Effectiveness of Mindfulness-Integrated Cognitive-Behavioral Group Therapy in Motivational Structure of Hepatitis B Patients

Background: It is essential to understand and support hepatitis B patients to minimize their challenges and limitations and provide them with appropriate treatment. Therefore, it is essential to incorporate training and consulting programs to prepare for and identify various aspects of the disease. Objectives: The present study aimed to investigate the effectiveness of mindfulness-integrated cognitive-behavioral group therapy (MiCBT) in the motivational structure of hepatitis B patients in Tehran, Iran. Methods: This quasi-experimental study utilized a pretest-posttest design with a control group. The study sample consisted of 28 hepatitis B patients selected from all patients visiting specialist clinics in Tehran in 2020. Following the interviews and completion of the Personal Concerns Inventory, 14 patients were selected per group using simple random sampling and were randomly divided into intervention and control groups. A posttest was conducted after 12 sessions of MiCBT (one 90-min group session weekly for three months). Data were analyzed using the multivariate analysis of covariance in SPSS software. Results: The results revealed a significant increase in adaptive motivational structure (P < 0.001) and a significant decrease in maladaptive motivational structure (P = 0.012) in hepatitis B patients following the therapeutic intervention. Conclusions: The study indicated the MiCBT effectiveness in increasing adaptive motivational structure and decreasing maladaptive motivational structure in hepatitis B patients. As a therapeutic approach, MiCBT can make the motivational structure of hepatitis B patients more adaptive.

Effectiveness of a Cognitive-behavioral Group Therapy for Complicated Grief in Family Members of Patients With Cancer

Introduction: complicated grief can affect a large number of individuals who have lost a relative due to cancer. Objective: to assess the efficacy of a cognitive-behavioral group therapy (CBGT) for complicated grief in those who have lost a relative due to cancer in comparison with a psychoducational and emotional expression intervention (PSDEEI).Method: 249 relatives of deceased cancer patients with complicated grief were randomly assigned to treatment with CBGT or PSDEEI. Complicated Grief (ICG), depression (BDI-II), hopelessness (BHS), anxiety (BAI) symptoms and general health (GHQ28) were assessed at pre-treatment, post-treatment, and follow-up at 6 and 12 months. Results: the CBGT group improved significantly (p<0.001), with the scores in ICG, BDI-II, BAI, BSH, and GHQ28 (p<0.001) being higher than those for the PSDEEI group in each of the assessed moments, with high effect sizes: ICG (η2=0.16), BDI (η2=0.10), BAI (η2=0.06), BSH (η2=0.21) and GHQ28 (η2=0.21). At the 12-month follow-up, the number of cases of complicated grief decreased by 81.1% for the CBGT group vs. 31.7% in the PSDEEI group. Conclusions: The CBGT treatment is effective for complicated grief, for depression, anxiety, and hopelessness symptoms and for mental health, and is superior to PSDEEI treatment.

Pseudomentalization as a Challenge for Therapists of Group Psychotherapy With Drug Addicted Patients

One of the main challenges in group therapy with drug-addicted patients is collective pseudomentalization, i.e., a group discourse consisting of words and clichés that are decoupled from any inner emotional life and are poorly related to external reality. In this study, we aimed to explore the phenomenology of pseudomentalization and how it was addressed by the therapist in an outpatient group for drug-addicted patients. The group was composed of seven members, and the transcripts of eight audio-recorded sessions (one per month) were rated and studied. The interventions of the therapist were measured with the mentalization-based group therapy (MBT-G) adherence and quality scale by independent raters. Two sessions, one with the highest and one with the lowest adherence, were selected, and the clinical sequences of pseudomentalization were analyzed in a comparative way. The findings revealed that pseudomentalization does occur as a collective phenomenon, akin to “basic assumptions” of Wilfred Bion, which we reconceptualized in this study. Any pseudomentalization seemed to be reinforced by the therapist when she was presenting frequent and long interventions, when abstaining from the management of group boundaries, when providing questions focused more on content than on the mental states of the group members, and when not focusing on emotions. However, the ultimate source of collective pseudomentalization seemed to be the fear of the group members of being overwhelmed by painful emotions, mental confusion, and a loss of identity. The findings also indicated that the principles of MBT-G may be a good antidote to pseudomentalization.

Evaluation of an Augmented Cognitive Behavioural Group Therapy for Perinatal Generalized Anxiety Disorder (GAD) during the COVID-19 Pandemic

The perinatal period is considered a window of vulnerability given the increased risk of psychiatric difficulties during this time, such as mood and anxiety disorders (ADs). Pre-pandemic rates of ADs in perinatal women were one in five but have since increased with the onset of the COVID-19 pandemic (COVID). In addition, recent research suggests that the focus of worry has shifted during the pandemic, with perinatal women reporting significantly more COVID-specific worries. The objective of this study was to augment our current evidence-based Cognitive Behavioural Group Therapy (CBGT) for perinatal anxiety protocol by targeting intolerance of uncertainty and tailoring existing strategies to address COVID-related worry and impact. Pregnant (n = 19) and postpartum (n = 49) women were recruited from regular clinic patient flow from a university-affiliated teaching hospital between September 2020 and March 2021. Improvements in generalized anxiety symptoms, worry, intolerance of uncertainty, and mood were observed at post-treatment, maintained at 3-months, and the intervention received high ratings of treatment satisfaction. This is the first study to examine an augmented CBGT for perinatal women with GAD during the pandemic and supports the inclusion of strategies that target intolerance of uncertainty as well as specific pandemic and perinatal worry content for effective outcomes.

Psychosocial Assistance Through a Support Group Program as a Strategy for Handling Adolescent Social Problems in the Village of Merak Belantung, South Lampung

Tujuan dari kegiatan pengabdian kepada masyarakat ini adalah membantu meningkatkan kesadaran remaja tentang pentingnya sehat secara sosial serta membantu pemerintah Daerah Lampung Selatan mengurangi permasalahan-permasalahan sosial khususnya masalah sosial remaja. Masa remaja merupakan masa transisi dari masa anak-anak ke masa dewasa. Dianggap dewasa belum, dianggap anak-anak juga bukan. Oleh karenanya remaja perlu didampingi secara psikososial supaya remaja bisa berkembang secara baik dan sesuai yang diharapkan oleh orang tua. Salah satu permasalahan remaja adalah masalah pencarian jati diri. Melihat situasai seperti ini timbul keiginan untuk mendampingi remaja dan bekerjasama dengan para tokoh masyarakat di Desa Merak Belantung Lampung Selatan untuk memberikan bimbingan dan penyuluhan serta pendampingan kepada para remaja warga di desa tersebut. Hal itu dilakukan supaya warga sadar akan pentingnya sehat secara sosial dan membantu pemerintah mengatasi masalah sosial remaja. Metode kegiatan untuk pengabdian kepada masyarakat ini menggunakan program Support Group, yang didalamnya akan ada kegiatan bimbingan, penyuluhan dan pendampingan psikososial kepada remaja di Desa Merak Belantung Lampung Selatan. Jika ini terealisir maka insyaalah permasalahan sosial remaja di Desa Merak Belantung Lampung Selatan akan teratasi. Salah satu kebanggaan kota Desa Merak Belantung adalah memiliki banyak tempat wisata yang ramai dikunjungi oleh para wisatawan baik lokal maupun domestik bahkan internasional. Keberadaan pariwisata tersebut idealnya memberi kontribusi kepada masyarakat khususnya remaja untuk berfikir dan bertindak sesuai norma-norma sosial masyarakat Desa Merak Belantung Lampung Selatan. Kenyataannya para remaja malah terpengaruh dengan lingkungan wisata yang relatif bebas tersebut. Disinilah urgensi pengabdian kepada masyarakat ini dilakukan. Keberadaan tempat wisata seharusnya tidak mengurangi untuk menjadi remaja yang sholeh secara pribadi, sosial dan spiritual. Kesimpulan dari pengabdian ini adalah (1) Support group therapy yang diberikan membuat informan mengenali dirinya, memahami bahwa setiap orang memiliki kelebihan dan kekurangan dan juga sejarah masing-masing, serta bisa menerima dirinya; (2) Support group therapy yang telah dilaksanakan mampu memberikan fungsi terapeutiknya terhadap kelompok, yaitu sebagai faktor dukungan (supportive factors), faktor keterbukaan diri dan katarsis, faktor belajar kebijaksanaan atau kearifan dari anggota kelompok lainnya, serta faktor-faktor psikologis yang berkaitan dengan bagaimana menjalin hubungan dengan orang lain dan bagaimana memahami diri sendiri.