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Background: Depression affects 5% of adults and it is a major cause of disability worldwide. Digital psychotherapies offer an accessible solution addressing this issue. This systematic review examines a spectrum of digital psychotherapies for depression, considering both their effectiveness and user perspectives. Objective: This review focuses on identifying (1) the most common types of digital psychotherapies, (2) clients’ and practitioners’ perspectives on helpful and unhelpful aspects, and (3) the effectiveness of digital psychotherapies for adults with depression. Methods: A mixed methods protocol was developed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search strategy used the Population, Intervention, Comparison, Outcomes, and Study Design (PICOS) framework covering 2010 to 2024 and 7 databases were searched. Overall, 13 authors extracted data, and all aspects of the review were checked by >1 reviewer to minimize biases. Quality appraisal was conducted for all studies. The clients’ and therapists’ perceptions on helpful and unhelpful factors were identified using qualitative narrative synthesis. Meta-analyses of depression outcomes were conducted using the standardized mean difference (calculated as Hedges g) of the postintervention change between digital psychotherapy and control groups. Results: Of 3303 initial records, 186 records (5.63%; 160 studies) were included in the review. Quantitative studies (131/160, 81.8%) with a randomized controlled trial design (88/160, 55%) were most common. The overall sample size included 70,720 participants (female: n=51,677, 73.07%; male: n=16,779, 23.73%). Digital interventions included “stand-alone” or non–human contact interventions (58/160, 36.2%), “human contact” interventions (11/160, 6.8%), and “blended” including stand-alone and human contact interventions (91/160, 56.8%). What clients and practitioners perceived a

A new, evidence-based, multimodal, and creative psychological therapy, Arts for the Blues, was piloted with survivors of cultic abuse in a workshop within a conference setting. The five facilitators, who occupied diverse roles and perspectives within the workshop and research project, reflected on heir experiences of introducing this novel intervention to the cult-survivor population. In this underreported territory of using structured, arts-based, psychological therapy with those who have survived cultic abuse, the authors used a process of collective biography to compile a first person, combined narrative based on those reflections. This approach allows for a visceral insight into the dynamics and obstacles encountered, and the counter transference responses of the facilitators. This reflexive process shined a light into aspects of research and practice that were not all visible to the individual researchers previously, with implications for research ethics, psychological therapy, and creative arts within the cult-survivor field.

Background: Women's health has received renewed attention in the last few years including health rehabilitation options for women affected by breast cancer. Dancing has often been regarded as one attractive option for supporting women's well-being and health, but research with women recovering from breast cancer is still in its infancy. Dancing with Health is multi-site pilot study that aimed to evaluate a dance programme for women in recovery from breast cancer across five European countries. Methods: A standardized 32 h dance protocol introduced a range of Latin American dances presented within a sports and exercise framework with influences from dance movement therapy. Fifty-four women (M age 53.51; SD 7.99) participated in the study who had a breast cancer diagnosis <3 years, chemotherapy >6 weeks, no indication of metastasis, or scheduled surgery/chemotherapy/radiation treatment for the duration of the intervention. Primary outcome data was collected for anthropometric and fitness measures next to cancer-related quality of life. T-tests and Wilcoxon signed ranked tests were used to establish differences pre and post intervention. Cohen's d was also calculated to determine the effect size of the intervention. Results: Statistically significant changes were found for: (i) weight, right and left forearm circumference and hip; (ii) 6 min walking, right and left handgrip, sit-to-stand and sit-and-reach; (iii) the EORTC-QLQ C30 summary score as well as the subscales of emotional and social functioning and symptoms. In all cases the direction of change was positive, while Cohen's d calculated showed that the effect of the intervention for these parameters ranged from intermediate to large. Conclusion: Changes on the above anthropometric, fitness and quality of life measures suggest that the intervention was of value to the participating women recovering from breast cancer. Results also advocate collaborative efforts across countries to further research.

Introduction: Depression affects many adults in the UK, often resulting in referral to primary care mental health services (e.g. Improving Access to Psychological Therapies, IAPT). Cognitive Behavioural Therapy (CBT) is the main modality offered in IAPT when clients experience depression, with other approaches offered in a limited capacity. Arts psychotherapies are rarely provided despite their attractiveness to clients. However, the recent drop-out rate of 64% from IAPT suggests clients’ needs are not being fully met. Therefore, in order to expand clients’ choices we developed a new creative psychological therapy integrating evidence-based approaches with arts psychotherapies. Method: A three-level approach to development was used: a)thematic synthesis of client-identified helpful factors in evidence-based approaches for depression and in arts psychotherapies; b)studio practice exploring Cochrane Review findings on arts psychotherapies for depression; c)pilot workshops for clients with depression and therapists. Findings and Discussion: Eight key ingredients for positive therapy outcomes were identified: encouraging active engagement, learning skills, developing relationships, expressing emotions, processing at a deeper level, gaining understanding, experimenting with different ways of being, and integrating useful material. These ingredients were brought together as Arts for the Blues for clients with depression: a 12-session evidence-based pluralistic group psychotherapy that integrates client goals and preferences with creative methods as well as talking therapy. Conclusion: The evidence-based foundation, creative content, and pluralistic nature of this new approach aligned with eight client-identified key ingredients for positive therapy outcomes, make it a promising therapy option that can be adapted to individual therapy. Implications include consideration for NICE approval as an additional therapeutic approach for

Creative arts can play an important role for cult survivors in surviving, transcending and healing from their past realities. Flow – an empowering state of mind-body integration and skilful, intuitive action while engaged in a challenging yet enjoyable task (Csikszentmihalyi, 1997) – may be an important mechanism in arts therapies and may be especially impactful as an experience for cult survivors. Research reporting on arts therapies for cult survivors, Flow in cult survivors, and Flow in arts therapies is currently severely lacking. This study reports on a multimodal creative psychological therapy, Arts for the Blues, piloted as a workshop with a small group of cult survivors. Results obtained from three participants show that they experienced Flow in their creative activities and increased attainment in a self-selected personal goal. Interviews with two participants reveal important considerations for working with cult survivors, the healing power of the arts, the attainment of Flow states in the process, and the impact of the Arts for the Blues approach. This study is the first of its kind to trial art therapies with ex cult-members, or to document participants’ views on Flow states during an arts therapy approach. Although limited by a small sample size, further research is warranted.

Introduction: Research over the last decade has identified both strengths and limitations in the use of routinely prescribed psychological therapies for depression. More recently, a focus on creative art therapies, and 'art on prescription' are developing a growing recognition of their potential additional therapeutic mechanisms for depression. Therefore, in an attempt to develop a new therapeutic intervention for depression, this research aligned both the evidence base surrounding the arts on prescription movement, collating these with client-reported helpful factors and preferences for therapeutic interventions. Study design: We developed a framework for a new pluralistic ‘meta-approach’ of therapy for depression, based on an interdisciplinary thematic synthesis of active ingredients, considered specific features implemented in therapy and client reported helpful factors considered to be the broad features or experiences in therapy from both talking therapies and creative approaches. This framework contributed to the development of a pilot workshop entitled; Arts for the Blues – A New Creative Psychological Therapy for Depression. An outline of, and evaluation from, this workshop is presented in this paper. Methods: Workshop participants were recruited via a voluntary workshop taking place at a North West Higher Education Institution Arts and Health conference (N=15). Results: The workshop was evaluated using quantitative measures, with results indicating around a 70% overall satisfaction, followed up with qualitative commentary around areas of good practice and areas for development. These included the positive reflection on the application of creative arts and the multimodal nature of the approach, whilst others reflected on the potential overwhelming nature of utilising multimodal methods for individuals with depression. Conclusion: Overall feedback from the pilot workshop is discussed in relation to prior research, giving credence to the potential for incorpor

Routinely prescribed psychological therapies for depression are not always effective. Arts therapies, particularly Dance Movement Psychotherapy, may offer additional therapeutic mechanisms for depression. Therefore, client-reported helpful factors from various therapy types, along with client preferences, are key in devising new therapeutic interventions. We present a framework for a new pluralistic ‘meta-approach’ of therapy for depression, based on an interdisciplinary thematic synthesis (Thomas & Harden, 2008) of active ingredients from both talking therapies and creative approaches. Lastly, we offer an example group therapy workshop based on this approach, to be piloted with clients and practitioners within an NHS mental health service. Further research is required to evaluate this pilot and to devise a full treatment for trialling within the service.