An evaluation of the psychosocial group programme at an inpatient detoxification and stabilisation unit: a service improvement project

Purpose The benefits of including a psychosocial group programme alongside a medical inpatient detoxification and stabilisation regime has been recognised within addiction research; however, a “gold standard” psychosocial intervention has not been established. This small-scale study aimed to evaluate the psychosocial group (“Straight Ahead”) currently running at a substance use inpatient unit based in the UK. Design/methodology/approach A mixed-methods questionnaire design aimed to capture service user perspectives of the group programme via a questionnaire and assess whether an individual’s recovery capital and emotion regulation scores improved during their stay. Findings Thirty-four service users participated in the evaluation. Results indicate the group significantly increased individuals’ recovery capital scores; however, it did not significantly improve emotion regulation. The three themes from the qualitative results focused on the importance of shared experiences, learning of new skills and the group as a positive experience. Service users provided suggestions for improvements, and these informed the provision of service-specific recommendations for the team and project commissioner. Originality/value The evaluation provides tentative support for the use of the Straight Ahead programme and provides an insight into what service users find helpful when attending a psychosocial group during an inpatient detoxification admission.

Being a parent in Finland: a culturally-tailored psychoeducative parental support programme

Problem Migrant origin children are overrepresented in child protective services and among cases of suspected maltreatment against children. Language barriers, poor understanding of the child welfare system and differences in perceptions of child rearing and disciplinary practices create additional burden during the assessment process. Authorities struggle to meet the needs of migrant origin families. Description of the problem A variety of universal, selective and indicative parenting support programmes are available. While these have been shown to be effective also among persons of migrant origin, cultural adaptation has also been suggested to increase the benefits. Any adaptation to a trial-tested programme may, however, impact its integrity. To avoid this, a separate culturally sensitive Being a Parent in Finland programme was developed to complement other parenting interventions and supporting services offered by the health and social welfare authorities. Intervention was developed as part of the Barnahus project coordinated by the Finnish Institute for Health and Welfare. Results The aim of the Being a Parent in Finland psychoeducational group programme is to increase the wellbeing and safety of children through group-based parental support. The programme consists of three two-hour meetings offered to parents of children aged 3 to 12 years. The main themes include the Finnish service system, parenting practices that support the child's development and wellbeing and wellbeing of the family as well as children's rights. Psychoeducational videos were produced as supportive material. Groups of maximum 8-10 participants are led by trained instructors, assisted by professional interpreters. Lessons The programme will be piloted by the city of Helsinki, with the first two groups starting in May 2021. Experiences and lessons learned from these groups will be presented. Impact assessment of the programme and will be launched in autumn 2021. Key messages While culturally sensitive adaptations may increase positive outcomes of parental programmes, there is a risk for compromising programme integrity, leading to minimized or even adverse consequences. Being a parent in Finland aims at supporting the wellbeing and safety of families through culturally sensitive psychoeducative groups administered as complementary support measure to other services.

Mixed methods evaluation of a self-management group programme for patients with neuromuscular disease and chronic fatigue

ObjectiveTo obtain insight into experiences of patients with a neuromuscular disease and chronic fatigue and their healthcare professionals regarding content and delivery of a multidisciplinary outpatient self-management group programme to improve social participation. This will inform future implementation.DesignA mixed method study alongside a randomised controlled trial.SettingUniversity hospital, rehabilitation centre and community health centre.Participants29 patients with a neuromuscular disease and chronic fatigue and 13 healthcare professionals participated in this mixed methods study.InterventionMultidisciplinary group programme, called Energetic, consisted of a 4 months intervention with weekly meetings and covered four modules: (1) individually tailored aerobic exercise training; (2) education about aerobic exercise; (3) self-management training in applying energy conservation strategies and (4) implementation and relapse prevention in daily life.Main measuresQuantitative data were collected by a questionnaire measuring patients’ (n=25, all completed the programme) satisfaction with the perceived results, content and delivery of the programme. Qualitative data were collected by individual and focus group interviews to gain insight in the experiences of patients (n=18), next of kin (n=2) and healthcare professionals (n=13) with facilitators and barriers to programme implementation.ResultsPatients were satisfied with the number and length of the sessions, the different modules and the therapists. Analysis of the interviews led to five themes: (1) the combination of modules makes a complete picture, (2) the programme is physically and mentally intensive, (3) the group setting is valuable, (4) small variations in delivery occur in different settings, (5) therapists are coaches. Suggestions for programme improvement include a combination of face to face and e-health, enhancement of therapists’ skills in guiding group interventions and inclusion of more booster sessions to evaluate and maintain self-management competencies.ConclusionsThe Energetic programme could be implemented in different healthcare settings and group settings, and a combination of modules proved to be a facilitator for improving self-management.Trial registration numberNCT02208687.

Healthy Parent Carers: feasibility randomised controlled trial of a peer-led group-based health promotion intervention for parent carers of disabled children

Background Parent carers of children with special educational needs or disability are at higher risk of poor mental and physical health. The need for a tailored, peer-led group programme was raised by parent carers, who co-developed the Healthy Parent Carers programme with researchers. This study aimed to test the feasibility of programme delivery in community settings, and the feasibility and acceptability of a randomised controlled trial design. Methods Participants were individually randomised with concealed allocation to a structured group programme and access to online resources (intervention), or access to the online resources only (control). Measures of wellbeing and secondary and economic outcomes were collected before randomisation, immediately post-intervention, and 6 months post-intervention. Descriptive statistics on recruitment and attrition, demographics, attendance, and fidelity of intervention delivery were analysed with feedback on the acceptability of the trial design. Results One hundred and ninety-three parent carers expressed an interest in taking part. Ninety-two participants recruited from across six sites were randomised (47 intervention, 45 control). Lead and assistant facilitators were trained and delivered the group sessions. Sixteen (34%) participants in the intervention arm did not attend any sessions, and attendance varied across sites and sessions. One participant withdrew post-randomisation, and 83 (90%) participants completed outcome measures at the six-month follow-up. Conclusions The study demonstrated that it was feasible to deliver the programme in community settings. The number of parent carers who expressed interest signifies the need for such a programme and the feasibility of recruiting to a definitive trial. Loss to follow-up was low. Further research is needed to explore ways to reduce barriers to participation in person and assess the feasibility and acceptability of programme content and delivery for more ethnically diverse groups, and potentially using interpreters. Given the Covid-19 pandemic and delivery format feedback, there is also a need to investigate remote or blended delivery strategies. Although the results indicate that a definitive trial is feasible, programme impact would be strengthened through exploration of these uncertainties. Trial registration ISRCTN, ISRCTN15144652, registered on 25 October 2018, ClinicalTrials.gov, NCT03705221, registered on 15 October 2018.

Improving Depressive Symptoms through Personalised Exercise and Activation (IDEA): Study Protocol for a Randomised Controlled Trial

Individuals who suffer from depressive symptoms experience a substantial impact on psychosocial functioning, physical health, mortality, and quality of life. In the search for therapeutic strategies, exercise has been found to play a relevant part in its treatment. However, the promotion of exercise entails adherence difficulties that arose out of the tendency towards sedentarism led by symptomatology. Personalised exercise plans on top of usual care have the potential to enhance behavioural changes and mental health. The present study aims at evaluating the changes in functioning deriving from a blended intervention merging a psychological intervention with a personalised exercise programme based on medical assessment. We will conduct a three-arm randomised controlled trial in which 172 participants suffering from mild–moderate depressive symptoms will be allocated to Intervention A (personalised exercise group programme + app with motivational messages), B (personalised exercise group programme + app with no motivational messages) or control group (app with no motivational messages). Data regarding global functioning, well-being, symptoms, physical activity, and exercise capacity will be collected at baseline, 4, 12, and 36 weeks. The results of this trial will provide information about whether this physical activity support programme may be efficient for improving mental and physical health outcomes. Trial registration: ClinicalTrials.gov NCT04857944 (accessed on 15 April 2021). Registered April 2021.

“Breaking down the wall” patients` and families` experience of multifamily therapy for young adult women with severe eating disorders

BackgroundThis paper addresses patients` and families` experience of multifamily therapy (MFT) for young adults (18–22) with an eating disorder (ED). EDs are serious illnesses leading to lowered quality of life for the patient and their family. The Regional Centre for Eating Disorders (RESSP) at Nordland Hospital in Bodø, Norway has developed an adjunct psychotherapeutic approach for the treatment of young adult patients with severe EDs. The patient’s family members take part in the multifamily therapy (MFT) group programme.MethodsThe aim of the study was to explore patients` and families` experience of MFT for young adult women with severe EDs. A Grounded Theory (GT) approach was used. Data were collected by field observations in two MFT groups, qualitative group interviews and qualitative individual interviews with patients and their family members. Data were analysed using the constant comparative method. The data analysis consisted of open and selective coding and memo writing.ResultsTwo main categories were identified: ‘Connectedness and recognition’ and ‘Opening up and sharing`.MFT was described as a space for recognition within which it was possible to speak of things happening in the family with others with similar difficulties. It felt good and freeing, but also painful, to meet others with similar experiences. The participants had in common a considerable loneliness because it is difficult for outsiders to grasp what it is like in a home dominated by an ED. The meeting with other families created an underlying safety. The participants received help to distinguish between realistic and unrealistic concerns and learned about openness and communication in relation to their daughter. Some women with EDs said that MFT was most important for the parents but also had been good for them as things had become better at home.ConclusionThe participants reported that their family had become better at talking to each other after having been in MFT. As a result, they were able to speak more openly about difficult things and share feelings. This gave rise to increased understanding. The study shows that MFT was found to be valuable and important. Never before had these families had such an opportunity, something so directly tailored to them. MFT for adults can be developed further and used in other groups, such as those concerning other chronic illnesses.