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Fear of cancer recurrence (FCR) involves anxiety about the possible return or progression of the disease. It is common among people surviving cancer, covering a range of adaptive and maladaptive responses including clinical presentations of FCR, for which different psychological interventions have been developed, most within the cognitive‐behavioural paradigm. Recently, emotion‐focused therapy (EFT) has been proposed as an alternative and has been the subject of research focusing on the cancer population and cancer‐related issues, including FCR. In this study, we looked closely at a successful case from a larger exploratory study, carrying out a discovery‐phase task analysis aimed at identifying the main components of EFT–FCR. We found that this approach generally followed the usual structure of an EFT intervention, with four distinct phases. However, we identified some specific secondary processes (e.g., hypervigilance and catastrophising) and clarified the nature of the core pain in this presentation as existential (e.g., fear of dying). [ABSTRACT FROM AUTHOR]

BackgroundThere is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcomes. However, the modes of delivery used to engage CYP in digital MH interventions may differ, with implications for the extent to which findings pertain to the level of engagement with the DHI. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible. ObjectiveThis review aimed to (1) identify modes of delivery used in CYP digital MH interventions, (2) explore influencing factors to usage and implementation, and (3) investigate ways in which the interventions have been evaluated and whether CYP engage in DHIs. MethodsA literature search was performed in the Cochrane Library, Excerpta Medica dataBASE (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and PsycINFO databases using 3 key concepts “child and adolescent mental health,” “digital intervention,” and “engagement.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least two reviewers. The selected articles were assessed for quality using the mixed methods appraisal tool, and data were extracted to address the review aims. Data aggregation and synthesis were conducted and presented as descriptive numerical summaries and a narrative synthesis, respectively. ResultsThis study identified 6 modes of delivery from 83 articles and 71 interventions for engaging CYP: (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. Overall, 2 themes emerged highlighting intervention-specific and person-specific barriers and facilitators to CYP’s engagement. These themes encompassed factors such as suitability, usability, and acceptability of the DHIs and motivation, capability, and opportunity for the CYP using DHIs. The literature highlighted that CYP prefer DHIs with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders. The findings of this review suggest a high average retention rate of 79% in studies involving various DHIs. ConclusionsThe development of DHIs is increasing and may be of interest to CYP, particularly in the area of MH treatment. With continuous technological advancements, it is important to know which modalities may increase engagement and help CYP who are facing MH problems. This review identified the existing modalities and highlighted the influencing factors from the perspective of CYP. This knowledge provides information that can be used to design and evaluate new interventions and offers important theoretical insights into how and why CYP engage in DHIs.

Idiographic patient‐reported outcome measures (I‐PROMs) are a growing set of individualized tools for use in routine outcome monitoring (ROM) in psychological therapies. This paper presents a position statement on their conceptualization, use, and analysis, based on contemporary evidence and clinical practice. Four problem‐based, and seven goal‐based, I‐PROMs, with some evidence of psychometric evaluation and use in psychotherapy, were identified. I‐PROMs may be particularly valuable to the evaluation of psychological therapies because of their clinical utility and their alignment with a patient‐centered approach. However, there are several challenges for I‐PROMs: how to generate items in a robust manner, their measurement model, methods for establishing their reliability and validity, and the meaning of an aggregated I‐PROM score. Based on the current state of the literature, we recommend that I‐PROMs are used to complement nomothetic measures. Research recommendations are also made regarding the most appropriate methods for analyzing I‐PROM data. [ABSTRACT FROM AUTHOR]

As routine outcome monitoring systems develop, questions emerge about how therapists incorporate feedback into their practice, and how this relates to therapeutic gains. A case of covert grief was monitored in each session with the Personal Questionnaire and the Helpful Aspects of Therapy instruments. At 4 months follow-up, the Change Interview was administered. Individualized items facilitated access to the private views and needs of each member, which was useful for case formulation and ongoing personalization of the intervention. Qualitative feedback of treatment experiences helped therapists confirm the impacts of interventions, monitor therapeutic alliance, reformulate clinical hypothesis, and plan sessions. Therapists followed a critical triangulation process to decide the clinical meaning of feedback, according to his/her intervention model, expertise, and case-specific context. [ABSTRACT FROM AUTHOR]

Abstract: Background: There is increasing interest in individualized patient‐reported outcome measures (I‐PROMS), where patients themselves indicate the specific problems they want to address in therapy and these problems are used as items within the outcome measurement tool. Objective: This paper examined the extent to which 279 items reported in an I‐PROM (PSYCHLOPS) added qualitative information which was not captured by two well‐established outcome measures (CORE‐OM and PHQ‐9). Design: Comparison of items was only conducted for patients scoring above the “caseness” threshold on the standardized measures. Setting and patients: 107 patients were participating in therapy within addiction and general psychiatric clinical settings. Main results: Almost every patient (95%) reported at least one item whose content was not covered by PHQ‐9, and 71% reported at least one item not covered by CORE‐OM. Discussion: Results demonstrate the relevance of individualized outcome assessment for capturing data describing the issues of greatest concern to patients, as nomothetic measures do not always seem to capture the whole story. [ABSTRACT FROM AUTHOR]

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Background: The backstage of research projects is seldom presented to the general audience, in particular, how the research questions emerged, how the team interacted and how the methods and design were decided upon. Aim: In this paper we will recount the story behind an international practice‐based research network for personalising health assessment, the joint journey of researchers and therapists from three different countries in creating the Individualised Patient‐Progress System (IPPS). Results: We first describe how the idea of the IPPS emerged; then we show how IPPS is being piloted and integrated into clinical practice. Next, we present the views of therapists and researchers who have been part of this project. Conclusions: We discuss some lessons learned from this 14‐year collaborative research programme. [ABSTRACT FROM AUTHOR]

Background Involving patients in treatment is becoming increasingly popular in mental health [Sales & Alves: Personalized evaluation of psychological treatments: A review of tools and research designs, submitted]. However, in substance misuse treatment settings, the patient perspective about treatment tends to be overlooked. This has been cited as a key priority by Orford et al. [Addiction, 103: 875-885, 2008] who included patient feedback about treatment as one of ten areas requiring an urgent paradigm shift in addiction research and practice. This project will apply an innovative method to involve substance misuse patients in psychological therapies, by asking them to suggest topics to evaluate their treatment. These topics suggested by patients can be written as a list of personalized items, so-called as patient-generated outcome measures (PGOM). Despite its patient-friendly features, PGOM's have never been used in this population, which is what this project aims to overcome. Methods/design This project is part of an International Exchange Platform on Personalising Addiction Treatment. Data will be collected in two phases (pre-post study and focus groups with patients) to explore the following: 1) How reliable and sensitive to change are PGOM's and standardised measures in substance misuse treatment? 2) Do PGOM's add relevant information to standardised measures? 3) What are the views of substance misuse patients about personalized outcome assessment? 4) Development of guidelines on using PGOM's in this population Discussion This research will potentially demonstrate the diversity of personal problems among patients seeking substance misuse treatment, suggesting the relevance of PGOM as a method to personalise outcome measurement and, ultimately, guiding treatment provision. It is expected that, as in previous studies, PGOM's will be perceived as helpful and patient-friendly tools, where patients may express their own concerns in a semi-structured setting. Similarly to other populations, we also expect PGOM's to be reliable, valid and sensitive to clinical changes in substance misuse treatment, as well as more content informative than their standardized counterparts. If these results are achieved, we might hypothesize that PGOM's are a potentially valid supplement to traditional standardised scales, by providing a closer insight to what motivates patients to participate in substance misuse treatment programmes. [ABSTRACT FROM AUTHOR]

This article aimed to provide a systematic narrative synthesis of existing studies on the mediators of change in psychotherapy with adolescents (10-19 years) and transition age youth (TAY) (20-29 years) who have experienced trauma-related symptoms or posttraumatic disorder. Additionally, we were interested in identifying psychotherapy-, trauma type-, and clients' age- and gender-specific mediators of treatment outcome. Following the preferred reporting items for systematic reviews and meta-analyses, a total of 3,723 studies published in PubMed and PsycINFO databases were screened against inclusion criteria, revealing 15 eligible studies. No studies with only TAY were found; therefore, all results were limited to therapy with adolescents. Cognitive mediators were tested in 66% of selected studies, followed by parents/family-related, mental-health-related, therapy-related, and behavioral mediators. Moderate evidence was found for posttraumatic cognitions, whereas therapeutic alliance seemed to be a promising candidate for future research. Striking absence of non-cognitive-behavioral therapy interventions, emotional and adolescent-specific mediators, as well as studies with males and in non-Western societies was evident. Future original studies would benefit from applying methodological rigor in respect to mediation testing., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: Healthy individuals from hereditary cancer families undergoing genetic testing for cancer susceptibility (GTC) report more distress when they perceive their social support as low and suppress their emotions. This study aimed to explore how suppressing emotions and perceiving others as unsupportive are related with cancer-risk distress., Methods: We performed a regression-based mediation analysis to assess if expressive suppression mediates or is mediated by perceived social support in the relation with cancer-risk distress. Participants were 125 healthy adults aged over 18 (M = 36.07, SD = 12.86), mostly female (72,4%), who undergone GTC to assess the presence of hereditary breast and ovarian cancer or Lynch syndromes., Results: Controlling for age and gender, we found a moderate size indirect effect of social support on cancer-risk distress through expressive suppression (β = -0.095) and a direct effect of expressive suppression on cancer-risk distress., Conclusions: When healthy individuals from hereditary cancer families perceive their social network as less responsive, they tend to not express their emotions, which relates to increased distress facing GTC., Practice Implications: Practitioners may assess cancer-risk related distress before the GTC and offer distressed individuals interventions focused on changing emotion regulation strategies in a safe group context., (Copyright © 2022 Elsevier B.V. All rights reserved.)

With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices)., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

As a response to the COVID-19 pandemic, many governments have introduced steps such as spatial distancing and "staying at home" to curb its spread and impact. The fear resulting from the disease, the 'lockdown' situation, high levels of uncertainty regarding the future, and financial insecurity raise the level of stress, anxiety, and depression experienced by people all around the world. Psychoactive substances and other reinforcing behaviors (e.g., gambling, video gaming, watching pornography) are often used to reduce stress and anxiety and/or to alleviate depressed mood. The tendency to use such substances and engage in such behaviors in an excessive manner as putative coping strategies in crises like the COVID-19 pandemic is considerable. Moreover, the importance of information and communications technology (ICT) is even higher in the present crisis than usual. ICT has been crucial in keeping parts of the economy going, allowing large groups of people to work and study from home, enhancing social connectedness, providing greatly needed entertainment, etc. Although for the vast majority ICT use is adaptive and should not be pathologized, a subgroup of vulnerable individuals are at risk of developing problematic usage patterns. The present consensus guidance discusses these risks and makes some practical recommendations that may help diminish them., Competing Interests: Declaration of competing interest MNP, DJS, DLK, DCH, JBS, MDG, JB, MWA, HKL, HJR, ARM, SH, NAF, ZD have been members of a WHO advisory group on the public health consequences of addictive behaviors. In this capacity they have been eligible for travel support from WHO or the host center to attend advisory group meetings but have not been remunerated for their work. MNP has received financial support or compensation for the following: MNP has consulted for and advised RiverMend Health, Opiant Pharmaceuticals, Idorsia, the Addiction Policy Forum and AXA; has received research support from the Mohegan Sun Casino and the National Center for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to addictive disorders or other health topics; has consulted for or advised law offices and gambling entities on issues related to addictive disorders and behaviors; has provided clinical care in the Connecticut Department of Mental Health and Addiction Services Problem Gambling Services Program; has performed grant reviews; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts. DJS has received research grants and/or consultancy honoraria from Lundbeck and Sun. DCH receives partial salary support from the Alberta Gambling Research Institute and volunteers on the Scientific Advisory Board of the International Center for Responsible Gaming. He has received conference travel support from a variety of non-profit associations. MDG's university currently receives research funding from Norsk Tipping (the gambling operator owned by the Norwegian Government). MDG has also received funding for a number of research projects in the area of gambling education for young people, social responsibility in gambling and gambling treatment from Gamble Aware (formerly the Responsible Gambling Trust), a charitable body which funds its research program based on donations from the gambling industry. MDG regularly undertakes consultancy for various gaming companies in the area of social responsibility in gambling. SRC consults for Ieso Digital Health and Promentis; he receives stipends from Elsevier for editorial work. SRC's involvement in this research was funded by a Wellcome Trust Clinical Fellowship (110049/Z/15/Z). JBu has been working as a consultant for Cogstate, Ltd. in the past several years. JMM has received research or networking funding from several spanish official research agencies: CIBERSAM-ISCIII and AGAUR, has received consultation fees from Janssen, research funding from Janssen, AbBiotics and Medtronic, and has accepted travel grants from Servier, in the last 36 months. JZ received grants from Lundbeck, Servier, Brainsway & Pfizer, and also received honoraria or consultation fees from Servier, Pfizer, Abbott, Lilly, Actelion, AstraZeneca, SunPharma, Roche and Brainsway. He also participated at sponsored events supported by Lundbeck, Roche, Lilly, Servier, Pfizer, Abbott, SunPharma and Brainsway. SW received in the last 5 years royalities from Thieme Hogrefe, Kohlhammer, Springer, Beltz. Her work was supported in the last 5 years by the Swiss National Science Foundation (SNF), different EU FP7s, Bfarm, ZInEP, Hartmann Müller-, Olga Mayenfisch-, Gertrud Thalmann-, Vontobel-Fonds. Outside professional activities are declared under www.uzh.ch/prof/ssl-dir/interessenbindungen/client/web/. NAF has been a member of the WHO advisory group on obsessive compulsive disorders. In the past 3 years NAF has held research or networking grants from the ECNP, UK NIHR, EU H2020, MRC, University of Hertfordshire; has accepted travel and/or hospitality expenses from the BAP, ECNP, RCPsych, CINP, International Forum of Mood and Anxiety Disorders, World Psychiatric Association, Indian Association for Biological Psychiatry, Sun; has received payment from Taylor and Francis and Elsevier for editorial duties; has accepted a paid speaking engagement in a webinar sponsored by Abbott. Previously, she has accepted paid speaking engagements in various pharmaceutical industry supported symposia and has accepted grants and funding support for various pharmaceutical industry-sponsored studies in the field of OCD treatment. She leads an NHS treatment service for OCD. She holds Board membership for various registered charities linked to OCD. She gives expert advice on psychopharmacology to the UK MHRA and NICE. ZD's university receives funding from the Szerencsejáték Ltd. to maintain a telephone helpline service for problematic gambling. ZD has also been involved in research on responsible gambling founded by Szerencsejáték Ltd. and the Gambling Supervision Board., (Copyright © 2020. Published by Elsevier Inc.)

Although efforts have been undertaken to determine how psychological interventions exert their effects, research on mediators and mechanisms of change remains limited, especially in the field of prevention. We aimed to assess available evidence on mediators of psychological and psychoeducational interventions for the prevention of depression and anxiety in varied populations. A systematic review using PubMed, PsycINFO, Web of Science, Embase, OpenGrey, and the Cochrane Central Register of Controlled Trials was performed. Two independent reviewers assessed the eligibility criteria of all articles, extracted data, determined the risk of bias in randomized controlled trials, and the requirements for mediators. The outcomes were mediators of the incidence of depression or anxiety and/or the reduction of symptoms of depression or anxiety. We identified 28 nested mediator studies within randomized controlled trials involving 7442 participants. Potential cognitive, behavioral, emotional and interpersonal mediators were evaluated in different psychological and psychoeducational interventions to prevent depression and anxiety. The effects were mediated mainly by cognitive variables, which were the most commonly assessed factors. For depression, the mediator with the strongest empirical support was negative thinking in adults. Cognitive change is an important mediator in preventive psychological and psychoeducational interventions for both anxiety and depression. REGISTRATION DETAILS: Registration number (PROSPERO): CRD42018092393., Competing Interests: Declaration of Competing Interest The authors all declare that they have no conflicts of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Fear of cancer recurrence (FCR) is a significant issue for most cancer survivors, with nearly half of cancer survivors reporting it at moderate to high levels of intensity. We aimed to further explore the experience of having FCR from the point of view of patients by systematically reviewing qualitative studies. Following PRISMA guidelines, 87 qualitative studies were selected. All participants' quotes about FRC were extracted, then analysed using a conceptual framework based on the emotion-focused therapy theory of emotion schemes, which consist of experienced/implicit emotions, along with perceptual-situational, bodily-expressive, symbolic-conceptual and motivational-behavioral elements. According to participant descriptions, FCR was found to be an intense, difficult, multi-dimensional experience. Considering the diversity of experiences identified, it is useful to look at FCR as an emotional experience that extends along a continuum of adaptive and maladaptive responses. For some participants, FCR was described in trauma-like terms, including forms of re-experiencing, avoidance, negative thoughts and feelings, and arousal or reactivity related to cancer-related triggers or memories. Vivid metaphors expressing vulnerability and conflict also reflect the strong impact of FCR in patients' lives and can help therapists empathize with their clients., (Copyright © 2018 Elsevier Ltd. All rights reserved.)