Solution-focused Intervention Research Articles

Feasibility and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with long-term physical conditions: an exploratory non-controlled study in Bosnia and Herzegovina, Colombia and Uganda

IntroductionThe management of long-term physical conditions is a challenge worldwide, absorbing a majority resources despite the importance of acute care. The management of these conditions is done largely in primary care and so interventions to improve primary care could have an enormous impact. However, very little data exist on how to do this. Mental distress is frequently comorbid with long term physical conditions, and can impact on health behaviour and adherence, leading to poorer outcomes. DIALOG+ is a low-cost, patient-centred and solution-focused intervention, which is used in routine patient-clinician meetings and has been shown to improve outcomes in mental health care. The question arises as to whether it could also be used in primary care to improve the quality of life and mental health of patients with long-term physical conditions. This is particularly important for low- and middle-income countries with limited health care resources.MethodsAn exploratory non-controlled multi-site trial was conducted in Bosnia and Herzegovina, Colombia, and Uganda. Feasibility was determined by recruitment, retention, and session completion. Patient outcomes (quality of life, anxiety and depression symptoms, objective social situation) were assessed at baseline and after three approximately monthly DIALOG+ sessions.ResultsA total of 117 patients were enrolled in the study, 25 in Bosnia and Herzegovina, 32 in Colombia, and 60 in Uganda. In each country, more than 75% of anticipated participants were recruited, with retention rates over 90% and completion of the intervention exceeding 92%. Patients had significantly higher quality of life and fewer anxiety and depression symptoms at post-intervention follow-up, with moderate to large effect sizes. There were no significant improvements in objective social situation.ConclusionThe findings from this exploratory trial suggest that DIALOG+ is feasible in primary care settings for patients with long-term physical conditions and may substantially improve patient outcomes. Future research may test implementation and effectiveness of DIALOG+ in randomized controlled trials in wider primary care settings in low- and middle-income countries.Trial registrationAll studies were registered prospectively within the ISRCTN Registry. ISRCTN17003451, 02/12/2020 (Bosnia and Herzegovina), ISRCTN14018729, 01/12/2020 (Colombia) and ISRCTN50335796, 02/12/2020 (Uganda).

4.P. Workshop: Mental health among adolescents – from epidemiological surveillance to school-based promotion

Abstract Tacitly it has been assumed that mental health would prevail in the absence of pathology. However, the relationship between mental illness and mental health is not symmetrical in the sense that the absence of the former necessarily means high levels of the latter. On the contrary, a growing body of evidence shows that high levels of well-being independently predict less subsequent mental illness and have a range of positive effects on individuals and society. If we continue to neglect positive conceptualisations of mental health and health assets in our research, we will end up with an impoverished picture of the distribution and determinants of mental health at the population level. Drawing from our experience with epidemiological surveillance and the development, testing and evaluation of a new manual-based intervention to promote adolescent mental health, the objective of this workshop will be to present how mental health can be conceptualized, monitored, and promoted using the two continua model of mental health. The latter holds that mental illness and mental health are two related but distinct dimensions as opposed to the conventional single continua model that puts mental illness at one end and mental health at the other as opposites. To accomplish the workshop in a coherent manner require four presentations. The first two presentations will illuminate the importance of including also mental well-being in epidemiological surveillance of mental health and an example will be made of this using a regional population survey among Swedish adolescents prior to and three years after the Covid-19 outbreak. The last two presentations will shift focus from measuring population needs to addressing these needs with a tailor made school-based intervention. The school with its compensatory mandate is an important arena for health-promoting interventions as it may positively influence students’ developmental trajectories into adulthood, especially their mental health. Likewise, mental health is important for the school and for society, since students who are mentally flourishing have an easier time learning things and better conditions to cope with school. However, there is a dearth of evaluated interventions designed specifically to promote mental well-being in adolescents. Current theories of hedonic and eudemonic well-being along with the solution-focused approach will be presented as frameworks for enhancing well-being in adolescents followed by its application in a new manual-based programme aimed at promoting mental well-being in upper secondary school. The Solution-focused Intervention for Mental health was developed over a period of five years in three feasibility studies. The last presentation will briefly describe from theory to practice how components of mental well-being are broken down to indicators, contextualised and given practical meaning in everyday life. Key messages • To properly assess adolescent mental health in a population, using the two continua model, means to measure and combine the results of both mental ill health and mental well-being. • The new Solution-focused Intervention for Mental health (SIM) is a manual-based program designed and tested to promote adolescent mental health in upper secondary school.

A solution-focused coaching approach to promote adolescent mental well-being in a school setting

Abstract Solution-focused brief coaching departs from the idea that a focus on the clients’ strengths and hopes for the future, rather than on past or present problems, will lead them to do more of what works well and move them toward a desired future. Compared to a problem-oriented approach, the solution-focused is systemic and interactive; the client is viewed as a resourceful individual in a context and as an expert on his or her own life. From this foundation, the Solution-focused Intervention for mental health (SIM) was developed for students in upper secondary school. SIM builds upon four fundamental assumptions. First, an understanding of the cause of a personal problem does not necessarily bring the student closer to a solution of it, or to a desired future. Second, what we focus our attention on and the language we use to describe and discuss our health will grow on us. Third, all students “want to and can do something” that can lead them towards their desired future. Fourth, all students are resourceful and can act in a self-desired direction. During the coaching process in SIM, what the students “hope will start to happen and resources and abilities that can make this possible” are explored and reinforced with a solution-focused dialogue. With support from a group coach and their classmates, students are encouraged to explore what could help towards a desired future and what efforts need to be taken to move in this direction. This is followed up in future sessions by focusing on what works well and efforts made towards what is wanted. The solutions-focused coaching approach, and its associated techniques, aim to engage the students in a process that enhances the awareness and motivation to explore their own strengths and resources so as to engender self-efficacy and self-confidence and strengthen their desire to further develop their abilities and skills. The objective of the process is to establish a mental health promotion that is positively self-reinforcing.

The Solution-focused Intervention for Mental health to promote adolescent mental well-being

Abstract With its compensatory mandate, the school is essential for health-promoting interventions. There are evaluated programs available that prevent mental problems, mental illnesses and various risk behaviours. However, there is a dearth of evaluated interventions designed to promote mental well-being in adolescents, which are adapted for upper secondary school. It was against this background that the development and evaluation of the Solution-focused Intervention for Mental health (SIM) began in 2018. This presentation will briefly overview the intervention, its components, design and results from feasibility studies. As an intervention programme, SIM consists of group-based coaching that starts from the core components and indicators of mental well-being and enjoying school. Thus, the intervention is based on a normative model of mental well-being; however, the dialogue conducted during the nine two-hour weekly group sessions is based on the solution-focused approach and its techniques. Specially trained teachers facilitating the content and process during group sessions lead SIM. The SIM programme is manual-based and designed to help students discover, explore, practice and develop existing personal resources in order to strengthen hedonic and eudemonic well-being. The teacher uses solution-focused coaching techniques to encourage the students to practise and discover how to utilise their existing resources. By focusing on what works small steps can be taken towards a desired future using indicators of well-being and solution-focused techniques. SIM has so far been tested in feasibility studies in 2019 (n∼140), 2021 (n∼200) and 2023 (n∼50). Results from focus group interviews, session scales ratings and pairwise testing of changes in well-being after compared to before interventions show promising results with increased well-being and total effect sizes ranging from Coheńs d of 0.19 to 0.59. SIM is now ready to be properly evaluated in a randomised controlled trial.

A randomized controlled trial of a nurse-led psychological pain solution-focused intervention for depressed inpatients: study protocol

BackgroundDepressed patients commonly experience psychological pain. Research pointed to positive psychological interventions as an effective means of ameliorating psychological pain, although the exact effect is unclear. Based on the hope theory and solution-focused brief therapy (SFBT), this study combines hope theory with solution-focused brief therapy to develop a nurse-led psychological pain solution-focused (PPSF) intervention in depressed patients.MethodsThis is an assessor-blinded randomized controlled trial following the SPIRIT guidance. A total of 84 depressed patients will be recruited from the inpatient wards of a psychiatric hospital and randomly assigned to the control and experimental groups. Patients in the control group will be treated as usual. In contrast, patients in the experimental group will receive 6 sessions of the PPSF intervention for two weeks on top of the routine care. Primary outcomes are psychological pain, hope, cognitive distortions. Secondary outcomes are depression and suicidal ideation. Data will be collected at 5-time points: baseline, 1 and 2 weeks (post-intervention), 1 month (follow up), and 6 months after baseline. Generalized equation evaluation will be used to assess the effectiveness of the PPSF intervention.DiscussionFrom a positive psychology perspective, there remains much room for developing psychological pain interventions in depressed patients. SFBT and hope theory are both based on positive psychology. With hope theory as the general framework and SFBT questions as the practical guide, the PPSF intervention program is designed that nursing staff can implement. If the intervention is effective, it will advance the development of psychological pain interventions for patients with depression.Trial registrationChiCTR2100048223

Effectiveness and cost-effectiveness of a solution-focused intervention in child protection services

The purpose of this research was to evaluate the impact on child welfare of introducing solution-focused principles and intervention techniques in the local child protection service of the island of Tenerife, Spain. 152 workers from 34 local child protection teams participated in the study. Goal achievement, parents’ and children’s self-reported well-being, and statutory child welfare measures were recorded during one year. Then the child protection teams were randomly assigned to a control or an experimental condition. 73 workers in the experimental condition, serving 271 families, received 30 h of training and 30 h of supervision in solution-focused brief therapy (SFBT). 79 workers in the control condition, serving 206 families, continued to intervene as usual. The dependent variables were evaluated again in the experimental and in the control group one year after the supervision in SFBT had finished. Results indicate that the experimental and the control group had equivalent outcomes at pre-test. At post-test, the experimental group achieved better outcomes than the control group: workers’ and parents’ goal achievement ratings as well as parents’ and children well-being ratings were higher, fewer cases had been referred to risk teams, fewer children had been removed from their homes and recidivism was lower. The effects were small for goal achievement, medium for recidivism, and large for well-being and child removal. The teams that used SFBT reached these outcomes with fewer sessions and allocating fewer additional resources than the control group.

A comparative study of the effectiveness of the solution-focused brief therapy and mindfulness-based therapy to reduce educational stress in junior high school students in Tehran

Introduction: Educational stress is a negative psychological condition; with its cognitive and emotional components, threatens students' health. Aim: This study aimed to compare the effectiveness of the solution-focused brief therapy and mindfulness-based therapy to reduce educational stress in junior high school students. Method: Through the framework of a clinical trial plan with pre-test and post-test and quarterly post hoc test, this study was conducted. In a purposive sampling manner, sixty students; among the first year of junior high school male students in Tehran district 13thin the school year 2019-2020, were selected and then surveyed by Don, Hu and Zhou (2011) Adolescent Educational Stress Scale and were randomly divided into 3 groups of 20: control group, solution-focused treatment group and mindfulness treatment group. Then the intervention process was run on the experimental groups and after three months the follow-up test was rerun. The data were analyzed by using SPSS-26 and the covariance analysis and mixed-design analysis of variance tests. Results: This study brought light on the effectiveness of both treatments methods in reducing educational stress among students, but the mindfulness method (Eta2=0.357) worked better rather the brief solution-focused intervention method(Eta2=0.318) to reduce students' stress (P<0.05). Conclusion: In regard to use mindfulness therapy primarily, therapists are highly recommended to use both the solution-focused brief intervention and mindfulness therapy to treat the adolescent students with educational stress.

Clinical- and cost-effectiveness of a technology-supported and solution-focused intervention (DIALOG+) in treatment of patients with chronic depression\u2014study protocol for a multi-site, cluster randomised controlled trial [TACK

BackgroundMany with an acute depressive disorder go on to develop chronic depression, despite ongoing care. There are few specifically designed interventions to treat chronic depression. DIALOG+, a technology-assisted intervention based on the principles of solution-focused therapy, may be beneficial. It has been shown to be effective as a treatment for patients with psychotic disorders, especially in regards to increasing quality of life. DIALOG+ was designed to be flexibly applied and not diagnosis-specific, aiming to structure communication and generate a personally-tailored care plan. This cluster randomised controlled trial (RCT) is part of a programme of research to adapt and test DIALOG+ for patients with chronic depression.MethodsPatients will be eligible for the trial, if they have exhibited symptoms of depression or non-psychotic low mood for at least 2 years, have regular contact with a clinician and have a low subjective quality of life and moderate depressive symptoms. Clinicians, who routinely see eligible patients, will be recruited from a number of sites across NHS England. Clusters will have between 1 and 6 patients per clinician and will be randomised in a 1:1 ratio to either the intervention (DIALOG+) or active control group (treatment as usual + DIALOG scale). Clinicians in the intervention group are trained and asked to deliver the intervention regularly for 12 months. Active control participants receive treatment as usual and are asked to rate their satisfaction with areas of life and treatment on the DIALOG scale at the end of the clinical session. Approximately 112 clinician clusters will be recruited to reach a total patient sample size of 376. Clinical and social outcomes including costs are assessed at baseline and 3, 6 and 12 months post randomisation. The primary outcome will be subjective quality of life at 12 months.DiscussionThis definitive multi-site, cluster RCT aims to evaluate the clinical- and cost-effectiveness of DIALOG+ for people with chronic depression. If shown to be effective for this patient population it could be used to improve outcomes of mental health care on a larger scale, ensuring that patients with complex and co-morbid diagnoses can benefit.Trial registrationISRCTN11301686. Registered on 13 Jun 2019.

Effectiveness of a structured intervention to make routine clinical meetings therapeutically effective (DIALOG+) for patients with depressive and anxiety disorders in Bosnia and Herzegovina: A cluster randomised controlled trial

BackgroundDIALOG+ is a patient-centred, solution-focused intervention, which aims to make routine patient-clinician meetings therapeutically effective. Existing evidence suggests that it is effective for patients with psychotic disorders in high-income countries. We tested the effectiveness of DIALOG ​+ ​for patients with depressive and anxiety disorders in Bosnia and Herzegovina, a middle-income country.MethodsWe conducted a parallel-group, cluster randomised controlled trial of DIALOG+ in an outpatient clinic in Sarajevo. Patients inclusion criteria were: 18 years and older, a diagnosis of depressive or anxiety disorders, and low quality of life. Clinicians and their patients were randomly allocated to either the DIALOG ​+ ​intervention or routine care in a 1:1 ratio. The primary outcome, quality of life, and secondary outcomes, psychiatric symptoms and objective social outcomes, were measured at 6- and 12-months by blinded assessors.ResultsFifteen clinicians and 72 patients were randomised. Loss to follow-up was 12% at 6-months and 19% at 12-months. Quality of life did not significantly differ between intervention and control group after six months, but patients receiving DIALOG ​+ ​had significantly better quality of life after 12 months, with a medium effect size (Cohen's d ​= ​0.632, p ​= ​0.007). General symptoms as well as specifically anxiety and depression symptoms were significantly lower after six and 12 months, and the objective social situation showed a statistical trend after 12 months, all in favour of the intervention group. No adverse events were reported.LimitationsDelivery of the intervention was variable and COVID-19 affected 12-month follow-up assessments in both groups.ConclusionThe findings suggest DIALOG ​+ ​could be an effective treatment option for improving quality of life and reducing psychiatric symptoms in patients with depressive and anxiety disorders in a low-resource setting.

Text or Not to Text? A Narrative Review of Texting as a Case Management Intervention.

To review current literature on texting as a sustainable intervention of case management in the outpatient setting. Texting, as a case management intervention, provides the medically complex client with a pathway to achieve care plan goals. Texting increases adherence, communication, and self-management. It can increase client enrollment in disease management programs, while providing support, flexibility, convenience, cost savings, and increased participation. In current practice, such as management of the coronavirus (COVID-19), other pandemics, or natural/environmental disasters, texting is a solution-focused intervention that can deliver and retrieve real-time information to a medically complex population. It can link patients to resources and increase outreach, efficiency, quality, and coordination of care. Texting can promote adherence to appointments, increase medication compliance and disease management interventions, and provide motivational change messages. However, there are legal and regulatory concerns that carry potential consequences and implications that should be approached judiciously (Mellette, 2015). Texting is not one size fits all; it can cause HIPAA breeches, hinder communication with certain populations, confuse health messaging, and replace human communication, thereby reducing staffing in practice.

Acceptability of a technology-supported and solution-focused intervention (DIALOG+) for chronic depression: views of service users and clinicians

BackgroundTreating chronic depression represents a significant burden for the NHS, yet there is a lack of evidence-based interventions and research specifically focused on this condition. DIALOG+, a technology-assisted and resource-oriented intervention found effective for people with psychosis, may improve care for this service user group. The aim of this study was to explore the acceptability and relevance of DIALOG+ for the treatment of chronic depression in community-based settings.MethodsA convenience sample of 16 mental health professionals and 29 service users with chronic depression tested the DIALOG+ intervention in routine community care appointments for 3 months across 3 different mental health NHS Trusts in England. Of these, 15 clinicians and 19 service users were individually interviewed about their experiences. Interview transcripts were analysed using thematic analysis by an analytic team which included a service user researcher.ResultsAnalysis of the combined dataset identified five overarching themes: DIALOG+ Structure; Therapeutic Communication; Reflecting and Monitoring; Empowerment and Powerlessness; and The Impact of Technology. Overall, service users and clinicians were interested in the continued use of DIALOG+ as part of routine care.ConclusionsDIALOG+ was viewed as acceptable by both service users with chronic depression and their clinicians who work in community care settings, albeit with some caveats. Clinician training required significant improvements to address the issues that were referenced, most notably around support with using technology.

Solution-focused wellness coaching: a mixed methods, longitudinal study with college students

ABSTRACT Research indicates that college students are experiencing mental health challenges of greater severity and frequency. College students present with a variety of wellness-related challenges, resulting in increased demand on campus health resources and service limitations including extended wait lists and increased off-campus referrals. This research study examined the effectiveness of a short-term solution-focused intervention on perceptions of wellness and stress among the college student population. This study utilized a longitudinal, mixed-methods design to assess the impact of a brief (seven-week) intervention on perceived stress and wellness among 52 college students at a large Midwestern University, using the Perceived Stress Scale (PSS) and Five-Factor Wellness Evaluation of Lifestyle (5 F-WEL). Repeated measures analysis of variance (RM-ANOVA) results indicated significant differences across time for perceived stress and wellness (p <.01). To augment quantitative data, a brief, semi-structured interview was completed with 24 study participants post-intervention, and an Applied Thematic Analysis (ATA) was conducted as a means of identifying themes. This study demonstrates the effectiveness of a solution-focused wellness (SFW) approach in changing perceptions of stress and wellness. Findings provide support for a prevention model in which college students are encouraged to proactively engage in lifestyle activities that enhance their wellness.

Process-Outcome-Relationships and Solution-Based Interventions With Grandparent Caregivers

Grandparents raising grandchildren face many challenges such as isolation, stigma, negative thoughts, and biases from age peers and service providers. In contrast, recent work suggests a need to re-frame grandparent caregiving in positive terms. In this light, the present study explored the processes key to the success of a solution-focused intervention with such persons. Fifty-two grandparents caregivers participated in a six-session solution focused intervention, using the theoretical framework of Selection, Optimization and Compensation (SOC) by Baltes & Baltes (1990). Throughout the program the emphases were on goal setting, solution focused thinking and communication skills. Participants were randomly assigned to intervention or waiting list control conditions. Within each session measures of hopefulness, positive thoughts about one’s grandchild, solution focused thinking, self-rated stress and perceived goal attainment were taken. Results indicated significant decreases in stress and increases over six sessions in hopefulness, positive thoughts about the grandchild, being solution-oriented and success in overcoming barriers interfering with goal setting and implementation (p<.05). Measures of goal accomplishment, strategy usage, success and satisfaction with effort were uniformly high. Such findings speak to key processes underlying the efficacy of a solution-focused intervention with grandparent caregivers. Measures of such processes also predicted outcome measures, e.g., resilience, positive affect, caregiver strain, well-being, loneliness, depression, parental efficacy and adequacy of service needs met. These findings reinforce the importance of understanding change processes as predictors of solution-focused intervention outcomes with grandparent caregivers and are consistent with the need to emphasize such persons’ strengths.

Integrated Discourse Therapy After Glioblastoma: A Case Report of Face-To-Face and Tele-NeuroRehabilitation Treatment Delivery

Background: Language and communication impairments are among the most frequently reported long-term behavioral consequences of brain tumor. Such deficits may persist long after a patient has been discharged from the hospital and can significantly impact return to work, resumption of prior social roles, and interpersonal relations, as well as full engagement in leisure activities. While considerable research has centered on identifying and describing communication impairments in brain tumor survivors, relatively little research has investigated language therapy for this population.Aims: This report (1) reviews the literature and describes the language and cognitive-communicative profile of a 35-year-old man 6 years post glioblastoma excision with subsequent chemo- and radiation therapies; (2) presents cognitive-communication outcome data for this individual following an integrated discourse therapy; and (3) assesses treatment feasibility in face-to-face (F2F) and tele-neurorehabilitation (TNR) contexts.Methods: A battery of tests and weekly conversation probes were administered to evaluate baseline performance and potential changes associated with F2F and TNR treatment delivery. Integrated Conversation Therapy (ICT) was administered across four alternating (F2F and TNR) treatment blocks over 2 months. ICT is a solution-focused discourse intervention that simultaneously targets word finding, sentence processing, and authentic patient-selected conversational interactions.Results: Although the participant presented with long term-language impairments that were clinically distinct from stroke-associated aphasia, statistically significant post-treatment gains (>2 SEM) were evident following F2F and TNR treatment delivery on standardized measures of apraxia, discourse production, verbal memory, and self-ratings of discourse production, communication, and living with aphasia. While objective measures of treatment effect size (probes of CIU discourse data) were consistent across F2F and TNR delivery models, results of a satisfaction survey indicated a slight but statistically significant participant preference for TNR treatment delivery.Conclusions: This study provides preliminary support for F2F and TNR delivery of ICT discourse intervention for glioblastoma survivors. It also highlights the need for more research specifically dedicated to language therapy for this population.

PSYCHOLOGICAL WELL-BEING OF DRUG ADDICTS IN PREDICTING TREATMENT OUTCOMES

Purpose of the study: This study aims to investigate whether psychological well-being could predict treatment outcomes in drug addicts after they had received solution-based psychosocial intervention in a drug treatment setting. The psychological well-being of individuals is an important variable in discussing treatment outcomes after they were given psychosocial interventions.&#x0D; Methodology: This study utilized a quasi-experimental research design using non-randomized pre-and post-test single group design. Fifty-seven participants were selected and they completed a pre- and post-assessment on psychological well-being changes and treatment outcomes questionnaire. Paired t-test and Pearson correlation were used to analyze the relationship between these two variables, while multiple linear regression was used to further explore whether participants' psychological well-being could predict their treatment outcomes.&#x0D; Main Findings: Results indicated a significant relationship between these two variables and more than twenty percent in treatment outcomes were explained by psychological variance. Few contextual meanings of psychological symptoms should need to be emphasized in discussing the findings and future research direction.&#x0D; Applications of this study: Having studied whether psychological well-being could predict treatment outcomes of drug addicts would benefit counselors and social workers who deal with addiction clients. The element of psychological well-being, such as mental health must be included in the treatment plan to increase the success of recovery amongst drug addict clients.&#x0D; The novelty of this study: The conclusions from this study offer significant insight into the utilization of solution-focused intervention in non-Western populations and the relation between psychological well-being and treatment outcomes for drug addict clients. The findings expand the existing literature review on the psychological well-being of drug addicts in a way it takes into accounts the cultural context in discussing the outcomes.

A reflective qualitative appreciative inquiry approach to restoring compassionate care deficits at one United Kingdom health care site

Following declining health care practices at one UK health care site the subsequent and much publicized Francis Report made several far-reaching recommendations aimed at recovering optimal levels of care including stringent monitoring of practice. The aftermath of these deliberations have had resounding consequences for quality care both nationally and internationally. A reflective qualitative appreciative qualitative inquiry using a hybrid approach combining case study and thematic analysis outlines the development and analysis of a solution-focused intervention aimed at restoring staff confidence and optimal care levels at one key UK hospital site. Personal diaries were used to collect data. Data were analysed using descriptive thematic analysis. The implications of the five emerging themes and the 10-step approach used are discussed in the context of understanding care erosion and ways to effect organisational change. A novel approach to addressing care deficits, which provides a promising bottom-up approach, initiated by health care policy makers is suggested for use in other health care settings when concerns about care arise. It is anticipated this approach will prove useful for nurse managers, particularly in relation to finding positive solutions to addressing problems that surround potential failing standards of care in hospitals.

Effect of solution-focused approach on self perceived burden and negative emotion in elderly patients with coronary heart disease complicated with type 2 diabetes

Objective To explore the effect of solution-focused approach on self perceived burden, anxiety and depression in elderly patients with coronary heart disease complicated with type 2 diabetes. Methods From January to June 2016, 76 elderly patients with coronary heart disease complicated with type 2 diabetes from inpatients department of Wuxi Second People's Hospital were selected as the research objects by convenience sampling method. The patients were divided into control group and observation group by random number table, each with 38 cases. Patients in the control group were given routine nursing and patients of the observation group were given solution-focused approach intervention on the basis of routine nursing. Self-perceived burden scale, self-rating anxiety scale and self-rating depression scale were used to evaluate the effect of intervention. Results Compared with the score before intervention, there was statistical difference in the self-perceived burden score after intervention in two groups (P 0.05) . After 3-month intervention, the self perceived burden score of the observation group was lower than that of the control group (P 0.05) . After 3-month intervention, the score of anxiety and depression in the intervention group was significantly lower than that in the control group (P<0.05) . Conclusions Solution focused approach can reduce the self-perceived burden of the elderly coronary heart disease patients with type 2 diabetes and alleviate the patients' negative emotions effectively. Key words: Anxiety; Depression; Aged; Coronary heart disease; Diabetes mellitus, type 2; Solution focused approach; Self-perceived burden

Self-determined goals in a solution-focused batterer intervention program: Application for building client strengths and solutions

ABSTRACTThe present study explores the content and characteristics of self-determined goals developed by violent offenders as part of a court-mandated treatment program. Data were collected from 89 domestic violence offenders enrolled in a solution-focused batterer intervention program. The data were analyzed using content analysis, and the emergent themes included (1) emotional regulation, (2) personal growth, (3) improve family relationships, and (4) improve communication. The findings from this study offer preliminary insight into the type of goals, the usefulness and importance of developing goals, and how goals might be helpful in reinforcing the change process while in treatment.

Effect of the miracle questions in solution-focused brief therapy on memory tend and emotional stage in college students

Objective To evaluate the effect of the miracle questions in solution-focused brief therapy on memory tend and emotional stage in a non-clinical situation in college students. Methods A quasi-experimental design was adopted, and two kinds of materials for self-coaching(solution-focused, problem-focused) were developed according to the previous researches. Seventy-two subjects were randomly divided into two groups, receiving the miracle questions in solution-focused brief therapy(The miracle question group, thirty-six subjects) or problem-focused coaching intervention(problem-focused group, thirty-six subjects). Exception memories number and positive and negative emotion level were evaluated between the two groups. Results The subjects receiving the miracle question group write more exception memories (3.67±2.07) than problem-focused group (1.61±1.18) (t=5.178, P 0.05). Conclusion The miracle questions in solution-focused brief therapy can trigger the subjects to exceptional memories .This suggests that in practical application, questions order has impact on the effect of consultation. Before asking exception question, miracle questions should be asked in the use of solution-focused intervention. Key words: Solution-focused brief therapy; College students; Miracle questions; Exception questions; Emotional stage; Cross-sectional studies

Feeding forward to a ‘miracle day’ – a pilot study of video feedforward in reactive attachment disorder

Video feedforward is a solution-focused intervention used to improve desired behaviour. We present two case studies of using video feedforward in reactive attachment disorder. Children with reactive attachment disorder, their caregivers and their clinician completed storyboards of behaviours desired during a 'miracle day' and filmed the individual scenes. These scenes were edited to a prolonged sequence of successful behaviour which was fed back to the child and their caregiver using principles of video interaction guidance. Families reported major improvements in the targeted behaviours, usually within a week of filming the 'miracle day'.