Search results for ‘Subject term:"mental health problems"’ Sort:
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Significant therapy events with clients with intellectual disabilities
- Authors:
- WILLS Sarah, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 12(5-6), 2018, pp.173-183.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore significant events in psychotherapy with clients with intellectual disabilities (IDs). Design/methodology/approach: Four therapy dyads, each consisting of one client and one therapist, were recruited. Following the brief structured recall procedure (Elliott and Shapiro, 1988), semi-structured interviews focused on helpful events in psychotherapy, using video of particular sessions as a stimulus to help prompt recall of that session. Findings: Using interpretative phenomenological analysis, five super-ordinate themes were identified: “The Uniqueness of the Therapeutic Relationship”; “Using adaptations to Express Emotions”; “Client Behaviour/Therapist Behaviour”; “Hope and Paternalism”; and “Meaning-Making”. The results provide additional evidence that significant therapy events occur for clients with IDs. Furthermore, the research enabled insights to be gained about the process of therapy for this client group and for exploration of therapeutic factors that may be involved in facilitating a significant therapy event. Research limitations/implications: This study highlights the need for therapists to work in such a way as to facilitate significant events in therapy. Whilst this study was a necessary first step, owing to the non-existence of research in this area, the sample size and qualitative design may limit any wider generalisation of the findings. Originality/value: Significant events have not previously been explored in psychotherapy with clients with IDs. This research could therefore make an important contribution to our understanding of the process of psychotherapy for this client group. (Publisher abstract)
The CORE-10: a short measure of psychological distress for routine use in the psychological therapies
- Authors:
- BARKHAM Michael, et al
- Journal article citation:
- Counselling and Psychotherapy Research, 13(1), 2013, pp.3-13.
- Publisher:
- Wiley
Background: There is a need for a generic, short, and easy-to-use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE-10 in response to this need. Method: Items were drawn from the CORE-OM and 10 items were selected according to a combination of usefulness, coverage of item clusters, and statistical procedures. Three CORE-OM datasets were employed in the development phase: (1) a primary care sample, (2) a sample from an MRC platform trial of enhanced collaborative care of depression in primary care, and (3) a general population sample derived from the Office of National Statistics Psychiatric Morbidity Follow-up survey. A fourth dataset comprising a sample from an occupational health setting was used to evaluate the CORE-10 in its standalone format. Results: The internal reliability (alpha) of the CORE-10 was .90 and the score for the CORE-10 correlated with the CORE-OM at .94 in a clinical sample and .92 in a non-clinical sample. The clinical cut-off score for general psychological distress was 11.0 with a reliable change index (90% CI) of 6. For depression, the cut-off score for the CORE-10 was 13 and yielded sensitivity and specificity values of .92 (CI=.83–1.0) and 0.72 (CI=.60–.83) respectively. Conclusion: The CORE-10 is an acceptable and feasible instrument that has good psychometric properties and is practical to use with people presenting with common mental health problems in primary care settings. (Publisher abstract)
Developing a theoretical understanding of therapy techniques: an illustrative analogue study
- Authors:
- FREEMAN Daniel, et al
- Journal article citation:
- British Journal of Clinical Psychology, 44(2), June 2005, pp.241-254.
- Publisher:
- Wiley
In psychological interventions, clients are often asked to review unhelpful beliefs. Surprisingly, there is no theoretical understanding of how beliefs are reviewed in therapy. Moreover, by understanding a therapeutic technique, potential interactions with symptom processes can be considered. An analogue study assessing the feasibility of researching therapy techniques is described, in which links between symptoms, reasoning style, and an experimental version of the cognitive therapy technique of belief evaluation are examined. Thirty individuals without psychiatric illness completed (i) dimensional measures of depression, anxiety, and delusions, (ii) a measure of confirmatory reasoning both before and after instruction in disconfirmatory reasoning, and (iii) a belief evaluation task. Compared with individuals with a confirmatory reasoning style, individuals with a disconfirmatory reasoning style were less hasty in their data gathering, considered a greater number of hypotheses during the task, had higher intellectual functioning, and had lower levels of depressive symptoms. Conversely, the individuals with the strongest confirmatory reasoning had higher levels of depression and preoccupation with delusional ideation. Successful adoption of disconfirmatory reasoning was associated with less hasty decision-making and lower levels of preoccupation and distress by delusional ideation. Individuals with a disconfirmatory reasoning style reported more evidence both for and against their beliefs in the belief evaluation task. In the context of clinical research indicating that individuals with delusions are hasty in their data gathering and have difficulty considering alternatives, a potential implication of the findings is that individuals with delusions may find belief evaluation in therapy.
Families with parental mental illness: studying a home-based intervention program
- Authors:
- OPPENHEIM-WELLER Shani, SHTARK Tammi, ALDOR Roy
- Journal article citation:
- Child and Family Social Work, 26(4), 2021, pp.617-628.
- Publisher:
- Wiley
This study is the first to systematically examine the implementation of the BROSH program, a therapeutic intervention program developed in Israel for families in which one or both parents suffer from mental illness. The program is multidisciplinary, encompassing the collaboration of four different services. It aims to engage the families into therapy by building a strong working alliance and helping in emotional stress regulation. Further, the program aims to prevent parental hospitalization and children's out-of-home placement. This study conducted an in-depth investigation of the functioning of parents and children participating in the program. This study analysed protocols that followed 11 families throughout the multidisciplinary professionals' meetings. The findings indicate that the functioning of parents and children showed positive changes - improved stress regulation by parents and children and more familial engagement in the treatment program. It seems that both parents and children participating in the BROSH program benefitted from it by establishing coping abilities and being able to receive therapeutic help. (Edited publisher abstract)
A closer look at involuntary treatment and the use of transport service in outdoor behavioral healthcare (Wilderness Therapy)
- Authors:
- HARPER Nevin J., MAGNUSON Doug, DOBUD Will W.
- Journal article citation:
- Child and Youth Services, 42(2), 2021, pp.200-219.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Outdoor behavioral healthcare (OBH or wilderness therapy) is an out-of-home adolescent treatment option serving tens of thousands of youths annually for behavioral, substance, and mental health issues in the United States. About half of OBH participants attend involuntarily and are transported by services specialized for “uncooperative” youth. Transportation has been argued by some researchers to have little impact on youth in treatment, and Tucker and colleagues found little difference in outcomes between not transported and transported youth. Ethical and empirical concerns arise from these findings, and we apply a critical perspective to address these concerns. Specifically, we examined the claim in OBH research that being transported has no significant bearing on client treatment outcomes. We propose that the findings of no difference were random, rather than systematic, because they were constructed on a post hoc measure of perceived voluntariness. To demonstrate, we used data from OBH to construct five different measures of voluntary/involuntary, also fabricated post hoc. All five operationalizations resulted in statistically significant differences across a variety of social and psychological outcomes, demonstrating inconsistencies across the findings. Further independent and rigorous research is called for in OBH to understand the use and ethics of forced transportation, coercion, and involuntary treatment. (Edited publisher abstract)
An open trial of psychodynamic psychotherapy for people with mild-moderate intellectual disabilities with waiting list and follow up control
- Authors:
- SKELLY Allan, McGEEHAN Caoimhe, USHER Robert
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 12(5-6), 2018, pp.153-162.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine the outcome of psychodynamic psychotherapy for people with intellectual disabilities (ID), which has a limited but supportive evidence base. Design/methodology/approach: The study is a systematic open trial of flexible-length psychodynamic therapy offered in an urban community to 30 people with mild and moderate ID, presenting with significant emotional distress on the Psychological Therapies Outcome Scale for people with intellectual disabilities (PTOS-ID). Allocation to therapy was made according to an established stepped care approach according to need, and the mean number of sessions was 22.03 (range 7–47). Treatment fidelity was checked via notes review and cases excluded from analysis where there were other significant psychological interventions. Findings: On both self-report (PTOS-ID) and independent ratings (Health of the Nation Outcome Scales-Learning Disability (HoNOS-LD)) recipients of therapy: did not improve while waiting for therapy; improved significantly during therapy, with large pre–post effect sizes; and retained improvements at six-month follow-up. Research limitations/implications: While it is important to conduct further controlled trials, the findings provide support for previous studies. High rates of abuse and neglect were found in the sample, suggesting that more trauma-informed and relational approaches should be explored for this client group. Originality/value: No other study of this size has been completed which used dedicated standardised outcome measures, with this therapy type, with both waiting list and follow-up control and with account of model fidelity. (Publisher abstract)
Computer‐assisted cognitive behavioural therapy: the experiences of adults who have an intellectual disability and anxiety or depression
- Authors:
- COONEY Patricia, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(6), 2018, pp.1032-1045.
- Publisher:
- Wiley
Background: Despite its evidence base in the general population, computerized cognitive behavioural therapy (cCBT) has not yet been adapted for use with people with intellectual disability. This study aimed to explore the experiences of adults with an intellectual disability who played a cCBT programme. Method: Twenty‐four adults (with a mild or moderate intellectual disability and clinically significant anxiety or depression) who were in the treatment arm of a pilot randomized controlled trial evaluating the cCBT programme were individually interviewed. Thematic analysis was used to analyse and report themes within the data. Results: Participants found playing the programme to be an enjoyable and novel experience and that it was challenging and helpful. It allowed them to develop and reflect on relationships and increased their awareness of thoughts, feelings and behaviours. Conclusions: Combining technology with CBT is an effective way to reduce barriers to accessing mental health interventions and technology for this population. (Edited publisher abstract)
Mental health needs and therapeutic service utilization of young children in foster care in Germany
- Authors:
- VASILEVA Mira, PETERMANN Franz
- Journal article citation:
- Children and Youth Services Review, 75, 2017, pp.69-76.
- Publisher:
- Elsevier
Although children in foster care often need therapeutic help, the ways to initiate therapeutic services for them is not regulated in Germany. The objective of this cross-sectional study is to identify factors associated with therapeutic service utilisation in young children in foster care in Germany. Additionally, it explores predictors of foster parents' perceived need for therapeutic help for the child. Foster parents of 286 children aged 3–7 years completed questionnaires about children's mental health, child and placement characteristics. Logistic regression models tested the impact of these factors on therapeutic service utilisation and foster parents' perceived need for child therapy separately for children with and without potentially traumatic experiences. Approximately 62% of the sample had some mental health problems; around 37% of these children received no treatment. Placement disruptions and cases where the child welfare services had the custodial rights predicted higher therapeutic service utilisation. Foster parents' stress was associated with perceived need for help. Children's symptoms – especially externalising problems – also predicted both outcomes. The findings indicate the need for strategies to increase therapeutic service utilisation in young children in foster care on caregiver, system, and legislative levels. Such strategies should target routine assessment of children's mental health as well as interventions on foster family characteristics. (Edited publisher abstract)
The journey of young people in an early psychosis program involved in participatory photography
- Authors:
- MANIAM Yogeswary, et al
- Journal article citation:
- British Journal of Occupational Therapy, 79(6), 2016, pp.368-375.
- Publisher:
- Sage
Introduction: The purpose of this study was to examine the experiences and perceptions of young people in an early psychosis programme towards participating in a 10-week photovoice and exhibition project and the themes that had emerged from their photographs. Method: Photographs create meanings and participants are able to tell their stories in a meaningful way. Eleven clients who had gone through a prior 10-week photovoice project and exhibition consented to being interviewed for this study. Clients chose and brought to the interview photos of theirs that had been exhibited. Structured questions were asked to generate discussions. Findings: Findings illustrated that participants were keen to educate the general public on mental health issues. They craved acceptance and were keen to make connections and build relationships. They were their own agents of change. Supportive networks create hope, which in turn helps people with mental health issues to reframe their outlook. Conclusion: The results of this study are important and provide occupational therapists with another tool for intervention and advocacy. As both photovoice and occupational therapy focus on the process rather than the product, occupational therapists can utilise photography in groups creatively to generate more client- and peer-led discussions. (Edited publisher abstract)
Adapted DBT programme for individuals with intellectual disabilities and problems managing emotions: staff awareness training
- Authors:
- ASHWORTH Sarah, MOONEY Paul, TULLY Ruth J.
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 10(3), 2016, pp.185-198.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to present the development and evaluation of an original training package for staff members on an awareness of an adapted Dialectical Behaviour Therapy programme, the “I Can Feel Good” programme (Ingamells and Morrissey, 2014) designed for individuals with intellectual disabilities (ID) and problems managing emotions. The quality and effectiveness of the training was assessed and is reported in this paper. Design/methodology/approach: The training was delivered for staff working with individuals with ID in a UK medium-secure psychiatric hospital and was attended by nursing staff. The workshop consisted of six modules: “Introduction to the programme”, “Mindfulness”, “Managing feelings”, “Coping in Crisis”, “People skills” and “Application and summary”. Level of self-reported knowledge, confidence and motivation regarding seven aspects of the training was measured by an evaluation questionnaire completed pre and post training. Findings: The results of this study showed that following the training there was a significant increase in self-reported knowledge, confidence and motivation regarding the seven aspects of the training. When perceptions of staff behaviours are observed, although in the right direction, this change was found not to be significant. Originality/value: This study highlights the potential for staff training to increase awareness of newly adapted therapeutic programmes for individuals with ID. The staff training may increase their ability and willingness to facilitate the running of such programmes and ability to support learning transfer in group members. (Publisher abstract)