Psychotherapeutic Support Research Articles

Fear of COVID-19: Psychological distress and coping among university students in Ghana.

The advent of the coronavirus pandemic has impacted the psychological well-being of many people. This study examined the relationship between fear of COVID-19, psychological distress (depression, anxiety, and stress) and coping strategies adopted by undergraduate students in Ghana. A sample of 209 students were recruited to complete online surveys on fear of COVID-19, psychological distress and coping strategies between June and July 2020. Students scored between normal to mild levels of psychological distress but above average scores on fear of coronavirus (M = 19.45, SD = 6.04). Fear of COVID-19 was positively related to psychological distress. Only maladaptive coping was found to be significantly and positively associated with fear of COVID-19. However post-hoc analysis of the components of coping strategies revealed that denial (β = .17, p = .028), venting (β = .18, p = .036) and humour (β = −.18, p = .023; an adaptive coping strategy) were associated with fear of COVID-19. Finally, both adaptive coping and maladaptive coping strategies had a mediating effect on fear of COVID-19 and psychological distress. These findings emphasize the need to design and optimize institutional interventions that will assess psychological distress and fear of COVID-19 levels during this pandemic and provide psychotherapeutic support for students as they return to school.

Beneath the Surface: Mental Health and Harassment and Abuse of Athletes Participating in the FINA (Aquatics) World Championships, 2019.

To assess the mental health and experience of sport-related harassment and abuse of elite aquatic athletes and to analyze it in relation to gender and discipline. Cross-sectional study using an anonymous survey. The FINA World Championships 2019. Registered athletes in the disciplines of swimming, diving, high diving, water polo, artistic swimming, and open water swimming. Athletes completed an online or paper-based questionnaire. The main outcome measures included screening for depression (10-item version of the Center for Epidemiological Studies Depression Scale revised), eating disorders (Brief Eating Disorders in Athletes Questionnaire), the subjective need for psychotherapeutic support, and the experience of sport-related harassment and/or abuse. A quarter (24.6%) of the 377 responding athletes were classified as depressed and 2.5% as having an eating disorder. More than 40% of the athletes stated that they wanted or needed psychotherapeutic support. Fifty-one athletes (14.9%) had experienced harassment/abuse in sport themselves, and 31 (9%) had witnessed it in another athlete. The experiences of harassment and abuse ranged from unwanted comments about body or appearance (40.2%) to rewards in sport for sexual favors (2.5%) and rape (0.3%). Athletes who had experienced harassment/abuse in sport themselves had higher average scores for depression and eating disorders, and more of them felt they needed psychotherapeutic support. Up to a third would not talk or report to anybody if they saw or experienced harassment/abuse, and less than 20% would talk to an official for help. Targeted initiatives are required to address mental health issues and harassment and abuse in sport in the FINA aquatic disciplines.

Problem-solving training as an active ingredient of treatment for youth depression: a scoping review and exploratory meta-analysis

BackgroundProblem-solving training is a common ingredient of evidence-based therapies for youth depression and has shown effectiveness as a versatile stand-alone intervention in adults. This scoping review provided a first overview of the evidence supporting problem solving as a mechanism for treating depression in youth aged 14 to 24 years.MethodsFive bibliographic databases (APA PsycINFO, CINAHL, Embase, MEDLINE, Web of Science) and the grey literature were systematically searched for controlled trials of stand-alone problem-solving therapy; secondary analyses of trial data exploring problem-solving-related concepts as predictors, moderators, or mediators of treatment response within broader therapies; and clinical practice guidelines for youth depression. Following the scoping review, an exploratory meta-analysis examined the overall effectiveness of stand-alone problem-solving therapy.ResultsInclusion criteria were met by four randomized trials of problem-solving therapy (524 participants); four secondary analyses of problem-solving-related concepts as predictors, moderators, or mediators; and 23 practice guidelines. The only clinical trial rated as having a low risk of bias found problem-solving training helped youth solve personal problems but was not significantly more effective than the control at reducing emotional symptoms. An exploratory meta-analysis showed a small and non-significant effect on self-reported depression or emotional symptoms (Hedges’ g = − 0.34; 95% CI: − 0.92 to 0.23) with high heterogeneity. Removing one study at high risk of bias led to a decrease in effect size and heterogeneity (g = − 0.08; 95% CI: − 0.26 to 0.10). A GRADE appraisal suggested a low overall quality of the evidence. Tentative evidence from secondary analyses suggested problem-solving training might enhance outcomes in cognitive-behavioural therapy and family therapy, but dedicated dismantling studies are needed to corroborate these findings. Clinical practice guidelines did not recommend problem-solving training as a stand-alone treatment for youth depression, but five mentioned it as a treatment ingredient.ConclusionsOn its own, problem-solving training may be beneficial for helping youth solve personal challenges, but it may not measurably reduce depressive symptoms. Youth experiencing elevated depressive symptoms may require more comprehensive psychotherapeutic support alongside problem-solving training. High-quality studies are needed to examine the effectiveness of problem-solving training as a stand-alone approach and as a treatment ingredient.

A safety study of laparoscopic single-anastomosis duodeno-ileal bypass with gastric plication (SADI-GP) in the management of morbid obesity

BackgroundBariatric surgery is more effective in the management of morbid obesity and related comorbidities than is conservative therapy. Pylorus-preserving single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-SG) is a modified duodenal switch technique. Gastric plication (GP) is an alternate to SG.MethodsMorbidly obese (BMI of > 40, or > 35 in the presence of diabetes or prediabetes) patients were recruited and operated on to perform SADI with GP. Complications related to surgery were recorded to assess the feasibility of the procedure. Weight-loss outcomes were analysed to determine efficacy. Minnesota Multiphasic Personality Inventory 2 (MMPI-2) was recorded after 1 year of follow-up, and test scales were used to describe physiological phenomena.ResultsSeventeen middle-aged (mean: 40 years) patients were involved in our study; 15 of them were females. The mean duration of surgery was 205 min. There were no complications of conversion, death, bleeding, VTE or 30-day readmission to hospital. We did experience CD4a (pulmonary insufficiency due to chronic lung disease) and a CD3b (anastomosis leakage treated laparoscopically) complications. Vomiting occurred in three cases (CD1). Obesity-related comorbidities showed favourable resolution rates (77.8% for hypertension, 81.2% for dyslipidaemia, 100% for diabetes at the 1-year follow-up). Weight-loss outcomes were favourable (53.20 EWL%, and 35.58 TWL% at 1-year follow-up). Greater weight loss caused significantly higher levels of Depression (t(13.958) = − 2.373; p = 0.00; p < 0.05) and Low Positive Emotions (t(13.301) = − 2.954; p = 0.00; p < 0.05) and Introversion/Low Positive Emotionality (t(13.408) = − 1.914; p = 0.02; p < 0.05) in MMPI-2 data.ConclusionAccording to our safety study, SADI-GP is a promising malabsorptive procedure, but a long-term high-volume case series or a randomised controlled trial is necessary to evaluate complication rates and weight-loss outcomes. Emotional dysregulation is common among bariatric surgery patients according to personality inventory data; therefore, psychological follow-up and psychotherapeutic support are necessary for weight-loss maintenance.

Adverse Childhood Experiences and Mental Health in Women: Pathways of Influence in a Clinical Sample.

While the negative impacts of Adverse Childhood Experiences (ACEs) on mental health have already been established in previous research, the pathways through which these events affect psychological well-being are still unclear. This cross-sectional study analyzed the relationship between ACEs and psychological distress. It also examined the role of coping strategies, emotion regulation, and adult attachment in this association. The sample consisted of 207 women receiving psychotherapeutic support from Public Mental Health Services in Spain. Just under half (46.4%) being treated by clinical psychology services and just over half (53.1%) were also being treated by psychiatry services. Descriptive and association analysis were performed on the variables involved. 48.3% of participants reported four or more ACEs and the correlation with symptom severity was significant. Regression equations showed that four variables explained 56.2% of the variance: Fear of Rejection and Abandonment, Lack of Control, Rejection and Cognitive Restructuring. ACEs are directly associated with the severity of psychological distress. The data suggest that appropriate, sensitive exploration of these experiences can be therapeutic. The relationships between type of adversity, attachment relationships, emotion regulation, and coping strategies reveal indirect pathways through which ACEs affect women's mental health.

Intérêts psychothérapiques du dessin du bonhomme dans le champ de la vieillesse

ObjectivesThe Draw-A-Person test is a well-known tool, generally used with children. Few studies have considered its relevance for an aging cohort ; and those that exist have sought, using a psychometric approach, to diagnose dementia or even depression. Favoring a subjective analysis, this study underlines the complementary interests of the benefits of drawing, such as psychological resources that are called upon and the various issues faced at this stage of life. MethodsSix drawings collected by a psychologist working in a nursing home constitute the basis of our investigation. The participants are between 64 and 95 years old. The analysis of the drawings is based on a frame of reference that is both phenomenological and psychoanalytical. As such, it draws on the subjects’ history and their experiences. ResultsThe various analyses make it possible to identify several issues that extend well beyond the sphere of dementia. In this sense, the use of the DAP test can be very useful for psychotherapeutic support and clinical research. Death anxiety, sense of identity, persecution anxiety, self-esteem, fragmentation phenomena, gendered identification, and depressive movements are some of the elements listed during our study. Drawing appears as a valuable tool with geriatric populations. DiscussionThe clinical approach to the drawing of a person calls various studies into question. Its use and study require adaptation, the modalities of which have been identified. ConclusionThe use of drawing people remains relevant in the context of psychotherapeutic support and also makes it possible to define the latter.

Personalized model of psychotherapeutic support for patients with COVID-19

The study of mental disorders resulting from COVID-19 has high social and medical significance. At present, there is a need for comprehensive research aimed at studying the psychopathogenesis of mental disorders that develop on the background of COVID-19. It is also necessary to develop personalized programs of pathogenetically based therapy and rehabilitation for patients who have recovered from COVID-19. It was examined 125 patients with COVІD-19 with non-psychotic mental disorders, both sexes (68 women and 57 men) with a mean age of (36.0±3.4) years. In the clinical picture of non-psychotic mental disorders in the examined patients are depressive (29.1%), anxious (33.4% of patients), astheno-neurotic (24.2%) and cognitive (13.3%) syndromes, as shown by results of clinical and psycho­pathological study. Taking into account data obtained during the comprehensive examination of psychological, pathopsychological and clinical-psychopathological features of patients with COVID-19, it was developed a model of personalized psychotherapeutic support for patients who have recovered from COVID-19, which includes psychotherapy and psychoeducation. The psychotherapeutic program consisted of three consecutive stages: stage I – formation of compliance, stage II – corrective, stage III – consolidation and maintenance of results. An important component of the psychotherapeutic support program is psychoeducation, which aims to form an adequate system of ideas about the impact and consequences of COVID-19, and to involve patients in active participation in treatment. According to study results on the background of personalized psychotherapeutic support program of patients who have recovered from COVID-19, there was a stable therapeutic effect in examined patients, positive dynamics of psychopathological symptoms, increased psychophysical activity, improved cognitive performance and significant reduction of anxiety and depression. Keywords: nonpsychotic mental disorders, coronavirus disease 2019, psycho­the­rapy, psychoeducation.

Review of the impact Covid-19 has on the Psychosocial factors affecting Well-Being

The COVID-19 pandemic has had a significant impact on the psychosocial factors that effect people globally. Particularly affected are children, students and health workers and the common symptoms identified are stress, anxiety disorders, depression and post-traumatic stress disorder. In addition, the various security measures implemented to ensure public safety have adversely affected relationships between people. This study directs public awareness to the value of psychotherapeutic support. Tele-therapy can be offered easily to people both at home or in the workplace, providing both cost effective and time sensitive solutions during times of crisis. The current review article provides an overview of the importance of maintaining psychological well-being during a pandemic and the identifies the role that empathetic communication has on wellbeing. The literature review was completed using electronic databases such as PubMed, Medline, and Scopus databases using the keywords covid-19, affected groups, affected relationships, psychology and its technological interventions, negative effects of pandemic so on.

POS1321 MENTAL HEALTH SCREENING IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

Background:Mental disorders often begin in the vulnerable phase of adolescence and young adulthood. Young people with chronic diseases are particularly at risk. Early recognition of mental health problems is necessary in order to be able to support those affected in a timely and adequate manner. By implementing a web-based generic screening tool for mental health in routine care, patients with juvenile idiopathic arthritis (JIA) and mental health conditions can be identified and provided with targeted treatment.Objectives:To investigate the prevalence of mental health conditions in young people with JIA in routine rheumatology care.Methods:Mental health screening is implemented as an add-on module to the National Paediatric Rheumatology Database (NPRD). The current data was gathered over a period of 24 months. Patients complete the screening tool which includes the Patient Health Questionnaire1 (PHQ-9, score 0-27) and the Generalized Anxiety Disorder scale2 (GAD-7, score 0-21) via a web-based questionnaire. The cut-off for critical values in PHQ-9 and GAD-7 were defined as values ≥ 10. Simultaneously, other data, such as sociodemographic data, disease activity (cJADAS10, score 0-30), functional status (CHAQ, score 0-3) were collected as well.Results:The analysis included 245 patients (75% female) with a mean age of 15.7 years and a mean disease duration of 8.8 years. 38.8% of the patients had oligoarthritis (18.0% OA, persistent/20.8% OA, extended) and 23.3% RF negative polyarthritis. At the time of documentation 49 patients (30.6%) had an inactive disease (cJADAS10 ≤ 1) and 120 (49.4%) no functional limitations (CHAQ = 0). In total, 53 patients (21.6%) had screening values in either GAD-7 or PHD-9 ≥10. Patients with critical mental health screening values showed higher disease activity and more frequent functional limitations than inconspicuous patients (cJADAS10 (mean ± SD): 9.3 ± 6 vs. 4.9 ± 4.9; CHAQ: 0.66 ± 0.6 vs. 0.21 ± 0.42). When compared to males, females were significantly more likely to report either depression or anxiety symptoms (11.7% vs. 24.9%, p = 0.031).17.6% of all patients with valid items for these data reported to receive psychological support, meaning psychotherapeutic support (14.5%) and/or drug therapy (8.6%). Among those with a critical mental health screening score, 38.7% received psychological support (psychotherapeutic support (35.5%) and/or drug therapy (16.1%)).Conclusion:Every fifth young person with JIA reported mental health problems, however, not even every second of them stated to receive psychological support. The results show that screening for mental health problems during routine adolescent rheumatology care is necessary to provide appropriate and targeted support services to young people with a high burden of illness.

Psychological Support and Psychotherapy during the COVID-19 Outbreak: First Response of Practitioners

Providers of psychological support and psychotherapy during the COVID-19 pandemic unfolding were facing the new unavoidable reality, which required making urgent changes in their practice. The paper aimed to study the "first responses” of psychologists and psychotherapists to the COVID-19 pandemic situation with its uncertainty before the lockdown. An online survey was developed and distributed among psychologists and psychotherapists from Ukraine from 14 to March 16, 2020. Results showed that among survey respondents (n=145), 35.9% had already changed their practice somehow, and 75.2% had been considering how their practice might be modified. The more often the COVID-19 pandemic was discussed by patients, the more often it affected the style and technique of the corresponding specialists, thereby pushing psychotherapists to change the format of their work. Practice restrictions due to quarantine measures affected more affiliated consultants, while difficulties with setting (e.g., canceled sessions, financial issues) were more frequent among private practice consultants, and both proposed online consultations to their patients. In conclusion, the pandemic situation caused relevant modifications in the organization of psychological and psychotherapeutic support even during the first weeks of the COVID-19 outbreak in Ukraine. The first responses of practitioners were related to (a) their experience and type of affiliation, (b) the main approach, (c) the subjective readiness or non-readiness to modify the usual form of work, (d) the way of interpreting the patient’s anxieties, (e) the lethal cases of coronavirus in the area of living.

Gender peculiarities of pain syndrome in older age patients

IntroductionThe study of gender-related peculiarities of vertebral pain syndrome course in order age patients appears to be highly relevant.ObjectivesStudy population included 46 female patients and 38 male patients in the age between 60 and 75 years old; mean age was 67,4±6,6 years old.MethodsPain syndrome intensity was assessed using the visual analogue scale (VAS), vegetative disfunction was assessed using A.M. Wayne Questionnaire; the Toronto Alexithymia ScaleResultsThe conducted comparative study showed that the male patients perceived the pain syndrome as more intense as compared to the female patients in lumbar spine: 4,5 ±0,8 vs 3,6±0,5 scores (р &lt;0,001) and in thoracic spine: 4,1 ±1,0 vs. 3,4±1,0 (р &lt;0,05). On the other hand, in vegetative dysfunction assessment, the male patients demonstrated generally lower score: 43,3±7,5 scores vs. 59,6+10,3 in female patients, р &lt;0,001. The results of correlation analysis pf interrelations between alexithymia and pain intensity revealed the differences between the study groups in emotion recognition accuracy (Mann-Whitney U-test = 109,00, р = 0.09): female patients showed lower scores (60,7 ±3,5) as compared to the male patients (74,2 ±2,1).ConclusionsTherefore, the vertebral pain syndrome tends to be more pronounced in older age male patients as compared to the similar population of older age female patients. Therefore, vertebral pain syndrome correction requires multidisciplinary approach, including psychotherapeutic support.

Psychotherapeutic support peculiarities’ in palliative care structure for cancer patients

IntroductionPPalliative medicine is aimed at achieving the best possible in a particular situation the level of quality of life of the patient.ObjectivesThe reaction of grief is one of the strongest and most painful human experiences.MethodsThere were 120 cancer patients observed. The reaction of grief consists of 4 stages: shock and protest - numbness, disbelief and acute dysphoria; absorption - acute longing, search and anger; disorganization - a sense of despair and acceptance of loss and decision.ResultsThe initial reaction of grief - shock, emotional numbness and disbelief. The excitement is most pronounced within about two weeks, followed by symptoms of depression, which reach its peak 4-6 weeks. Eventually, the former intense pain of severe loss begins to subside. In addition to the reaction of grief, there is a pathological, which is divided into suppressed (inhibited), delayed (delayed) and chronic. The role of the psychotherapist at this stage is to provide psychological support and assistance to both the patient and his environment to cope with this situation.ConclusionsThe principle of the concept of palliative care is the need to ensure the psychological comfort of the patient.

Medicinal psychedelics for mental health and addiction: Advancing research of an emerging paradigm.

The medical use of psychedelic substances (e.g. psilocybin, ayahuasca, lysergic acid diethylamide and 3,4-methylenedioxymethamphetamine) is attracting renewed interest, driven by a pressing need for research and development of novel therapies for psychiatric disorders, as well as promising results of contemporary studies. In this Viewpoint, we reflect upon the 'Clinical Memorandum on Psychedelics' recently released by the Royal Australian and New Zealand College of Psychiatrists and note subsequent developments including the application for down-scheduling of psilocybin and 3,4-methylenedioxymethamphetamine presently being considered by the Therapeutic Goods Administration and approvals for access via the Special Access Scheme. We suggest that this field is worthy of rigorous research to assess potential benefits, address safety parameters and clarify therapeutic mechanisms. To this end, we outline recent research findings, provide an overview of current knowledge relating to mechanisms of action and discuss salient aspects of the psychedelic-assisted psychotherapy treatment model. The sum of this research points towards medicinal psychedelics as a potential new class of psychiatric treatments when used within a medically supervised framework with integrated psychotherapeutic support. However, before widespread translation into clinical use can occur, appropriately designed and sufficiently powered trials are required to detect both potential positive and negative outcomes. Unique safety and regulatory challenges also need to be addressed. As for any new medical therapy, psychedelic research needs to be conducted in a rigorous manner, through the dispassionate lens of scientific enquiry. Carte blanche availability to practitioners, without specific protocols and appropriate training, would be potentially harmful to individuals and detrimental to the field.

Protective Elements of Mental Health Status during the COVID-19 Outbreak in the Portuguese Population.

The outbreak of COVID-19 might produce dramatic psychological effects on individuals’ lives. In this study, we aimed to explore the elements that may reduce the negative effects on mental health of the quarantine period imposed by most governments during this worldwide crisis. We conducted an online survey to evaluate demographic, lifestyle and mental health variables in a sample of 1280 Portuguese individuals (79.8% females) with an average age of 37 years. We observed that factors related to living conditions, maintaining work either online or in the workplace, frequency of exercise and absence of previous psychological or physic disorders are protective features of psychological well-being (anxiety, depression, stress and obsessive-compulsive symptoms). Finally, the individuals previously receiving psychotherapeutic support exhibited better psychological indicators if they did not interrupt the process as a consequence of the outbreak. Our results indicate that the practice of physical exercise, reduced consumption of COVID-19 information and the implementation of remote mental healthcare measures might prevent larger impacts on mental health during the COVID-19 outbreak.

Effectiveness of the "blue cards" procedure with regard to aggression and stress in perpetrators and victims of domestic violence

The aim of the research was to verify whether the actions which have been taken within the framework of the “Blue Cards” procedure towards the families affected by domestic violence are an effective psychotherapeutic support. The two factors which may have influence on the occurrence of the phenomenon of domestic violence within a family system were examined, namely level of stress and aggression syndrome among partners of intimate relationship. Participants in the study were 30 female victims of domestic violence (mean age 40 years old) and 30 male perpetrators of domestic violence (mean age 37 years old). Aggression syndrome was measured by using the Inventory of Psychological Aggression Syndrome (IPSA II) and stress level was assessed by the Perceived Stress Scale (PSS – 10). The test-retest procedure was used in the prospective study. Both aggression and stress were measured twice: at baseline, and after six months from the beginning of the “Blue Cards” procedure. Participants have evaluated their own aggression syndrome and level of stress, and also they have estimated the aggression syndrome of his/her partner’s. Nonparametric statistical tests have been used for group comparisons. The results show that active participation in assistant activities decreased the level of stress in the group of victims of domestic violence, and the scale of aggression syndrome in the group of violence users. The procedure “Blue Cards” is an effective method of support people who are both victims and perpetrators of domestic violence.

Mental health assessment of medical workers during the COVID-19 pandemic in Russia: results of an online survey

To assess the mental health of health workers during a pandemic. Eight hundred and twelve medical workers took part in a cross-sectional Internet survey. The questionnaire included a socio-demographic block, a block of questionnaires for assessing the level of symptoms of anxiety and depression (PHQ-9 and GAD-7). The data were processed using statistical methods. The prevalence of anxiety and depression among healthcare providers during the pandemic was 48.77% and 57.63% respectively. Subjectively poor quality of sleep was noted by 37.4% of respondents. Cluster analysis distinguished 4 groups of respondents: group 1 was characterized by high scores on PHQ-9 and GAD-7 and a low subjective assessment of sleep quality; group 2 had low scores on PHQ-9 and GAD-7 and a high subjective assessment of sleep quality; respondents from clusters 3 and 4 had average total scores on PHQ-9 and GAD-7, however, group 4 was characterized by significantly lower values of subjective sleep quality assessment. The division into clusters makes it possible to understand which groups of medical workers require psychological (psychotherapeutic) support in the first place. Cluster 1 respondents with high levels of anxiety and depression, as well as poor sleep quality, need priority assistance.

Crisis intervention for serious mental disorders. The example of the First Department of Psychiatry of Athens University

We describe the crisis management and resolution service for serious mental disorders established by the First Department of Psychiatry of the National and Kapodistrian University of Athens. The service is intended to meet patients' needs for adequate management of acute mental crisis without hospitalization, while implementing modern standards in mental care and considering existing restrictions in mental health resources and public expenditure. Last decade we witness an increase in demand for psychiatric beds in Psychiatric clinics of General Hospitals resulting in a drastic increase of auxiliary beds that becomes a serious problem in mental health provision. The shutdown of big psychiatric hospitals in the process of psychiatric reform, accompanied by a delay in the establishment of all the anticipated beds in general hospitals together with overloaded and insufficient network of mental health services in the community are the major determinants. Additionally, fiscal economic crisis of the last decade intensified even more the problem by diminishing funding for the recruitment of new personnel and drastically reducing allocated funding for new and old services. In 2016 we set up a crisis intervention service for serious mental disorders within the operational framework of the emergency psychiatric services of the Department of Psychiatry in Eginition Hospital in Athens. The crisis resolution team is composed by two psychiatrists, a psychiatric nurse, social workers, a psychologist, mental health volunteers, and mental health trainees/students. The patient enters the service through the emergency service when an indication for hospitalization is given by the emergency psychiatrist, followed by the clinical estimation of a member of our team. The therapeutic team convenes twice a week for the new entrants and for follow-up sessions with the participation of the patient and the family members whenever feasible. The rest of the therapeutic interventions take place during the week. The work 'with' the person and not 'to' the person encapsulates the philosophy of the service, which is characterized by a holistic treatment approach aiming to empower the individual strengths and sense of control of the patient for crisis resolution on the basis of a safe therapeutic milieu. Therapeutic interventions include family and supportive members, as well as community interventions. In summation, interventions consist of a) comprehensive evaluation (psychiatric/ physical) and therapeutic plan, b) psychopharmacological treatment, c) psychotherapeutic support for the patient and the family for management of the crisis, d) training for the management of future crises and e) referral to appropriate community services for follow up management and treatment. Treatment lasts approximately 6-8 weeks. Initial data of the evaluation study indicate clinical effectiveness and high levels of satisfaction for patients and family. Conclusively, crisis management and resolution services are feasible even in a time of heavy restrictions in recourses, and anticipated benefits are multiple for the economy, mental health provision, the public health system, patients and relatives alike.

Exploring the caregiver's experience in an innovative homebound hematopoietic stem cell transplantation program.

Home care for hematopoietic stem cell transplants (HSCTs), an alternative to traditional inpatient or outpatient recovery programs, is safe and feasible but may place greater demand on full-time caregivers. The goal of this study was to characterize the experiences of caregivers in a newly piloted homebound HSCT program as a means of identifying unmet needs and ensuring adequate support. A qualitative approach was utilized. Participants created self-recorded video diaries guided by open-ended prompts at designated time points throughout recovery and participated in a single follow-up interview within four weeks post-discharge. Diaries and interviews were transcribed, analyzed, and coded to identify recurrent ideas and themes. Data were collected from 12 caregivers of homebound HSCT patients. Thematic content analysis yielded four themes: facilitators (external support, sense of normalcy, and patient wellness), challenges (difficulties with transplant care instructions, managing the patient's physical and emotional health, and caregiver psychological distress), roles in recovery (caregiving responsibilities), and analysis of homebound experience (positive outcomes and suggestions for improvement). Caregivers perceived the homebound program as offering high-quality medical care in a setting that provided a sense of normalcy, privacy, and greater level of oversight. Unmet needs included lacking preparedness in completing nursing responsibilities and handling caregiver and patient distress. While the homebound program was preferred to routine hospital care, psychotherapeutic support and programming to improve caregiver preparedness in a homebound HSCT recovery program is indicated.

The Mental Health of Frontline Health Care Providers During Pandemics: A Rapid Review of the Literature.

This rapid review addresses two key questions posed by the COVID-19 pandemic: What are the anticipated mental health sequelae for frontline health workers? and What are best practices during health emergencies to address the mental health needs of these workers? This review synthesized the literature on the mental health sequelae for health workers during major pandemics and epidemics that occurred in the 21st century (severe acute respiratory syndrome, Middle East respiratory syndrome, Ebola virus disease, and swine flu) and interventions used to address related mental health sequelae. PubMed, MEDLINE, and PsycINFO were searched with terms related to these epidemics/pandemics. Of 3,876 articles retrieved, 94 were included in this review. Across these studies, most health workers exhibited some adverse psychological experiences during outbreaks, with stress and anxiety being most common. Psychological distress decreased over time. Some studies reported insomnia, burnout, and posttraumatic stress for a subset of individuals up to 3 years after the disease outbreak. Few interventions have been implemented to address providers' mental health needs, and these strategies have not been evaluated systematically. Systems-level interventions may alleviate distress for most providers without the need for specialized mental health intervention. Psychotherapeutic support and referral to specialty care should be available to health workers with severe and intense adverse psychological outcomes during and beyond the COVID-19 pandemic. Evidence-based interventions are urgently needed to better serve health workers both during and following epidemics/pandemics.

System of psychotherapeutic support for injured combatants

The effects of combat stress most often cause non-psychotic mental disorders, which are manifested in significant emotional experiences, disorders of cognitive processing of information, deformation of social ties of combatants. We examined and treated 145 male combatants, who were injured and treated at the Military Medical Clinical Center of the Northern Region (Kharkiv), aged 20-55 years. According to the data obtained during the study, the following non-psychotic disorders were noted in the surveyed combatants: acute stress reaction (F43.0) in 36.2 % of combatants, post-traumatic stress disorder (F43.1) in 32.1 %, prolonged depressive reaction (F43.21) in 11.3 %, mixed anxiety-depressive reaction (F43.22) in 12.2 %, depressive episode (F32.1, F32.2) in 8.2 % of combatants. We developed and tested a program of personalized psychotherapeutic support for combatants, based on the obtained data from clinical psychopathological features of non-psychotic mental disorders. It is proved that the developed program of psychotherapeutic support of combatants promotes productive dynamics of psychopathological symptoms, forms a feeling of self-sufficiency, psychological well-being, promotes improvement of interpersonal relations and general perception of quality of life. Keywords: combatants, mental trauma, psychotherapeutic support.