The birth trauma psychological therapy service: An audit of outcomes.

OBJECTIVE: To evaluate routinely collected service data from a 'Birth Trauma' psychology clinic integrated into maternity services, in order to review effectiveness for women with symptoms of Post-Traumatic Stress Disorder (PTSD) following childbirth. BACKGROUND: Prevalence of PTSD after child-birth has been estimated to be around 3% for women meeting full diagnostic criteria and up to 9% for sub-threshold symptoms. This can occur even in response to deliveries considered to be medically straightforward. NICE guidelines (2018) recommend psychological therapy as a first line treatment for symptoms of PTSD. METHODS: The sample included 114 women referred post-natally for psychological assessment and intervention following a traumatic birth experience. Measures were routinely administered as part of initial assessment (T1) and at completion of intervention (T2). Data from these measures were collated and analyzed using a series of paired sample t tests. Following assessment 101 women were taken on for psychological intervention and of these, 74 completed both T1 and T2 measures. RESULTS: There were highly significant reductions across all measures of PTSD, anxiety and negative mood symptoms. The treatment effect sizes were very large. Mean total score on a measure of PTSD symptomatology was no longer clinically significant following interventions. CONCLUSION: This evaluation suggests an integrated Birth Trauma psychology clinic using a small number of contact sessions is a highly efficient and effective model of care for women experiencing symptoms of PTSD following childbirth.

The experience of men using an upper limb prosthesis following amputation: positive coping and minimizing feeling different.

PURPOSE: Psychosocial factors are likely to play a crucial role in adjustment to upper limb amputation and prosthesis use, and yet have received only minimal exploration within the literature. This study therefore, sought to gain a rich understanding of the experience of living with an upper limb amputation and of using a prosthetic arm and hand. METHODS: The qualitative method of Interpretive Phenomenological Analysis was used. Purposive sampling culminated in a homogenous sample of 11 males with unilateral upper limb amputations, who wore a prosthesis at least weekly. Semi-structured interviews were carried out, transcribed and analysed according to the methodology. RESULTS: Participants identified a theme of ongoing awareness of difference in appearance and ability. Consequently, participants described themes of psychosocial and functional adjustment to minimize this sense of difference. This was facilitated by the participants' prostheses and their positive coping style. Within this, participants also identified the personal meanings of their prosthesis and highlighted the terms of its use. The minimization of their sense of difference resulted in participants regaining a sense of worth. CONCLUSIONS: The findings offer a greater psychological insight into adjustment from an upper limb amputation and the role of prostheses. These findings have implications for both the clinical rehabilitation of patients who undergo upper limb amputations, as well as for future research into the use and value of prostheses in facilitating the adjustment to this experience.

Cognitive distortions of religious professionals who sexually abuse children.

This study uses grounded theory to investigate the cognitive distortions in the self-report statements of 14 clergymen who had sexually abused children. These clergy were residents at an assessment and treatment center for child molesters. The content of the offenders'cognitive distortions was identified and categorized into thematic groups. These categories were found to relate to the various stages of the offending cycle. A tentative model was generated that illustrates the relationship between the categories and the hypothesized sequence of thought facilitating the initiation and maintenance of sexually abusive behavior In addition, a number of cognitive processes were identified as contributing to offenders' beliefs. The study also reveals that the clergymen used their religious role and relationship with God within their distorted beliefs. These beliefs were predominantly concentrated in the areas of giving themselves permission to offend, denial of likelihood of getting caught, reduction of guilt after offending, and maintaining a positive sense of self.