En Europe, la France a le plus haut niveau de consommation de cannabis. En 2014, près d’un quartdes jeunes français de 15 à 25 ans étaient consommateurs mensuels. Fumer du cannabis engendre desconséquences somatiques, psychiatriques et sociales, ainsi qu’un sur-risque d’accident mortel aprèsavoir consommé. Les effets de la consommation durant l’adolescence sont responsables de microlésionscérébrales souvent irréversibles. La lutte contre la consommation de cannabis est un enjeu de santépublic majeur pour de nombreux pays. En France, 80% des jeunes de 15-25 ans ont consulté un médecingénéraliste dans l’année écoulée, ce qui en fait un interlocuteur privilégié pour le repérage précoce de laconsommation de cannabis. Pourtant, peu de médecins généralistes interrogent leurs patients sur leurconsommation. L’Intervention Brève est une technique d’entretien motivationnel, centrée sur le patientet ayant pour objectif un changement de comportement. Des études ont montré l'acceptabilité et lafaisabilité de cette technique auprès des consommateurs. Le médecin généraliste pourrait donc utilisercette technique pour repérer et prendre en charge les jeunes consommateurs.Nous avons réalisé 2 études qualitatives, l’une par entretiens individuels auprès de jeunesconsommateurs, l’autre par focus group auprès de MG, afin de mieux comprendre leur relation et dansle but d’améliorer leur communication. L’étude qualitative auprès des adolescents soulignaitl’ambivalence propre à cette période et à la consommation d’une substance. Ils percevaient le MGcomme juge et possible délateur, mais également comme une autorité bienveillante et l’interlocuteurprivilégié pour parler de leur consommation. Le manque de temps et de connaissances du MG étaientperçus comme des obstacles au dialogue, connaître le MG depuis longtemps était un facilitateur.L’étude auprès des MG révélait également une ambivalence : conscients des dangers du cannabis, ilsconcevaient pourtant sa consommation comme du domaine de la vie privé des consommateurs. Ils ontrapporté un manque de connaissances et de temps pour aborder le sujet. Connaître le patient depuislongtemps était un frein à la relation.Nous avons ensuite réalisé un essai contrôlé randomisé en cluster afin d’évaluer l’effet à 12 mois dela réalisation d’une intervention brève par des médecins préalablement formés auprès d’adolescentsconsommateurs de cannabis de 15 à 25 ans. Après 1 an, la consommation des patients du groupeintervention (GI) est passée de 30 [6-80] à 17.5 (2–60) et celle du groupe témoin (GT) de 20 [5-40] à 17.5(4–40). L’étude n’a pas montré de résultats statistiquement significatifs entre les deux groupes à 1 an : p= 0.13. Cependant, l’étude a montré une diminution significative du nombre de joints fumés dans le GI(p = 0.02), ce qui n’est pas le cas dans le GT (p=0,29). A 1 an également, les consommateurs nonquotidiens fumaient moins dans le GI (GI = 3 [0–15] versus GC =10 [3–30] joints par mois ; p = 0.01). Au6ème mois, l’étude a montré une différence significative en analyse multivariée entre les niveaux deconsommation pour les moins de 18 ans (GI = 12.5 [1–30] versus GC = 20 [12–60], p = 0.04).Ces résultats sont de nature à encourager les médecins généralistes à repérer précocement leursjeunes patients consommateurs de cannabis et à réaliser une intervention brève. La posture d’expert desanté, distancié des représentations personnelles et de citoyen, lui permet d’être univoque dans sonmessage et sa prise en charge, tout en usant d’empathie qui permet une alliance thérapeutique avec lejeune consommateur. La recherche clinique sur le cannabis est délicate en raison de l’aspect illégal de sa consommation et interroge sur la recherche sur les substances illicites en général. Les dangers du cannabis sont tels, qu’ilfaut continuer à encourager l’émergence de travaux sur cette thématique pour comprendre lescomportements des consommateurs et optimiser leur prise en charge / A major public health issue in many countries, the consumption of cannabis is higher in France thananywhere else in Europe. In 2014, nearly a quarter of French youths aged 15 to 25 were monthlyconsumers. Smoking cannabis has somatic, psychiatric and social consequences, and there is a high riskof a fatal accident during or after consumption. Consumption is responsible for cerebral micro-lesions inadolescents in particular, the effects of which are often irreversible. In France, 80% of young peopleaged 15-25 consult a general practitioner (GP) in a typical year, making these professionals ideallyplaced to detect and advise on cannabis use early on. Few general practitioners question their patientsabout their intake, however. Brief Intervention (BI) is a motivational, patient-centered interviewtechnique designed to change behavior, and studies have shown its acceptability and feasibility forusers, including younger consumers’. GPs could make use of it to identify and treat cannabis users.Two qualitative studies were carried out, one using individual interviews with young users, the otherby focus group with the GP, in order to better understand the relationship and to improvecommunication between them. The qualitative study among adolescents highlighted the ambivalencepeculiar to this age group and to substance use in particular. They perceived the GP to be a judge and apossible informer, but also a benevolent authority and a privileged interlocutor in discussions aboutdrug use. A lack of time, and poor knowledge of the GP were perceived to be obstacles to dialogue, butknowing the MG for a long time made matters easier. Studying GPs also revealed an ambivalence:conscious of the dangers of cannabis, they nevertheless conceived its consumption to be a feature ofthe private lives of consumers. They also reported a lack of knowledge and time to address the topic.Knowing the patient for a long time was a brake to the drug dialogue.Based on the data obtained from the study, we developed a one-day training seminar for GPs. Theobjectives were to remove barriers to communication, to refresh doctors on current knowledge aboutcannabis, and to train them in brief intervention.A randomized controlled cluster trial were performed to evaluate the 12-month effects of briefintervention by the GP who had previously been trained among adolescents between 15 and 25 years ofage who used cannabis. After 1 year, cannabis use in the intervention group (IG) decreased from 30 [6-80] to 17.5 [2-60] and that in the control group (CG) decreased from 20 [5-40] to 17.5 [4-40]. The studydid not show any statistically significant results between the two groups after 1 year: p = 0.13. However,it did show a significant decrease in the number of joints smoked in the IG (p = 0.02), which was not thecase for the CG (p = 0.29). Also after 1 year, non-daily consumers smoked fewer joints per month in theIG (IG = 3 [0-15] versus CG = 10 [3-30], p = 0.01). In the 6th month, the study revealed a significantdifference in the multivariate analysis between consumption levels for those under 18 (IG = 12.5 [1-30]versus CG = 20 [12-60], p = 0.04).This study has also allowed an understanding of the complexity of the approach to the cannabisuse in primary care. The structuring of research on primary care is complex and requires methodologicalreflection that is essential for all future projects. Clinical research on cannabis is a delicate matterbecause of the illegality of its use and more general questions of research on illegal substances. Thedangers of cannabis are such that it is necessary to continue to encourage further work on this topic inorder to understand the behaviors of consumers and improve care regimes.

The thesis deals with the relationship between one's time perspective and their ability to cope with the termination of the relationship. The time perspective is composed of five temporal orientations - past positive, past negative, present hedonistic, present fatalistic and future - which differ from each other in personality characteristics and their influence on human behavior. Our aim was to explore the differences among them in the choice of coping strategies in dealing with a breakup and verify the hypothesis. The following methods were used in the research: Zimbardo Time Perspective Inventory (ZTPI), questions concerning respondent's breakup and Brief COPE, which measured a total of 14 coping strategies on a sample of 237 respondents. The results confirmed the different choices of coping strategies among five time orientations. Although it was not proved that some temporal orientations (past negative) would cope with the breakup more problematically, it seems, however, that these ones mostly use maladaptive coping strategies which can make their breakup adjustment harder. In the conclusion, therefore, are also considered the possibilities of application of our results in psychological counseling practice. Powered by TCPDF (www.tcpdf.org)

Few studies have systematically evaluated whether preferences can reliably be identified using brief procedures. Typically, studies have used brief procedures to select potential reinforcers for use in intervention procedures. A total of 17 food and leisure paired-choice preference assessments were administered to 10 subjects in order to evaluate the extent to which the results of a brief (i.e., single-session) assessment correspond with those from more extended procedures (i.e., 5 sessions). Eleven out of the 17 brief and extended assessments identified the same stimulus as the most preferred (highest rank). Outcomes suggest that a brief assessment can be useful when a single, potent reinforcing stimulus is desired, and an extended assessment should be conducted when a larger number of preferred stimuli is desired.

Bakgrund: Alkoholproblematik förekommer i hela världen och drabbar miljoner människor på olika sätt. Tidigare forskning visar att rådgivande samtal är en effektiv metod för patienter med alkoholproblematik, som vill genomgå en förändring i sitt beteende. Syfte: Syftet var att belysa patienters upplevelser av rådgivande samtal i samband med alkoholproblematik. Metod: En allmän litteraturöversikt med induktiv ansats baserades på åtta vetenskapliga artiklar. Resultatet gav tre teman: upplevelser av vårdrelationen, upplevelser av behandlingsmetoden och upplevelser av behandlingsmetodens effekt. Resultat: Litteraturöversikten belyser hur patienter med alkoholproblematik upplever rådgivande samtal. Temat upplevelse av vårdrelationen visade hur viktigt det var för patienten att känna sig förstådda av samtalsledaren och att det fanns tillit och trygghet för att patienten skulle våga prata om sin alkoholkonsumtion. Temat upplevelse av behandlingsmetoden visade att patienterna hade delade åsikter om rådgivande samtal, men att större delen av patientgruppen upplevde de rådgivande samtalen som behjälpliga. Temat upplevelse av behandlingsmetodens effekt visade att patienterna upplevde att det fått mer kunskap om hur alkohol kan påverka olika delar i livet, och det gav motivation till att begränsa sin alkoholkonsumtion. Slutsats: Patienterna upplevde att vårdrelationen var viktigt i ett rådgivande samtal. Det rådgivande samtalet var också tvunget ha ett syfte för att upplevas relevant av patienterna. / Background: Alcohol misuse is prevalent around the world and affects a great number of people. Early research shows that brief interventions are an effective method of treatment for persons when changing behaviors associated with alcohol misuse. Aim: The aim of the study was to describe patient’s experiences of counseling as used to treat alcohol misuse. Method: A general literature review with an inductive approach was based on eight scientific articles. In the result three different themes emerged: experiences of the care relationship, experiences of the counseling method and experiences of the counseling effect. Result: The literature review illustrates how patients with alcohol problems experience counseling. The theme experiences of the care relationship showed how important it was to feel understood by the interviewer and that there was trust and safety for the patient to dare to talk about the alcohol consumption. The theme experiences of the counseling method showed that the patients had shared opinions about counseling, but most of the patients experienced the counseling as helpful. The theme experiences of the counseling effect showed that the patients experienced that they gained more knowledge about how alcohol can affect different parts of their lives, and it gave motivation to limit their alcohol consumption. Conclusion: The patients experienced that the care relationship was important in counseling. The counseling was also compelled to have a purpose in order to be considered relevant by the patients.

Bakgrund: En hög alkoholkonsumtion är en av de levnadsvanor som utgör störst hälsorisk. Trots detta screenas sällan patienter för sitt alkoholbruk i kontakten med primärvården vilket går emot rådande rekommendationer och riktlinjer från flera instanser.Syfte: Syftet med denna litteraturstudie var att klargöra de bakomliggande orsaker som hindrar diskussionen kring alkoholvanor i vårdpersonalens möte med patienten inom primärvården.Metod: Litteraturstudie med kvalitativ ansats. Litteratur söktes i databaserna PubMed och CINAHL med sökord grundade i POR-modellen. Vidare identifierades MeSH-termer och CINAHLheadings för att öka specificiteten i litteratursökningarna. Valda artiklar granskades med hjälp utav SBU:s mall för granskning av kvalitativa artiklar. Sedan genomfördes en innehållsanalys för att framställa resultaten. Resultat: Två övergripande områden identifierades vilka var Organisatoriska förutsättningar och Personalens attityder och syn på patienten. Vårdpersonalen uttryckte främst tidsbrist, kunskapsbrist samt ineffektiva verktyg och rutiner kring screening för alkoholbruk som hinder relaterade till de Organisatoriska förutsättningarna. Under Personalens attityder och syn på patienten visade sig personalens egna attityder och föreställningar om hur patienten skulle reagera utgöra barriärer för diskussionen kring alkohol. Konklusion: Då framförallt tids- och kunskapsbrist sågs som ett hinder för att diskutera alkoholvanor var det av vikt att verksamheten tillgodoser tidsbehovet samt stöd och fortbildning för att öka personalens känsla av trygghet. För att kringgå de hinder relaterade till vårdpersonalens attityd och förförståelse, kunde de bemöta patienten på ett icke-dömande sätt samt fokusera på det medicinska och hälsofrämjande perspektivet. / Background: A high level of alcoholic intake is one of the most hazardous lifestyle risk factors. Despite this risk, patients visiting the primary health care are rarely screened for their alcohol use, thereby neglecting existing recommendations and guidelines presented by several institutions.Aim: The aim of this literature review was to elucidate the underlying reasons impeding on the discussion about alcohol habits when the health-care staff and the patient meets in a primary health-care setting.Methods: Literature review with a qualitative approach. The literature-search was undertaken in the PubMed- and CINAHL-databases, using terms stemming from the POR-model. Further, MeSH-terms and CINAHLheadings were identified to increase the specificity of the literature search. The chosen articles were reviewed using the SBU-template for qualitative research, and then a textual data analysis was undertaken.Findings: Two overarching factors were identified as Organizational Conditions and The Attitudes of Health-Care Staff and Their View of the Patient. The staff expressed the lack of time, lacking knowledge as well as inefficient tools and routines for screening alcohol use as barriers related to the Organizational Conditions. Relating to the The Attitudes of Health-Care Staff and Their View of the Patient, the attitudes of the staff and their presumptions about the patients expected reactions formed the main barriers for discussing alcohol.Conclusion: The lack of time and knowledge were seen as barriers for discussing alcohol habits, therefore it is of importance for the organization to provide the needed time and continuous education to increase the confidence of the personnel. To avoid the presumed negative patient reactions, the staff could treat the patient in a non-judgemental way as well as focus on the medical and health-promoting perspective.

abstract: Emerging adulthood represents a liminal space between adolescence and adulthood. Attachment with a romantic partner is commonly developed during this time; however, the nature of the dating relationship often remains ambiguous and/or undefined. Dating provides emerging adults the opportunity to develop their romantic competence and navigate these particular attachment relationships. Conflict, and how it is managed, is a critical variable during this time and differentiates between couples who progress in their relationship from those who terminate. What is more, partners may become stuck in destructive cycles, or patterns, of conflict (i.e., demand-withdrawal). Using the theoretical frameworks of attachment theory and emotionally focused couples therapy, this study’s goal it to examine the impact of a brief writing-intervention on relational quality, secure attachment behaviors (i.e., accessibility, responsiveness, and engagement) and attachment dimensions (i.e., anxiety, avoidance). Sixty-seven participants were randomly assigned to one of three conditions for a two-wave study: (1) a treatment condition that was provided an educational presentation regarding couples’ negative cycles of interaction and attachment needs, followed by a guided writing task; (2) a comparison condition that only received the educational presentation; and (3) a control condition that received neither the educational presentation nor the writing task. Hypotheses proposed that participants in the treatment condition would experience increased relational quality, secure attachment behaviors (for both themselves and their partner), and greater secure attachment (i.e., decreased anxiety and avoidance) across time compared to the comparison and control conditions. Data did not support the hypotheses. These findings offer important implications for the development of future brief couples’ interventions and aim to generate future research. / Dissertation/Thesis / Doctoral Dissertation Communication Studies 2020

This dissertation consists of two projects. Project 1 is comprised of two systematic review studies in which self-report measures of adult characterological resilience were identified and summarized. In Study 1, 51 personality-based instruments across five personality-based resilience constructs (ego-strength, grit, hardiness, mental toughness, and resilience) were identified. Information for each measure inclusive of measure title, construct, item count, factors, response scale and items, scoring method, and score range was summarized. In Study 2, 1,322 articles were identified that described 1,193 studies and 1,351 participant samples who completed between one and four of these resilience measures. Measure use frequency and contextual use information related to study and sample attributes are summarized. Project 2 is a series of meta-analyses that were conducted to investigate the psychometric properties of scores on the Brief Resilience Scale (BRS) reported in 149 studies of adult participants. Reliability generalization methods are used to summarize 86 observations of internal consistency (mean Cronbach’s α = .86) and validity generalization methods are used to summarize eight observations of convergent validity (Mr = .61). Concurrent validity is also investigated via validity generalization methods for the most frequently observed mental health correlates of BRS scores. For each set of mental health measures, an estimated summary effect was calculated (anxiety, Mr = -.47; depression, Mr = -.49; optimism, Mr = .44; social support, Mr = .24; and stress, Mr = -.53). Of the significant moderators conducted for concurrent validity estimates, the largest was sample category (accounting for 100% of the variance in the observed correlations between the BRS and measures of social support). Geographic location and participant age, accounted for 55%, and 24%, of the variation in the observed correlations between the BRS and significantly moderated the relation between the BRS and perceived stress. Discussion for both projects include how the obtained relate to resilience theory, and the potential broader implications of these findings. Also based upon these reviews and meta-analyses, the challenges of resilience measure use are discussed and observations/recommendations are provided.

Adlerian brief therapy is a specific application of Individual Psychology that aims to bring focus and effective change to the lives of individuals in a relatively short period of time. The authors believe that a focused Adlerian approach meets the needs of individual clients now and in at least the early decades of the 21st century. This article is designed to explicate the process and practice of Adlerian brief therapy with an emphasis on the flow of therapy sessions and the specific listening skills that facilitate change in a time-limited format.

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Adlerian Brief Therapy is a specific approach to Individual Psychology that uses relational strategies to bring about effective change in the lives of individuals, groups, couples, and families(Bitter, Christensen, Hawes, & Nicol, 1998; Sonstegard, Bitter, Pelonis-Peneros, & Nicoll, 2001). In this article, the authors discuss a relationship-intervention continuum s an integration of two approaches. A therapy session demonstrating Adlerian Brief Therapy with individuals is use to highlight the integration.