Difficult Emotions Research Articles

The impact of patient death on the risk of developing occupational burnout in midwives a preliminary cross-sectional study

The study aimed to assess the impact of experienced emotional states on the risk of the development of occupational burnout in midwives who experienced the death of a patient while on duty. The study was conducted on 54 midwives in Warsaw, Poland. We used the Oldenburg Burnout Inventory (OLBI) and the author’s questionnaire. The average professional burnout level of midwives participating in the study was determined as 5.08 ± 0.67. Helplessness (57.4%) and depression (48.1%) were the most frequently experienced emotions. The number of deaths of patients experienced by the respondents did not affect the severity of burnout (Z = − 0.753; p > 0.05). However, midwives who declared that they had experienced the death of a patient more than 10 times while on duty were more likely to experience a feeling of relief (2.83 vs. 2.00; Z = − 2.30; p < 0.05) and calmness (2.97 vs. 2.24; Z = − 1.95; p < 0.05). The experienced depression positively correlated with the level of exhaustion (rho = 0.465; p < 0.001) and the overall level of occupational burnout (rho = 0.291; p < 0.05). However, it was not correlated with the level of disengagement (p > 0.05). Depression has a significant impact on the risk of developing occupational burnout, which highlights the need to develop and implement effective support methods for midwives experiencing difficult emotions related to the death of patients while on duty.

Abstract B155: “Quite devastating, traumatic and lonely”: The mental health experiences of Hispanic/Latino rectal cancer patients

Abstract Background: Numerous studies have shown that emotional distress increases after a cancer diagnosis. Psycho-oncology literature also indicates that Hispanic/Latino patients are less likely to receive mental health care after being diagnosed, placing them at risk of poor psychological adjustment. The purpose of this qualitative analysis was to explore how Hispanic/Latino adults experience their rectal cancer journey, how their needs change between receiving their initial diagnosis and undergoing treatment, and what can be done to help process difficult emotions at each phase. Methods: We partnered with Visión y Compromiso, a network of promotores (Spanish-speaking community health workers), to recruit 20 Hispanic/Latino rectal cancer patients and/or their caregivers in California's Bay Area and Central Valley. Semi-structured interviews were conducted in-person or virtually; participants could also choose their preferred language. Using reflexive data analysis, themes were developed and refined iteratively amongst a diverse team of researchers. Results: We identified three main themes. The first is the reactions experienced during initial diagnosis and what triggered these emotions. Patients reported experiencing fear, going blank, and feeling traumatized from the hurried and emotionally distant delivery of their diagnosis, thinking they’re going to die, and contemplating their quality of life. The second theme focused on what emotions were felt during treatment and what caused the feelings. Patients conveyed feeling depressed, frustrated, and embarrassed during their treatment due to pain, treatment difficulties, and poor communication from their providers. Treatment difficulties for this population included being racially profiled, fear of losing insurance coverage, and mounting hospital and transportation costs. Lastly, patients reported what helped them cope and/or what could help others. Religion/faith and support from caregivers were mentioned as coping strategies with the caveat that caregiver burnout is a risk. Better communication from the treatment team was an actionable recommendation. Examples of this included providers being more sensitive when conveying the initial diagnosis, providers explaining complex concepts in layman’s terms during the treatment process and having a Spanish translator available at each phase. Conclusion: Hispanic/Latino rectal cancer patients endure emotional distress at multiple stages of their cancer journey; tailored interventions may mitigate this psychological burden. Previous studies have shown that promotores can help reduce health disparities within the Hispanic/Latino population. In the context of our results, promotores could connect cancer patients to resources to address or cope with stressors, which may help bridge the gap in mental health care access and utilization. Future interventions with promotores should be explored as a way to provide culturally and linguistically concordant emotional support for patients and their caregivers at each step of the cancer journey. Citation Format: Zaria N. Cosby, Eleanor Brown, Julian P. Howland, Lucas K. Carpenter, Min Young Kim, Kristen M. Davis-Lopez, Patricia Castañeda, Maria Gonzalez, Miriam T. Hernandez, Ysabel Duron, Gladys M. Rodriguez, Sandra S. Zaky, Arden M. Morris, Aaron J. Dawes. “Quite devastating, traumatic and lonely”: The mental health experiences of Hispanic/Latino rectal cancer patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B155.

Addressing emotional distress to improve outcomes in adults with type 1 diabetes: Protocol for ACT1VATE randomized controlled trial

BackgroundDiabetes distress (DD) is a prevalent concern among people with type 1 diabetes (T1D) and is linked to poor clinical outcomes. Instead of targeting the elimination of DD, we propose a novel approach that empowers individuals with strategies to manage their diabetes effectively in the context of DD: Acceptance and Commitment Therapy (ACT). The purpose of this in-progress trial is to compare an ACT group intervention (ACT1VATE) with usual care in improving HbA1c, DD, quality of life, and cost-effectiveness in adults with T1D. MethodsThis is a two-arm, parallel group, randomized controlled superiority trial enrolling N = 250 adults with T1D, elevated HbA1c, and significant DD in a real-world community-based health system. Participants are randomized to receive ACT1VATE (a five-week ACT group telehealth intervention) or diabetes self-management education and support (usual care as the first-line recommended intervention for DD). The trial will examine comparative effectiveness in improving HbA1c, DD, quality of life, and cost-effectiveness over 12 months. DiscussionWe predict that ACT1VATE will be superior given its (1) specific focus on DD, without any expectation that difficult diabetes-related thoughts and emotions must (or can) be completely eliminated; and (2) purposeful linkage of diabetes self-care behaviors to an individual’s deeply held values, thus eliciting intrinsic, patient-centric motivation for meaningful and lasting health behavior changes. This trial will provide a valuable test of real-world effectiveness, drive sustainability and scalability, and inform the future of chronic disease care.Trial registration: NCT04933851 (https://clinicaltrials.gov/ct2/show/NCT04933851).Clinical Trial: Clinicaltrials.govNCT04933851https://clinicaltrials.gov/study/NCT04933851

Somatic small body map protocol: renegotiating trauma with LGBTQIA+ service users

ABSTRACT Background LGBTQIA+ service users suffer microaggressions on a daily basis within a heterosexual, cisgendered society. They may become so accustomed to feeling unsafe that this becomes unconsciously considered the norm. Context A Somatic Small Body Map Protocol has been devised that introduces a lived experience of a safe environment. The protocol has been used with twenty service users in an individual setting. This paper explores specific responses from three different service users. Approach The protocol integrates psychodynamic art therapy with Somatic Experiencing in order to create a guided process that pendulates between somatic verbal feedback and the lived experience of the creative process, moving back and forth between inner sensations and their visual expression on paper, changing constantly in response. Outcomes The service users report positive feedback following the protocol that includes reduced anxiety, greater awareness of the effects of social homophobia on their psychological and physiological states and improved ability to contact difficult emotions without being overwhelmed. Conclusions The protocol may be useful within art therapy as a somatic tool to renegotiate trauma connected to microaggressions, increase awareness of bodily sensations and support the capacity to tolerate potentially overwhelming emotions. Implications for research The necessity of integrating somatic techniques when working with trauma is widely acknowledged. The protocol offers a structured tool to facilitate this, and specific training is being organised for its use. It may be adapted for use with other minority identities or in general to renegotiate any situation where a person has felt unsafe. Plain-language summary People who are lesbian, gay, bisexual, transgender, queer, intersex, asexual or otherwise differ (LGBTQIA+) from heteronormative conventions concerning gender, biological sex or sexual orientation can often feel unsafe outside their home. They may be so accustomed to this, they don’t consider it unusual. To help change this, the art therapist has produced a guided process based around the completion of a small body outline that is coloured in according to the person’s physical sensations. Art therapist and service user then explore together what could be represented in the area external to the body outline in order to help the person feel as safe as possible. They will proceed to track the felt sensations created by these reassuring things, and explore what changes are now necessary inside the body outline to reflect how their feelings have transformed in this new environment. This paper examines three service users’ reactions to this experience. The process combines art therapy with Somatic Experiencing, the name given to techniques that use verbal communication to work with body sensations. The therapist supports the service user in contacting their body’s sensations and describing them so that they can be represented inside the outline. The body’s response to what has been drawn can then be explored. By introducing positive things during difficult moments, the art therapist can help the person become less anxious about feeling painful things. Many people believe that working somatically with body sensations is key when working with trauma and the art therapist hopes that this guided somatic art therapy process will be useful for other art therapists. She offers specific training for its use. This process may be helpful not just for LGBTQIA + people but for everyone who has felt unsafe at any time.

Supporting Patients with Amputated Lower Limb in Accepting Their New Body Images by Traumatology Nurses of Central Hospital Yaoundé-Cameroon: An Exploratory Study

This study aims at exploring the role of the nurse in supporting patients with the amputated lower limb towards the acceptance of their new body images in the traumatology B unit of the Central Hospital in Yaoundé-Cameroon. The study used a qualitative exploratory design. The study population was made up of eight nurses from the traumatology unit of the central hospital in Yaoundé-Cameroon. Data were collected using a semi-structured interview guide from a purposeful sample of nurses. The saturation level determined the sample size for the study. Data were analyzed using inductive content analysis. The results obtained from this study showed that it is difficult to take care of patients with amputated lower limbs as physical support e.g. hygiene care; wound dressings, pain evaluation and care were outlined by most of the nurses as the main mode of support given to patients. Consideration should be given to non-pharmacological and less invasive surgical interventions for phantom limb pain, as they are associated with less common and less severe side effects. Active listening, reassuring patients, helping relationship and confidence were the main elements of psychological support stated by the nurses. The main challenges nurses encountered in supporting amputated patients were difficult communication and language barrier. The findings from this study proposed that there were many factors to take into account in order to be able to help patients with amputated lower limb: physical and moral pain, the psychological aspect with modification of body image, loss of self-esteem etc... The nurse must demonstrate human and relational qualities and great psychological resistance in order to effectively support the amputated patient on the physical level by providing hygiene and comfort care, dressing; and on the psychological level by questioning the patients about their difficult emotions while being available to listen in order to establish a nursing diagnosis and help the patients to cope with their difficulties.

Intimate places

Our essay starts from our first-person experience of visiting El Eco Experimental Museum in Mexico City. Over the course of our visit, El Eco became, what we will call an ‘intimate place’ in which we were able to explore personal thoughts, memories, and feelings. We go on to compare El Eco to Black Water (2021), a site-specific art installation by RAAAF. We draw on Donald Winnicott’s work on play to show how intimate places like the El Eco museum have commonalities with the therapeutic setting of psychotherapy. They are places that enable people to freely associate by enabling a visitor to be in a state of relaxation, and by affording a rich array of disruptive possibilities for self-exploration. We understand such intimate places as playgrounds that can (temporarily) disrupt rigid patterns of resistance or avoidance, enabling a person to confront difficult emotions and experiences that might otherwise go unnoticed.

“They should ask me so that they can help me”: Patterns of young children's expressed feelings and beliefs when interviewed about violence and difficult experiences

BackgroundChildren's participation in research is a rights-based principle. However, young children are often excluded from research on sensitive topics, due to gatekeepers concerns that participation would cause distress/re-traumatization and conflict with the principle of providing adequate protection from harm. ObjectiveTo provide evidence around young children's feelings, including potential distress, and beliefs in mixed-method interviews about violence and difficult experiences. Participants and settingData were collected from South African interviewer focus group discussions and young child (age 6–10) interviews, along with observations and fieldnotes from young child (age 6–17) interviews. MethodsWe collected and analyzed qualitative data focused on children's displayed and reported emotions and beliefs in violence-focused interviews. ResultsFindings showed the quantitative interview was frequently a positive experience for young children, and children who became upset or emotional stated their feelings were due to violence they experienced. The interviewer seemed to represent a safe person to whom the child could disclose. The play- and arts-based methods of the interview were useful in building this safety and providing space for children to regulate difficult emotions. ConclusionsIn a carefully managed interview environment using developmentally appropriate methods, young children are enthusiastic participants and do not appear to experience undue distress or trauma when asked about violence and other sensitive topics. Findings demonstrate that young children can be safely included in research about violence and issues that impact them and can exercise their right to participation when research methods, environments, and safeguards are appropriately adapted to their needs.

Unified in remembrance: reflections on collective war commemoration by war-affected immigrants in the Netherlands

Decades after World War II, major commemorations are still organised to collectively remember this war. Aiming for inclusive societies, the perspectives of immigrants with different war experiences are important to be heard in relation to these commemorations. Research reveals that commemorations can kindle difficult emotions such as sadness and bring distressing memories to the fore. Concurrently, psychosocial factors such as societal support and meaning making may buffer the emotional distress and contribute to a beneficial impact. It is not well known how this applies to immigrants. The present study explores how war-affected immigrants in the Netherlands relate to the Dutch Remembrance Day. Semi-structured interviews were conducted with 25 war-affected immigrants from 8 different countries (including countries in Europe, Asia, Africa, and South America). Qualitative analyses revealed that participants experienced multiple and mixed emotions during the Dutch Remembrance Day, including sadness, longing, and gratitude. Memories about own war experiences and losses often arose, of which the impact varied from distress to relief. The context of war in participants’ countries of origin, such as ongoing conflict or a contested history, often hindered commemoration of these wars. Through the Dutch commemoration, most war-affected immigrants experienced social connectedness and openness for (emotional) expression which contributed to dealing with their past experiences. Insights from this study may guide counsellors working with war-affected immigrants and help societies to organise optimally appealing commemorations within an inclusive society.

A Qualitative Investigation of Civic Engagement and Well-Being among Non-College-Bound Young Adults

Young adulthood is an important developmental milestone during which individuals could greatly benefit from health promotion tools. Civic engagement has been linked with positive mental health and well-being; however, little is known about civic behavior among young adults who do not attend college. We investigated the relationship between civic engagement and well-being among non-college-bound young adults (NCYAs). Investigators conducted semi-structured focus groups and interviews with 14 young adults (aged 18–25 years old) who were not enrolled in college. Using qualitative thematic analysis procedures, coders defined five key themes within the data pertaining to the intersection of civic engagement and mental health: (1) experiencing, witnessing, and believing in the fruits of civic engagement labor; (2) managing emotions and conflict; (3) balancing individual needs with those of the collective; (4) garnering social connectedness and support; and (5) acting in alignment with values. Participants described complex, bidirectional relationships between civic engagement and well-being. Participants experiencing empowerment and political efficacy resulting from their civic engagement experiences reported greater well-being. Some participants used civic engagement as a strategy to cope with distressing emotions, while others were civically disengaged to avoid conflict and negative affect. Participants described the need to attend to personal needs first before engaging in actions to help the collective. Connecting with others was a notable promoter of well-being among those who were civically active, although negative peer influence was also a notable detractor. Finally, participants described strong value systems and identities related to civic engagement. Civic engagement can elicit both positive and negative emotional, psychological, and social well-being. The results underscore potential mechanisms that mediate the civic engagement to well-being pathway, which can be used to inform efforts to engage and retain NCYAs in civic engagement. Interventionists should cultivate strong coping and conflict management skills among engagers to manage difficult emotions that arise before, during, and after civic activity if health outcomes are to be achieved.

Teaching under an orange sky: Toward reimagining educational purpose on a damaged planet

I begin with an assumption that there are intersectional relations among education, humans, cyber technologies, and nature, and assert that an expansive understanding of formal educational purpose is needed in the twenty first century. Drawing on Biesta’s (2009) three domains of educational purpose (qualification, socialization, and subjectification), I examine how posthuman, decolonial, and ecofeminist insights manifest in each domain. I employ Haraway’s concepts of kin-making and thinking-with as a methodological approach, using personal narrative to bridge theory and practice. By establishing “theoretical alliances” with diverse thinkers, scholars, and communities, I aim to challenge traditional individualistic and hierarchical approaches to philosophy in environmental education, fostering a more interconnected practice of living and learning in a time of ecological emergencies. Qualification is reconceptualized to include understandings that provide space for unknowing and mystery. Socialization is reimagined to include kin-making processes, while subjectification entails grappling with the difficult emotions surrounding ecological breakdown.

“I start to doubt whether any of my actions will matter”: youth activists’ experiences and expressions of the emotions associated with climate change

This study provides insights on the ways that youth express and process the emotions arising from their involvement in climate action. The specific objectives were to: (1) understand the ways youth come to know, conceptualize and reflect on climate change, (2) explore how youth’s emotions in response to climate change impacts their everyday lives; and (3) determine the modalities in which youth are expressing and processing such emotions. We used a grounded theory approach and the photovoice interview method to elicit participant’s views on climate-change-related emotions and interviews were analysed using qualitative data analysis software according to a grounded theory approach. The study resulted in identifying key themes, as well as supports for youth experiencing difficult emotions associated with climate change.

Self-Criticism: Conceptualization, Assessment and Interventions

Self-criticism, considered as a transdiagnostic concept in the emergence of various psychopathologies, is considered as negative evaluations directed towards oneself especially in perceived failure situations. In literature various views regarding self-criticism, suggesting it as a personality trait, a style of relating to oneself, a coping response to various situations, or a safety strategy developed to restrain negative experiences, exist. In this regard, various researchers have conceptualized self-criticism with different dimensions and structures, leading to the development of various measurement tools. Findings obtained from these scales indicate that self-criticism is a risk factor for psychopathology and a factor that affects individuals to experience difficult emotions and their engagement in various challenging behaviors such as perfectionism and emotional eating. For this reason, several interventions aimed at reducing individuals' levels of self-criticism have been conducted in the literature. In this study the scales developed based on different conceptualizations of self-criticism were introduced, the effects of self-criticism on individuals were presented by compiling results of studies in which the relationships between self-criticism and various variables were examined and finally the results of intervention studies based on Cognitive Therapy, Emotion-Focused Therapy, and Compassion-Focused Therapy were summarized. It is believed that providing comprehensive theoretical and empirical knowledge related to self-criticism will contribute to future studies in the field.

The experiences of grandparents involved in the home-based end-of-life care of their grandchild with cancer: A qualitative secondary data analysis

While grandparents are often a valuable resource in home-based pediatric end-of-life care, they may also experience psychological consequences when faced with their grandchild’s illness and death. In this qualitative study, we performed semi-structured interviews with seven bereaved grandparents of four children with cancer who received home-based end-of-life care and died at home at age <18. Through qualitative content analysis we identified the overarching theme: “Navigating complex and unclear roles to support the family” and five themes: (1) Providing comfort and support; (2) Balancing and adapting involvement; (3) Worrying silently; (4) Managing difficult emotions; and (5) Calling for support and understanding. The findings underline the often conflicting roles that grandparents undertake of providing support while respecting parents’ autonomy and putting aside their own emotional reactions. Involving grandparents in pediatric end-of-life care may enhance family resources, but should also consider grandparents’ perspectives and need for support.

Teacher vulnerability as a pedagogical tool: A comparative case study in two literacy classrooms

AbstractViewing teacher vulnerability as a pedagogical tool, this comparative case study examined two secondary literacy teachers' use of vulnerability in relation to various instructional goals. Through the analysis of eight video‐recorded lessons, we found that teachers demonstrated vulnerability through multiple ways within their literacy instruction through modeling ways of connecting personal experiences to texts, and establishing classroom norms that welcome difficult emotions and experiences. However, we also found that teacher vulnerability can sometimes lead to uncertainty, and even constrain student participation. We argue that teacher vulnerability helps establish a humanizing pedagogy, and offer possible strategies for teachers who are vulnerable within literacy instruction. We conclude with a discussion of different levels of appropriating vulnerability as a pedagogical tool.

Perezhivanie-agency dialectic: Examining Vietnamese EFL educators’ experiences and negotiation of dramatic classroom events

Tensions and conflicts are common in teachers' everyday professional lives, yet research on how these experiences influence pedagogical decisions and teacher agency remains limited. This study employs a broad sociocultural perspective, integrating cultural-historical activity theory (CHAT) and Vygotsky's concept of perezhivanie, to examine how two Vietnamese English-as-a-Foreign-Language (EFL) educators responded agentively to emotionally charged events. Data were collected through semi-structured interviews and reflective journals, and analyzed using qualitative content analysis. The findings of the study illustrate that mismatches between educators' expectations and students' behaviors not only underpin educators' negative emotions and cognitive responses but also catalyze a cycle of reflection, which subsequently leads to modifications in teaching practices and strengthens educators' agency. This study underscores the complex interplay between teachers' experiences of dramatic events and their agency, highlighting the importance of equipping educators with the necessary knowledge and skills to constructively manage difficult emotions and enhance their problem-solving capabilities. This study exemplifies a critical integration through the development of Integrative Cultural-Historical Activity Theory (iCHAT), which synergistically combines elements of CHAT and Vygotsky's perezhivanie, providing a robust framework to investigate a range of complex phenomena beyond teacher agency in diverse educational and cultural contexts.

Grief and Collaborative Storytelling: The Colours of Loss

ABSTRACT This article describes a novel methodology for involving the public in a creative co-produced project about grief, which invited bereaved people to work together to create a fictional story about loss and then reflect on the experience in focus groups. Devised by Crowded Room Theatre Company and researchers at the University of Bristol, the project aimed to explore the risks and benefits of collaborative storytelling about emotionally charged subjects. Thematic analysis of the focus group transcripts generated seven themes: storytelling as protective and enabling; support and understanding; new perspectives; connecting to grief and loved ones who have died; complicated emotions; workshop anxiety; and anticipating the audio story. These findings corroborate research that suggests storytelling can provide a safe space to explore and make meaning from difficult emotions and experiences; it may also appeal to bereaved individuals who are less likely to attend conventional support groups. The audio story created from the workshop recordings is available online (https://www.spreaker.com/episode/the-colours-of-loss--53334166).

Discussing Patient Emotions in Audiology: Provider Experiences With the Implementation Process of Hearing Loss Psychological Inflexibility Screenings.

This study aimed to investigate barriers and facilitators experienced by clinical educators and graduate students when talking with patients about difficult emotions and thoughts related to their hearing. A longitudinal observational design was used and an Implementation Research Logic Model guided the process. Five clinical educators and five graduate students participated in the study. Participants completed pre- and postmeasures and attended individual debriefing sessions during the 8-month study period. Four themes emerged from the debriefing sessions: (a) learning process, (b) confidence, (c) barriers, and (d) supervision. Participants described that the Acceptance and Action Questionnaire-Managing Child Hearing Loss and Acceptance and Action Questionnaire-Adult Hearing Loss served as a reminder to ask about patients' internal barriers and increased awareness of their discomfort in talking about patient emotions. Participants also described barriers and struggles related to supporting students in gaining counseling skills. Screening for internal challenges helped clinicians remember to talk with patients about their difficult thoughts and emotions. Clinician hesitancy to engage in conversations with patients about their emotions can interfere with opportunities for patients to share their struggles and with training student in these skills.

Friendship and self-harm: a retrospective qualitative study of young adults' experiences of supporting a friend who self-harmed during adolescence.

Self-harm amongst young people is becoming increasingly prevalent. Understanding, responding to, and supporting young people who self-harm is vital. Friends are typically the first and sometimes the only source of support sought by adolescents who self-harm. Despite their important role as confidants, friends' perspectives and experiences remain poorly understood. We conducted retrospective qualitative semi-structured interviews, prompted by an adapted version of the Card Sort Task for Self-Harm (CaTS-FF), about the experiences of nine female young adults (18-20 years old) who supported a friend who self-harmed during adolescence. Data were analyzed using thematic analysis. Four themes were developed: (1) "I did not realize my friend was on the road to self-harm": Friends' reactions to self-harm; (2) "That's what friends do": the role of friends; (3) The impact of supporting a friend who self-harms; and (4) "They were quite formative years": reflecting on growth through the experience. The present findings highlight the complex experiences of young people supporting a friend who self-harms. Despite being willing to take on the role of a supporter, participants experienced a range of difficult emotions and consequences. The temporal transition running through the four themes reflects the evolving nature of participants' attitudes, knowledge, and friendships. Overall, results highlight the unmet needs of adolescents supporting young people who self-harm, as well as identifying potential pathways to "support the supporters" toward resilience.

Hip-Hop and Rap Music Interventions on Mental Health and Well-Being: A Systematic Review

ABSTRACT Hip-hop and rap music interventions are modern approaches, often used in counseling with marginalized populations, to facilitate emotion processing and enhance well-being. The purpose of this systematic review is to (a) identify hip-hop and rap music interventions that have been empirically studied in counseling, (b) summarize the outcomes of research studies that integrate hip-hop and rap music interventions in counseling, and (c) critically appraise the available research studies to date. Overall, researchers reported that integrating hip-hop and rap music in the counseling process contributes to increased emotional awareness, empowerment, and the ability to process difficult emotions.

Mindful awareness and resilience skills for adolescents (MARS-A): a mixed-methods study of a mindfulness-based intervention for a heterogeneous adolescent clinical population.

Mindful Awareness and Resilience Skills for Adolescents (MARS-A) is a mindfulness-based intervention adapted for the adolescent population. While previous studies have explored the benefits of MARS-A in various single-diagnosis populations, the aim of this study was to assess MARS-A for a heterogenous clinical adolescent population with mental health and/or chronic diagnoses, focusing on the underlying suffering present in all these conditions rather than its effects on a single diagnosis itself. Qualitative data was collected through interviews to understand post-intervention participant perspectives and experiences. Quantitative data was collected through measures to investigate preliminary secondary outcomes. After participating in MARS-A, participants reported qualitative benefits in enhanced well-being, including coping with difficult emotions and managing sleep and/or pain. Quantitative results showed a reduction in functional disability, psychological distress, perceived stress, and depressive symptoms; increase in positive affect; and benefit in coping with pain and chronic conditions. MARS-A shows great potential in a heterogeneous clinical adolescent population.