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The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.

This paper aims to reflect on the outcomes of a community-based video-conferencing intervention for depression, predating the COVID-19 pandemic. The study investigates the potential implications of its findings for enhancing adherence to digital mental health interventions. The primary objective is to present considerations for researchers aimed at minimising the intention-behaviour gap frequently encountered in digital mental health interventions.

A randomised control feasibility trial design was used to implement a telehealth model adapted from an established face-to-face community-based intervention for individuals clinically diagnosed with depression. In total, 60 participants were initially recruited in association with a local mental health charity offering traditional talking-based therapies with only eight opting to continue through all phases of the project. Modifications aligning with technological advancements were introduced.

However, the study faced challenges, with low uptake observed after an initial surge in recruitment interest. The behaviour-intention gap highlighted technology as a barrier to service accessibility, exacerbated by participant age. Furthermore, the clinical diagnosis of depression, characterised by low mood and reduced interest in activities, emerged as a potential influencing factor.

The limitations of the research include its pre-pandemic execution, during a nascent stage of technological mental health interventions when participants were less familiar with online developments.

Despite these limitations, this study's reflections offer valuable insights for researchers aiming to design and implement telehealth services. Addressing the intention-behaviour gap necessitates a nuanced understanding of participant demographics, diagnosis and technological familiarity.

The study's relevance extends to post-pandemic society, urging researchers to reassess assumptions about technology availability to ensure engagement. This paper contributes to the mental health research landscape by raising awareness of critical considerations in the design and implementation of digital mental health interventions.

Reflections from a pre-pandemic intervention in line with the developments of a post-pandemic society will allow for research to consider that because the technology is available does not necessarily result in engagement.

This paper aims to explore and review the potential of robotic rehabilitation as a treatment approach for Alzheimer’s disease (AD) and its impact on the health and quality of life of AD patients.

The present discourse endeavors to provide a comprehensive overview of extant scholarly inquiries that have examined the salience of inhibitory mechanisms vis-à-vis robotic interventions and their impact on patients with AD. Specifically, this review aims to explicate the contemporary state of affairs in this realm by furnishing a detailed explication of ongoing research endeavors. With the objective of elucidating the significance of inhibitory processes in robotic therapies for individuals with AD, this analysis offers a critical appraisal of extant literature that probes the intersection of cognitive mechanisms and assistive technologies. Through a meticulous analysis of diverse scholarly contributions, this review advances a nuanced understanding of the intricate interplay between inhibitory processes and robotic interventions in the context of AD.

According to the review papers, it appears that implementing robot-assisted rehabilitation can serve as a pragmatic and effective solution for enhancing the well-being and overall quality of life of patients and families engaged with AD. Besides, this new feature in the robotic area is anticipated to have a critical role in the success of this innovative approach.

Due to the nascent nature of this cutting-edge technology and the constrained configuration of the mechanized entity in question, further protracted analysis is imperative to ascertain the advantages and drawbacks of robotic rehabilitation vis-à-vis individuals afflicted with Alzheimer’s ailment.

The potential for robots to serve as indispensable assets in the provision of care for individuals afflicted with AD is significant; however, their efficacy and appropriateness for utilization by caregivers of AD patients must be subjected to further rigorous scrutiny.

This paper reviews the current robotic method and compares the current state of the art for the AD patient.

The aim of this study is to explore the dual-experiences of AN recovered service providers. Prognoses for anorexia nervosa (AN) and anorexia nervosa-like (AN-like) presenting patients remain poor, and notably, no current treatment approach is reliably successful. Past research into AN has focused on singular experiences, those of either AN patients or those of practitioners providing treatment, but has yet to explore the experiences of recovered AN service users now working as AN service providers.

In this study, four UK-based female participants shared their dual experiences of treatment for AN or AN-like presentations through individual semi-structured interviews. Data collection and analysis were conducted in accordance with an Interpretative Phenomenological Analysis methodology.

Analysis revealed four primary themes, including barriers to accessing services; the impact of treating professionals’ approaches; displacement of responsibility for treating AN; and the value of dual-experience of AN.

This study focuses on AN and AN-like presentations and does not address the other eating disorders. Additionally, only female-identifying individuals volunteered their participation. As such, this study is notably lacking the voices of individuals of other genders.

Participant narratives suggest that improvements in the treatment of AN lie in improving professionals’ understanding of – and compassion towards – this patient group to optimise the power of the therapeutic relationship across all AN-treating professions.

Participants revealed a pervasive misunderstanding of AN among treating professionals that is hindering patients’ treatment and suggested that lived experience can be an asset in a professional context.

Individuals with dual experiences of AN can provide a unique and reflective insight into experiences of treatment through their combined personal and professional expertise and elucidate the experiences that both helped and hindered their own recovery.

The current review aims to focus on how risk and protective factors for self-harm in secure mental health hospitals are captured in the literature.

Fifty-seven articles were included in a systematic review, drawn from an initial 1,119 articles, post duplicate removal. Databases included Psycinfo, Psycarticles, Psycnet, Web of Science and EBSCO host. A thematic analysis was used, which included a meta-ethnographic approach for considering qualitative papers.

There was a clear focus on risk factors, with eight identified (in order of occurrence): raised emotional reactivity and poor emotion regulation; poor mental health; traumatic experiences; personality disorder diagnosis and associated traits; increased use of outward aggression – dual harm; constraints of a secure environment and lack of control; previous self-harm and suicide attempts; and hopelessness. Protective factors featured less, resulting in only three themes emerging (in order of occurrence): positive social support and communication; positive coping skills; and hope/positive outlook.

This includes a proposal to move focus away from “risk” factors, to incorporate “needs”, in terms of individual and environmental factors. There is also a need for more attention to focus on developing high quality research in this area.

The research captures an area where a synthesis of research has not been comprehensively undertaken, particularly with regards to capturing protective as well as risk factors.

This chapter has been specifically written for readers interested in incorporating positive education into practice. Expanding on concepts and models first introduced in Chapter 1, it starts with an overview of commonly used wellbeing models and frameworks from positive psychology adapted for application in schools. The chapter also explores the significance of positive education in enhancing educator wellbeing and shares experienced-based insights on how positive education has been implemented effectively, or not. As part of this, the chapter identifies common implementation challenges and offers key recommendations for achieving success. Aligned to this book’s overarching objective of connecting theory with practice, it provides empirical and practical insights, including a Positive Psychology in Practice case study of a UK educator’s experience with embedding positive education in further education (FE).

Stigma is a major impediment to human rights in health care that causes discrimination, isolation and the exclusion of individuals from essential health-care services. It fosters fear, leading to negative stereotyping of individuals based on their social, cultural or health status and undermines their dignity and respect, consequently violating their right to health. Therefore, the purpose of this study is to evaluate the moderating role of psychological flexibility in the relationship between stigma (enacted, anticipated and internalized), mental health and the quality of life of substance users.

This study was based on a cross-sectional design and included 200 male patients with an age range of 18–65 years from 23 rehabilitation centers in four cities in Pakistan. The purposive sampling technique was used, and the sample size ranged from 4 to 23 participants for each site. Four scales were used to measure stigma, general mental health, quality of life and psychological flexibility in substance users.

The data were analyzed using SPSS and Smart PLS, which showed that stigma (enacted, anticipated and internalized) had a detrimental effect on substance users’ mental health and quality of life. Additionally, psychological flexibility acts as an efficient moderator between them.

This research unveils the moderating role of psychological flexibility in mitigating stigma’s adverse effects on individuals with substance use disorders. Future investigations should prioritize interventions aimed at enhancing psychological flexibility to ameliorate the repercussions of stigma, ultimately enhancing the well-being and quality of life of substance users.

The purpose of this study was to investigate cognitive behavior therapists and trainees’s beliefs about various aspects of traumatic memory and to investigate cognitive behavior therapists’ practices in relation to alleged traumatic experiences and whether they are linked with their beliefs about various aspects of traumatic memory.

In the current study, the authors surveyed, by a questionnaire (in Italian), certified Italian cognitive behavioral (CB) therapists and trainees with respect to their beliefs in traumatic memories and whether they discussed about the possibility of repressed memory with their patients.

The majority of participants held strong beliefs about many controversial aspects related to traumatic memory, such as the mind being able to block out of consciousness memories of traumatic experiences. Also, more than half of CB therapists stated that they sometimes discussed about the importance of traumatic events in the genesis of their patient’s disorder and half of them sometimes talked with patients about memories for traumatic events of which they may be unaware. Such practices could lead to false memories of abuse

One particularly novel finding relates to the evidence that therapists reported that they had discussed with patients the importance of traumatic events in the genesis of their illness and frequently noted that they talked about the possibility of repressed memories with them. In turn, patients may be induced to recall traumatic experiences from their lives, thereby producing false memories which may tear families apart and could even lead to wrongful convictions.

Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour in association with repeated self-injury and chronic suicidal ideation. People diagnosed with BPD also have high rates of co-occurring psychopathology, including disorders associated with disturbed impulse control, such as substance use disorder (SUD) and disordered eating behaviours. The co-occurrence of BPD and impulse control disorders contributes to the severity and complexity of clinical presentations and negatively impacts the course of treatment and recovery. This study qualitatively documents aspects of the lived experience and recovery journeys of people diagnosed with BPD and co-occurring SUD and/or disordered eating. This study aims to identify similarities with respect to themes reported at different stages of the recovery process, as well as highlight important factors that may hinder and/or foster recovery.

In-person, in-depth, semi-structured interviews were conducted with 12 specialist service consumers within a clinical setting. Ten women and two men (22–58 years; mean: 35.5 years) were recruited. Interview transcripts were analysed using thematic analysis principles.

As expected, participants with co-occurring disorders experienced severe forms of psychopathology. The lived experience descriptions aligned with the proposition that people with BPD engage in impulsive behaviours as a response to extreme emotional states. Key emergent themes and sub-themes relating to recovery comprised three domains: factors hindering adaptive change; factors assisting adaptive change and factors that constitute change. An inability to regulate negative affect appears to be an important underlying mechanism that links the three disorders.

This study highlights the potential shortcomings in the traditional approach of treating co-occurring disorders of BPD, SUD and eating disorders as separate diagnoses. The current findings strongly support the adoption of an integrative approach to treating complex mental health issues while concurrently emphasising social connection, support and general health and lifestyle changes.

The findings of this study contribute to the burgeoning BPD recovery literature. A feature of the current study was its use of in-depth face-to-face interviews, which provided rich, many layered, detailed and nuanced data, which is a major goal of qualitative research (Fusch and Ness, 2015). Furthermore, the interviews were conducted within a safe clinical setting with engagement facilitated by a clinically trained professional. There was also a genuine willingness among participants to share their stories in the belief that doing so would inform effective future clinical practice. Their willingness and engagement as participants may reflect their progress along the path to recovery in comparison to others with similar diagnoses. Finally, most of the interviewees were engaging in dialectical behavioural therapy (DBT)-style therapies; two were receiving mentalisation-based therapy treatment, and most had previously engaged in cognitive behavioural therapy or acceptance and commitment therapy-based approaches. The predominance of DBT-style therapy may have influenced the ways that themes were articulated. Future studies could supplement this area of research by interviewing participants receiving therapeutic interventions other than DBT for the treatment of BPD and heightened impulsivity.

This paper aims to report on the results of a global search to identify the characteristics of successful sexual offender treatment programs, with a view to providing guidance for program development.

A keyword search was conducted of criminology and social science databases. Successful programs were selected on evaluations that used standard scientific designs.

This study identified 18 evaluations of 16 programs showing significant reductions in reconvictions. Most programs used cognitive behavioural therapy (CBT), with both group and individual sessions; and many evidenced multisystemic therapy (MST) approaches involving families and/or local communities. CBT-based approaches were also common in the 20 unsuccessful programs identified in the study, although fewer MST-oriented features were in evidence. Noncustodial settings, and combined custodial-noncustodial settings, were also more prominent in the successful programs.

There is a shortage of studies focused on the specific components of successful treatment programs for sexual offenders, including for subsets of offenders, such as ethnic minority groups and women.

The findings demonstrate the need for more investment in treatment programs with strict evaluation processes. New and modified programs are likely to benefit from the application of CBT, MST and a community-based reintegration component. More research is needed on effective elements of sexual offender treatment programs.

To the best of the authors’ knowledge, this appears to be the first study that examines features of successful sexual offender treatment programs, compared to unsuccessful programs, using a case-study approach. The findings reinforce the known value of CBT and systemic approaches as core features of programs but raise important questions about what other components are key to activating success.