55 research outputs found
Supplemental material - Service evaluation of multi-family therapy for anorexia groups between 2013–2021 in a specialist child and adolescent eating disorders service
No full textSupplemental material for Service evaluation of multi-family therapy for anorexia groups between 2013–2021 in a specialist child and adolescent eating disorders service by See Heng Yim, and Sam White in Clinical Child Psychology and Psychiatry.</p
See Heng Yim - Thesis submitted in partial fulfilment of doctor of clinical psychology (DClinPsych)
Full text linkThe effectiveness and feasibility of psychological interventions for populations under ongoing threat: A systematic review
Current views of psychological therapies for trauma typically assume the traumatic event to be in the past. Yet individuals who live in ongoing organised violence or experience intimate partner violence (IPV) may continue to be (re)exposed to related traumatic events or have realistic fears of their recurrence. This review considers the effectiveness, feasibility and the requirement for adaptations of psychological interventions for individuals living with ongoing threat. Eighteen papers featuring 15 trials were included (12 on organised conflict, three on ongoing IPV). For political violence, most studies showed moderate to large effects in reducing trauma-related symptoms when compared to waitlists. For IPV, findings were varied. Most studies found providing psychological interventions were feasible. The findings, albeit preliminary with mixed methodological quality, showed psychological treatments can be beneficial and should not be withheld in context of ongoing organised conflicts and IPV. Clinical and research recommendations are outlined.
Patients’ experiences of clinical team meetings (ward round) at an adult inpatient eating disorders ward: a mixed-method service improvement project
Aims
Ward rounds are key to treatment-related decision making but are often stressful for patients. This project aimed to explore and improve patients’ experiences of the clinical team meeting (CTM, historically known as ward round) in an adult inpatient eating disorders unit. A mixed-method approach was adopted using in-vivo observations, two focus groups, an interview, and a staff survey. Six patients participated. Two former patients contributed to data analysis, co-production of service improvement initiatives and write-up.
Results
The mean CTM duration was 14.3 minutes. Patients spoke half of the time, followed by psychiatry colleagues. ‘Request’ was the most-spoken category. Thematic analysis identified (1) CTMs are important but impersonal, (2) CTMs generate a sense of palpable anxiety; (3) divergent views between staff and patients.
Clinical implications
The findings and implementation of co-produced changes to CTMs improved patients’ experiences despite COVID-19 challenges. Factors beyond CTMs including the ward’s power hierarchy, culture and language need addressing to facilitate shared decision-making.
Sudden Gains in internet cognitive therapy for social anxiety disorder in routine clinical practice
Background
Research on sudden symptom improvements (sudden gains) in internet-delivered psychological interventions are limited in routine practice.
Objective
This was a study on sudden gain and its relationship to outcome and cognitive processes. The intervention examined was a therapist-guided internet Cognitive Therapy intervention for social anxiety disorder (iCT-SAD) delivered in primary mental health services in the UK. The aim was to replicate the approach of a previous exploratory study (Thew et al., submitted) where the data were drawn from a randomised controlled trial (Clark et al., 2022).
Methods
The study used data from a larger implementation study (N = 193). Liebowitz Social Anxiety Scale was the primary outcome measure. Process variables examined included negative social cognition measured by the Social Cognition Questionnaire, self-focused attention (Social Phobia Weekly Summary Scale) and depressed mood (Patient Health Questionnaire).
Results
Seventy sudden gains were found among 57 participants. The occurrence rate of sudden gain was 39%. Individuals who experienced sudden gains had a larger reduction in social anxiety symptoms at end of intervention and at three-month follow-up. There was evidence of a reduction in the frequency of negative social cognitions prior to the gain, whereas change in self-focused attention occurred simultaneously with the gain. Depressed mood did not show significant changes over these timepoints.
Conclusions
Sudden gain was found in routine practice and was found to be related to meaningful symptom improvement
sj-docx-1-tva-10.1177_15248380231156198 – Supplemental material for The Effectiveness and Feasibility of Psychological Interventions for Populations Under Ongoing Threat: A Systematic Review
No full textSupplemental material, sj-docx-1-tva-10.1177_15248380231156198 for The Effectiveness and Feasibility of Psychological Interventions for Populations Under Ongoing Threat: A Systematic Review by See Heng Yim, Hjördis Lorenz and Paul Salkovskis in Trauma, Violence, & Abuse</p
Views and experiences of eating disorders treatments in East Asia: a meta-synthesis
No full textIntroduction: Although there have been qualitative meta-syntheses on experiences of eating disorders treatments, there is a paucity of syntheses specifically examining the perspectives and experiences of eating disorders treatments (ED) in East Asia (EA). Such synthesis could facilitate a better understanding of culture-specific perspectives and experiences. This review complements a quantitative scoping review published on ED treatments in EA (Yim & Schmidt, 2023), where most interventions reviewed focused on cognitive behavioural therapy (CBT) and internet interventions. The present meta-synthesis summarises stakeholders’ views on treatments and to synthesise clinical and research recommendations. Method: A systematic search of five databases and a citation search were conducted to identify relevant studies and data were analysed using thematic synthesis. Out of the 301 studies found, a total of 12 papers were included in the analysis. Results: A diverse range of treatments, such as family therapy, paediatric/psychiatric inpatient care, CBT, and counselling, were discussed. Three overarching themes were identified: Delineating Physical and Psychological Recovery; ‘I am not alone in this battle’; and Barriers to Change. The themes further delve into the various obstacles to recovery, including financial concerns and limited access to professionals and services. Culture-specific factors include family obligations and promoting family harmony. Balancing interdependence and independence from one’s family, as well as understanding family body ideals versus broader societal body ideals, are important considerations in ED interventions. Discussion: Some themes paralleled other qualitative syntheses, highlighting improved family relationships, perceived authoritarianism in treatments, and financial barriers. The review extends beyond the previous findings, revealing nuanced factors like family roles, cultural values, and norms. Clinical recommendations include incorporating family context in treatment and considering cultural influences on body image ideals. Capacity building through telemedicine and increased training is essential for advancing ED treatment in East Asia. Continued research is needed to better understand and treat people affected by ED in EA.link_to_subscribed_fulltex
Cultural heritage through the lens of community psychology and narrative therapy: a community project on Chinese and Vietnamese diaspora in <i>London</i>
No full textThis reflexive article documents a project which explored the oral history of Chinese and Vietnamese communities in London through the methodology of object-based storytelling. The project was titled the Soul Relics Migration Project. Stories of migration were collected from community members, with a particular focus on aspects of wellbeing shaped or impacted by their experiences. These stories were then curated and exhibited in local community spaces. Through the medium of object-based storytelling, the project sought to highlight culturally-specific beliefs about distress and wellbeing, facilitate the re-authoring of personal and collective migration narratives, and document testimonies in a tangible form that supports community building. Methodologically, I argue that the method of narrative therapy coupled with community psychology practices could be a useful way to facilitate the creation of collective memory and heritage, as well as spur collective action and resistance in marginalised communities.link_to_subscribed_fulltex
A Critique of Coordinated Management of Meaning and Circularity in Relation to Countering Oppressive Practice: Reflections from a Trainee Therapist
No full textThis is a personal reflective piece based on my clinical and personal experience in the current environment, which can feel at times oppressive. I situate my critique as an early-career psychologist who holds multiple marginalised identities. Using systemic ideas, particularly coordinated management of meaning, circularity, and reflective teams, I use case examples to illustrate how practitioners can deconstruct power and resist dominant narratives, countering oppressive practice in action. I critique the existing systemic literature in relation to anti-oppressive work and offer suggestions for future research and practice such as holding an anti-oppressive lens and understanding power and difference within the reflecting team.link_to_subscribed_fulltex
Experiences of computer‐based and conventional self‐help interventions for eating disorders: A systematic review and meta‐synthesis of qualitative research
Full text linkObjective: Self-help interventions have been demonstrated to be effective in treating bulimic-type eating disorders (EDs). In particular, computer-based interventions have received increasing attention due to their potential to reach a wider population. This systematic review aimed to synthesize findings from qualitative studies on users' experiences of self-help interventions for EDs and to develop an exploratory framework. Method: A systematic review and meta-synthesis on seven peer-reviewed qualitative studies on structured computer and book-based self-help interventions for EDs was conducted using Noblit and Hare's (1988) 7-phase meta-ethnography. Four of the selected studies investigated computer-based self-help programs, and three of the studies investigated book-based guided self-help programs. Results: Six concepts were synthesized. They included intervention-related factors (anonymity and privacy; accessibility and flexibility; guidance) and user-related factors (agency/autonomy; self-motivation; and expectations/attitudes). The study revealed the “machine-like” and relational properties of the computer; the expansion of treatment time and space in psychological interventions, the changing role of the medical health professional from a “therapist” to a “guide,” and a change from understanding interventions as a conclusive treatment plan to a starting point or stepping stone toward recovery. Discussion: Computer-based self-help interventions should take advantage of the “machine-like” properties of a computer (neutrality, availability, etc.) as well as its ability to facilitate human interactions. Users should also be facilitated to have a realistic understanding of the purpose of self-help interventions and the place of self-help interventions in their broader treatment plans to moderate expectations and attitudes.</p
Service evaluation of multi-family therapy for anorexia groups between 2013–2021 in a specialist child and adolescent eating disorders service
No full textThe aims of the service evaluation were to examine the effectiveness of multi-family therapy for anorexia nervosa (MFT-AN) on family relationships, as well as to understand families’ experiences of MFT in a specialist child and adolescent eating disorders service between 2013–2021. Mixed-methods were used (t-tests and reflexive thematic analysis). Delivery was in-person in 2013–2019, and moved online from 2020 due to COVID-19. Responses from a total of 57 families and 190 people were analysed. MFT improved family functioning from pre-to post MFT as measured by the Systemic Clinical Observation in Routine Evaluation (SCORE-15). Sub-group analysis by family roles showed that at four-month follow-up, the effects were no longer significant among parents. On the contrary, preliminary analysis showed that although young people did not report any improvement at post-intervention, family functioning was reported to increase at follow-up. Four themes were constructed: being together as a family and as a group; individuality: everyone’s recovery is different; MFT as an emotion ‘hotpot’, and in-person versus virtual groups: not a one-size-fits-all. More robust follow-up data are needed to ascertain the effects of online MFT-AN.link_to_subscribed_fulltex
Clinician bodies in eating disorder services: a commentary
No full textThis article discusses the important yet under-addressed issue of clinician bodies within eating disorder services. I would like to further the discussion on a particular correspondence in, where a professional who was perceived as dangerously thin was challenged and confronted by their colleagues in a work setting. This article will consider the issue from four perspectives, being the implications for the therapeutic relationship, how we approach biases and assumptions about weight and body size, ethical and legal issues, and how to manage lived experience. I argue for a more nuanced, considered approach towards professionals in the field before decisions are made to manage or confront them.link_to_subscribed_fulltex
Self-Help Treatment of Eating Disorders
No full textThe authors provide an overview of the current state of research on self-help interventions for eating disorders. The efficacy of different forms of self-help interventions for bulimia nervosa, binge eating disorder, and other eating disorders at various stages of the care pathway (from prevention to relapse prevention)is described. Cost-effectiveness studies are also presented. Moderators of outcome, such as guidance and adherence, are discussed. Overall, the findings are promising and support the use of self-help interventions in the treatment of bulimic disorders, across the stages of the care pathway. Less is known about the use of self-help in anorexia nervosa.link_to_subscribed_fulltex
- …
