Primary care providers have become the front line of treatment for mental health in the United States. Group interventions have been argued to be an effective way to treat more patients with fewer resources, which could reduce the burden of psychopathology on primary care settings. Group therapy faces many barriers to successful implementation in primary care, including site constraints, provider perceptions, population needs, and recruiting difficulties. A survey was developed to assess primary care providers’ perspectives on these areas and distributed via online survey to practitioners in Appalachia; 28 providers responded. No hypotheses were supported, likely a result of the small sample size. Analysis of quantitative and quantitative data elucidated some potential areas for future exploration. Respondents held generally favorable views of group therapy in primary care, and may be more responsive to the peer support and learning elements of group interventions than time or cost benefits. Respondents reported scheduling and a lack of mental health providers with group expertise to be a significant barrier to group interventions in primary care. Billing may not be a significant concern for primary care providers, as is typically reported. Discrepancies between psychopathology frequently seen in primary care settings and the demand on provider time and attention are also discussed.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24131号 / 医博第4871号 / 新制||医||1059(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 阪上 優, 教授 佐藤 俊哉, 教授 小杉 眞司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Objectives. This study explored mechanisms of change for Compassion Focused Therapy (CFT) groups. The feasibility and acceptability of a new group therapy protocol were assessed in a college counseling center population.Method. Seventy-five participants engaged in eight transdiagnostic CFT groups. Group CFT consisted of 12 weekly sessions. Participants completed measures of fears of compassion, flows of compassion, self-reassurance, self-criticism, shame, and psychiatric distress at pre, mid, and post time points. Significant and reliable change was assessed. Potential mechanisms of change were examined using correlations. Self-report feasibility and acceptability data were collected from therapists and participants respectively.Results. Significant and reliable change was found for fears of self-compassion, fears of compassion from others, fears of compassion to others, self-compassion, compassion from others, self-reassurance, self-criticism, shame, and psychological distress. Improvements in fears and flows of compassion predicted improvements in self-reassurance, self-criticism, shame, and psychiatric distress. The protocol was judged to be feasible and acceptable.Conclusion. The new CFT group protocol appears to be feasible, acceptable, and effective in a transdiagnostic college counseling center population. The identified mechanisms of change support the theory of CFT that transdiagnostic pathological constructs of self-criticism and shame can be decreased by decreasing fears and increasing flows of compassion.

Virtual group therapy offers multiple unique advantages to improving access to mental health care for Canadian youth and families. However, virtual environments may hinder the development of the type of relationships within groups that promote positive treatment outcomes. The present study explores the extent to, and ways in which, service providers working in the youth and family mental health sector in Eastern Ontario adapt to the unique characteristics of virtual environments in order to communicate effectively and develop therapeutic relationships. Secondary quantitative and qualitative data were analyzed using a mixed-methods design. Survey responses (n = 58) and interview recordings (n =12) collected from service providers involved in the delivery of virtual groups for youth and families in response to COVID-19 were analyzed using a concurrent triangulation design. Descriptive statistics indicate service providers achieved moderate satisfaction regarding their ability to communicate and develop relationships within virtual groups, and that this ability was perceived as approximating in-person processes. Thematic analysis suggests that while virtual group environments involve unique challenges and and elevated complexity, facilitators adapt to virtual delivery by both employing diverse strategies and accepting certain limitations. The present study suggests that the unique challenges and complexities involved in virtual group-based therapy need not deter the implementation of virtual groups as a means of better addressing the mental health needs of Canadian youth and families.

No description available.

The aim of this qualitative study was to conduct a naturalistic examination of the process of a music therapy group with preverbal individuals on the autistic spectrum. The study involved a music therapy treatment process, based on music-centered music therapy and music psychotherapy, that occurred in 16 sessions over a period of approximately four months. The study investigated the nature of the clinical process, the elements that characterized the intrapersonal and interpersonal dynamics of the group, and the way participants engaged with and utilized the music in their intrapersonal and interpersonal dimensions. The research design was one originally developed by Smeijsters and Storm (1996) in which the researcher functions in an ongoing consultative role to the therapists as the therapy process proceeds. The study investigated and discussed the advantages and disadvantages of Smeijsters and Storm’s (1996) model. The analyses of the 16 sessions revealed that all the studied clients were able to operate, in terms of intra-relationship, according to Greenspan and Wieder’s (2006) first developmental stage: they demonstrated interest, curiosity, and initiative. In terms of inter-relationship, they were able to operate according to Greenspan and Wieder’s (2006) developmental second stage: they engaged and established relationship with others. It was concluded that music had a relevant role in the process of assessing, treating, and evaluating the individuals in the group. / Music Therapy

The purpose of this Delphi study was to explore and identify a panel of experts' opinions of essential elements for successful multi-family group therapy (MFGT) and to propose the identified elements as guidelines for future MFGT theoretical and program development. Multi-family group therapy continues to be implemented while there is little empirical research to support how it is effective and with what populations and presenting problems it is best employed. A panel of MFGT experts identified 35 essential elements for successful MFGT. Many of the identified elements coincided with elements identified in the relevant literature. However, elements specific to MFGT were distinguished. The essential elements are presented as guidelines for MFGT theoretical and program development. The implications of this study for theory, research, and practice are discussed. / Ph. D.

In die studie is besin oor die wyse waarop die opvoedkundige sielkundige die probleme wat deur die epileptiese adolessente dogter ondervind word, kan aanspreek. 'n Groepterapeutiese begeleidingsprogram is ten doel gestel sodat die intra- en inter-psigiese effek daarvan op die epileptiese adolessente dogter bepaal kon word. Agt epileptiese adolessente dogters is vir die doel van hierdie studie geselekteer, waama hulle aan 'n reeks psigometriese toetse onderwerp is. Voorts het die onderskeie vakonderwysers 'n evalueringsvraelys voltooi. Daar is bevind dat die dogters in die algemeen 'n negatiewe selfkonsep het. Die meeste proefpersone was angstig en depressief. Verhoudingsprobleme en 'n gebrek aan doelstellings het ook onder hulle voorgekom. Volgens die literatuurstudie blyk dit 66k dat die epileptiese kind oor die algemeen 'n hoe voorkoms van psigo-sosiale probleme toon en <lat <lit dikwels lei tot 'n negatiewe selfkonsep. Faktore wat die psigo-sosiale wording van die epileptiese kind kan bei'nvloed, is neuroIV biologiese faktore (byvoorbeeld die tipe toeval), psigo-sosiale faktore (byvoorbeeld stigmatisering) en farmakologiese faktore (byvoorbeeld newe-effekte van medikasie ). Die proefpersone is onderwerp aan 'n groepterapeutiese begeleidingsprogram van tien sessies. Die program het gefokus op intra-psigiese aspekte soos die regstelling van negatiewe selfspraak, asook op die bewusmaking en oefening van interpersoonlike vaardighede. Uit die resultate van die na-toetsing kan afgelei word dat persoonlike groei plaasgevind het - in die algemeen was daar 'n verhoging ten opsigte van die selfkonsep. Interpersoonlike verhoudinge het skynbaar ook verbeter, terwyl angs afgeneem en depressie verminder het. Voorts het die proefpersone se skolastiese prestasie met 5,1 persent verbeter. Die groepterapeutiese begeleidingsprogram het dus 'n positiewe intra- en inter-psigiese effek op die epileptiese adolessente dogter gehad. / This study addressed the ways in which the educational psychologist can address the problems experienced by epileptic adolescent girls. Eight epileptic adolescent girls were subjected to a series of psychometric tests. The results indicated that in general, the majority of the girls were suffering from a negative self-concept, depression and anxiety. They experienced problems with relationships and reflected a lack of goals. The epileptic adolescent girls were subjected to a group therapeutic guidance programme. The programme focussed on intra- and interpsychological aspects such as the modification of negative self-talk and the exercising of interpersonal skills. The results of follow-up tests revealed that in general there had been an improvement of the self-concept. Apparently inter-personal relations had improved, whereas anxiety and depression had declined. At the same time, school performance had increased. Hence, the group therapeutic guidance programme had a positive intra- and interpsychological effect on the epileptic adolescent girls. / Psychology of Education / M.Ed.

In the United States, Black women are more likely to be sexually victimized than any other ethnic group. Despite the higher rates among Black women, there is little research that provides therapists with approaches and techniques that are culturally specific to Black women. Instead, most literature has focused on women as a whole, rather than examining the different cultural values and forms of support that are needed for recovery in different ethnic groups. Therefore, this report will provide therapists with a sociocultural lens to increase awareness of the Black woman's identity, while suggesting a Womanist theoretical approach to group psychotherapy as an ideal method of treatment. / text

Depression is believed to be the most prevalent mental dysfunction among older adults, and depression and anger are frequently linked in theory and in therapy. This study was undertaken to determine whether participation in group counseling sessions would increase awareness and expression of anger and decrease depression levels in women aged 65 and older. Treatment group members were compared to a matching control group. Both groups completed the Anger Self Report Questionnaire and the Beck Depression Inventory. Comparison of the ASR subscale scores, Awareness of Anger, Expression of Anger, Guilt, Condemnation of Anger, and Mistrust, revealed no significant differences between the treatment and control groups. However, the treatment group scored significantly higher on the BDI than did the control group. Analysis of variance of the ASR and the BDI, and the variables upon which the treatment and control groups were matched revealed some significant differences, and comparison of the women in this study with the two groups upon whom the ASR was validated showed this study's older women scored significantly lower than the validation groups on the ASR. The author concluded that six sessions is not long enough to effect change in either anger awareness or expression in older women, and more time is needed to establish group cohesiveness in older populations than that generally thought to be needed for younger populations. Replication of the study with men and women, and replication of Khe study using a longitudinal design is recommended in order to determine whether awareness and expression of anger change with age, or whether differences between older and younger populations are due to historical and environmental influences.