scholarly journals Behind the Scenes of Online Therapeutic Feedback in Blended Therapy for Depression: Mixed-Methods Observational Study (Preprint)

2018 ◽  
Author(s):  
Mayke Mol ◽  
Els Dozeman ◽  
Simon Provoost ◽  
Anneke van Schaik ◽  
Heleen Riper ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Patient Outcomes ◽  
Qualitative Content Analysis ◽  
Online Communication ◽  
Depression Symptom ◽  
Written Feedback ◽  
Symptom Change ◽  
Change Scores

BACKGROUND In Internet-delivered cognitive behavioral therapies (iCBT), written feedback by therapists is a substantial part of therapy. However, it is not yet known how this feedback should be given best and which specific therapist behaviors and content are most beneficial for patients. General instructions for written feedback are available, but the uptake and effectiveness of these instructions in iCBT have not been studied yet. OBJECTIVE This study aimed to identify therapist behaviors in written online communication with patients in blended CBT for adult depression in routine secondary mental health care, to identify the extent to which the therapists adhere to feedback instructions, and to explore whether therapist behaviors and adherence to feedback instructions are associated with patient outcome. METHODS Adults receiving blended CBT (10 online sessions in combination with 5 face-to-face sessions) for depression in routine mental health care were recruited in the context of the European implementation project MasterMind. A qualitative content analysis was used to identify therapist behaviors in online written feedback messages, and a checklist for the feedback instruction adherence of the therapists was developed. Correlations were explored between the therapist behaviors, therapist instruction adherence, and patient outcomes (number of completed online sessions and symptom change scores). RESULTS A total of 45 patients (73%, 33/45 female, mean age 35.9 years) received 219 feedback messages given by 19 therapists (84%, 16/19 female). The most frequently used therapist behaviors were informing, encouraging, and affirming. However, these were not related to patient outcomes. Although infrequently used, confronting was positively correlated with session completion (ρ=.342, P=.02). Therapists adhered to most of the feedback instructions. Only 2 feedback aspects were correlated with session completion: the more therapists adhere to instructions containing structure (limiting to 2 subjects and sending feedback within 3 working days) and readability (short sentences and short paragraphs), the less online sessions were completed (ρ=−.340, P=.02 and ρ=−.361, P=.02, respectively). No associations were found with depression symptom change scores. CONCLUSIONS The therapist behaviors found in this study are comparable to previous research. The findings suggest that online feedback instructions for therapists provide sufficient guidance to communicate in a supportive and positive manner with patients. However, the instructions might be improved by adding more therapeutic techniques besides the focus on style and form.

scholarly journals Barriers to Family Caregivers’ Coping With Patients With Severe Mental Illness in Iran

2018 ◽  
Vol 28 (6) ◽  
pp. 987-1001 ◽  
Author(s):  
Hossein Ebrahimi ◽  
Naeimeh Seyedfatemi ◽  
Hossein Namdar Areshtanab ◽  
Fatemeh Ranjbar ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Severe Mental Illness ◽  
Family Caregivers ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Interview Method ◽  
Bipolar Affective Disorders

The broad spectrum of problems caused by caring for a patient with mental illness imposes a high burden on family caregivers. This can affect how they cope with their mentally ill family members. Identifying caregivers’ experiences of barriers to coping is necessary to develop a program to help them overcome these challenges. This qualitative content analysis study explored barriers impeding family caregivers’ ability to cope with their relatives diagnosed with severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders). Sixteen family caregivers were recruited using purposive sampling and interviewed using a semi-structured in-depth interview method. Data were analyzed by a conventional content analytic approach. Findings consisted of four major categories: the patient’s isolation from everyday life, incomplete recovery, lack of support by the mental health care system, and stigmatization. Findings highlight the necessity of providing support for caregivers by the mental health care delivery service system.

scholarly journals Young voices in mental health care: Exploring children’s and adolescents’ service experiences and preferences

2016 ◽  
Vol 22 (1) ◽  
pp. 140-151 ◽  
Author(s):  
Stefan Persson ◽  
Curt Hagquist ◽  
Daniel Michelson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Children And Adolescents ◽  
Qualitative Content Analysis ◽  
Developmental Needs ◽  
Mental Health Clinics ◽  
Wide Range ◽  
Community Mental Health Clinics ◽  
A Priority

The development of ‘youth-friendly’ services has become a priority across a wide range of health-care contexts. However, relatively few studies have specifically examined users’ experiences of, and preferences for, child and adolescent mental health care. The current study investigated young service users’ views of outpatient and community mental health clinics in Sweden, based on two data sources. First, focus group interviews were conducted with seven children and adolescents (aged 10–18 years) to explore both positive and negative experiences of mental health care. Second, written suggestions about specific service improvements were obtained from 106 children and adolescents. Qualitative content analysis revealed three overarching themes: ‘Accessibility’, ‘Being heard and seen’ and ‘Usefulness of sessions’. Young people’s recommendations for improving practice included more convenient appointment times, offered in welcoming settings; opportunities to communicate more openly with clinical staff, enabling sensitive discussion of mental health and wider personal issues; and more structured treatments that offer greater credibility and relevance to young people’s mental health and developmental needs. Young people also discussed being compelled by parents and school professionals to engage in treatment. Attending to young people’s preferences must be a priority in order to overcome ambivalence about session attendance, and enhance treatment participation and outcomes.

scholarly journals Implementation of treatment guidelines for specialist mental health care

2014 ◽  
Vol 20 (2) ◽  
pp. 82-82
Author(s):  
C. Barbui ◽  
F. Girlanda ◽  
E. Ay ◽  
A. Cipriani ◽  
T. Becker ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Patient Outcomes ◽  
Psychotic Disorders ◽  
Treatment Guidelines ◽  
Evidence Base ◽  
Provider Performance

A huge gap exists between the production of evidence and its take-up in clinical practice settings. To fill this gap, treatment guidelines, based on explicit assessments of the evidence base, are commonly employed in several fields of medicine, including schizophrenia and related psychotic disorders. It remains unclear, however, whether treatment guidelines have any impact on provider performance and patient outcomes, and how implementation should be conducted to maximise benefit.

scholarly journals Better access to psychology services in primary mental health care: an evaluation

2006 ◽  
Vol 30 (2) ◽  
pp. 195 ◽  
Author(s):  
Sanjyot Vagholkar ◽  
Lesley Hare ◽  
Iqbal Hasan ◽  
Nicholas Zwar ◽  
David Perkins
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practice ◽  
Mental Health Care ◽  
Patient Outcomes ◽  
New South ◽  
Psychological Services ◽  
South Wales ◽  
The University ◽  
Program Data

Introduction: The Access to Allied Psychological Services program was introduced as part of the Better Outcomes in Mental Health Care initiative in 2001?2002. Divisions of General Practice are funded to establish programs that allow GPs to refer patients for psychological treatments. The University of New South Wales evaluated programs run by the Southern Highlands and Illawarra Divisions of General Practice. This paper presents the findings of these evaluations. Method: Both evaluations analysed process and patient outcomes. This was obtained from a combination of program data and qualitative satisfaction data. Results: The two program models differed in the mechanism of retention of the psychologists and the method of referral of patients. Anxiety and depression were the main reasons for referral, and clinical data showed there was improvement in patient outcomes. Patients, GPs and psychologists expressed satisfaction with the programs. Discussion: The Access to Allied Psychological Services programs in both Divisions have proven popular. Flexibility in the program structure allows Divisions to develop a model which suits their local circumstances. There is support for ongoing Commonwealth funding and the challenge is to find the most effective and financially sustainable model of delivery for psychological services in primary care.

Associations Between Continuity of Care and Patient Outcomes in Mental Health Care: A Systematic Review

2015 ◽  
Vol 66 (4) ◽  
pp. 354-363 ◽  
Author(s):  
Stephen Puntis ◽  
Jorun Rugkåsa ◽  
Alexandra Forrest ◽  
Amy Mitchell ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Care ◽  
Patient Outcomes ◽  
Continuity Of Care

scholarly journals Dilemmas in delivering health promotion activities: findings from a qualitative study of mental health nurses in Denmark

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e036403
Author(s):  
Jane Ege Møller ◽  
Anne Møller ◽  
Loni Ledderer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Promotion ◽  
Mental Health Care ◽  
Qualitative Content Analysis ◽  
Mental Healthcare ◽  
Mental Illnesses ◽  
Interactive Approach ◽  
Mental Health Nurses ◽  
Long Term Conditions

ObjectiveRecent studies have shown that people with mental illnesses have higher mortality and morbidity rates due to long-term conditions and lifestyle diseases. This knowledge has led to health promotion initiatives in mental health care to improve the physical health of people with mental illness. This article explores how mental health nurses experience working with health promotion activities in mental healthcare practices.DesignWe adopted a qualitative research design using an interactive approach. Qualitative content analysis was used to develop the analytical framework.ParticipantsFocus groups (n=7; n=5) were conducted with two groups of mental health nurses who attended health specialist training sessions in Denmark in the spring and fall of 2018.ResultsThe findings showed that working with health promotion activities in mental health care created two dilemmas for the mental health nurses: (1) dilemmas related to health promotion that involved discrepancies between the health promotion activities that were offered and patients’ autonomy and wishes, and (2) system-related dilemmas stemming from working with screening for risk factors and documentation programmes. The mental health nurses developed different strategies to navigate these dilemmas, such as devising interview techniques for the screening questions and bending guidelines.ConclusionsMental health nurses found it challenging to implement health promotion activities in mental health care, although they generally found these activities meaningful. The findings show that new health promotion activities need to be adapted to nurses’ existing mental healthcare practices; however, this may require some adaptation of existing nursing practices.

Posttraumatic stress symptom change after family involvement in veterans’ mental health care.

2018 ◽  
Vol 15 (4) ◽  
pp. 520-528 ◽  
Author(s):  
Holly B. Laws ◽  
Shirley M. Glynn ◽  
Susan J. McCutcheon ◽  
Theresa M. Schmitz ◽  
Rani Hoff
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Posttraumatic Stress ◽  
Family Involvement ◽  
Symptom Change ◽  
Posttraumatic Stress Symptom ◽  
Stress Symptom

Challenges faced by peer support workers during the integration into hospital-based mental health-care teams: Results from a qualitative interview study

2020 ◽  
Vol 66 (3) ◽  
pp. 263-269
Author(s):  
Ina Otte ◽  
Anna Werning ◽  
Alexa Nossek ◽  
Jochen Vollmann ◽  
Georg Juckel ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Qualitative Content Analysis ◽  
Psychiatric Hospitals ◽  
Health Care Teams ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Specific Implementation

Background: Being aware of the challenges that may occur during the implementation of peer support work in psychiatry is important to facilitate the integration of peer support workers (PSWs) into multidisciplinary mental health-care teams. Aim: The purpose of this study is to explore the challenges faced by PSWs during their integration into hospital-based mental health-care teams. Methods: Qualitative content analysis of nine open-ended, semi-structured interviews with PSWs is undertaken in five adult psychiatric hospitals in North Rhine-Westphalia, Germany. Results: The analysis of the data revealed three themes: (1) ‘Pioneers and the pressure to succeed’; (2) ‘a colleague, a rival or yet another patient?’ and (3) ‘sharing of information, boundaries and professionalism’. All three themes relate to several concrete challenges on different systemic levels and have the potential to impede the PSWs’ integration process. Conclusion: Specific implementation strategies which address potential barriers on the different systemic levels should be developed and applied prior to the start of the integration of PSWs into multidisciplinary mental health-care teams.

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