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Article

Sue Holttum

The randomised controlled trial, though highly valued, has been criticised as not helping to understand how results occur: Real-life complexity is not captured, i.e. what…

Abstract

Purpose

The randomised controlled trial, though highly valued, has been criticised as not helping to understand how results occur: Real-life complexity is not captured, i.e. what actually happens at trial sites (rather than what was intended). The purpose of this paper is to summarise and comment on two 2014 research papers addressing this challenge of randomised trials – concerning new therapeutic approaches for people diagnosed with psychotic disorders.

Design/methodology/approach

One paper is about what staff thought when adopting a new recovery-focused approach in two mental health services as part of a randomised trial. The other is the plan for a small pilot trial of a new treatment for psychosis called positive psychotherapy. It describes how the researchers planned to study the detail of what happens in their small trial, to help them improve the design of a future, larger trial.

Findings

The first paper recommends avoiding services undergoing too many changes and ensuring managers will visibly support the project. When training staff in a new approach, trainers should recognise staff's existing knowledge and skills and use practical methods like role-play. In the second paper, the plan for the small positive psychotherapy trial seems detailed enough to explain what really happens, except in one area: looking at how clinicians actually select service users for the trial.

Originality/value

These papers concern pioneering therapeutic approaches in psychosis. With randomised trials highly influential, both these papers recognise their potential problems, and seem to represent good attempts to understand what really happens.

Details

Mental Health and Social Inclusion, vol. 18 no. 4
Type: Research Article
ISSN: 2042-8308

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Article

Katalin Ujhelyi Gomez, Jerome Carson, Gill Brown and Mark Holland

Positive psychology (PP) interventions have been suggested to be beneficial in the treatment of dual diagnosis (DD). The purpose of this paper is to investigate the…

Abstract

Purpose

Positive psychology (PP) interventions have been suggested to be beneficial in the treatment of dual diagnosis (DD). The purpose of this paper is to investigate the perspective of psychosocial intervention (PSI) workers to explore the potential of a positive strengths-based approach in DD recovery.

Design/methodology/approach

A qualitative approach was employed with PSI workers who attended and observed a positive intervention delivered to DD clients. A focus group explored what these practitioners are already doing that resembles PP and their opinion regarding the utility of such interventions in recovery.

Findings

Findings revealed that practitioners were already engaging in positive practice, however, randomly and infrequently with limited impact. Although this new approach was found valuable, potential challenges were identified and a possible discrepancy between staff views of clients and clients’ views of themselves in terms of their potential was detected.

Research limitations/implications

The study involved a small and homogeneous sample. Further research is necessary to investigate staff views and ways of integrating PP with traditional treatment.

Practical implications

Rather than merely attending to the psychological problems and dealing with symptoms, it is also necessary to directly target well-being to enable people to flourish with consideration of their readiness to change.

Originality/value

Addressing a gap in the literature, the present study explored positive themes in current practice and forms part of the evaluation of a newly developed strengths-based approach for individuals with coexisting problems.

Details

Advances in Dual Diagnosis, vol. 12 no. 3
Type: Research Article
ISSN: 1757-0972

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Article

Julian Himmerich

Psychodynamic psychotherapy is increasingly adapted and used with individuals with intellectual disability (ID) and mental health difficulties. However, the evidence base…

Abstract

Purpose

Psychodynamic psychotherapy is increasingly adapted and used with individuals with intellectual disability (ID) and mental health difficulties. However, the evidence base is still small and largely based on case studies and small trials whose participants mainly have mild to moderate ID. This paper aims to review and critique the literature in regards to the adaptations; and the effectiveness of psychodynamic psychotherapy for those with severe and profound ID.

Design/methodology/approach

A systematic literature search of PsycINFO, Social Policy and Practice, Medline, Cumulative Index to nursing and allied health literature and applied social sciences index and abstracts was conducted. Six studies met inclusion criteria and underwent a quality evaluation and critical review.

Findings

Six papers (all case studies) met inclusion criteria and underwent a quality evaluation and critical review. Some adaptations to therapy were reported, such as a more flexible therapeutic frame and increased use of the physical environment as a therapeutic tool. Due to significant methodological weaknesses of the included studies, it is yet unclear whether psychodynamic psychotherapy is an effective intervention for individuals with severe and profound ID.

Research limitations/implications

Only a small number of case studies met the inclusion criteria. Further research should use more robust outcome measures, larger samples and compare psychodynamic psychotherapy to alternative interventions.

Originality/value

This paper is the first to review the psychodynamic psychotherapy literature with regard to its effectiveness as a treatment specifically for individuals with severe and profound ID and mental health difficulties.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 14 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

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Article

David Coyle, Mark Matthews, John Sharry, Andy Nisbet and Gavin Doherty

Although mental health problems increase markedly during adolescent years, therapists often find it difficult to engage with adolescents. The majority of disturbed…

Abstract

Although mental health problems increase markedly during adolescent years, therapists often find it difficult to engage with adolescents. The majority of disturbed adolescents do not receive professional mental health care and of those who do fewer still will fully engage with the therapeutic process (Offer et al. 1991; US Surgeon General 1999). Personal Investigator (PI) is a 3D computer game specifically designed to help adolescents overcome mental health problems such as depression and help them engage more easily with professional mental health care services. PI is an implementation of a new computer mediated model for how therapists and adolescents can engage. The model has its theoretical foundations in play therapy and therapeutic storytelling and applies current research on the educational use of computer gaming and interactive narrative systems to these foundations. Previously demonstrated benefits of computer games and interactive narrative systems in education include increased motivation, increased self‐esteem, improved problem solving and discussion skills and improved storytelling skills (Bruckman 1997; Bers 2001; Robertson 2001; Robertson and Oberlander 2002; Bers et al. 2003; Squire 2003). PI aims to take advantage of these benefits in a mental health care setting. PI incorporates a goal‐oriented, strengths based model of psychotherapy called Solution Focused Therapy (SFT). By engaging adolescents, in a client‐centred way, it aims to build stronger therapeutic relationships between therapists and adolescents. PI is the first game to integrate this established psychotherapy approach into an engaging online 3D game. Results of trials of PI with four adolescents, referred to clinics for issues including anxiety and behaviour problems, attempted suicide, and social skills difficulties, are presented.

Details

Interactive Technology and Smart Education, vol. 2 no. 2
Type: Research Article
ISSN: 1741-5659

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Article

Dave Dagnan

It has been suggested that the emotional needs of people with intellectual disabilities have been neglected (Kroese, 1998). More recently there has been evidence of…

Abstract

It has been suggested that the emotional needs of people with intellectual disabilities have been neglected (Kroese, 1998). More recently there has been evidence of increased clinical and research activity in this area (Beail, 2003; Bouras & Holt, 2007; Foundation for People with Learning Disabilities, 2004). Currently much of the focus in this area is on mental ill‐health. This article will consider briefly the literature on mental ill‐health, with particular emphasis on the development of individual treatment approaches. From this discussion it will be evident that much of the research and theory in this area focuses on deficits and disadvantage. I will go on to suggest that a clinical and research focus that explores strengths and resilience will offer a more positive agenda for developing understanding of emotional well‐being and mental ill‐health in people with intellectual disabilities.

Details

Tizard Learning Disability Review, vol. 13 no. 1
Type: Research Article
ISSN: 1359-5474

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Article

Ahir Gopaldas, Marina Carnevale, Richard Kedzior and Anton Siebert

The marketing literature on service conversation in dyadic services has elaborated two approaches. An advisory approach involves providers giving customers expert advice…

Abstract

Purpose

The marketing literature on service conversation in dyadic services has elaborated two approaches. An advisory approach involves providers giving customers expert advice on how to advance difficult projects. By contrast, a relational approach involves providers exchanging social support with customers to develop commercial friendships. Inspired by the transformative turn in service research, this study aims to develop a third approach, one that helps customers to cultivate their own agency, potential and well-being.

Design/methodology/approach

The emergent model of service conversation is based on in-depth interviews with providers and clients of mental health services, including psychological counseling, psychotherapy and personal coaching.

Findings

A transformative approach to service conversation involves the iterative application of a complementary pair of conversational practices: seeding microtransformations by asking questions to inspire new ways of thinking, feeling and acting; and nurturing microtransformations via non-evaluative listening to affirm customers’ explorations of new possibilities. This pair of practices immediately elevates customers’ sense of psychological freedom, which, in turn, enables their process of self-transformation, one microtransformation at a time.

Practical implications

This study offers dyadic service providers a conceptual framework of advisory, relational and transformative approaches to service conversation for instrumental, communal and developmental service encounters, respectively. This framework can help dyadic service providers to conduct more collaborative, flexible and productive conversations with their customers.

Originality/value

Three approaches to service conversation – advisory, relational and transformative – are conceptually distinguished in terms of their overall aims, provider practices, customer experiences, customer outcomes, allocations of airtime, designations of expertise, application contexts, prototypical examples and blind spots.

Details

Journal of Services Marketing, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0887-6045

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Article

Abstract

Details

Advances in Mental Health and Learning Disabilities, vol. 3 no. 4
Type: Research Article
ISSN: 1753-0180

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Article

Kerry Sheldon and Allison Tennant

This paper provides a clinical practice overview of the challenges that can arise when working with dangerous and severe personality‐disordered patients in a high secure…

Abstract

This paper provides a clinical practice overview of the challenges that can arise when working with dangerous and severe personality‐disordered patients in a high secure hospital. Poor engagement and treatment readiness, mistrust, paranoia and dominant interpersonal styles are all clinical features that affect treatment delivery. The paper discusses the impact of these features, and suggests how clinicians can engage effectively with individuals who have personality disorders in regard to therapy in general.

Details

The British Journal of Forensic Practice, vol. 13 no. 1
Type: Research Article
ISSN: 1463-6646

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Article

Inga-Lill Söderberg, James E Sallis and Kent Eriksson

The purpose of this paper is to use psychological theory to improve our understanding of financial advice-taking. The paper studies how a working alliance between…

Abstract

Purpose

The purpose of this paper is to use psychological theory to improve our understanding of financial advice-taking. The paper studies how a working alliance between financial service customers and advisors affects the advisor's assessment of the financial service buyer's perceived risk preferences, and what role trust plays as a mediating variable.

Design/methodology/approach

The paper obtained data by means of a questionnaire that was answered by 375 matched pairs of bank advisors and customers.

Findings

This paper explains how the working alliance method – a concept from psychotherapeutic theory – between financial service customers and advisors affects the advisor's understanding of the financial service buyer's perceived risk preferences. The paper also finds that the role of trust is perceived differently by the advisor and the customer. Advisors see that as their clients learn to trust them they lose touch with the customer's perceived risk preferences, whereas customers do not perceive that their trust in the advisor has any relationship to their risk preferences.

Practical implications

This results suggest that advisors lose touch with the risk preferences of trusting customers, and that psychological methods are needed if the advisor should actually understand customer perceived risk preferences.

Originality/value

The paper advances psychological methods in marketing, and provides a partial answer to the difficulties of financial advice giving.

Details

International Journal of Bank Marketing, vol. 32 no. 3
Type: Research Article
ISSN: 0265-2323

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Article

Yehuda Baruch and Rod Lambert

This paper seeks to present a dual‐level framework for developing change management theory, based on the concept of anxiety as an organizational phenomenon and its…

Abstract

Purpose

This paper seeks to present a dual‐level framework for developing change management theory, based on the concept of anxiety as an organizational phenomenon and its potential for prevention, recognition and treatment. When encountering crisis, confusion, and difficulties, both individuals and organizations can suffer from anxiety‐related problems. The paper aims to argue that organizational anxiety can be diagnosed and treated in a similar way to those of individuals.

Design/methodology/approach

This is a conceptual paper and examines how individual anxiety can inform analysis of organizational performance in times of change. A model of organizational anxiety is presented. Three case studies are used to examine the validity of the model. The potential for preventive and treatment strategies for organizational anxiety is examined.

Research limitations/implications

The concepts presented should be examined initially through single case study designs, but developed into the equivalent of a randomized controlled trial across a number of organizations.

Practical implications

Recognition of organizational anxiety is only advantageous if methods of prevention or treatment are possible and available. Preventive strategies include training in threat appraisal and response for senior management teams. Treatment strategies include short‐term consultancies for evaluation of threats and responses; organizational development for organizations where inappropriate responses to threats and opportunities can be recognized, and rethinking/reframing of organizations where an organizational history may be inhibiting progress or development.

Originality/value

This paper presents a new way for organizations to examine their performance in times of change, and adds significantly to the literature on organizational change management.

Details

Journal of Managerial Psychology, vol. 22 no. 1
Type: Research Article
ISSN: 0268-3946

Keywords

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