Using implementation intentions to prevent relapse after remission from psychological treatment for depression: The SMArT intervention

Background: It is recognized that a significant proportion of people with depression are prone to relapse, even after successful treatment, and that self-management interventions should be developed and provided. There is evidence that implementation intentions (IMPS) can be successfully applied to health-related behaviours but their application to self-management of mental health problems has been limited. Aims: This paper describes the design and initial evaluation of a Self-Management After Therapy (SMArT) intervention, which incorporated IMPS and followed psychological therapy for depression. We sought to assess the feasibility and acceptability of SMArT. Method: The SMArT intervention was designed with reference to the MRC guidance on developing and evaluating complex interventions and co-designed with and implemented in a UK Improving Access to Psychological Therapies (IAPT) service. Eleven patients who were in remission following treatment for depression received the SMArT intervention, provided by Psychological Wellbeing Practitioners (PWPs). The evaluation used routine IAPT outcome measures at each session, feedback from patients and PWPs, and analysis of the type of IMPS identified and their fidelity with the model. Six patients provided brief feedback about the intervention to an independent researcher. Results: Feedback from patients and PWPs suggested that the intervention was feasible, acceptable and could potentially help patients to stay well after therapy. Patients confirmed the value of setting their own goals in the form of IMPS, receiving support from PWPs and in some cases from partners, friends and family members. Conclusions: Implementation intentions are a promising approach to support the self-management of depression.

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Chronic Pain: Fundamental Scientific Considerations, Specifically for Legal Claims

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2013.janfeb01 ◽

2013 ◽

Vol 18 (1) ◽

pp. 1-18 ◽

Cited By ~ 1

Author(s):

Robert J. Barth

Keyword(s):

Health Outcomes ◽

Pain Perception ◽

Driving Forces ◽

Psychological Treatment ◽

Dominant Role ◽

Meta Analysis ◽

General Medicine ◽

Pain Syndrome ◽

Problematic Relationship

Abstract Scientific findings have indicated that psychological and social factors are the driving forces behind most chronic benign pain presentations, especially in a claim context, and are relevant to at least three of the AMA Guides publications: AMA Guides to Evaluation of Disease and Injury Causation, AMA Guides to Work Ability and Return to Work, and AMA Guides to the Evaluation of Permanent Impairment. The author reviews and summarizes studies that have identified the dominant role of financial, psychological, and other non–general medicine factors in patients who report low back pain. For example, one meta-analysis found that compensation results in an increase in pain perception and a reduction in the ability to benefit from medical and psychological treatment. Other studies have found a correlation between the level of compensation and health outcomes (greater compensation is associated with worse outcomes), and legal systems that discourage compensation for pain produce better health outcomes. One study found that, among persons with carpal tunnel syndrome, claimants had worse outcomes than nonclaimants despite receiving more treatment; another examined the problematic relationship between complex regional pain syndrome (CRPS) and compensation and found that cases of CRPS are dominated by legal claims, a disparity that highlights the dominant role of compensation. Workers’ compensation claimants are almost never evaluated for personality disorders or mental illness. The article concludes with recommendations that evaluators can consider in individual cases.

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Are Individuals in Rorschach Nonpatient Samples Truly Psychologically Healthy?

Rorschachiana Journal of the International Society for the Rorschach ◽

10.1027/1192-5604/a000052 ◽

2015 ◽

Vol 36 (2) ◽

pp. 112-155 ◽

Cited By ~ 5

Author(s):

Anna Maria Rosso ◽

Andrea Camoirano ◽

Gabriele Schiaffino

Keyword(s):

Psychological Treatment ◽

Coping Styles ◽

Anxiety And Depression ◽

Future Research ◽

Extensive Form ◽

Community Needs ◽

Rorschach Comprehensive System ◽

Form Quality ◽

And Coping ◽

Rorschach Variables

Abstract. The aim of this study was to collect a Rorschach Comprehensive System (RCS) adult nonpatient sample from Italy using more stringent exclusion criteria and controlling for psychopathology, taking into account the methodological suggestions of Ritzler and Sciara (2008) . The authors hypothesized that: (a) adult nonpatient samples are not truly psychologically healthy, in that a high number of psychopathological symptoms are experienced by participants, particularly anxiety and depression, although they have never been in psychological treatment; (b) significant differences emerge between healthy and nonhealthy groups on Rorschach variables, particularly on CS psychopathological indexes; (c) RCS psychopathological indexes are significantly correlated in the expected direction with scores on psychopathological scales. The results confirmed the hypotheses, indicating the need to collect psychologically healthy samples in addition to normative and nonpatient samples. Because differences were found in the comparison between Exner’s sample (2007) and the healthy group in this study regarding form quality and coping styles, the authors suggest that future research should investigate the construct validity of ambitent style and culturally specific influences on form quality. Moreover, the Rorschach scientific community needs to have more extensive form quality tables, enriched with objects that are currently not included.

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