Search Results (49)

Background/Objectives: Art therapy is a psychotherapeutic technique that involves the creation of tangible visual arts and represents a coping strategy to support children with cancer. Evaluating the effects of such activities on children with cancer is essential for providing evidence of the value that creativity holds within healthcare systems. A dedicated tool for assessing the creative process is the Arts Observational Scale (ArtsObS), focusing on mood and emotional states as key indicators of psychosocial well-being. This study aims to validate a translated version of the ArtsObS in the Italian language. Methods: The translation process followed recommendations for translation and cultural adaptation. The distribution properties of the scores, internal consistency, sensitivity to change, reliability, and convergent validity were assessed through observations conducted by two different evaluators. Results: The ArtsObS in its Italian adaptation is proven to be an adequate tool for capturing changes following an intervention, with good internal consistency and low sensitivity to differences between operators. The analysis supports the reliability of the ArtsObS across different observers. Conclusions: The Italian ArtsObS is a valid and reliable instrument for evaluating the impact of art therapy on pediatric patients’ mood and emotional states. It provides a standardized tool for clinical and research settings to assess creative interventions in pediatric oncology. Full article

Background: Borderline personality disorder (BPD) is a severe psychiatric condition characterised by emotional instability, impulsivity, interpersonal dysfunction, and self-injurious behaviours. Despite growing clinical interest, the neuropsychological mechanisms underlying these symptoms are still not fully understood. This review aims to summarise findings from neuroimaging, psychophysiological, and neurodevelopmental studies in order to clarify the neurobiological and physiological basis of BPD, with a particular focus on emotional dysregulation and implications for the treatment of adolescents. Methods: A narrative review was conducted, integrating results from longitudinal neurodevelopmental studies, functional and structural neuroimaging research (e.g. FMRI and PET), and psychophysiological assessments (e.g., heart rate variability and cortisol reactivity). Studies were selected based on their contribution to understanding the neural correlates of BPD symptom dimensions, particularly emotion dysregulation, impulsivity, interpersonal dysfunction, and self-harm. Results: Findings suggest that early reductions in amygdala volume, as early as age 13 predict later BPD symptoms. Hyperactivity of the amygdala, combined with hypoactivity in the prefrontal cortex, underlies deficits in emotion regulation. Orbitofrontal abnormalities correlate with impulsivity, while disruptions in the default mode network and oxytocin signaling are related to interpersonal dysfunction. Self-injurious behaviour appears to serve a neuropsychological function in regulating emotional pain and trauma-related arousal. This is linked to disruption of the hypothalamic-pituitary-adrenal (HPA) axis and structural brain alterations. The Unified Protocol for Adolescents (UP-A) was more effective to Mentalization-Based Therapy for Adolescents (MBT-A) at reducing emotional dysregulation compared, though challenges in treating identity disturbance and relational difficulties remain. Discussion: The reviewed evidence suggests that BPD has its in early neurodevelopmental vulnerability and is sustained by maladaptive neurophysiological processes. Emotional dysregulation emerges as a central transdiagnostic mechanism. Self-harm may serve as a strategy for regulating emotions in response to trauma-related neural dysregulation. These findings advocate for the integration of neuroscience into psychotherapeutic practice, including the application of neuromodulation techniques and psychophysiological monitoring. Conclusions: A comprehensive understanding of BPD requires a neuropsychologically informed framework. Personalised treatment approaches combining pharmacotherapy, brain-based interventions, and developmentally adapted psychotherapies—particularly DBT, psychodynamic therapy, and trauma-informed care—are essential. Future research should prioritise interdisciplinary, longitudinal studies to further bridge the gap between neurobiological findings and clinical innovation. Full article

Ketamine infusion therapy has gained recognition as an innovative treatment for treatment-resistant depression (TRD), demonstrating rapid and robust antidepressant effects. Its therapeutic promise is increasingly understood to involve molecular and neurobiological processes that promote neural plasticity and cognitive flexibility. These changes may create a unique window for psychotherapeutic interventions to take deeper effect. This retrospective chart review examined the clinical outcomes of individuals with TRD who received either single or repeated ketamine infusion(s), with or without weekly psychotherapy. Depression severity, measured by Beck Depression Inventory scores, was assessed pre-treatment and 30 days post-infusion(s). The results showed significant symptom reduction across all groups, with the most pronounced effects observed in those who received concurrent psychotherapy. While infusion number did not significantly alter outcomes, the integration of ketamine with psychotherapy appeared to enhance treatment response. Full article

Given the suboptimal responses to medication and cognitive behavioral therapies in the treatment of post-traumatic stress disorder (PTSD), new approaches are needed. Background/Objectives: Therapies that include a somatic component such as Emotional Freedom Techniques (EFT) and Eye Movement Desensitization and Reprocessing (EMDR) have demonstrated efficacy in the treatment of PTSD in numerous clinical trials. This case series introduces the Trauma Reintegration Process (TRP), a psychotherapeutic process developed by the author that can be combined with somatic therapies to enhance their effectiveness, especially in patients with dissociation. Methods: This case series describes the use of TRP in combination with EFT, an energy-based somatic treatment that engages the meridian system of the body through gentle tapping on acupressure points. TRP uses EFT in combination with a focused guided imagery sequence. This case series describes the treatment of two patients: a 20-year-old woman who experienced PTSD and somatic symptoms following a serious motor vehicle accident (MVA) and a 45-year-old woman with a history of severe abuse as a child as well as adult trauma who had also been in a serious MVA. The cases contrast the way TRP can be applied in patients with single versus multiple traumas and who experience dissociation. Results: In both cases, EFT treatment stalled when the patient dissociated. After TRP was introduced, however, the EFT treatment regained momentum, leading to significant improvement in PTSD symptoms including a reduction of nightmares and flashbacks and resolution of other somatic symptoms. Conclusions: The trauma reintegration process (TRP) in combination with EFT has the potential to assist in the memory processing of patients with dissociation and complicated trauma presentation without retraumatizing the client and causing further distress or dissociation. In addition, it provides the patient with a self-empowering method to alleviate any additional traumatic sequelae. Full article

Early readmission to psychiatric units poses a significant challenge for both patients and healthcare institutions. It hampers patient progress and prognosis, and the professional approach taken during discharge can greatly influence the recovery process. This paper proposes a multicomponent discharge transition intervention to mitigate the risk of early readmission to a mental health hospitalization unit (MHHU). The present proposal consists of two distinct phases with two clearly differentiated main objectives. On the one hand, following an observational design, the development of a measurement instrument to assess patients’ risk of early readmission, allowing for stratification into the high-, medium-, and low-risk categories. On the other hand, according to a quasi-experimental design, the implementation and evaluation of the intervention program, with a focus on tailored interventions to ensure adherence and continuity of care post-discharge, with a more intensive approach for high-risk patients. A post-discharge psychotherapeutic group will also be introduced for high-risk cases to support recovery. The program’s effectiveness will be evaluated by comparing the early readmission rates at the Regional Hospital of Malaga’s MHHU to those of the previous year. Two other hospitals in the province, where the intervention is not applied, will serve as control groups. Success will also be measured through pre- and post-assessments of the recovery, functionality, subjective well-being, social support, and treatment satisfaction of those participating in the psychotherapeutic group. This proposal aims to address the issue of early readmission by enhancing predictability and understanding intervention strategies to reduce readmission rates. Full article

Background/Objectives: This study aimed to assess the impact of integrated psychiatric-psychotherapeutic treatment on anxiety levels, mental health perception, and depression severity. Methods: Patients with a diagnosis of depressive or anxiety disorders were included in the study. The group was randomly divided into two subgroups. The first was the study group (N = 32), which underwent a process of standardized integrated treatment, while the second was the control group (N = 32), whose course of treatment lacked a standardized integrated treatment involving direct cooperation between a psychiatrist and a psychotherapist. Both groups of patients participated in the study for a period of three months (12 weeks). All study participants (N = 64) had the following psychological questionnaires administered at three time points (at study enrollment, after 6 weeks of psychotherapy, and after 12 weeks): STAI, GHQ-28, and BDI-II. Results: The analysis showed a statistically significant beneficial effect of integrated psychiatric and psychotherapeutic treatment on anxiety (both state and trait), severity of depressive symptoms, and all dimensions measured on the GHQ-28 scale except somatic symptoms. In addition, comparing the impact of the integrated approach and standard psychotherapeutic methods, the analysis indicated a group × time interaction effect for the variable ‘trait anxiety’ (STAI) and ‘anxiety, insomnia’ (GHQ-28). Conclusions: The use of an integrated psychotherapeutic model can be beneficial in patients with anxiety and depressive symptoms. Full article

Background: Cognitive processes play a crucial role in the perception of pain. Catastrophizing, defined as a tendency to focus on a painful experience or amplify its unpleasantness, even in an anticipated form, might increase patients’ negative expectations and feelings of helplessness. In fact, high levels of pain catastrophizing are associated with a reduction in resilient behaviors among patients with physical pain. The objective of the present study is to investigate the employment of psychological and psychotherapeutic interventions in patients reporting pain, focusing on their improvements in terms of resilience and catastrophizing. Methods: This review was conducted following the PRISMA guidelines using three databases including articles published from 2006 to February 2024: PubMed, Scopus, and Web of Science. The search strategy was based on the PIO (Population, Intervention, Outcome) scheme. Following the Cochrane recommendations, quality assessment was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized studies and the Cochrane Risk of Bias for NonRandomized Studies (ROBINS-I). We included all English language studies reporting on psychological interventions in the context of pain management and related catastrophic thinking and resilience behaviors. Reviews, book chapters, editorials, conference abstracts and notes, observational studies, and non-English studies were excluded. Two independent authors were involved in the screening and data extraction phase. Results: A total of 10 studies were finally selected. The selected studies included five randomized controlled trials (RCTs); three single group, nonrandomized pilot trials; one single case study; and one nonrandomized pilot trial. The studies were mostly conducted in the United States (n = 7). Overall, the studies reported that psychological interventions in patients with physical pain may improve their psychological health and pain management. Reduced levels of catastrophic thinking and improved psychological resilience were found in subjects undergoing psychological treatments in most selected studies. Conclusions: Further studies are needed, above all controlled trials, to confirm the impact of these interventions in improving patients’ emotional and physical health in the long-term management of physical pain, improving their resilience and reducing catastrophic thinking. Full article

This case study examined the process of integration of cognitive behavioral therapy (CBT) and sensorimotor psychotherapy (SP) in three-phase trauma treatment with a 32-year-old female Bengali refugee with Complex Post Traumatic Disorder (C-PTSD). The treatment was provided in a Western country. The client’s improvement was assessed by using self-report assessments of post-traumatic, dissociative, and depressive symptoms. Psychodiagnostics’ scores gathered after 2 years of treatment showed significant improvements in post-traumatic, dissociative, and depressive symptoms. Although firm conclusions cannot be drawn due to the limitations of this study, results suggest that integrating CBT and SP in a phase-trauma approach may be an effective treatment for C-PTSD in a transcultural setting. However, replicating and standardizing such preliminary results on larger samples is necessary. Background/Objectives: SP is an innovative psychotherapeutic intervention aimed at treating trauma through a bottom-up approach, however, little research exists regarding the efficacy of this psychotherapy. This case study aims to investigate the efficacy of the combination of CBT and SP in treating a C-PTSD patient in a transcultural setting. Methods: Three questionnaires were administered to investigate post-traumatic, depressive, and dissociative symptoms. Results: Clinical and psychodiagnostic outcomes highlight significant psychological improvements in the patient. Conclusions: Although any firm conclusion cannot be drawn because of various intrinsic limitations (i.e., single case study) that straiten our ability to extend these results, this case study suggests that the integration of CBT and SP may be an effective treatment for C-PTSD in a transcultural setting. Full article

Context: The systematic evaluation of a practitioner’s adherence to and competence in delivering psychotherapeutic interventions can be complex. This study describes the development of a fidelity assessment tool for the Reitman Centre CARERS Program (RCCP), a carer group-psychotherapy intervention with multiple didactic and clinical components. The tool’s value in informing psychotherapy training and best practices for practitioners from diverse professional settings is examined. Methods: The RCCP Fidelity Assessment Tool (RCCP-FAT) was developed following an iterative process of item writing and checking. Seven components of the RCCP—Group Structure, Dementia Education, Problem-Solving Techniques, Therapeutic Simulation, Vertical Cohesion, Horizontal Cohesion, and Overall Global Rating—were assessed, with three to eight items, and a “global score” assigned to each. Fifteen trained raters were paired up to rate 36 RCCP sessions using the RCCP-FAT. Rater agreement, correlation between itemized and global scores, and correlation between global ratings and RCCP participants’ satisfaction were calculated. Results: A total of 1188 RCCP-FAT items were rated by each of the two rater groups. Rater agreement was calculated to be 54.3% (κ = 0.32; 95% CI, 0.02681–0.3729). A positive correlation was found between the itemized and global scoring for four RCCP components evaluated (R = 0.833 to 0.929; p < 0.01). The global score and the participants’ satisfaction with “Simulation” was also positively correlated (R = 0.626, p < 0.01). Conclusions: The study provided evidence for fair rater agreement for all RCCP-FAT assessment items. More importantly, the process of developing the tool systematically crystallized the clinical elements of the RCCP and helped to standardize the training methods by creating a framework for providing feedback to learners that matches the items on the RCCP-FAT. The use of the RCCP-FAT to guide the training and mentoring of incoming group leaders is essential in the scaling and dissemination of a complex training method like the RCCP to ensure fidelity to the original evidence-based intervention. Full article

Walking Miracles, a dance/theater project, was created from the stories of six adult survivors of child sexual abuse and completed due to the conscientious work of many collaborators. A psychotherapy group of fourteen sessions was audiotaped and attended by the six survivors, three dancer/choreographers, and one psychotherapist. Our goals were to provide positive psychotherapeutic experiences for the survivors and the foundation for a dance/theater piece that would then be presented to the public at the conclusion of the group sessions. Our hope was that audiences would gain a deeper empathetic understanding of child sexual abuse and would become stronger allies for the survivors and stronger advocates for child abuse prevention. Empathetic abilities were critical for this project—in the psychotherapy process, in the care taken to protect the trust and confidentiality of the survivors, and in the creation of the script, choreography, music, and poetry. I will examine the nature of empathy and the processes for creating specific movements from such dark experiences. How does one approach a work about issues so intensely personal? What care do we need to provide for the participants during the progression of the work? What are the ethical aspects of such projects that use the personal narratives of hidden communities? Full article

Bipolar disorder (BD) is characterized by recurrent episodes of mania, hypomania, and depression and is often complicated by comorbid substance use disorders (SUDs). Up to 60% of individuals with BD experience SUDs, which exacerbate mood instability and increase the risk of rapid cycling, suicide, and poor clinical outcomes. Current treatment strategies, including lithium and valproate, show limited efficacy in treating both BD and SUD. Psychotherapeutic approaches such as cognitive behavioral therapy (CBT) offer benefits but lack a specific focus on substances such as cannabis and cocaine. Since there is still debate on how to treat this comorbidity, there is a need to find new therapeutic options; this mini-review examines the pharmacological properties of cariprazine and its emerging role in the treatment of comorbid BD and SUD. Cariprazine, an atypical antipsychotic with partial agonism at dopamine D2 and D3 receptors, has shown promise in treating both mood symptoms and cognitive dysfunction in BD. Its unique affinity for D3 receptors, which are involved in motivation and reward processing, may offer advantages in reducing drug craving. Clinical trials indicate that cariprazine effectively treats manic, depressive, and mixed episodes in BD with a favorable side effect profile, particularly at lower doses. Preliminary results suggest its potential to reduce craving and substance use in individuals with co-occurring BD and SUD. Therefore, cariprazine, with its unique pharmacodynamic mechanism, could be further studied for the treatment of BD in comorbidity with SUD. However, evidence on the role of cariprazine in the treatment of SUDs remains limited, based primarily on case reports and animal studies. Further research, including large-scale clinical trials, is needed to determine its full efficacy in this dual diagnosis. Full article

The purpose of this paper is to discuss the idea that the misdeeds of ancestors will have negative consequences for their descendants, as encapsulated by biblical quotes about ‘the sins of the fathers’. The prevalence of these ideas in religion and folklore, through the notion of family curses, is discussed, as is an analysis of what constitutes ‘sin’. How the so-called sins of our forebears might reach across future generations is considered in two ways. The first is that detrimental characteristics, behaviours, and health conditions can be transmitted to descendants via genetic, epigenetic, environmental, and psychosocial mechanisms (and the interactions between these). The second is that descendants can feel guilt and shame as a result of the actions of their ancestors. Overcoming the effects of ancestral fault and disadvantage may occur through improvements in living standards, medical advances, more tolerant and inclusive cultural beliefs, as well as other environmental and social changes. These processes are also likely to be assisted by greater knowledge and understanding of one’s own family history. Such knowledge, in historical context, has the potential to facilitate both personal psychotherapeutic change and decisions about appropriate reparations where these are indicated. Full article

Dream research today assumes that there is a connection between dreams and waking life. However, the structural alteration of dream motifs in connection with the psychotherapeutic process and waking life has not yet been researched extensively. This study depicts the development of the new Motif Analysis and Phase Model (MAP), a dynamic method which allows research on the previous aspects. The following question was investigated as an accompanying key issue: can a connection be established between the course of the dream patterns and the agency of the dream ego as well as the dream contents and the course of the psychotherapies of the dreaming person as a whole? Four hypotheses were formulated and tested. The data material consists of 217 dreams of a male test subject. The motifs were analysed using Structural Dream Analysis (SDA) at first. Thereafter, the content was linked to the test subject’s waking life in a guided interview. The findings show a strong connection between the dream content and the psychotherapies as well as the test subject’s waking life. Five motifs with structural changes were found, through which the Phase Model with four phases was developed. At turning points, the transformative child motif also appears in the dreams. The course of the dream patterns and agency of the dream ego, however, has not changed. The results, the method and the generalisability were critically discussed and recommendations for future research were formulated. Full article

Background: Psoriasis and atopic dermatitis are chronic skin diseases found all over the world that cause a lot of suffering to patients. Objectives: The aim of this study was to answer the following questions: whether people suffering from psoriasis and AD have greater problems with recognizing emotions, the effectiveness of attention and memory processes, and whether they use different strategies of coping with stress than healthy people. Methods: This study involved 90 patients, including 30 patients with psoriasis, 30 patients with AD and 30 healthy patients, aged 21 to 63 years, including 54 women and 36 men. This study used a battery of the CANTAB Cognitive Tests, Mini-COPE Questionnaire Inventory, Toronto Alexithymia Scale TAS Questionnaire, Psoriasis Area and Severity Index, and Eczema Area and Severity Index. Results: People with psoriasis and AD had higher total scores on the alexithymia scale and had greater difficulty in identifying and verbalizing emotions. People with psoriasis and AD are less likely to choose the correct stimulus and achieve a shorter length of the sequence that should be remembered. Psoriasis patients with more severe symptoms are less likely to use the strategy of a sense of humor in stressful situations. AD patients with more severe symptoms are less likely to use strategies of operative thinking, denial and self-blame, and the strategy of seeking instrumental support is used more often. Conclusions: Patients with psoriasis and AD require a holistic approach; in addition to dermatological treatment, psychological support, psychotherapeutic support and possible psychiatric treatment are recommended. Full article

Background: This systematic review investigated the impact of familial factors on individuals aged 10–17 who have clinical signs or symptoms of eating disorders. Simultaneously, it scrutinized the involvement of the family in therapy, as well as other forms of intervention. Methods: The PsycINFO, PubMed, and Scopus databases were used to search for research material comprehensively. After applying specific criteria, 46 articles were deemed suitable and included in the systematic review. The study comprised a cohort of 4794 adolescents who received a diagnosis of either Anorexia Nervosa (AN), Bulimia Nervosa (BN), or Binge-Eating Disorder (BED). In addition, controls were utilized for 1187 adolescents, 1563 parents, 1809 siblings, and 11 other relatives. Results: The connection between family factors and eating disorders is primarily determined by the families’ level of functioning, satisfaction with the family dynamic, parents’ attitudes toward their children, and the role of food within the family system. Family Therapy was the most used psychotherapeutic approach in the treatment of AN. The incidence of reports in BN closely paralleled that of Cognitive–Behavioral Therapy (CBT) models. Articles about (Enhanced) CBT were exclusively associated with BED. Conclusions: Family-based approaches are crucial in comprehending, preventing, and addressing eating disorders in adolescents. Incorporating the study of family dynamics and actively engaging families in the treatment process can significantly enhance recovery rates and decrease the occurrence of relapses. Full article