The Effects of Art Therapy and Psychosocial Skills Training on Symptoms and Social Functioning in Patients with Schizophrenia and Their Relatives. / Sizofreni Hasta ve Yakinlariyla Yapilan Sanatla Terapi ve Ruhsal Toplumsal Beceri Egitiminin Hastalik Belirtileri ve Sosyal Islevsellik Üzerine Etkileri.

OBJECTIVE: The effects of antipsychotics on negative symptoms are limited. The most appropriate approach in the treatment of schizophrenia is the integration of drug therapy with psychological and social interventions. The purpose of this study was to evaluate and compare the effects of art therapy and psychosocial skills training (PSST) in the treatment of schizophrenia. METHODS: A total of 15 patients diagnosed with schizophrenia according to the criteria in DSM-5 and 12 patient relatives were included in the study. The patients were randomly divided into 2 groups, 7 were included in the art therapy program and 8 were included in the PSST program for schizophrenia. 90-minute sessions of art therapy and PSST were carried out once a week for 17 weeks. Participants with schizophrenia were evaluated with the Positive and Negative Syndrome Scale (PANSS), Social Functioning Scale (SFS) and the Calgary Depression Scale for Schizophrenia and the relatives were given Beck Depression Inventory, Beck Anxiety Inventory and Zarit Burden Interview. RESULTS: There was a significant decrease in the PANSS negative symptoms, PANSS general psychopathology, SFS pro-social activities and SFS recreation scores in both groups, while the SFS social withdrawal scores decreased significantly only in the art therapy group. In the PANSS negative symptoms subscale, passive social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation and stereotyped thinking scores were significantly lower in the art therapy group. In the PSST group only the score for difficulty in abstract thinking declined significantly. CONCLUSION: The findings of the present study suggest that art therapy and PSST have positive effects on the improvement of negative symptoms as well as improvements in social and cognitive functionality in schizophrenia.

Mothers' and birthing parents' experiences with 1-day cognitive behavioural therapy-based workshops for postpartum depression: A descriptive qualitative study.

WHAT IS KNOWN ABOUT THE SUBJECT?: One in five mothers and birthing parents are affected by postpartum depression (PPD), yet only a small proportion of those with PPD receive treatment. Given cost and accessibility barriers to treatment, brief therapies (e.g. 1 day) could help address PPD on a large scale, though understanding participants' unique experiences with this novel treatment will help guide its refinement and use. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper describes the experiences, perspectives and satisfaction of participants who attended a 1-day workshop for PPD. Participants appreciate being taught practical techniques and the receipt of social support from facilitators and other attendees in the group setting, while some recommended further 'booster sessions' to enhance effectiveness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: One-day CBT-based workshops may be an effective, low-intensity treatment option that provides helpful skills and builds social networks for individuals with PPD. Additional post-workshop booster sessions may enhance participant satisfaction with this new treatment by providing a reinforcement of their learning and an opportunity to re-connect with other birthing parents. ABSTRACT: INTRODUCTION: Postpartum depression (PPD) affects up to one in five mothers and birthing parents. Understanding their perceptions of therapeutic interventions is key to their effectiveness and scalability. AIM: The aim of the study was to understand participants' experiences attending an in-person or online 1-day cognitive behavioural therapy (CBT)-based workshop for PPD and compare their experiences participating in either modality. METHOD: This descriptive qualitative study was embedded in two separate randomized controlled trials evaluating the effectiveness of 1-day CBT-based workshops for PPD delivered in-person or online. Responses were provided by 94 in-person and 95 online participants about their experiences. Content analysis was used to code and categorize the data. RESULTS: Participants appreciated learning skills to improve PPD symptoms and joining a community of individuals with shared experiences. Integrating practical coping techniques after the workshop was reported to be most useful, though some wanted additional post-workshop support. Online participants identified additional barriers to workshop engagement. DISCUSSION: Participants who attended either workshop found them to be valuable and effective. Participants valued psychoeducation, social connections and applying practical CBT techniques. IMPLICATIONS FOR PRACTICE: One-day CBT-based workshops may be an accessible treatment option for individuals with PPD, providing new skills and social support, though some prefer to receive additional post-workshop support.

A experiência de atendimento de um grupo terapêutico durante a graduação: a obstaculização pelo pacto denegativo / La experiencia de asistir a un grupo terapéutico durante la graduación: el obstáculo causado por el pacto negativo / The experience of attending a therapeutic group during graduation: the obstacle caused by the negative pact

Grupos psicoterapêuticos encontram crescente receptividade nos serviços públicos e privados de saúde. Eles conjugam a expansão da capacidade de atendimento com atuação clínica crítica e propositiva frente ao individualismo da sociedade contemporânea. É importante assim pensarmos os desafios da formação dos psicólogos para este trabalho. Este artigo parte de uma dificuldade encontrada por estagiários de 4° e 5° ano do curso de psicologia, na condução de um grupo psicoterapêutico. Coloca-se como objetivo analisar a relação entre um pacto denegativo que obstaculiza o processo terapêutico com as experiências iniciais de atendimento dos estagiários. Aspectos vivenciados serão apresentados e debatidos à luz da teoria. Descreve-se a existência de um pacto denegativo neste grupo, que se opõe ao processo terapêutico dos pacientes e complexifica o desenvolvimento dos estagiários ao desafiar a confiança em suas percepções e associações, dificultando a realização de intervenções. Conclui-se que o pacto denegativo que obstaculiza o grupo se apresenta, a princípio, como um desafio aos estagiários, porém, mediante o apoio na relação entre os estagiários e supervisão é possível transformar este desafio em fonte de aprendizado.

Grupos psicoterapéuticos son cada vez más recibidos en los servicios de salud. Combinan la expansión de la capacidad de servicio con una acción clínica crítica y decidida frente al individualismo de la sociedad contemporánea. Es importante pensar en los desafíos de formar psicólogos para este trabajo. Este artículo se basa en una dificultad que enfrentan los pasantes de 4° y 5° año de psicología al momento de conducir un grupo psicoterapéutico. El objetivo es analizar la relación entre un pacto negativo que obstruye el proceso terapéutico y las experiencias de cuidado de los internos. Se debatirán experiencias y la teoría. Se describe la existencia de un pacto negativo, que se opone al proceso terapéutico de los pacientes e intensifica el desafío de los alumnos al desafiar la confianza en sus percepciones y asociaciones, lo que dificulta la realización de intervenciones. Se concluye que el pacto negativo que obstaculiza al grupo se presenta, en un primer momento, como un reto para los aprendices, sin embargo, a través del apoyo en la relación entre los aprendices y la supervisión es posible transformar este reto en una fuente de aprendizaje.

Psychotherapeutic groups are increasingly employed in health services. They combine the expansion of the service capacity with critical and purposeful clinical action in face of the individualism of contemporary society. It is important to think about the challenges of training psychologists for this work. This article is based on a difficulty encountered by 4th and 5th year psychology students, acting as trainees, when conducting a psychotherapeutic group. The objective is to analyze the relationship between a denegative pact that obstructs the therapeutic process and the trainees' initial clinical experience. This text debates aspects of this practice in light of theory. It describes a denegative pact in this group, which opposes the patients' therapeutic process and intensifies the trainees' challenge by challenging the trust in their perceptions and associations, making it more difficult for them to find spaces to intervene. It concludes that the negative pact that hinders the group presents itself, in principle, as a challenge to the trainees, however, through support in the relationship between the trainees and supervision it is possible to transform this challenge into a source of learning.

Novas Pontes na Escuta: Laços e Territórios Virtuais no Cuidado dos Migrantes e Refugiados / New Device of Therapeutic Listening: Virtual Bonds and Territories in the Care of Migrants / Nuevos Puentes en la Escucha: Vínculos y Territorios Virtuales en la Atención a Migrantes

experiência do Projeto Ponte no atendimento de grupos terapêuticos online mostra a potência deste dispositivo no atendimento aos migrantes; nosso projeto defronte à pandemia teve de se adaptar a novos parâmetros no atendimento virtual. Participamos de uma rede de serviços específica ao público migrante, essencial na pandemia de COVID-19, para o apoio e continuidade do trabalho. As referências do projeto são: o conceito de interculturalidade, o atendimento grupal no formato slow open, a língua portuguesa e a psicanálise de grupos e vínculos. Nos atendimentos clínicos com migrantes, consideramos os processos de ruptura da migração, a dupla pertença aos países de origem e destino, bem como a dificuldade de se instalar no país de destino, a estranheza da experiência e o lugar de estrangeiro que o migrante ocupa. Por isso adotamos o dispositivo grupal, onde o migrante encontra um lugar para a construção e elaboração da migração, bem como para estabelecer uma possível pertença.

The experience of Ponte Project in attending therapeutic groups online shows the power that this device provokes in attending migrants; this work with the arrival of the COVID-19 pandemic had to adapt to the new parameters of virtual therapy. We also participate in a network in the psychological consultation of the migrant public, essential for the continuity of the project's work. The theoretical framework of the project has always been based on: the concept of interculturality, a slow-open group, Portuguese language and Psychoanalysis with groups and bonds. In clinical sessions with the migrants we will consider the processes of rupture caused by migration, the double belonging, as well as the difficulty of settling in the country of destination, all the strangeness caused by this experience and also the place of foreigner that the migrant occupies. That is why we chose to work with groups, where the migrant finds a place to elaborate the effects of migration, in addition to establishing a possible place of belonging.

La experiencia del Proyecto Puente en la atención terapéutica grupal en línea muestra la potencia de este dispositivo en la atención a migrantes. Nuestro proyecto, frente a la pandemia, tuvo que adaptarse a los nuevos parámetros para la atención virtual. Participamos en una red de servicios específicos para el público migrante, esencial en la pandemia del COVID-19, para brindar apoyo y continuidad al trabajo. Las referencias del proyecto son: el concepto de interculturalidad, la atención grupal en el formato slow open, la lengua portuguesa, el psicoanálisis de grupo y los vínculos. En las sesiones clínicas con migrantes consideramos los procesos de ruptura de la migración, la doble pertenencia a los países de origen y destino, la dificultad de integración en el país de destino, la extrañeza de la experiencia y el lugar de extranjero que ocupa el migrante. Por eso adoptamos el dispositivo grupal, donde el migrante encuentra un lugar para la construcción y elaboración de la experiencia migratoria, permitiéndole así establecer una posible pertenencia.

Effects of Problem Solving Therapy in Substance Use Disorder in Adolescents. / Ergenlerdeki Madde Kullanim Bozuklugunda Sorun Çözme Terapisinin Etkileri.

OBJECTIVE: In this study, it was aimed to examine the effects of problem solving therapy, which is a cognitive behavioral method, on adolescents diagnosed with alcohol and substance use disorder. METHOD: A semi-structured interview and intelligence test were administered to adolescents with diagnosis of substance use disorder to identify comorbidities. 46 adolescents who met the inclusion criteria were divided into two groups. Problem solving therapy was applied to the first group for 5 weeks, once a week, while the other group continued their routine controls in the center. Beck Depression Inventory, Screen for Child Anxiety Disorders, Revised Social Problem Solving Inventory, Addiction Profile Index and Treatment Motivation Questionnaire were administered to the groups at the beginning of the study and at the end of the 5th week and the results were analyzed. RESULTS: Sociodemographic and substance use characteristics, comorbid psychopathologies and scale mean scores of the groups in the first evaluation were found to be similar to each other. Although the depression and anxiety scores decreased significantly in both groups, no significant difference was found between the groups. Problemsolving skills and treatment motivation increased in the therapy group and decreased in the control group. The difference between groups was found to be significant (p=0.045, 0.037 for problem solving and treatment motivation respectively). While the severity of addiction decreased in therapy group, it increased in control group, but the difference was not significant. CONCLUSION: This study is important in that it shows that psychosocial interventions strengthen the treatment of substance use disorder in adolescents. In our country, no other study was evaluating the effects of the intervention methods in addicted adolescents was found. Future studies with larger sample sizes and where the long-term results of substance use disorder are evaluated are needed.

Mindfulness-based treatment for smoking cessation: a randomized controlled trial / Tratamento baseado em atenção plena (mindfulness) para cessação do tabagismo: ensaio clínico controlado randomizado

ABSTRACT Objective: To evaluate the efficacy of a mindfulness-based treatment (MBT) for smoking cessation or reduction and compare it with that of cognitive behavioral therapy (CBT). Methods: This was a single-center randomized controlled clinical trial including 113 patients divided into two groups: MBT (n = 54) and CBT (n = 59). The interventions comprised eight 90-min sessions. The primary outcome was smoking cessation at 16 weeks after program initiation. Secondary outcomes included reduction in the mean number of cigarettes smoked/day at 16 weeks after treatment initiation, as well as smoking cessation and reduction in the number of cigarettes smoked/day at the last program session. Participants had to attend ≥ 50% of the sessions to be included in the primary outcome analysis. An intention-to-treat analysis was also performed. Results: There was no difference between the groups regarding the primary outcome (30.4% in the MBT group vs. 31.6% in the CBT group, p = 0.68) or immediate abstinence rates (47.8% in the MBT group vs. 36.8% in the CBT group, p = 0.47). Both treatments were equally effective in reducing the number of cigarettes smoked/day at the last program session (a reduction of 93.33% [0-100%] in the MBT group and of 70% [33.3-100%] in the CBT group, p = 0.92) and at 16 weeks after program initiation (a reduction of 57.1% [0-100%] in the MBT group and of 70% [25-100%] in the CBT group, p = 0.49). Conclusions: MBT appears to be as effective as CBT for smoking cessation or reduction and can be an option for the treatment of tobacco use disorders in Brazil (Brazilian Registry of Clinical Trials identifier: RBR-3w2scz [http://www.ensaiosclinicos.gov.br])

RESUMO Objetivo: Avaliar a eficácia de um mindfulness treatment (MT, tratamento baseado em atenção plena) para a cessação ou redução do tabagismo e compará-la à da terapia cognitivo-comportamental (TCC). Métodos: Ensaio clínico controlado randomizado realizado em um único centro, com 113 pacientes divididos em dois grupos: MT (n = 54) e TCC (n = 59). As intervenções consistiram em oito sessões de 90 min cada. O desfecho primário foi a cessação do tabagismo 16 semanas após o início do programa. Os desfechos secundários foram a redução da média de cigarros fumados/dia em 16 semanas após o início do programa, bem como a cessação do tabagismo e redução do número de cigarros fumados/dia na última sessão do programa. Os participantes deveriam comparecer a ≥ 50% das sessões para que fossem incluídos na análise do desfecho primário. Foi também realizada uma análise por intenção de tratamento. Resultados: Não houve diferença entre os grupos quanto ao desfecho primário (30,4% no grupo MT vs. 31,6% no grupo TCC, p = 0,68) ou às taxas de abstinência imediata (47,8% no grupo MT vs. 36,8% no grupo TCC, p = 0,47). Ambos os tratamentos foram igualmente eficazes na redução do número de cigarros fumados/dia na última sessão do programa [redução de 93,33% (0-100%) no grupo MT e de 70% (33,3-100%) no grupo TCC, p = 0,92] e em 16 semanas após o início do programa [redução de 57,1% (0-100%) no grupo MT e de 70% (25-100%) no grupo TCC, p = 0,49]. Conclusões: A MT parece ser tão eficaz quanto a TCC para a cessação ou redução do tabagismo e pode ser uma opção para o tratamento do tabagismo no Brasil. [Registro Brasileiro de Ensaios Clínicos - ReBEC; número de identificação: RBR-3w2scz (http://www.ensaiosclinicos.gov.br)]

Reflexões teórico-técnicas sobre processo grupal on-line desenvolvido em contexto pandêmico / Theoretical-technical reflections on online group process developed in a pandemic context

A pandemia acentua perdas em todos os cenários e esferas da vida em sociedade e tem impulsionado movimentações profissionais e acadêmicas para compreender seus impactos. Adaptações e transformações nas estratégias de atenção à saúde mental das pessoas e nas formas de conceber as experiências universitárias também têm sido requeridas. O texto problematiza os conceitos pichonianos de tarefa e emergente grupal, em busca de subsídios para compreender fenômenos grupais mediados pela internet, face ao contexto pandêmico e ao imperativo de afastamento de atividades presenciais que ele impõe. Propomos que recursos artísticos, tidos como mediadores dialógicos na situação de atendimento remoto, sejam apoiados no redimensionamento dos conceitos de tarefa e emergente, por meio dos neologismos e-tarefa e e-mergente. O resultado do processo de reflexão teórico-técnica é ilustrado a partir de uma vinheta recortada de sessão grupal on-line, na qual um(a) participante, caloura(o) de Curso de Psicologia de instituição pública federal, escolhe e propõe diálogo a partir do conto "Venha ver o pôr do sol", de autoria de Lygia Fagundes Telles. O enlace do dispositivo grupal on-line com a linguagem literária apresenta potência transformadora das realidades compartilhadas no grupo e permite que suas(seus) integrantes possam traduzir e, por conseguinte, se apropriar de experiências emocionais difíceis, como as resultantes da suspensão da vida no espaço físico universitário e da consequente imposição do processo de ensino-aprendizagem remoto.(AU)

The pandemic accentuates losses in all scenarios and spheres of life in society and has driven professional and academic movements to understand its impacts. Adaptations and transformations in peoples mental health care strategies and in ways of conceiving university experiences have also been required. The text problematizes the Pichonian concepts of task and group emergent, searching subsidies to understand group phenomena mediated by the internet, in view of the pandemic context and the compulsory departure from face-to-face activities that it imposes. We propose that artistic resources, considered as dialogical mediators in the situation of remote intervention, should be supported in the redimensioning of the concepts of task and emergent, through the neologisms e-task and e-mergent. The result of the reflection process is illustrated from a cut-out vignette of an online group session, in which a participant, beginning student of Psychology Course of federal public institution, chooses and proposes dialogue based on the literary tale "Come and see the sunset", written by Lygia Fagundes Telles. The link between the online group intervention and the literary language presents a transformative power of the realities shared in the group and allows its members to translate and, consequently, appropriate difficult emotional experiences, such as those resulting from the suspension of life in the university physical space and the consequent imposition of the remote teaching-learning process.(AU)

La pandemia acentúa las pérdidas en todos los escenarios y esferas de la vida de la sociedad y ha impulsado a movimientos profesionales y académicos a comprender sus impactos. También se han requerido adaptaciones y transformaciones en las estrategias de atención en salud mental de las personas y en las formas de concebir las experiencias universitarias. El texto problematiza los conceptos pichonianos de tarea y los emergentes grupales, en busca de subsidios para comprender los fenómenos grupales mediados por internet, ante el contexto pandémico y el imperativo de alejarse de las actividades presenciales que él demanda. Proponemos que los recursos artísticos, vistos como mediadores dialógicos en situación de teleasistencia, sean apoyados en el redimensionamiento de los conceptos de tarea y emergente, a través de los neologismos e-tarea y e-mergent. El proceso de reflexión teórico-técnico resultante se ilustra mediante una viñeta recortada de una sesión grupal online, momento en el que un participante, estudiante novato del curso de psicología de una institución pública federal, elige y propone un diálogo a partir del cuento "Ven a ver el atardecer", de Lygia Fagundes Telles. El entrelazamiento del dispositivo grupal en línea con el lenguaje literario presenta un poder transformador de las realidades compartidas en el grupo y permite a sus miembros traducir y apropiarse de experiencias emocionales difíciles, como las resultantes de la suspensión de la vida en el ámbito físico universitario y la consiguiente imposición del proceso de enseñanza-aprendizaje a distancia.(AU)

Grupo de adolescentes em serviços de saúde mental: uma ferramenta de reabilitação psicossocial / Group of adolescents in mental health services: a psychosocial rehabilitation tool / Grupo de adolescentes en servicios de salud mental: una herramienta de rehabilitación psicosocial

Este estudo teve como objetivo conhecer a dinâmica de funcionamento de grupos de adolescentes coordenados por enfermeiras/os em Centros de Atenção Psicossocial (CAPS). Trata-se de uma pesquisa de abordagem qualitativa. A coleta de dados foi realizada entre março e maio de 2019. Neste período foram realizadas observações sistemáticas em grupos de adolescentes realizados em dois centros de atenção psicossocial. As observações foram registradas em diário de campo, e entrevistas discursivas foram realizadas com os enfermeiros coordenadores destes grupos. A análise temática dos dados foi baseada no referencial teórico de grupos de Pichon-Rivière. Evidenciou-se que as técnicas grupais se mostraram fundamentais enquanto práticas de reabilitação psicossocial para os adolescentes nestes grupos, por este ser um período de muitas dúvidas e experimentações. Contudo, os enfermeiros nem sempre coordenam os grupos a partir de um referencial teórico. Considera-se que a orientação teórica é importante para o desenvolvimento desta terapêutica. Por fim, a teoria de Pichon-Rivière se mostrou uma abordagem possível para se pensar a prática do enfermeiro no atendimento em grupo no CAPS.

This study aimed to understand the functioning dynamics of the adolescent's groups coordinated by nurses in Psychosocial Care Centers. It is a qualitative research. Data collection was carried out between March and May 2019. During this period, systematic observations were carried out in adolescents groups of two psychosocial care centers. The observations were recorded in a field diary, and discursive interviews were conducted with the nurse coordinators of these groups. Thematic analysis of the data was based on the theoretical framework of Pichon-Rivière groups. It was evident that group techniques were fundamental as psychosocial rehabilitation practices for adolescents in these groups, as this is a period of many doubts and experiments. However, nurses do not always coordinate groups based on a theoretical framework. It is considered that theoretical guidance is important for the development of this therapy. Finally, Pichon-Rivière's theory proved to be a possible approach to think about the nurse's practice in group care at CAPS.

Este estudio tuvo como objetivo comprender la dinámica del funcionamiento de grupos de adolescentes coordinados por enfermeras en Centros de Atención Psicosocial (CAPS). Es una investigación cualitativa. La recolección de datos se realizó entre marzo y mayo de 2019. Durante este período, se realizaron observaciones sistemáticas en grupos de adolescentes en dos centros de atención psicosocial. Las observaciones se registraron en un diario de campo y se realizaron entrevistas discursivas con las enfermeras coordinadoras de estos grupos. El análisis temático de los datos se basó en el marco teórico de los grupos de Pichon-Rivière. Se evidenció que las técnicas grupales fueron fundamentales como prácticas de rehabilitación psicosocial para los adolescentes de estos grupos, ya que este es un período de muchas dudas y experimentos. Sin embargo, las enfermeras no siempre coordinan grupos en base a un marco teórico. Se considera que la orientación teórica es importante para el desarrollo de esta terapia. Finalmente, la teoría de Pichon-Rivière resultó ser un posible enfoque para pensar en la práctica de la enfermera en la atención grupal en CAPS.

Oxytocin-enhanced group therapy for methamphetamine use disorder: Randomized controlled trial.

BACKGROUND: Methamphetamine (METH) use is a public health crisis that disproportionately affects men who have sex with men (MSM). There are currently no FDA-approved pharmacological interventions to treat methamphetamine use disorder (MUD). MUD is associated with social impairments and extremely high treatment attrition rates. Administration of oxytocin, a neuropeptide involved in social attachment, may be a novel approach to addressing these issues. Moreover, oxytocin administration has shown promise for reducing METH-related addictive behavior in animal models, but has not yet been investigated in clinical trials for MUD. Last, oxytocin is known to modulate stress responsivity via regulation of the autonomic nervous system, which is dysregulated in METH users. We hypothesize that oxytocin, in combination with group psychotherapy, will increase treatment engagement, reduce addiction behavior, and mitigate stress hyperreactivity. METHODS: This is a randomized, double blind trial of oxytocin 40-IU (n = 24) or placebo (n = 24) administered intranasally prior to each of six weekly motivational interviewing group therapy (MIGT) sessions for MUD in MSM. PRIMARY OUTCOME: (a) session attendance. SECONDARY OUTCOMES: (b) group cohesion, (c) anxiety, (d) METH craving, (e) METH use, and (f) in-session cardiac physiology. RESULTS: Participants receiving oxytocin had significantly higher group therapy attendance than those receiving placebo, OR 3.26, 95% CI [1.27-8.41], p = .014. There was a small effect of oxytocin on group cohension, but not anxiety or craving. METH use did not change over the six-week MIGT course in either treatment arm. Participants receiving oxytocin had lower average heart rates during MIGT sessions and higher heart rate variability. There were positive main effects of MIGT over Time regardless of study drug. CONCLUSIONS: This evidence, and the lack of any serious adverse events, suggests that oxytocin may safely increase treatment attendance. One possible mechanism by which it may do so is its modulation of the autonomic nervous system. Further investigation is warranted.

Lockdown in a specialised rehabilitation unit: the best of times.

Specialised rehabilitation units offer inpatient multi-disciplinary rehabilitation for individuals with severe and enduring mental illness. A cornerstone of therapy is the work in the community through further education and community organisations. However, coronavirus restrictions have meant that such external supports are no longer available for the duration of the crisis. This has led to opportunities for developing new ways of offering rehabilitation within hospital environments. This article describes some of the new initiatives developed. The benefits of the lockdown for service users are also discussed. Many found the cessation of visits from family members with whom they had an ambivalent relationship helpful. The lockdown improved relationships between patients on the unit and encouraged a greater feeling of community. The lockdown has also emphasised the importance of team self-awareness and an awareness of the nature of the treatments offered.

Effectiveness of Group Narrative Therapy on Depression, Quality of Life, and Anxiety in People with Amphetamine Addiction: A Randomized Clinical Trial.

BACKGROUND: Drug abuse is a major issue and one of the main causes of health, psychological, and social problems. Studies have shown the effectiveness of narrative therapy in reducing psychological symptoms of addiction. The present study aimed to assess the effectiveness of group narrative therapy on depression, quality of life (QoL), and anxiety among people with amphetamine addiction in Kermanshah, Iran. METHODS: A randomized clinical trial was conducted during 2015-2016 among patients (n=26) with amphetamine addiction in Kermanshah, Iran. The participants were randomly divided into intervention and control groups. The intervention group followed 10 sessions of narrative therapy, whereas the control group received routine psychiatric care. The data collection tools included a demographic data form, Beck depression inventory-II, QoL questionnaire, and Beck anxiety inventory. The data were analyzed using SPSS software (version 22.0). P<0.05 was considered statistically significant. RESULTS: There was a statistically significant reduction in depression and anxiety scores between the pre- and post-intervention stages (P<0.001) in the intervention group. However, their QoL was unaffected by the therapy (P=0.487). These variables did not show a significant change in the control group. CONCLUSION: Group narrative therapy reduced the level of depression and anxiety in patients with amphetamine addiction. However, their QoL was unaffected by the therapy. Trial Registration Number: IRCT2016010425442N.

Development of an early intervention programme for adolescents with emotion dysregulation and their families: Actions for the treatment of adolescent personality (ATraPA).

AIM: Borderline personality disorder and severe emotion dysregulation in adolescence is a major public health concern. Dialectical Behaviour Therapy is a promising treatment for suicidality in adolescents. The aim of this work is to present an adaptation of this intervention to the Spanish national health system, Actions for the Treatment of Adolescent Personality (ATraPA). METHOD: Data consists of a description of the different ATraPA subprogrammes, including interventions for adolescents aged 13 to 17 and their families. Participants were referred to ATraPA from different hospitals within the region of Madrid, Spain. RESULTS: ATraPA has been developed as an intensive outpatient treatment and it comprises different subprogrammes. ATraPA-TAI is an intensive outpatient treatment, including a skills-based group, individual therapy and email therapy. ATraPA-FAL is a psychoeducational intervention for families, including emotion regulation strategies for parents themselves. Finally, the Alternatives Group is offered to adolescents during the hospital admission, with the aim of promoting alternative coping skills. The group of therapists provides a support network to the professionals involved in ATraPA. CONCLUSIONS: ATraPA has been successfully implemented in a Child and Adolescent Psychiatry Service within the Spanish national health system. Future studies should address the efficacy of ATraPA using a controlled design.

Oficinas terapêuticas em Centro de Atenção Psicossocial: para além dos muros da loucura / Therapeutic workshops in Psychosocial Care Center: beyond the walls of madness

Objetivo: refletir sobre oficinas terapêuticas como atividades que possibilitam consolidar o processo de mudança e a inserção social de pessoas com transtornos mentais em Centros de Atenção Psicossocial. Metodologia: trata-se de um estudo de reflexão, com apoio na literatura sobre a temática. O levantamento de dados ocorreu no período de outubro a dezembro de 2017. Resultados: as oficinas terapêuticas são atividades que contribuem para a efetivação da mudança social acerca da loucura e para a inclusão de pessoas com transtornos mentais no cotidiano familiar, na comunidade e do próprio agir do sujeito. Visam à melhoria na qualidade de vida dos usuários do serviço, incentivadas pela abordagem multidisciplinar, tomando como norte a visão de que os profissionais atuem contribuindo para a reabilitação psicossocial dos usuários e para o aprendizado de novos saberes, numa relação dialógica. Considerações finais: é necessário um incessante espírito de reflexão crítica acerca do trabalho em oficinas terapêuticas para se evitar cair nas armadilhas da segregação de cuidado e se avançar na reabilitação.

Objective: to reflect on therapeutic workshops as activities that make it possible to consolidate the process of change and social insertion of people with mental disorders in Psychosocial Care Centers. Methodology: this is a reflection study, supported by the literature on the subject. The data collection took place from October to December 2017. Results: Therapeutic workshops are activities that contribute to the realization of social change about madness and to the inclusion of people with mental disorders in the family's daily life, in the community and in the subject's own actions. They aim to improve the quality of life of service users, encouraged by the multidisciplinary approach, taking as a guideline that professionals act contributing to the psychosocial rehabilitation of users and to the learning of new knowledge, in a dialogical relationship. Final considerations: an incessant spirit of critical reflection on working in therapeutic workshops is necessary to avoid falling in to the pitfalls of segregation of care and advancing rehabilitation.

O cotidiano de mulheres com fibromialgia e o desafio interdisciplinar de empoderamento para o autocuidado / El cotidiano de mujeres con fibromialgia y el desafío interdisciplinar de empoderamiento para el autocuidado / The routines of women with fibromyalgia and an interdisciplinary challenge to promote self-care

Resumo OBJETIVOS Descrever o cotidiano das mulheres que vivem com fibromialgia durante a intervenção do grupo interdisciplinar e analisar seus benefícios à saúde das mulheres após a intervenção. MÉTODO Trata-se de um estudo descritivo exploratório, de abordagem qualitativa, desenvolvido com 12 mulheres participantes do grupo interdisciplinar de educação em saúde, em uma Universidade Estadual do Rio de Janeiro. Os dados foram coletados em 2016 por meio de entrevista semiestruturada e, em seguida, organizados e submetidos à análise de conteúdo segundo Bardin. O presente estudo foi aprovado pelo comitê de ética recebendo o número do CAAE 16413013013100005259, em consonância aos aspectos éticos legais da resolução 466/2012. RESULTADOS Do corpus analítico, emergiram duas categorias intituladas: A expressão do cotidiano e Repercussões do grupo interdisciplinar. CONCLUSÃO As ações do grupo interdisciplinar proporcionaram inúmeros benefícios tanto físicos, quanto psicológicos e sociais para cada mulher.

Resumen OBJETIVOS Describir el cotidiano de las mujeres que viven con fibromialgia durante la intervención del grupo interdisciplinario y analizar sus beneficios a la salud de las mujeres después de la intervención. MÉTODO Se trata de un estudio descriptivo exploratorio, de abordaje cualitativo, desarrollado con 12 mujeres participantes del grupo interdisciplinario de educación en salud, en una Universidad Estadual del Río de Janeiro. Los datos fueron recolectados en 2016 por medio de entrevistas semiestructuradas y luego organizados y sometidos al análisis de contenido según Bardin. El presente estudio fue aprobado en el comité de ética recibiendo la numeración del CAAE 16413013013100005259, en consonancia a los aspectos éticos legales de la resolución 466/2012. RESULTADOS Del corpus analítico, emergieron dos categorías tituladas: La expresión del cotidiano y Repercusiones del grupo interdisciplinario. CONCLUSIÓN Las acciones del grupo interdisciplinario proporcionaron innumerables beneficios tanto físicos, como psicológicos y sociales para cada mujer.

Abstract OBJECTIVE To describe the daily lives of women living with fibromyalgia through the implementation of an interdisciplinary group intervention and verify its benefits to the participants' health. METHOD This descriptive, exploratory, qualitative study was conducted with 12 women who participanted in an interdisciplinary health education group at the State University of Rio de Janeiro. Data were collected in 2016 through semi-structured interviews, which were organized and analyzed according to Bardin's content analysis. This study was approved by the Institutional Review Board (CAAE 16413013013100005259), in accordance with the legal and ethical guidelines estabished by Resolution 466/2012. RESULTS Two categories emerged from the analytical corpus, namely: Expression of everyday life and Repercussions of the interdisciplinary group. CONCLUSION The actions implemented by the interdisciplinary group resulted in numerous physical, psychological and social benefits for the women.

Clinical Outcomes From a 10-Week Follow-Up Psychoeducational Program for Dual Diagnosis.

BACKGROUND: Dual diagnosis covers a broad spectrum of mental health and substance misuse conditions occurring concurrently (NICE, 2016 ). Its manifestation is complex and, as such, the disorder is recognized as influencing adherence to prescribed medication and service engagement and has a worse prognosis than substance use and mental health conditions occurring independently. AIMS: To determine the effectiveness of psychoeducational group therapy in a sample of dual diagnosis patients. METHODS: Patients who met the Diagnostic and Statistical Manual of Mental Disorders-IV Axis 1 criteria for serious mental illness and current substance misuse were approached to take part in a psychoeducational program. Those who consented were assessed at baseline and end point using measures of psychiatric syptomatology, psychological well-being, and substance use patterns with the following scales: the Brief Psychiatric Rating Scale, the Hospital Anxiety and Depression Scale, the Maudsley Addiction Profile, and the Warwick-Edinburgh Mental Wellbeing Scale. RESULTS: Fifty-one patients completed the program, while 29 dropped out after initial assessment. Between baseline and follow-up, there was a decline in the number of participants using alcohol, cannabis, cocaine, amphetamine, illicit benzodiazepines and methadone. However, the number of participants using heroin remained constant. The mean amount of substances used was not reduced over the study period except in the case of alcohol. Overall improvements in syptomatology and psychological well-being were observed. DISCUSSION: Mental health services should focus on integrated approaches via multimodal treatment interventions that encapsulate harm reduction and educational initiatives. Despite the modest sample, the findings have emphasized the importance of a broad range of treatment approaches delivered within a unitary delivery system.

ANÁLISIS DE LA EXPERIENCIA SUBJETIVA EN MUJERES CON CÁNCER DE MAMA / SUBJECTIVE EXPERIENCE ANALYSIS IN WOMEN WITH BREAST CANCER

En este artículo se analiza la experiencia y necesidades psicológicas presentes en el discurso de las participantes durante una intervención psicoterapéutica grupal dirigida a mujeres con cáncer de mama. Se transcriben las sesiones del grupo y se realiza un análisis del discurso, recogiendo los temas más prevalentes. Las principales dificultades psicológicas recogidas son el cambio en su imagen corporal y su sexualidad, la nueva vivencia de las relaciones interpersonales, las repercusiones del discurso social sobre la importancia de las emociones positivas, el miedo a la recidiva, las relaciones con el personal sanitario y los cambios tras la enfermedad. Se recogen aspectos que las pacientes consideran factores de ayuda en el grupo (sentirse comprendidas, ver a las compañeras como modelos de afrontamiento o cambiar su relación con la enfermedad). Se apuntan implicaciones clínicas para una mejora en la atención integral a las pacientes con cáncer de mama.

In this article the psychological experience and needs shown in the discourse of women diagnosed with breast cancer in a psychological group intervention were analyzed. The sessions are transcribed and a discourse analysis is performed, selecting the most prevailing topics. The main psychological difficulties perceived by the participants are the following: body identity change, sexuality changes, new quality of interpersonal relationships, implications of positive thinking culture, fear of recurrence, the relationship with the hospital staff, and change after diagnosis. The aspects that the group considered helpful are also addressed, i.e. feeling understood by the others, seeing the rest of participants as coping models, changing their relationship with the illness. Several clinical implications are highlighted in order to improve a comprehensive care.

Psicoterapia de Grupo de inspiração fenomenológico-existencial em pacientes esquizofrênicos / Group psychotherapy of phenomenological-existential inspiration in schizophrenic patients

A psicoterapia existencial é uma abordagem filosoficamente informada à psicoterapia. Surgiu como um esforço de convergir conhecimentos da fenomenologia e do movimento existencial com a prática terapêutica. Esta psicoterapia é um processo colaborativo e integrativo que privilegia a confrontação com os existenciais e a compreensão empática da experiência subjetiva do paciente, promovendo o desenvolvimento de um self autêntico. Previamente descrita por alguns autores como insegurança ontológica e perda do contato vital com a realidade, a esquizofrenia acarreta frequentemente dificuldades acrescidas em diversas áreas da vida e isolamento social. O objetivo deste artigo é discutir a aplicabilidade da psicoterapia de grupo de inspiração fenomenológico-existencial na esquizofrenia. Primeiro, revemos a literatura existente acerca da psicoterapia de grupo na esquizofrenia, introduzindo a terapia existencial e enfatizando áreas de convergência e de diferença. Depois, descrevemos a experiência de um grupo psicoterapêutico de pacientes com esquizofrenia. Numa perspetiva conceptual, a terapia de inspiração fenomenológico-existencial pode fundar qualquer intervenção terapêutica na esquizofrenia. Durante as sessões de grupo os pacientes foram encorajados a explorar descritivamente o seu mundo vivido e a reconhecer as suas liberdades e responsabilidades. Foi de grande valor a abordagem das preocupações existenciais, frequentemente negligenciadas em outros modelos psicoterapêuticos. Esta abordagem não pretende substituir o tratamento padrão, reconhecendo que uma mudança dramática de paradigma podia significar uma visão despatologizada da esquizofrenia. Em vez disso, argumentamos pela assimilação. E numa altura em que os terapeutas se encontram focados no alívio sintomático imediato e sobrecarregados com resultados funcionais esta assimilação pode ter particular importância.(AU)

Existential Psychotherapy is a philosophically informed approach to psychotherapy. It began as an effort to merge valuable insights coming from phenomenology and the existential movement with the therapeutic practice. This psychotherapy is a collaborative and integrative process which privileges the confrontation with the givens of existence and the empathic understanding of the patient's subjective experience, promoting the development of an authentic self. Previously described by some authors as ontological insecurity and loss of vital contact with reality, schizophrenia often leads to increased difficulties in diverse areas of daily life and to social isolation. The aim of this article is to discuss the feasibility of group psychotherapy of phenomenologicalexistential inspiration in schizophrenia. First, we review the published literature of group psychotherapy in schizophrenia, introducing existential therapy and highlighting areas of commonality and difference. Then we describe the experience of a psychotherapeutic group of patients with schizophrenia. From a conceptual perspective, phenomenological-existential inspired therapy could provide a theoretical foundation for any therapeutic intervention in schizophrenia. During group sessions, patients were encouraged to descriptively explore their lived-worlds and to acknowledge their freedom and responsibility. It was highly valuable to address existential concerns, which are often neglected in other psychotherapeutic models. This approach is not meant to replace the current treatment standards, recognizing that a dramatic shift could bring a de-pathologizing view of schizophrenia. Instead, we argue for assimilation. When therapists are becoming increasingly preoccupied with immediate symptom relief and burdened with functional outcomes, this assimilation may be of particular significance.(AU)

Effects of group medical visits and peer education on compliance behaviors of patients with acne vulgaris / 中华皮肤科杂志

Objective To evaluate the effects of group medical visits and peer education on the compliance behaviors of patients with acne vulgaris,and to explore the effective health education approaches for patients with acne vulgaris.Methods A total of 80 patients with acne vulgaris were enrolled from Hospital of Dermatology,Chinese Academy of Medical Sciences during December 2016.They were randomly and equally divided into 2 groups:intervention group receiving conventional health education combined with group medical visits and peer education,and control group receiving conventional health education alone.At week 1,2 and 4 after the intervention,the compliance behaviors were compared between the 2 groups.Results Totally,18 patients were lost to the follow-up due to refusals and non-response,and 32 patients in the intervention group and 30 patients in the control group finally completed the study.At week 1,2 and 4 after the intervention,the scores of compliance behaviors were significantly higher in the intervention group (83.6 ± 9.3,85.9 ± 9.1,91.2 ± 8.4 respectively) than in the control group (77.1 ± 7.3,77.1 ± 8.6,79.1 ± 10.2 respectively;all P ＜ 0.05).Moreover,the scores of compliance behaviors significantly increased over time (P ＜ 0.05),and there was a significant interaction effect between the intervention methods and treatment duration (P ＜ 0.05).Conclusion Health education approaches including group medical visits and peer education can improve the compliance behaviors of patients with acne vulgaris.

Tratamiento Grupal Intensivo del Tabaquismo / Intensive Smoking Cessation Group Therapy

Resumen Se describe la metodología utilizada en el Instituto Nacional del Tórax para el tratamiento del tabaquismo, modalidad grupal. Se realizan 7 sesiones semanales, donde se utilizan los principios de la Entrevista Motivacional. Hay una primera etapa de preparación (3 sesiones), se fija día D y luego 4 sesiones de acompañamiento, manejo del síndrome de privación, prevención de recaídas y mantención de la abstinencia.

We describe the methodology used at the Instituto Nacional del Tórax for smoking cessation, group therapy. We carried out 7 weekly sessions, where the principles of the Motivational Interview are used. There is a first stage of preparation (3 sessions), fixed D-day and then 4 sessions of follow up, for the management of deprivation syndrome, relapse prevention and maintenance of abstinence.

Aconselhamento em saúde: fatores terapêuticos em grupo de apoio psicológico para transtornos alimentares / Counseling in health: therapeutic factors in a psychological support group for eating disorders

Este estudo teve como objetivo identificar fatores terapêuticos em um grupo de apoio para pacientes com transtornos alimentares (anorexia e bulimia). O grupo de apoio psicológico é parte da estratégia de assistência oferecida por um serviço especializado em saúde. Duas sessões, com um total de 10 participantes, foram audiogravadas e transcritas na íntegra. A análise de conteúdo temática evidenciou que, ao reconhecerem na experiência alheia aspectos semelhantes aos seus próprios problemas, os participantes puderam se identificar uns com os outros e construir um espaço homogeneizado pela normalização das dificuldades. Além disso, os participantes mencionaram que o grupo promove esperança, conforto e bem-estar a partir do compartilhamento de experiências vitais. Desse modo, universalidade e instilação de esperança foram os principais fatores terapêuticos de apoio ativados nas sessões grupais, contribuindo para potencializar processos de mudança em uma perspectiva ampliada de saúde...

This study aimed to identify therapeutic factors in a support group for patients with eating disorders (anorexia and bulimia). Psychological support groups compose part of the strategy of assistance offered by a specialized health service. Two group sessions with 10 participants were audio recorded and transcribed in full. Thematic content analysis showed that, the participants recognized similar aspects of their own problems in the experience of others, and could identify with each other and construct a space homogenized by standardization of the difficulties. In addition, the participants mentioned that the group promotes hope, comfort and well-being through the sharing of life experiences. Thus, universality and instillation of hope were the main therapeutic factors activated in the group sessions, helping to improve the process of change in a broad perspective of health...