Psychotherapeutic Interventions Research Articles

Intra- and interpersonal influences on child adjustment and resilience in welfare care: A qualitative study with former caregivers in Switzerland

Despite the growing research on child maltreatment within welfare care, few studies have included the caregivers who were involved in care provision and can provide insights on an intra- and interpersonal level. Therefore, this study aimed to examine intra- and interpersonal factors that promoted or hindered the adaptive adjustment and resilience of children in welfare care, from the previously neglected perspective of former caregivers. Qualitative semi-structured interviews were conducted with N = 12 Swiss former caregivers. Participants were 10 females and 2 males, aged between 58–91 years (mean age = 74.5 years). Interviews were audio-recorded, transcribed, and analyzed using framework analysis. Two themes emerged from the data on both the intrapersonal level (i.e., Core Characteristics, Coping), and interpersonal level (i.e., Caregiving Attitudes and Actions, Relationships and Attachment). Resilience hindering factors included emotion regulation difficulties, issues within the child-caregiver relationship (e.g., differential treatment, abuse and punitive measures, lack of affection and attachment), and placement disruptions. Resilience promoting factors included coping via creativity and imagination, and social and emotional support beyond the caregiver (e.g., siblings, animals). Results highlight key areas for action at the intra- and interpersonal levels, including psychotherapeutic interventions for children in care (e.g., addressing insecure attachment), and psychoeducation and mentoring programs to enhance caregiver reflective practices and improve care provision. Future research and practice should incorporate the caregiver perspective to develop the training and support for care staff and ensure the safeguarding of (current and future) children in welfare care.

Supportive psychotherapeutic intervention and video directing observed therapy to increase family adherence

To determine the effect of supportive psychotherapy and video-directing observed therapy interventions on family compliance in assisting patients with mental disorders in the working area of the Kabila Health Center, Bone Bolango District, Gorontalo City. Research design quasi-experimental design with a one group pre- and post-test design, where the variables to be measured are family adherence in providing treatment assistance, which are included in the dependent variable. The independent variables in this study were supportive psychotherapy and video-directed observation therapy. The sampling technique used was a total sampling technique with a sample size of 39 respondents. Data analysis was performed using univariate analysis, namely descriptive analysis (frequency, percentage, median, minimum value, and maximum value) and bivariate analysis (Wilcoxon test), with a significance level of <0.05, which was performed using SPSS version 25 software. Supportive psychotherapy and video-directing observed therapy increased family compliance accompanying the treatment of patients with mental disorders (p-value of x1=0.020, x2=0.000, p<0.05). Supportive psychotherapy interventions and video-directed observed therapy have been proven to increase family compliance in treatment assistance, which can improve the quality of life of patients with mental disorders.

Characteristics and Effectiveness of Individual Psychotherapy for Palliative and End-of-Life Care: A Literature Review for Randomized Controlled Trials

Objective The introduction of psychotherapy in palliative and end-of-life care settings has become increasingly common and is effective in decreasing many psychological problems. This review reports the characteristics and effectiveness of individual psychotherapeutic interventions for patients receiving palliative and end-of-life care. In addition, the review reports the effectiveness of psychotherapies considering the expected life expectancy.Methods The PubMed, Google Scholar, and Cochrane Library databases were searched for English-language articles published between January 2000 to May 2023.Results Twenty-six studies were included and classified into a total of nine types of psychotherapies, namely, dignity therapy (DT), life review therapy, narrative therapy, managing cancer and living meaningfully (CALM), individual meaning-centered psychotherapy, meaning and purpose therapy, meaning-making therapy, meaning-of-life therapy, and cognitive therapy.Conclusion Most of the psychotherapies provided to patients receiving palliative and end-of-life care showed effectiveness in the reduction of negative emotions and positive factors related to end-of-life issues. Most studies targeted patients with advanced cancer; however, studies on DT did not limit the target group to patients with cancer. Considering the expected life expectancy, CALM was found to be suitable for patients receiving early palliative care.

SLEEP QUALITY AND AVOIDANCE BEHAVIOR IN COMBATANTS WITH POST-TRAUMATIC STRESS DISORDER

Introduction. Post-traumatic stress disorder (PTSD) is often characterized by various symptoms that result in behavioral changes in patients, among which sleep disturbances and avoidant behavior are commonly observed. However, despite evidence indicating a complex bilateral relationship between emotions and sleep, only few studies have explored the associations between sleep disturbances and avoidant behavior in the context of PTSD. The aim of the study is to assess the severity of avoidant behaviour and insomnia in combatants with posttraumatic stress disorder. Materials and methods. We conducted a clinical study of 45 combatants who were divided into 2 groups: group 1 (n=24) included combatants with PTSD; group 2 (n=21) consisted of combatants without PTSD. The Pittsburgh Sleep Quality Questionnaire was used to analyse sleep quality, namely subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, sleep medication use, and daily dysfunction. Avoidance behavior was measured using a multidimensional experience avoidance questionnaire. Results. We found that group 1 demonstrated worse subjective sleep quality (p=0.002), longer sleep latency (p<0.001), lower sleep efficiency (p=0.019) and more severe sleep disturbances (p<0.001). There were no statistically significant differences between the groups in terms of sleep duration, severity of sleeping pills use, and daily dysfunction. The overall severity of sleep quality disorders was higher in group 1 compared to group 2 (p<0.001). Avoidance behavior (p=0.007) and repression and denial (p<0.001) were more pronounced in group 1 compared to group 2. At the same time, group 1 had lower stress endurance (p<0.001). The overall level of experiental avoidance in group 1 was higher than in group 2 (p<0.001). Numerous associations between sleep quality characteristics and experiental avoidance were found as well. Conclusions. The study has revealed that combatants with PTSD have more pronounced manifestations of behavioural avoidance, repression and denial, as well as a lower level of stress endurance. At the same time, combatants with PTSD demonstrate a deterioration in the subjective quality of sleep, a decrease in its effectiveness and an increase in the severity of its disturbances. It has been found that avoidance behavior in combatants has numerous connections with the characteristics of sleep quality that may be suggested as a potential factor for improving psychotherapeutic interventions.

A decolonized mental health framework for black women and birthing people

Black perinatal mental health is an area that has received less focus in psychotherapy research in the United States. This area is especially important as recent attacks on Reproductive Justice impact not only birthing people’s rights and freedoms but also their mental health and emotional well-being. Current psychotherapy interventions are rooted in evidence-based treatments (EBTs) that may not always align with the values and practices of frameworks like radical healing and liberation psychology that are meant to emphasize collective healing and empower individuals. To date, psychological research involving radical healing and liberation psychology approaches have not had a specific focus on birthing people. Psychotherapeutic interventions have also largely excluded the unique intersectional identities and healing of Black birthing people. In moving toward decolonizing psychotherapy, this conceptual paper will propose a multi-pronged framework for addressing racial stressors and other mental health concerns during the perinatal period. The proposed framework, The Three Cs of Decolonization, includes three components: Community, Creativity, and Connection to Self. These components of the framework are meant to address and highlight culturally relevant ways of healing for Black birthing people. Larger systemic changes are needed and necessary for the desired change across mental health, medical, and other integrated systems of care that have been impacted by racism and discrimination. The current framework is dedicated to healing and empowering Black birthing people with approaches and considerations that are consistent with Reproductive Justice.

The influence of pretreatment respiratory sinus arrhythmia dimensions on trauma-focused cognitive behavioral therapy outcomes: Findings from a randomized controlled feasibility trial.

Child maltreatment is associated with respiratory sinus arrhythmia (RSA) dysregulation, a physiological indicator of emotion regulation that predicts elevated posttraumatic stress disorder (PTSD) symptoms and may be a mechanism of action for exposure-based therapies, such as trauma-focused cognitive behavioral therapy (TF-CBT). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT for improving emotion regulation following maltreatment. The current study reports findings from a randomized controlled feasibility trial (N = 33; Mage = 11.79 years, SD = 3.08; 63.6% White; 66.7% female) that measured youths' resting RSA, RSA reactivity, and RSA recovery in response to a pretreatment laboratory challenge. We tested whether (a) lower pretreatment resting RSA was associated with blunted RSA during the challenge; (b) either of the pretreatment RSA dimensions predicted more severe pretreatment PTSD symptoms; and (c) either of the pretreatment RSA dimensions predicted less severe posttreatment PTSD symptoms and, as an exploratory aim, whether this was moderated by treatment group (i.e., TF-CBT vs. TF-CBT + AAT). Results from multiple linear regression indicated that, after controlling for pretreatment symptom severity, there was a large effect size for higher resting RSA predicting less severe caregiver-reported posttreatment PTSD symptoms, β = -.52, p =.058, and higher RSA during recovery predicting less severe child-reported posttreatment PTSD symptoms, β = -.70, p =.056, although these findings were not significant. These preliminary results offer important insights for future studies to investigate how the ability to regulate RSA informs which children need additional support to benefit from psychotherapeutic treatment.

Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis.

Background: This systematic review aggregates research on psychotherapeutic interventions for Post-Traumatic Stress Disorder (PTSD) in children and adolescents. PTSD in this demographic presents differently from adults, necessitating tailored therapeutic approaches. In children and adolescents, PTSD arises from exposure to severe danger, interpersonal violence, or abuse, leading to significant behavioral and emotional disturbances that jeopardize long-term development. The review focuses on describing PTSD within two age groups, children (6 to 12 years) and adolescents (12 to 18 years), while evaluating the effectiveness of various clinical interventions aimed at this condition. Methods: Utilizing the PRISMA guidelines, this review systematically examines studies that assess clinical interventions for PTSD in the younger population. Results: Key symptoms of PTSD in children and adolescents include avoidance, overstimulation, flashbacks, depression, and anxiety. The review identifies several effective treatments, including Cognitive Behavioral Therapy (CBT), Trauma-Focused CBT (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), Systemic Therapy, Play Therapy, Exposure Therapy, Relaxation Techniques, and Psychodynamic Psychotherapy. Particularly, TF-CBT is highlighted as the most effective and commonly used method in treating childhood and adolescent PTSD, as supported by most of the studies reviewed. Conclusions: A significant outcome of this study is the short-term effectiveness of CBT in reducing PTSD symptoms in children and adolescents. The findings underline the importance of psychotherapeutic interventions and mark a substantial advancement in understanding PTSD in young populations. It is crucial for practitioners to integrate various psychotherapeutic strategies into their practice to improve patient outcomes and treatment efficacy.

Meta-cognitive Therapy in Obsessive Compulsive Disorder: A Case Report

Psychotherapeutic developments in the management of anxiety disorders are evolving, with notable evidence in obsessive compulsive disorder (OCD). Third-wave therapies significantly contribute to the reduction in psychopathological symptoms and, thus, provide a positive turning point in the socio-occupational spectrum of the patient. One such third-wave approach is meta-cognitive therapy (MCT), which addresses cognitive attention syndrome (CAS) and directly prohibits ritualistic behavior, thereby decreasing the burden of symptoms. In India, it seems there is a dearth of literature exploring the effectiveness of MCT. The present case report provides a detailed insight into the psychotherapeutic treatment using MCT, in which 10 sessions were provided to an OCD patient along with pharmacotherapy. The treatment shows a noteworthy improvement in thought fusion, obsessional beliefs, meta-cognitive beliefs, and psychopathology. The symptoms gradually waned during the three- and six-month follow-up baseline period. Therefore, the case report demonstrates the effectiveness of combined medication and MCT in treating OCD. Additionally, it shows the potency of MCT in prolonged improvements in cognitive flexibility and inflated feelings of responsibility and perfection.

Experiences of schizophrenia patients with treatment buddy support during the COVID-19 pandemic

Background: Schizophrenia is a major psychiatric disorder affecting physical, psychosocial, and cognitive functioning. Treatment includes pharmacological and psychotherapeutic interventions. Adherence to prescribed medication is critical but reportedly low, because of side effects, failure to understand instructions, a lack of insight about the condition, cognitive deficits, and financial difficulties. Interventions to promote adherence to medication are required. This study introduced a treatment buddy to provide the patient with virtual support in adherence to medication.Aim: The aim of this study was to explore the participants’ lived experiences of a treatment buddy support.Setting: A specialised psychiatric clinic in a resource-constrained district of KwaZulu-Natal, South Africa.Methods: A qualitative study design, using semi-structured one-on-one interviews, was used to collect in-depth data from 24 participants, suffering from schizophrenia and who had been offered virtual treatment buddy support for 6 months. Data were analysed using thematic analysis.Results: The intervention improved adherence to medication. Participants indicated that the text messages served as reminders to take their medication daily. An alleviation of associated problems such as sleeping difficulties was observed. Participants were willing to encourage other patients suffering from schizophrenia to join ‘treatment buddy services’.Conclusion: The virtual treatment buddy support increased awareness of the importance to adhere to antipsychotic medications among patients suffering from schizophrenia and helped to resolve other schizophrenia-related problems experienced by the participants.Contribution: The study has provided a supportive intervention that can be utilised by mental health institutions to address poor adherence to medication by patients suffering from schizophrenia.

Diagnostic accuracy and clinical utility of the PHQ-2 and GAD-2: a comparison with long-format measures for depression and anxiety.

Anxiety and depression are highly prevalent and often comorbid mental disorders that are encompassed within the broad category of emotional disorders. The frequent comorbidity of anxiety and depression can pose challenges for accurate diagnosis and treatment which, in turn, highlights the need for reliable measurements that are simultaneously responsive to change and prevent non-response bias. Brief measures of anxiety and depression can potentially increase response rates due to their brevity and ease of administration. This study evaluates the psychometric characteristics, discriminative accuracy, and sensitivity to change of the Generalized Anxiety Disorder 2-item scale (GAD-2) and the Patient Health Questionnaire 2-item scale (PHQ-2) within a clinical population. The sample comprised treatment-seeking participants (n = 3,411), screened (n = 2,477) to receive an internet-based psychotherapeutic intervention (cognitive-behavioral, psychodynamic, or waitlist). Brief measures can effectively detect individuals who may be eligible for a diagnosis of depression and anxiety, not only prior to but also during and following the completion of psychological treatment. The discriminative ability of the GAD-2 was significantly greater during active treatment and at post-assessment compared with pre-treatment screening, although no such differences were found for the PHQ-2. Finally, endorsing the most severe response option on the GAD-2 and PHQ-2 was associated with a high probability of presenting with clinically relevant anxiety and depressive symptoms. Brief measures of anxiety and depression are viable instruments to screen for and monitor anxiety and depressive symptoms. ClinicalTrials.gov, identifier NCT05016843.

Contrasting Psychotherapeutic Treatments in Inflammatory Bowel Disease: an Exploratory Review

The aim of this study is to explain the effectiveness of psychotherapeutic treatments in patients with inflammatory bowel disease through an exploratory review of selected literature (2016-2022). Nineteen studies comprising interventions with cognitive behavioral psychotherapy, acceptance and commitment psychotherapy, and mindfulness were included, show data from N = 2506 people diagnosed with IBD, adult, adolescent and child participants, from different face-to-face and distance therapeutic programs. Results display a disparity of findings and are not definitive. The intervention that has the greatest verifiable therapeutic potential, given a better systematization of methodological procedures used, is cognitive behavioral psychotherapy. Future research on psychological interventions in IBD should focus on the use of trial of control and experimental groups, with random assignmentof participants and compliance with parameters that guarantee comparison between groups and replicability of studies, including design of a more standardized version of intervention procedures.

What is needed for the roll-out of psychedelic treatments?

The pace of psychedelic treatments continues to increase. Regulation and coherent clinical guidance have not been established. A philosophical divide limits effective resolution of a practice delivery quandary: is this primarily a pharmacological or psychotherapeutic intervention? Lykos (formerly MAPS) has submitted its new drug application (NDA) request to the FDA for 3-4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for PTSD and is expecting a response by the summer of 2024. Australia endorsed psilocybin and MDMA for regulated use in 2023. Multiple phase II and III clinical trials are also being conducted in the United States and Europe to study the use of psilocybin. Currently, Colorado and Oregon have legalized psilocybin in different manners. In Colorado, plants containing psilocybin, ibogaine, dimethyltryptamine (DMT) and mescaline (other than peyote) are now legal to possess, share and cultivate. Guidelines for regulated treatment with psilocybin containing mushrooms are in process with service delivery to begin early in 2025. In Oregon, clients must complete a preparation session with a licensed facilitator before consuming psilocybin products at a licensed service center. A prescription is not required. It is expected that other states will follow suit with a ballot measure likely in Massachusetts this year. Additionally, in the United States, the DEA, state boards, pharmaceutical distributors, and professional liability carriers all share mounting concerns about the in-home use of compounded ketamine used as a psychedelic therapeutic via remote prescribing. Psychedelic treatments are rapidly entering the mainstream of medical care delivery in the United States. Clinical guidelines are urgently needed to ensure well tolerated practice and coherent regulation. The delivery of this guidance is limited by a core philosophical disagreement. Resolution of this conflict will be needed to deliver coherent clinical guidelines. Current research and clinical experience provide a solid foundation for practical clinical guidance and the introduction of psychedelics into healthcare.

Mentalization-based approach for schizophrenia spectrum disorders: a psychotherapeutic proposal for evolved schizophrenic trajectories and serious mental disorders.

There is a growing interest in psychotherapeutic approaches to pre-psychotic high-risk states or first-episode psychosis, where mentalization-based treatment has shown its utility. This article presents a mentalization-based approach for the treatment of those individuals diagnosed with an evolved schizophrenia spectrum disorder, whose characteristics make them especially inaccessible to reflective psychotherapeutic treatment. A synthesis of the conceptual frameworks that justify the needs for technical modification of the mentalization-based treatment foundational techniques is carried out, followed by the proposal of adaptations, with a focus in self-agency and patient-therapist dyad. Therapeutic interventions are outlined, including illustrative examples. The mentalizing approach presented here holds promise for future research and treatment opportunities for patients with evolved schizophrenia and other serious mental disorders.

Eye movement intervention facilitates concurrent perception and memory processing.

A widely used psychotherapeutic treatment for post-traumatic stress disorder (PTSD) involves performing bilateral eye movement (EM) during trauma memory retrieval. However, how this treatment-described as eye movement desensitization and reprocessing (EMDR)-alleviates trauma-related symptoms is unclear. While conventional theories suggest that bilateral EM interferes with concurrently retrieved trauma memories by taxing the limited working memory resources, here, we propose that bilateral EM actually facilitates information processing. In two EEG experiments, we replicated the bilateral EM procedure of EMDR, having participants engaging in continuous bilateral EM or receiving bilateral sensory stimulation (BS) as a control while retrieving short- or long-term memory. During EM or BS, we presented bystander images or memory cues to probe neural representations of perceptual and memory information. Multivariate pattern analysis of the EEG signals revealed that bilateral EM enhanced neural representations of simultaneously processed perceptual and memory information. This enhancement was accompanied by heightened visual responses and increased neural excitability in the occipital region. Furthermore, bilateral EM increased information transmission from the occipital to the frontoparietal region, indicating facilitated information transition from low-level perceptual representation to high-level memory representation. These findings argue for theories that emphasize information facilitation rather than disruption in the EMDR treatment.

Localizing somatic symptoms associated with childhood maltreatment

Childhood maltreatment has been linked to adult somatic symptoms, although this has rarely been examined in daily life. Furthermore, the localization of somatization associated with childhood maltreatment and its subtypes is unknown. This large-scale experience sampling study used body maps to examine the relationships between childhood maltreatment, its subtypes, and the intensity and location of negative somatic sensations in daily life. Participants (N = 2,234; 33% female and 67% male) were part of MyBPLab 2.0, a study conducted using a bespoke mobile phone application. Four categories of childhood maltreatment (emotional abuse, emotional neglect, physical abuse, and physical neglect) were measured using the Childhood Trauma Questionnaire. Using gender-matched human silhouettes, participants indicated the location and intensity of feelings of negative activation in the body. Childhood maltreatment generally and its four measured subtypes were all positively associated with heightened negative activation on both the front and back body maps. For females, total childhood maltreatment was associated with negative activation in the abdomen and lower back, while for males, the association was localized to the lower back. Similarly, each of the four subscales had localized associations with negative activation in the abdomen and lower back in females and lower back in males, except for emotional abuse, which was also associated with negative activation in the abdomen in males. These associations likely reflect increased somatization in individuals exposed to childhood maltreatment, suggesting a role for psychotherapeutic interventions in alleviating associated distress.

Rational timepoint of medical rehabilitation in chronic tinnitus : Applying for rehabilitation options for achronic course

Chronic tinnitus is acommon symptom of the auditory system. Acausal therapy does not yet exist. The recommended treatment includes expert counseling, psychotherapeutic interventions, particularly cognitive behavioral therapy, and measures to improve hearing. The treatment modules are multimodal and can be combined individually. Depending on the severity of the different disease dimensions (tinnitus and comorbidities), arehabilitative approach may be useful for maintaining health and occupational ability. In addition to athorough and well-founded diagnosis and counseling, specific cognitive behavioral therapy and non-specific psychotherapeutic interventions (mindfulness/relaxation) on an individual or group basis, physiotherapy, and exercise, as well as auditory rehabilitation measures (hearing aids, auditory therapy) in the context of multimodal therapy approaches are necessary.

Depression with comorbid borderline personality disorder - could ketamine be a treatment catalyst?

Borderline personality disorder (BPD) is diagnosed in 10-30% of patients with major depressive disorder (MDD), and the frequency of MDD among individuals with BPD reaches over 80%. The comorbidity of MDD and BPD is associated with more severe depressive symptoms and functional impairment, higher risk of treatment resistance and increased suicidality. The effectiveness of ketamine usage in treatment resistant depression (TRD) has been demonstrated in numerous studies. In most of these studies, individuals with BPD were not excluded, thus given the high co-occurrence of these disorders, it is possible that the beneficial effects of ketamine also extend to the subpopulation with comorbid TRD and BPD. However, no protocols were developed that would account for comorbidity. Moreover, psychotherapeutic interventions, which may be crucial for achieving a lasting therapeutic effect in TRD and BPD comorbidity, were not included. In the article, we discuss the results of a small number of existing studies and case reports on the use of ketamine in depressive disorders with comorbid BPD. We elucidate how, at the molecular and brain network levels, ketamine can impact the neurobiology and symptoms of BPD. Furthermore, we explore whether ketamine-induced neuroplasticity, augmented by psychotherapy, could be of use in alleviating core BPD-related symptoms such as emotional dysregulation, self-identity disturbances and self-harming behaviors. We also discuss the potential of ketamine-assisted psychotherapy (KAP) in BPD treatment. As there is no standard approach to the application of ketamine or KAP in individuals with comorbid TRD and BPD, we consider further research in the field as imperative. The priorities should include development of dedicated protocols, distinguishing subpopulations that may benefit most from such treatment and investigating factors that may influence its effectiveness and safety.

Do the elderly and those with comorbid chronic physical conditions have improved access to outpatient psychotherapy post structural reforms in Germany? Results of the ES-RiP study.

In 2017, a reform of the German outpatient psychotherapy guideline was carried out, aiming to reduce waiting times and facilitate low-threshold access. This study analyzes the extent to which the implementation of the two new service elements 'psychotherapeutic consultation times' and 'acute short-term psychotherapeutic interventions' improved psychotherapeutic care for patients with mental disorders and chronic physical conditions (cMPs), for patients with mental disorders without chronic physical conditions (MnoP), and elderly patients. In a quantitative secondary analysis, we analyzed health insurance data of patients with psychotherapy billing codes obtained from the National Association of Statutory Health Insurance Physicians (KBV) for the years 2015-2019, evaluating descriptive statistical parameters for specific patient groups and care services. Between 2015 and 2019, the number of mentally ill receiving psychotherapy at least once in the corresponding year increased by 30.7%. Among these, the proportion of cMPs-patients increased from 26.8% to 28.2% (+1.4%), while that of MnoP-patients decreased from 68.3% to 66.4% (-1.9%). The number of elderly people receiving treatment also increased. Since increases and decreases in the percentage shares occur evenly over the years investigated, it is questionable whether the reform in 2017 has had a direct influence on these changes. ID DRKS00020344, URL: https://www.bfarm.de/DE/Das-BfArM/Aufgaben/Deutsches-Register-Klinischer-Studien/_node.html.

Internet-Delivered Affect-Focused Psychodynamic Therapy for Adolescent Depression: Treatment Principles and Clinical Application in the ERiCA Project

ABSTRACT Internet-delivered, therapist-guided, self-help programs are novel ways to deliver psychotherapeutic interventions adapted from established therapy models. Such programs can be easily accessed online and may offer an important treatment option for patients who struggle with barriers to seeking out and engaging in face-to-face psychotherapy, including depressed adolescents. While there are evidence-based Internet-delivered self-help programs based on cognitive-behavioral therapies (i.e. ICBT) for adolescent depression, a program based on psychodynamic principles (i.e. IPDT) has so far been lacking. In this article we describe the IPDT program developed within the ERiCA project, which has so far been evaluated in two randomized controlled trials (RCTs). We further provide a case example from one of the trials to illustrate the treatment process and therapeutic interaction in detail. Given the novelty of the approach, we will particularly highlight and discuss how a psychodynamic understanding of adolescent development and depressive dynamics as well as affect-focused treatment principles inform the treatment, including the therapist’s role, tasks, and choice of interventions. The potential implications and utility of IPDT for regular clinical practice are elaborated as well as potential research directions for the future.

Group Intervention Program to Facilitate Post-Traumatic Growth and Reduce Stigma in HIV.

Background: Research on post-traumatic growth (PTG) and HIV is scarce and the relationship between PTG and stigma is controversial. Group psychotherapeutic interventions to facilitate PTG in clinical samples are effective but none exist to simultaneously decrease stigma in the HIV population. The main objective was to evaluate the effectiveness of an intervention in increasing PTG and decreasing stigma in HIV, as well as to explore relationships between the variables. Methods: Quasi-experimental design with a sample of 42 HIV-positive adults (M = 46.26, SD = 11.90). The experimental group (EG) was subjected to a 9-week group intervention. Instruments: CBI, PTGI-X, PSS-10, HIV stigma, emotional expression, HIV stress indicators, HIV literacy, and skills. Multiple linear regression analysis was performed to assess the relationship between the variables. Results: There was an increase in PTG and a significant decrease in stigma in all domains and subscales in the EG. Compared to the control group, stigma (t(42) = -3.040, p = 0.004) and negative self-image (W = -2.937, p = 0.003) were significant, showing the efficacy of the intervention. Discussion: The intervention demonstrated success in facilitating PTG, attesting that in order to increase PTG, personal strength, and spiritual change, it is necessary to reduce stigma and negative self-image. The research provides more information on group interventions for PTG in HIV, relationships between variables, and population-specific knowledge for professionals.