Time-limited Group Research Articles

Effect of Time-Limited Training on Endoscopic Submucosal Dissection in an Ex Vivo Porcine Stomach Model: A Prospective Randomized Controlled Study

Abstract Introduction Endoscopic submucosal dissection (ESD) is the first choice for superficial tumor resection. There is no report on whether the training effect is affected by limiting the operation time of each ESD operation. This study aimed to prospectively evaluate the efficiency of time-limited ESD training by using an ex vivo porcine stomach model. Methods ESD was performed in accordance with the standard procedure on ex vivo porcine stomach model. The time-limited group required each operation time to be controlled within 30 minutes, and the nonlimited group did not limit the operation time. The en bloc resection rate, surface area of the resected specimen, procedure speed, and perforation rate were compared in the two groups. Results Compared with the en bloc resection rate in the time-limited group, that in the nonlimited group was significantly higher in ESD-1 and ESD-2. In each ESD procedure, the median resection area in the nonlimited group was significantly larger than that in the time-limited group. The difference in median procedure speed between the two groups in ESD-1 to ESD-4 did not reach significance in the statistical analysis. The speed of ESD-5 in the time-limited group was significantly higher than that of the nonlimited group. The perforation rate of the time-limited group was similar to that of the nonlimited group. Conclusion Limiting the training time does not help the trainees to complete large resection of lesions and reduce the perforation rate, but it may help to improve the operation speed.

The efficacy of a training program for social skills in reducing addictive Internet behaviors among Palestinian university students

BackgroundFor youth in geopolitically at-risk environments, such as Palestine, the issues related to Internet overuse and addictions are complex. Youth residing in the occupied territories of Palestine as in other highly militarized zones have high levels of environmental stressors (e.g., militarization, poverty, lack of employment opportunities, cultural pressures, etc.) and few chemical or social outlets such as alcohol, intoxicants, and leisure activities. As such, the easily accessible and unrestricted opportunities for stress-reducing social contact of social media can lead easily to excessive and maladaptive Internet use. Therefore, interventions directly aimed at awareness and education on how to manage Internet use are critical for addressing these issues in high risk populations.AimsThe purpose of the current study was to test the efficacy of a time-limited group training program aimed at improving social skills and reducing addictive Internet behaviors among university students.Methods and resultsThe sample consisted of 30 university students who self-reported high scores on an Internet addiction scale. Participants were randomly assigned to either wait list or treatment group (15 in each condition). Results demonstrated that using a social skills training program over an 8-week period improved the level of social skills and reduced addictive Internet behaviors significantly in those who experienced the intervention when compared with a wait list control group.ConclusionsThese findings support the implementation of time limited training programs targeting social skills and addictive patterns of Internet use with university students identified with high levels of Internet addictive behaviors.

Organizing talk in group speaking tests: learning from high-scoring students

Abstract This article investigates how group speaking test candidates manage group talk during assessed, time-limited tasks. Drawing on recorded and transcribed data, it explores how higher-scoring learners manage spoken assessment tasks through their talk, moving conversations on or slowing them down in order to perform and complete the tasks’ requirements in a timely way. These data are contrasted with the ways in which lower-scoring test candidates attempt to organize and manage assessed group talk. While the data and findings from this particular study can be used to teach students about, and prepare them for, multi-person discussions and, more specifically, task-oriented and time-limited group speaking tests, we also suggest that our awareness-raising investigatory approach, if brought into the classroom, offers learners (and teachers) a way of uncovering some of what actually occurs during talk, illuminating the ‘invisible rules’ that guide how participants engage in and manage interaction.

An intervention to improve the quality of life in children of parents with serious mental illness: the Young SMILES feasibility RCT.

An intervention to improve the quality of life in children of parents with serious mental illness: the Young SMILES feasibility RCT.

Group Therapy Treatment for Food Selectivity (FS17-05-19)

ObjectivesThe purpose of this quality improvement project was to implement a group exposure therapy intervention to more efficiently serve the patients that are referred to our hospital due to severe food selectivity. MethodsThe intervention used evidenced-based practices such as systematic desensitization, a token economy, counterconditioning, and parent training to help patients expand their food repertoire. The intervention is a 12-week multi-family group therapy for children that range in age from 4–14. Patients are placed into groups of no more than six members of similar age. In 11 of the sessions, therapists direct patients through an exposure hierarchy with novel foods and record the number of bites patients take of each food. In 4–5 sessions, a psychologist meets with parents separately to discuss how to use exposure therapy to treat food selectivity. We examined data from the groups that ran from March 2016 to June 2018. ResultsUsing a Wilcoxon Signed-Ranks Test, we compared the number of bites of novel foods that patients took in the first and last food exposure sessions. Results indicated that patients took significantly more bites of novel foods in the last group (median = 34) compared to the first group (median = 8.5), z = 4.79, P < .001. ConclusionsThe outcomes of this project suggest that time-limited group interventions may help children who struggle with severe food selectivity. Time-limited groups also may also decrease treatment wait time for patients with severe food selectivity because patients can be seen simultaneously and with clear start and end date for the service. Funding SourcesN/A. Supporting Tables, Images and/or Graphs▪

Increasing the intensity and comprehensiveness of aphasia services: identification of key factors influencing implementation across six countries

ABSTRACTBackground: Aphasia services are currently faced by increasing evidence for therapy of greater intensity and comprehensiveness. Intensive Comprehensive Aphasia Programs (ICAPs) combine these elements in an evidence-based, time-limited group program. The incorporation of new service delivery models in routine clinical practice is, however, likely to pose challenges for both the service provider and administering clinicians. This program of research aims to identify these challenges from the perspective of aphasia clinicians from six countries and will seek to trial potential solutions. Continual advancements in global communication technologies suggest that solutions will be easily shared and accessed across multiple countries.Aims: To identify the perceived and experienced barriers and facilitators to the implementation of 1) intensive aphasia services, 2) comprehensive aphasia services, and 3) ICAPs, from aphasia clinicians across six countries.Methods and procedures: A qualitative enquiry approach included data from six focus groups (n = 34 participants) in Australia, New Zealand, Canada, United States of America (USA), United Kingdom (UK), and Ireland. A thematic analysis of focus group data was informed by the Theoretical Domains Framework (TDF).Outcomes and results: Five prominent theoretical domains from the TDF influenced the implementation of all three aphasia service types across participating countries: environmental context and resources, beliefs about consequences, social/professional role and identity, skills, and knowledge. Four overarching themes assisted the identification and explanation of the key barriers and facilitators: 1. Collaboration, joint initiatives and partnerships, 2. Advocacy, the promotion of aphasia services and evidence-based practice, 3. Innovation, the ability to problem solve challenges, and 4. Culture, the influence of underlying values.Conclusions: The results of this study will inform the development of a theoretically informed intervention to improve health services’ adherence to aphasia best practice recommendations.

Group treatment for survivors of torture and severe violence: A literature review

The authors conducted a systematic review of scholarly journals and manuscripts. The search was limited to articles published in English that focused on group treatment with torture survivors. The authors identified 36 articles and chapters for review describing a variety of group interventions for survivors of torture, including: • Supportive Group Therapy • Empowerment Workshops • Group Treatment for Sleep Disorders • Den Bosch model • Wraparound approach • Stage-oriented model The literature examined varied in approach and format: present-day and past-focused groups; structured, time-limited groups; and flexible, ongoing support groups. The studies took place in diverse locations, including Denmark, Germany, Guinea, Namibia, the Netherlands, Palestine, Serbia, the U.S., the UK, and Zimbabwe, and, in conflict, post-conflict and/or humanitarian settings. The interventions were facilitated by licensed mental health professionals, paraprofessionals, and bilingual/bicultural staff - or a combination of the latter two. Group treatment is an approach which can be administered to larger groups of survivors to address a range of treatment issues. The authors examined key clinical practice issues for group treatment including group composition and content, facilitation and measurement strategies. While the literature does provide a compelling conceptual rationale for using group treatment, the empirical literature is in fact very limited at this time, and needs to be strengthened in order to build confidence in outcomes across contexts and survivor communities. This paper points to a growing interest in the topic of group treatment for survivors of torture and severe violence, providing a comprehensive picture of group-based interventions and highlighting the need for additional research and knowledge-building.

Time Constraints Do Not Limit Group Size in Arboreal Guenons but Do Explain Community Size and Distribution Patterns

To understand how species will respond to environmental changes, it is important to know how those changes will affect the ecological stress that animals experience. Time constraints can be used as indicators of ecological stress. Here we test whether time constraints can help us understand group sizes, distribution patterns, and community sizes of forest guenons (Cercopithecus/Allochrocebus). Forest guenons typically live in small to medium sized one-male–multifemale groups and often live in communities with multiple forest guenon species. We developed a time-budget model using published data on time budgets, diets, body sizes, climate, and group sizes to predict maximum ecologically tolerable group and community sizes of forest guenons across 202 sub-Saharan African locations. The model correctly predicted presence/absence at 83% of these locations. Feeding-foraging time (an indicator of competition) limited group sizes, while resting and moving time constraints shaped guenon biogeography. Predicted group sizes were greater than observed group sizes but comparable to community sizes, suggesting community sizes are set by competition among guenon individuals irrespective of species. We conclude that time constraints and intraspecific competition are unlikely to be the main determinants of relatively small group sizes in forest guenons. Body mass was negatively correlated with moving time, which may give larger bodied species an advantage over smaller bodied species under future conditions when greater fragmentation of forests is likely to lead to increased moving time. Resting time heavily depended on leaf consumption and is likely to increase under future climatic conditions when leaf quality is expected to decrease.

Receiving slaps, receiving words. The violence of separation in a public service time limited psychotherapy group for adolescents

The authors propose a reflection on a time-limited psychoanalytic group for children, adolescents and families, run in a public service. Some patients in the group give accounts of violent relationships and traumatic experiences. The accounts of violent, interpersonal and intrapsychic relationships influence the group’s capacity of thinking, which leads to difficulties in the processing of symbolic aspects. The fundamental question is that of whether it is possible to work in a time-limited, institutional, psychoanalytical framework, in which psychotherapists have to attempt to give meaning to experiences which take place in a repetitive present, in a space/time in which the prospect of a conclusion appears to be inconceivable. By means of a clinical example, and with particular emphasis on the first sessions and the dream brought up by a patient who has been a victim of domestic violence, the authors discuss the possibility of modifying, chiefly from within, the feeling of the immutability of early psychic material, which is itself intrinsically violent.

Cracking the Intrapsychic “Glass Ceiling” for Women in Leadership: Therapeutic Interventions

ABSTRACTThe number of women holding elite-level positions in politics and business have significantly increased in recent years, but the lack of parity between the genders is still apparent. This article addresses the stereotypical thinking and the double-bind dilemma women face in obtaining promotions to top positions. It posits internal obstacles that stem from early socialization and may be worked through therapeutically. It proposes that individual psychoanalytic psychotherapy, in the context of object relations and attachment theories, combined with group therapy can facilitate intrapsychic growth towards leadership. Participation in a time-limited group for women may further their insight into the underlying barriers to top positions and facilitate the learning of how to move from fitting in to having a voice and becoming more independent and assertive. Women cracking the glass ceiling may contribute to external societal changes as the relational style of women will continue to gain momentum and redefine leadership in the workplace. Clinical examples will illustrate the therapeutic interventions.

Development of a Brief Psychoanalytic Group therapy (BPG) and its application in an asbestos national priority contaminated site.

The aim of the present paper is to describe the development of a Brief Psychoanalytic Group therapy for contaminated sites and its application in the National Priority Contaminated Site of Casale Monferrato. Before presenting the core of the clinical intervention, a brief examination of some clinical features encountered working with malignant mesothelioma patients and their caregivers is offered. These aspects have been pivotal elements in the construction of a psychoanalytically oriented time-limited (i.e., 12 sessions) group therapy. This model of intervention was designed by one of the Authors (AG) and is aimed at reducing the impact of living in a threatening place where both physical well-being and health are put to the test. At a psychological level, in fact, living in contaminated sites arouses death anxieties, which can deeply compromise the quality of time remaining to live together with loved ones after a fatal cancer diagnosis.

Development of a Bereavement Group in a Geriatric Mental Health Clinic for Veterans

ABSTRACTObjectives: This article describes the development and program evaluation of an 8-session outpatient geriatric mental health clinic bereavement group for United States military veterans who experienced the death of a loved one.Methods: Group materials were developed based on a review of literature, with a focus on the dual process model of coping with bereavement and complicated grief treatment. Data are presented from 19 veterans who attended at least 4 of the 8 sessions across the five offerings of this group between 2013 and 2015.Results: Self-report measures of complicated grief and depressive symptoms decreased significantly from the first to the final session. Veterans indicated that the group met their treatment goals and that they would recommend it to others. Adaptations made to the group over time based on feedback from members and facilitators are discussed.Conclusions: Preliminary evidence suggests that the group described in this manuscript is effective for bereaved older, male veterans. Future research would be helpful including larger samples and controlled studies.Clinical Implications: Most bereaved individuals do not require formal mental health treatment. However, for individuals with distressing symptoms, time-limited group therapy may be an effective treatment.

The Mindfulness Perspective

ABSTRACTMindfulness-based cognitive therapy is a time-limited (eight-week) group therapy program designed to help participants manage depression, anxiety, and other forms of emotional distress. Research has shown it to be especially effective in reducing symptoms of depression and preventing relapse. In addition to attending the eight weekly group meetings, participants are expected to complete extensive daily assignments at home. While not for everyone, this program offers many potential benefits for those suffering from depression and anxiety, either on its own or in conjunction with other modes of treatment.

Effects of Group Psychotherapy on Young Adults’ Romantic and Career Functioning

A growing number of young adults have difficulties meeting developmental challenges and experience psychological distress as a consequence of which they seek help to address these difficulties. A time-limited group psychotherapy focusing on addressing age-related tasks was developed to meet the needs of young people. Thirty-one young people seeking psychological help participated in 16 to 18 sessions of group psychotherapy. Psychological distress and goal pursuit capabilities were assessed at the beginning and the end of therapy. Compared with young people on a waiting list, participants undergoing group psychotherapy showed a significant decrease in psychological distress and increase in adaptive goal pursuit and independent functioning. Our findings indicate the importance of integrating a developmental perspective in group intervention to enhance young adults’ competence in handling age-related tasks, as well as to improve their well-being.

Psychodynamic Group Psychotherapy by J. Scott Rutan, Walter N. Stone, and Joseph J. Shay (review)

issn 0362-4021 © 2016 Eastern Group Psychotherapy Society group, Vol. 40, No. 4, Winter 2016 361 1 Correspondence should be addressed to Ed Elder, MDiv, MHS, LMHC, LMFT, 19 West 34th Street, Suite 1200, New York, NY 10001. E-mail: edwardelder@msn.com. Book Review Psychodynamic Group Psychotherapy, 5th edition. By J. Scott Rutan, Walter N. Stone, and Joseph J. Shay. New York: Guilford Press, 2014, 465 pp. Reviewed by Ed Elder1 I still have a copy of the first edition of Rutan and Stone’s Psychodynamic Group Psychotherapy on my shelf. Though at the time it was not called the first edition. And I still find it useful to refer to much that is written there. This latest edition is obviously much more comprehensive than that first edition, which was a slim 222 pages long. While many of us have gotten thicker over the years, few of us have put on such impressive, important, and in-depth weight as these later editions have. But then, this is what one would expect of three such impressive authors. Rutan is a Distinguished Fellow and past president of the American Group Psychotherapy Association (AGPA). He also founded the Center for Group Psychotherapy at Massachusetts General Hospital/Harvard Medical School and cofounded the Boston Institute of Psychotherapy. Stone is Professor Emeritus of Psychiatry at the University of Cincinnati College of Medicine. He also is a Distinguished Fellow and past president of AGPA. Shay is a staff psychologist at the joint McLean/Massachusetts General Hospital. He also has an appointment in the Department of Psychiatry at Harvard Medical School and serves on the faculty of three other training institutes. Across editions, the authors have stayed with the same general structure of their textbook. They begin with a discussion of the role of groups in today’s society and move to a history of group therapy (theory and practice). This is followed by three chapters dealing with the psychology and metapsychology of group work (group dynamics, therapeutic factors, mechanism of change). Only after the reader has gotten a firm grounding in the theory of group dynamics and process do the authors shift to address the more nitty-gritty aspects of our work. In these three chapters, they extensively deal with how to form a group, select patients, and prepare patients 362 elder for the group itself. Once that is taken care of, they move on to issues around the role of the group therapist, the beginning phase of the group, and leadership of the group. The next four chapters take on a diversity of concepts: working with affect in the group, a case presentation with commentary, difficult groups/patients, and time-limited groups. The final chapter, as one would expect, takes on the issue of termination in group. And finally, as in all their editions, there is a FAQ section that is extremely helpful. It hardly needs to be stated that this book could serve as the foundational text of any training program in group psychotherapy and probably does serve that function in many programs. The first chapters introduce the reader to the many different ways mental health has been constructed over the years, from “hysterics” in the Victorian era to “narcissists” in the modern era. While a philosophy of psychology course would want to add more readings to flesh out this section, it opens the door to ideas that begin to shift our work out of the domain of the all-knowing therapist into the more relational perspective shared by these authors. The chapter titled “The History of Small-Group Theory and Practice” gives an excellent overview of most of the major theorists who have dealt extensively with group therapy. Some of the theorists were less well known to me (e.g., Ezriel, 1973, whose work I now want to explore) or are not discussed much anymore (or not often enough), such as Whitaker and Liebermann (1964). But each subsection develops these theorists’ ideas clearly and succinctly and (in my case at least) makes the reader want to find out more. One impressive aspect of the book as a whole is just how well most of these theorists’ works will be used throughout the...

How Creative Group Work Helps Adolescents Create Relations with Self and Peers

ABSTRACTPractitioners often face questions about how to approach adolescents to join a group where they can develop healthy relationships with themselves and their peers. A growing number of practitioners and researchers value creative—nondeliberative—forms of working with such groups. This article discusses the artful, actional methods the authors use in their work with time-limited small groups of adolescents (age 14–17) who experienced behavioral challenges. These creative methods were used in settings such as secondary schools, counseling centers, and nongovernmental organizations in Lithuania during social skills training groups facilitated by the social workers.

The World within the Walls: A Music Therapy Group for Patients in Long-Term Segregation at the National High Secure Service for Women in the UK

This article describes work undertaken at a high secure service for women in the UK. It provides an account of an on-ward, time-limited music therapy group for individuals detained in long-term segregation in the intensive care unit of the hospital. The high level of risk patients pose to themselves and others means mixing with their peers requires close supervision, and also results in long periods of isolation. The group was initiated with the primary focus being to help develop relationships between the women. Often the whole ward team participated, with staff members taking the role of participant-observer during the session. A background to the work, including the nature of the forensic setting, is provided. Group music therapy in this setting is then described, with consideration given to the impact of institutional dynamics on the process. The relationship between the culture of the NHS and the high-secure setting, with the inevitable struggle to maintain authentic therapeutic relationships, is also explored.

English

The purpose of this study was to test the effectiveness of a time-limited group counseling program based on expressive activities in improving levels of self awareness and reducing PTSD symptoms for children experiencing symptoms of trauma in the West Bank of Palestine. The sample consisted of 30 children who have all experienced significant losses and trauma from Nablus, Palestine ranging from 9-12 years of age. Participants were randomly assigned to either a treatment or control group (15 in each condition). &nbsp;Results demonstrated that using expressive techniques in a counseling group over a 16 week period improved the level of self-awareness and reduced symptoms of PTSD significantly when compared to a no treatment control group. These findings support the implementation of time limited counseling groups using expressive techniques with children in situations of high intensity and multiple exposure trauma.&nbsp; &nbsp; Key words: Group counseling for children, expressive activities, self- awareness, trauma symptoms, Palestine. &nbsp

Clinical efficacy and therapeutic alliance in a time-limited group therapy for young adults

&lt;p class="MsoNormal" style="text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;"&gt;&lt;span style="font-size: small;"&gt;&lt;span style="font-family: Times New Roman;"&gt;&lt;span style="mso-ansi-language: EN-GB;" lang="EN-GB"&gt;This study evaluated the clinical efficacy of a time limited psychodynamic therapy for a group of young adult patients in terms of outcome and process. The results register a favourable outcome that does not concern only the gravity of patients' initial symptoms&lt;span style="mso-spacerun: yes;"&gt;&amp;nbsp; &lt;/span&gt;but the structural personality changes and attachment style too. In an exploratory perspective this study investigated the connection between the outcome of the treatment and therapeutic alliance measured by CALPAS-G into three different time intervals of therapy. A correlational analysis highlighted a relevant connection between the &lt;/span&gt;&lt;em style="mso-bidi-font-style: normal;"&gt;&lt;span style="mso-ansi-language: EN-US;" lang="EN-US"&gt;Patient Commitment &lt;/span&gt;&lt;/em&gt;&lt;span style="mso-ansi-language: EN-GB;" lang="EN-GB"&gt;scale&lt;/span&gt;&lt;span style="mso-ansi-language: EN-US;" lang="EN-GB"&gt; &lt;/span&gt;&lt;span style="mso-ansi-language: EN-GB;" lang="EN-GB"&gt;assessed at the beginning and the final outcome of the therapy. &lt;/span&gt;&lt;em style="mso-bidi-font-style: normal;"&gt;&lt;span style="mso-ansi-language: EN-US;" lang="EN-US"&gt;Working Strategy Consensus &lt;/span&gt;&lt;/em&gt;&lt;span style="mso-ansi-language: EN-US;" lang="EN-US"&gt;and &lt;em style="mso-bidi-font-style: normal;"&gt;Group Understanding and Involvement&lt;/em&gt; &lt;/span&gt;&lt;span style="mso-ansi-language: EN-GB;" lang="EN-GB"&gt;assessed in the middle of the therapy course, show significant correlations with the final outcome of&lt;span style="mso-spacerun: yes;"&gt;&amp;nbsp; &lt;/span&gt;therapy.&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;span style="mso-ansi-language: EN-US;" lang="EN-US"&gt;&lt;/span&gt;&lt;/p&gt;

Clinical Efficacy and Therapeutic Alliance in a Time-Limited Group Therapy for Young Adults

This study evaluated the clinical efficacy of a time limited psychodynamic therapy for a group of young adult patients in terms of outcome and process. The results register a favourable outcome concerning not only the gravity of patients' initial symp-toms but also the structural personality changes and attachment style. In an exploratory perspective this study investigated the connection between the outcome of the tre-atment and therapeutic alliance measured by CALPAS-G in three different time intervals of therapy. A correlational analysis highlighted a strong connection between the Patient Commitment scale assessed at the beginning and the final outcome of the therapy. Work-ing Strategy Consensus and Group Understanding and Involvement assessed in the middle of the therapy course, show significant correlations with the final outcome of therapy.