Effectiveness Of Psychosocial Interventions Research Articles

Evolutionary systems therapy for paranoid personality disorder: A seven cases series.

Little is known about effective psychosocial treatments for paranoid personality disorder. This study explores the feasibility of a novel treatment, namely Evolutionary Systems Therapy, in supporting individuals diagnosed with paranoid personality disorder. Seven patients attended 10 months of individual therapy without receiving any psychopharmacological treatment. The primary outcome was the feasibility of the intervention, while the secondary outcomes were remission from the diagnosis and reliable changes in personality pathology and paranoid ideation. All recruited patients completed the intervention and did not report any adverse events. Six out of seven patients experienced remission from the diagnosis of paranoid personality disorder. All participants showed reliable changes in personality pathology and paranoid ideation, which were maintained at the 1-month follow-up. Further research is needed to confirm these encouraging results.

Identifying the barriers to kidney transplantation for patients in rural and remote areas: a scoping review.

Populations in rural and remote areas have higher rates of chronic kidney disease and kidney failure than those in urban or metropolitan areas, and mortality rates for chronic kidney disease are almost twice as high in remote areas compared to major cities. Despite this, patients residing in regional, rural, or remote areas are less likely to be wait-listed for or receive a kidney transplant. The objective of this scoping review is to identify specific barriers to kidney transplantation for adult patients residing in rural and remote areas from the perspectives of health professionals and patients/carers. Studies were identified through database (MEDLINE, CINAHL, Emcare, Scopus) searches and assessed against inclusion criteria to determine eligibility. A descriptive content analysis was undertaken to identify and describe barriers as key themes. The 24 selected studies included both quantitative (n = 5) and qualitative (n = 19) methodologies. In studies conducted in health professional populations (n = 10) the most prevalent themes identified were perceived social and cultural issues (80%), burden of travel and distance from treatment (60%), and system-level factors as barriers (60%). In patient/carer populations (n = 14), the most prevalent themes were limited understanding of illness and treatment options (71%), dislocation from family and support network (71%), and physical and psychosocial effects of treatment (71%). Patients in regional, rural, and remote areas face many additional barriers to kidney transplantation, which are predominantly associated with the need to travel or relocate to access required medical testing and transplantation facilities.

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications.

The opioid overdose epidemic is exacerbated by the emergence of Xylazine as an illicit drug adulterant. Xylazine, a veterinary sedative, can potentiate opioid effects while also causing toxic and potentially fatal side effects. This systematic review aims to assess the impact of Xylazine use and overdoses within the opioid epidemic context. A systematic search was conducted following PRISMA guidelines to identify relevant case reports, and case series related to Xylazine use. A comprehensive literature search included databases like Web of Science, PubMed, Embase, and Google Scholar, utilizing keywords and Medical Subject Headings (MeSH) terms related to Xylazine. Thirty-four articles met the inclusion criteria for this review. Intravenous (IV) administration was a common route for Xylazine use among various methods, including subcutaneous (SC), intramuscular (IM), and inhalation, with overall doses ranging from 40 mg to 4300 mg. The average dose in fatal cases was 1,200 mg, compared to 525 mg in non-fatal cases. Concurrent administration of other drugs, primarily opioids, occurred in 28 cases (47.5%). Intoxication was identified as a notable concern in 32out of 34 studies, and treatments varied, with the majority experiencing positive outcomes. Withdrawal symptoms were documented in one case study, but the low number of cases with withdrawal symptoms may be attributed to factors such as a limited number of cases or individual variation. Naloxone was administered in eight cases (13.6%), and all patients recovered, although it should not be misconstrued as an antidote for Xylazine intoxication. Of the 59 cases, 21 (35.6%) resulted in fatal outcomes, with 17 involving Xylazine use in conjunction with other drugs. The IV route was a common factor in six out of the 21 fatal cases (28.6%). This review highlights the clinical challenges associated with Xylazine use and its co-administration with other substances, particularly opioids. Intoxication was identified as a major concern, and treatments varied across the studies, including supportive care, naloxone, and other medications. Further research is needed to explore the epidemiology and clinical implications of Xylazine use. Understanding the motivations and circumstances leading to Xylazine use, as well as its effects on users, is essential for developing effective psychosocial support and treatment interventions to address this public health crisis.

Machine-learning analysis of opioid use disorder informed by MOR, DOR, KOR, NOR and ZOR-based interactome networks

Opioid use disorder (OUD) continuously poses major public health challenges and social implications worldwide with dramatic rise of opioid dependence leading to potential abuse. Despite that a few pharmacological agents have been approved for OUD treatment, the efficacy of said agents for OUD requires further improvement in order to provide safer and more effective pharmacological and psychosocial treatments. Proteins including mu, delta, kappa, nociceptin, and zeta opioid receptors are the direct targets of opioids and play critical roles in therapeutic treatments. The protein–protein interaction (PPI) networks of the these receptors increase the complexity in the drug development process for an effective opioid addiction treatment. The report below presents a PPI-network informed machine-learning study of OUD. We have examined more than 500 proteins in the five opioid receptor networks and subsequently collected 74 inhibitor datasets. Machine learning models were constructed by pairing gradient boosting decision tree (GBDT) algorithm with two advanced natural language processing (NLP)-based autoencoder and Transformer fingerprints for molecules. With these models, we systematically carried out evaluations of screening and repurposing potential of more than 120,000 drug candidates for four opioid receptors. In addition, absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties were also considered in the screening of potential drug candidates. Our machine-learning tools determined a few inhibitor compounds with desired potency and ADMET properties for nociceptin opioid receptors. Our approach offers a valuable and promising tool for the pharmacological development of OUD treatments.

Therapeutic Approaches for ADHD by Developmental Stage and Clinical Presentation.

Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder with three presentations: inattentive, hyperactive/impulsive and combined. These may represent an independent disease entity. Therefore, the therapeutic approach must be focused on their neurobiological, psychological and social characteristics. To date, there is no comprehensive analysis of the efficacy of different treatments for each presentation of ADHD and each stage of development. This is as narrative overview of scientific papers that summarize the most recent findings and identify the most effective pharmacological and psychosocial treatments by ADHD presentation and age range. Evidence suggests that methylphenidate is the safest and most effective drug for the clinical management of children, adolescents and adults. Atomoxetine is effective in preschoolers and maintains similar efficacy to methylphenidate in adults, whereas guanfacine has proven to be an effective monotherapy for adults and is a worthy adjuvant for the management of cognitive symptoms. The psychosocial treatments with the best results in preschoolers are behavioral interventions that include training of primary caregivers. In adolescents, the combination of cognitive and cognitive-behavioral therapies has shown the best results, whereas cognitive-behavioral interventions are the most effective in adults. Pharmacological and psychosocial treatments must be adjusted to the ADHD presentation and its neurocognitive characteristics through the patient’s development.

A Once Malignant Malady: the Story of Schizophrenia and the Path to Prevention

Schizophrenia is synonymous in the public’s mind with madness. To see someone experiencing a florid psychosis, who has lost the ability to distinguish between the real and the imagined, is to know that you are in the presence of insanity. Schizophrenia has existed for centuries. It’s one of the leading causes of disability in the world, with a lifetime prevalence of about 1 percent of the population. That’s 3.3 million people in the US and 78 million worldwide. Schizophrenia afflicts rich and poor, genders, all races and ethnic groups. Schizophrenia has been subject to many misconceptions, from spiritual affliction to social deviance, psychodynamic conflicts to romanticized notions of iconoclastic creativity. Perhaps, the most significant myth about the disease is that there are no effective treatments or cure. But the reality couldn’t be more different: today’s treatments are effective and often lifesaving. Beginning in the mid-twentieth century, scientific progress has enhanced our understanding of schizophrenia as a brain disorder that disrupts thought, perception, and emotion. Findings of abnormalities in brain structure, biochemical analytes and genetic mutations have revealed its causal mechanisms and have guided the search for effective pharmacologic and psychosocial treatments. This presentation traces the evolution of our social and scientific understanding of Schizophrenia. It will elucidate how science and medicine dispelled the superstition and myth surrounding this ancient malady of the mind and forged a path toward its understanding as a brain disorders and offers affected people, not just humane treatment, but the promise of its ultimate prevention.DisclosureNo significant relationships.

The Evidence Base For Psychiatric Support For Living Independently And Being Included In The Community

Functional recovery of subjects with schizophrenia remains an unmet need despite the availability of effective pharmacological and psychosocial treatments. The focus of recovery-oriented approaches is on fostering hope and resilience, fighting self-stigma, supporting self-determination and promoting social inclusion. The implementation of recovery-oriented plans requires an in depth understanding of key factors influencing real-life functioning, health status and quality of life. Recently published data from the Italian Network for Research on Psychoses have provided evidence that baseline variables associated with functional outcome at follow-up included domains not routinely assessed and targeted by intervention programs in community mental health services. As pointed out by experts in schizophrenia research and care, the management of subjects with schizophrenia has not significantly improved and only a minority of them receives integrated and personalized treatments. Shared decision-making and integrated pharmacological and psychosocial treatments, tailored on subjects’ needs, might significantly improve the outcome of subjects with schizophrenia, supporting independent living and inclusion in the community.DisclosureHonoraria, advisory board, or consulting fees from Angelini, Astra Zeneca, Bristol-Myers Squibb, Gedeon Richter Bulgaria, Innova-Pharma, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer, and Pierre Fabre, for services not related to this abstract

Group Psychoeducation to Improve Cognitive Emotion Regulation in Nigerian Women with Breast Cancer

ABSTRACT Breast cancer is a life-altering stressor requiring patients to use a variety of psychosocial strategies to cope. Patients employing maladaptive cognitive coping strategies are likely to experience detrimental effects in their lives. Studies of group psychoeducation (GPE) interventions and its effects on positive and negative cognitive emotion regulation are scarce, especially in low- and middle-income countries (LMICs) such as Nigeria. The present study investigated the effect of eight weeks of a GPE intervention on cognitive emotion regulation (CER) among a single group of Nigerian women with breast cancer. Twenty-eight women with breast cancer were randomly allocated to one of two conditions: a treatment group (TG, N = 15) and a control condition (CC, N = 13). The TG received eight weeks of GPE sessions, which included a 90-minute session per week, while the control condition (CC) included only a psychoeducational pamphlet. Assessments were carried out at baseline, posttreatment and 2-month follow-up with measures of CER Questionnaires. Data were analyzed using an independent sampled t test and chi square. The effect size was estimated with standard mean difference (SMD) and 95% confidence interval. The results showed that TG participants had a significant improvement in adaptive CER (acceptance and positive reappraisal) in posttest and at 2-month follow-up compared to CC. Participants in TG also showed a significant decrease in maladaptive CER (self-blame, rumination and catastrophizing) relative to CC at posttest and 2-month follow-up. Group psychoeducation is an effective psychosocial treatment for better CER management of breast cancer. Group psychoeducation may be integrated as an adjunct therapy in the management of cancer patients, especially in Nigeria oncology, to improve the quality of life of patients and increase their survival rate.

The additive value of continuous positive airway pressure treatment on psychological symptoms

ABSTRACT Objective To screen psychological problems of patients with obstructive sleep apnea syndrome (OSAS) by utilizing the psychological symptom screening test Symptom Checklist-90-Revised (SCL-90-R) and to evaluate the effect of continuous positive airway pressure (CPAP) treatment. Methods The SCL-90-R and Epworth Sleepiness Scale (ESS) test were applied to 66 patients with Apnea-Hypopnea Index (AHI ≥ 30/h) using CPAP device and 20 healthy individuals; the test results were compared. Results The age of the patients ranged from 28 to 67 years, and the patient group comprised 54 males (81.8%) and 12 females (18.2%). The AHI scores ranged from 30.05 to 99.80, with a mean of 49.34 ± 21.40. Significant improvement was seen in 6 of the 11 SCL-90-R scores in CPAP-treated patients. Conclusion The authors conclude that the SCL-90-R test may be appropriate for evaluating the response to CPAP treatment in OSAS patients and monitoring the psychosocial effects of treatment.

Parenting under pressure: A mixed-methods investigation of the impact of COVID-19 on family life.

Backgrounddevelopment and implementation of effective family-based psychosocial intervention and treatment strategies during COVID-19 will require a detailed understanding of how the virus has impacted the lives of families.Methodswritten reports on the life impacts of COVID-19 for parents (n = 56) and their children (n = 43), and a questionnaire assessing parent positive and negative affect, were collected between April and May 2020. An inductive approach was used to identify themes in written reports, followed by statistical analysis to explore associations between themes and changes in parent positive and negative affect pre- and post-writing.Resultsparents and children reported both positive and negative psychosocial impacts of the virus, though parents expressed a greater diversity of positive themes than children. Common themes reported by parents included concerns about the impact of COVID-19 on their children, health concerns for others, and the stressful balancing act of parenting, assisting with children's school work, and working from home. Many parents reported gratitude, and reflected on the upsides of the pandemic for family relationships and parent-child bonding. Parents who expressed gratitude reported a decrease in negative affect pre- to post-writing. Common child-reported themes included yearning to return to school, pandemic-related fears, and longing for social connection.Limitationsthe sample included a cross-section of mostly White (non-Hispanic), dual income, well-educated mothers, primarily from the United States.Conclusionsboth parents and children reported reduced wellbeing during the COVID-19 pandemic. Future research should focus on identifying how to fulfill children's social needs and lessen caregivers’ burdens during this time.

Feasibility, Acceptability, and Considerations for Sustainability of Implementing an Integrated Family-Based Partial Hospitalization Program for Children and Adolescents with Mood Disorders

ABSTRACT There are many clinically effective outpatient psychosocial treatments for youth with mood disorders, and many of them include engaging caregivers in treatment. Despite the prevalence and severity of impairment related to mood disorders, there is a dearth of research addressing implementing evidence-based treatment (EBT) models for youth with mood disorders in intensive outpatient programs (IOP) or partial hospitalization programs (PHP). The current study provides preliminary results on the feasibility, acceptability, considerations for sustainability, and consumer satisfaction of youth and their caregivers who attended the Child and Adolescent Integrated Mood Program (CAIMP), a two-week family-based PHP for youth ages 9–18 with mood disorders. The feasibility, acceptability, and sustainability of CAIMP are addressed by reviewing access, utilization, insurance coverage, and participant satisfaction. High attendance and low attrition rates were found. Youth and caregivers reported positive outcomes of attending the program as a family unit. Access, utilization, and patient insurance coverage were favorable and suggest the potential for program sustainability. Preliminary results suggest a two-week family-based PHP is accepted and tolerated by youth and their caregivers, referred to by a range of providers, and supported by a variety of payor sources. Youth and caregivers reported positive elements of the program. The current PHP model shows promise for being an important addition to the treatment options for youth with severe mood disorders and their families.

Community Re-integration of a Person with Schizophrenia and Poor Family Support

Community re-integration is an integral part of treating persons with mental illness. Especially in India, presence of family support facilitates the process of community integration. Several initiatives are available now for effective integration for the homeless mentally ill back to their families, people with severe mental illness in the community and long stay in-patients in mental hospitals. However, in the absence of family support and community resources, community re-integration of a person with severe mental illness, like schizophrenia, can be highly challenging. This case reflects the challenges in the process of community re-integration in a person with schizophrenia, who was managed by a multi-disciplinary team at a tertiary care centre in Bengaluru, India. While close monitoring of the case was helpful in maintaining improvement, lack of community resources was one of the major challenges in the process of community re-integration. The case also highlights that if long-stay psychiatric facilities/ hospitals can offer a safe, supportive and stimulating environment, they can be useful to plan effective psychosocial treatments and interventions for community re-integration than just for custodial care.

Effective Treatment Interventions for Global Mental Health: An Analysis of Biomedical and Psychosocial Approaches in Use Today

We are in an important moment for mental health treatment around the world, as many Low and Middle Income Countries (LMICs) – representing an increasing majority of the world’s population – are currently developing and scaling up services for the first time. Yet, research on Global Mental Health (GMH) best practices remains scattered and difficult to synthesize. This review aims to simplify existing GMH research on effective biomedical and psychosocial treatment approaches from both high-income countries and LMICs to enable a more comprehensive understanding of the benefits and drawbacks of existing interventions, based on the highest quality, up-to-date research. By understanding which treatments are most effective and why, we can begin to not only implement more effective practices, but guide the future of GMH research in the right directions. The purpose of this review is therefore to understand mental illness, what it is, how it was treated in the past, how it manifests differently around the globe, and how to best treat it. Ultimately, while psychosocial approaches are advised for patients with more mild to moderate disorders, medications and other biomedical approaches are recommended increasingly only for more severe cases. While significant evidence exists to justify the use of psychotropic medications for mental illness, their adverse effects indicate that psychosocial approaches should be prioritized as first line treatments, particularly for mild to moderate disorders. As one of the first to analyze this research, this review is useful not only for GMH scholars, but for practitioners and public health workers globally, as well.

Predicting Pain Catastrophizing of Women with Breast Cancer Based on Perceived Injustice and Past Time Perspective

Background: Pain experience is still the most important problem in women with breast cancer that could lead to psychological problems. There is notable literature that revealed perceived injustice, time perspective, and pain catastrophizing are associated with the same psychological variables and health-related behaviors. Objectives: This study aimed at predicting pain catastrophizing based on a perceived injustice and past time perspective in women with breast cancer. Methods: The present study was descriptive-correlational in terms of method. The statistical population consisted of all women aged 20 to 50 years with a breast cancer diagnosis in 5 hospitals in Tehran, Iran (Emam Khomeini, Hazraterasol, Mohebmehr, Shahram, and Khatam). A total of 142 voluntary patients were selected through the available sampling method. The instruments of the study included the Zimbardo Time Perspective Inventory (ZTIP), The Injustice Experiences questionnaire (IEQ), and the Pain Catastrophizing scale (PCS). The data was analyzed, using Pearson correlation and step by step regression and path analysis. Results: The results showed that perceived injustice, past negative, and past positive had a significant relationship with pain catastrophizing. The perceived injustice, past negative, explained approximately 72% of the variance of pain catastrophizing. Also, perceived injustice is a mediator variable between past negative and pain catastrophizing. Conclusions: Overall, the results of this study support the role of past negative time perspective and perceived injustice in predicting pain catastrophizing in women with breast cancer. Since pain is experienced in a complex social and cultural milieu, there is a great value for identifying variables that might mitigate or exacerbate perceived pain and could contribute greatly to the development of more effective psychosocial treatments. Therefore, dealing with past negative time perspective and perceived injustice can prevent pain catastrophizing and, consequently, perceived pain and its intensity could be decreased.

Parenting Under Pressure: A Mixed-Methods Investigation of the Impact of COVID-19 on Family Life

Background: ​Development and implementation of effective family-based psychosocial intervention and treatment strategies during COVID-19 will require a detailed understanding of how the virus has impacted the lives of parents, children, and families.Methods: ​Written reports on the life impacts of COVID-19 for parents (n=56) and their children (n=43), and a questionnaire assessing parent positive and negative affect, were collected between April and May 2020. An inductive approach was used to identify themes in parents’ and children’s written reports, followed by statistical analysis to explore associations between themes and changes in parent positive and negative affect pre- and post-writing.Findings: ​Parents and children reported both positive and negative psychosocial impacts of the virus, though parents expressed a greater diversity of positive themes than children. Common themes reported by parents included concerns about the impact of COVID-19 on their children (particularly their social development), health concerns for others (particularly elderly family members), and the stressful balancing act of parenting, assisting with children’s school work, and working from home. Many parents reported gratitude for what they had, and reflected on the upsides of the pandemic for family relationships and parent-child bonding. Parents who expressed gratitude in their writing also reported a decrease in negative affect pre- to post-writing. Common themes reported by children included yearning to return to school, pandemic-related fears and difficulties, and longing for social connection.Interpretation: ​Within a largely White middle-class population, both parents and children reported reduced wellbeing during the COVID-19 pandemic. Future research and policy should focus on identifying how to fulfill children’s social needs and lessen caregivers’ burdens during this time.Funding: ​NoneDeclaration of Interests: The authors declare no conflicts of interest.Ethics Approval Statement: The study protocol was approved by the Institutional Review Board at the University of California, Los Angeles.

EMBRACING DISCOMFORT AND DISTRESS: CONVENTIONAL AND INNOVATIVE APPLICATIONS OF EXPOSURE TREATMENT

Exposure-based treatments are among the most effective psychosocial treatments. Regrettably, the use of exposure-based procedures in treatment-as-usual settings is less than optimal. Knowledge, skill, and attitudinal barriers truncate proper application. As a result, this Clinical Perspectives presentation aims to increase the implementation, scale, and sustainability of exposure-based treatments by providing attendees with state-of-the-science findings and practical applications. These goals match the conference themes, emphasizing translational research to improve clinical care, training programs, and service delivery systems.

Psychosocial treatment for methamphetamine use and the associated mental health symptoms

Purpose Methamphetamine users commonly experience induced methamphetamine associated mental health symptoms. Currently, psychosocial treatment is implemented to reduce use; however, to date, the effectiveness of psychosocial treatment in methamphetamine use and the associated mental health symptoms has not been reviewed. The paper aims to discuss this issue. Design/methodology/approach A systematic literature review was performed by searching databases (PubMed, Embase, Ovid MEDLINE, PsychINFO and CINAHL) and following clear inclusion/exclusion criteria. Findings In total, 12 studies met the inclusion/exclusion criteria, measuring a variety of psychosocial interventions and measuring a variety of different mental health outcomes. Decreased methamphetamine use was observed in the five studies which recorded this. Research limitations/implications Most studies in this review were preliminary trials and only three were RCTs. Additionally, methamphetamine use is a particular problem in Japan and is becoming more prevalent in Europe, yet neither primary nor secondary searching identified papers from these regions. Practical implications While the findings may not provide sufficient supporting evidence to instigate changes in clinical practice, this work should be developed further, as it is clear that psychosocial interventions can be successful in treating this population. Social implications This review demonstrates that psychosocial treatments can improve symptoms associated with methamphetamine use. Reduction in mental health symptoms has been shown to attract individuals to drug use treatment and thus indirectly reducing methamphetamine use. Originality/value Given the consequences of methamphetamine for individuals and communities treatment options must be explored. A review of psychosocial interventions in the treatment of methamphetamine use and associated mental health symptoms had not been done previously. This review provides a foundation for further research.

Effects of an epilepsy-specific Internet intervention (Emyna) on depression: Results of the ENCODE randomized controlled trial.

Depression and anxiety are highly prevalent among people with epilepsy (PwE) but often remain unrecognized and treated inadequately. Effective psychosocial treatments such as cognitive behavioral therapy (CBT) are rarely available to most PwE, which is one reason electronically delivered CBT (eCBT) is regarded as promising. This study examined an eCBT intervention, termed Emyna, that was tailored to suit the needs of PwE. It includes CBT-related content on depression, stress and anxiety, seizure triggers and auras, and lifestyle habits. The trial examined the efficacy of Emyna in reducing symptoms of depression (primary outcome) and anxiety as well as improving quality of life. Participants (N=200) with epilepsy, a diagnosis of a depressive disorder, and at least moderate depressive symptoms were randomized to Emyna or care as usual. At baseline and after 3, 6, and 9months, participants were invited to complete online questionnaires. The primary outcome was improvement of depressive symptoms at 3months. Relative to the control group, intervention group participants experienced significantly greater improvements in depression, anxiety, stress, social-occupational impairment, and epilepsy-related quality of life, in both intention-to-treat (ITT) and per-protocol analyses. In ITT analyses, effects of medium magnitude were observed, as measured by the Patient Health Questionnaire-9 items (Cohen d=0.54, 95% confidence interval [CI] = 0.25-0.82, P<0.001) and the Neurological Disorders Depression Inventory for Epilepsy (d=0.51, 95% CI = 0.23-0.79, P<0.01). At 3months, intervention group participants also reported fewer illness-related days off work and fewer days hospitalized over the preceding months, compared to control group participants (P≤0.05), whereas no such differences were present at baseline (P>0.30). These findings showed that Emyna, used adjunctively to usual care, could help improve mental health, social-occupational functioning, and quality of life among PwE. The program provides an additional treatment option that could produce clinically relevant symptom reductions and reduce key cost drivers (ie, hospitalization rates and illness-related inability to work).

Systematic Reviews of Mindfulness and Acceptance and Commitment Therapy for Alcohol Use Disorder: Should we be using Third Wave Therapies?

Third wave therapies have shown efficacy for treating emotional disorders and potential for treating substance use disorders. There is developing interest in whether they can more specifically be used for treating alcohol use disorders (AUDs). We were interested in whether third wave therapies have value alongside current evidence-based psychosocial treatments for AUDs. We conducted systematic reviews of third wave therapies for AUDs. We searched PsycINFO, Embase and Medline for peer reviewed journal articles where mindfulness or Acceptance and Commitment Therapy (ACT) were used to treat adults with AUDs or alcohol use that caused impairment. We identified 11 studies where mindfulness was used for treating AUDs and 6 where ACT was used for AUDs. The studies identified included RCTs, non-randomized controlled studies and uncontrolled studies. We found preliminary support that both third wave therapies are better than no treatment, treatments of minimal efficacy, as well as some evidence they are comparable to effective psychosocial treatments for AUDs. We conclude ACT and mindfulness provide an alternative to existing treatments, particularly for patients who have not responded to, or have disengaged from, standard treatments. We also found some evidence ACT and mindfulness are useful for comorbid mental health conditions. Yet while these results are promising, further research is needed to determine their utility, ideally employing randomized-controlled designs, larger clinical samples and longer follow-ups. Furthermore, few studies in this review directly compared third wave therapies to first line treatments, making it difficult to determine their relative efficacy.

\u201cSong of Life (SOL)\u201d study protocol: a multicenter, randomized trial on the emotional, spiritual, and psychobiological effects of music therapy in palliative care

BackgroundAlthough patients in palliative care commonly report high emotional and spiritual needs, effective psychosocial treatments based on high quality studies are rare. First research provides evidence for benefits of psychosocial interventions in advanced cancer care. To specifically address end-of-life care requirements, life review techniques and creative-arts based therapies offer a promising potential. Therefore, the present study protocol presents a randomized controlled trial on the effectiveness of a newly developed music therapy technique that is based on a biographically meaningful song (“Song of Life”; SOL).MethodsIn a design with two parallel arms, 104 patients at two palliative care units will be randomly assigned to three sessions of either SOL (experimental group) or relaxation exercises (control group). Improvements in the psychological domain of quality of life will be the primary endpoint, while secondary outcomes encompass spiritual well-being, ego-integrity, overall quality of life, and distress. Additionally, caregivers will be asked to provide feedback about the treatment. Assessment of biopsychological stress markers and qualitative analysis of perceived strengths and weaknesses will complement data collection.DiscussionBased on the results of a previous pilot study, we dedicated considerable efforts to optimizing the intervention and selecting appropriate outcomes for the present trial. We are confident to have designed a methodologically rigorous study that will contribute to the evidence-base and help to develop the potential of psychosocial interventions in palliative care.Trial registrationGerman Clinical Trials Register (DRKS) – DRKS00015308 (date of registration: September 07th 2018).