Psychosocial Group Research Articles

Lessons Learnt From the First Year of a First-of-Its-Kind Breast Cancer Patient Psychosocial Support Group in Ethiopia and Promising Practices for Initiation and Implementation of Survivor Support Programs in Low-Resource Settings

PURPOSE Psychosocial support helps cancer patients adjust to diagnosis and treatment and improve their overall well-being. With few resources committed to cancer prevention and treatment in Ethiopia, patients’ and survivors’ mental health needs are frequently disregarded, resulting in low quality of life. In October 2020, a support group for breast cancer (BC) patients was formed at Adama Hospital Medical College (AHMC), the first of its kind in Ethiopia. Here, we reflect on lessons learnt from the first year of implementation and share promising practices for establishing such groups in low-resource settings. METHODS The founder and facilitators of the AHMC BC patient and survivor support group describe the program and critically reflect on its impact, challenges to implementation, lessons learned, and ideas for further improvement. Ng and Colombani’s framework for selecting best practices in public health (2015) is used to organize key themes. RESULTS One Saturday each month, 20-30 patients and survivors gather with a traditional Ethiopian coffee ceremony. Participants report feelings of empowerment, hope, and confidence, a stronger sense of interconnectedness with others, and increased engagement in social activities. One notable success was the advocacy opportunity for the women to speak with hospital administrators and Ministry of Health officials at a BC Awareness Month celebration this year. Implementation challenges include a lack of funding, lack of a trained psychologist, and ethical uncertainty about distress caused when members die (not uncommon as patients typically present with advanced stage disease). Clinicians have learned important lessons about patients’ lay beliefs and consequently, patient counseling has been improved to incorporate topics of diet, sexuality, and pregnancy. CONCLUSION A first-of-its-kind BC patient and survivor support group improves perceived psychosocial well-being and quality of life for women in Ethiopia. The low-cost program shares promising practices for survivor support groups and patient-centered cancer treatment in low-resource contexts.

Children with cancer and their families after active treatment: analyses of biopsychosocial needs and implications for healthcare – a study protocol

IntroductionPatients and families affected by paediatric cancer experience psychosocial burden not only during active treatment but also during follow-up care. Use of health services during follow-up treatment should be organised...

Modifiable psychosocial risk factors and delayed onset of dementia in older populations: analysis of two prospective US cohorts

ObjectivePreventing Alzheimer’s dementia (AD) fundamentally equates to delaying onset. Thus, we quantified associations of modifiable, psychosocial risk factors to years of delayed onset of dementia.DesignTwo prospective cohorts (n=2860) with negative...

LeiP#netz 2.0: mapping COVID-19-related changes in mental health services in the German city of Leipzig

PurposeThe purpose of the study was to investigate the changes in psychosocial and psychiatric services in the German city of Leipzig during the COVID-19-pandemic.MethodsA participatory, mixed-methods study was used involving a quantitative online survey and qualitative semi-structured interviews with professionals. Quantitative findings were reported with descriptive statistics, and thematic analysis was conducted for qualitative data.ResultsFifty professionals from various mental health services participated in the survey and eleven professionals were interviewed. Quantitative findings showed that some services were closed intermittently and that there was a stiff increase in use of digital/telephonic service and a decrease in face-to-face services. Staff or funding did not change considerably during the pandemic. Psychosocial groups were suspended or reduced, while access to services became more difficult and professional training for staff was stopped. Thematic analysis of the interviews showed that professionals experienced different phases and levels of change during the pandemic, including changes on a structural level, on the users’ level, and on the staff’ level. Professionals particularly criticised the equivocality of COVID-19 regulations, a defective flow of information and lack of attention for mental healthcare in public policies. They also saw positive aspects, such as the capacity of users and the outpatient care system to adapt to the new situation.ConclusionThis study suggests directions for policy and service development, such as communicating clearly in infection-control measures, fostering outpatient care and networks between services.

Effects of an immersive psychosocial training program on depression and well-being: A randomized clinical trial

Psychiatry stands to benefit from brief non-pharmacological treatments that effectively reduce depressive symptoms. To address this need, we conducted a single-blind randomized clinical trial assessing how a 6-day immersive psychosocial training program, followed by 10-min daily psychosocial exercises for 30 days, improves depressive symptoms. Forty-five adults were block-randomized by depression score to two arms: (a) the immersive psychosocial training program and 10-min daily exercise group (36 days total; total n = 23; depressed at baseline n = 14); or (b) a gratitude journaling control group (36 days total; total n = 22; depressed at baseline n = 13). The self-report PHQ-9 was used to assess depression levels in both groups at three time points: baseline, study week one, and study week six. Depression severity improved over time, with a significantly greater reduction in the psychosocial training program group (−82.7%) vs. the control group (−23%), p = 0.02 for baseline vs. week six. The effect size for this reduction in depression symptoms was large for the intervention group (d = −1.3; 95% CI, −2.07, −0.45; p < 0.001) and small for the control group (d = −0.3; 95% CI, −0.68, 0.03; p = 0.22). Seventy-nine percent (11/14) of depressed participants in the intervention condition were in remission (PHQ-9 ≤ 4) by week one and 100% (14/14) were in remission at week six. Secondary measures of anxiety, stress, loneliness, and well-being also improved by 15–80% in the intervention group (vs. 0–34% in the control group), ps < 0.05. Overall, this brief, immersive psychosocial training program rapidly and substantially improved depression levels and several related secondary outcomes, suggesting that immersive interventions may be useful for reducing depressive symptoms and enhancing well-being.

Examining the association between group context effects and individual outcomes in an interdisciplinary group-based treatment for chronic pain based on acceptance and commitment therapy.

BackgroundAlthough cognitive-behavioural treatments for chronic pain are delivered in groups, there is little research investigating group effects in these treatments.PurposeThe aim of this study was to investigate associations between group composition variables at the start of treatment and individual outcomes following intensive interdisciplinary treatment for pain based on Acceptance and Commitment Therapy.MethodsThis was a secondary analysis of routinely collected observational data. Five-hundred and sixteen patients completed a standard set of demographic, pain-related and psychosocial measures at pre- and post-treatment. Intracluster correlations (ICCs) were computed to examine the clustering of outcomes within groups and multilevel models explored the association between group composition variables and individual level outcomes.ResultsThe ICCs for pain intensity (0.11) and interference (0.09) suggested that multilevel models were warranted for these outcomes, while a multilevel model for post-treatment depression (ICC = 0.04) was not warranted. Group percentage of participants receiving disability benefits and group mean pain intensity at pre-treatment were significantly positively associated with individual level pain intensity at post-treatment, controlling for pre-treatment individual level pain intensity. Group mean pain intensity at pre-treatment was the only group variable that significantly predicted post-treatment pain interference at the individual level. Psychosocial group composition variables were not significantly associated with individual level outcomes.ConclusionGiven the limited predictive utility of group composition variables in the current study, future research should undertake direct assessment of group level therapeutic and countertherapeutic processes to advance understanding of who benefits from group treatments for pain and how. As the variance in outcomes accounted for by group clustering was relatively small and significant within groups variance remained, research is also needed to further understand individual level factors that influence cognitive-behavioural treatment outcomes for pain.

Ambient particulate air pollution, blood cell parameters, and effect modification by psychosocial stress: Findings from two studies in three major Chinese cities

The associations between particulate matter (PM) exposure, psychosocial stress and blood cell parameters are bringing novel insights to characterize the early damage of multiple diseases. Based on two studies conducted in three Chinses cities using cross-sectional (Beijing, 425 participants) and panel study (Tianjin and Shanghai, 92 participants with 361 repeated measurements) designs, this study explored the associations between short-term exposure to ambient PM and blood cell parameters, and the effect modification by psychosocial stress. Increasing PM2.5 exposure was significantly associated with decreases in red blood cell (RBC) count and mean corpuscular hemoglobin concentration (MCHC), and increases in mean corpuscular volume (MCV), platelets count (PLT) and platelet hematocrit (PCT) in both studies. For instance, a 10 μg/m3 increment in PM2.5 concentration was associated with a 1.04% (95%CI: 0.16%, 1.92%) increase in PLT (4-d) and a 1.09% (95%CI: 0.31%, 1.87%) increase in PCT (4-d) in the cross-sectional study, and a 0.64% (95%CI: 0.06%, 1.22%) increase in PLT (1-d) and a 0.72% (95%CI: 0.33%, 1.11%) increase in PCT (1-d) in the panel study, respectively. In addition, stronger increases in MCV, PLT, and PCT associated with PM2.5 exposure were found in higher psychosocial stress group compared to lower psychosocial stress group (p for interaction <0.10), indicating that blood cell parameters of individuals with higher psychosocial stress might be more susceptible to the early damages of PM2.5 exposure.

Delivery of an online psychosocial recovery program during COVID-19: A survey of young people attending a youth mental health service.

AimsThe COVID‐19 pandemic forced the rapid move of mental health services to being delivered online. This included the delivery of a psychosocial recovery program (PRP) delivered in youth mental health services in Melbourne, Australia which consists of groups that address functional recovery. At the time, there was limited evidence about how this switch in service provision would be received by service users or what impact the pandemic was having on their mental health.MethodsYoung people engaged with the PRP between March and May 2020 were sent a link to complete an online survey that was co‐developed by young people and clinicians. Attendance data at groups were extracted as a proximal measure of feasibility and acceptability.ResultsA total of 44 young people undertook the survey with the domains of wellbeing most impacted by lockdown being work/study, motivation and social connection. Groups provided online were generally well attended during lockdown, particularly those that had a focus on therapeutic content. Young people indicated little preference for continuing to attend groups run purely online when restrictions eased, with many expressing a preference for these to be offered face‐to‐face or in a combined format.ConclusionsThese findings suggest that implementation of online psychosocial groups during periods of lockdown is both feasible and acceptable. Whilst young people found accessing groups online to be of benefit at the time, they felt that continued substitution of face‐to‐face groups would not necessarily be preferable and clinical services should consider these preferences in their long‐term service delivery.

Xeroderma pigmentosa: a report of three paediatric cases in Eastern Zambia, and review of the literature of this rare condition amongst sub-Saharan Africans (case report)

The diagnosis and management of xeroderma pigmentosa (XP) remains a challenge in sub-Saharan Africa due to limited health care access, lack of specialist care and weak diagnostic testing. The purpose of this paper is to highlight the importance of clinical approach in the diagnosis of XP in a low resource setting and to discuss some of the challenges these patients face living with XP. Three cases of children who presented with signs and symptoms of XP are discussed; their case histories are notable for demonstrating some of the challenges of managing the condition in sub-Saharan Africa. Management of XP is particularly complicated by the fact that there is no known cure for the condition and the need for complete shielding from ultraviolet (UV) light in a region with warm weather and abundant sunshine. A previously unreported effect of XP on the patients and their families is stigma and social exclusion. Setting up of, and linking the clients to psychosocial support groups would be of great benefit in alleviating the psychological effects of the disease.

Association of Menstrual cycle with Suicide in Female of Reproductive Age Group: A Hospital based Prospective Study using Histological Technique

Suicide attempt and suicidal death among women of reproductive age group are very common in INDIA. Different socio-economic factors along with psychological ups and downs are leading cause. Aims of the study is to find out relation between female suicide and various demographic factors like age, marital status, time of attempt and also to find out association between female suicide and phases of menstrual cycle by histological study of uterus. Hormonal changes throughout menstrual cycle leading to premenstrual syndrome can be a precipitating factor. A prospective cross sectional observational study conducted on 91 women who committed suicide between 15 to 45 years age group. Tissue from uterus collected, processed, sectioned, stained and examined under microscope to identify phase of menstrual cycle. Data is expressed in frequency distribution table and chi-square test done to detect statistical significance. Most of the women were between 18 to 30 years age group, married, committed suicide between 6 am to 6 pm and adopted burn for the purpose. 63.8% (approximately 2/3rd) women committed suicide during secretory phase. Association between phase of menstrual cycle and age of victim, marital status was statistically significant (P value < 0.05). Suicidal rate can be minimized by proper education, counselling, psychiatric evaluation, psychosocial group therapy and also by reducing domestic violence and substance abuse.

Causal Mediation of Stress Reduction in Family Dementia Caregivers: A Focus on Mindfulness

Although mindfulness therapies have demonstrated benefits for reducing stress and improving psychological symptoms in family dementia caregivers, the mechanisms underlying these salutary effects are unknown. We report a causal mediation pathway to improvement of stress symptoms in family dementia caregivers with Mentalizing Imagery Therapy (MIT), which employs mindfulness and guided imagery tools to reduce stress and improve understanding of self and others. In a randomized controlled trial of short-term 4-week MIT (N=24) versus a psychosocial support group (N=22), MIT demonstrated superior benefit for reducing perceived stress (p=.006). Increased trait mindfulness was a causal mediator of this effect (p=.02). Neuroimaging pre and post intervention found that increased mindfulness was associated with strengthened connectivity of the dorsolateral prefrontal cortex with an emotion regulation network (p<.001). The results are discussed in light of theories of cognitive control and may inform the design of future studies aimed at reducing family caregiver stress.

Research policy in supportive care and palliative care for cancer dyspnea.

BackgroundDyspnea is a common and distressing symptom in patients with cancer. To improve its management, multicenter confirmatory studies are necessary. Research policy would be useful in conducting these studies. Here, we propose a new research policy for the management of dyspnea in patients with cancer.MethodsThe first draft was developed by a policy working group of 11 specialists in the field of supportive care or palliative care for dyspnea. Then, a provisional draft was developed after review by a research support group (the Japanese Supportive, Palliative and Psychosocial Care Study Group) and five Japanese scientific societies (Japanese Association of Supportive Care in Cancer, Japanese Society of Medical Oncology, Japanese Society of Palliative Medicine, Japanese Association of Rehabilitation Medicine and Japanese Society of Clinical Oncology), and receipt of public comments.ResultsThe policy includes the following components of research policy on dyspnea: (i) definition of dyspnea, (ii) scale for assessment of dyspnea, (iii) reason for dyspnea or factors associated with dyspnea and (iv) treatment effectiveness outcomes/adverse events. The final policy (Ver1.0) was completed on 1 March 2021.ConclusionsThis policy could help researchers plan and conduct studies on the management of cancer dyspnea.

An evaluation of the psychosocial group programme at an inpatient detoxification and stabilisation unit: a service improvement project

PurposeThe benefits of including a psychosocial group programme alongside a medical inpatient detoxification and stabilisation regime has been recognised within addiction research; however, a “gold standard” psychosocial intervention has not been established. This small-scale study aimed to evaluate the psychosocial group (“Straight Ahead”) currently running at a substance use inpatient unit based in the UK.Design/methodology/approachA mixed-methods questionnaire design aimed to capture service user perspectives of the group programme via a questionnaire and assess whether an individual’s recovery capital and emotion regulation scores improved during their stay.FindingsThirty-four service users participated in the evaluation. Results indicate the group significantly increased individuals’ recovery capital scores; however, it did not significantly improve emotion regulation. The three themes from the qualitative results focused on the importance of shared experiences, learning of new skills and the group as a positive experience. Service users provided suggestions for improvements, and these informed the provision of service-specific recommendations for the team and project commissioner.Originality/valueThe evaluation provides tentative support for the use of the Straight Ahead programme and provides an insight into what service users find helpful when attending a psychosocial group during an inpatient detoxification admission.

The development of a cognitive rehabilitation and psycho-social group programme for teenage and young adult survivors of brain tumours: A feasibility study.

Treatment for childhood and adolescent brain tumours is often intensive, with significant neurocognitive and psycho-social late effects (Zeltzer et al., 2009). This feasibility Study aimed to inform the development of a cognitive rehabilitation and psycho-social group intervention for Teenage and Young Adult (TYA) survivors of brain tumours. A group-based intervention incorporated ideas from the current evidence base, including psychoeducation and compensatory strategy training, with a focus on real-life goals and improving quality of life. Participants (N = 19, 13-24 years) were recruited from the University College London Hospital TYA Oncology Service. Participants had received treatment for a malignant brain tumour and had completed their treatment at least 1 year prior to participation. Four group-based, whole-day interventions ran every 3 months throughout a year. Feasibility criteria were established to answer questions about acceptability of the intervention and recruitment. Qualitative and quantitative feedback from all four groups demonstrated acceptability and suitability of the intervention with regards to the content, structure and delivery. Recruitment presented more of a challenge with 35% fewer referrals than expected. Feedback suggests that the intervention is suitable and acceptable, whilst limitations include numbers of referrals and referral pathways. Future directions are discussed.

A reproductive justice response to HIV/AIDS and COVID-19

Lana is a young Black woman living with HIV in Kingston, Jamaica. A mother of young children, she was concerned about what COVID-19 would mean for her pre-existing diagnosis. During the COVID-19 pandemic she has struggled to find psychosocial support groups, consistent access to antiretrovirals, and employment opportunities to maintain her health and support herself and her family. Pam, a middle-aged HIV-positive woman in Detroit, MI, USA, is a caregiver and local HIV organiser who provides emotional and social support to other newly diagnosed people.

Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Psychosocial factors are associated with the achievement of optimal cardiovascular disease risk factor (CVDRF) levels. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing psychosocial profiles among individuals with CVDRF. Further, it is unknown whether profiles are associated with achievement of CVDRF levels longitudinally. Therefore, we characterized psychosocial profiles of individuals with CVDRF and assessed whether they are associated with achievement of optimal CVDRF levels over 15years. We included 1148 CARDIA participants with prevalent hypertension, hypercholesterolemia and/or diabetes mellitus in 2000-2001. Eleven psychosocial variables reflecting psychological health, personality traits, and social factors were included. Optimal levels were deemed achieved if: Hemoglobin A1c (HbA1c) < 7.0%, low-density lipoprotein (LDL) cholesterol < 100mg/dl, and systolic blood pressure (SBP) < 140mm Hg. Latent profile analysis revealed three psychosocial profile groups "Healthy", "Distressed and Disadvantaged" and "Discriminated Against". There were no significant differences in achievement of CVDRF levels of the 3 targets combined across profiles. Participants in the "Distressed and Disadvantaged" profile were less likely to meet optimal HbA1c levels compared to individuals in the "Healthy" profile after demographic adjustment. Associations were attenuated after full covariate adjustment. Distinct psychosocial profiles exist among individuals with CVDRF, representing meaningful differences. Implications for CVDRF management are discussed.

Investigating of Psychosocial Effects Individual, Couple and Group Interventions in Infertility Counselling

Investigating of Psychosocial Effects Individual, Couple and Group Interventions in Infertility Counselling

Interdisciplinary clinician perspectives on an embedded palliative oncology model in pediatric cancer care.

9 Background: Integration of palliative care into cancer care is recognized as best practice by international oncology and pediatrics organizations. However, optimal strategies for integration of pediatric palliative care (PPC) within cancer care remain understudied. While the majority of PPC provision for cancer patients occurs through subspeciality consultation, growing evidence suggests that models embedding PPC within cancer care have the potential to improve quality of care. Embedded models rely on partnerships with multidisciplinary clinicians, whose perspectives regarding this model are not well known. Methods: We conducted 25 focus groups with 175 clinicians in an academic pediatric cancer center, with groups stratified by discipline (physicians, advance practice providers (APPs), nurses, psychosocial providers) and by care team (hematologic malignancy, bone marrow transplant, solid tumor, brain tumor). Focus groups were led by trained research facilitators and audio-recorded for subsequent targeted content analysis to identify clinician perspectives regarding embedded PPC models. Results: Across 4 physician, 5 APP, 12 nurse, and 4 psychosocial focus groups, 25 physicians, 30 APPs, 71 nurses, and 49 psychosocial providers participated, respectively. When asked to describe features of an “ideal” PPC model, physicians, APPs, and nurses predominantly discussed care delivery and identified early integration of PPC into cancer care as a core feature of an ideal model. Physicians, nurses, and psychosocial providers also emphasized the importance of having a formalized, structured care model. The need for collaboration was the dominant theme for psychosocial providers. Clinicians in all disciplines identified potential benefits from an embedded model, including access to PPC across care settings, normalization of PPC integration, and emphasis on collaboration, teamwork, communication, and earlier PPC involvement. Physicians, APPs, and nurses anticipated similar challenges with an embedded model, including possible reticence of oncology providers and inadequate PPC staffing. Nurses, APPs, and psychosocial providers also voiced concern about potential lack of clarity in delegation of roles and responsibilities between PPC and oncology providers. Conclusions: Pediatric oncology multidisciplinary providers recognize the potential value of an embedded model for integration of PPC in the care of children with cancer. Though providers at times identified similar themes with respect to ideal PPC provision and the benefits and challenges to an embedded model, some identified priorities varied by discipline. These findings highlight the importance of integrating varied interdisciplinary perspectives when developing an embedded care model to align with priorities of diverse pediatric cancer stakeholders.

Comparison of the Effects of a Genetic, a Mild Encephalitis, and a Psychosocial Causal Explanation of Schizophrenia on Stigmatizing Attitudes - a Pilot Study With a Quasi-Experimental Design.

Background: Previous research has shown that the endorsement of biogenetic causal explanations of schizophrenia is associated with stronger stigmatizing attitudes against people with schizophrenia than the endorsement of psychosocial explanations. However, little is known about whether different biogenetic causal explanation beliefs differentially affect stigmatizing attitudes. This is particularly valid for the endorsement of the mild encephalitis hypothesis of schizophrenia.Aim: To examine to what extent different causal explanations of schizophrenia influence the desire for social distance from persons with schizophrenia.Methods: A study with a prospective, quasi-experimental design was carried out with students in Germany (N = 333). A case vignette depicting a person with schizophrenia-typical symptoms was presented, and a social distance scale (SDS) was used to measure the stigmatizing attitude against the person described. Participants were randomly assigned to one of three groups receiving different causal explanations of schizophrenia (genetic, mild encephalitis hypothesis, or psychosocial) without treatment information.Results: A one-way ANOVA showed that the mean SDS was lowest in the group with the mild encephalitis hypothesis explanation, followed by the genetic explanation group, and highest in the psychosocial explanation group. However, the differences between the groups were small and not significant. A subanalysis revealed a significant interaction between gender and causal explanation. Women showed a significantly lower desire for social distance than men when receiving the mild encephalitis hypothesis. Neither the study discipline nor the number of semesters of study had significant effects on the mean SDS. The differences between the mean SDS scores for the different items were much bigger than the differences for the different causal explanations. Regardless of the causal explanation, the extent of the desired social distance depends strongly on social proximity.Conclusion: The present study fits into previous research, which has found that biogenetic beliefs were either associated with more social distance or did not yield a statistically significant association. Although we found a small gender-specific effect of the endorsement of the mild encephalitis hypothesis, we do not recommend gender-specific anti-stigmatization campaigns because they might rightly raise suspicions of dishonesty and manipulation. Rather we support recovery-oriented messages focusing on effective treatments.

Online psychosocial group intervention for adolescents with a chronic illness: A randomized controlled trial

ObjectiveThe present study aimed to evaluate the efficacy of Op Koers Online, a protocolled online psychosocial group intervention for adolescents with a chronic illness (CI). MethodsAdolescents (12–18 years) with different types of CI (N = 59; Mean age = 15.1 years, SD = 1.7; 54% female) participated in a parallel multicenter randomized controlled trial comparing Op Koers Online (N = 35) with a waitlist control group (N = 24). Assessments (online questionnaires) took place at baseline (T0), 6-months (T1) and 12-months follow-up (T2). Primary outcomes were internalizing and externalizing behavioral problems and disease-related coping skills. Health-Related Quality of Life was secondary. Efficacy was tested with linear mixed models. ResultsCompared to the control group, the intervention had a significant positive effect (p < .05) on disease-related coping skills T1 vs T0 (use of relaxation, β = 0.68; social competence, β = 0.57) and T2 vs T0 (information seeking, β = 0.61), and on HRQoL (social-, school-, psychosocial functioning and total HRQoL) T1 vs T0 (β = 0.52 to β = 0.60). No intervention effects on internalizing and externalizing behavioral problems were found. ConclusionThe results of this randomized controlled trial indicate a positive effect of Op Koers Online. The intervention had beneficial effects on disease-related coping skills and HRQoL. Practice implicationsThe next step is to implement Op Koers Online for adolescents in clinical practice.