Significant Reductions In Psychological Distress Research Articles

The feasibility of a psychological first aid intervention as a supportive tactic for feelings of psychological distress and mental health recovery outcomes among earthquake survivors in Northern Syria.

This study aimed to investigate the feasibility of implementing a psychological first aid intervention for psychological distress, resilience capacity, quality and meaning of life among survivors affected by earthquake adversity in Northern Syria. A quasi-experimental, pre-posttest, two-group research design was utilized. A convenience sample of 95 survivors (46 in the study group and 49 in the control group) was recruited for the psychological First Aid intervention at a 1:1 ratio. The psychological first aid intervention was delivered in 10 sessions, twice weekly, followed by 3-month follow-up. A statistically significant improvement in the mean scores of resilience capacity, quality and meaning of life among survivors, along with a significant reduction in psychological distress, was registered among the study group compared with the control group. Our work verified the suitability of implementing psychological first aid following the catastrophic temblors which struck Northern Syria. Given that the psychological first aid intervention is grounded in psychological safety, cognitive reframing, mobilization of social support and installation of hope, the feasibility of its path following public health emergency, traumatic events or even a personal crisis can be favourable.

Efficacy of Internet-based Cognitive Behavioral Therapy for Hong Kong University Students: A Randomized Controlled Trial

Purpose: This study examined the efficacy of a 10-week internet-based cognitive behavioral therapy (iCBT) program “REST Online” for Hong Kong university students with mild to moderate levels of psychological distress. Method: A total of 206 Hong Kong university students were randomized into: (1) web-based and (2) app-based iCBT, and (3) waitlist control (WLC) groups. Results: Compared with the WLC group, the participants in the two iCBT groups showed a significant reduction in psychological distress, depression and anxiety symptoms, and negative thoughts and emotions, and significant increase in positive thoughts and emotions, with medium to large effect sizes. The positive effects were sustained at the 3-month follow-up test. No significant intervention effects were found between the two iCBT groups except for anxiety symptoms. Discussion: The findings were discussed in terms of program design and service delivery, and suggestions for delivering digital mental health service in Hong Kong universities were proposed.

Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment – results of an observational single-centre pilot study

ABSTRACT Background: Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe difficulties in relationships) which are frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. So far, evidence of psychodynamic treatment approaches for CPTSD is scarce. Methods: In this single-centre observational pilot study, symptom change during a 6-week psychodynamic inpatient treatment in a multimodal psychosomatic rehabilitation centre was evaluated using repeated measures analyses of variance (ANOVAs). Patients completed questionnaires on PTSD and CPTSD symptoms (ITQ), anxiety, depression and somatization (BSI-18), functional impairment (WHODAS) and epistemic trust, mistrust and credulity (ETMCQ) before (T1) and at the end of treatment (T2). A hierarchical linear regression analysis was calculated to identify factors associated with improved CPTSD symptoms. Results: A total of n = 50 patients with CPTSD were included in the study, of whom n = 40 (80%) completed treatment. Patients reported a significant reduction of CPTSD symptoms during treatment with a large effect size (−3.9 points; p < .001; η 2 = .36), as well as a significant reduction of psychological distress (p < .001; η 2 = .55) and functional impairment (p < .001; η 2 = .59). At the end of treatment, 41.0% of patients no longer fulfilled the diagnostic criteria for CPTSD. Changes in epistemic stance included improved epistemic trust (β = –.34, p = .026) and decreased epistemic credulity (β = .37, p = .017), which together with lower age (β = .43, p = .012) and lower depression levels at baseline (β = .35, p = .054) were significantly associated with baseline adjusted mean change of CPTSD symptoms during therapy and explained 48% of its variance. Discussion: In our study, patients reported a significant reduction of CPTSD symptoms and comorbid symptoms during a multimodal psychodynamic inpatient rehabilitation treatment. Improved epistemic trust may facilitate the establishment of a trusting therapeutic relationship, thus fostering an environment of openness for knowledge transfer (i.e. social learning) and the exploration of diverse viewpoints and perspectives in the therapeutic process.

Practice-based evidence for spiritually integrated psychotherapies: Examining trajectories of psychological and spiritual distress.

The aims of this practice-based evidence study were to (a) examine clients' trajectories of psychological and spiritual distress over the course of spiritually integrated psychotherapies (SIPs) and (b) explore the role of varying types of spiritual interventions in these outcomes. In total, 164 practitioners of SIPs from 37 settings in a practice-research network administered the Clinically Adaptive Multidimensional Outcome Survey (Sanders et al., 2018) at each session with 1,227 clients and reported their use of theoretical orientations and spiritual interventions on an after-session summary checklist. Focusing on sessions over an initial 12-week period, latent growth curve modeling analyses revealed that clients, on average, experienced significant reduction of psychological distress during their engagement in SIPs with improvements occurring most sharply in the first month. Further, other findings revealed a salient reciprocal interplay with spiritual distress throughout treatment, such that clients who were struggling with their religious faith and/or spirituality were more psychologically distressed and displayed a more attenuated and gradual pattern of symptom reduction. In such cases, clinicians frequently utilized spiritual interventions involving basic skills (e.g., spiritual assessment), virtues (e.g., discuss self-control), and religious attachment (e.g., encourage acceptance of divine love) that were uniquely associated with clients' rate and duration of decline in psychological and spiritual distress. The present findings affirm the routine effectiveness of SIPs along with highlighting the potential value of certain spiritual interventions in supporting holistic recovery among clients who want clinicians to be culturally responsive to their spiritual and/or religious identities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

App-based support for breast cancer patients to reduce psychological distress during therapy and survivorship - a multicentric randomized controlled trial.

The negative impact of unmanaged psychological distress on quality of life and outcome in breast cancer survivors has been demonstrated. Fortunately, studies indicate that distress can effectively be addressed and even prevented using evidence-based interventions. In Germany prescription-based mobile health apps, known as DiGAs (digital health applications), that are fully reimbursed by health insurances, were introduced in 2020. In this study, the effectiveness of an approved breast cancer DiGA was investigated: The personalized coaching app PINK! Coach supports and accompanies breast cancer patients during therapy and follow-up. PINK! Coach was specifically designed for breast cancer (BC) patients from the day of diagnosis to the time of Follow-up (aftercare). The app offers individualized, evidence-based therapy and side-effect management, mindfulness-based stress reduction, nutritional and psychological education, physical activity tracking, and motivational exercises to implement lifestyle changes sustainably in daily routine. A prospective, intraindividual RCT (DRKS00028699) was performed with n = 434 patients recruited in 7 German breast cancer centers from September 2022 until January 2023. Patients with BC were included independent of their stage of diseases, type of therapy and molecular characteristics of the tumor. Patients were randomized into one of two groups: The intervention group got access to PINK! over 12 weeks; the control group served as a waiting-list comparison to "standard of care." The primary endpoint was psychological distress objectified by means of Patient Health Questionnaire-9 (PHQ-9). Subgroups were defined to investigate the app's effect on several patient groups such as MBC vs. EBC patients, patients on therapy vs. in aftercare, patients who received a chemotherapy vs. patients who did not. Efficacy analysis of the primary endpoint revealed a significant reduction in psychological distress (least squares estimate -1.62, 95% confidence interval [1.03; 2.21]; p<0.001) among intervention group patients from baseline to T3 vs, control group. Subgroup analysis also suggested improvements across all clinical situations. Patients with breast cancer suffer from psychological problems including anxiety and depression during and after therapy. Personalized, supportive care with the app PINK! Coach turned out as a promising opportunity to significantly improve psychological distress in a convenient, accessible, and low-threshold manner for breast cancer patients independent of their stage of disease (EBC/MBC), therapy phase (aftercare or therapy) or therapy itself (chemotherapy/other therapy options). The app is routinely available in Germany as a DiGA. Clinical Trial Registration: DRKS Trial Registry (DRKS00028699).

Translation, adaptation, and initial evaluation of a guided self-help intervention to reduce psychological distress among nurses during COVID-19 in China.

This study aimed to reduce the unprecedented and intense psychological distress that nurses were forced to experience during the COVID-19 pandemic. A Chinese version of the World Health Organization's Self-Help Plus (SH+) intervention guide was adapted and tested among nurses. The objective of this study was to translate and adapt the SH+ guideline into the Chinese version and to test its feasibility in reducing psychological distress among nurses during COVID-19. A staged approach comprising translation, adaptations, initial evaluation by pilot implementation, and a qualitative process evaluation was conducted in two hospitals in Xi'an, China. The translation of the Chinese version was authorized by the World Health Organization. We adapted SH+ for use among clinical nurses working during the pandemic in China through a qualitative process evaluation, which was guided by the descriptive phenomenological study design. The outcomes of the pilot included psychological distress, psychological flexibility, depressive and anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and subjective psychological wellbeing, which were assessed using the Kessler 6 symptom checklist, the Comprehensive Assessment of ACT Process (CompACT), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), the PTSD Checklist-Civilian Version (PCL-C), and the Index of Wellbeing (IWB), respectively. The SH+ materials, including audio-recorded sessions and an accompanying illustrated manual, were translated into Chinese and adapted in line with feedback from the nurses. An uncontrolled pilot study (n = 28) for 5 weeks showed a statistically significant reduction of psychological distress (mean difference in Kessler 6 score, -2.74; 95% CI [-3.71, -1.78]; p < 0.001). We also found improvements in psychological flexibility (mean difference in CompACT score, 6.89; 95% CI [-12.35, -4.47]; p < 0.001), subjective psychological wellbeing (mean difference in IWB score, 0.86; 95% CI [0.07, 1.65]; p < 0.05), and depressive symptoms (mean difference in PHQ-9 score, -1.52; 95% CI [-2.78, -0.26]; p < 0.05). The process evaluation showed that nurses found the SH+ program very useful but difficult to adhere to. We found that the translated Chinese version of SH+ was applicable and feasible in the Chinese cultural context. There was a potential effect of adapted SH + in reducing nurses' psychological distress during COVID-19 and suggested the value of exploring strategies to increase adherence to the program.

The effects of Managing Cancer and Living Meaningfully (CALM) on psychological distress in esophageal cancer patients.

Aim: To evaluate the effectiveness of Managing Cancer and Living Meaningfully (CALM) in esophageal cancer with psychological distress during treatment. Materials & methods: The study assigned eligible patients to either a CALM group or a usual care group. Psychological distress, anxiety, depression and quality of life scores were assessed for both groups at baseline, during the intervention period and at the end of the intervention. Results: Patients showed a significant reduction in psychological distress, anxiety and depression and demonstrated improved quality of life after the CALM intervention, and the positive effect remained after 1month of follow-up. Conclusion: This study suggests that CALM may be an effective approach for targeting psychological distress in patients with esophageal cancer.

The efficacy of a facilitated support group intervention to reduce the psychological distress of individuals experiencing family estrangement

BackgroundStand Alone is a charity operating in the United Kingdom that supports adults who are estranged from a family member. The charity recognises that those who experience estrangement from a family member experience sadness, anger and a sense of loss. Due to stigma, they rarely disclose their experiences of estrangement to others. ObjectiveTo assess the efficacy of a six-session facilitated support group intervention for individuals experiencing family estrangement in reducing psychological distress. MethodsAttendees (N = 263) completed the CORE-10 questionnaire assessing psychological distress at registration and at completion of the groups. They also completed a brief survey at each time-point, including an open-ended question about how they felt the support groups had impacted their wellbeing (N = 51). ResultsAttendees experienced a statistically significant reduction in psychological distress, with average scores of distress falling from moderate levels of distress to mild. After attending the groups, attendees felt less alone and less ashamed. ConclusionSix-week facilitated support groups are an effective way of reducing psychological distress for individuals experiencing estrangement from a family member, helping attendees feel less alone and ashamed. Practice implicationsThrough facilitated support group intervention, it is possible to reduce the psychological distress of those individuals experiencing family estrangement.

Brief, structured, group art therapy for women with breast and/or gynaecological cancer

ABSTRACT Background This paper describes a structured group approach for women vulnerable to psychological distress following treatment for breast and/or gynaecological cancer. Aims Set in Hong Kong, the aim was to develop and pilot a brief art therapy intervention sensitive to local concerns and the specific needs of service-users. Methods A mixed methods study was developed and piloted in two phases over six-years in collaboration with female service-users recovering from breast and/or gynaecological cancer treatment. Key therapeutic goals and core themes were identified in phase 1 leading to the piloting of a six-session structured intervention with six groups in phase 2. This was evaluated using qualitative and quantitative methods: through service-user feedback and reflections; informal feedback captured through the art therapy process; and pre and post assessment of emotional distress (Distress Thermometer) and mental wellness (C-SWEMWBS). Results A consistent six-session structure was developed addressing four therapeutic goals: stress release and relaxation; amelioration of psychological and emotional distress; exploration of self-image; promotion of self-acceptance and awareness. Six core themes relating to loss and readjustment were established through the art therapy process. Participants experienced statistically significant reductions in psychological distress and increased mental well-being. Conclusion A new brief, structured, group art therapy approach was developed for women recovering from breast and/or gynaecological cancer treatment. Implications for practice/policy/future research The study contributes to the evidence base for the efficacy of art therapy in psycho-oncology and highlights the importance of service-user involvement in the design of a tailored, culturally sensitive, intervention responsive to local concerns. Plain-language summary This paper describes a brief art therapy group approach for women in recovery from treatment for breast and/or gynaecological cancer who are finding it difficult to adjust to changes in their bodies and the way they see themselves in the world. The aim of the project was to explore the use of a participatory approach to develop and test a brief art therapy intervention designed to meet the specific needs of such women. The project took place in Hong Kong, in a community cancer service offering support with the emotional impact of a cancer diagnosis and treatment. The theme-based group model was developed in two phases over six years in collaboration with female participants, all of whom were over the age of eighteen and had received treatment for breast and/or gynaecological cancer in the previous two years. Four therapeutic goals were identified: relaxation, reduction of emotional distress; exploration of feelings about oneself in the world, and awareness and acceptance of various aspects of oneself and one’s situation. Common issues relating to feelings of loss and difficulties adjusting to bodily changes led to the further identification of six core themes. These were creatively explored through the art therapy process leading to the development of a consistent six-session structure. The themed group approach was evaluated through service-user feedback and reflections, informal feedback during the art therapy process, and established measurement tools for assessing emotional distress and mental wellness. Results suggest an overall reduction in emotional distress with improvements in mental wellbeing. This contributes to the evidence base for the efficacy of art therapy in cancer care. Positive outcomes also reflect the participants’ involvement in the design of a culturally sensitive intervention responsive to local needs.

Pilot exploration of low-intensity psychoeducation workbook interventions in a prison setting, adapted for use throughout the COVID-19 pandemic

PurposeThis paper aims to explore the use of low intensity in-cell workbooks within a psychological therapies service for male prisoners, an intervention adapted for use during the COVID-19 pandemic. It seeks to explore the effectiveness of the intervention in reducing psychological distress, explore individuals’ progression through the service following engagement with the workbooks and, finally, to understand individual’s experiences of the intervention through evaluating feedback provided.Design/methodology/approachCORE-10 scores from 66 male prisoners at a Category C prison were evaluated pre and post completion of an adapted in-cell workbook intervention, to explore the potential effectiveness of the intervention in reducing psychological distress. Qualitative feedback given by participants was also explored to understand individual’s experiences of engaging with the intervention.FindingsEvaluation of 66 male prisoners revealed significant reductions in psychological distress on the CORE-10. Findings demonstrated that over half of men included in the evaluation were “stepped-up” for further interventions as per the stepped-care treatment model. Feedback forms highlighted the value of the therapeutic relationship and a “something versus nothing” approach.Research limitations/implicationsThe paper considers several limitations to the research approach, of which future studies should seek to explore when carrying out similar research.Practical implicationsThe paper includes implications for the use of low intensity self-help interventions in prison psychological services, during a time when the provision of face-to-face interventions was limited due to the COVID-19 pandemic.Originality/valueThe paper explores the use of self-help materials in psychological treatment settings, of which there is very little research on in prisons. In addition, the paper contributes to the body of research on psychological well-being during the COVID-19 pandemic.

Community‐based counselling for benzodiazepine withdrawal: A mixed‐methods study of client outcomes

AbstractDespite adverse health outcomes being associated with long‐term tranquilliser use, health professionals face numerous barriers in reducing reliance on benzodiazepines. This study investigated the effectiveness of focused counselling in facilitating benzodiazepine withdrawal. In phase one of a two‐phase mixed‐methods evaluation, preintervention and postintervention quantitative data for 24 participants were analysed. Measures included the Australian Treatment Outcome Profile, Kessler 10, and two client outcome ratings. In phase two, follow‐up individual interviews were conducted with six participants. Following counselling, 88% of participants reported either reduced use or withdrawal from benzodiazepines. Significant reductions in psychological distress were obtained in Kessler 10 scores, and the calculated effect size (d = 0.84) was large. Medically supervised tapering was well received when combined with focused counselling. We found strong support for the tapering process and for the appropriateness of counselling. Withdrawal was facilitated when services were well coordinated and the client's sense of control was maintained.

Contextualising the Effectiveness of an Employee Assistance Program Intervention on Psychological Health: The Role of Corporate Climate.

Organisations often engage Employee Assistance Programs (EAPs) to assist employees experiencing psychological distress, yet EAPs primarily focus on individual remedies rather than addressing the context of the problem (e.g., the corporate climate) which may render them limited in effectiveness. We investigated the effectiveness of EAPs and the role of organisation psychosocial safety climate (PSC) (the corporate climate for worker psychological health and safety) and client satisfaction in reducing client psychological distress. Client participants (Time 1, n = 100, Time 2, n = 28, Matched n = 25) from Australia and New Zealand entering an EAP took part in two online surveys, pre- and post-EAP, around five weeks apart. Multilevel analysis showed a significant reduction in psychological distress due to the EAP (individual effect) but particularly at high levels of PSC (organisational effect). Thus, EAPs could engender a more significant impact by also assisting organisations to improve their PSC (i.e., through implementation of policies, practices and procedures for worker psychological health and safety), in combination with individual interventions.

Yoga Therapy in Cancer Care via Telehealth During the COVID-19 Pandemic.

Yoga is an evidence-based mind-body practice known to improve physical and mental health in cancer patients. We report on the processes and patient-reported outcomes of one-on-one yoga therapy (YT) consultations delivered via telehealth. For patients completing a YT consultation between March 2020 and October 2021, we examined demographics, reasons for referral, and self-reported symptom burden before and after one YT session using the Edmonton Symptom Assessment Scale (ESAS). Changes in ESAS symptom and subscale scores [physical distress (PHS), psychological distress (PSS), and global distress (GDS)] were evaluated by Wilcoxon signed-rank test. Descriptive statistics summarized the data. Ninety-seven initial YT consults were completed, with data evaluated for 95 patient encounters. The majority were women (83.2%) and white (75.8%), The mean age for females was 54.0 and for males was 53.4; the most common diagnosis was breast cancer (48%), 32.6% had metastatic disease, and nearly half (48.4%) were employed full-time. Mental health (43.0%) was the most common reason for referral, followed by fatigue (13.2%) and sleep disturbances (11.7%). The highest symptoms at baseline were sleep disturbance (4.3), followed by anxiety (3.7) and fatigue (3.5). YT lead to clinically and statistically significant reductions in PHS (mean change = -3.1, P < .001) and GDS (mean change = -5.1, P < .001) and significant reductions in PSS (mean change = -1.6, P < .001). Examination of specific symptom scores revealed clinically and statistically significant reductions in anxiety (mean change score -1.34, P < .001) and fatigue (mean change score -1.22, P < .001). Exploratory analyses of patients scoring ≥1 for specific symptoms pre-YT revealed clinically and statistically significant improvements in almost all symptoms and those scoring ≥4 pre-YT. As part of an integrative oncology outpatient consultation service, a single YT intervention delivered via telehealth contributed to a significant improvement in global, physical, and psychosocial distress. Additional research is warranted to explore the long-term sustainability of the improvement in symptoms.

Examining the Preliminary Effectiveness and Acceptability of a Web-Based Training Program for Australian Secondary School Teachers: Pilot Study of the BEAM (Building Educators' Skills in Adolescent Mental Health) Program.

BackgroundSecondary schools are increasingly supporting adolescents’ mental health and well-being, yet many teachers report that they lack the skills and confidence to do so. Building Educators’ skills in Adolescent Mental Health (BEAM) is a web-based training program developed to improve secondary school teachers’ knowledge and confidence in caring for students’ mental health.ObjectiveThis pilot study examined the preliminary effectiveness and acceptability of the BEAM program for improving mental health knowledge, attitudes, confidence, helping behaviors, and psychological distress among secondary school teachers.MethodsA single-arm pilot trial was conducted from July to December 2019 among secondary school teachers located in New South Wales, Australia, who were employed in leadership positions responsible for managing student well-being (ie, Year Advisors). Participants had access to the BEAM program for 6 weeks. Self-report surveys, delivered at baseline, postintervention (6-weeks post baseline) and 3-month follow-up (19 weeks post baseline) were used to measure changes in training outcomes. Acceptability was assessed by program use, barriers, satisfaction, and participants’ perceptions of program effectiveness.ResultsA total of 70 secondary school teachers took part (mean age 36.5 years, SD 9.41 years, range 24-60 years). Significant improvements in confidence were reported at postintervention and 3-month follow-up. Significant improvements in helping behaviors were reported at 3-month follow-up only. There was also a significant reduction in psychological distress at postintervention. Participants agreed that the program content was easy to understand and relevant, but program completion was challenged by lack of time, competing priorities, and forgetfulness.ConclusionsFindings indicated that a web-based training program may be beneficial for improving secondary school teachers’ abilities to care for students’ mental health; however, program modifications are required to increase training completions.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12619000821190, Universal Trial Number U1111-1232-7680; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377529

Effectiveness of an Adventure-based Cognitive Behavioral Program for Hong Kong University Students

Objectives: This pilot study developed an adventure-based cognitive behavioral intervention (aCBI) program and tests its effectiveness in improving the mental health of Chinese university students in Hong Kong. Method: A total of 217 undergraduate students participated in an aCBI program in the form of an interdisciplinary general education course in a university in Hong Kong. A battery of standardized online questionnaires was administered to the students before joining and upon completion of the course, and at a 3-month follow-up test. Results: The participants showed a significant reduction of psychological distress, perceived stress, depressive symptoms, and negative thoughts and emotions and a significant increase of positive thoughts upon immediate completion of the program. The positive effects maintained at the 3-month follow-up test. Conclusion: The integration of cognitive behavioral intervention and adventure training in a class setting might be an effective and feasible approach for the mental health counseling of university students.

Does Relationship Counselling for One Work? An Effectiveness Study of Routine Relationship Counselling Services Where Only One Individual Attends

There are no published studies investigating the effectiveness of relationship counselling (RC) where only one individual attends (individual relationship counselling (IRC)), in improving client psychological distress (PD). This is important to investigate considering the high prevalence of PD in this client group and the potential for its negative effects to cascade into other domains of an individual’s life. The current study aims to address this gap by investigating the short‐term effectiveness of IRC on PD. This study further builds on previous research by investigating variables that may explain changes in counselling outcomes, including client demographics, interpersonal factors, and therapeutic factors. Data were collected from a national sample of 273 individuals presenting for RC at an Australian not‐for‐profit organisation. Results from multilevel modelling showed a significant reduction in PD over time with moderate effect size. Further, relationship status, family functioning, and the Task subscale of the Working Alliance Inventory emerged as significant predictors of PD. The results of this study have important implications for routine practice in informing opportunities to target these key variables as an avenue to increasing the effectiveness of IRC.

Treatment outcomes of a lesbian, gay, bisexual, transgender and queer alcohol and other drug counselling service in Australia: A retrospective analysis of client records.

Substance use disorders are more prevalent among lesbian, gay, bisexual, transgender and queer (LGBTQ) people than among their heterosexual and cisgender peers. There has been limited alcohol and other drug (AOD) treatment research with LGBTQ people outside of North America. This study aimed to examine the treatment outcomes of clients attending a LGBTQ-specific AOD counselling service in Australia (ACON's Substance Support Service) and compare their client profile and treatment outcomes with LGBTQ and non-LGBTQ clients of similar mainstream services. This study was a retrospective analysis of the health records of 284 ACON clients and 1011 clients of five mainstream services in 2016-2018. Clients completed clinical interviews at treatment entry and periodically throughout treatment and completed measures of substance use, severity of dependence, psychological distress and quality of life. Most ACON clients were seeking treatment for methamphetamine (58%) and alcohol use (26%). Among ACON clients, there were reductions in past month days of substance use and severity of dependence between treatment entry and counselling sessions 4, 8 and 12 (all P< 0.001). There were statistically significant reductions in psychological distress and improved quality of life among ACON clients. Despite ACON and the mainstream services having similar treatment approaches, their client profiles were markedly different in terms of sociodemographic characteristics, substance use and source of referral, which precluded comparison of treatment outcomes. ACON's clients showed reduced substance use and improved psychosocial wellbeing during treatment. The findings support the provision of LGBTQ-specific AOD services.

A Mental Health-Informed Physical Activity Intervention for First Responders and Their Partners Delivered Using Facebook: Mixed Methods Pilot Study.

BackgroundFirst responders (eg, police, firefighters, and paramedics) are at high risk of experiencing poor mental health. Physical activity interventions can help reduce symptoms and improve mental health in this group. More research is needed to evaluate accessible, low-cost methods of delivering programs. Social media may be a potential platform for delivering group-based physical activity interventions.ObjectiveThis study aims to examine the feasibility and acceptability of delivering a mental health–informed physical activity program for first responders and their self-nominated support partners. This study also aims to assess the feasibility of applying a novel multiple time series design and to explore the impact of the intervention on mental health symptoms, sleep quality, quality of life, and physical activity levels.MethodsWe co-designed a 10-week web-based physical activity program delivered via a private Facebook group. We provided education and motivation around different topics weekly (eg, goal setting, overcoming barriers to exercise, and reducing sedentary behavior) and provided participants with a Fitbit. A multiple time series design was applied to assess psychological distress levels, with participants acting as their own control before the intervention.ResultsIn total, 24 participants (12 first responders and 12 nominated support partners) were recruited, and 21 (88%) completed the postassessment questionnaires. High acceptability was observed in the qualitative interviews. Exploratory analyses revealed significant reductions in psychological distress during the intervention. Preintervention and postintervention analysis showed significant improvements in quality of life (P=.001; Cohen d=0.60); total depression, anxiety, and stress scores (P=.047; Cohen d=0.35); and minutes of walking (P=.04; Cohen d=0.55). Changes in perceived social support from family (P=.07; Cohen d=0.37), friends (P=.10; Cohen d=0.38), and sleep quality (P=.28; Cohen d=0.19) were not significant.ConclusionsThe results provide preliminary support for the use of social media and a multiple time series design to deliver mental health–informed physical activity interventions for first responders and their support partners. Therefore, an adequately powered trial is required.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ACTRN): 12618001267246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001267246.

An integrative healthcare model with heartfulness meditation and care coordination improves outcomes in cyclic vomiting syndrome.

Cyclic vomiting syndrome (CVS) is associated with psychosocial comorbidity and often triggered by stress. Since the current disease-centered care model doesnot address psychosocial factors, we hypothesized that holistic, patient-centered care integrating meditation and addressing psychosocial needs through a care coordinator will improve healthcare outcomes in CVS. We conducted a prospective randomized controlled trial: 49 patients with CVS (mean age: 34±14years; 81% female) were randomized to conventional health care (controls) or Integrative Health care (IHC) (27: controls, 22: IHC). The IHC group was assigned a care coordinator and received meditation with a certified instructor. Outcomes including psychological distress, coping strategies to manage chronic stress, cognitive symptom management, and Health-Related Quality of Life (HRQoL) were measured. In intention-to-treat analyses, patients receiving IHC showed significant improvement in multiple domains of coping including positive reframing, planning, and reduction in self-blame (p values ≤0.05), and physical HRQoL (p=0.03) at 6months. They also leaned toward spirituality/religion as a coping measure (p≤0.02 at 3 and 6months). Subgroup analysis of compliant patients showed additional benefit with significant reduction in psychological distress (p=0.04), improvement in sleep quality (p=0.03), reduction in stress levels (0.02), improvement in physical HRQoL (0.04), and further improvement in other domains of coping (p<0.05). An IHC model incorporating meditation and care coordination improves patient outcomes in CVS and is a useful adjunct to standard treatment. Studies to determine the independent effects of meditation and care coordination are warranted.

Effect of a Compassion Cultivation Training Program for Caregivers of People With Mental Illness in Denmark

Caregivers of people with mental illness are at increased risk of developing depression, anxiety, and stress. To investigate the effect of a compassion cultivation training (CCT) program on decreasing caregiver psychological distress. This waitlist-controlled randomized clinical trial was conducted in 2 different community settings in Denmark. Caregivers were excluded if they had a diagnosed and untreated mental illness, addiction, meditation practice, or current psychotherapeutic treatment. Enrollment occurred between May 2018 and March 2019. A repeated measurement model was used to examine the impact of the intervention. The primary analysis was based on the intention-to-treat principle. Data analysis was conducted from June 4 to July 7, 2020. Participants were randomized 1-to-1 to an 8-week CCT course or waitlist control. Block randomization was used with 40 participants in each block. The main outcome was reduction in psychological distress, as measured by the Depression, Anxiety, Stress Scale (DASS). Baseline, postintervention, and 3- and 6-month follow-up measurements were collected. Among 192 participants assessed for eligibility, 161 participants were included in the study (mean [SD] age, 52.6 [12.5] years; 142 [88.2%] women), with 79 participants randomized to the CCT intervention and 82 participants in the waitlist control group. At baseline, the mean (SD) DASS scores for the intervention vs control groups were 10.89 (8.66) vs 10.80 (8.38) for depression, 6.89 (6.48) vs 6.68 (5.33) for anxiety, and 14.96 (7.90) vs 15.77 (7.40) for stress. The CCT group experienced statistically significant improvement in the primary outcome in mean change from baseline vs the control group at postintervention (adjusted mean difference: depression, -4.16 [95% CI, -6.75 to -1.58]; P = .002; anxiety, -2.24 [95% CI, -3.99 to -0.48]; P = .01; stress, -4.20 [95% CI, -6.73 to -1.67]; P = .001), the 3-month follow-up (adjusted mean difference: depression, -3.78 [95% CI, -6.40 to -1.17]; P = .005; anxiety, -2.50 [95% CI, -4.27 to -0.73]; P = .006; stress, -3.76 [95% CI, -6.32 to -1.21]; P = .004), and the 6-month follow-up (adjusted mean difference: depression: -4.24 [95% CI, -6.97 to -1.52]; P = .002; anxiety, -2.12 [95% CI, -3.96 to -0.29]; P = .02; stress: -3.79 [95% CI, -6.44 to -1.13]; P = .005). These findings suggest that CCT was superior to the waitlist control in supporting caregivers' mental health. Statistically and clinically significant reductions in psychological distress were found and sustained at the 6-month follow-up. The improvements noted in this randomized clinical trial could serve to encourage implementation of future evidence-based programs for caregivers. ClinicalTrials.gov Identifier: NCT03730155.