Common mental disorders in Gestalt therapy treatment: a multiple case study comparing patients with moderate and low integrated personality structures.

Introduction: Empowerment is central to self-development and growth in Gestalt therapy. The self evolves through interactions with others, forming self- and object-relations, and ego-functions. Underlying structural functions build the ability to regulate, differentiate, and integrate experiences, leading to self-, and emotion-regulation. Our study examined the self-development of seven clients with prevalent mental health issues and structural challenges, all of whom underwent 30 sessions of Gestalt therapy in a real-world individual therapy context. Methods: Using a multiple case study approach, we contrasted two client groups: those with moderately integrated and those with low-integrated personality structures, as defined by the operationalised psychodynamic diagnostic manual. Our exploration centered on specific factors of empowerment, therapy processes, and interventions. The study's mixed-method design encompassed quantitative outcome measures (empowerment, wellbeing, psychosocial health, and severity of personality functioning), therapy diaries from both clients and therapists, and semi-structured client interviews about empowering factors in therapy. Results: Both groups showed positive therapy outcomes on wellbeing, psychosocial health, and empowerment. Specific empowerment-related factors included promoting experiences, relationships, and self-efficacy in the low-integrated group. Support of self-regulation was reported to be essential for successful outcomes in the moderately integrated group. While the therapy processes proceeded similarly in both groups, we observed a strong focus on body awareness-oriented interventions and promotion of verbalisation in the low-integrated group and a relationship-oriented emphasis in the moderately integrated group. Emotional experience linked to positive experience was limited in the low-integrated group, suggesting an impairment of emotional processing, including bodily felt feelings. No change was reported in the level of personality functioning after 30 sessions in both groups. Discussion: These results underscore the need for tailored therapeutic approaches based on the client's level of personality integration. Future research should probe the long-term effects of therapy and delve deeper into shifts in personality functioning, especially concerning emotional and bodily experiences. In practical terms, therapists should prioritize linking bodily sensations with emotions for clients with low-integrated personalities. For those with moderate integration, the emphasis should be on fostering exploration, awareness, and bolstering self-regulation.

Enabling Transdisciplinary Collaboration: Stakeholder Views on Working With "Children With Mentally Ill Parents" Research Groups.

Working collaboratively and openly together with stakeholders has become a common phenomenon in research. While previous studies have gathered a clear picture on researchers' attitudes, motivations, and barriers for actively involving stakeholders in transdisciplinary research, the stakeholder perspective is yet unknown. Therefore, this paper sets out to identify how stakeholders perceive transdisciplinary collaborations with researchers. This paper in particular reveals the enablers and barriers for such collaborations from the viewpoint of stakeholders. To do so, we look at how stakeholders, who were actively involved in the governance structure of two "children with mentally ill parents" research groups in Austria, perceived their collaboration with researchers. We used a mixed-method, quantitative-qualitative design. We conducted an online survey and interviews with the members of the advisory board and competence group. These stakeholders reported great satisfaction with the transdisciplinary collaboration and emphasized the value of different expertise. As the most important enablers for successful, transdisciplinary collaboration stakeholders emphasized researchers' open-mindedness toward new perspectives and approaches, flexibility to adapt to the research process along the way, and creativity dealing with diverse backgrounds and skills. Stakeholders further underlined the importance of a person facilitating the collaboration process between researchers and stakeholders to resolve any tensions and insecurities. Concluding, researchers' attitudes, and in particular their understanding of the value of stakeholder involvement in research are key enablers for successful transdisciplinary research collaborations.

Introducing patient and public involvement practices to healthcare research in Austria: strategies to promote change at multiple levels.

BACKGROUND: Patient and public involvement (PPI) in research is well-established in the UK. However, it can be challenging to introduce PPI to research communities where there is limited prior knowledge, experience or appreciation of PPI. We aimed to explore current PPI practices, experiences and ethical and operational challenges with PPI within our own research community in Austria, to inform strategies for supporting PPI in Austria going forward. METHODS: We surveyed scientists at 21 research institutes of the Ludwig Boltzmann Gesellschaft (LBG) and representatives of 32 medical and university research ethics committees in Austria using online questionnaires. We analysed quantitative data using descriptive statistics, and we collated textual responses to open questions. We combined survey data with anecdotal evidence from our personal experience to summarise current challenges around implementing PPI in Austria. RESULTS: Nineteen scientists from nine research institutes indicated generally positive attitudes towards PPI. However, the majority reported they rarely or never involved patients and members of the public in roles of consultation, collaboration or control in research. Six of eight ethics committees were unfamiliar with PPI. We discern five current challenges to implementing PPI in Austria: lack of knowledge and skills for PPI among scientists, scepticism about the usefulness of PPI, conflation of PPI with qualitative research, uncertainty about ethical requirements for PPI and uncertainty about publishing PPI activities. DISCUSSION: We suggest that the provision of guidance about ethical requirements of PPI is a strategic priority. To address this, and following on from a recently introduced PPI training and grant scheme by the LBG, our surveys have initiated a dialogue with ethics committees and have informed the development of a checklist for ethical aspects of PPI. CONCLUSION: Our experiences may provide useful examples to others who seek to introduce or strengthen PPI practices within their own research communities.

Co-creating a patient and public involvement and engagement 'how to' guide for researchers.

PLAIN LANGUAGE SUMMARY: Research should benefit society at large. Involving citizens those who are affected by research may not only increase the quality, but can also push research towards generating greater societal benefits and relevant outcomes for citizens. Including citizens in research also has ethical implications, which necessitate structured guidance on 'how to' meaningfully involve them. In our project, we invited a multi-stakeholder group consisting of researchers from multiple disciplines, citizen scientists, youth and patient advocates to co-create a guide on 'how to' meaningfully involve citizens in research. In five consecutive workshops, we discussed how the characteristics of interactions between researchers and citizens (e.g., building trustful relationships and communication) and what a possible project steering structure enabling meaningful public involvement in research could look like. As a result of these workshops, the PPIE 'How to' Guide for Researchers was developed to support the implementation of 'Patient and Public Involvement and Engagement' (PPIE) activities and informed a PPIE Implementation Programme funding public involvement activities in Austria. ABSTRACT: Involving citizens in research is not widely utilised across research disciplines and countries. It requires the readiness of researchers and their organisations as well as guides on 'how to' successfully involve citizens in a meaningful way. Including the patient and citizen voice in research activities has been most frequently demonstrated in health research, however, is implemented along various degrees of involvement - from passively receiving information about science to actively involving the citizens in steering projects and research activities. In this commentary, we aim to report a multi-stakeholder co-creation process developing 'Patient and Public Involvement and Engagement' (PPIE) activities across disciplines to provide guidance for researchers and the public. We use Ludwig Boltzmann Society's (LBG) organisational framework as a case study, hence it consists of research institutes ranging from the life sciences to humanities and therefore represents a well-suited research environment for this endeavour. In a co-creation approach - to accomplish a shared understanding of public involvement in research among different stakeholders - a multi-stakeholder group comprising 11 researchers from natural sciences, life sciences, social sciences and humanities, and 13 citizens (such as patient advocates, young people and citizen scientists) were involved. In five consecutive workshops, we co-developed the nature of interactions between citizens and researchers, as well as governance structures enabling meaningful involvement in research. The workshops' content was informed by an initial literature review. As a result of this process, the PPIE 'How to' Guide for Researchers was developed to support the implementation of involvement activities in their research projects according to the public involvement principles. These principles informed assessment criteria for the newly established PPIE Implementation Programme at LBG. It provides funding and support for public involvement activities in research to embed a sustainable and meaningful implementation of public involvement activities in Austria.

Combined Effects of Gaze and Orientation of Faces on Person Judgments in Social Situations.

In social situations, faces of others can vary simultaneously in gaze and orientation. How these variations affect different kinds of social judgments, such as attractiveness or trustworthiness, is only partly understood. Therefore, we studied how different gaze directions, head angles, but also levels of facial attractiveness affect perceived attractiveness and trustworthiness. We always presented pairs of faces - either two average attractive faces or a highly attractive together with a less attractive face. We also varied gaze and head angles showing faces in three different orientations, front, three-quarter and profile view. In Experiment 1 (N = 62), participants rated averted gaze in three-quarter views as more attractive than in front and profile views, and evaluated faces with direct gaze in front views as most trustworthy. Moreover, faces that were being looked at by another face were seen as more attractive. Independent of the head orientation or gaze direction, highly attractive faces were rated as more attractive and more trustworthy. In Experiment 2 (N = 54), we found that the three-quarter advantage vanished when the second face was blurred during judgments, which demonstrates the importance of the presence of another person-as in a triadic social situation-as well as the importance of their visible gaze. The findings emphasize that social evaluations such as trustworthiness are unaffected by the esthetic advantage of three-quarter views of two average attractive faces, and that the effect of a faces' attractiveness is more powerful than the more subtle effects of gaze and orientations.

Trusting the Looks of Others: Gaze Effects of Faces in Social Settings.

Eye gaze is an important social cue in human communication that serves as a predictor of changes in attention, indicates social interest, and even affects the evaluation of objects that have been looked at. However, it needs to be shown how this strong nonverbal signal affects social and aesthetic evaluations in social settings. In this study, we presented natural scenes with two faces in three gaze conditions showing different directions of gaze. Participants evaluated faces that were looked at or not, that showed direct or averted gaze, for attractiveness (aesthetic) as well as trustworthiness (social). In Experiment 1, faces looking directly at the perceiver were rated as more attractive and as more trustworthy. In Experiment 2, when the direct gaze condition was omitted, faces that were looked at by another face were judged as more trustworthy. In Experiment 3a, participants did not remember the directions of gaze of two faces, demonstrating the dependence of the judgement on the actual situation and excluding a memory explanation. In Experiment 3b, we confirmed that these gaze effects depend on the direction of gaze and not the mere presence of another person. Our findings show how gazing in real world settings affects social and aesthetic evaluations.