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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.

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.

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.

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.

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.

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 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.

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

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.

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.

The results of empirical research on the patient–psychotherapist relationship have led to the fundamental conclusion that the therapeutic alliance is one of the key factors ensuring the positive outcomes of psychotherapy. The main aim of the present study is to determine what variables pertaining to the context of psychotherapy (type of treatment applied in accordance with the psychotherapist’s modality/orientation, type of disorder diagnosed in the patient) differentiated the alliance.

Participants for the main study were recruited from public and private psychotherapy offices across Poland. The working alliance was assessed based on 262 psychotherapist–patient dyads. The sample consisted of 428 participants. To assess the quality of therapeutic alliance, the author used the full version of the Working Alliance Inventory as adapted into Polish.

The results of analyses led to several basic conclusions. The study revealed a differentiating effect of type of psychotherapy on the quality of therapeutic alliance. Alliance quality was not differentiated by the type of disorder diagnosed in patients and treated in the psychotherapeutic process.

The results of analyses presented in this empirical study allowed for exploring the quality of the therapeutic alliance with contextual variables related to the psychotherapeutic process taken into account.

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.

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.

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.

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.

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.

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.

The authors examine psychologically informed coaching approaches for evidence-based work-applied management through a meta-analysis. This analysis synthesized previous empirical coaching research evidence on cognitive behavioral and positive psychology frameworks regarding a range of workplace outcomes, including learning, performance and psychological well-being.

The authors undertook a systematic literature search to identify primary studies (k = 20, n = 957), then conducted a meta-analysis with robust variance estimates (RVEs) to test the overall effect size and the effects of each moderator.

The results confirm that psychologically informed coaching approaches facilitated effective work-related outcomes, particularly on goal attainment (g = 1.29) and self-efficacy (g = 0.59). Besides, these identified coaching frameworks generated a greater impact on objective work performance rated by others (e.g. 360 feedback) than on coachees' self-reported performance. Moreover, a cognitive behavioral-oriented coaching process stimulated individuals' internal self-regulation and awareness to promote work satisfaction and facilitated sustainable changes. Yet, there was no statistically significant difference between popular and commonly used coaching approaches. Instead, an integrative coaching approach that combines different frameworks facilitated better outcomes (g = 0.71), including coachees' psychological well-being.

Effective coaching activities should integrate cognitive coping (e.g. combining cognitive behavioral and solution-focused technique), positive individual traits (i.e. strength-based approach) and contextual factors for an integrative approach to address the full range of coachees' values, motivators and organizational resources for yielding positive outcomes.

Building on previous meta-analyses and reviews of coaching, this synthesis offers a new insight into effective mechanisms to facilitate desired coaching results. Frameworks grounded in psychotherapy and positive appear most prominent in the literature, yet an integrative approach appears most effective.

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.

This research aimed to explore individuals with intellectual disabilities (ID) experiences of the therapeutic relationship.

Six individuals with ID were recruited who were currently having 1:1 therapy. Semi-structured interviews focused on their experiences of the therapeutic relationship.

Using interpretative phenomenological analysis, six personal experiential themes were identified. These were labelled as a person-centred experience, the importance of adaptions, “I feel like I know you”, a secure base is offered, change does occur and an overlap of subjective experience. The results indicate that participants’ accounts of their experiences indicated that the relationship was important to them. This research also demonstrated that the benefits and value of involving individuals with ID in qualitative research.

To the best of the authors’ knowledge, exploring the therapeutic relationship from the perspective of individuals with ID has not been previously explored in the literature. This research highlights considerations for therapists working with this population to help them facilitate positive therapeutic outcomes.

Forensic psychiatric treatment is aimed at reducing violence risk factors (Bonta and Andrews, 2017) and achieving positive, prosocial life goals (Willis et al., 2013). Drama education can be provided as part of this treatment, but the evidence base is scarce. Therefore, the present study aims to provide insight into experiences with drama education as part of forensic psychiatric treatment.

A qualitative study was conducted, based on participant observation and 16 interviews, to explore the experiences of patients and treatment providers with drama education during forensic psychiatric treatment. Analyses were conducted following the consensual qualitative research method (Hill et al., 1997).

The five central themes that emerged from the analysis were knowledge, happiness, excellence in play, community and staff-patient hierarchy. Participants reported that they enjoyed the drama lessons, appreciated the group atmosphere and were able to practice their social-emotional skills. Furthermore, patients and their treatment providers became better acquainted with each other because the power differences between patients and staff decreased during the drama lessons.

Drama education can be considered a useful part of clinical forensic psychiatric treatment, given the positive experience of participants and its perceived positive impact on treatment.

This was one of the first studies to examine the influence that drama education may have on forensic psychiatric treatment. Four of the five themes were in line with the good lives model (Willis et al., 2013), indicating that drama education fulfiled basic human needs or “primary goods” that are important to address in forensic psychiatric treatment, as it decreases the need to compensate these goods with criminal behaviour.

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.

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.

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.

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.

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.