scholarly journals What contributes to good outcomes? The perspective of young people on short-term psychoanalytic psychotherapy for depressed adolescents

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257334
Author(s):  
Harriet Housby ◽  
Lisa Thackeray ◽  
Nick Midgley
Keyword(s):  
Young People ◽  
Lived Experiences ◽  
Interpretative Phenomenological Analysis ◽  
Large Scale ◽  
Controlled Trial ◽  
Evidence Base ◽  
Psychoanalytic Psychotherapy ◽  
Valuable Insight ◽  
Short Term ◽  
Good Treatment Outcome

Depression is the fourth leading cause of adolescent illness and disability worldwide. A growing evidence base demonstrates that Short Term Psychoanalytic Psychotherapy [STPP] is an efficacious treatment for moderate to severe adolescent depression. However, with research in its infancy, key factors contributing to efficacy are unknown. Service users’ lived experiences provide valuable insight in this area. This study aimed to elucidate what adolescents value in treatment by inductively exploring lived experiences of STPP. Five adolescents with the largest reduction in depressive symptoms scores between baseline and end of treatment, who had taken part in a large-scale randomized controlled trial, were sampled. In-depth interviews carried out soon after the end of therapy were analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified: “Therapy as a Transformational Process”, “Explorative and Exposing: The Therapeutic Space” and “Being Heard and Working Together: The Therapeutic Relationship”. Adolescents valued a process of collaborative exploration with the therapist which when it was achieved was felt to facilitate a deep-rooted transformation in self-perception. Additionally, they described how an adjustment was needed to the particular frame of a psychoanalytic therapy. However, not all participants with a good treatment outcome experienced therapy in this way, suggesting a potential gap between the quantitative assessment of outcomes, and the way young people experience and understand the change process. Clinical implications and directions for research are discussed.

scholarly journals A randomised controlled trial of energetic activity for depression in young people (READY): a multi-site feasibility trial protocol

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
N. Howlett ◽  
L. Bottoms ◽  
A. Chater ◽  
A. B. Clark ◽  
T. Clarke ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Young People ◽  
Large Scale ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Retention Rates ◽  
Feasibility Trial ◽  
Exercise Session ◽  
Randomised Controlled ◽  
The Impact

Abstract Background Prevalence of depression is increasing in young people, and there is a need to develop and evaluate behavioural interventions which may provide benefits equal to or greater than talking therapies or pharmacological alternatives. Exercise could be beneficial for young people living with depression, but robust, large-scale trials of effectiveness and the impact of exercise intensity are lacking. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery. Methods The design is a three-arm cluster randomised controlled feasibility trial with embedded process evaluation. Participants will be help-seeking young people, aged 13–17 years experiencing mild to moderate low mood or depression, referred from three counties in England. The intervention will be delivered by registered exercise professionals, supported by mental health support workers, twice a week for 12 weeks. The three arms will be high-intensity exercise, low-intensity exercise, and a social activity control. All arms will receive a ‘healthy living’ behaviour change session prior to each exercise session and the two exercise groups are energy matched. The outcomes are referral, recruitment, and retention rates; attendance at exercise sessions; adherence to and ability to reach intensity during exercise sessions; proportions of missing data; adverse events, all measured at baseline, 3, and 6 months; resource use; and reach and representativeness. Discussion UK National Health Service (NHS) policy is to provide young people with advice about using exercise to help depression but there is no evidence-based exercise intervention to either complement or as an alternative to medication or talking therapies. UK National Institute for Health and Care Excellence (NICE) guidelines suggest that exercise can be an effective treatment, but the evidence base is relatively weak. This feasibility trial will provide evidence about whether it is feasible to recruit and retain young people to a full RCT to assess the effectiveness and cost-effectiveness of an exercise intervention for depression. Trial registration ISRCTN, ISRCTN66452702. Registered 9 April 2020.

Occupational Therapy and Interpretative Phenomenological Analysis: Comparable Research Companions?

2009 ◽  
Vol 72 (8) ◽  
pp. 332-338 ◽  
Author(s):  
Jane Cronin-Davis ◽  
Alan Butler ◽  
Christine A Mayers
Keyword(s):  
Occupational Therapy ◽  
Lived Experiences ◽  
Interpretative Phenomenological Analysis ◽  
Occupational Therapists ◽  
Evidence Base ◽  
Phenomenological Analysis ◽  
Data Process ◽  
Analysis Process ◽  
Complete Access ◽  
Research Analysis

Interpretative phenomenological analysis (IPA) is a research method gaining in popularity, particularly in health psychology and related fields. Derived from phenomenology, as the name suggests, it has potential for occupational therapy as an underpinning framework for research. This method was developed to enable researchers to provide participants with the opportunity to describe their perceptions of their lived experiences, which are subsequently interpreted by the researcher. A two-stage data process allows participants to make sense of their own world while the researcher attempts to make sense of participants' lived experiences. IPA acknowledges that researchers cannot gain complete access to the participant's world and that each participant is an expert in his or her field. However, it does recognise that the researcher's analysis of this world is a dynamic and interpretative process. During the research analysis process, themes are identified and connected and followed by higher-order interpretation. Data can be collected using a variety of methods, including interviews, case studies and focus groups. This paper describes the potential of IPA as an appropriate and worthy methodology for occupational therapists and, therefore, an important adjunct to the occupational therapy evidence base.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

Lived Experiences of Young People who Live with Mental Healthcare Users in Limpopo, South Africa

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Mamakota Maggie Molepo ◽  
Faniswa Honest Mfidi
Keyword(s):  
South Africa ◽  
Mental Illness ◽  
Young People ◽  
Lived Experiences ◽  
Daily Living ◽  
Support Systems ◽  
Family Members ◽  
Mental Healthcare ◽  
Limpopo Province ◽  
Burden Sharing

Mental illness is more than just the diagnosis to an individual – it also has an impact on the social functioning of the family at large. When a parent or relative has a mental illness, all other family members are affected, even the children. The purpose of the study was to provide insight into the lived experiences of young people who live with mental healthcare users and the way in which their daily coping can be maximised. A qualitative, descriptive, phenomenological research was undertaken to explore and describe the lived experiences of young people who live with mental healthcare users in the Limpopo province, South Africa. Audiotaped, unstructured in-depth interviews were conducted with 10 young people who grew up and lived with a family member who is a mental healthcare user in their homes, until data saturation was reached. A content analysis was used to derive themes from the collected qualitative data. Four major themes emerged as features reflective of the young people’s daily living with mental healthcare user, namely psychological effects, added responsibilities, effects on school performances, and support systems. This study recommends that support networks for young people be established through multidisciplinary team involvement and collaboration and the provision of burden-sharing or a relief system during times of need. With the availability of healthy coping mechanisms and support systems, the daily living situations and coping of young people could be maximised, thereby improving their quality of life while living with their family members with mental illness.

Dietary Patterns: A New Therapeutic Approach for Depression?

2019 ◽  
Vol 20 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Mariana Jesus ◽  
Tânia Silva ◽  
César Cagigal ◽  
Vera Martins ◽  
Carla Silva
Keyword(s):  
Depressive Symptoms ◽  
Dietary Patterns ◽  
Large Scale ◽  
Randomized Clinical Trials ◽  
Dietary Intervention ◽  
Common Mental Disorder ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Inverse Association ◽  
The Impact

Introduction: The field of nutritional psychiatry is a fast-growing one. Although initially, it focused on the effects of vitamins and micronutrients in mental health, in the last decade, its focus also extended to the dietary patterns. The possibility of a dietary cost-effective intervention in the most common mental disorder, depression, cannot be overlooked due to its potential large-scale impact. Method: A classic review of the literature was conducted, and studies published between 2010 and 2018 focusing on the impact of dietary patterns in depression and depressive symptoms were included. Results: We found 10 studies that matched our criteria. Most studies showed an inverse association between healthy dietary patterns, rich in fruits, vegetables, lean meats, nuts and whole grains, and with low intake of processed and sugary foods, and depression and depressive symptoms throughout an array of age groups, although some authors reported statistical significance only in women. While most studies were of cross-sectional design, making it difficult to infer causality, a randomized controlled trial presented similar results. Discussion: he association between dietary patterns and depression is now well-established, although the exact etiological pathways are still unknown. Dietary intervention, with the implementation of healthier dietary patterns, closer to the traditional ones, can play an important role in the prevention and adjunctive therapy of depression and depressive symptoms. Conclusion: More large-scale randomized clinical trials need to be conducted, in order to confirm the association between high-quality dietary patterns and lower risk of depression and depressive symptoms.

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