Simple Psychological Interventions Research Articles

Aspiring to a Better Future: Can a Simple Psychological Intervention Reduce Poverty?

Aspiring to a Better Future: Can a Simple Psychological Intervention Reduce Poverty?

Can Simple Psychological Interventions Increase Preventive Health Investment?

Behavioral constraints may explain part of the low demand for preventive health products. We test the effects of two light-touch psychological interventions on water chlorination and related health and economic outcomes using a randomized controlled trial among 3,750 women in rural Kenya. One intervention encourages participants to visualize alternative realizations of the future, and the other builds participants' ability to make concrete plans. After 12 weeks, visualization increases objectively measured chlorination, reduces diarrhea episodes among children, and increases savings. Effects on chlorination and savings persist after almost 3 years. Effects of the planning intervention are weaker and largely insignificant. Analysis of mechanisms suggests both interventions increase self-efficacy-beliefs about one's ability to achieve desired outcomes. Visualization also increases participants' skill in forecasting their future utility. The interventions do not differentially affect beliefs and knowledge about chlorination. Results suggest simple psychological interventions can increase future-oriented behaviors, including use of preventive health technologies.

Psycho-oncology service provisions for hospitalised cancer patients before and during the COVID-19 pandemic in an oncology centre in eastern India.

BackgroundAddressing the mental health needs of cancer patients and their caregivers improves the quality of care the patient receives in any cancer care ecosystem. International practice currently encourages integrated care for physical and mental health in oncology. The coronavirus disease (COVID-19) pandemic has affected the delivery of healthcare services across the world. The current research paper is on the psycho-oncology service provision for hospitalised cancer patients before and during the COVID-19 pandemic.MethodsAll patients who were referred to psycho-oncology services during the study period of 1 month, in the two successive years of 2019 and 2020, were included in the study. Retrospective data were collected from the centralised electronic medical records for patients. Data included cancer diagnosis, reason for admission, admitting team and reason for a psychiatric referral. Other parameters that were measured were the timing of the psychiatric assessment, psychiatric diagnosis and psycho-oncology care provided, which included psychological interventions carried out and medications prescribed. The overall institutional data on cancer care provision are also presented in brief to provide context to the psycho-oncology services.ResultsIntegrated psycho-oncology services reviewed and managed patients round the year in the hospital where the study was conducted. During the 1-month study period, in 2019 and 2020, the total number of hospitalised cancer patients managed by the services was 74 and 52, respectively. During the study period of 2020, 292 patients with cancer who were being treated in the hospital had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tested on reverse transcription-polymerase chain reaction (RT-PCR) and 50 members of healthcare staff also tested positive. The most common diagnosis of patients was found to be stress-related adjustment disorder [16/74 (21.6%) in 2019 and 16/52 (30.8%) in 2020]. The paper discusses the common stressors voiced by the patients and their caregivers during the COVID-19 pandemic. Several challenges of providing psychological services were overcome by the team and the paper touches upon the common strategies that were used during the pandemic. Most patients did not need medications, but a significant minority did benefit from treatment with psychotropic medications. Simple psychological interventions such as sleep hygiene, supportive therapy sessions and psycho-education benefited many patients and were feasible even during the pandemic.ConclusionThe provision of psycho-oncology services to cancer patients and their caregivers was important before and during the COVID-19 pandemic.Watch a video which illustrates the psycho-oncology service provisions in an oncology centre in Eastern India during the COVID-19 pandemic here: https://ecancer.org/en/video/9707-psycho-oncology-service-provisions-for-hospitalised-cancer-patients-before-and-during-the-covid19-pandemic.

Crossing the divide: a longitudinal study of effective treatments for people with autism and attention deficit hyperactivity disorder across the lifespan

BackgroundAutism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) frequently persist into adolescence and young adulthood. However, there are few clinical services that support those with these disorders through adulthood.ObjectiveOur aim was to determine if clinical services meet the needs of people with ASD and ADHD, who are ‘at transition’ from childhood to adulthood.DesignA longitudinal study of individuals with ASD and ADHD, the impact of services and treatments.MethodsOur research methods included (1) interviewing > 180 affected individuals (and their families) with a confirmed diagnosis of ASD and/or ADHD, (2) screening for ASD and ADHD in approximately 1600 patients and (3) surveying general practitioner prescribing to 5651 ASD individuals across the UK. In addition, we tested the effectiveness of (1) new ASD diagnostic interview measures in 169 twins, 145 familes and 150 non-twins, (2) a magnetic resonance imaging-based diagnostic aid in 40 ASD individuals, (3) psychological treatments in 46 ASD individuals and (4) the feasability of e-learning in 28 clinicians.SettingNHS clinical services and prisons.ParticipantsFocus – young people with ASD and ADHD as they ‘transition’ from childhood and adolescence into early adulthood.InterventionsTesting the utility of diagnostic measures and services, web-based learning interventions, pharmacological prescribing and cognitive–behavioural treatments.Main outcome measuresSymptom severity, service provision and met/unmet need.ResultsPeople with ASD and ADHD have very significant unmet needs as they transition through adolescence and young adulthood. A major contributor to this is the presence of associated mental health symptoms. However, these are mostly undiagnosed (and untreated) by clinical services. Furthermore, the largest determinant of service provision was age and not severity of symptoms. We provide new tools to help diagnose both the core disorders and their associated symptoms. We also provide proof of concept for the effectiveness of simple psychological interventions to treat obsessional symptoms, the potential to run treatment trials in prisons and training interventions.LimitationsOur findings only apply to clinical service settings.ConclusionsAs individuals ‘transition’ their contact with treatment and support services reduces significantly. Needs-led services are required, which can both identify individuals with the ‘core symptoms’ of ASD and ADHD and treat their residual symptoms and associated conditions.Future workTo test our new diagnostic measures and treatment approaches in larger controlled trials.Trial registrationCurrent Controlled Trials ISRCTN87114880.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

Simple Psychological Interventions for Reducing Pain From Common Needle Procedures in Adults: Systematic Review of Randomized and Quasi-Randomized Controlled Trials.

This systematic review evaluated the effectiveness of simple psychological interventions for managing pain and fear in adults undergoing vaccination or related common needle procedures (ie, venipuncture/venous cannulation). Databases were searched to identify relevant randomized and quasi-randomized controlled trials. Self-reported pain and fear were prioritized as critically important outcomes. Data were combined using standardized mean difference (SMD) or relative risk (RR) with 95% confidence intervals (CI). No studies involving vaccination met inclusion criteria; evidence was drawn from 8 studies of other common needle procedures (eg, venous cannulation, venipuncture) in adults. Two trials evaluating the impact of neutral signaling of the impending procedure (eg, "ready?") as compared with signaling of impending pain (eg, "sharp scratch") demonstrated lower pain when signaled about the procedure (n=199): SMD=-0.97 (95% CI, -1.26, -0.68), after removal of 1 trial where self-reported pain was significantly lower than the other 2 included trials. Two trials evaluated music distraction (n=156) and demonstrated no difference in pain: SMD=0.10 (95% CI, -0.48, 0.27), or fear: SMD=-0.25 (95% CI, -0.61, 0.10). Two trials evaluated visual distraction and demonstrated no difference in pain (n=177): SMD=-0.57 (95% CI, -1.82, 0.68), or fear (n=81): SMD=-0.05 (95% CI, -0.50, 0.40). Two trials evaluating breathing interventions found less pain in intervention groups (n=138): SMD=-0.82 (95% CI, -1.21, -0.43). The quality of evidence across all trials was very low. There are no published studies of simple psychological interventions for vaccination pain in adults. There is some evidence of a benefit from other needle procedures for breathing strategies and neutral signaling of the start of the procedure. There is no evidence for use of music or visual distraction.

A pilot telephone intervention to increase uptake of breast cancer screening in socially deprived areas in Scotland (TELBRECS): study protocol for a randomised controlled trial.

BackgroundBreast cancer accounts for almost 30% of all cancers and is the second leading cause of cancer deaths in women in Scotland. Screening is key to early detection. The Scottish Breast Screening Programme is a nationwide, free at point of delivery screening service, to which all women aged between 50 and 70 years are invited to attend every 3 years. Currently over three-quarters of invited women regularly attend screening. However, women from more deprived areas are much less likely to attend: for example in the 3 years from 2010–2012 only 63% of women in the most deprived area attended the East of Scotland Breast Screening programme versus 81% in the least deprived. Research has suggested that reminders (telephone or letter) and brief, personalised interventions addressing barriers to attendance may be helpful in increasing uptake in low-income women.Methods/DesignWe will employ a brief telephone reminder and support intervention, whose purpose is to elicit and address any mistaken beliefs women have about breast screening, with the aim that the perceived benefits of screening come to outweigh any perceived barriers for individuals. We will test whether this intervention, plus a simple anticipated regret manipulation, will lead to an increase in the uptake of breast cancer screening amongst low-income women who have failed to attend a first appointment, in a randomised controlled trial with 600 women. Participants will be randomly allocated to one of four treatment arms i.e. 1) Letter reminder (i.e. Treatment as usual: CONTROL); 2) Telephone reminder (TEL), 3) Telephone reminder plus telephone support (TEL-SUPP) and 4) Telephone reminder plus support plus AR (TEL-SUPP-AR). The primary outcome will be attendance at breast screening within 3 months of the reminder letter.DiscussionIf this simple telephone support intervention (with or without AR intervention) leads to a significant increase in breast screening attendance, this would represent a rare example of a theoretically-driven, relatively simple psychological intervention that could result in earlier detection of breast cancer amongst an under-served group of lower socio-economic women.Trial registrationCurrent Controlled trials: ISRCTN06039270. Registered 16th January 2014.

Treatment of Behavioral and Psychological Symptoms of Alzheimer’s Disease

Behavioral and psychological symptoms of dementia (BPSD) are frequent amongst people with Alzheimer's disease (AD) and other dementias, commonly confer risk to that person and others, and present a significant management challenge for clinicians. There is increasing evidence to support the value of simple psychological interventions and the treatment of pain as a first-line management strategy prior to pharmacotherapy. The most widely prescribed pharmacological treatments-atypical antipsychotics-have a modest but significant beneficial effect in the short-term treatment of aggression (over 6-12weeks) but limited benefits in longer-term therapy. In addition, there have been increasing concerns regarding the potential for serious adverse outcomes, including stroke and death. The potential pharmacologic alternatives to atypical antipsychotics with the most encouraging preliminary evidence include memantine, carbamazepine, citalopram, and prazosin. Large, prospective, randomized placebo-controlled trials are needed to establish the role of these agents as clinical therapies for the treatment of BPSD.

Implementing the NICE guideline for schizophrenia recommendations for psychological therapies: a qualitative analysis of the attitudes of CMHT staff

Despite national guidelines recommending cognitive-behavioural therapy (CBT) and family intervention (FI) in the treatment of schizophrenia, levels of implementation in routine care remain low. The present study investigates attitudinal factors amongst community mental health team (CMHT) staff affecting guideline implementation. CMHTs were audited to measure the capacity and delivery of CBT and FI, and semi-structured interviews were conducted with staff from the teams. Methods. Four CMHTs were audited, and five care coordinators from each team were interviewed. A purposive approach to sampling was used to represent the range of professional training of care coordinating staff. Data were analysed using thematic content analysis. Positive views towards guidelines were evident, although tempered by specific implementation issues. Employing simple psychological interventions and approaches as part of the care coordinating role also emerged as highly valued by staff. Severe workload, time pressure and the need for specialist staff were crucial barriers to implementation. Pessimistic views of recovery for clients with psychosis were also apparent and may affect implementation. Staff attitudes and knowledge are an important area of research when examining guideline implementation and require further study. Key themes that have emerged could inform future training agendas and should be considered when developing guideline implementation strategies for the updated 2009 guidelines.

Management of agitation and aggression associated with Alzheimerʼs disease: controversies and possible solutions

Behavioral and psychological symptoms of dementia (BPSD) are frequent among people with Alzheimer's disease and other dementias, commonly confer risk to the person and others, and present a significant management challenge for clinicians. The purpose of this review is to describe the current state of knowledge regarding management of BPSD, with a particular focus on agitation. There is increasing evidence to support the value of simple psychological interventions and staff-training programs as a first-line management strategy for agitation prior to pharmacotherapy. The most widely prescribed pharmacological treatments - atypical antipsychotics - have a modest but significant beneficial effect in the short-term treatment of aggression (over 6-12 weeks), but limited benefits in longer term therapy. In addition, there have been increasing concerns regarding the potential for serious adverse outcomes, including stroke and death. The potential pharmacological alternatives to atypical antipsychotics with the most encouraging preliminary evidence include memantine, carbamazepine and citalopram. Large prospective, randomized, placebo-controlled trials are needed to establish the role of agents other than neuroleptics as clinical therapies for the treatment of BPSD and studies are urgently needed to evaluate BPSD treatments in non-Alzheimer dementias.

Encouraging young males to perform testicular self‐examination: A simple, but effective, implementation intentions intervention

The objective of this study was to examine the effectiveness of a simple psychological intervention known as 'implementation intentions' to promote performance of testicular self-examination (TSE) in a sample of young males. A prospective, randomized controlled design measured knowledge of testicular cancer, prior experience with TSE and intention to perform TSE within a 3-week period. Participants in the intervention group were instructed to formulate specific plans for when and where they would perform TSE. Three weeks later, a second questionnaire assessed self-reported performance of TSE during the study period and future intention to perform TSE. One hundred and fifty-nine male undergraduates aged between 18 and 35 were assigned, at random, to an intervention or non-intervention group. Men over 35 were excluded so that the sample reflected the highest risk age group for testicular cancer. Just under half the original participants (76/159) completed the study. We measured performance of TSE and future intention to perform TSE. Responders and non-responders did not differ on any of the measures assessed at Time 1. At Time 2, 30 (65%) participants in the intervention reported performing TSE compared with 12 (40%) in the control condition, and chi-squared analyses revealed that the difference was significant. The implementation intentions intervention procedure, which encourages the use of environmental and contextual 'cues' to prompt a desired behaviour, appears to offer a promising strategy for encouraging the performance of TSE.

Helping with deliberate self-harm: Some practical guidelines

Deliberate self-harm poses particular problems for helpers, and people who harm themselves often receive a poor service. This paper explores the reasons why people harm themselves, looks at a case example where a simple psychological intervention proved effective, and offers some practical suggestions that can be used in any service setting.