This qualitative study was aimed at examining which therapeutic attitudes and procedures it is possible to find regarding obsessive-compulsive disorder (OCD), to see if there are any specific factors that crystallizes as particularly important for this disorder. A total of ten therapists with different background and experiences concerning OCD participated in the study where semi-structured interviews was used to collect the data. To analyze the data thematic analysis was used. Three main-themes grew from the analysis, which were all related to the study’s overall purpose. The first main-theme was general therapeutic attitudes. Under this theme, there are two sub-themes, personal characteristics of the therapist and degree of knowledge. The second main-theme, therapeutic approaches regarding OCD, also includes two sub-themes, degree of therapeutic distinctiveness and specific treatment interventions. The third main-theme was the treatment results components. This theme also includes two sub-themes, therapeutic factors and choice of method. In the participants’ stories about which therapeutic attitudes and procedures that are important regarding the treatment of people suffering from OCD, several factors became visible. These are connected to a general therapeutic attitude across diagnosis, such as warmth, empathy, and the ability to form an alliance, in addition to several therapeutic factors which are important to OCD specifically, such as experience and maturity, and being creative. The participants also emphasizes to a large degree ERP as the first choice in regards to treatment. Specifically for this study is that one participant emphasizes ACT as the preferred treatment intervention, where ERP did not result in a satisfactory treatment outcome.

Relatively few pre-treatment interventions to increase out-patient mental health (MH) service use have been created and experimentally tested. Therefore, not only is there limited availability of these interventions, it is uncertain whether existing interventions are effective. Moreover, it is unclear which components of the interventions are effective. To address these gaps in knowledge, a systematic review of pre-treatment interventions was conducted, using the Cochrane Review methodology. Three primary outcomes were evaluated: attendance at any type of out-patient MH visit; number of appointments of any type of out-patient MH visit; and/or initiation and adherence to psychotropic medication. PubMed and PsycINFO databases were thoroughly searched for studies that met the inclusion criteria. A data extraction form was designed and employed to systematically extract data from all included studies. In the 15 included studies, 18 different active interventions were evaluated. The interventions ranged in duration of interaction from one mailed flyer to ten 90-minute psychoeducation sessions. Most studies (n = 11) included one intervention group, compared with one control, or usual care, group. The interventions were categorized by the type of barriers they aimed to address, resulting in six broad categories: MH knowledge; MH knowledge/attitudes; MH knowledge/attitudes/ logistical barriers; MH knowledge/family involvement; care management; and home visits. All included studies received a quality assessment rating of "good" or "fair." The main finding of this thesis is that all categories of interventions increased at least two of the three primary outcomes. The care management interventions measured and increased all three outcomes; these interventions also had some of the highest quality ratings. Therefore, care management interventions appear most effective at increasing out-patient MH service use. Implications for practice and research are discussed.

Studiens syfte var att undersöka kriminalvårdens centrala riktlinjer för psykisk ohälsa bland anstaltsklienter och om dessa riktlinjer realiseras i praktiskt arbete på två olika avdelningar: normalavdelning och behandlingsavdelning på en anstalt av högsta säkerhetsklass i Sverige. Data samlades in genom intervjuer med åtta kriminalvårdare och en psykolog. Resultatet visade att psykisk ohälsa ur ett personalperspektiv är vanligt förekommande, främst ADHD, depression, ångest och sömnsvårigheter. Majoriteten av respondenterna visste inte om vilka riktlinjer som finns vid behandling av klienters psykiska ohälsa. Slutsatsen är att det råder brister i kommunikationen mellan ledningen och kriminalvårdarna inom anstalten. / The purpose of this study was to examine the correctional institutions central guidelines for mental problems among their clients and whether these guidelines are used in practical work within two different facilities: normal facilities and treatment facilities at an institution of a maximum security prison in Sweden. Data was collected through interviews with eight prison officers and a psychologist. The results showed that mental problems from a staff perspective are common, mainly ADHD, depression, anxiety and insomnia. The majority of the respondent did not have knowledge about the central guidelines for client’s mental problems. Conclusion is that there are deficiencies in communication between management and the prison officers within the correctional institution.

Promoting Alternative Thinking Strategies (PATHS) is an intervention program for children with behavioral and emotional deficits, designed for use, and shown to be effective when used in the classroom a minimum of 3 times per week. However, in some settings, as in the current study, PATHS is being used just once per week. The purpose of this quantitative study was to determine whether PATHS was beneficial in helping elementary school aged children improve their behavioral and emotional health when implemented once per week in a group therapy setting. PATHS was developed based on cognitive behavioral theory, which focuses on improving internalizing symptoms of mental health disorders (thoughts) as well as the externalizing symptoms (behaviors). A one-way, repeated measures ANOVA was utilized to analyze archival data of 193 scores, collected over a single school year. Results indicated that elementary school aged children who received PATHS once per week in a group setting showed a decrease in aggression and disruptive behaviors, and an increase in concentration and attention as well as social and emotional competence. Social change implications could involve the results of the study informing how we might promote overall emotional and behavioral well-being in children. At the organizational level, the expansion of the use of PATHS at reduced costs and time within other settings will extend these benefits to more children with behavioral and emotional deficits. Future studies are suggested to examine further the effectiveness of PATHS when implemented in other programs and alternative ways.