"A mismatch between what is happening on the inside and going on, on the outside": a qualitative study of therapists' perspectives on student mental health.

BACKGROUND: Although a growing number of studies indicates a high prevalence of reported mental health problems in students and that the problems are growing in number and severity, less is known about the experiences of students facing mental health problems and personnel who interact with students that seek help for these problems. The aim of this study is to examine the perspectives of therapists working with students seeking therapy for mental health problems. METHODS: A qualitative study of 15 therapists' perspectives. Data are collected with in-depth, semistructured and open-ended interviews, and analyzed using a reflexive thematic analysis. RESULTS: We developed four themes that summarize how the therapists viewed and understood the students' experiences of mental health problems: (1) an agonizing mismatch between the inside and the outside, (2) conflicting needs for closeness and distance, (3) no room for pain, and (4) a major potential for ripple effects. CONCLUSIONS: We relate our findings to the existing theory and research, and we discuss the implications for clinical practice and the limitations of the study. We argue that our findings demonstrate the need to provide students room to explore and make meaning of their difficulties and pain related to mental health problems, in addition to offer some symptom-reducing tools and techniques that can enhance performance and academic achievements. More research is needed to understand what student mental health problems might be related to and what students need.

Patients with delayed sleep-wake phase disorder show poorer executive functions compared to good sleepers.

OBJECTIVE: Delayed Sleep-Wake Phase Disorder (DSWPD) is associated with negative outcomes, including reduced daytime performance and difficulties with treatment adherence. These outcomes are mediated by executive functions (EF). In this study, we investigated whether patients with DSWPD report inferior EF compared to a control group. The study consisted of 40 patients diagnosed with DSWPD (12 males, mean age 20.7 (±3.1)) and 20 healthy controls (six males, 21.3 (±2.2), p = 1.00) between 16 and 25 years (p = 0.42). METHODS: Behavior Rating Inventory of Executive Function-Adult version Self-Report (BRIEF-A) was used for adults ≥18 years (DSWPD n = 28; controls n = 17) whereas Behavior Rating Inventory of Executive Function Self-Report Version (BRIEF-SR) was used for assessment of EF in adolescents <18 years (DSWPD n = 12; controls n = 3). Independent samples t-tests were used to compare patients to controls. RESULTS: The total group of patients with DSWPD scored significantly poorer compared to the control group on the main indexes; Behavioral Regulation Index (BRI) (p = <0.0005), Metacognition Index (MI) (p = <0.0005), and Global Executive Composite (GEC) (p = <0.0005). The adult group with DSWPD scored significantly poorer than the adult control group on eleven of the twelve BRIEF-A scales. Among patients <18 years, the DSWPD-group scored significantly poorer than the control group on 8 of the 13 BRIEF-SR-scales. CONCLUSION: Patients with DSWPD reported significantly poorer EF compared to controls. Assessment of EF in patients with DSWPD can be valuable for understanding the consequences of the disorder regarding treatment tailoring and adherence.