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This mixed-methods study evaluated early implementation outcomes of Resilience Alliance (RA), an intervention delivered to child welfare professionals. RA included 12 sessions that were held for 60–90 minutes. Sessions focused on teaching participants skills to cope with secondary traumatic stress and increase resilience such as emotion regulation, cognitive reframing, and mindfulness. Findings indicated high adoption and moderate feasibility. Most participants (83.6%) completed RA. Findings from semi-structured focus groups identified three themes that highlighted supports and barriers that occurred individually, organizationally, and systemically and influenced the adoption and feasibility of the intervention. Additionally, results demonstrated that participants' experiences differed by job role. [ABSTRACT FROM AUTHOR]

Stereotactic body radiation therapy (SBRT) and hypofractionation using pencil-beam scanning (PBS) proton therapy (PBSPT) is an attractive option for thoracic malignancies. Combining the advantages of target coverage conformity and critical organ sparing from both PBSPT and SBRT, this new delivery technique has great potential to improve the therapeutic ratio, particularly for tumors near critical organs. Safe and effective implementation of PBSPT SBRT/hypofractionation to treat thoracic malignancies is more challenging than the conventionally fractionated PBSPT because of concerns of amplified uncertainties at the larger dose per fraction. The NRG Oncology and Particle Therapy Cooperative Group Thoracic Subcommittee surveyed proton centers in the United States to identify practice patterns of thoracic PBSPT SBRT/hypofractionation. From these patterns, we present recommendations for future technical development of proton SBRT/hypofractionation for thoracic treatment. Among other points, the recommendations highlight the need for volumetric image guidance and multiple computed tomography–based robust optimization and robustness tools to minimize further the effect of uncertainties associated with respiratory motion. Advances in direct motion analysis techniques are urgently needed to supplement current motion management techniques. [ABSTRACT FROM AUTHOR]

AbstractSurvivors of sexual violence often experience short-and long-term mental and physical health conditions due to the victimization. Rape Crisis Centers are community-based advocacy organizations that provide free supportive services to survivors of sexual assault, such as 24-hour crisis hotlines, medical advocacy, individual and group therapeutic services, and victim advocacy services for those with cases within the criminal justice system. However, the efficacy of these services in assisting survivors is not well known, often due to researchers’ lack of access to clients. In this paper, we investigate the experiences of survivors directly from the survivors receiving psychotherapy services from a Rape Crisis Center in an urban jurisdiction in the Midwestern United States. We qualitatively interviewed nine survivors who attended individual and/or group therapy. In-depth analysis showed that four themes emerged regarding their experiences. Two themes pertain to positive outcomes—emotional processing and group therapy dynamics. One theme concerns obstacles. The final theme relates to suggestions for service improvement. The discussion includes summaries of the reflective findings and recommendations for future practice. This research contributes to informing and improving practices and policies to better serve survivors of sexual assault. [ABSTRACT FROM AUTHOR]

Perinatal depression is a serious public health issue among African American adolescents who experience significant racial health disparities in addition to age-related mental and physical health risks. Perinatal depression prevention interventions that specifically target the needs of African American adolescents are warranted. The current study presents the development and preliminary results of an intervention designed to prevent perinatal depression among African American adolescents using the heuristic framework for cultural adaptations. Adaptations were applied to an existing evidence-based cognitive behavioral group intervention to develop the Mothers and Babies Course for African American Adolescents. Adaptations were guided by qualitative data collected from a focus group and individual interviews, and by existing research on specific risk and protective factors that drive engagement with and barriers to interventions for this population. The adapted intervention was piloted with 7 pregnant and 21 postpartum African American adolescent students at four different public high schools in an urban city in the United States. The Edinburgh Postnatal Depression Scale was used to assess pre- and post-intervention perinatal depression scores. Accessibility and feasibility were assessed using participant and observer evaluations, respectively. Results indicated reductions in pre- to post-intervention depression scores and high acceptability and feasibility of the pilot study. Additional adaptations of the intervention based on qualitative feedback from study participants are discussed. Future development and implementation of the intervention provides an opportunity to reduce a mental health disparity that disproportionately affects African American adolescents. Highlights: Perinatal depression is a serious public health issue among African American adolescents who experience significant racial health disparities in addition to age-related mental and physical health risks. Introduces adaptation methods and results of an intervention pilot-study designed to prevent perinatal depression among African American adolescents. The intervention was adapted from an existing evidence-based perinatal depression prevention intervention using the heuristic framework for cultural adaptations. [ABSTRACT FROM AUTHOR]

The article highlights the importance of culture in the development of psychoanalytic theory and practice, especially in collectivist cultures. It mentions the difference between collectivist and individualist cultures in terms of values and ways of relating. Additionally, it suggests that studying the culturally conditioned mother-group in collectivist individuals can offer possibilities for research in various areas. The text also discusses the relationship between the mother, the group, and the child in collectivist culture, and how this relationship can vary in different cultures. The relationship between the patient and the group is discussed in the context of therapy, emphasizing the importance of understanding and addressing cultural dynamics in individual or group psychoanalytic therapy with patients from a collectivist background. The article focuses on the case of a single immigrant mother in the United States who exhibits unusual behaviors in her relationship with her child's daycare staff, and how the conflict was resolved by considering cultural factors. [Extracted from the article]

Refugee newcomers resettled in the United States face numerous challenges impacting their mental health and overall well-being. Despite extensive research on clinical interventions, multimodal interventions with peer-based group models in resettlement contexts remain scarce. Adopting a realist evaluation approach, this study aims to conduct a comprehensive implementation evaluation of a complex community-based mental health and psychosocial support (CB-MHPSS) group intervention, examining its mechanisms and processes while considering the interplay among context, implementing agents, and community settings. Qualitative and quantitative data on the implementation process were collected from 11 refugee agencies, involving trained resettlement staffers (n = 32) and refugee community facilitators (n = 31) who implemented the 31 CB-MHPSS psychosocial groups in 2021. The analysis included fidelity reports, process reflections, and follow-up survey responses, utilizing a structured template based on the CB-MHPSS Theory of Change (ToC) and Medical Research Council (MRC) guidance. Results of an in-depth exploration of complex relations between context and implementation processes reveal the vital role that adaptability to socio-ecological circumstances during the global coronavirus pandemic played in achieving successful implementation of psychosocial group interventions. Striking a balance between fidelity and refinement of intervention of the intervention curriculum emerged as crucial factors for aligning facilitation goals with newcomer needs. This approach maintained the integrity and appropriateness of the intervention, requiring implementers to utilize local knowledge of community resources and their understanding of lived experience of forced migrants and their within the community. Furthermore, exploring intervention barriers and facilitators revealed merits aligned with program change theories and areas for adjustment, while cataloged guidelines addressed community needs, showcasing competence beyond standard checkboxes. Strategic dissemination guidance provided by the central office in a supportive and nonintrusive manner facilitated uptake in a participatory and context-specific manner. This study emphasizes the importance of leveraging community partnerships and local knowledge to result in sustained improvements in the mental health and well-being of refugees. [ABSTRACT FROM AUTHOR]

Primary progressive aphasia (PPA) is a language-prominent dementia that fundamentally impacts the lives of not only the person with the diagnosis, but also their family members. While assuming a caregiving role, care partners are vulnerable to negative health and psychosocial consequences of their own. Support groups are one way to meet the needs of care partners, providing opportunities for individuals with common experiences to socialize, obtain knowledge about disorders, and learn coping strategies. Given that PPA is rare and that in-person support groups are sparse in the United States, there is a need for alternative meeting modalities, to overcome the limitations imposed by relative scarcity of potential participants, lack of appropriately-trained clinical professionals, and the logistical demands faced by overburdened care providers. Telehealth-based support groups provide care partners with opportunities to connect virtually with other care partners; however, research regarding their feasibility and benefit is limited. This pilot study investigated whether a telehealth-based support group for care partners of persons with PPA is feasible and yields benefits in psychosocial functioning. Ten care partners of persons with PPA (7 females; 3 males) participated in a group intervention comprising psychoeducation about relevant topics, followed by group discussion. Meetings were held twice monthly for four months via teleconference. All participants completed pre- and post-intervention measures to examine support group satisfaction as well as psychosocial functioning, including quality of life, coping, mood, and caregiving perception. Consistent group member participation across study phases supports the feasibility of this intervention model. Quantitative results from paired-samples permutation tests indicate no significant changes from pre- to post-intervention on psychometrically-validated psychosocial measures. Qualitatively, results from an in-house Likert-type survey indicate positive outcomes in quality of life, social support, caregiving skills, and psychoeducation. Relatedly, post-intervention themes derived from a thematic analysis of written survey responses included: Enhancing knowledge about PPA, feeling connected and mutually supported, and desire for more time together. Consistent with existing literature evaluating virtually-delivered care partner support groups in dementia and other acquired medical conditions, findings from this study support the feasibility and benefit of telehealth-based support groups for care partners of persons with PPA. [ABSTRACT FROM AUTHOR]

Objective: The overarching goal of this review is to provide a clinical overview of epidemiology, diagnosis, and treatment, and to discuss the public health impact, social determinants including access to care, and implications for health care delivery and research. It is estimated that approximately 1 in 4 individuals suffering from a serious mental illness (SMI) may have a co‐occurring opioid use disorder (OUD). In these individuals, the overall disease burden is higher and clinical outcomes are worse compared to those without a co‐occurring illness, making an integrated approach to diagnosis and treatment an urgent priority. Methods: We conducted a selective review of the literature to investigate prevalence, etiology for co‐occurring OUD and SMI, and diagnostic and clinical guidelines in the United States, and consideration special populations. Findings: Our findings suggest that, despite the high prevalence of co‐occurring OUD and SMI, contemporary diagnostics and treatment approaches are underutilized in this patient population. The literature also suggests that both pharmacological and psychosocial treatment approaches need to be tailored to optimize clinical management, and that integrated treatment is pivotal for improving overall outcomes, yet comprehensive clinical guidelines for co‐occurring OUD and SMI are lacking at this time. [ABSTRACT FROM AUTHOR]

Background: Early interventions are needed to support the behavioral health of healthcare staff in the context of the COVID-19 pandemic. Stress First Aid (SFA) is a self-care and peer support model for reducing burnout and stress that is designed for use in high-stress occupations. Methods: We conducted a mixed-methods evaluation of an SFA program in the Veterans Health Administration (VHA). This brief, multi-session, didactic program was adapted for hospital workgroups. Program attendees completed a survey assessing implementation outcomes, burnout, stress, mood, and SFA skills at the beginning (N = 246) and end (n = 94) of the SFA program and a subgroup (n = 11) completed qualitative feedback interviews. Findings: Program acceptability, appropriateness, and feasibility were rated highly. From pre- to post-SFA, the impact of the pandemic on stress and anxiety, as well as proficiency in supporting peers increased. Qualitative findings suggest the program provided a shared language to discuss stress, normalized stress reactions, met a need for stress management tools, and helped staff feel valued, empowered, connected with each other. Staff reported being more aware of their stress, but SFA was insufficient to address many of the systemic sources of burnout and stress. Conclusions and Applications to Practice: While the SFA program was well received, the impact of brief programs is likely to be modest when implemented in the middle of an ongoing pandemic and when burnout arises from chiefly from systemic sources. Lessons learned during the program implementation that may guide future efforts are discussed. [ABSTRACT FROM AUTHOR]

Importance: Some autistic adults experience depression and anxiety related to their social relationships. There is a need for evidence-based occupational therapy interventions that decrease depression and anxiety and improve the health of social relationships for autistic adults. Objective: To determine the feasibility and preliminary effectiveness of the Healthy Relationships on the Autism Spectrum (HEARTS) intervention, a six-session, group-based psychoeducational intervention for the improvement of relationship health. Design: One-group pretest–posttest design with a 3-mo follow-up after baseline. Setting: United States; online intervention through community organization. Participants: Fifty-five adults, ages 20 to 43 yr, with a professional or self-diagnosis of autism and the capacity to independently participate in an online, group-based, participatory class. Intervention: Participants received 6 90-min weekly sessions that addressed healthy relationship topics, including recognizing abuse, meeting people, maintaining relationships, setting interpersonal boundaries, neurohealth for relationships, and ending relationships. A psychoeducational approach that provided education and involved guided discovery and strategy acquisition was used. Outcomes and Measures: All measures were self-administered through an online survey. Depression and anxiety were assessed using instruments from the Patient-Reported Outcomes Measurement Information System. Results: Fifty-five participants completed the intervention. Postintervention scores revealed statistically significant improvements in depression and anxiety. Conclusions and Relevance: HEARTS is a promising intervention for improving depression and anxiety among autistic adults and should be investigated further. What This Article Adds: HEARTS offers a potentially effective, nonpharmacological, psychoeducational group-based intervention option to promote healthy relationships for autistic adults. Positionality Statement: This article uses identity-first language (autistic person) in accordance with the preference of autistic self-advocates (Autistic Self Advocacy Network, 2020; Kenny et al., 2016; Lord et al., 2022). Healthy Relationships on the Autism Spectrum (HEARTS) offers a potentially effective, nonpharmacological, psychoeducational group-based intervention option to promote healthy relationships for autistic adults. [ABSTRACT FROM AUTHOR]

The prevalence of depression and the use of antidepressant medications have risen steadily in the United States over the past three decades. Antidepressants are the most commonly prescribed medications for U.S. adults 20 to 59 years of age. Second-generation antidepressants (e.g., selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, serotonin modulators, atypical antidepressants) are first-line therapy for depression. Psychotherapy, including cognitive behavior therapy and other types of individual and group therapy, is also a first-line treatment. The combination of medication and psychotherapy is preferred for severe depression. Treatment history, comorbidities, costs, and risk of adverse effects should be considered when choosing an antidepressant medication. Although many patients use antidepressants indefinitely, few studies have examined safety and effectiveness beyond two years. There is an increased risk of relapse or recurrence of depressive symptoms when an antidepressant is discontinued, compared with continued use. Gradually tapering the dosage while concurrently providing cognitive behavior therapy can decrease this risk. High-quality evidence on antidepressant use in pregnancy is lacking. Depression and use of antidepressants are both associated with preterm birth. (Am Fam Physician. 2023; 107(2): 173–181. Copyright © 2023 American Academy of Family Physicians.) The prevalence of depression and the use of antidepressant medications have risen steadily in the United States over the past three decades. Antidepressants are the most commonly prescribed medications for U.S. adults 20 to 59 years of age. Second-generation antidepressants (e.g., selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, serotonin modulators, atypical antidepressants) are first-line therapy for depression. Psychotherapy, including cognitive behavior therapy and other types of individual and group therapy, is also a first-line treatment. The combination of medication and psychotherapy is preferred for severe depression. Treatment history, comorbidities, costs, and risk of adverse effects should be considered when choosing an antidepressant medication. Although many patients use antidepressants indefinitely, few studies have examined safety and effectiveness beyond two years. There is an increased risk of relapse or recurrence of depressive symptoms when an antidepressant is discontinued, compared with continued use. Gradually tapering the dosage while concurrently providing cognitive behavior therapy can decrease this risk. High-quality evidence on antidepressant use in pregnancy is lacking. Depression and use of antidepressants are both associated with preterm birth. [ABSTRACT FROM AUTHOR]

Utilization of telehealth modalities to provide cognitive and behavioral therapies is rapidly increasing. Limitations to access to care can prohibit individuals from getting the care they need, especially evidence-based treatments. In the U.S., Veterans are a population in great need of accessible and high-quality evidence-based psychotherapy for insomnia, as it often co-occurs with other common syndromes such as depression and PTSD. Cognitive Behavioral Therapy for Insomnia (CBT-I) offers effective treatment for insomnia and can be delivered via telehealth and in a group format to greatly increase availability and accessibility. To date, however, few programs exist offering telehealth-to-home CBT-I, fewer still are offered in a primary care setting, and none to our knowledge are offered in group format. We examine the feasibility and efficacy of a fully telehealth-to-home (TTH) group CBT-I pilot program in primary care and compare primary outcomes to those seen in a face-to-face (F2F) format as well as meta-analytic studies of group CBT-I. Primary endpoints, as typically defined such as sleep efficiency (SE) and scores on the insomnia severity index (ISI) appear comparable to those seen in F2F groups in our clinic, and to outcomes seen in the literature. We discuss challenges and strategies for successful implementation of such a program in integrated primary care to increase access and availability of this evidence-based treatment. [ABSTRACT FROM AUTHOR]

Understanding the psychological health of women of color (WOC) in a racialized and gendered society requires accessing, validating, and processing the lived experiences and emotions that stem from interlocking systems of oppression. Despite the importance of responding to the psychological health needs of this population, the group therapy literature on how to design and facilitate group therapy for women of color remains limited. For this reason, the present research aims to identify group therapy-oriented experiences based on data provided by ten women of color group psychotherapists practicing in the United States. Findings from the consensual qualitative research (Hill, 2012) revealed six domains: (a) group development, (b) personal and professional significance, (c) group facilitation behaviors, (d) perceived healing factors, (e) challenges, and (f) advice. Suggestions for future research and recommendations for women of color groups positioned as a wellspring of empowerment, liberation, and psychological health are also discussed. [ABSTRACT FROM AUTHOR]

Background: Mindfulness-based cognitive therapy (MBCT) is an effective group intervention for reducing rates of depression relapse. However, about one-third of graduates experience relapse within 1 year of completing the course. Objective: The current study aimed to explore the need and strategies for additional support following the MBCT course. Methods: We conducted 4 focus groups via videoconferencing, two with MBCT graduates (n = 9 in each group) and two with MBCT teachers (n = 9; n = 7). We explored participants' perceived need for and interest in MBCT programming beyond the core program and ways to optimize the long-term benefits of MBCT. We conducted thematic content analysis to identify patterns in transcribed focus group sessions. Through an iterative process, multiple researchers developed a codebook, independently coded the transcripts, and derived themes. Results: Participants said the MBCT course is highly valued and was, for some, "life changing." Participants also described challenges with maintaining MBCT practices and sustaining benefits after the course despite using a range of approaches (ie, community and alumni-based meditation groups, mobile applications, taking theMBCT course a second time) to maintain mindfulness and meditative practice. One participant described finishing the MBCT course as feeling like "falling off a cliff." Both MBCT graduates and teachers were enthusiastic about the prospect of additional support following MBCT in the form of a maintenance program. Conclusion: Some MBCT graduates experienced difficulty maintaining practice of the skills they learned in the course. This is not surprising given that maintained behavior change is challenging and difficulty sustaining mindfulness practice after a mindfulness-based intervention is not specific to MBCT. Participants shared that additional support following the MBCT program is desired. Therefore, creating an MBCT maintenance program may help MBCT graduates maintain practice and sustain benefits longer-term, thereby decreasing risk for depression relapse. [ABSTRACT FROM AUTHOR]

The goal of this study was to evaluate changes in knowledge, attitudes, and other key suicide prevention issues for substance use disorder (SUD) counselors trained to administer the Preventing Addiction Related Suicide (PARS) module as part of a large-scale clinical trial. PARS is a 3-hour, PowerPoint based intervention designed with and for community SUD agencies for their Intensive Outpatient (IOP) group therapy programs. A previous randomized study of 906 patients from 15 community SUD sites showed positive changes in patients' suicide prevention knowledge, attitudes, and help seeking. Counselor participants completed measures of knowledge and attitudes about suicide and their confidence treating suicidal patients at each step of a large, stepped wedge cluster randomized trial of PARS, including after the final step. Data analysis compared scores in steps prior to counselors' training in PARS with scores in the steps following counselors' PARS training. A total of 126 counselors participated in the study (89 % of those approached; 89–92 % retention across follow-up). Evaluation of both PARS efficacy and the PARS training by SUD counselors was highly rated. Counselor scores after receiving PARS training (vs. scores prior to PARS training) showed greater suicide knowledge, less maladaptive attitudes about suicide, and greater confidence in working with suicidal patients. Based on this rigorous test of PARS training for SUD counselors working in community SUD intensive outpatient programs, PARS training, as well as doing the PARS intervention, was rated as highly effective and acceptable. PARS offers an integrated, brief, engaging, and effective training method to improve suicide care for both SUD counselors and SUD clients. • Counselors are not confident in their ability to help clients experiencing suicide. • Preventing Addiction Related Suicide (PARS) training is experiential. • Training increased counselor's suicide knowledge, attitudes, and confidence. • Counselors found the PARS training effective and fit well into their workload. [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to assess the effects of mental health interventions for children, adolescents, and adults not quarantined or undergoing treatment due to COVID-19 infection.Methods: We searched 9 databases (2 Chinese-language) from December 31, 2019, to March 22, 2021. We included randomised controlled trials of interventions to address COVID-19 mental health challenges among people not hospitalised or quarantined due to COVID-19 infection. We synthesized results descriptively due to substantial heterogeneity of populations and interventions and risk of bias concerns.Results: We identified 9 eligible trials, including 3 well-conducted, well-reported trials that tested interventions designed specifically for COVID-19 mental health challenges, plus 6 other trials with high risk of bias and reporting concerns, all of which tested standard interventions (e.g., individual or group therapy, expressive writing, mindfulness recordings) minimally adapted or not specifically adapted for COVID-19. Among the 3 well-conducted and reported trials, 1 (N  =  670) found that a self-guided, internet-based cognitive-behavioural intervention targeting dysfunctional COVID-19 worry significantly reduced COVID-19 anxiety (standardized mean difference [SMD] 0.74, 95% confidence interval [CI], 0.58 to 0.90) and depression symptoms (SMD 0.38, 95% CI, 0.22 to 0.55) in Swedish general population participants. A lay-delivered telephone intervention for homebound older adults in the United States (N  =  240) and a peer-moderated education and support intervention for people with a rare autoimmune condition from 12 countries (N  =  172) significantly improved anxiety (SMD 0.35, 95% CI, 0.09 to 0.60; SMD 0.31, 95% CI, 0.03 to 0.58) and depressive symptoms (SMD 0.31, 95% CI, 0.05 to 0.56; SMD 0.31, 95% CI, 0.07 to 0.55) 6-week post-intervention, but these were not significant immediately post-intervention. No trials in children or adolescents were identified.Conclusions: Interventions that adapt evidence-based strategies for feasible delivery may be effective to address mental health in COVID-19. More well-conducted trials, including for children and adolescents, are needed. [ABSTRACT FROM AUTHOR]

The State of Tennessee granted appropriations to an urban university in the West Tennessee region to address the needs of at-risk African refugee children and families who have experienced Adverse Childhood Experiences (ACEs). Action oriented research efforts were conducted to address the needs of youth in the local region by developing, implementing, and evaluating a community-based intervention that was not only trauma responsive but culturally competent. The Trauma Healing Club was a treatment package developed and researched for this purpose and offered in an after school support program. This identified intervention utilized an existing evidence-based trauma intervention framework that was adapted to include more culturally responsive processes such as pyramid mentoring and African drumming. This work aimed to evaluate the effectiveness of an integrated trauma-informed practice model for community-based programming and the effectiveness of adapting an existing intervention to better fit the community needs. Results indicated that the adaptation of the trauma-responsive intervention was effective and supportive of the child-participant and his/her family needs –both culturally and as it relates to improved participant functioning post intervention. [ABSTRACT FROM AUTHOR]

Culture can broadly be defined as "the values, norms, and assumptions that guide human action" (Wilson 2008, 14). In contrast with the broader civilian society, the experiences and environments within the military community create a unique cultural subset. The United States armed forces are unified by their primary mission to provide external defense, security, and protection, and each branch (Army, Navy, Marine Corp, Air Force, Coast Guard and National Guard) shares a unique core set of values and norms. Because this culture is so complex and unique, it can sometimes be a challenge for many civilian professionals to work with this community, so having a strong competency in understanding military culture, as well as knowledge of specific conflicts and wars, one is not only able to begin to understand the lives and personalities of our soldiers but also able to recognize that this culture aids in survival. This paper will demonstrate and discuss the importance of competency in military culture when practicing music therapy or other interdisciplinary approaches within the process of group therapy with veterans. Other topics covered will include: issues of social transmission as it relates to transitioning into civilian society; the importance of being a witness to veterans' stories; and facilitators' ethical responsibilities when working with this population. [ABSTRACT FROM AUTHOR]

Purpose An increasing number of workers in the US have chronic health conditions that limit their ability to work, and few worksite interventions have been tested to improve worker coping and problem solving at work. The purpose of this study was to evaluate a worksite-based health self-management program designed to improve workplace function among workers with chronic health conditions. Methods We conducted a randomized, controlled trial of a worksite self-management program ("Manage at Work") (clinicaltrials.gov #NCT01978392) for workers with chronic health conditions (N = 119; 82% female, ages 20–69). Most workers were recruited from the health care or light manufacturing industry sectors. Workers attended a 5-session, facilitated psychoeducational program using concepts of health self-management, self-efficacy, ergonomics, and communication. Changes on outcomes of work engagement, work limitation, job satisfaction, work fatigue, work self-efficacy, days absent, and turnover intention at 6-month follow-up were compared to wait-list controls. Results The most prevalent chronic health conditions were musculoskeletal pain, headaches, vision problems, gastrointestinal disorders, respiratory disorders, and mental health disorders. The self-management program showed greater improvement in work engagement and turnover intent at 6-month follow-up, but there was no evidence of a parallel reduction in perceived work limitation. Trends for improved outcomes of work self-efficacy, job satisfaction, and work fatigue in the intervention group did not reach statistical significance in a group x time interaction test. Conclusions Offering a worksite self-management program to workers with chronic health conditions may be a feasible and beneficial strategy to engage and retain skilled workers who are risking disability. Clinical trial registration: Clinicaltrials.gov #NCT01978392. [ABSTRACT FROM AUTHOR]

Difficulty controlling anger is a significant concern among combat veterans with posttraumatic stress disorder (PTSD), yet few controlled studies have examined the efficacy of anger treatments for this population. This study examined the effects of a group cognitive behavioral therapy (CBT) intervention compared with a group present-centered therapy (PCT) control condition in male and female combat veterans with PTSD. Thirty-six combat veterans with PTSD and anger difficulties began group treatment (CBT, n = 19; PCT, n = 17). Separate multilevel models of self-rated anger, PTSD symptoms, and disability were conducted using data from baseline, each of 12 treatment sessions, posttreatment, and 3- and 6-month follow-up time points. Significant decreases in anger and PTSD symptoms were observed over time, but no significant differences between CBT and PCT were observed on these outcomes. A significant interaction of therapy by time favoring the PCT condition was observed on disability scores. Gender differences were observed in dropout rates (i.e., 100% of female participants dropped out of CBT). Findings suggest that both CBT and PCT group therapy may be effective in reducing anger in combat veterans with PTSD. Results also highlight potential gender differences in response to group anger treatment. [ABSTRACT FROM AUTHOR]

Background. Latinos have lower colorectal cancer (CRC) screening rates compared to other racial/ethnic groups in the United States, despite an overall increase in CRC screening over the past 10 years. To address this disparity, we implemented a promotor -led intervention to increase CRC screening test adherence in community-based settings, connecting community members with a partnering federally qualified health center. Purpose. To evaluate the Juntos Contra el Cáncer /Together Against Cancer (JUNTOS) intervention, by assessing pre–post changes in (1) CRC screening test adherence and (2) CRC knowledge and perceived barriers to CRC screening. We also assessed the feasibility and acceptability of program activities. Method. JUNTOS was a group-based intervention, delivered by promotores (community health workers), to promote CRC screening test adherence among Latino adults. The intervention consisted of a culturally tailored 2½-hour interactive workshop followed by an appointment scheduling assistance from a promotor. Workshop participants were Latino adults (males and females) aged 50 to 75 years who were not up-to-date with CRC screening guidelines. We conducted interviews before and 6 to 9 months after the workshop to assess program outcomes. Results. Of the 177 participants included, 118 reported completing the CRC screening test (66.7%) by 6 to 9 months postintervention. We observed baseline to 6- to 9-month increase in CRC knowledge and lower perceived barriers to obtaining CRC screening. Furthermore, the intervention was found to be feasible and acceptable. Conclusion. Results suggest that JUNTOS can be feasibly implemented in partnership with a federally qualified health center. The current study supports group-based CRC interventions in community and clinic settings. [ABSTRACT FROM AUTHOR]

Summary: As refugees of the war in Southeast Asia, Hmong experienced various traumatic events. Evidence suggests the persistence of psychiatric disorders related to trauma in refugees even after prolonged resettlement in their host country. This systematic review aimed to summarize the mental health literature on the Hmong population with a focus on cultural and social factors. The databases PsycINFO, PsycARTICLES, Social Services Abstracts, Web of Science, and PubMed were reviewed for peer-reviewed articles published up to April 2018. Forty articles were included in the final review. Findings: Results highlight three primary themes: (1) mental health outcomes were associated with a variety of premigration and postmigration factors, (2) group and community-based treatment and interventions provided promising results, and (3) barriers to mental health care were primarily stigma, communication challenges, discrimination, and mental health literacy. The results of this systematic review shed light on the limited and small studies with the Hmong population. Applications: Implications for social work and culture-sensitive research, practice, and policymaking for this population are discussed. [ABSTRACT FROM AUTHOR]

This research comprises three studies conducted in the United States and Poland, investigating predictors of radical action intentions within anti-vaccine movements. The American sample included 252 participants (N1), while the Polish samples had 316 (N2) and 538 (N3) participants. The studies focused on the association between personality traits (meanness, disinhibition, subclinical sadism) and willingness to engage in radical collective action. Building on previous work connecting antisocial tendencies to social behaviours, our research delves into the specific link between non-clinical traits and violent collective actions. Across all studies, positive and significant associations were found between these traits and radical collective action intentions. Notably, our findings highlight that the perception of social norms moderates these relationships. When radical actions are perceived as normative, the link between disinhibition and willingness to choose radical means is stronger and significant. Conversely, when actions are seen as non-normative and unacceptable, the relationship weakens. This moderation effect is consistent in both Poland and the United States, with some observed differences in the strength of indirect effects. The synthesis of insights from personality and social psychology proves vital for a nuanced understanding of collective behaviour. • Dark traits can have an impact on engaging in collective action (CA) intention. • Disinhibition, meanness, and sadism are significant for violent (V) CA intention. • Normalized violence is an important factor for VCA intention. • Perceived group norms act as a moderator between personality and VCA intention. • Both social and personality psychology are important in understanding VCA intention. [ABSTRACT FROM AUTHOR]

This study examined the clinical effects of a brief group experiential therapy treatment centered on psychodrama in a sample of military veterans. The sample (N = 72) comprised male (n = 54) and female (n = 18) United States military veterans (Mage = 44.19, SDage = 12.51) who completed the six-day treatment. Self-reported military-related posttraumatic stress (M-PTSD), anxiety, depression, and quality of life were assessed at baseline (T0), end of treatment (T1), three-month follow-up (T2), and six-month follow-up (T3). Prior combat exposure was also measured at T0, and acceptability and user satisfaction ratings were reported at T1. Within-subjects changes on all outcomes from T0 to T1, T2, and T3 were medium to large in effect size. After controlling for relevant demographic characteristics, prior combat exposure, and baseline multimorbidity, the results revealed significant improvements in clinical symptoms and quality of life from T0 to T1, T2, and T3. A majority of the participants who met criteria for M-PTSD, anxiety, or depression caseness at T0 attained recovery status at T1, T2, and T3. Acceptability and satisfaction ratings were high. The findings offer preliminary evidence supporting the efficacy of the group experiential treatment in sustaining reduced psychological symptoms and improving the quality of life of military veterans. [ABSTRACT FROM AUTHOR]

This systematic review provides an examination of the status of HIV/AIDS prevention interventions for Black, heterosexual women in the U.S. from 2012 to 2019. Using PRISMA guidelines, 28 interventions were identified. Over half of the interventions were: conducted in the southern region of the U.S.; evaluated using a randomized controlled trial; focused on adults; used a group-based intervention delivery; were behaviorally focused and theoretically driven. None included biomedical strategies of PrEP, nPEP, and TasP. Few interventions included adolescent or aging Black women; none included their sex/romantic partners. Future studies dedicated to addressing the specific needs of subpopulations of Black, heterosexual women may provide opportunities to expand and/or tailor current and future HIV/AIDS prevention interventions, including offering participants with options to choose which, and the level of involvement, of their sex/romantic partner(s) in their sexual health decision-making. While strides to improve HIV prevention efforts with Black, heterosexual women have occurred, more is needed. [ABSTRACT FROM AUTHOR]

This study explored the issues around parents' engagement in services at a therapeutic day school. The study site is located within an urban, Midwestern medical center in the United States (US) serving thirty-three students in grades kindergarten through 8th with emotional, social and behavioral disabilities. Parents are expected to be active participants in their child's treatment and family sessions. However, there are instances where parental engagement is poor. To explore the dynamics underlying engagement, the research team conducted semi-structured interviews with parents of children enrolled in the day school. All parents and guardians with a child enrolled at the day school were eligible to participate (N = 32). All sessions were recorded, transcribed and the data analyzed in line with qualitative descriptive methods. Five overarching themes emerged from the data: the "long road" to a therapeutic school, parent's view of their role, service utilization and engagement, discerning what parents value, and the journey continues. With a greater sense of parents' perspective on treatment and expectation for involvement, the clinical staff plan on shaping strategies that improve parent engagement and ultimately student outcomes. [ABSTRACT FROM AUTHOR]

Based on the growing need for music therapy programming at military treatment facilities and clinics that specialize in the rehabilitation of service members, this article describes a music therapy group protocol and the findings of 201 post-session evaluations. In addition, we present clinical perspectives and recommendations from three music therapists who have facilitated this group protocol on four military bases across the United States. The group session outlined in the protocol is intended as an introduction to music therapy. It familiarizes service members to various music therapy experiences specifically structured to enhance feelings of safety during emotional risk-taking. In addition, the protocol functions as an initial assessment of service members' responses to the various receptive and interactive music experiences and includes psychoeducation regarding the role of music therapy in an interdisciplinary treatment model. The post-session evaluation data suggest that service members endorsed this introductory group as moderately to very helpful. Perceived benefits included the opportunity to express various emotions and increased awareness of somatic responses through music. A large number of requests for continued music therapy services following the introductory session suggest that the protocol is successful in facilitating understanding in service members regarding the potential benefits of music therapy in interdisciplinary treatment. Feedback from the music therapists indicated that the group protocol is a helpful initial experience for service members to acclimate to music therapy and for music therapists to learn about their patients' specific needs to inform subsequent treatment. [ABSTRACT FROM AUTHOR]

Background: Perinatal depression is a prevalent public health concern. Although preventive interventions exist, there is limited literature on the acceptability and appropriateness of these interventions, especially those delivered by paraprofessionals. The Mothers and Babies Program (MB) is a group-based perinatal depression preventive intervention delivered prenatally. A cluster-randomized controlled trial examined the acceptability, appropriateness, and effectiveness of MB delivered by mental health professionals compared to paraprofessional staff from home visiting programs.Methods: The full study enrolled 874 pregnant women. Fifty-three facilitators were trained and delivered the MB intervention to women in one of seven states in the United States. Semi-structured interviews were attempted with a randomly-selected subset of the full sample of pregnant women who received the MB intervention and with all facilitators. Specifically, interviews were conducted with 88 women who received the MB group intervention (45 in the paraprofessional-led arm and 43 in the mental health professional-led arm) and 46 women who facilitated the groups (27 home visiting staff and 19 mental health professionals). Interviews were conducted over the phone in English or Spanish and audio recorded. The recordings were translated into English, as needed, and transcribed. Thematic analysis was conducted using NVIVO to identify key themes related to intervention acceptability and appropriateness. Similarities and differences between study arms were explored.Results: Clients and facilitators found the MB content and group format acceptable. Challenges included maintaining group attendance, transportation issues, and managing group discussion. Overall, facilitators found the intervention appropriate for pregnant clients with some challenges presented for clients in crisis situations, experiencing housing instability, and with literacy and learning challenges. Participants provided suggestions for improvement, both for the course content and implementation. There were no significant differences found between study arms.Conclusions: Overall, clients and facilitators enjoyed MB irrespective of study arm, and facilitators found the intervention appropriate for the population. These findings add to the qualitative literature on perinatal depression preventive interventions, specifically those delivered by paraprofessionals.Trial Registration: This trial is registered on ClinicalTrials.gov (Initial post: December 1, 2016; identifier: NCT02979444). [ABSTRACT FROM AUTHOR]

Objectives: This article examines an innovative mental health program in the largest Mexican consulate in the United States guided by a social good organizing framework and an intersectionality lens. The mental health program, Modulo de Salud Mental, was designed to address barriers to help seeking. Methods: The Modulo used the central characteristics of the social good model, such as innovative collaborations between systems that otherwise do not typically collaborate and burgeoning technologies to overcome barriers for service utilization among this population. We conducted a qualitative study to examine how the Modulo addressed structural and cultural barriers to care. Results: The salient themes from interviews were classified into four categories: current political situation, reasons for seeking services, prior barriers to care addressed by program, and perceived benefits of the program. Conclusions: Findings suggest that the Modulo's services and convenient location in an unconventional setting can serve as a model for promoting social good by facilitating help seeking and alleviating illness burden for this immigrant community. [ABSTRACT FROM AUTHOR]

Background Bevacizumab (BEV) received accelerated FDA approval in 2009 for the treatment of recurrent glioblastoma (rGBM). Unfortunately, prospective randomized controlled phase 3 studies (AVAglio and Radiation Therapy Oncology Group 0825 in newly diagnosed, European Organisation for Research and Treatment of Cancer 26101 in rGBM) failed to show an overall survival benefit with BEV added to standard therapy. In light of these data, we aimed to capture current utilization patterns and perceived value of BEV in the treatment of GBM among experts in the field. Methods An online questionnaire comprising 14 multiple choice questions was sent out in spring 2017 to 207 oncologists/neuro-oncologists treating patients with GBM at all National Cancer Institute–designated cancer centers in the United States. Results Sixty-two of 207 (30%) invitees responded (by training, 70% neuro-oncologists, 20% medical oncologists, 10% pediatric oncologists/neuro-oncologists). Participants reported use of BEV most frequently in rGBM for control of edema (85% of respondents) and/or when no other treatment options were available (68%). BEV is rarely used in newly diagnosed GBM (<5% of cases by 78% respondents and in 5% to 10% cases by 15% respondents). Sixty-six percent of participants indicated that they thought BEV improved symptoms, 30% that it improved symptoms and survival, 3% that it had no benefit in GBM patients. Conclusion In this cross-sectional online survey we found that among neuro-oncology experts in the United States in 2017, BEV is predominantly utilized in select patients with rGBM, and is only rarely used in a small subgroup of patients with newly diagnosed GBM for control of edema. The low response rate may have introduced a nonresponse bias. [ABSTRACT FROM AUTHOR]

Pregnancy, a sensitive time when two bodies are changing and developing simultaneously, demands careful consideration in assessing and treating mental health conditions. Add to that the restrictions on researching such a vulnerable population, psychiatric nurses face a challenge in providing evidence-based care. The current article focuses on the epidemiology of postpartum depression and long-term consequences, neurobiology of postpartum depression that guides medication selection, and treatment options for supporting postpartum women and their families. [Pregnancy, a sensitive time when two bodies are changing and developing simultaneously, demands careful consideration in assessing and treating mental health conditions. Add to that the restrictions on researching such a vulnerable population, psychiatric nurses face a challenge in providing evidence-based care. The current article focuses on the epidemiology of postpartum depression and long-term consequences, neurobiology of postpartum depression that guides medication selection, and treatment options for supporting postpartum women and their families. [Journal of Psychosocial Nursing and Mental Health Services, 57(11), 9–14.] [ABSTRACT FROM AUTHOR]

In 1968, Weight Watchers International introduced behavior modification practices to their established commercial program. At the time, the addition of behavioral psychology gave Weight Watchers a distinct advantage over the many competing weight control groups in postwar America. The process of combining group therapy with a controlled diet plan, behavior techniques and later, exercise, has significantly influenced American popular culture. This article considers how the commercialization of group weight control impacted the development and dissemination of a new multidimensional approach for weight management and how this has shaped popular ideas associated with dieting and wider understandings of healthy living. [ABSTRACT FROM AUTHOR]

Rationale: Opioid overdose deaths and healthcare costs associated with opioid use disorder (OUD) continue to escalate while the majority of addiction treatment providers in the United States do not use medication-assisted treatment (MAT) in spite of proven efficacy. The primary resistance to the use of MAT has been associated with the philosophical conflict many 12-step based treatment programs have with the use of these medications.Objective: This study sought to determine whether patients self-selecting into a treatment program based upon the 12-step philosophy would elect to use MAT and, if so, what initial outcomes might result.Methods: This naturalistic, prospective study of patients (N = 253) with OUD included a combination of OUD-specific group therapy and the use of buprenorphine-naloxone, oral naltrexone, injectable naltrexone, or no medication with standard 12-step treatment initiated in a residential or day treatment setting with outpatient follow-up. Baseline assessment of subjects with OUD included level of craving and opioid withdrawal symptom severity. Post-residential treatment outcomes at 1- and 6-months included craving, opioid withdrawal, residential treatment completion, continuing care compliance, medication compliance, substance use frequency and 12-step meeting attendance.Results: Irrespective of medication condition, nearly all patients successfully completed residential treatment and the majority attended additional programming afterward. Among those who elected to take a medication (71%), differences were associated with medication compliance. Patients who reported compliance with their medication at 1 and 6 months following residential treatment had significantly higher abstinence rates than patients who reported noncompliance. Among those who relapsed post-discharge, neither medication use nor compliance was significantly related to a change in the frequency of alcohol use days or drug use days at 6 months.Conclusion: These preliminary results suggest that it is feasible to administer medications, including partial opioid agonists like buprenorphine, within the context of 12-step based treatment and taking these medications as prescribed is associated with favorable outcomes. [ABSTRACT FROM AUTHOR]

Although most female veterans treated in specialized intensive Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) programs receive services in settings in which over 95% of participants are men, two programs include only women. Whether outcomes for women with PTSD are superior in women-only programs has not been evaluated. National program evaluation data on 1,357 women veterans from 57 sites were collected at program entry and 4 months after discharge. With adjustment for differences in baseline characteristics, outcomes of women in two women-only programs (n = 469) were compared with those from 55 mixed-gender programs (n = 888), using mixed models with random effect for site. The primary outcome was total PTSD symptom level, with supplementary information on PTSD assessment subscales, substance use, and other outcomes. At program entry, female veterans in women-only programs had lower scores on measures of total PTSD symptoms, p = .013, d = -0.24, and on several subscales. Adjusting for these differences, there were no significant differences between program types in terms of PTSD total score or scores on secondary measures. In women-only programs, veterans had longer lengths of stay and were rated by their clinicians to have a higher level of commitment to therapy at discharge. Thus, women-only programs did not show superior outcomes; however, compared to participants in mixed-gender programs, those in women-only programs had longer lengths of stay, higher levels of commitment to therapy, and were more likely to participate in posttreatment outcome assessments following discharge. [ABSTRACT FROM AUTHOR]

Caregivers in the United States are often under supported and are at higher risk for mental and physical health issues including chronic stress, depression, and hypertension. The current study provided a horticultural therapy support group for a small group of caregivers and assessed its efficacy using many psychometric measures including those measuring gratitude, loneliness, mindfulness of mind and body, subjective vitality, burden, depression, anxiety, and stress. We found that the support group had large effects on subjective vitality and loneliness and medium effects on gratitude, depression, and burden. All of these effects were in such a direction that indicated an improved quality of life. These findings, while promising, must be taken in consideration of some limitations such as the small sample size and some clients' concurrent participation in individual therapy. Future research should aim to replicate these findings using control groups such as a wait-list group or a group of individuals not in individual therapy. Future studies should continue using psychometrically sound instruments to assess the impact of interventions. [ABSTRACT FROM AUTHOR]

Although there are data on the psychometric properties of the Client Satisfaction Questionnaire (CSQ-8) in the United States Hispanic population, there are no data about the suitability of the questionnaire in Spanish-speaking populations in Spain. Trained and independent interviewers administered a Castilian Spanish translation of the CSQ-8 to 205 subjects (86.3% women, mean age 55.6 years) with subclinical depressive symptoms who participated in brief cognitive-behavioral group therapy interventions in Spain to treat subclinical depression. The internal consistency of the scale was satisfactory (α =.80). A single factor was identified that aggregated all eight items with high loadings in this global factor, which accounted for 43.5% of total variance. Differences in satisfaction were found based on the patients' education level (p =.038) and post-treatment depressive symptoms (p =.021). There were no differences in level of satisfaction based on sex, age, marital status, social class, pre-treatment depressive symptoms or the number of sessions attended. The results indicate that the Castilian Spanish CSQ-8 has adequate psychometric properties and maintains those of the original questionnaire; therefore, it is suitable for use in Spain for assessment of satisfaction with services received. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) and alcohol use disorder are frequently comorbid and present significant treatment challenges. Unfortunately, since the September 11, 2001, terrorist attacks in the United States, the rates of PTSD and hazardous drinking among active duty service members have increased significantly. Previous research on PTSD has typically excluded participants with current substance abuse. However, there is some research examining independent treatments for PTSD and substance abuse provided consecutively, concurrently, or as enhancements to other treatment. The current study examined the association between current hazardous drinking and PTSD treatment among 108 active duty service members with PTSD in a randomized controlled trial of group cognitive processing therapy and group present-centered therapy. Total scores above 8 on the Alcohol Use Disorders Identification Test defined hazardous alcohol use. At baseline, 25.0% of the sample was categorized as hazardous drinkers, and the hazardous and nonhazardous drinking groups did not differ in PTSD symptom severity, F(1, 106) = 0.08, p = .777, d = 0.06. Over the course of treatment, the two groups also did not differ significantly in PTSD symptom severity change on the PTSD Checklist, F(1, 106) = 1.20, p = .280, d = 0.33. Treatment for PTSD did not exacerbate hazardous drinking, and the hazardous drinking group showed significant reductions in drinking following PTSD treatment. Limitations and implications for treatment considerations are discussed. [ABSTRACT FROM AUTHOR]

Growing racial and ethnic diversity in the United States and globally requires culturally competent mental health professionals who can address ongoing racial tensions and experiences of racism and xenophobia. Attending to racial and ethnic issues and infusing race and ethnic dialogues in group psychotherapy can play a major role in addressing mental health problems, promoting racial harmony, and healing deep psychological wounds and trauma that are the result of racial tensions. This article describes seven key issues necessary to effectively address race and ethnicity in group psychotherapy. [ABSTRACT FROM AUTHOR]

Ravit Raufman's paper contributes to the bridging gap between relational approaches and group therapy. It is also important in its recognizing the (group) therapist's aggression and suggesting how to use it in the service of the group development. In this review I focus on the dynamics of a group of women led by a woman to explain some of the phenomena that Raufman describes in her article, and I add some social unconscious ideas to enrich our understanding of that group. [ABSTRACT FROM AUTHOR]

This paper describes ways of handling aggression and difficulty in containing intense emotional experiences in group psychotherapy. The clinical vignette illustrates how, in cases of overprotectiveness, an external trigger may sometime serve as a vehicle of liberation and ventilation. The therapist's enactment in response to the sudden penetration of a wasp into the room is discussed by relating to the functions it serves in the process of encountering aggression, as well as the group and therapist's capacity to move from "twoness" to a "co-created third." Whereas aggression, in general, is difficult to deal with, in a group it might prove to be extremely threatening, posing dangers unique to groups. Moreover, openly discussing the group conductor's aggressiveness is especially challenging in a group. The paper illustrates the fruitful intersection of group analytic thinking and relational psychoanalytic conceptualization. [ABSTRACT FROM AUTHOR]

Raufman's paper is located in the ongoing integration of relational concepts into the world of group analysis. Raufman's difficult days of therapeutic impasse in her group are regarded as emblematic of the theoretical bind that she and other group analysts find themselves in, caught between older, more classically based theory that inheres in much group therapy and theory and the recent embrace of relational concepts. An alternate reading of the group enactment is offered from the perspective of an unobtrusive relational group analyst with a focus on the conductor's negative capability and capacity to companion the group's organic psychological language and idiom in a process of enactive co-narration. It is suggested that when Raufman killed the wasp, the group finally found the vitalizing, enlivening, and companioning object in the leader, that it had been seeking all along. [ABSTRACT FROM AUTHOR]

This pilot study is to systematically investigate the therapist's experience while implementing single-session group improvisational music therapy in adult inpatient psychiatric care. In this study, there were three participants who are board certified music therapist working in inpatient psychiatry; a phenomenological study was conducted to explore the therapist's experience. The data collection included the following three stages: (a) an individual phenomenological interview, (b) a group musical improvisation, approximately 2 weeks after individual interviews, and (c) a group post-session interview. Two analysis cycles were conducted. In the first analysis cycle, a descriptive coding method was used to code the interviews.A phenomenological method of analysis was used to analyze improvisational music playing. In the second analysis cycle, the researcher conducted a composite review of the data. The data were comprehensively reflected on, clustered, and thematized, yielding the following four themes: (a) work in adult inpatient psychiatric care, (b) the concept of the single-session model, (c) music as a means of therapy, and (d) the formation of structure in single-session group improvisational music therapy. This study found that music therapists in inpatient psychiatry must adapt treatment goals and interventions, and in single-session group improvisational music therapy, learning and changing may occur. [ABSTRACT FROM AUTHOR]

The SIU (Société Internationale d'Urologie)-ICUD (International Consultation on Urologic Diseases) working group on systemic therapy for metastatic bladder cancer has summarized the most recent findings on the aforementioned topic and came to conclusions and recommendations according to the evidence published. In Europe and the United States, treatment for metastatic UC has changed a great deal recently, mainly involving a move from chemotherapy to immune checkpoint blockers. This is particularly true in platinum-refractory disease, where supportive randomized data exist. Five checkpoint blockers have been approved in this setting by the FDA: avelumab, atezolizumab, durvalumab, nivolumab, and pembrolizumab. Nivolumab, pembrolizumab, and atezolizumab have been approved in Europe. [ABSTRACT FROM AUTHOR]

Introduction: Acute care mental health inpatients have the expertise to evaluate different group-based music therapy interventions. Moreover, from an objectivist worldview, there is a need for data concerning non-symptom measures that are specific to group-based music therapy experiences using randomized designs. The purpose of this posttest-only study is to compare how adult acute care mental health inpatients rated group experiences of three different types of educational music therapy for illness management and recovery (EMT-IMR) interventions and a recreational music therapy (RMT) intervention. Methods: Participants (N = 91) were cluster-randomized to one of four single-session group-based conditions: EMT-IMR-songwriting, EMT-IMR-lyric analysis, EMT-IMR-social story, or RMT-music therapy game. Results: There were significant between-group differences concerning RMT and EMT-IMR (both lyric analysis and songwriting conditions) in the sharing of emotions and experiences subscale. Participants in the EMT-IMR conditions rated this subscale higher than participants in the RMT condition. Although no other difference was significant, descriptive statistics tended to favor the three EMT-IMR conditions. Group experiences descriptive data from people in community mental health services from a previous study were also compared with data collected in the current study. Results indicated tendencies for the three EMT-IMR conditions to have slightly higher mean group experiences scores across all subscales than participants in the non-music therapy community mental health services condition. Discussion: Specifically targeting illness management and recovery via EMT-IMR may be practical, effective, and constitute an ideal model within acute care mental health facilities. Limitations, suggestions for future inquiry, and implications for clinical practice are provided. [ABSTRACT FROM AUTHOR]

Indigenous people experience health disparities, including higher rates of substance use disorders (SUDs). Digital therapeutics are a growing platform for treatment services and have the potential to expand access to culturally responsive interventions for Indigenous people. As one of the first randomized controlled trials for SUDs for American Indian and Alaska Native (AI/AN) adults, the aim of this study was to pilot test the efficacy of a culturally tailored intervention among urban Indigenous adults. The study used a randomized controlled parallel design of 12 weeks of treatment-as-usual (TAU) (n = 26) versus TAU + Therapeutic Education System-Native Version (TES-NAV) (n = 27) with follow-up assessments at end of treatment and week 24 in an urban outpatient addiction treatment program for Native American adults. TAU consisted of individual/group counseling and cultural activities. The TES-NAV arm comprised TAU + 26 self-directed culturally tailored digital skills-based modules grounded in the community reinforcement approach with contingency management for abstinence and module completion. Primary outcome was longest consecutive weeks of abstinence from drugs and heavy drinking measured using self-report (Timeline Followback) and urine alcohol and drug toxicology screen during 12 weeks of treatment. Secondary outcomes were percent days abstinence during and posttreatment, coping strategies, social connectedness, and substance use and sexual risk behaviors. The study enrolled fifty-three (52.8 % male) AI/AN adults seeking treatment for a SUD. Although the study did not detect a benefit of TAU+TES-NAV over TAU on the primary outcome (Median = 2 consecutive weeks of abstinence for both arms) at end of treatment (treatment effect: Z = −0.78, p = 0.437), TAU+TES-NAV participants did demonstrate significantly greater percent days of abstinence at the week 24 follow-up (69.3 % versus 49.0 % for TAU; t = 2.08, p = 0.045) and significantly greater change in social connectedness mean score, baseline to week 12 (Z = −2.66, p = 0.011), compared to TAU. The study detected no differences between treatment arms for coping strategies or risk behaviors. The addition of TES-NAV to TAU did not significantly improve consecutive weeks of abstinence from drugs or heavy drinking; however, several secondary findings suggest promise for a culturally tailored digital therapeutic SUD intervention among urban Indigenous people. #NCT03363256. • Indigenous people face substance use disorder disparities. • Adapted digital interventions may improve access to culturally responsive treatment. • A digital intervention did not significantly improve in-treatment abstinence. • A digital intervention improved post treatment abstinence and social connection. [ABSTRACT FROM AUTHOR]

Despite the current tension between the United States and Cuba, the author predicts that conditions will someday improve sufficiently to permit U.S. consultants to provide group therapy training in a country just 90 miles away. The Cuban culture is organized around the family and other group entities, such as the Communist Party and People's Power, making group interventions compatible with prevailing attitudes and experience. The country's commitment to health care for all further suggests that cost-effective group treatment would be welcomed there, opening up opportunities for U.S. trainers. This article is intended to brief the would-be teachers and supervisors for this anticipated collaboration. In turn, they will develop insights about closing the gap in mental health services in low-resource settings, preparing them for additional international work. [ABSTRACT FROM AUTHOR]

We describe a multiyear pilot dissemination of a trauma-focused group treatment, Trauma and Grief Component Therapy for Adolescents, coupled with a trauma-informed staff training, Think Trauma, to six residential juvenile justice (JJ) facilities. All staff members were trained in Think Trauma. Seventy-seven youth from four facilities completed the treatment groups and 69 completed all pre- and postgroup assessment measures. The aims of this study were to determine whether trauma-focused interventions (a) could be implemented in complex JJ systems, (b) would be associated with a decrease in posttraumatic symptoms and reactions in youth, and (c) might contribute to reduced Incident Reports in facilities. A related question was whether we would receive feedback that youth who participated in the trauma and/or grief narrative components of the intervention were adversely affected. Pre- and postgroup assessments indicated significant reductions in symptoms of posttraumatic stress, depression, and anger, but not in anxiety or sexual concerns. There were significantly greater reductions in posttraumatic stress disorder (PTSD) among incarcerated youth who completed all modules of the group treatment intervention relative to incarcerated youth who received an abbreviated version. Two of the facilities tracked their Incident Reports and reported reductions. No Incident Reports or therapist feedback documented that the trauma/grief processing components of the intervention were destabilizing to the youth. [ABSTRACT FROM AUTHOR]

African Americans are disproportionately impacted by homicide in the United States. Individuals who have lost a relative to homicide often experience symptoms of complicated grief. The objective of this study was to explore the impact of a culturally tailored psychoeducational pilot intervention whose development was informed by a conceptual model of coping for African American survivors of homicide victims and was designed to (a) educate participants about the manifestation of complicated grief and symptoms and (b) help participants develop ways to cope with their grief. Pre- and post-test results indicate preliminary support for this encouraging intervention in achieving its intended outcomes to help participants identify complicated grief symptoms, supports, and services to help them manage their grief. Implications for posthomicide research and practice are discussed. [ABSTRACT FROM AUTHOR]

Group counseling interventions can be complex to assess and research. Over the years, The Journal for Specialists in Group Work (JSGW) has highlighted many of these challenges and offered valued approaches to designing projects that promote the efficacy and meaningfulness of group work in various settings. Similarly, school counseling literature has increasingly called for more research specific to the work of school counselors and highlighted the value of establishing practitioner-researcher partnerships to design and implement studies with fidelity. The following article considers these recommendations and offers a rationale for using Consensual Qualitative Research, a modern approach to qualitative inquiry, to help practitioners and researchers collaborate in the design and implementation of group work research in the schools. [ABSTRACT FROM AUTHOR]