubjective dialogue. [ABSTRACT FROM AUTHOR]

Common mental disorders (CMDs) are prevalent throughout the population. Psychological therapy is often sought via primary care; however, equitable access is not commonplace. This review aims to investigate the barriers and facilitators adults experiencing CMDs perceive when accessing evidence-based psychological treatment in England. A qualitative systematic review with meta-synthesis was conducted (PROSPERO CRD42020227039). Seven electronic databases were searched for papers from 2008 to October 2022. Searches identified 30 studies from which three themes were developed with seven subthemes. Stigma and patients' perceptions and understandings of CMDs impacted their help-seeking decision-making and engagement with services. This meant that services were not used as a first resort for help-seeking. Upon reaching services, patients appeared to perceive primary care as not prioritising mental health problems, nor as being the place where they would be supported, particularly as healthcare professionals did not appear to know about CMDs and therapy was seen as difficult to access. The interaction between healthcare professional and patients was seen as pivotal to whether patients accessed support or not. The review is limited to research conducted within England. Additionally, it only explores access barriers prior to treatment experiences. Knowledge, attitudinal, systemic and relational barriers and facilitators were identified. Future research should focus on developing stigma reduction initiatives. Clinical implications include provision of standardised training across primary care HCP (healthcare professionals). • Barriers, such as stigma, are experienced by patients before engaging with services. • Primary care is not viewed as where common mental health disorders are supported. • The patient-healthcare professional relationship is pivotal to accessing support. [ABSTRACT FROM AUTHOR]

Purpose: Bipolar disorder is associated with poor mental and physical health outcomes, and therefore, it is crucial to research and develop effective interventions for this population (Grande et al., 2016). Unfortunately, research on the efficacy of current interventions shows only small improvements in symptoms and quality of life (Oud et al., 2016). Additionally, individuals with bipolar disorder face barriers to accessing care like social stigma, isolation and financial constraints (Blixen et al., 2016). This paper aims to introduce and examine the effectiveness of an accessible, peer-led group program, Mood Lifters (Votta and Deldin, 2022), in those who completed the program and also self-reported a diagnosis of bipolar disorder. Design/methodology/approach: Mood Lifters is a 15-week, peer-led group program that approaches mental wellness from a biopsychosocial framework using strategies from a variety of evidence-based treatment methods (e.g. cognitive-behavioral therapy, dialectical behavior therapy, interpersonal psychotherapy, etc.). Participants meet once a week for 1 hour to review various mental health topics, including behavioral changes and insight into mood patterns. Individuals who participated in nonacademic groups in a company setting and self-reported a bipolar diagnosis were surveyed at the beginning and end of their program to measure various aspects of psychological functioning. Findings: Results suggest that these individuals experienced significant improvements in depression, anxiety, social functioning and perceived stress, along with flourishing and positive and negative affect. Originality/value: These findings are promising, given that bipolar disorder is historically difficult to treat (Grande et al., 2016). Based on this preliminary evidence, the authors have developed a Mood Lifters program specifically for individuals with bipolar disorder and are launching a randomized control clinical trial. [ABSTRACT FROM AUTHOR]

A co-design project, consisting of individual and collective design activities, was organized with clients of a mental health service, in order to explore its potential to support people with psychosis. The group met for approximately two hours, weekly, for six months, participating in design activities and collectively deciding on the project purpose and outcome – a boardgame. The experience of one group participant (Anthony) is explored, selected as the first case study within an Interpretative Phenomenological Analytical (IPA) framework. Following IPA's ideographic focus, Anthony's case was purposefully selected, as it portrayed a detailed picture, informing theoretical reflection on designing as therapeutic. The paper includes Anthony's first-hand account, combined with an analysis of data from three semi-structured interviews, photographic evidence and a reflective diary kept by the lead researcher. Results suggest that, for Anthony, design activity: a) helps developing a sense of agency b) is experienced as grounding in reality c) contributes to the development of inter-personal relationships, and d) has a different sense of rhythm than artistic practice. These results are contextualized within literature on the lived experience of psychosis and suggest that designing can be beneficial for people with psychosis, providing the backdrop for further research and practice. [ABSTRACT FROM AUTHOR]

Introduction: Despite children and young people (CYP) with long term conditions (LTCs) having significantly elevated mental health needs, accessing evidence-based psychological support remains difficult. Previous work suggests low-intensity CBT (LICBT) interventions are effective for CYP with mental health needs in the context of LTCs. If embedded in hospitals LICBT may increase access and better integrate physical and mental health care. This new provision is currently being implemented in paediatric hospitals across the UK. A vital part of successful implementation is effective training. The current paper describes hybrid training in LICBT interventions delivered to staff from a range of health care settings. The aim of the study was to analyse the effectiveness of, and satisfaction with, this training. Methods: Two days of hybrid training in LICBT for mental health needs in the context of LTCs were delivered to staff. Attendees were introduced to LICBT strategies to support CYP with anxiety, depression and challenging behaviour. A brief questionnaire and evaluation form were completed before and after training on attendees' understanding of the topics covered and their views of the training (usefulness, relevance, preparedness). Results: Thirteen attendees completed the questionnaire before and after training was completed. Total scores significantly increased from pre-training to post-training. Qualitative feedback indicated the majority found the training highly relevant to their work and enjoyed the hybrid model. Conclusion: These findings support the acceptability and effectiveness of two-day hybrid training as part of enabling a paediatric hospital workforce to deliver psychological support for CYP with LTCs. Future training could consider this format to help overcome barriers to successful implementation. This work highlights the opportunity a new or existing workforce holds in integrating psychological therapies into existing physical health care pathways, coordinating care and ensuring equitable access to mental health support for CYPs, irrespective of their LTCs. [ABSTRACT FROM AUTHOR]

The psychedelic state can be thought about as an interdependent intrapsychic, somatic, interpersonal and spiritual happening which encourages, perhaps both to the relief and dismay of those participating in the experience, the shocking and impressive emergence of one's unconscious desires and traumata's; a state which may be experienced as cathartic or healing, and as anxiety‐provoking and confusing. Often, in clinical trials investigating psychedelics in mental health conditions, these go hand in hand. Amid a renewed, at times hyperbolic, interest in psychedelics as a potential treatment for mental ill health, significant gaps of knowledge remain. Additional studies exploring the impact of the extra‐pharmacological factors and adjunct therapeutic models on treatment outcomes are needed. Drawing from psychoanalytic perspectives, this paper explores points of intersectionality between psychedelic therapy under investigation and psychoanalysis in the context of traumatic stress. To that end, the psychedelic state will be considered an attempt to make the unconscious conscious by immersing self in a bewildering waking‐dream to better tolerate reality; immersing self in a wilful state of vulnerability, to develop trust in one's agency and capacity to trust others; immersing self in an indescribable experience to learn how to redescribe, to self and to others the traumatic past. [ABSTRACT FROM AUTHOR]

The article highlights the conference "Succeeding Laius: Intergenerational Difficulties in Psychotherapy Organizations," which was held in London, England by the Confederation for Analytical Psychology on March 10, 2007. The conference is part an attempt by the Confederation to reflect on turbulence in the organization associated with a transition in leadership from a founder member to a second generation.

Purpose: The purpose of this paper is to explore waiting times in improving access to psychological therapies (IAPT) services before and throughout the COVID-19 pandemic. The paper aims to help develop a better understanding of waiting times in IAPT so that interventions can be developed to address them. Design/methodology/approach: IAPT national data reports was analysed to determine access and in-treatment waiting times before, during and after the COVID-19 pandemic. Time-series data was used to examine referral patterns, waiting list size and waiting times between the period of November 2018 and January 2022. The data covers all regions in England where an IAPT service has been commissioned. Findings: There was a dramatic drop in referrals to IAPT services when lockdown started. Waiting list size for all IAPT services in the country reduced, as did incomplete and completed waits. The reduction in waiting times was short-lived, and longer waits are returning. Practical implications: This paper aims to contribute to the literature on IAPT waiting times both in relation to, and outside of, COVID-19. It is hoped that the conclusions will generate discussion about addressing long waits to treatment for psychological therapy and encourage further research. Originality/value: To the best of the authors' knowledge, there is no published research examining the performance of IAPT waiting times to second appointment. The paper also contributes to an understanding of how IAPT waiting times are measured and explores challenges with the system itself. Finally, it offers an overview on the impact of the COVID-19 pandemic on waiting time performance nationally. [ABSTRACT FROM AUTHOR]

Background: The implementation of new and complex interventions in mental health settings can be challenging. This paper explores the use of a Theory of Change (ToC) for intervention design and evaluation to increase the likelihood of complex interventions being effective, sustainable, and scalable. Our intervention was developed to enhance the quality of psychological interventions delivered by telephone in primary care mental health services. Methods: A ToC represents how our designed quality improvement intervention targeting changes at service, practitioner, and patient levels was expected to improve engagement in, and the quality of, telephone-delivered psychological therapies. The intervention was evaluated following implementation in a feasibility study within three NHS Talking Therapies services through a qualitative research design incorporating semi-structured interviews and a focus group with key stakeholders (patients, practitioners, and service leads) (N = 15). Data were analysed using the Consolidated Framework for Implementation Research (CFIR) and the ToC was examined and modified accordingly following the findings. Results: CFIR analysis highlighted a set of challenges encountered during the implementation of our service quality improvement telephone intervention that appeared to have weakened the contribution to the change mechanisms set out by the initial ToC. Findings informed changes to the intervention and refinement of the ToC and are expected to increase the likelihood of successful future implementation in a randomised controlled trial. Conclusions: Four key recommendations that could help to optimise implementation of a complex intervention involving different key stakeholder groups in any setting were identified. These include: 1-developing a good understanding of the intervention and its value among those receiving the intervention; 2-maximising engagement from key stakeholders; 3-ensuring clear planning and communication of implementation goals; and 4-encouraging the use of strategies to monitor implementation progress. [ABSTRACT FROM AUTHOR]

This paper offers a preview of a forthcoming article on the world's first, universal free‐to‐access, evidence‐based talking therapies programme to treat depression: Improving Access to Psychological Therapies. It was pioneered not in the USA, but the UK, in 2007. At one time it could have been led by psychoanalysts, but it wasn't. It was a New Deal, in fact, for CBT. But did this New Deal in 2007 also offer psychoanalysis an opportunity to renew its vitality as a discipline, after decades of being eroded by our long‐term retreat into private practice? Illustrated in the film From Here to Eternity, through characters played by Burt Lancaster, Montgomery Clift and Frank Sinatra, this Preview shows how applied psychoanalysis can once again aspire to become a universal, genuinely popular, relevant professional discipline. How would we engage ethically with psychiatric casualties of war, for example, within an evidence‐based practice framework today? A novel, brief psychoanalytic treatment for depression, Dynamic Interpersonal Therapy, was developed for use in the UK's Improving Access to Psychological Therapies (IAPT) programme. It is recommended by NICE (National Institute for Health and Care Excellence) as cost‐effective for treating depression. By engaging with evidence‐based practice in this way—as Street Level Bureaucrats—we can reclaim our position at the centre of contemporary publicly funded mental health services. [ABSTRACT FROM AUTHOR]

In the past decade, technological advancements in mental health care have resulted in new approaches and techniques. The proliferation of mobile apps and smartphones has significantly improved access to psychological self-help resources for individuals. In this paper, a narrative review offers a comprehensive overview of recent developments in mental health mobile apps, serving as a foundation to introduce the design and development of "Safer". Safer is a mobile application that targets the transdiagnostic process of emotion dysregulation. The review outlines the theoretical framework and design of Safer, an mHealth app grounded in the Dialectical Behavior Therapy (DBT) model, aimed at fostering emotion regulation skills. [ABSTRACT FROM AUTHOR]

The training system in clinical psychology in Spain is a process that will test the adaptability of trainees to the limit, especially if they do not have adequate supervision and institutional support. Aware of this issue, the present paper aims to normalize the complexity of training as a clinical psychologist in Spain, placing special emphasis on the first steps as a trainee in the Spanish National Health System and on the personal challenges involved. Moreover, it seeks to increase sensitivity and awareness about the importance of establishing measures that enable trainees to survive clinical psychology. Therefore, the state of the art on the topic of self-care within the field of clinical psychology and psychotherapy is discussed from the perspective that better trained specialists will improve the National Health System and mental health care for the most vulnerable people. [ABSTRACT FROM AUTHOR]

Limited evidence exists for the effectiveness of psychological interventions that target the mental health needs of people who use forensic mental health services. Capturing service users' perspectives and experiences may provide information helpful to understanding why this is the case. It may also provide information that could help to improve the effectiveness of such interventions with this population. This paper aimed to address this and reviewed qualitative studies to identify the factors that are considered important to the effectiveness of interventions from the perspectives of service users. A review of the literature was conducted and eleven papers were identified as meeting the inclusion criteria. A meta-ethnography approach was used to synthesize the data. Six super-ordinate themes emerged which were synthesized into a hierarchy of treatment based on two main categories: "Treatment Foundations" and "Treatment Benefits." The findings suggested that addressing the Treatment Foundation factors such as enabling informed decision-making; developing trusting therapeutic relationships; and providing accessible materials whilst considering service user preferences can in turn result in service users benefitting from treatment in a number of ways. The findings have significant implications for future research, mental health service providers, clinicians and therapists, and for those who design therapeutic interventions. [ABSTRACT FROM AUTHOR]

It is well documented that there is a shortage of mental health care providers, mental health literacy, and underutilization of mental health services in Pakistan. This systematic review aimed to assess the available evidence on factors hindering and/or facilitating access to care among people with mental health issues, health care providers, carers, or any other population group (e.g., students, teachers) in Pakistan. Thirteen published studies of barriers and facilitators in Pakistan were identified through nine electronic databases: Ovid MEDLINE, Ovid Embase, Ovid Emcare, CINAHL plus, Proquest Central, PsycInfo, Scopus, Pubmed, and ScienceDirect. Thematic analysis revealed that factors facilitating access to mental health services were trust in the effectiveness of mental health services and acknowledging the seriousness of the problem. However, factors hindering the access were financial issues/constraints, personal issues/other priorities, stigma, low mental health knowledge, side-effects/dissatisfaction from previous treatments, time and distance constraints, reliance on traditional/religious healers, and lack of social (i.e., family and peers) support/encouragement. Findings suggest the need for reducing barriers to and enhancing facilitators of seeking mental health services. To improve help-seeking, the focus of strategies should be on enhancing mental health literacy, lowering stigma, and increasing trust in mental health services' effectiveness. What is known about this topic? There is a scarcity of empirical evidence on mental health and its correlates in Pakistan-a developing country and mental health services are restricted to psychiatry departments of teaching hospitals or in privately run clinics. There is a scarcity of psychiatrists in rural areas having 60% population and there is a need for recognizing facilitators and reducing barriers to reasonable mental health care is crucial. What the paper adds: Factors facilitating access to mental health services were trust in the effectiveness of mental health services and acknowledging the seriousness of the problem. Factors hindering the access were financial issues/constraints, personal issues/other priorities, stigma, low mental health knowledge, side-effects/dissatisfaction from previous treatments, time and distance constraints, reliance on traditional/religious healers, and lack of social (i.e., family and peers) support/encouragement. This recognition can help to design adequate programs and policies for people with mental health issues. There is a need to raise public awareness of the importance of seeking mental health services as well as for designing, testing, and executing strategies to reduce self and social stigma related to mental health problems. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the extent to which principles of recovery-oriented practice are evident in the published perspectives and experiences of health professionals and service users on seclusion in adult mental health services. Design/methodology/approach: A systematic review informed by PRISMA guidelines was conducted, drawing from four databases, which were searched in August 2018 and August 2022. Only original empirical studies rated as having "major" relevance were included. Data were extracted from 31 studies and qualitatively synthesised through deductive analysis using recovery principles as themes. Findings: There was limited evidence of perceptions of seclusion being being consistent with recovery principles, with greater evidence of perceptions that directly opposed them. Studies of service user perspectives highlighted this more often than staff perspectives. The findings highlight paradoxical relationships between care and control and conflicting rights and emphasise the need to openly acknowledge the complexity of seclusion and its interface with recovery. Research limitations/implications: This review was developed in line with international best practice and the protocol was registered. Using a search string with only three components maximised sensitivity during searches and minimised the risk of relevant literature being missed. Limitations include the focus on studies where the full text was published in English. Originality/value: This review makes a unique contribution, highlighting that, to the best of the authors' knowledge, no studies to date have explicitly explored the perspectives and experiences of staff and service users on the use of seclusion in the context of recovery-oriented practice. The findings are relevant to clinical practice, policy and future research, including amending procedures and practices to partially reconcile seclusion and recovery where the seclusion is deemed necessary. [ABSTRACT FROM AUTHOR]

Satisfying daily life functioning is essential in mental healthcare. Standard assessments focus on symptoms and are designed to detect underlying vulnerabilities. However, they offer insufficient insight into patterns of contextual variability and resilience. Consequently, interventions are planned using incomplete information. The experience‐sampling method (ESM) is a structured moment‐to‐moment diary assessing the individual's affect, thoughts, perception and behaviour in the daily life context. ESM helps to understand variation in mental states (e.g., anxiety or sleeping problems) as adaptational processes in relation to contextual challenges (functional analysis). Although ESM has been extensively studied across psychological disorders, the adoption by mental health professionals and their patients remains limited because the 'how to' is unclear. This paper presents a practical guide for ESM application in routine clinical care. It integrates empirical knowledge with expert experiences and provides real‐world examples and recommendations for successful implementation. The guide comprises how to engage and motivate patients and how to customize assessments to the patient's needs. It also includes instructions to interpret results and create an atmosphere of shared decision‐making. Experience‐sampling technology has merits for patients with various mental health complaints and across healthcare settings, although the exact use and implementation may vary depending on the individual case. [ABSTRACT FROM AUTHOR]

The beginning of a full-scale invasion of Russian troops into Ukraine became a traumatic event of a powerful force for all the population of Ukraine. In the face of cruel military aggression, the need to develop a comprehensive approach to maintaining, preserving and restoring the psychological health of different segments of the population is becoming increasingly urgent. Day after day is increasing the need for competent and timely psychological intervention in the preparation of people for numerous trials. The problem of increasing the social and adaptive capabilities of a person, which involves the development of psychologically sound and empirically proven interventions that would restore the psychological health of the victims due to prolonged traumatization and has interfered with further complications. This paper examines and shows how war has changed people's life, routine and psychological first aid. The article emphasizes that the solution to problems with psycho-trauma lies not only in the development of the social protection system in Ukraine, a network of institutions that take care of mental health issues, and the training of specialists in methods of diagnosis and psycho-correction but also in work in society to change entrenched stereotypes. People need to know more about psychological trauma, post-traumatic syndrome, and ways to provide first aid because, unfortunately, psycho-trauma is a part of life, especially nowadays. The research deeply highlights the social and emotional effects of psycho trauma and aims to develop a comprehensive approach to preserving and restoring the psychological health of the individual who has suffered from prolonged hostilities and their consequences. To achieve this goal, it is necessary to solve the following tasks: to develop theoretical and methodological foundations of technologies for the restoration of psychological health of personality; to investigate the technologies of social and psychological rehabilitation of participants of hostilities, internally displaced persons, and the population of Ukraine, which was affected as a result of military aggression of the Russian Federation; identify ways of mobilizing personality resources that ensure the effectiveness of social and psychological rehabilitation. [ABSTRACT FROM AUTHOR]

Objective. The purpose is to understand the depression status of the elderly in the community, explore its influencing factors, formulate a comprehensive psychological intervention plan according to the influencing factors, implement demonstration psychological intervention, and evaluate and feedback the effect, so as to provide a reference for improving the mental health of the elderly. Method. In order to make the output of different emotional data in LSTM more discriminative, a method to dynamically filter the output of LSTM is proposed. Combining the methods of Attention-LSTM, time-dimensional AI attention, and feature-dimensional AI attention, the best model in this paper is obtained. The multistage stratified cluster sampling method was used to conduct a questionnaire survey on the elderly aged 60 and above in a certain area, including the general demographic characteristics questionnaire of the elderly, the self-rating scale of mental health symptoms, and the health self-management ability of adults. All data were entered into a database using Excel software, and SPSS 19.0 statistical software was used for statistical analysis. Results/Discussion. The detection rate of depression (GDS ≥ 11 points) among the elderly in a community in a certain area was 39.38%. Multivariate logistic regression analysis showed that family history of mental illness, more negative life events, decreased ability of daily living, living alone, and suffering from physical diseases in the past six months were the risk factors for depression in the elderly. Community health education can partially alleviate depression in the elderly. The detection rate and degree of depression of the elderly in the comprehensive psychological intervention group were significantly lower than those in the control group, and the difference was statistically significant (P < 0.05). [ABSTRACT FROM AUTHOR]

In this paper, the authors describe how patients and therapists may, paradoxically, perceive a greater sense of closeness as a result of the physical distance inherent in conducting psychotherapy over synchronous video telehealth. Case material is used to illustrate ways in which tele-psychotherapy facilitated engagement, strengthened the alliance, and created unique therapeutic opportunities that may not be possible when therapy is conducted in person. This paper aims to challenge preconceived notions about the ability to develop a strong therapeutic relationship with patients and implement lasting change through tele-psychotherapy. Implications for future clinical work are discussed, with particular consideration of the recent COVID-19 outbreak's influence on psychotherapy. [ABSTRACT FROM AUTHOR]

Background: Quality of care and access to effective interventions have been widely criticised as limited for people diagnosed with 'personality disorder' or who have comparable needs (described in some recent papers as "Complex Emotional Needs" (CEN). It is important to identify effective interventions and the optimal context and mode of delivery for people with CEN. We aimed to investigate the effectiveness of psychosocial interventions delivered in community and outpatient settings in treating symptoms associated with 'personality disorder', and the moderating effects of treatment-related variables. Methods: We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, HMIC, ASSIA for articles published in English, from inception to November 23, 2020. We included randomized controlled trials examining interventions provided in community or outpatient settings for CEN. The primary outcome was 'personality disorder' symptoms, while secondary outcomes included anxiety symptoms, depressive symptoms, and global psychiatric symptoms. Random-effects meta-analysis was conducted for each outcome, and meta-regression analysis was performed to assess the moderating effects of treatment characteristics. The quality of the studies and the degree of publication bias was assessed. Results: We included 54 trials (n = 3716 participants) in the meta-analysis. We found a large effect size (g = 0.78, 95% CI: 0.56 to 1.01, p < 0.0001) favoring interventions for 'borderline personality disorder' (BPD) symptoms over Treatment as Usual or Waitlist (TAU/WL), and the efficacy was maintained at follow-up (g = 1.01, 95% CI: 0.37 to 1.65, p = 0.002). Interventions effectively reduced anxiety symptoms (g = 0.58, 95% CI: 0.21 to 0.95, p = 0.002), depressive symptoms (g = 0.57, 95% CI: 0.32 to 0.83, p < 0.0001), and global psychiatric symptoms (g = 0.50, 95% CI: 0.35 to 0.66, p < 0.0001) compared to TAU/WL. The intervention types were equally effective in treating all symptom categories assessed. Treatment duration and treatment intensity did not moderate the effectiveness of the interventions for any outcome. Conclusions: People with a 'personality disorder' diagnosis benefited from psychological and psychosocial interventions delivered in community or outpatient settings, with all therapeutic approaches showing similar effectiveness. Mental health services should provide people with CEN with specialised treatments in accordance with the availability and the patients' preferences. [ABSTRACT FROM AUTHOR]

Maternal depression negatively impacts child mental health and is a well-known risk factor for child psychopathology. However, maternal depression treatment and child mental health treatment are rarely integrated. The purpose of this review was to assess the impact of maternal depression on child mental health treatment, including (1) how treatment of maternal depression affects child mental health outcomes, (2) the impact of maternal depression on children receiving mental health care, and (3) emerging models that address maternal depression in primary-care pediatrics and child mental health settings. A systematic literature review was conducted using PubMed and PsycInfo. Initial search yielded 224 records, and after exclusion, 29 papers were reviewed. Effective treatment of maternal depression is associated with a significant decrease in child psychiatric symptoms. Maternal depression negatively affects child mental health treatment in that there is a high rate of untreated mental illness among mothers of psychiatrically ill children, and maternal depression impedes effective child mental health treatment. Current models to address maternal depression in child settings include screening in pediatric primary care, psychotherapy for depressed mothers of psychiatrically ill children, and emerging models that integrate maternal and child mental health treatment. Effective treatment of maternal depression significantly improves child mental health and should be better integrated into child treatment. Opportunities to improve care include more robust screening for parental mental illness, supports to refer parents to psychiatric care, and on-site services for parents. Such interventions hold promise, but require significant support from a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Research and practice in the area of mental health has been conventionally predominated by the deficit-based approach, which attempts to improve lives by fixing symptoms. However, the growing impact of the positive psychology movement in the last two decades has resulted in incorporation of the strength-based approach into mental health work. The objective of this article is to (i) emphasize the efficacy of strength-based approach in the area of mental health (ii) identify shortcomings in the Indian Mental Health System (MHS) (iii) recognize micro-level initiatives in the MHS and (iv) provide recommendations for the future. These objectives are accomplished via reflections obtained from an ethnographic research with participants reporting mental health symptoms. Additionally, opinions gathered from mental health professionals, and government and non-government organizations working in the area were also considered. This work has shed light on the recent micro-level transformations in the system including contextualization of mental illness and treatment, valuing patient's input in the treatment process, and the creation and effective functioning of mental health task-forces. This paper concludes with a four-point recommendation that can help to incorporate the strength-based approach in MHSs for better outcomes. [ABSTRACT FROM AUTHOR]

People with severe mental disorders report significantly poorer physical health and a higher mortality rate compared with the general population. Several interventions have been proposed in order to challenge this mortality gap, the promotion of physical activities represents one of the most important strategies. In fact, in people with severe mental disorders, physical activity can improve body composition, quality of life, personal functioning, self-esteem, cognition, and cardiorespiratory fitness, as well as reducing affective, psychotic and anxiety symptoms, cardiometabolic burden and increase the global recovery. While sport-based programs are consistently being proposed as an integral part of effective personalized treatment approaches for people with severe mental disorders, their routine implementation is hampered by poor working task integration among different professionals and the lack of training programmes for sport professionals focused on people with severe mental disorders. In this paper, we will: (a) review the efficacy of exercise/sport-based interventions for people with severe mental disorders; (b) describe the main difficulties in engaging patients with severe mental disorders in these interventions; and (c) report the results of the first study on the best practices available in Europe in the field of sport and mental health carried out in the context of the European Alliance for Sport and Mental Health (EASMH) project. According to the EASMH survey, sport-based psychosocial interventions are not frequently available in mental health services, with significant differences at the European level. In the near future, it would be advisable to promote the integration and collaboration between mental health professionals and sport professionals, in order to improve the dissemination and availability of sport-based interventions in routine clinical practice. The EASMH project aims to fill this gap by creating a network of collaborators, researchers and stakeholders with different backgrounds in order to improve the dissemination of sport-based rehabilitation interventions and by developing an innovative training programme for sport coaches in order to improve their skills in interacting and building an effective relationship with people with severe mental disorders. [ABSTRACT FROM AUTHOR]

In order to explore the real effect of art mental health therapy, this paper proposes a feature selection algorithm based on genetic algorithm. The algorithm takes college students as the research object and discusses the effect of psychotherapy on college students through painting art therapy. The results showed that there were extremely significant differences in EPQ extraversion factors among the people treated with the educational intervention of art psychology course (P < 0.01), and there was no significant change in other factors (P > 0.05). There was no significant change in total depression score and depression index (P > 0.05). There were significant differences in social avoidance factors and social anxiety (P < 0.05), and there were relatively significant differences in the total score of sadness (P < 0.01). It is concluded that the use of artistic elements can effectively help people express themselves and express their psychological emotions, which has a certain effect in mental health treatment. [ABSTRACT FROM AUTHOR]

The article introduces an article in the series about the treatment resistance and patient authority at the Austen Riggs Center in Stockbridge, Massachusetts. It notes that the paper explores and illustrate the work of treatment teams as an adjunctive therapeutic psychoanalysis modality as an approach for treatment resistant patients at the center.

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.

In the case of psychological treatments, these outcome monitoring tools consist of psychological self-report scales (patient-reported outcome measures, PROMs), which are filled out by the patient usually before each session to capture ongoing therapeutic change. Routine outcome monitoring (ROM) is the regular assessment of patient outcomes to evaluate clinical progress during the course of therapy. Idiographic patient reported outcome measures (I-PROMs) for routine outcome monitoring in psychological therapies: Position paper. [Extracted from the article]

Background: Major depressive disorder (MDD) is a leading cause of morbidity and mortality. Shortfalls in treatment quantity and quality are well-established, but the specific gaps in pharmacotherapy and psychotherapy are poorly understood. This paper analyzes the gap in treatment coverage for MDD and identifies critical bottlenecks. Methods: Seventeen surveys were conducted across 15 countries by the World Health Organization-World Mental Health Surveys Initiative. Of 35 012 respondents, 3341 met DSM-IV criteria for 12-month MDD. The following components of effective treatment coverage were analyzed: (a) any mental health service utilization; (b) adequate pharmacotherapy; (c) adequate psychotherapy; and (d) adequate severity-specific combination of both. Results: MDD prevalence was 4.8% (s.e., 0.2). A total of 41.8% (s.e., 1.1) received any mental health services, 23.2% (s.e., 1.5) of which was deemed effective. This 90% gap in effective treatment is due to lack of utilization (58%) and inadequate quality or adherence (32%). Critical bottlenecks are underutilization of psychotherapy (26 percentage-points reduction in coverage), underutilization of psychopharmacology (13-point reduction), inadequate physician monitoring (13-point reduction), and inadequate drug-type (10-point reduction). High-income countries double low-income countries in any mental health service utilization, adequate pharmacotherapy, adequate psychotherapy, and adequate combination of both. Severe cases are more likely than mild-moderate cases to receive either adequate pharmacotherapy or psychotherapy, but less likely to receive an adequate combination. Conclusions: Decision-makers need to increase the utilization and quality of pharmacotherapy and psychotherapy. Innovations such as telehealth for training and supervision plus non-specialist or community resources to deliver pharmacotherapy and psychotherapy could address these bottlenecks. [ABSTRACT FROM AUTHOR]