Mental Practice Research Articles

The Perceived Power and Powerlessness in School Health Nurses' Mental Health Promotion Practices: A Synthesis of Qualitative Studies.

Schools are important arenas for mental health promotion initiatives. School nurses have the opportunity and ability to support and promote students' mental health, but their role and practices have been perceived as somewhat unclear. Therefore, the aim of this study was to explore school nurses' mental health promotion practices. A total of 12 scientific studies were synthesized through a meta-ethnographic approach. The overarching results of the synthesis show that school nurses' mental health promotion practices are largely about balancing and combining the students' needs with different professional perspectives, competencies, and conditions. The school nurses perceived that they had the power to influence their practices through a variety of ways, highlighting the importance of letting the students' needs guide the practices. Yet, at the same time they described feelings of powerlessness because of the different organizational structures that were hindering their mental health promotion practices.

Positive parenting practices support children at neurological risk during COVID-19: a call for accessible parenting interventions

Children and youth with neurological and/or neurodevelopmental conditions were at high risk for behavioral and mental health challenges during the COVID-19 pandemic. Positive and responsive parenting practices may be one way to prevent and manage potential difficulties in families. We aimed to identify whether positive parenting practices were associated with reduced behavioral concerns in children at neurological risk during the late stages and aftermath of the COVID-19 pandemic. In addition, we examined whether ongoing parental stress, anxiety, and depression impacted parenting practices during this time period. Families (N = 179) with children 4 to 15 years old (M = 7.11y, SD = 2.02) diagnosed with neurological (84.3%), neurodevelopmental (54.8%) or comorbid neurological and/or neurodevelopmental conditions (21.2%) were contacted to complete online questionnaires regarding demographics, parent stress, child behavior, COVID-19 conditions, and parenting practices. Multivariable linear regression (MLR) analyses examined the association between positive parenting practices and parenting competency measures with child behavioral outcomes, controlling for relevant covariates, including COVID-19 related stress. MLR were also run to determine whether parental mental health impacted parenting practices. More positive parenting practices predicted fewer child problem behaviors and lower intensity of problem behaviors. Similarly, a higher sense of satisfaction with parenting competence also predicted fewer child problem behaviors and lower intensity of problem behaviors. In addition, higher reported parental depression, anxiety, and stress significantly predicted fewer reported positive parenting practices. Findings points to the promising application of positive parenting interventions to support vulnerable families, as well as the need for parental mental health intervention to support parenting practices.

“Seeing Myself Through Someone Else’s Eyes”: Embodying the Perfect Nurturer in Compassion Focused Therapy

Compassion-focused chairwork has become a recent focus of empirical investigation. This study extended this area of research by exploring how participants with depression experienced the ‘compassionate other’ imagery exercise enacted via chairwork methods. Eight individuals from primary care NHS mental health services were interviewed about their experience of the practice. The resultant data were analysed using interpretive phenomenological analysis (IPA). Three group experiential themes were identified: care that feels real, chairwork processes and encountering challenges on the road to discovery. The findings indicate that the intervention has therapeutic utility both as an intervention for cultivating compassion and as means of assessing for and identifying blocks to compassion. The results also suggest that there is potential value in enacting compassion-focused imagery techniques through chairwork methods, especially for those who have difficulty accessing mental imagery practices. The findings are contextualised within broader theory and literature, and clinical and research implications are discussed.

Expanding FOAMed to Voice Activated Artificial Intelligence: Mental Practice of Emergency Medicine Procedures via Alexa

Expanding FOAMed to Voice Activated Artificial Intelligence: Mental Practice of Emergency Medicine Procedures via Alexa

Interweaving Narratives of Lived Experience in Mental Health Social Work Curriculum

ABSTRACT This study explored the metacurriculum of an undergraduate mental health social work subject that was developed and delivered collaboratively by lived experience and social work academics in a regional Australian university. Metacurriculum refers to implicit messages about how students learn how to learn that is, the ontological and epistemological positioning of curriculum. In this subject, students were invited to reflect on multiple, diverse, lived-experience narratives of mental distress as they developed their understanding of mental health social work practice. Using cooperative inquiry, we collectively critically reflected on the experience of teaching and learning with this curriculum. Coresearchers included a student who had completed the subject; a mental health social work practitioner/tutor, a social work academic, and a lived-experience academic who coproduced the subject material; and mental health academics acting as critical friends. Findings revealed engaging with lived-experience narratives was experienced as generating compassion for all humanity; challenging stigma by sharing the responsibility of positioning; and enabling critically reflexive dialogue. We concluded that diverse, lived-experience narratives can be incorporated to enact metacurriculum that aligns social work teaching and learning with emerging transformative approaches to mental health. IMPLICATIONS Incorporating diverse narratives of mental distress into curriculum can highlight the operation of intersectionality and privilege. Engaging with multiple narratives of mental distress undermines the binary construction of “them” and “us”. Metacurriculum enacting inclusive, collaborative knowledge development aligns teaching and learning with transformative mental health.

Barriers and bridges: Exploring the introduction of meditation and mindfulness training into Canadian policing

Canadian police organizations are under significant pressure to enhance the health and wellness of their employees. Growing research suggests that training in meditation and mindfulness can contribute to the well-being of police personnel and may even be a catalyst for police reform. Limited research, however, has been conducted that seeks to understand how these practices should be introduced into Canadian police organizations. This article contributes to this understanding by sharing results from an exploratory study that asked 11 Commissioned Officers, who regularly practice meditation, to identify the key factors that should be considered when introducing mindfulness practice into their large Canadian police service. Using semi-structured interviews and focus groups, and guided by a reflexive thematic analysis approach, six themes were developed. These can be viewed as both barriers (invincibility and stigma; overworked and overstressed; and checkbox cynicism) and bridges (credible champions; the whole person perspective; and the philosophy of servant leadership) to the successful introduction of meditation and mindfulness practices into Canadian police organizations. This study advances the literature on introducing mindfulness to policing as it is one of the first to focus on the perceptions of mindfulness practicing Commissioned Police Officers. It also offers practical suggestions for police leaders, and leaders from other public safety professions, to consider when contemplating the introduction of these mental practices into their organizations.

Spirituality and Recovery From Severe Mental Disorders: A Systematic Review.

The current study investigated the impact of spirituality and mental disorder recovery practices among individuals with severe mental disorders. A comprehensive search across six databases-Scopus, ScienceDirect, ProQuest, SpringerLink, PubMed, and CINAHL-was performed to identify relevant articles. A total of 651 articles were screened, and 16 met inclusion criteria. Findings revealed that spirituality significantly contributed to the improvement of individuals with severe mental disorders by fostering the development of self-confidence, self-control, strength, and hope, thereby enhancing overall quality of life. In addition, spirituality appeared to correlate with increased self-efficacy. Within the mental health recovery framework, spirituality has emerged as a crucial element in facilitating significant life improvements through the exploration of essential motivational strategies. Psychiatric-mental health nurses could play a pivotal role in helping individuals with severe mental disorders by addressing their spiritual needs, thereby promoting holistic recovery and care. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Prototype development of the Mental Health benchmarking Industry Tool for residential aged Care (MHICare Tool): a protocol paper of a two-stage sequential and mixed methods codesign study

ObjectivesCurrent mental health practices for people living in residential aged care (RAC) facilities are poor. In Australia, there are no mechanisms to monitor and promote mental health for people living...

Exploring Methodological Issues in Mental Practice for Upper-Extremity Function Following Stroke-Related Paralysis: A Scoping Review.

In this scoping review, we aimed to comprehensively clarify the methodology of Mental practice (MP) by systematically mapping studies documenting the application of MP to post-stroke paralytic upper-extremity function. Specifically, when is an MP intervention most commonly applied after stroke onset? What is the corresponding MP load (intervention time, number of intervention days, and intervention period)? What are the most common methods of Motor Imagery (MI) recall and MI tasks used during the application of MP? Is MP often used in conjunction with individual rehabilitation? What are the paralyzed side's upper-limb and cognitive function levels at the start of an MP intervention? The research questions were identified according to PRISMA-ScR. The PubMed, Scopus, Medline, and Cochrane Library databases were used to screen articles published until 19 July 2022. In total, 694 English-language articles were identified, of which 61 were finally included. Most of the studies were conducted in the chronic phase after stroke onset, with limited interventions in the acute or subacute phase. The most common intervention time was ≤30 min and intervention frequency was 5 times/week in MP. An audio guide was most commonly used to recall MI during MP, and 50 studies examined the effects of MP in combination with individual rehabilitation. The Fugl-Meyer Assessment mean for the 38 studies, determined using the Fugl-Meyer Assessment, was 30.3 ± 11.5. Additional research with the aim of unifying the widely varying MP methodologies identified herein is warranted.

Inter-Professional Education Interventions, and Practice Outcomes Related to Healthcare Setting and Patients Within Mental Healthcare: A Scoping Review.

This scoping review aimed to examine 1) types of inter-professional (IPE) interventions using Strosahl's typology framework, 2) practice outcomes related to healthcare setting and patients using Kirkpatrick's model of training evaluation, and 3) enablers and challenges related to the effectiveness of IPE interventions specific to the mental healthcare setting in order to guide the development of such future programs. This scoping review was conducted in accordance with the methodology of the Joanna Briggs Institute for scoping reviews. Several databases were searched for relevant studies from database inception until December 2023. Articles were included if it 1) involved IPE interventions within mental healthcare, 2) reported practice outcomes related to healthcare setting and patients, and 3) was published in English. Variables of interest included the mode of IPE intervention using Strosahl's typology, enablers, and challenges related to IPE interventions. Overall, 16 studies were included. IPE intervention outcomes within healthcare setting related to shifts in practice culture, engagement with family members, and increased collaborations with other inter-professional groups. Reported patient outcomes included clinical improvements (e.g., reduced depression and anxiety, psychotropic drug use, better psychosocial functioning), patient empowerment, satisfaction, and confidence in treatment. The enablers and challenges included resource limitations, inter-professional group and individual participation, and pedagogy. Future efforts in IPE mental healthcare practice can focus on garnering sustained institutional support, identifying and investing in committed faculty, encouraging greater learner participation, and making iterative changes to the IPE program structure to facilitate involvement of inter-professional disciplines for better patient care.

Heritage sites in the 21st century: virtual tours and digital artefacts, an online example

ABSTRACT Former asylums are often significant heritage sites for their architecture and what they can tell us about mental health care practices. One example is the historic Mayday Hills asylum in Beechworth, Victoria, Australia. Built in Italianate style and set in extensive grounds, it is under National Trust protection for its heritage and historical significance. In this article, we outline the creation of a pilot online virtual tour of Mayday Hills and the nearby Beechworth Cemetery. We used curation as a methodology, informed by the concept of crystallisation. Innovative digital imagery was crafted through drone footage and virtual technology. The website includes narratives and reminiscences from former staff and others associated with the institution, along with a blog written by the research team. Maydayhills.org.au demonstrates the feasibility of using virtual technology to depict how mental illness was once treated in Australia. The website is available to anyone unable to travel to Beechworth and to enrich the experience of those visiting in person. This online digital space is now essential for the preservation of history, memories and material culture given that many original buildings are being repurposed. It complements the built and natural environment of Mayday Hills asylum and Beechworth Cemetery.

The impact of a comprehensive physical, mental and spiritual programme on fall risk, physical fitness and blood pressure in elderly residents of nursing homes: An RCT Study

As bodily functions decline, older people encounter various challenges in physical, mental and social well-being, for example risk of falls, hypertension and depression. Physical exercise is among the most recommended solutions to address the issues faced by the elderly. This study aimed to evaluate a holistic programme incorporating diverse physical exercises (aerobic exercise, muscle strength, flexibility), combined with mental and spiritual practices (breathing relaxation and gratitude) in reducing fall risk, enhancing physical fitness, and regulating blood pressure, in elderly residents of nursing homes. The study employed a Cluster Randomised Controlled Trial design in Surakarta, Indonesia. Seventy-one participants were randomly assigned to either the intervention group (n=42) or control groups (n=29). The intervention group engaged in the programme three times per week, for 60 minutes per session, over 16 weeks. The control group continued their routine activities, including sunbathing or other relaxing pursuits. In the fall risk variable, the intervention group exhibited a higher mean score than the control group, specifically 49.79 ±2.70 compared to 46.21 ±3.16, p=0.05, while for physical fitness, 60.24 ±7.65 compared to 49.57 ±11.66, p=0.05. Concerning systolic blood pressure, the mean value for the intervention group was 146.11 ± 20.07, while the control group was 148.59 ± 23.20, p = 0.63. The intervention group recorded a mean value of 84.10 ± 13.75 for diastolic blood pressure, whilst the control group recorded 86.25 ± 9.83, p = 0.98. This research underscored the influence of SPIRIT programme on reducing fall risk and enhancing physical fitness in elderly nursing home residents, although it is not effective in lowering blood pressure. Elderly people in nursing homes and communities can consider the SPIRIT programme as an attempt to prevent non-communicable diseases. Additional research is recommended to explore the impact of this programme on the blood pressure of older people.

Acculturation and Mental Health: A Scoping Review.

Background: Acculturative stress theory and the healthy immigrant paradox provide conflicting frameworks from which to study the mental health of immigrant groups. This scoping review aims to provide clarity on the mental health effects of acculturation. Review Question: How are anxiety, depression, and stress expressed in the adolescent and adult children of immigrants? Method: Considering various generational classifications, 1333 articles were screened and 25 articles were selected. This review highlights the presentation of cultural stress and its mental health effects in the children of immigrants ranging from 13 to 28 years of age. Conclusions: Social support is necessary as these children and young adults work to reconcile different worldviews. There is a need for a multifaceted approach to health care that incorporates the development of culturally appropriate responses to stressors. Collaboration among health practitioners growing in cultural competency can assist this population not only in the development of coping strategies, but also in self-actualization. The conflicting results found in this review suggest a need for more work in the area of acculturation stress, to grow the understanding of health practitioners within various cultural groups in order to transform mental health clinical practice.

Implementation fidelity, student outcomes, and cost-effectiveness of train-the-trainer strategies for Masters-level therapists in urban schools: results from a cluster randomized trial

BackgroundLittle is known about the effectiveness and cost-effectiveness of train-the-trainer implementation strategies in supporting mental health evidence-based practices in schools, and about the optimal level of support needed for TT strategies.MethodsThe current study is part of a larger type 2 hybrid cluster randomized controlled trial. It compares two train-the-trainer strategies, Train-the-Trainer (TT) and Train-the-Trainer plus ongoing consultation for trainers (TT +) on the delivery of a group cognitive behavioral treatment protocol for anxiety disorders. Participants were 33 therapists, 29 supervisors, and 125 students who were at risk for anxiety disorders from 22 urban schools. Implementation outcomes were implementation fidelity and treatment dosage. Student outcomes were child- and parent-reported symptoms of anxiety, child-reported symptoms of depression, and teacher-reported academic engagement. We estimated the cost of implementing the intervention in each condition and examined the probability that a support strategy for supervisors (TT vs TT +) is a good value for varying values of willingness to pay.ResultsTherapists in the TT and TT + conditions obtained similarly high implementation fidelity and students in the conditions received similar treatment dosages. A mixed effects modeling approach for student outcomes revealed time effects for symptoms of anxiety and depression reported by students, and emotional disaffection reported by teachers. There were no condition or condition × times effects. For both conditions, the time effects indicated an improvement from pre-treatment to post-treatment in symptoms of anxiety and depression and academic emotional engagement. The average cost of therapist, supervisor, and consultant time required to implement the intervention in each condition was $1002 for TT and $1431 for TT + (p = 0.01). There was a greater than 80% chance that TT was a good value compared to TT + for all values of willingness to pay per one-point improvement in anxiety scores.ConclusionsA TT implementation approach consisting of a thorough initial training workshop for therapists and supervisors as well as ongoing supervision for therapists resulted in adequate levels of fidelity and student outcomes but at a lower cost, compared to the TT + condition that also included ongoing external expert consultation for supervisors.Trial registrationClinicalTrials.gov identifier: NCT02651402.

Bilateral vs unilateral motor imagery training: effects on motor execution performance and ERD

Bilateral movement has been reported to enhance actual motor performance more than unilateral movement and increase motor cortex activation more than unilateral movement. We hypothesized that bilateral motor imagery would result in greater improvements in event-related desynchronization (ERD) amplitude and ball rotation performance than unilateral motor imagery. Forty healthy young adults participated in this study. The mental practice session was performed in the unilateral hand condition (right and left hands) and bilateral hand condition for four blocks. ERD in mental practice was calculated using electroencephalography (EEG). The ball rotations were compared between the pre-and post-tests of mental practice. The results showed a greater improvement in actual motor performance with unilateral motor imagery than with bilateral motor imagery. ERD analysis showed no significant differences in multiple comparisons. These results did not support this hypothesis. Nonetheless, the present study showed that unilateral movements resulted in greater performance gains than bilateral movements, suggesting that bilateral motor imagery may have additional control processes similar to actual movements.

Recovery of Volitional Motor Control and Overground Walking in Participants With Chronic Clinically Motor Complete Spinal Cord Injury: Restoration of Rehabilitative Function With Epidural Spinal Stimulation (RESTORES) Trial-A Preliminary Study.

Spinal cord injury (SCI) is damage to any part of the spinal cord resulting in paralysis, bowel and/or bladder incontinence, and loss of sensation and other bodily functions. Current treatments for chronic SCI are focused on managing symptoms and preventing further damage to the spinal cord with limited neuro-restorative interventions. Recent research and independent clinical trials of spinal cord stimulation (SCS) or intensive neuro-rehabilitation including neuro-robotics in participants with SCI have suggested potential malleability of the neuronal networks for neurological recovery. We hypothesize that epidural electrical stimulation (EES) delivered via SCS in conjunction with mental imagery practice and robotic neuro-rehabilitation can synergistically improve volitional motor function below the level of injury in participants with chronic clinically motor-complete SCI. In our pilot clinical RESTORES trial (RESToration Of Rehabilitative function with Epidural spinal Stimulation), we investigate the feasibility of this combined multi-modal approach in restoring volitional motor control and achieving independent overground locomotion in participants with chronic motor complete thoracic SCI. Secondary aims are to assess the safety of this combination therapy including the off-label SCS usage as well as improving functional outcome measures. To our knowledge, this is the first clinical trial that investigates the combined impact of this multi-modal EES and rehabilitation strategy in participants with chronic motor complete SCI. Two participants with chronic motor-complete thoracic SCI were recruited for this pilot trial. Both participants have successfully regained volitional motor control below their level of SCI injury and achieved independent overground walking within a month of post-operative stimulation and rehabilitation. There were no adverse events noted in our trial and there was an improvement in post-operative truncal stability score. Results from this pilot study demonstrates the feasibility of combining EES, mental imagery practice and robotic rehabilitation in improving volitional motor control below level of SCI injury and restoring independent overground walking for participants with chronic motor-complete SCI. Our team believes that this provides very exciting promise in a field currently devoid of disease-modifying therapies.

Physical practice, mental practice or both: a systematic review with meta-analysis

Introduction: Previous research has reached positive conclusions regarding the effects of mental practice on performance and learning of a motor skill. The purpose of this study was to use the aggregate data meta-analytic approach to assess the impact of physical practice (PP), mental practice (MP), and the combination of both on acquisition, retention, and transfer tests in motor skill performance. Methodology: Twenty-seven studies published up to 2022 were included by searching six databases. Random effects model using the standardized mean difference effect size (ES) was used to pool results. Results: A total of 42 ES, were calculated and separated into pairwise comparisons for acquisition, retention, and transfer phase. In the acquisition phase, it was found that MP was more effective than no practice (ES=0.508; n=25; CI=0.29,0.72), PP was more effective than no practice (ES=1.78; n=15; CI=0.97,2.60), CP was more effective than no practice (ES=1.16; n=12; CI=0.57,1.75), PP was more effective than MP (ES=-1.16; n=23; CI=-1.88,-0.45), PP had similar results as CP (ES=-0.01; n=16; CI=-0.31,0.28), and CP was more effective than MP (ES=0.61; n=12; CI=0.17,1.04). In the retention phase, it was found that MP was more effective than no practice (ES=1.11; n=5; CI=0.44,1.79), PP was more effective than no practice (ES=1.03; n=4; CI=0.08, 1.99), PP was more effective than MP (ES=-1.29; n=9; CI=-3.12,0.54), PP had similar results as CP (ES=0.16; n=8; CI=-0.29,0.63), CP had similar results as MP (ES=-0.06; n=3; CI=-1.22,1.09). In the transfer phase, it was found that MP was more effective than no practice (ES=1.12; n=5; CI=0.01,1.59), PP had similar results as no practice (ES=0.41; n=5; CI=-0.02,0.85), and PP was more effective than MP (ES=0.50; n=6; CI=0.12,0.87). Age, skill level, type of mental practice, total of sessions, and type of skill were considered as possible moderator variables. Conclusions: Mental practice does not replace physical practice, however, under some conditions, physical practice can be complemented with mental practice.

Beyond Traditional Therapy: A Novel Multimodal Regimen for Stroke-Related Hand Dysfunction.

Objective: The study aims to explore the effect of a blended multimodal practice aregimen on enhancing upper extremity function in chronic stroke patients. Specifically, we seek to investigate the potential benefits of incorporating MMP into the existing rehabilitation protocols for stroke survivors and assess its effectiveness in improving motor outcomes. Methods: The study utilized a randomized controlled trial design with chronic stroke patients who experienced upper extremity impairments. The participants were provided multimodal physical practice, multimodal mental practice, and blended multimodal practice regimen for three months. Results: The ANOVA analysis revealed a significant difference among the groups for the MMPG measure, indicating that the Blended Multimodal Practice Group (BMPG) performed significantly better compared to the Multimodal Physical Practice Group (MPPG) and the Multimodal Mental Practice Group (MMPG).  Conclusion: The findings of this study suggest that incorporating multimodal mental practice approaches into stroke rehabilitation programs can enhance upper extremity function in chronic stroke patients.

Overcoming Barriers to Mental Health Care for All: Interview With Ya-Shu Liang, PhD

Discover specific ways that practitioners can sometimes “drop the ball” when it comes to supporting people of different sociocultural groups. Dr. Ya-Shu Liang joins with ideas for patients, practitioners, and even psychology students to help reduce disparities in mental health care practices. Episode made possible by CSPP Alliant International University.

Nurse Reports of Moral Distress During the COVID-19 Pandemic.

COVID-19 was devastating for many frontline nurses embroiled in health care's response. Most media outlets reported from several large metropolitan areas in New York, California, and Florida, leaving other regions to wonder about the extent to which their nurses were suffering. The purpose of this article was to understand the specific needs and experiences of Northeast Ohio nurses caring for patients with COVID-19 before designing interventions targeting negative mental outcomes. This phenomenological study interviewed 16 Northeast Ohio nurses to understand their experiences of caring for patients with COVID-19. Although not asked about it directly, the participants' stories consistently included details that could be linked to moral distress. Two themes describing their lived experiences included "acquiring moral distress" and "living with moral distress." Additional findings are also reported separately because although they do not represent the lived experience of COVID-19 nursing, they did represent significant concerns that participants had for the future and are reported here to assist other researchers with the intervention design. Furthermore, these participants thought that participation in support groups with other nurses who cared for COVID-19 patients and possibly led by mental health advanced practice nurses offered the best intervention to process their trauma from the pandemic. The long-term effects of moral distress have been discussed routinely in recent literature and are further complicated by the effects of the COVID-19 pandemic. Threats to the shrinking workforce of nurses must be taken seriously and interventions to improve the mental health and morale of frontline nurses must be prioritized and tested.