Georgina A. Maddox, Glen E. Bodner, Matthew W. Christian, Paul Williamson
{"title":"On the Effectiveness of Visual Arts Therapy for Traumatic Experiences: A Systematic Review and Meta-Analysis","authors":"Georgina A. Maddox, Glen E. Bodner, Matthew W. Christian, Paul Williamson","doi":"10.1002/cpp.3041","DOIUrl":"10.1002/cpp.3041","url":null,"abstract":"<p>Arts therapy is a popular intervention used to work through the effects of traumatic experience. We evaluate previous reviews and report a meta-analysis of the effectiveness of arts therapy following trauma for reducing symptoms of PTSD, enhancing positive outcomes (e.g., quality of life) and decreasing negative outcomes (e.g., depression). Database searches identified 21 (<i>N</i> = 868) randomised controlled trials (RCTs). Outcomes were categorised as PTSD specific, positive non-PTSD specific and negative non-PTSD specific. Several moderators were tested: age, diagnosis type, trauma type, intervention instruction, control type, therapy mode and therapy duration. Overall, random-effects analysis indicated that arts therapy was favoured relative to control for positive non-PTSD-specific outcomes (<i>g</i> = 1.53, <i>p</i> < 0.001), but not for negative non-PTSD-specific (<i>p</i> = 0.069) or PTSD-specific outcomes <i>(g</i> = 0.89, <i>p</i> = 0.052). Regression analyses indicated that arts therapy was effective in reducing PTSD-specific outcomes in children (<i>Z</i> = 2.81, <i>df</i> = 1, <i>p</i> = 0.005), positive non-PTSD-specific outcomes in group-based arts therapy (<i>Z</i> = −2.40, <i>df</i> = 1, <i>p</i> = 0.016, <i>I</i><sup><i>2</i></sup> = 57.33) and for reducing negative non-PTSD outcomes following acute traumas (e.g., combat-related trauma or sexual abuse) (<i>Q</i> = 10.70, <i>df</i> = 3, <i>p</i> = 0.013, <i>I</i><sup>2</sup> = 77.09). We highlight the need for additional RCTs and standardised protocols to address heterogeneity. Our review provides an important benchmark for gauging the effectiveness of arts therapy in the treatment of trauma.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruth Middlehurst, Nima Moghaddam, David L. Dawson, Andy Reeve
{"title":"Perceived Change Processes in Dialectical Behaviour Therapy From the Perspective of Clients With a Diagnosis or Traits of Borderline Personality Disorder: A Systematic Literature Review","authors":"Ruth Middlehurst, Nima Moghaddam, David L. Dawson, Andy Reeve","doi":"10.1002/cpp.3038","DOIUrl":"10.1002/cpp.3038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To synthesise qualitative research on individuals diagnosed with (or reportedly showing traits of) borderline pattern personality disorder who underwent dialectical behaviour therapy, aiming to comprehend their perceptions of change processes and the therapy's effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted across multiple online databases and grey literature sources. Papers were quality appraised using an adapted version of the Critical Appraisal Skills Programme tool. A metaethnographic approach was employed during the synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven studies met criteria for inclusion in the review. The main themes identified through the synthesis process were the impact of DBT, the supportive structure and the 1:1 therapy component.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The synthesis uncovered the importance of various processes within DBT that patients perceived as active ingredients for their change. Many of these processes aligned with proposed theoretical processes of change and quantitative research on DBT's effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessia Caffieri, Rosa Fabbricatore, Giorgia Margherita
{"title":"COVID-19 Posttraumatic Effects on Perinatal Psychological Distress: A Cross-Sectional Study at the End of the Pandemic Health Emergency","authors":"Alessia Caffieri, Rosa Fabbricatore, Giorgia Margherita","doi":"10.1002/cpp.3037","DOIUrl":"10.1002/cpp.3037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Psychological distress in pregnant and postpartum women increased during the COVID-19 pandemic. However, the impact of the pandemic in perinatal women at the end of the health emergency has been rarely studied. This study is aimed at investigating the psychological health of pregnant and postpartum women at the end of the COVID-19 public health emergency, hypothesizing that the COVID-19-related fears influence perinatal psychological distress via the mediation of the COVID-19-related posttraumatic impact and loneliness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 200 women in the perinatal period, of which 125 were pregnant and 75 were postpartum, participated in an online survey at the end of the COVID-19 public health emergency in Italy. Depression, anxiety, stress, loneliness, posttraumatic impact of COVID-19 pandemic and COVID-19-related fears were assessed. To test the hypotheses, robust serial mediation analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Increased levels of COVID-19-related fears were associated with an increase in perinatal depression, anxiety and stress indirectly through the serial mediation of COVID-19 posttraumatic impact and loneliness. Loneliness played a stronger role in mediating the relationship between COVID-19-related fears and depression than anxiety and stress outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study should be considered exploratory for its methodological characteristics and nonreplicability of the pandemic condition. However, this study suggests the importance of assessing posttraumatic reactions to ‘collective’ crises in pregnant and postpartum women for research and clinical practice. In addition, it sustains the role of loneliness as a transversal construct that should be greatly considered in targeting psychological interventions for women in the perinatal period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haleemah Ahmed, Caroline Bendall, Faiza Anwar, Mariam Al-Janabi, Lisa Wood
{"title":"A Systematic Review and Narrative Synthesis Examining the Facilitators and Barriers of Psychological Intervention Delivery in Crisis Resolution Home Treatment Teams","authors":"Haleemah Ahmed, Caroline Bendall, Faiza Anwar, Mariam Al-Janabi, Lisa Wood","doi":"10.1002/cpp.3032","DOIUrl":"10.1002/cpp.3032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mental health crisis rates in the United Kingdom are on the rise. The emergence of community mental health models, such as Crisis Resolution Home Treatment Teams (CRHTTs), offers a vital pathway to provide intensive assessment and treatment to individuals in their homes, including psychological interventions. Previous qualitative literature has identified facilitators and barriers to the implementation of psychological interventions within CRHTT settings; however, a synthesis of this literature has not yet been conducted. To address this gap, a systematic review was undertaken with the aim of identifying the reported facilitators and barriers of implementing evidence-based psychological interventions in CRHTTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic review and narrative synthesis were conducted. Studies were included if they examined the implementation of evidence-based psychological interventions in a CRHTT setting. The study population had to be 18 and over and could include healthcare professionals working in CRHTTs, service users of CRHTTs, or family and carers of CRHTT service users. Studies of any formal research methodology were included. Four databases were searched (MEDLINE, CINAHL Plus, Embase and PsycINFO), along with Google Scholar, to identify eligible studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies were identified, using mixed qualitative and quantitative methodologies, with the predominant focus being the exploration of stakeholder perspectives on care implementation within CRHTTs, encompassing aspects including but not restricted to psychological care implementation. The literature was deemed to be of moderate to high quality. Facilitators included adapting psychological therapies, prioritizing the therapeutic relationship, increasing psychological skills and training of CRHTT staff and psychologically informed CRHTT models. The barriers identified included a medical model bias within teams, resource constraints and elements pertaining to CRHTT services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Further robust research in this area is imperative. We recommend that future research be implemented in the form of service evaluations and randomized controlled trials (RCTs) and that the principles of implementation science be used to assess and develop the evidence base for psychological intervention delivery in CRHTTs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Schürmann-Vengels, Christoph Flückiger, Emilia Reyer, Patrizia Odyniec, Ulrike Willutzki
{"title":"The Impact of Mental Imagery Instructions on Patients' and Therapists' Positive Affect and Strength-Based Behaviours Within Psychotherapy Sessions: A Randomized Controlled Process Study","authors":"Jan Schürmann-Vengels, Christoph Flückiger, Emilia Reyer, Patrizia Odyniec, Ulrike Willutzki","doi":"10.1002/cpp.3036","DOIUrl":"10.1002/cpp.3036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Increased attention has recently been paid to the well-being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength-based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a secondary analysis of a randomized controlled trial. Seventy-eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; <i>M</i><sub><i>age</i></sub> = 40.31) treated by 13 therapists were selected. PA and strength-based behaviours of patients and therapists were coded on a minute-by-minute basis with the Resource-Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength-based behaviours were employed in one-fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength-based behaviours in the beginning phase of sessions, <i>p</i> < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, <i>p</i> < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018).</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carla Smith Stover, Margaret L. Holland, Ellen Martin, Edoardo Modanesi, Meghan Clough Fish, Rebecca Beebe
{"title":"Comparing in Person to Telehealth Delivery of a Family Violence Intervention","authors":"Carla Smith Stover, Margaret L. Holland, Ellen Martin, Edoardo Modanesi, Meghan Clough Fish, Rebecca Beebe","doi":"10.1002/cpp.3034","DOIUrl":"10.1002/cpp.3034","url":null,"abstract":"<div>\u0000 \u0000 <p>There is increasing evidence that therapy and intervention services delivered by telehealth are effective at reducing a variety of mental health symptoms. Limited studies have indicated online services can reduce intimate partner violence (IPV), but none have tested in-person compared to telehealth-delivered interventions for men who have used IPV. Clinical outcome data from 311 parents (192 fathers and 119 linked coparent mothers) engaged in the Fathers for Change (F4C) intervention following referral by child protective services for IPV were examined to determine if in-person delivery of the intervention differed in terms of client treatment engagement and retention or outcomes. Parents who enrolled during a 1-year period prior to the COVID pandemic received their F4C therapy in person, while those who enrolled during the pandemic received their intake and most of their sessions via telehealth delivery. Parents reported significantly greater symptoms of depression, anxiety, and stress prior to treatment if they enrolled prior to COVID than if they enrolled during the pandemic. There were few differences in completion rates or outcomes based on in-person compared to telehealth delivery. Fathers were slightly more likely to complete treatment and attended a significantly higher percentage of their sessions when it was delivered by telehealth during COVID. Fathers reported significantly lower stress scores posttreatment when they received COVID telehealth delivery compared to prior to COVID in-person delivery of F4C. These findings suggest that telehealth may be an appropriate and viable option for the delivery of IPV interventions for families.</p>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Wood, Hannah Butterworth, Patrick Nyikavaranda, Aderayo Ariyo, Nira Malde-Shah, Ella Guerin, Mary Birken, Karen Persaud, Ceri Dare, Nicola Morant, Sonia Johnson
{"title":"Patient's Experiences of a Cognitive Behaviour Therapy Informed Crisis Intervention for Psychosis Delivered in Inpatient Settings: A Qualitative Exploration","authors":"Lisa Wood, Hannah Butterworth, Patrick Nyikavaranda, Aderayo Ariyo, Nira Malde-Shah, Ella Guerin, Mary Birken, Karen Persaud, Ceri Dare, Nicola Morant, Sonia Johnson","doi":"10.1002/cpp.3033","DOIUrl":"10.1002/cpp.3033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Cognitive behaviour therapy for psychosis (CBTp) should be offered to patients receiving psychiatric inpatient care, yet very little is known about patients' perspectives on this. The aim of this study was to examine patients' experiences of a CBTp-informed intervention delivered in inpatient settings. We recruited 10 participants from the intervention arm of a randomised controlled trial examining the feasibility and acceptability of a CBTp-informed intervention for psychiatric inpatient settings. We undertook semistructured interviews examining their experiences of the intervention and analysed them using thematic analysis. The study was conducted in partnership with a coproduction group of key stakeholders (people with lived experience, family and carers, and clinicians). The intervention was found helpful by almost all participants, and all participants would recommend it to others in similar situations to themselves. The results demonstrated that participants valued the therapist's professionalism and emphasised the importance of the therapeutic relationship. Participants highlighted the importance of the therapy focusing on navigating admission and developing skills to manage the crisis experience so they could return to their normal lives. Participants described challenges to having psychological therapy in the acute crisis context including therapy interruptions and ongoing distressing experiences of psychosis. The study demonstrated the importance of prioritising the therapeutic relationship, that therapy was a valued process to navigate admission and discharge, but that some environmental and patient-level challenges were present. Further research is needed to explore inpatients' experiences of psychological interventions in this setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ISRCTN trial registry: ISRCTN59055607</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Systematic Review of Momentary Social Predictors of Positive Psychosis Experiences","authors":"Leanne Irwin, Alisa Udachina, Tobyn Bell, Lesley-Anne Carter, Fritz Handerer, Katherine Berry","doi":"10.1002/cpp.3030","DOIUrl":"10.1002/cpp.3030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Social factors can play an important role in the development and maintenance of psychosis. Clarifying this relationship is vital for advancing theoretical understanding and development of targeted interventions. Psychosis is increasingly researched with an experience sampling methodology (ESM), which provides an ecologically valid approach, that reduces recall biases. Studies examining momentary associations between social factors and psychosis have not yet been summarised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We identified 29 ESM studies investigating associations between social factors and positive psychotic experiences through a pre-registered systematic search of the published literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Being alone did not predict increase in psychosis; however, appraisals and feelings associated with being alone such as feeling socially disconnected, lonely and unwanted did. Being with familiar company was found to reduce psychosis experiences but feeling stressed by the current company increased psychosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While issues with sample size and generalisability mean these results should be interpreted with caution, some putative conclusions can be made. Individuals with psychosis or emerging symptoms should be offered interventions that improve social networks such as peer support, community participation and engagement skills training. These individuals may also benefit from virtual reality or compassion-based interventions which aim to dampen perceived social threat. Moreover, digital interventions which monitor changes in social variables that predict relapse in symptoms would allow early intervention to prevent mental health crises.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prolonged Exposure for Posttraumatic Stress Disorder in Patients Exhibiting Psychotic Symptoms: A Scoping Review","authors":"D. H. K. Deleuran, O. Skov, S. Bo","doi":"10.1002/cpp.3027","DOIUrl":"10.1002/cpp.3027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trauma is a significant risk factor for developing psychosis. Nevertheless, psychosis is often considered grounds for not receiving trauma-focused therapy due to concerns of exacerbating psychotic symptoms. Prolonged exposure (PE) is a recognized and effective evidence-based therapy modality for the treatment of severe trauma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the available empirical evidence for PE as a feasible treatment programme for posttraumatic stress disorder (PTSD) in patients with psychotic symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic literature search was conducted using the databases Scopus, PsycINFO (OVID) and PubMed MEDLINE in December 2023 with a priori defined eligibility criteria. The literature search identified 1226 articles, of which eight met the eligibility criteria. Five studies exploring the effects of PE treatment on patients diagnosed with PTSD and suffering from comorbid psychotic experiences were included. Three studies containing follow-up data or secondary analysis on PTSD and psychotic symptoms from original studies fulfilling the inclusion and exclusion criteria were included. Each study was assessed for quality to estimate the risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Acknowledging the scarcity of available evidence, the results of the scoping review indicate that PE may be an effective treatment approach for reducing PTSD symptoms in patients with PTSD and comorbid psychotic symptoms. The reviewed studies found no iatrogenic effects, including no increase in psychotic symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PE appears to be a possibly effective PTSD treatment for patients suffering from PTSD and comorbid psychotic symptoms or disorders. However, the evidence is scarce, and larger confirmative trials are required for more conclusive evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Effectiveness of Imagery Rescripting Interventions for Military Veterans With Nightmares and Sleep Disturbances: A Systematic Review and Meta-Analysis","authors":"Marya Hicks, Laura M. Simonds, Linda Morison","doi":"10.1002/cpp.3025","DOIUrl":"10.1002/cpp.3025","url":null,"abstract":"<p>Imagery rescripting (ImRs) interventions have been found effective in improving sleep outcomes, although research has mostly focused on civilian, rather than military, samples. The aim of this review was to estimate the overall effectiveness of ImRs interventions for military veterans on primary outcomes of nightmare frequency and sleep quality. A systematic search was conducted in CINAHL, MEDLINE, PsycArticles, PsycINFO, Psychology and Behavioural Sciences Collection and the PTSDpubs database and was completed on 1 November 2021. Randomised controlled trials, nonrandomised trials and pre–post studies of ImRs interventions in veterans with sleep disturbances or nightmares were included. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool, and meta-analysis was performed using Stata. Nineteen articles from 15 empirical studies were included in the review, and data from the 15 studies (involving 658 participants) were included in the meta-analysis. Meta-analysis findings indicated that ImRs interventions are associated with significant positive changes from pretreatment to posttreatment for nightmare and sleep quality. Significantly greater improvements were found in ImRs interventions compared to control groups for sleep quality (Hedges' <i>g</i> = −0.65, 95% CI [−1.20, −0.10]) but not for nightmare frequency (Hedges' <i>g</i> = −0.10, 95% CI [−0.34, 0.14]). Overall, the meta-analysis included a relatively small number of studies with poor methodological quality and considerable heterogeneity; therefore, findings should be cautiously interpreted. Further research should focus on veteran participants with larger samples and from a broader range of sources to determine effectiveness more confidently.</p>","PeriodicalId":10460,"journal":{"name":"Clinical psychology & psychotherapy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpp.3025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}