Cognitive-behavioral Approach Research Articles

The effect of educational animation illustrations on the self-efficacy of post-ORIF (Open Reduction and Internal Fixation) lower extremity patients

<p><strong><em>Background: </em></strong><em>Low self-efficacy is currently one of the health problems in post-operative patients. Patients who have undergone surgery can experience decreased self-efficacy due to post-operative complications. Efforts to overcome low self-efficacy can be done through a cognitive behavioral approach by providing education, one of which is through animated illustration educational videos.</em><em></em></p><p><strong><em>Objectives: </em></strong><em>This study aims to determine the effect of animated illustration education on low patient self-efficacy in performing early mobilization after lower extremity ORIF.</em></p><p><strong><em>Methods: </em></strong><em>This study used a “pre-experimental” method with a One Group pre-test post-test design approach. Respondents were selected using a purposive sampling technique, based on the inclusion criteria that had been set, totaling 34 respondents. Respondents were given animated illustration education intervention, then an assessment was conducted whether there was an effect of animated illustration education on respondents' self-efficacy. The research instrument was a self-efficacy measurement questionnaire based on 3 aspects, namely level assessment, generality, and strength. Data analysis test using paired sample t-test (α = 0.001).<strong></strong></em></p><p><strong><em>Results </em></strong><em>: </em><em>The results of the study showed that the patient's self-efficacy score before being given preoperative animated illustration education was relatively low, namely 35.29. After being given education, the average score increased to moderate, namely 43.85. There was an increase in the self-efficacy score of 8.56. The results of the paired sample t-test obtained a p value of 0.001 <ɑ (0.05). This means that there is an effect of providing animated illustration education to lower extremity post-ORIF patients on patient self-efficacy in carrying out early mobilization.</em><em></em></p><p><strong><em>Conclusion</em></strong><strong><em>s</em></strong><strong><em>:</em></strong><em> </em><em>Education based on animated illustration videos can improve patient understanding of post-operative procedures and in turn increase patient self-efficacy or confidence in performing movements, including early mobilization, which will ultimately accelerate the healing process of the disease</em>.</p>

The effect of educational animation illustrations on the self-efficacy of post-ORIF (Open Reduction and Internal Fixation) lower extremity patients

<p><strong><em>Background: </em></strong><em>Low self-efficacy is currently one of the health problems in post-operative patients. Patients who have undergone surgery can experience decreased self-efficacy due to post-operative complications. Efforts to overcome low self-efficacy can be done through a cognitive behavioral approach by providing education, one of which is through animated illustration educational videos.</em><em></em></p><p><strong><em>Objectives: </em></strong><em>This study aims to determine the effect of animated illustration education on low patient self-efficacy in performing early mobilization after lower extremity ORIF.</em></p><p><strong><em>Methods: </em></strong><em>This study used a “pre-experimental” method with a One Group pre-test post-test design approach. Respondents were selected using a purposive sampling technique, based on the inclusion criteria that had been set, totaling 34 respondents. Respondents were given animated illustration education intervention, then an assessment was conducted whether there was an effect of animated illustration education on respondents' self-efficacy. The research instrument was a self-efficacy measurement questionnaire based on 3 aspects, namely level assessment, generality, and strength. Data analysis test using paired sample t-test (α = 0.001).<strong></strong></em></p><p><strong><em>Results </em></strong><em>: </em><em>The results of the study showed that the patient's self-efficacy score before being given preoperative animated illustration education was relatively low, namely 35.29. After being given education, the average score increased to moderate, namely 43.85. There was an increase in the self-efficacy score of 8.56. The results of the paired sample t-test obtained a p value of 0.001 <ɑ (0.05). This means that there is an effect of providing animated illustration education to lower extremity post-ORIF patients on patient self-efficacy in carrying out early mobilization.</em><em></em></p><p><strong><em>Conclusion</em></strong><strong><em>s</em></strong><strong><em>:</em></strong><em> </em><em>Education based on animated illustration videos can improve patient understanding of post-operative procedures and in turn increase patient self-efficacy or confidence in performing movements, including early mobilization, which will ultimately accelerate the healing process of the disease</em>.</p>

The Role of Acceptance and Commitment Therapy in the Treatment of Obsessive-Compulsive Disorder

This study focuses on the treatment of obsessive-compulsive disorder (OCD), and in particular the effect of Acceptance and Commitment Therapy (ACT) method will be examined. Obsessive-Compulsive Disorder (OCD) is a condition consisting of disturbing mental obsessions in which the person is excessively worried or unwanted thoughts or impulses are constantly repeated, and compulsions, which are repetitive behaviours to eliminate these obsessions. Compulsions manifest themselves as behaviours such as repeating certain rules, patterns or rituals, checking or cleaning a certain number of times. Individuals with OCD experience serious problems in their daily lives because of these thoughts and behaviours. Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that focuses on the person's inner experiences as part of the cognitive behavioural therapy approach. ACT aims to help the person to accept disturbing thoughts, feelings and physical sensations quietly and with understanding, and to cope with them in a more flexible way. Research shows that ACT is effective in reducing OCD symptoms and is therefore considered as an effective therapy option in the treatment of OCD. Furthermore, it should focus on how the integration and combination of ACT with other treatment modalities can benefit in the field of OCD treatment. In this way, more effective and personalised methods can be developed in the treatment of OCD patients.

Enhancing social-emotional skills in early childhood: intervention study on the effectiveness of social and emotional learning

BackgroundSocial and emotional learning (SEL) is crucial for developing skills such as emotional regulation, cooperation, and goal achievement. Deficits in these skills are linked to later academic and behavioral problems. While SEL interventions have been widely implemented internationally, few have been tested in early childhood settings in Japan, and their effectiveness remains unclear. In 2022, the Fun FRIENDS social and emotional learning program was introduced in class units for 4–5-year-olds attending kindergartens and children’s schools in Wakayama Prefecture, Japan. Thus, this study examined the effectiveness of the Fun FRIENDS program in children aged 4–5 years in Japan.MethodsFun FRIENDS is based on a cognitive-behavioral approach designed to teach participants how to cope with anxiety and stress, and to develop resilience and confidence. The program consists of 10 weekly sessions of approximately 1 h each. The intervention group comprised 115 children from two facilities, while the control group comprised 93 children from three facilities. Intervention effectiveness was evaluated through changes in externalizing (e.g., aggression, oppositional behavior) and internalizing behaviors (e.g., anxiety, depression), measured using the Strengths and Difficulties Questionnaire. Finally, data from 94 participants in the intervention group and 66 participants in the control group were analyzed.ResultsIn the intervention group, externalizing behaviors showed a significant reduction both before and after the intervention and internalizing behaviors also decreased significantly. Conversely, the control group did not exhibit any significant changes in either externalizing or internalizing behaviors before or after the intervention. The effect size for externalizing behaviors in the target group was 0.744, while the effect size for internalizing behaviors was 0.653.ConclusionsSocial and emotional learning programs in classrooms may effectively control problem behaviors in early childhood and prevent school maladjustment. A whole-class approach can reach more children, maximizing the preventive effects. The program can improve academic performance and social adaptation, contributing to the long-term development of psychological health and social skills. Nevertheless, further longitudinal research is required to assess the program’s long-term effects. In summary, strengthening the focus on social-emotional learning in early childhood education policy is key to realizing long-term benefits for child development.

SOCIAL WORK PRACTICE WITH A CHILD WITH DIABETES: A CASE STUDY

Diabetes is a chronic metabolic disease that affects individuals' physical health as well as their psychosocial well-being. Diabetes can occur at any age, including childhood. As with many chronic diseases, combating the effects of diabetes in children requires collaboration among many disciplines. Social work is one such discipline. Although the history of social work in the medical field, especially in chronic diseases, is old, studies of diabetes are limited. However, with the increase in diabetes cases globally and in Türkiye in recent years, the need for social work practice evidence on this subject is increasing. In this context, an example of social work intervention for a fictional case of a child with diabetes is analyzed in this article. The intervention was conducted according to the stages of the planned change model for social work. The ecological model, empowerment approach, and cognitive-behavioral approach were used together in the evaluation and intervention processes. Although various roles were adopted in the case, it can be said that resource connection, empowering, and educational roles came to the fore more. In addition, communication skills, problem-solving skills, teamwork, collaboration and coordination, and multitasking skills were effectively used in this case. In terms of application levels, studies were conducted with child with diabetes and his family at the micro level and interventions were conducted at the mezzo level in the school system.

Using a Cognitive Behavioral Approach in Individual Counseling with Patients Undergoing Bariatric Surgery

Morbid obesity is linked to physical and psychological well-being. Bariatric surgery has shown tremendous success with rapid weight loss in patients with morbid obesity. However, some patients experience weight regain post-surgery, which can be linked to psychological and social factors. Mental health counseling is rarely offered in bariatric surgery programs. We used a six-session individual Cognitive Behavioral Therapy (CBT) approach with patients following bariatric surgery, using a single case research design to treat four participants. We measured the effectiveness of a six-session CBT treatment and assessed for psychosocial improvements. Results indicated that each participant experienced psychosocial improvements, decreased comorbid maladaptive behavior post treatment, and lost body weight during the study. In conclusion, CBT treatment may be beneficial for post-surgery bariatric patients.

Enhancing healthcare professionals' biopsychosocial perspective to chronic pain: assessing the impact of implementing an interdisciplinary training program.

Advancements in clinical science have shown the necessity for a paradigm shift away from a biomedical toward a biopsychosocial approach. Yet, the translation from clinical science into clinical practice is challenging. The aim of this study was to assess the short-term and mid-term changes in pain knowledge and attitudes and guideline-adherent recommendations of healthcare professionals (HCP) by means of an interdisciplinary training program (ITP) about chronic pain. Belgian HCPs, with a priority for medical doctors, physiotherapists, occupational therapists, nurses, psychologists, and pharmacists in primary care, participated in the ITP, which contained 2 e-learning modules and two 7-hour workshops provided in small interdisciplinary groups in 5 cities. The objective of ITP was to improve HCP's competencies for integrating biopsychosocial chronic pain management with a cognitive behavioral approach into clinical practice. Primary outcomes were changes in knowledge and attitudes about pain and guideline-adherent recommendations for continuation of physical activity, sports, and work; avoiding bed rest; and not supporting opioid usage measured through 2 clinical vignettes. They were measured before, immediately after, and 6 months after the ITP. Changes were analyzed using (generalized) linear mixed models. A total of 405 HCPs participated. The knowledge and attitudes about pain scores improved at post-training (Δ = 9.04, 95% confidence interval 7.72-10.36) and at 6-month follow-up (Δ = 7.16, 95% confidence interval 5.73-8.59). After the training program, HCPs provided significantly more recommendations in accordance with clinical guidelines. Thus, an ITP can improve the biopsychosocial perspective of chronic pain management among HCPs in the short-term and mid-term.

Extending Child and Adolescent Psychoanalysis to Special Populations: Regulation-Focused Psychotherapy for Children (RFP-C) and Transference-Focused Psychotherapy for Adolescents (TFP-A)

ABSTRACT In the last decade clinicians and researchers have developed Regulation-Focused Psychotherapy for Children (RFP-C) and Transference-Focused Psychotherapy for Adolescents (TFP-A), two manualized, evidence-based, time-limited treatments derived from child and adolescent psychoanalysis. These therapies are designed to treat special, complex patient populations including children with severe externalizing behaviors and adolescents with nascent or actual severe personality disorders, youth thought to be beyond the reach of traditional psychoanalysis or thought to benefit from modifications of standard psychoanalytic technique to maximize the effectiveness and efficiency of psychoanalytic treatment. Despite the effectiveness of psychoanalysis, manualized cognitive-behavioral approaches like parent management training and dialectical behavior therapy are currently the most popular treatments for these patients, partially because there are too few child and adolescent psychoanalysts to meet demand. The authors describe RFP-C and TFP-A and illustrate their effectiveness using clinical material. The authors advocate for wider acceptance and utilization of these two broadly teachable manualized treatments by the psychoanalytic and psychotherapeutic communities to extend the reach of psychoanalysis to severely suffering patients who can reap the unique benefits of these essentially psychoanalytic approaches.

Exploring stigma, shame, and safety behaviours in social anxiety and paranoia amongst people diagnosed with schizophrenia.

Social anxiety and paranoia are connected by a shared suspicion framework. Based on cognitive-behavioural approaches, there is evidence for treating social anxiety and psychosis. However, mechanisms underlying the relationship between social anxiety and paranoia remain unclear. To investigate mediators between social anxiety and paranoia in schizophrenia such as negative social appraisals (i.e. stigma or shame; Hypothesis 1), and safety behaviours (i.e. anxious avoidance or in situ safety behaviours; Hypothesis 2). A cross-sectional study was conducted among Asian out-patients with schizophrenia (January-April 2020). Data on social anxiety, paranoia, depression, shame, stigma, anxious avoidance, and in situ behaviours were collected. Associations between social anxiety and paranoia were investigated using linear regressions. Mediation analysis via 10,000 bias-corrected bootstrap samples with 95% confidence intervals (CI) was used to test the indirect effects (ab) of mediators. Participants (n=113, 59.3% male) with a mean age of 44.2 years were recruited. A linear relationship between social anxiety and paranoia was found. In multiple mediation analyses (co-varying for depression), stigma and shame (Hypothesis 1) did not show any significant indirect effects with ab=.004 (95%CI=-.013, .031) and -.003 (-.023, .017), respectively, whereas in situ behaviours (Hypothesis 2) showed a significant effect with ab=.110 (.038, .201) through the social anxiety-paranoia relationship. Social anxiety and paranoia are positively correlated. In situ safety behaviours fully mediated the social anxiety and paranoia relationship. Targeted interventions focusing on safety behaviours could help reduce paranoia in psychosis. Symptom severity should be measured to help characterise the participants' characteristics.

Blended Psychological Therapy for the Treatment of Psychological Disorders in Adult Patients: Systematic Review and Meta-Analysis.

Blended therapy (BT) combines digital with face-to-face psychological interventions. BT may improve access to treatment, therapy uptake, and adherence. However, research is scarce on the structure of BT models. We synthesized the literature to describe BT models used for the treatment of psychological disorders in adults. We investigated whether BT structure, content, and ratio affected treatment efficacy, uptake, and adherence. We also conducted meta-analyses to examine treatment efficacy in intervention-control dyads and associations between treatment outcomes versus BT model structure. PsycINFO, CINAHL, Embase, ProQuest, and MEDLINE databases were searched. Eligibility criteria included articles published in English till March 2023 that described digital and face-to-face elements as part of an intervention plan for treating psychological disorders in adult patients. We developed a coding framework to characterize the BT interventions. A meta-analysis was conducted to calculate effect size (ES; Cohen d and 95% CIs) regarding pre- and posttreatment outcomes in depression and anxiety versus BT structure. The review was registered with PROSPERO and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Searches identified 8436 articles, and data were extracted from 29 studies. BT interventions were analyzed and classified according to mode of interaction between digital and face-to-face components (integrated vs sequential), role of the components (core vs supplementary), component delivery (alternate vs case-by-case), and digital materials assignment mode (standardized vs personalized). Most BT interventions (n=24) used a cognitive behavioral therapy approach for anxiety or depression treatment. Mean rates of uptake (91%) and adherence (81%) were reported across individual studies. BT interventions were more effective or noninferior to treatment as usual, with large spread in the data and a moderate to large ES in the treatment of depression (n=9; Cohen d=-1.1, 95% CI -0.6 to -1.6, P<.001, and z score=-4.3). A small, nonsignificant ES was found for anxiety outcomes (n=5; Cohen d=-0.1, 95% CI -0.3 to 0.05, P=.17, and z score=-1.4). Higher ESs were found in blended interventions with supplementary design (depression: n=11, Cohen d=-0.75, 95% CI -0.56 to -0.95; anxiety: n=8, Cohen d=-0.9, 95% CI -0.6 to -1.2); fewer (≤6) face-to-face sessions (depression: n=9, Cohen d=-0.7, 95% CI -0.5 to -0.9; anxiety: n=7, Cohen d=-0.8, 95% CI -0.3 to -1.3); and a lower ratio (≤50%) of face-to-face versus digital sessions (depression: n=5, Cohen d=-0.8, 95% CI -0.6 to -1.1; anxiety: n=4, Cohen d=-0.8, 95% CI 0.006 to -1.6). This study confirmed integrated BT models as feasible to deliver. We found BT to be effective in depression treatment, but anxiety treatment results were nonsignificant. Future studies assessing outcomes across different psychological disorders and therapeutic approaches are required. PROSPERO CRD42021258977; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258977.

A Trans-Theoretical Systematization of Clinical Interventions Based on Dynamical Systems Research (DSR)

The scientific literature focused on the categorization of therapists’ interventions in clinical sessions, and their effects on patients, is not very extensive and often autoreferential. The most relevant findings clearly show the eclecticism of clinicians, grounding only 10–14% of their interventions on the specific theoretical approach to which they belong. Despite that, a trans-theoretical systematization of clinical interventions is lacking. The present work aims to verify the feasibility of a trans-theoretical categorization of clinical interventions based on Dynamical Systems Research in psychotherapy (DSR). For this purpose, the authors present the results of three literature reviews. The first sections of this paper present the literature on the historical development of clinical interventions within the psychodynamic and cognitive-behavioral approaches. In the fourth section, the review of the DSR literature in psychotherapy and the systematization of clinical interventions according to such a unifying framework are introduced. Clinical interventions can be aimed at increasing the patient’s stability and flexibility, with the final objective of promoting H-L Synchronization and S-F Oscillations. The connections between the DSR-based categorization and the literature pertaining to the psychodynamic and cognitive-behavioral approaches are highlighted. Finally, in the conclusions, the limitations and potential developments of this scientific area are discussed.

A replication and development of the Short Cognitive Mediation Beliefs Questionnaire (CMBQ-S).

The Cognitive Mediation Beliefs Questionnaire is a 15-item tool that assesses individuals' emotion beliefs about the cognitive mediation of emotions. It measures two emotion beliefs: stimulus-response generation beliefs and cognitive mediation change beliefs. This study aimed to reduce the number of items and test the validity of a briefer version of the Cognitive Mediation Beliefs Questionnaire. We combined data from 13 unpublished data sets collected between 2019 and 2023 and reached a final sample of 2,872 participants. While this data set is relatively large and diverse (e.g., participants from 53 nationalities), most were from developed countries, and the data were not fully representative across demographic characteristics, such as age and ethnicity. The data were randomly split by 50%/25%/25% (60%/40% female/male) to conduct one exploratory factor analysis and two confirmatory factor analyses. Using an iterative process in the exploratory factor analysis, seven items were deleted for failing to meet item retention criteria, resulting in an eight-item solution across two factors. Across two confirmatory factor analyses with independent samples, the eight-item and the 15-item solutions were tested. The eight-item model was superior in terms of model fit in both samples. These results were in line with our hypothesis in that an eight-item Short Cognitive Mediation Beliefs Questionnaire confirmed the validity of the two-factor structure. The present study offers a valid and efficient measure of emotion beliefs that can be used to make a rapid assessment of beliefs about emotions and to support clinical interventions, particularly cognitive behavioral therapy approaches, where cognitive change is fundamental. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluating the Impact of a Rebt-Based Suicide Prevention Program for Individuals with Alcohol Use Disorders

The purpose of this study was to evaluate the effectiveness of a suicide prevention program based on Rational Emotive Behavior Therapy (REBT) for individuals with Alcohol Use Disorder. Theoretical Framework: The study is grounded in the Rational Emotive Behavior Therapy (REBT) framework, which aims to reduce irrational beliefs, one of the root causes of emotional disturbances, including depression and suicidal ideation. Methods: A nonequivalent quasi-experimental design was employed, involving participants from two Addiction Management Integrated Support Centers in K Province, South Korea. Forty-eight individuals were divided into two groups: 24 in the experimental group and 24 in the control group, each assigned to a different center. The experimental group underwent 10 REBT sessions over 5 weeks, in addition to standard interventions. The control group received only the usual interventions. Outcome variables measured included irrational beliefs, depression, suicidal ideation, and problem-solving ability. Data were collected at baseline and again five weeks after the program ended. Statistical analyses were conducted using chi-square, Fisher's exact test, and independent t-tests. Results: Prior to the intervention, no significant differences in demographic characteristics or baseline outcome variables were observed between the two groups. After the intervention, the experimental group exhibited a significant reduction in irrational beliefs (t=2.36, p=.023), depression (t=3.80, p&lt;.001), and suicidal ideation (t=4.59, p&lt;.001) compared to the control group. Additionally, the experimental group demonstrated a significant improvement in problem-solving ability (t=4.59, p&lt;.001). Discussion/Implications: The study demonstrates that the REBT-based suicide prevention program was effective in reducing irrational beliefs, depression, and suicidal ideation, while also enhancing problem-solving ability in individuals with Alcohol Use Disorder. These results underscore the potential benefits of integrating cognitive-behavioral approaches like REBT into suicide prevention programs for this population. Originality/Value: This research contributes to the limited literature on suicide prevention programs tailored for individuals with Alcohol Use Disorder and offers valuable insights into the applicability of REBT in community-based mental health interventions. The findings suggest the importance of developing structured therapeutic programs that address both cognitive distortions and emotional well-being to prevent suicide in vulnerable populations.

Evaluating the effectiveness of a multi-component lifestyle therapy program versus psychological therapy for managing mood disorders (HARMON-E): protocol of a randomised non-inferiority trial

BackgroundMood disorders, including unipolar and bipolar depression, contribute significantly to the global burden of disease. Psychological therapy is considered a gold standard non-pharmacological treatment for managing these conditions; however, a growing body of evidence also supports the use of lifestyle therapies for these conditions. Despite some clinical guidelines endorsing the application of lifestyle therapies as a first-line treatment for individuals with mood disorders, there is limited evidence that this recommendation has been widely adopted into routine practice. A key obstacle is the insufficient evidence on whether lifestyle therapies match the clinical and cost effectiveness of psychological therapy, particularly for treating those with moderate to severe symptoms. The HARMON-E Trial seeks to address this gap by conducting a non-inferiority trial evaluating whether a multi-component lifestyle therapy program is non-inferior to psychological therapy on clinical and cost-effectiveness outcomes over 8-weeks for adults with major depressive disorder and bipolar affective disorder.MethodsThis trial uses an individually randomised group treatment design with computer generated block randomisation (1:1). Three hundred and seventy-eight adults with clinical depression or bipolar affective disorder, a recent major depressive episode, and moderate-to-severe depressive symptoms are randomised to receive either lifestyle therapy or psychological therapy (adjunctive to any existing treatments, including pharmacotherapies). Both therapy programs are delivered remotely, via a secure online video conferencing platform. The programs comprise an individual session and six subsequent group-based sessions over 8-weeks. All program aspects (e.g. session duration, time of day, and communications between participants and facilitators) are matched except for the content and program facilitators. Lifestyle therapy is provided by a dietitian and exercise physiologist focusing on four pillars of lifestyle (diet, physical activity, sleep, and substance use), and the psychological therapy program is provided by two psychologists using a cognitive behavioural therapy approach. Data collection occurs at baseline, 8-weeks, 16-weeks, and 6 months with research assistants blinded to allocation. The primary outcome is depressive symptoms at 8 weeks, measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) (minimal clinically important difference = 1.6). A pre-specified within-trial economic evaluation will also be conducted.DiscussionShould lifestyle therapy be found to be as clinically and cost effective as psychological therapy for managing mood disorders, this approach has potential to be considered as an adjunctive treatment for those with moderate to severe depressive symptoms.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12622001026718, registered 22nd July 2022.Protocol version: 4.14, 26/06/2024

Adult recollections of childhood memories in individuals convicted of sexual offences: implications for narrative therapy

ABSTRACT This study examines the autobiographical memories of 84 individuals convicted of sexual offences. Our results indicate that despite their adverse childhoods, chaotic families, and compromised social competence, justice-involved clients can engage meaningfully in longform narrative interviews that contain probing personal and reflective questions about their early lives. In fact, many participants expressed gratitude that they were invited to engage and share their experiences in this way. This pioneering interdisciplinary study has important practical implications for providers of psychotherapeutic treatment who work with custodial and community samples of people convicted of sexual offences. We conclude by emphasising the value of narrative therapy and present directions for future research. PRACTICE IMPACT STATEMENT Most therapeutic approaches offered in correctional settings emphasise a cognitive behavioural approach intended to dismantle cognitive distortions. Our results suggest that the willingness and ability of justice-involved individuals to participate in narrative therapy has been likely underestimated. Accordingly, this study will help clients and clinicians alike to make the treatment experience more personalised and meaningful.

Financial needs and opioid use among head and neck cancer (HNC) survivors: Baseline findings from the HN-STAR trial (WF-1805CD).

365 Background: HNC survivors often experience post-treatment pain. Given known disparities in pain management and opioid use in the non-cancer population, we explored sociodemographic predictors of opioid use in HNC survivors enrolled in the HN-STAR trial (NCT04208490, funding: American Cancer Society and UG1CA189824). Methods: Survivors of HNC (stages I-III) who completed therapy 6-24 months prior and had no evidence of disease were enrolled throughout the NCI Community Oncology Research Program (NCORP). Survivors were randomized to a clinical informatics intervention or usual care. Baseline surveys elicited recent prescription opioid use in the prior week (yes/no). Blinded to arm assignment, we conducted bivariate analyses of recent opioid use and the following sociodemographic predictors: age, gender, marital status, race and ethnicity (non-white/Latinx vs all others), highest level of education, and being able to meet daily financial needs in the prior 4 weeks. We conducted stepwise multivariable logistic regression to evaluate the association of these factors on opioid use. Results: Among 254 survivors (mean age 63, 74% male, 25% non-white/non-Latinx, 13% reporting financial need) at 25 oncology practices, 14% (n=35) reported recent opioid use. In bivariate analyses, survivors who reported financial needs were more likely to have used opioids (odds ratio [OR] 4.35, 95% confidence interval [CI] 1.85-10.20, p&lt;.001). In stepwise multivariable analyses, only having financial needs remained in the final model (Table). Conclusions: In a national sample of post-treatment HNC survivors during a subacute survivorship period (6-24 months after treatment completion), 1 in 7 survivors reported using opioids in the past week – more than twice the annual rate of opioid receipt in the general adult population. Several demographic factors related to opioid use were examined and not associated with recent opioid use among HNC survivors. Findings suggest that financial concerns may be a barrier to non-narcotic pain management (e.g., cognitive behavioral approaches, physical therapy) – or simply that unmet financial needs are associated with lower quality of pain management. Attention should focus on equitable pain management in this population. Clinical trial information: NCT04208490 . Predictors of opioid use in past week. Bivariate Models Estimate (standard error) p-value Age (years) -.01 (.02) .52 OR (95% CI) p-value Female .98 (.41, 2.16) .97 Latinx/non-white .71 (.27, 1.63) .45 Married .56 (.27, 1.18) .13 Some college or more .62 (.30, 1.30) .20 Had financial needs 4.35 (1.85,10.20) &lt;.001 Final model OR (95% CI) p-value Had financial needs 4.35 (1.85,10.20) &lt;.001

Feasibility of a primary care-based program for supporting youth following traumatic events: First Approach Skills Training for Trauma (FAST-T)

BackgroundIntegrated primary care (IPC) offers an opportunity to identify and support youth impacted by trauma. Trauma interventions with strong evidence exist but require adaptation for IPC. The First Approach Skills Training for Trauma (FAST-T) program was developed as a scalable, flexible, brief, stepped-care, cognitive-behavioral approach to supporting trauma-affected youth and families. ObjectiveThis paper describes program development and implementation of FAST-T in real-world IPC settings. All FAST-T resources, including modular child, teen and caregiver workbooks, handouts, training videos, and clinical guides/scripts are provided via hyperlink. Participants and SettingEight behavioral health clinicians (BHCs) from across Washington State were trained in FAST-T and provided de-identified treatment delivery and outcome data from all patients enrolled in FAST-T over three months. MethodsPosttraumatic stress symptom change and clinician-rated improvement were collected, as were data on treatment components used, number of sessions, and discharge disposition. Clinicians reported on acceptability, appropriateness, feasibility and other implementation outcomes. ResultsAcceptability, appropriateness and feasibility were rated by BHCs as favorable with good evidence of uptake in routine care at six months post-training. Nineteen youth received FAST-T and while the sample was underpowered to evaluate clinical outcomes, those with repeat measures of posttraumatic stress showed significant improvement. BHC ratings indicated most patients improved and none worsened during FAST-T. Conclusions: Findings offer preliminary support for addressing childhood trauma impact with flexible, brief programming within IPC.

Social Management for The Prevention of Addiction to Social Networks and Anxiety in University Students

Objective: The objective of this study was to explain from the preventative context the relationship between dependence on social networks and anxiety in university students. Theoretical benchmark: Dependence on social networks is an important factor that can negatively affect mental health, causing behavioral phenomena such as anxiety, stress, depression, among others. Psychosocial problems in university students are related to the presentation of certain behaviors that affect their personal development and academic formation. Method: The type of study is non-experimental and the design of the study was descriptive across the board. The sample was composed of 320 university students of the psychology course. The ARS Scale of Dependence on Social Networks and the EAS Social Anxiety Scale were used as instruments. Results and discussion: The evidence showed a statistically significant correlation between social network dependence and anxiety rho=0,575 (p=0,000). In relation to the factors, the existence of a statistically significant relationship between obsession with social networks, lack of personal control, excessive use and physiological, cognitive and behavioral factors rho&gt;.100 (p=0,000) was determined. Conclusion: The indiscriminate use of networks is associated with symptoms of anxiety in university students. Value: Therefore, preventive actions are guided from a cognitive-behavioral approach to managing social awareness about the effects and repercussions on your professional training and your future, as well as emphasizing the importance of the effective integration of social networks through responsible use.

The role of positive thinking in overcoming stress a cognitive-behavioural approach

This article discusses the role of positive thinking in Cognitive Behavioral Therapy (CBT) for treating psychological disorders. The relevance of the topic is due to the growing use of CBT in psychotherapeutic practice and the need for a better understanding of its effectiveness, including the role of positive thinking. This work highlights the importance of positive thinking in promoting mental health and well-being. It argues that positive thinking is a practical tool for developing adaptive cognitive strategies, rather than an unattainable ideal. In CBT, positive thinking is not just about replacing negative thoughts with positive ones, but is a component of a comprehensive approach to re-evaluating an individual's experience. Such an approach contributes to the formation of a more realistic and adaptive perception of oneself and the world. The main methods and techniques of CBT, including cognitive restructuring and behavioral experiments, utilize positive thinking as a tool for correcting destructive thoughts and behaviors. This article discusses different perspectives on the effectiveness of positive thinking in CBT, weighing the arguments for and against its potential limitations. It contributes to improving an individual's psychological well-being and developing psychological resilience, which enables more effective coping with life challenges and stresses. However, to achieve maximum effectiveness, the application of positive thinking must be closely integrated with a comprehensive treatment strategy that considers the individual needs and characteristics of each client. This approach requires a profound understanding of the mechanisms of cognitive distortions and their impact on a person's emotional state.

Exploring College-Aged Student Anxiety: Aggravating Factors and Coping Strategies

&lt;i&gt;Undergraduate college-aged students are increasingly experiencing anxiety. Yet, many struggle to cope effectively, resulting in poor school performance and compromised health and well-being. Our goal was to identify common anxiety-inducing and aggravating stressors, as well as preferred adaptive coping strategies, in this exploratory study to inform anxiety intervention development. A total of 19 undergraduate students (17 female and 2 male) were recruited. Students previously diagnosed or treated for anxiety by a clinician participated in a two-week, daily diary entry study. A total of 219 diary entries were transcribed and thematically analyzed for student reports of awareness variables and associated coping responses. Data were compared and triangulated. Framed by cognitive-behavioral approaches to anxiety and the transactional theory of stress and coping, we identified five primary categories of anxiety-inducing or aggravating stressors: academic time management and performance, communication anxiety, competing life stressors, others’ presence and problems, and &lt;/i&gt;&lt;i&gt;generalized uncertainty. In addition, we found that students primarily utilized adaptive coping strategies, employing a mix of intrapersonal (e.g., alone time, breaks, hobbies/music, and staying productive) and interpersonal techniques (e.g., hanging out with and talking with friends and family). Findings highlight common anxiety stressors and demonstrate preferred and efficacious coping strategies employed by students, providing valuable insight into best practices for student well-being interventions beyond a clinical setting to manage anxiety and improve student well-being.&lt;/i&gt;