Hoarding disorder (HD) is a mental health condition characterized by difficulty letting go of possessions, resulting in clutter that prevents use of active living spaces. Consequences associated with hoarding include strained family relationships, distress for children in the home, and increased burden on social services. Currently, the most empirically supported treatment for HD is cognitive-behavioral therapy (CBT), which includes such components as education about the nature of hoarding, challenging unhelpful thoughts, and exposure to distressing stimuli. Despite its demonstrated effectiveness, CBT does not result in clinically significant improvement for at least 50% of individuals, indicating the need for alternative interventions for those who do not respond to CBT. Acceptance and commitment therapy (ACT), an acceptance- and mindfulness-based therapy, is one potential alternative. The overarching aim of ACT is to improve psychological flexibility, the ability to act consistently with meaningful life directions in the presence of difficult internal experiences. Given the high levels of avoidance (e.g., of decision making, of distress) consistently observed in hoarding, increasing one’s range of responses to previously avoided stimuli in the service of more fulfilling activities may be a particularly useful skill. Furthermore, ACT has been found to be effective for clinical presentations related to HD, including anxiety disorders and obsessive-compulsive disorder. The current exploratory study compared the effects of acceptance-based training to psychoeducation on several measures of hoarding severity in a sample of college students with elevated hoarding. Participants (N = 47) completed a discarding behavioral task and self-report measures at postintervention as well as an online follow-up survey one week later. There were no differences in outcomes between conditions over time, suggesting that acceptance training was not more effective than psychoeducation alone. Hoarding severity and thoughts related to hoarding significantly decreased from baseline to one-week follow-up, indicating that both interventions improved hoarding symptoms in our sample. These findings also suggest that early intervention may be a useful approach to alleviating hoarding symptoms.

Thought-action fusion (TAF) is the phenomenon whereby one has difficulty separating cognitions, particularly those that are intrusive and disturbing, from their corresponding behaviors. Recent work has suggested that TAF is malleable and amenable to change. The current study examined the effects of three different psychoeducational interventions on thought-action fusion, anxiety, thought suppression, magical thinking, and responsibility cognitions. Assessments were conducted both immediately following the interventions and after a two-week period. Results indicated that individuals who received a cognitive-based intervention that targeted irrational thoughts had significantly lower TAF scores than individuals who received an intervention that discussed thoughts from a non-evaluative framework and individuals in the control group, both immediately following the intervention and at the two-week follow-up. As hypothesized, all groups experienced a significant decrease in anxiety between the post-intervention and follow-up assessments; however, there was a trend towards significance for those who were exposed to the cognitive-based intervention to experience a greater decrease in anxiety than those in the control group. The cognitive-based intervention group was the only group that did not experience a significant increase in thought-suppression from baseline to post-intervention, and was also the only group to experience an increase in both frequency of and belief in low-responsibility thoughts from baseline to follow-up. No significant group differences were found for the construct of magical thinking. Implications are discussed.

Background: Relapses and, subsequently, readmissions are common in patients with schizophrenia. Psychoeducation has been shown to reduce the number and duration of readmissions. Yet, only little more than 20% of psychiatric patients in German speaking countries receive psychoeducation. Among other reasons, costs may be considered too high by hospitals. The objective of the present study was to test the feasibility of a new cost-efficient approach in the psychoeducation of patients with schizophrenia. In this study, films were used to impart knowledge about the illness to inpatients.

The current literature on victims of sex trafficking lacks adequate research on effective therapeutic treatments for this population. This study aims to find an effective therapy for female victims of sex trafficking to treat trauma-related symptoms including PTSD, depression, anxiety, self-blame, self-esteem, and overall well-being by testing the effectiveness of eye-movement desensitization reprocessing (EMDR), trauma recovery and empowerment model (TREM), and psychoeducation. In this study, approximately 180-200 female victims of sex trafficking ages 18 or older will be randomly assigned to either the EMDR, TREM, psychoeducation, or a control-wait-list group. Trauma-related symptoms will be assessed pre-treatment (Time 1), post-treatment (Time 2), and 6- months post-treatment (Time 3) to assess the effectiveness of each intervention over time. It is expected that participants in all therapy groups will display significantly improved trauma-related symptoms compared to participants in the control-wait list group at time 2. It is further expected that participants in the TREM group will display significantly reduced self-blame and increased self-esteem and overall well-being at time 2 compared to participants in the EMDR and psychoeducation groups. Lastly, it is expected that improvement in trauma-related symptoms will be maintained from time 2 to time 3. These expected findings suggest that TREM will be the most effective long-term therapy for female victims of trafficking.

Made available in DSpace on 2016-03-22T17:27:36Z (GMT). No. of bitstreams: 1 viviane tab mestrado 03dez2012.pdf: 1170965 bytes, checksum: 0f84be28c745330527884c188e8412d4 (MD5) Previous issue date: 2012-12-17 / The aim of this study was to investigate the effectiveness of a psychoeducational intervention through a randomized clinical trial with 177 primary caregivers of users Centers for Psychosocial Care (CAPS) in the city of Pelotas, Brazil. These caregivers showed high levels of overload through the Zarit Burden Interview (ZBI) and were allocated in two groups (control and intervention). The intervention group received six home visits and the control group only support standard of CAPS. After the intervention was performed a reassessment of overload. Sixty-six caregivers received psychoeducation while 64 caregivers no received. The group that received the intervention showed a reduction of 4.8 points in mean ZBI (p = 0.008), whereas in the control group the reduction was 1.9 points in the mean (p = 0.305). The results of this study showed that the psychoeducation group had a considerable decrease in the overhead, thus one might think that psychoeducation has fulfilled its role / Com o objetivo de investigar a eficácia de uma intervenção em psicoeducação foi realizado um ensaio clínico randomizado com 177 principais cuidadores de usuários dos Centros de Atenção Psicossocial (CAPS) da cidade de Pelotas, RS. Estes cuidadores apontaram elevados níveis de sobrecarga através da escala Zarit Burden Interview (ZBI) e foram divididos em dois grupos (intervenção e controle), o grupo intervenção recebeu seis visitas domiciliares e o grupo controle apenas o apoio que já vinha recebendo no CAPS, após o término da intervenção realizou-se uma novamente, nos dois grupos, uma visita de para uma reavaliação da sobrecarga. Cento e setenta e sete cuidadores (40,6%) pontuaram acima de 45 na escala ZBI. Após a randomização 89 indivíduos compuseram o grupo que recebeu a psicoeducação e 88 indivíduos foram alocados para o grupo controle. O Grupo que recebeu intervenção apresentou uma redução de 4,8 pontos nas médias do ZBI (p=0,008), já o grupo controle a redução foi de 1,9 pontos na média, não sendo significativa (p=0,305). Os resultados encontrados neste estudo evidenciaram que o grupo que recebeu a psicoeducação teve uma diminuição considerável nas médias de sobrecarga, com isso pode-se pensar que a psicoeducação cumpriu com seu papel

Clinical decision-making about psychological interventions is best supported by robust evidence and informed patient choice. Randomised controlled trials (RCTs) are the current gold standard in evaluating intervention effectiveness and identifying harm. At present, RCTs of psychological intervention are unlikely to include measurement of adverse effects and this is in part due to lack of consensus about this topic. A Delphi study was conducted with a panel of both professionals and people with personal experience of face-to-face psychotherapy across the spectrum of mental health difficulties to seek consensus on what to include on a measure of adverse effects. Fifty-four items derived from an initial list of 147 items generated by the panel, are included on the APTMOS outcome measure, which now in it's preliminary form now requires validation before use in RCTs. To date, the evidence for psychological interventions for psychosis and schizophrenia has not been synthesised, which is important to inform patient choice and decision-making. Network meta-analysis compares multiple interventions using direct evidence from randomised controlled trials (RCTs) and indirect evidence from the network. A systematic review of the literature identified 91 RCTs across 23 different intervention/control group categories. Psychological interventions were more effective at reducing total symptoms of psychosis than control groups. One intervention with a low risk of bias, mindfulness-based psychoeducation, was consistently identified as most effective, with large effect sizes. Subgroup analyses identified differential effectiveness in different settings and for different subgroups. Further high quality RCT evidence of the highest ranked interventions is required to inform updates to clinical guidelines of psychological interventions for psychosis.

This thesis evaluated training groups for adoptive parents of special-needs children. It was hypothesized that training would influence parenting stress, stress symptoms, and marital satisfaction, and that helpfulness of training sections would depend upon the status of the participants' children (i.e., foster, adopted, or adoption in process). Data were collected from 15 participants who were sampled through agencies that typically interact with adoptive parents. Repeated measures ANOY As were computed to compare scores on the PSI/SF Parental Distress Subscale, OQ-45, and RDAS across three time intervals. No significant differences were found. Data from a scale of helpfulness were analyzed using descriptive statistics. There was a general trend such that foster parents reported the training groups as least helpful, adoptive parents reported them as more helpful, and participants in the process of adoption reported the highest ratings of helpfulness. Explanations for results are discussed along with implications and recommendations for future research.

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical lens through which this study was conducted. It was hypothesized that there is an association between veterans’ involvement in the wellness component of a program and their perceived QOL. The program is a specialty VA service known as Mental Health Intensive Case Management (MHICM). A total of 112 veterans served by a single MHICM program in the U.S. Southeast completed a validated VA survey that measures health related QOL. A chart audit was conducted to gather information such as years served by the program and type of wellness services received. Regression modeling was used to assess the relationship between a veteran’s involvement in the wellness interventions and his or her perceived QOL. The study results showed that the interventions were not significant predictors of veterans QOL. Two covariates, age and gender, were found to be significant predictors, but each accounted for less than 7% of the variance. The study findings show the need for further research to explore the role of wellness interventions in a veteran’s recovery. Social change may result from encouraging veterans with SMIs to participate in self-rated QOL measures.

Anxiety sensitivity, defined as the fear of anxiety-related sensations and their consequences (Reiss & McNally, 1985), has been consistently shown to be associated with risk for anxiety psychopathology as well as other mental health problems. The primary objective of the present secondary prevention trial sought to examine strategies to reduce anxiety sensitivity among persons with elevated anxiety sensitivity by testing the singular and combined efficacy of two commonly used strategies in multi-component interventions for reducing anxiety sensitivity: (a) anxiety psychoeducation emphasizing the benign nature of stress and (b) interoceptive exposure (i.e. repeated inhalations of 35% CO₂ gas mixture). To provide a stringent control for non-specific effects associated with anxiety psychoeducation and interoceptive exposure with CO₂, two control strategies were included in the study design: general health and nutrition education and repeated inhalations of regular room air. Utilizing a 2X2 design, participants were randomly assigned to receive an education component and intervention sessions consisting of one of two gas mixtures. The current study did not support the relative efficacy of hypothesized active intervention strategies. Rather, all conditions led to significant reductions in anxiety sensitivity. In addition, within-condition effect sizes for conditions in the present study were comparable to effect sizes of active interventions that were efficacious in previous research. Findings from the present study support that anxiety sensitivity is malleable following brief, cost-efficient interventions and these reductions are maintained over a one-month follow-up period. Data from the present study suggest that in the presence of stringent control conditions, hypothesized active intervention strategies provided little additional benefit. The present study has implications for methodological considerations for future secondary prevention trials for the reduction of anxiety sensitivity. The absence of stringent control groups might lead to premature conclusions that reductions in anxiety sensitivity are due to the specific effects of active interventions. Further research is needed to elucidate specific effects of intervention strategies for the reduction of anxiety sensitivity in at risk populations in order to refine secondary prevention interventions aimed to reduce risk for psychopathology. / text

The widespread prevalence of depression throughout the world, across a variety of demographics, stresses the importance of examining different ways of coping with the affliction. This paper provides a background of different theories of coping with depression and it reviews how therapeutic songwriting, a form of active music therapy, can work as a highly effective method of coping with depression. The review indicates that therapeutic songwriting can be a successful coping mechanism through its positive influence as a primary and secondary control engagement coping strategy. Furthermore, songwriting acts as an adaptive distractor and emotion regulator, and has a positive impact on self-esteem and subsequently self-compassion. Additional benefits of therapeutic songwriting are discussed such as its time effectiveness and its ability to act as a therapy motivator and a psychoeducational tool. The findings indicate a need for future research to examine original therapeutic songwriting, in which the therapy-participant creates both original music and lyrics with the guidance of the therapist, as a potentially successful treatment for depression.