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Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.

Differences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.

Significant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.

To the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.

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.

Bipolar disorder is associated with poor mental and physical health outcomes, and therefore, it is crucial to research and develop effective interventions for this population (Grande et al., 2016). Unfortunately, research on the efficacy of current interventions shows only small improvements in symptoms and quality of life (Oud et al., 2016). Additionally, individuals with bipolar disorder face barriers to accessing care like social stigma, isolation and financial constraints (Blixen et al., 2016). This paper aims to introduce and examine the effectiveness of an accessible, peer-led group program, Mood Lifters (Votta and Deldin, 2022), in those who completed the program and also self-reported a diagnosis of bipolar disorder.

Mood Lifters is a 15-week, peer-led group program that approaches mental wellness from a biopsychosocial framework using strategies from a variety of evidence-based treatment methods (e.g. cognitive-behavioral therapy, dialectical behavior therapy, interpersonal psychotherapy, etc.). Participants meet once a week for 1 hour to review various mental health topics, including behavioral changes and insight into mood patterns. Individuals who participated in nonacademic groups in a company setting and self-reported a bipolar diagnosis were surveyed at the beginning and end of their program to measure various aspects of psychological functioning.

Results suggest that these individuals experienced significant improvements in depression, anxiety, social functioning and perceived stress, along with flourishing and positive and negative affect.

These findings are promising, given that bipolar disorder is historically difficult to treat (Grande et al., 2016). Based on this preliminary evidence, the authors have developed a Mood Lifters program specifically for individuals with bipolar disorder and are launching a randomized control clinical trial.

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 preliminary study aims to investigate and describe aggression-supportive normative beliefs among patients of a high-secure hospital.

Therapy data from a sample of high-secure forensic hospital patients (N = 11) who had participated in Life Minus Violence-Enhanced, a long-term violence therapy, was examined using interpretative phenomenological analysis (IPA). During therapy, cognitions linked to past incidences of aggression were explored using aggression choice chains.

IPA was applied to data generated through this process to examine the presence and nature of normative beliefs reported, identifying seven themes: rules for aggressive behaviour; use of violence to obtain revenge; processing emotions with violence; surviving in a threatening world; do not become a victim; using violence to maintain status; and prosocial beliefs.

Findings demonstrate that forensic patients have specific aggression-supportive normative beliefs, which may be malleable. Limitations and implications are discussed.

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.

A range of adaptations and therapy processes have been explored in relation to therapy with people with intellectual disabilities; however, there remain a few areas of therapy practice that have not yet been considered in depth. This study aims to report the results of an online survey of the practice of therapists working with people with intellectual disabilities in managing endings in therapy.

Thirty-one therapists working with people with intellectual disabilities responded to an online survey. The data were analysed using reflexive thematic analysis.

Three superordinate themes were identified: Theme 1 was “preparing for a therapeutic ending” with subordinate themes of “planning early”, “providing boundaries” and “validating feelings”; Theme 2 was “providing a therapeutic ending”, with subordinate themes of “a collaborative decision” and “fostering growth”; and the third theme was “post-ending issues” in which participants acknowledged a “spectrum of emotion”, and, in the case of difficult endings, a sense of “unfinished business”.

This is the first systematic exploration of therapy endings as described by therapists working with people with intellectual disabilities. The authors discuss implications for practice and further areas of research.

There has been a move towards the implementation of digital/e-health interventions for some time. Digital/e-health interventions have demonstrable efficacy in increasing individual empowerment, providing timely access to psychological interventions for those experiencing mental ill-health and improving outcomes for those using them. This study aims to determine the efficacy of digital/e-health interventions for individuals detained in prison who experience mental ill-health.

A systematic search of five academic databases – CINAHL, ASSIA, PsycINFO, Embase and Medline – was completed in December 2020 and updated in February 2022. The review was guided by the Whittemore and Knafl (2005) framework for integrative reviews. A total of 6,255 studies were returned and screened by title and abstract. A full-text screening of nine (n = 9) studies was conducted.

No study met the inclusion criteria for the clinical efficacy of digital/e-health interventions in a prison setting. Subsequently, a review of the literature that made it to the full-text review stage was conducted, and gaps in the literature were identified to inform policy, practice and future research.

To the best of the authors’ knowledge, this is the first integrative review conducted on the efficacy of digital/e-health interventions for mental ill-health in prison settings.

The use of mindfulness interventions (MIs) as means to manage unwanted or undesirable affect and behaviour has increased in popularity recently. This has resulted in the trial of MIs as a means to benefit well-being within prisons, with some intention of reducing recidivism. This study aims to examine current research regarding the use of MIs within prisons.

A total of 14 studies were manually selected for review inclusion according to their determined eligibility. All studies were required to have taken place in a prison and to include an explicit mindfulness intervention, including mindfulness theory and practice.

Most interventions reviewed demonstrated success, particularly when tailored to the unique needs of a prison environment. Positive changes reported included improvements in participant mental health symptoms, as well as reduced stress and increased mindfulness skills. Some preliminary evidence was provided to indicate the potential longevity of some of these benefits. This review further highlighted some significant questions regarding the generalisability of the proposed suitability of MIs within prison environments including practical delivery constraints and the lack of acknowledgment of the unique challenges and circumstances faced by prisoners.

The findings of this review show positive potential for the use of MIs within prison populations, where these are well-linked to mindfulness theory and to the needs of inmates. The review also suggest that MIs should be investigated thoroughly, examining potential negative implications alongside positive changes. There needs to be further review of the role of MIs within prison populations to ensure their suitability in the custodial environment.

MIs are somewhat inflated in terms of predicted outcomes and sometimes applied to potentially unsuitable groups. A significant gap within the literature also persists regarding potentially negative implications associated with MIs, particularly within unique prison populations. Prison treatment programmes should be developed with careful consideration of unique prisoner needs in comparison to a general population.

The purpose of the paper is to present an integrated methodology for identifying trends in a particular subject area based on a combination of advanced text mining and expert methods. The authors aim to test it in an area of clinical psychology and psychotherapy in 2010–2019.

The authors demonstrate the way of applying text-mining and the Word2Vec model to identify hot topics (HT) and emerging trends (ET) in clinical psychology and psychotherapy. The analysis of 11.3 million scientific publications in the Microsoft Academic Graph database revealed the most rapidly growing clinical psychology and psychotherapy terms – those with the largest increase in the number of publications reflecting real or potential trends.

The proposed approach allows one to identify HT and ET for the six thematic clusters related to mental disorders, symptoms, pharmacology, psychotherapy, treatment techniques and important psychological skills.

The developed methodology allows one to see the broad picture of the most dynamic research areas in the field of clinical psychology and psychotherapy in 2010–2019. For clinicians, who are often overwhelmed by practical work, this map of the current research can help identify the areas worthy of further attention to improve the effectiveness of their clinical work. This methodology might be applied for the identification of trends in any other subject area by taking into account its specificity.

The paper demonstrates the value of the advanced text-mining approach for understanding trends in a subject area. To the best of the authors’ knowledge, for the first time, text-mining and the Word2Vec model have been applied to identifying trends in the field of clinical psychology and psychotherapy.