The present study sought to more rigourously explore outcomes of psychological well-being immediately following a psychotherapeutic yoga class. Specifically, the study hypothesized improvements in state anxiety and subjective well-being as well as an observable relationship between state and trait mindfulness following a yoga intervention, all while controlling for differences between yoga instructors, prior yoga experience, and participant endorsements of psychological symptoms. Previous yoga experience was not found to be a significant factor in any of the tested hypotheses. Findings revealed that psychotherapeutic yoga decreased anxiety and increased subjective well-being, even after controlling for therapist variability, prior yoga experience, and client diagnosis. Results also indicate differential impacts on decreased anxiety and increased subjective well-being by class instructor. This is the first study to examine outcomes of an ongoing yoga based-practices in the naturalistic setting of an outpatient counseling center while rigorously controlling for confounding factors (e.g. therapist variability). Methodological and statistical limitations are discussed in depth, and future directions to improve on this study and clarify the present findings are emphasized.

Selective mutism (SM) is a diagnosis marked by withdrawal of speech in certain social situations. The treatment of SM is often a difficult and lengthy process and there are many barriers to successful intervention. Behavioral therapy is most effective in the treatment of SM and the addition of therapeutic activities such as games and mobile devices may provide distinct advantages to this treatment (i.e., decreased patient anxiety levels and more active engagement). The current investigation examined the utility of mobile applications during the behavioral treatment of SM as well as the effect of using mobile applications on child-reported and physiological indicators of anxious responding. Results indicated that children made remarkable treatment gains in just two treatment sessions (i.e., spoke to the clinician within 22 minutes of treatment and held five, five-minute conversations with additional adults during a second session) regardless of modality of delivery (using mobile applications, other activities, or reinforcement alone). Children shaped to speak with the inclusion of mobile applications reported less anxiety and exhibited decreased physiological anxious distress during treatment. The utility of mobile applications during the treatment of SM is discussed in addition to areas for future research (e.g., mobile-based treatment dissemination initiatives).

Text in Afrikaans / Aangesien depressie en angs hedendaags so 'n ingrypende invloed het op mense se lewens en hulle lewenskwaliteit, is daar 'n dringende behoefte aan 'n dinamiese, korttermyn en gerigte terapie om so gou as moontlik by die werklike onderliggende oorsake van die depressie en angs uit te kern. Hierdie studie het ten doel om die gebruik van hipnoterapie in die hantering van depressie en angs by adolessente en volwassenes te ondersoek. Tydens die studie word aangetoon dat die mediese hipnoanalise model 'n geskikte benadering is om as diagnostiese tegniek en terapeutiese intervensie, die oorsprong van depressie en angs aan te spreek. Emosionele probleme soos depressie en angs se oorsprong lê dikwels by foutiewe persepsies wat ontstaan tydens insidente in die kindertyd. Aangesien die persoon se breinprosesse in daardie stadium nag nie goed genoeg ontwikkel is om te besef dat die bedreiging verby is nie, word sulke persepsies nie verwyder nie. Elke persoon analiseer 'n nuwe stresvolle situasie of bedreiging vanuit sy persepsies en verwysingsraamwerk uit die verlede. Tydens 'n stresvolle insident is die depressie- en angslyer in die gewoonte om vanuit 'n depressiewe en angsvolle verwysingsraamwerk te dink en op te tree. Hierdie wyse van dink en optree is volgens sy onbewuste beter vir sy oorlewing van die stresvolle situasie, as wat denke en optrede vanuit 'n verwysingsraamwerk van die werklike onderliggende probleem sou wees. Die mediese hipnoanalise model is in staat om, tydens regressie, die ou foutiewe gedagtepatrone te verander deur die onderliggende gedagte, wat probleme veroorsaak, bloot te lê en te verwyder. Sodoende word die werklike onderliggende probleem blootgelê en verwyder. Die persoon word vry van foutiewe persepsies van die verlede en in staat om te dink en in die toekoms op te tree volgens die nuwe, akkurate persepsies. Deur hierdie meganismes, bewys mediese hipnoanalise homself as 'n geskikte terapeutiese ingreep om depressie en angs suksesvol aan te spreek. / In the light of the far-reaching effects that depression and anxiety have on the lives and the quality of people's lives, there is a need for a dynamic, short term and directed therapy in order to determine the real underlying causes of depression and anxiety as soon as possible. This study aims to examine the use of hypnotherapy in the treatment of depression and anxiety with adolescents and adults. During the course of this study, it is shown that the medical hypnoanalysis model is well suited as a diagnostic technique and therapeutic intervention for treating the origins of depression and anxiety. The origin of emotional problems like depression and anxiety, often lies in the faulty perceptions that have been formulated during childhood incidents. Since the brain processes are not yet as developed as they will become in adult life, the conscious mind does not realize that the threat ceased to exist, and can therefore not remove such perceptions. Each person analyses new stressful situations from the perspective of his own perceptions and the frame of reference of the past. A person suffering from depression and anxiety is in the habit of generating depressive and anxious ways of thinking and acting when confronted with a new stressful situation. The subconscious mind considers these ways of thinking and acting as the best way of surviving the stressful situation, better than ways of thinking and acting from the frame of reference of the underlying problem. The medical hypnoanalysis model can detect and remove the real underlying problem by regressing the person to the time of the incident, thus correcting the old patterns of thinking and acting. The person is freed from past false perceptions, and can think and act according to his new, corrected perceptions. Through use of these mechanisms, medical hypnoanalysis has shown itself to be well suited to the treatment of depression and anxiety. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

Previous research has suggested that depressive disorders are common in youth and are associated with many negative outcomes. As a result, understanding how to treat depression effectively is very important. It is unclear; however, what factors predict treatment success or failure for depressed youth. Researchers are starting to investigate whether comorbid anxiety is a possible moderator of treatment outcome for youth with depression. Studies of the relation between comorbid anxiety and treatment outcome have produced mixed findings and have almost exclusively focused on older depressed adolescents. There is also limited research exploring whether parent intervention moderates the effect of comorbid anxiety on treatment outcome in depressed youth. This study focused on investigating the relation between comorbid anxiety and treatment outcome in a sample of 84 depressed female early adolescents who received either group cognitive behavioral therapy (CBT) or group CBT plus a parent intervention. The addition of parent intervention was explored as a moderator of the relation between anxiety and treatment outcome. Treatment outcome was measured by changes in depression severity and global functioning during treatment. The depression severity and global functioning scores of depressed girls with comorbid anxiety were also compared to depressed girls without comorbid anxiety prior to treatment to determine whether the first group of girls entered treatment with a different level of psychopathology. Participants and their primary caregivers were administered a semi-structured diagnostic interview which was used as a measure of depression severity, global functioning, anxiety severity, and to determine whether participants met diagnostic criteria for depressive and anxiety diagnoses. The results of this study suggested that depressed youth with comorbid anxiety or higher anxiety severity started out treatment with higher depression severity and lower functioning. Results also suggested that comorbid anxiety was not related to negative treatment outcome and that youth with comorbid anxiety actually experienced larger reductions in depression severity over the course of treatment than youth without comorbid anxiety. Parent intervention did not significantly moderate the effect of comorbid anxiety on treatment outcome. The study’s limitations, implications of the results, and recommendations for future research were discussed. / text

Text in Afrikaans / Aangesien depressie en angs hedendaags so 'n ingrypende invloed het op mense se lewens en hulle lewenskwaliteit, is daar 'n dringende behoefte aan 'n dinamiese, korttermyn en gerigte terapie om so gou as moontlik by die werklike onderliggende oorsake van die depressie en angs uit te kern. Hierdie studie het ten doel om die gebruik van hipnoterapie in die hantering van depressie en angs by adolessente en volwassenes te ondersoek. Tydens die studie word aangetoon dat die mediese hipnoanalise model 'n geskikte benadering is om as diagnostiese tegniek en terapeutiese intervensie, die oorsprong van depressie en angs aan te spreek. Emosionele probleme soos depressie en angs se oorsprong lê dikwels by foutiewe persepsies wat ontstaan tydens insidente in die kindertyd. Aangesien die persoon se breinprosesse in daardie stadium nag nie goed genoeg ontwikkel is om te besef dat die bedreiging verby is nie, word sulke persepsies nie verwyder nie. Elke persoon analiseer 'n nuwe stresvolle situasie of bedreiging vanuit sy persepsies en verwysingsraamwerk uit die verlede. Tydens 'n stresvolle insident is die depressie- en angslyer in die gewoonte om vanuit 'n depressiewe en angsvolle verwysingsraamwerk te dink en op te tree. Hierdie wyse van dink en optree is volgens sy onbewuste beter vir sy oorlewing van die stresvolle situasie, as wat denke en optrede vanuit 'n verwysingsraamwerk van die werklike onderliggende probleem sou wees. Die mediese hipnoanalise model is in staat om, tydens regressie, die ou foutiewe gedagtepatrone te verander deur die onderliggende gedagte, wat probleme veroorsaak, bloot te lê en te verwyder. Sodoende word die werklike onderliggende probleem blootgelê en verwyder. Die persoon word vry van foutiewe persepsies van die verlede en in staat om te dink en in die toekoms op te tree volgens die nuwe, akkurate persepsies. Deur hierdie meganismes, bewys mediese hipnoanalise homself as 'n geskikte terapeutiese ingreep om depressie en angs suksesvol aan te spreek. / In the light of the far-reaching effects that depression and anxiety have on the lives and the quality of people's lives, there is a need for a dynamic, short term and directed therapy in order to determine the real underlying causes of depression and anxiety as soon as possible. This study aims to examine the use of hypnotherapy in the treatment of depression and anxiety with adolescents and adults. During the course of this study, it is shown that the medical hypnoanalysis model is well suited as a diagnostic technique and therapeutic intervention for treating the origins of depression and anxiety. The origin of emotional problems like depression and anxiety, often lies in the faulty perceptions that have been formulated during childhood incidents. Since the brain processes are not yet as developed as they will become in adult life, the conscious mind does not realize that the threat ceased to exist, and can therefore not remove such perceptions. Each person analyses new stressful situations from the perspective of his own perceptions and the frame of reference of the past. A person suffering from depression and anxiety is in the habit of generating depressive and anxious ways of thinking and acting when confronted with a new stressful situation. The subconscious mind considers these ways of thinking and acting as the best way of surviving the stressful situation, better than ways of thinking and acting from the frame of reference of the underlying problem. The medical hypnoanalysis model can detect and remove the real underlying problem by regressing the person to the time of the incident, thus correcting the old patterns of thinking and acting. The person is freed from past false perceptions, and can think and act according to his new, corrected perceptions. Through use of these mechanisms, medical hypnoanalysis has shown itself to be well suited to the treatment of depression and anxiety. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

Studies have revealed that nursing students experience greater amounts of stress and anxiety than the average college student. Nursing students attribute increased stress levels to the twin demands of their classroom and clinical workloads. Higher stress levels frequently result in students reporting symptoms of poor health and lack of psychological well-being. It is important to note that some nursing students are also actively working in clinical settings and contending with the added stress of the recent COVID-19 pandemic. Mindfulness meditation is a natural measure that can help alleviate the feelings of perceived stress and anxiety and improve levels of mindfulness and self-compassion. An experimental two group pretest-posttest randomized controlled design was used to evaluate the effect of a virtual mindfulness meditation intervention on levels of perceived stress, anxiety, self-compassion, and mindfulness of nursing students. Study participants were randomly assigned to either an intervention or control group and received recordings prepared by the study authors. The intervention group received a 10-minute mindfulness meditation recording each week and the control group simultaneously received five 10-minute separate recordings on nursing news and information. Both groups were instructed to listen to the recordings at least three days per week for four weeks. The instruments used in this study were the Perceived Stress Scale (PSS), the Generalized Anxiety Disorder subscale (GAD-7), the Self-Compassion Scale (SCS), and the Mindfulness Attention Awareness Scale (MAAS). These surveys were provided at baseline and at a 4-week follow-up. The study presented in this dissertation is part of a larger study that was a collaboration between this author, Debra Heinrich, and Shohini Holden. Other instruments in the original study that are not discussed here are the Depression, Anxiety, and Stress Scale (DASS) and the Five Factor Mindfulness Questionnaire (FFMQ). This dissertation consists of three articles. The first article provides an analysis of the effect of a mindfulness meditation intervention on the stress and anxiety levels of nursing students. A two-way mixed ANOVA revealed a significant interaction between group assignment and timing of test on participants’ stress levels and on their anxiety levels. Follow-up simple main effects tests involving independent-samples t tests revealed that the intervention group, receiving the online mindfulness meditation recordings, experienced lower levels of stress and anxiety on the posttest surveys than the control group. The second article reports on a study of the effect of the intervention on mindfulness and self-compassion levels. The findings of a two-way mixed ANOVA and independent t tests demonstrated that mindfulness meditation can increase levels of mindfulness and self-compassion in nursing students. The third article compares two instruments used to self-report feelings of anxiety, reports on the demographic variables related to anxiety among nursing students, and explores the correlation between levels of mindfulness and levels of anxiety in this study. There were no significant relationships found between any demographic variable and anxiety scores. The GAD-7 instrument was found to be more sensitive to mild and moderate anxiety then the DASS instrument, and it is, therefore, the recommended instrument for use in nursing programs. There was a significant inverse relationship between levels of mindfulness and anxiety for students in this study. The findings of this study demonstrate that mindfulness meditation can reduce stress and anxiety, while increasing mindfulness and self-compassion levels in nursing students. This could be useful for nurse educators assisting students to manage the stress and anxiety often experienced in nursing education. Nursing programs could screen students to evaluate their levels of stress, anxiety, and mindfulness. Stress relief techniques, such as mindfulness meditation, could be incorporated into nursing programs as part of a wellness program or curricular offering. Mindfulness meditation could also be part of orientation programs in clinical sites for new nurses and offered to all nursing staff as part of continuing education. Further research, using rigorous scientific methods, will be needed to study the most effective methods to evaluate and manage stress and anxiety. This could ultimately decrease the stress and anxiety levels and improve well-being for student nurses and nurses, which could in turn positively impact patient care and outcomes.

The present study modified an intervention known as the expressive writing paradigm to assess its efficacy in reducing academic worry, general anxiety, and general psychological distress in a sample of Mexican origin college students. Traditionally, the expressive writing paradigm involves having participants write about a topic of concern for 15 consecutive minutes, 3 consecutive days, without attending to details about grammar or punctuation. The aim of the present study was to modify the writing paradigm into a more structured, problem-focused writing intervention and to assess whether this modification would facilitate the reduction of Latino participantsí academic worry and produce a reduction of their overall worry and psychological distress. The expressive writing paradigm was modified by incorporating components of cognitive behavioral therapy, and specifically cognitive restructuring, into the new writing intervention. It was hypothesized that by combining the writing paradigm and cognitive restructuring techniques, the benefits derived from the expressive writing paradigm would likely be enhanced. Participants were randomly assigned to one of three conditions ñ the traditional writing paradigm (TWP) condition, the structured writing intervention (SWI) condition, or to a control group condition. This study also assessed the relation of level of acculturation and traditional Mexican family values on the efficacy of the treatment interventions. Assessments were conducted at pre-treatment, post-treatment, two week follow-up, and one month follow-up. Results indicated that the TWP condition outperformed the SWI condition at post-treatment in reducing overall psychological distress. However, these effects did not last at follow up assessments. Additionally, family value scores served as a moderator of treatment effects. The results of this study highlight the importance of conducting culturally-informed intervention research to assess the validity of the assumption clinicians currently use to guide their treatments. These findings also highlight the importance of focusing on patients' values when formulating treatment interventions. Theoretical and clinical implications are discussed. / text

This pilot study examined the effects of single sessions of music therapy on the level of anxiety in older persons with psychiatric disorders. The studied intervention was a 30 minute music therapy group and the control intervention was a verbal therapeutic intervention in the form of a reminiscence group. Participants acted as their own control. The measurement tool was the state part of a “State Trait Anxiety Inventory”. It was administered a total of four times, pre- and post- the music therapy intervention and preand post- the reminiscence therapy (control) group. A total of 9 participants were recruited for the study. The results indicated that single sessions of music therapy significantly reduced the level of anxiety for older persons with psychiatric disorders [t(8)=4.626, p<0.0017] as compared to the control intervention as measured by the state part of the “State Trait Anxiety Inventory”. There was no evidence for a significant carryover effect since the baselines prior to each intervention did not differ significantly (p=0.55). These results can be considered to be a part of a pilot study and early inquiry into this field since methodological difficulties and the time limitation of the research resulted in some necessary deviations from the original protocol. A major limitation of the study was the choice of a measurement tool, which required the client to be cognitively high functioning. Thus these results are limited to cognitively able clients, which is a relatively small proportion of this client group that could potentially benefit from music therapy. It is suggested that for future research with this client group the measured variable be physical relaxation, rather than anxiety.

This research report documents the therapeutic intervention undertaken with a 23-year-old Swazi rape victim. The format of this research report takes the form of a case study that follows the principles proposed by Fishman (2005). Its aim is to document the treatment process of an individual of African decent in order to establish whether the treatment model can be effective in clinical settings and in contexts and cultural settings different from that in which it was developed. The Ehlers and Clark (2000) cognitive therapy model for post-traumatic stress disorder (PTSD) was utilised to assess, conceptualise, and treat the case. The client entered therapy three years after being raped for a third time. The case formulation identified factors maintaining the disorder as well as how other traumatic and abusive events earlier in her life influenced her response to the rapes. Data consisted off audio-tape recordings and detailed written synopses of each assessment and therapy session, psychometric measurement instruments and self-report scales completed throughout the intervention, material written by the client, and a research interview conducted by an independent party. She was treated for PTSD and comorbid depression over a period of five months in accordance with the principles described by Ehlers and Clark and a narrative of the treatment process was written. The case narrative in conjunction with quantitative data suggested that this model assisted the client in initiating a healing process. As such the model was found to be both effective and transportable to an African context. Various points of discussion are highlighted, including the challenges of working with PTSD and comorbid major depression, the client-therapist relationship, and that a client and therapist from different cultures, backgrounds, and with different home languages can work together effectively using the Ehlers and Clark model.

This study investigated the relationship among anxiety, depression, and sleep disturbances and the treatment of these three disorders through neurotherapy. Research suggests that these conditions commonly co-occur in the general population and that central nervous system (CNS) arousal may play a primary role in the development and maintenance of these disorders. Several recent studies suggested that neurotherapy, a biofeedback-based treatment for CNS dysregulation, might be an effective treatment for comorbid conditions, particularly the ones of interest here, depression, anxiety, and sleep disturbances. This investigation used a clinical case-series design to assess pre/post neurotherapy changes on objective measures of anxiety, depression, and sleep and to determine whether changes in anxiety and depression then predict improvements in sleep quality. Data for 23 participants (10 males) were obtained from files of adults (Mage = 40.22 years, SD = 16.20) who received at least 15 neurotherapy sessions (M = 47.83 sessions, SD = 22.23) the University of North Texas Neurotherapy Lab. Matched pair t-tests revealed that symptoms of sleep disturbance, depression, and anxiety showed significant improvements following neurotherapy. Neurotherapy treatment effect sizes generally ranged from moderate to large (d = .414 - .849). Multiple regression analysis found that changes in self-reported anxiety symptoms, but not depressive symptoms, predicted observed improvements in sleep quality (adjusted R2 = .26). Last, the implications and limitations were discussed in relation to neurotherapy practice and the associated research.