Meeting the psychological needs of the culturally and linguistically different has always posed challenges to mental health providers. The Haitian community in South Florida has been one such group for whom mental health services have been less than readily available. Some reasons include a lack of trust from the community, a pejorative cultural framework of mental health services, as well as, a lack of competent Haitian Creole speaking therapists armed with culturally congruent therapeutic skills. These present as challenges for community based-agencies attempting to meet the mental health needs of this population. It is even more problematic for humanitarian voluntary agencies (VOLAG) that sponsor refugees and support them throughout their resettlement efforts. Additionally, the 2010 earthquake has given rise to gender based violence disproportionally impacting women and girls (Amnesty International, 2011) who are now seeking safe haven in the U.S. and particularly South Florida. Tasked with assisting in the resettlement of Haitian refugees/asylees/parolees, many psychologically affected by pre and post migration traumas, these agencies must find unique solutions to help their clients toward the ultimate goal of resettlement, self-sufficiency (Stenning, 1996). This Applied Clinical Project (ACP) showcases a community-university partnership with a VOLAG. Participatory Action Research (PAR) protocol was used as an explorative tool to learn from stakeholders about the efficacy of incorporating Solution-Focused Group Therapy (SFBT) in a resettlement integrative program for Haitians. Results will also contribute to the future development of a toolkit to support family therapists in adapting their western trainings to provide culturally and linguistically competent mental health services.

The United States Supreme Court decision in the Roe v. Wade (1973) case provides women with a right to privacy and the liberty to make decisions concerning their reproductive lives. With this, women who become pregnant are offered the right to choose between keeping their pregnancy and terminating the pregnancy by way of abortion. Since Roe v. Wade (1973), many women have exercised their reproductive liberties, as evidenced by the termination of over 60 million pregnancies via legal abortion in the United States. Still, secrecy among women with a history of abortion remains a common phenomenon. Studies conducted on abortion and reasons for abortion are innumerable and literature on reasons women keep abortion secret are readily available. However, research lacks in the area of examining the lived experience of women with history of abortion secret. Thus, this research examines this phenomenon from women’s lived experiences and the effects of the secret on their relationship(s) when kept from at least one person(s) with whom the post-abortive women are/were in relationship. Purposive sampling was used to select five female participants for this study. To examine participants’ lived experience with abortion secret history as it relates to its effects on relationship(s), the researcher employed qualitative method Interpretative Phenomenological Analysis (IPA) in conjunction with Bowen Family Systems Theory approach. Seven superordinate themes emerged from the data analysis: self-sacrifice, emotional aftermath of abortion secret; secrecy as protection; dance of anxiety; effects on relationships; generational experiences; and, finding freedom. The collaborative use of IPA and Family Systems Theory provided an understanding of participants’ experiences, the effects of the secret on participants, as well as their emotional systems. The data collected added to the limited research available on this phenomenon providing space for post-abortive women’s secrecy experience to be heard.

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Psykisk ohälsa är något som har stort inflytande på människors dagliga rutiner där de drabbade kan sakna motivationen för att hålla sig till sina vardagliga uppgifter. På marknaden finns det idag appar som ska motivera användare till att ta hjälp och skapa nya rutiner. Hos dessa appar fattas det dock önskvärda funktioner eller så ligger de bakom en betalvägg vilket kan göra att man tappar motivationen till att använda apparna. UX- och UI-design kan vara väldigt viktigt för att användare ska kunna skapa nya användningsrutiner, speciellt vid appar för psykisk ohälsa. Vi har därför skapat en app-prototyp, med inspiration från analysmetoden kognitiv beteendeterapi (KBT), som har en UX- och UI-design som ska uppmuntra till rutinskapande och vara lättillgänglig. För att validera vårt arbete samt utveckla vår gestaltning har vi haft ett flertal itereringstester, samtal med psykologer och kuratorer samt utfört anonyma användartester. Undersökningens resultat visar att applikationer för kontinuerligt bruk uppmuntrar till rutinskapande och användning via enklare funktioner samt en estetiskt tilltalande UI-design. / Mental illness is something that has a big influence on people's everyday routines where the affected person may lack the motivation to abide by their daily tasks. On today's market there are apps which are for motivating users to get help and make new routines, but there is a lack of desirable features or they’re behind a paywall which can affect the motivation to use the apps. UX- and UI-design can be very important for the making of routines for users, especially when it comes to apps for mental illness. Therefore we have created an app-prototype, with inspiration from Cognitive Behavioral Therapy (CBT), which has an UX- and UI-design that will encourage routine making and be more available. To validate our work and develop our design we have had several iteration tests, conversations with psychologists and social workers, and anonymous user tests. The result of the study shows that applications for continuous usage encourage new routines and utilization through simplified features and an aesthetically pleasing UI-design.

Psychodynamic therapy (PDT) and Cognitive behavioral therapy (CBT) are the main Therapeutic Orientations (TO) in Sweden and this study aims to explore the relationship between psychologists personal value preferences and their inclination toward PDT/CBT. Furthermore, the study explored if there is a tendency to explicitly appreciate one TO and depreciate the other (explicit bias) and additionally, if that tendency is associated with personal value preferences. Participants consisted of a voluntary response sample of clinical psychologists in Sweden (N = 151). The subjects answered an online survey advertised in the largest Swedish group for psychologists only on a social network. The survey was comprised from three already existing questionnaires (Portrait Values Questionnaire (PVQ57), Therapeutic orientation questionnaire (TOQ-R) and Therapeutic orientation- and experiences questionnaire (TOES). Results showed that inclination toward CBT was significantly associated with the personal value preferences security and power and that there was a clear tendency of explicit bias. The sample was skewed toward appreciating CBT and depreciating PDT and the personal value preference benevolence was higher for the unbiased group than it was for the biased group. This study shows accordance with previous research with the exception of there being less extensive differences regarding personal value preferences and inclination towards TO. / Psykodynamisk terapi (PDT) och kognitiv beteendeterapi (KBT) är de mest tillämpade terapiorienteringarna (TO) i Sverige och denna studie syftar till att utforska sambandet mellan psykologers personliga värderingspreferenser och deras benägenhet för PDT/KBT. Därtill utforskas huruvida det finns en tendens att uttryckligen uppskatta den ena TO och nedvärdera den andra (explicit bias) och dessutom, om den tendensen är förknippad med personliga värderingspreferenser. Deltagarna bestod av ett frivilligt svarsurval av kliniska psykologer i Sverige (N = 151). Försökspersonerna svarade på en webbenkät som hänvisades till i den största sociala nätverksgruppen för svenska psykologer. Undersökningen använde sig av tre redan existerande frågeformulär. Webbenkäten bestod av tre redan existerande frågeformulär: Portrait Values Questionnaire (PVQ57), Therapeutic orientation questionnaire (TOQ-R) and Therapeutic orientation- and experiences questionnaire (TOES). Resultaten visade att en benägenhet för KBT var signifikant förknippad med personliga värderingspreferenserna säkerhet och makt samt att det fanns en tydlig tendens till explicit bias. Urvalet lutade mot att uppskatta KBT och nedvärdera PDT samt att personliga värderingspreferensen välvilja var högre för gruppen bland psykologer utan bias än de med hög bias. Denna studie visar överensstämmelse med tidigare forskning, men uppvisar mindre skillnader vad gäller personliga värderingspreferenser och föredragen TO.

La population âgée est vulnérable face à des problèmes d’insomnie qui peuvent parfois être accompagnés d’anxiété. La thérapie cognitivo-comportementale pour insomnie (TCCi) est le traitement de première ligne pour l’insomnie mais reste peu accessible. Le développement d’une TCC pour l’insomnie et l’anxiété délivrée sur la plateforme en ligne e-SPACE fournit l’accessibilité d’une intervention novatrice pour les personnes âgées isolées. Les objectifs étaient : 1) d’évaluer la convivialité et l’acceptabilité de e-SPACE 2) vérifier l’efficacité de la TCC en ligne pour l’insomnie et l’anxiété. Ainsi, 92 participants âgés insomniaques répartis aléatoirement dans deux groupes (groupe 1 TCCi en ligne N = 47 et groupe 2 liste d’attente N = 45) ont complété : - Agenda de sommeil, Index de Sévérité de l’Insomnie (ISI) et Inventaire d’anxiété gériatrique (GAI) avant et après thérapie/attente pour vérifier l’efficacité - Questionnaire de satisfaction adapté de l’échelle de mesure de la convivialité (SUS) et du questionnaire du modèle d’acceptation technologique 2 (TAM-2), pour vérifier la convivialité et l’acceptabilité La moyenne de score SUS indique que la plateforme e-SPACE est conviviale. Les questions du TAM-2 confirment que son acceptabilité repose sur sa facilité d’utilisation, son utilité et la démontrabilité des résultats. La diminution significative des scores ISI (F = 19.855, p < 0.001) et GAI (F = 11.332, p = 0.001) uniquement chez le groupe 1 démontre l’efficacité de la thérapie. Cependant, il reste une marge d’amélioration afin que la plateforme soit plus adaptée et plus efficace à traiter les symptômes d’insomnie et d’anxiété pour les aînés. / The elderly population is vulnerable to insomnia problems that can sometimes come along with anxiety. Cognitive-behavioural therapy for insomnia (CBTi) is considered as the first-line treatment for insomnia but is still not widely available. The development of an internet-delivered CBT for insomnia and anxiety on the e-SPACE online platform provides accessibility to an innovative intervention for isolated seniors. The objectives were : 1) to assess the usability and acceptability of e-SPACE 2) to verify the efficacy of the online CBT for insomnia and anxiety. Thereby, 92 elderly participants with insomnia were randomised into two groups (group 1 online CBTi N = 47 and group 2 waiting list N = 45) and completed : - Sleep Diary, Insomnia Severity Index (ISI) and Geriatric Anxiety Inventory (GAI) before and after therapy/waiting to verify efficacy - Satisfaction questionnaire adapted from the System Usability Scale (SUS) and the extension of Technology Acceptance Model (TAM-2) to verify usability and acceptability The means of SUS score indicates that the e-SPACE platform is user-friendly. The TAM-2 questions confirm its acceptability is predominantly based on perceived ease of use, perceived usefulness and the result demonstrability. The significant decrease of ISI (F = 19.855, p < 0.001) and GAI (F = 11.332, p = 0.001) scores in group 1 alone confirms the effectiveness of the therapy. However, there is room for improvement so that the platform is more suitable and more effective in treating the symptoms of insomnia and anxiety for seniors.

Funktionella neurologiska symtom är vanliga och funktionsnedsättande symtom som ofta anses svårbehandlade. En vanlig förklaringsmodell har varit att den drabbade varit med om något stressande och traumatiskt som lett till kroppsliga symtom. Denna förklaringsmodell leder till frågan om psykologisk behandling med fokus på trauma kan påverka funktionella neurologiska symtom. En systematisk litteraturöversikt, i enlighet med riktlinjer från Statens beredning för medicinsk och social utvärdering, har genomförts för att undersöka om psykologisk traumabehandling med kognitiv beteendeterapi och Eye Movement Desensitization and Reprocessing Therapy kan minska funktionella neurologiska symtom vid symtom på komorbid posttraumatiskt stressyndrom. Resultaten av litteraturöversikten består av totalt 10 artiklar, merparten fallstudier. Slutsatsen av litteraturöversikten tyder på att den forskning som gjorts visar på minskning av funktionella neurologiska symtom efter behandling av symtom på posttraumatiskt stressyndrom. Detta forskningsområde är dock väldigt litet och består främst av fallstudier med något bristande kvalitet. Trots detta anser vi att det finns underlag för att rekommendera att det bör finnas ett fokus på erfarenheter av trauma vid bedömning av funktionella neurologiska symtom.

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