Whilst Cognitive Behavioural Therapy for Psychosis (CBTp) has been found to reduce psychotic symptoms, most evidence supporting its implementation originates from studies in Western and high-income countries. Furthermore, questions remain regarding the efficacy of CBTp conducted via teleconsultation. Herein we report an ongoing case in Indonesia involving an individual with schizoaffective disorder, who received 60 sessions of CBTp over seven months. Sessions were delivered via a combination of voice and video calls. The patient, a 40-year-old male, was diagnosed with schizoaffective disorder at the age of 26. He exhibited symptoms of paranoid and religious delusions, hallucinations (auditory, visual, and somatic) and disorganised speech during our intake interview. Negative symptoms were not apparent. In the 14 years prior to our initial consultation, the patient was prescribed antipsychotics and demonstrated good adherence. He had no history of psychotherapy independent of our clinic. Treatment involved CBTp techniques, including psychoeducation, a symptom diary, relaxation, and behavioural experiments. Study outcome was assessed with Psychotic Symptom Rating Scales. Both hallucination and delusion subscale scores improved 53% from 53 at intake to 25 during an assessment administered 6 months later. Results from this study demonstrate that the CBTp is both feasible, and beneficial, when conducted via teleconsultation in Indonesia.

There is currently a lack of clinical research that would strongly support the application of CBT in the treatment of narcolepsy type 1. Despite that, there are several guidelines that suggest some techniques should be routinely applied. Currently, there is still a lack of results on what to do with patients who have comorbid sleep and psychiatric disorders or other psychosocial comorbidities and problems. This case study concerns a 27-year-old female who had narcolepsy type 1 and history of sleep, psychosocial, and psychiatric problems. Her main problems included cataplexy, daily tiredness and sleepiness, a problem with daily physical activity, and problems in her psychosocial functioning. The patient received 7 session of CBT treatment based on recommended techniques for patients with hypersomnia. Self-reported measure of sleep, anxiety, and depression were collected at the start and 1-month post-treatment. Objective psychological measures recorded positive changes in post-treatment assessment of CBT effect on her sleep pattern, significant reduction of cataplexy, depressive and anxiety symptoms, daily activity, and tiredness during the day.

Health-Risk Behaviours (HRBs) are significantly associated with avoidable mortality in adolescents, and preventing HRBs requires an adequate understanding of related factors. Among associated factors, emotion regulation difficulties may impact youths’ engagement in HRBs. Researchers explored the relation of emotion regulation with HRBs; however, specific emotion regulation difficulties for less severe and more prevalent HRBs, such as self-harming behaviour, risky-driving, violence, unhealthy dietary behaviour, and poor adherence to prescribed medication, has not been much explored. The current study aimed to explore the predictability of adolescents’ specific difficulties in emotion regulation in relation to their engagement in HRBs. For this purpose, six different HRBs, that is, self-harm, violence, risky-driving, unhealthy dietary behaviour, inadequate physical activity, and lack of medication adherence, were studied. A total of 617 (Males = 356) adolescents (Mage = 15.77) from five districts of Punjab state (India) provided required information on standardised self-report measures. The data were subjected to regression analysis, and the findings show that the participants who scored high on emotion regulation difficulties reported engagement in HRBs more than their counterparts. Some specific difficulties are more important than others for different forms of HRBs. It implies that the intervention programmes targeting specific HRBs should address specific facets of emotional dysregulation.

Young mothers are more likely to access healthcare for their children in emergent care settings and less likely to use preventive care. This study examines the healthcare-seeking behaviours of young mothers to inform the design of tailored interventions. Semi-structured interviews with nine young mothers (aged ≤ 25 years) who were attending a supported playgroup in Brisbane, Australia were conducted and explored using the Capability, Opportunity and Motivation and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Five behavioural themes were identified (navigating the system, complex referral pathways, delays and long wait times, understanding child development, and connecting to services) and the role of the supported playgroup in shaping young mothers’ understanding of child development and connecting them to services was highlighted. Recommended strategies to address these factors include opportunities for young mothers to learn about child developmental milestones, improving young mothers’ health literacy, increasing young mothers’ skills and/or the availability of support to help them navigate health services, and providing more accessible entry points for child assessments, referrals, or early intervention programs.

Half of the people who seek treatment for Obsessive–Compulsive Disorder (OCD) do not benefit from first-line interventions. A better understanding of the factors associated with obsessions and compulsions may inform the development of more effective treatments. This study aimed to examine whether a fear of guilt is associated with obsessive–compulsive symptoms. Fear of guilt incorporates two domains: punishment (the tendency to believe that guilt means one is bad and to punish oneself for feelings of guilt) and harm prevention (the tendency to believe that guilt implies failure to be one's ideal self and the drive to prevent feelings of guilt). Online questionnaires assessing OCD symptoms, fear of guilt, and other related factors were administered to 192 adults. In contrast to previous studies, key conceptually relevant constructs, such as shame, anxiety, and depression symptoms, were also assessed. The punishment dimension of fear of guilt subscale was positively associated with OCD symptoms controlling for age, sex, guilt, shame, responsibility for harm, generalised anxiety, and depression. The punishment domain of fear of guilt may therefore be an important factor to consider and potentially target in treatments for OCD. Future investigations with clinical populations may clarify the importance of fear of guilt in OCD.

The current study used behavioural and electroencephalograph measures to compare the transferability of three home-based interventions — cognitive training (CT), neurofeedback training (NFT), and CT combined with NFT — for reducing symptoms in children with attention-deficit/hyperactivity disorder (AD/HD). Following a multiple-baseline single-case experimental design, twelve children were randomised to a training condition. Each child completed a baseline phase, followed by an intervention phase. The intervention phase consisted of 20 sessions of at-home training. Tau-U analysis and standardised visual analysis were adopted to detect effects. Results showed that CT improved inhibitory function and NFT improved alpha EEG activity and working memory. The combined condition, which was a reduced ‘dose’ of CT and NFT, did not show any improvements. The three conditions did not alleviate AD/HD symptoms. While CT and NFT may have transfer effects on executive functions, considering the lack of improvement in symptoms, this study does not support CT and NFT on their own as a treatment for children with AD/HD.

Behavioural activation (BA) is an efficacious treatment approach. Activity monitoring is a key component of brief BA treatments; however, no studies have examined the most efficacious format for monitoring. The present pilot study tested brief versus intensive activity monitoring approaches during a BA intervention administered in a college orientation course. Outcomes characterised (1) engagement with the treatment protocol via activity monitoring and (2) participant qualitative experiences with monitoring and the intervention as reported during focus group interviews. Four course sections were randomly assigned to receive monitoring forms that were brief (assessed activities three times daily) or intensive (assessed activities hourly). Forms were provided electronically to students via a web-based platform which tracked completion. There were no significant differences in monitoring frequency (38.0 vs. 23.0 days; p = .154) or the duration of monitoring engagement (62.0 vs. 36.0 days; p = .054) between the brief and intensive conditions. Qualitative findings suggested that participants in both conditions found utility in activity monitoring, particularly during the first month as they transitioned to college. Overall, findings indicated that participants may find utility in monitoring during the first month of a BA intervention using either brief or intensive monitoring forms.

Clinical Trials Registration Number: NCT04038190

Social anxiety disorder (SAD) is a common mental health condition that is characterised by a persistent fear of social or performance situations. Despite effective treatments being available, many individuals with SAD do not seek treatment or delay treatment seeking for many years. The aim of the present study was to examine treatment barriers, treatment histories, and cognitive behavioural therapy (CBT) delivery preferences in a sample of women with clinically relevant SAD symptoms. Ninety-nine women (Mage = 34.90, SD = 11.28) completed the online questionnaires and were included in the study. Participants were recruited from advertisements on community noticeboards and posts on social media. The results demonstrated that less than 5% of those who received psychological treatment in the past were likely to have received best-practice CBT. The most commonly cited barriers to accessing treatment for women with SAD related to direct costs (63%) and indirect costs (e.g., transport/childcare) (28%). The most preferred treatment delivery method overall was individual face-to-face treatment (70%). The study demonstrates a need to provide a variety of treatment options in order to enhance access to empirically supported treatment for women with SAD.

Although irritability is common in youth, research on treatment is in its infancy. Threat biases are more pronounced in irritable compared to low irritable youth, similar to evidence found in anxious youth. Therefore, interventions targeting these biases may be promising for reducing irritability. This study utilised a multiple baseline case series design to determine the feasibility, acceptability, and efficacy of positive search training (PST) for irritable children. Three children were included who met criteria for a principal diagnosis of Disruptive Mood Dysregulation Disorder (DMDD), and a secondary diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or Major Depressive Disorder (MDD). PST was feasible with two of the three participants; one child refused to continue after one session. For the two participants who completed PST, acceptability was stable with moderate-to-high ratings of engagement and enjoyment, and high and stable treatment-relevant verbalisations of the key strategies. Both cases showed declines in DMDD severity across treatment and no longer met criteria at post-treatment. Both participants met criteria for Oppositional Defiant Disorder (ODD) at post-treatment (considered less severe for irritability than DMDD). Declines in parent-reported irritability occurred for both cases, however some returns to baseline were observed. Overall, PST for irritable youth shows promise as an acceptable and feasible intervention. Further studies are needed combining PST with strategies for secondary diagnoses, given its high comorbidity with disruptive behaviour disorders.

When followed, there is evidence that social distancing measures play a major role in reducing the transmission of viruses such as COVID-19. However, not all individuals follow the guidance. We explored barriers and facilitators to compliance with UK social distancing guidelines during the COVID-19 pandemic through semi-structured interviews with 116 adults. Data were analysed using reflexive thematic analysis and themes mapped to the Capability, Opportunity and Motivation Model of Behaviour (COM-B). Barriers to compliance included inconsistent rules, caring responsibilities, fatigue, unintended consequences of control measures, and the need for emotional support. Facilitators were informational support and social responsibility. Six themes were both a barrier and a facilitator: lived environment, beliefs about consequences of non-compliance, influence of others, practical support, and trust in government. Reflective motivation, psychological capability, and social opportunity were important drivers for compliance. Measures that enable social support alongside strategies to maintain motivation to comply, provide clear guidance and optimise social cohesion should be promoted.

Obsessive-compulsive disorder (OCD) is often a chronic disorder characterised by uncontrollable, reoccurring thoughts (obsessions), and/or behaviours (compulsions). Accumulating evidence suggests that metacognitive beliefs may underlie many of the processes implicated in the formation and perpetuation of OCD. Metacognitive therapy (MCT) for OCD aims to modify these maladaptive metacognitive beliefs and processes to treat this debilitating disorder. The current study examines the outcome of a pilot trial of MCT for OCD in 26 (17 females; 9 males) adults (18–64 years) referred to a specialist outpatient service. Results were promising, with significant decreases in OCD and depression symptoms, which were maintained at the 3-month follow-up. The improvement in Yale-Brown Obsessive-Compulsive Scale scores between pre-treatment and follow-up in the completer sample (n=22) was large (d=1.29), and comparable to outcomes of well-established treatments. These encouraging results add to early empirical support for the effectiveness of group MCT as an OCD treatment alternative, as well as reinforcing the role of metacognitions contributing to this disorder.

During the COVID-19 pandemic, there was an increase in online gaming behaviour among college students. This study aimed to examine the impact of online self-help interventions consisting of different components within the Acceptance and Commitment Therapy (ACT) framework on college students’ gaming disorder and gaming frequency. Additionally, it evaluated the effectiveness of both interventions in addressing psychological distress among college students during the COVID-19 pandemic. One intervention was a full ACT program, which consists of six core components, while the other intervention focused on the engaged components of ACT (specifically targeting value-based actions). The study employed a 2 conditions (Full ACT vs. Engaged ACT) × 3 times (pre-, mid- and post-program) design to examine the effectiveness of these interventions. Each intervention consisted of 10 sessions, delivered at a frequency of five sessions per week over a 2-week period for both groups. The participants in this study were enrolled in two online classes. Participants with gaming disorder scores in the top 20% were selected and assigned to either the Full group (N = 49) or the Engaged group (N = 41) for the interventions. The study assessed outcome variables, including gaming disorder, psychological flexibility, daily gaming hours, weekly gaming days and psychological distress, at pre-intervention, mid-intervention, post-intervention and one-month follow-up for both groups. No significant differences were observed between the two groups on these outcomes at the pre-intervention stage. The findings of this study indicate that both interventions effectively reduced gaming disorder and weekly gaming frequency, while enhancing psychological flexibility. Nonetheless, the Engaged group exhibited a significant reduction in daily gaming hours. There was no substantial change in psychological distress in either group during and after the intervention. The implications and limitations of this study were also reported.

The study was a randomised controlled trial evaluating the effectiveness of the Group Triple P Program for Chinese immigrant parents living in New Zealand. Sixty-seven Chinese immigrant parents of a 5- to 9-year-old child with disruptive behaviour problems were randomly allocated to either an intervention or a waitlist group. Parents completed measures of child adjustment problems, general parenting practices, parenting practices in children's academic lives, parental adjustment, parental teamwork, and family relationships at pre-, post-, and 4-month follow-up. Intervention group ratings of programme satisfaction were collected following programme completion. Significant short-term intervention effects were found for improvements in child behaviour, parenting practices, parental teamwork, and parenting in the child academic context. All intervention effects, except for parental teamwork, were maintained at 4-month follow-up. There were no significant intervention effects for parental adjustment, however, medium effect sizes were found at post-intervention and follow-up. A high level of programme satisfaction was reported.

The COVID-19 pandemic presents challenges to the provision of community programs and access to mental health services for young people. We examined the feasibility, reach, and acceptability of multi-technology delivery of an integrated system that assesses and provides feedback on youth mental health and wellbeing and connects them to care within the context of a youth sports development program. The system was delivered via computer, telephone, and teleconference with 66 adolescent boys participating in a rugby league development program in three communities in Australia. Young people completed online wellbeing and mental health measures (Assess step), parents were provided with telephone feedback on results, support, and referral options (Reflect step), and youth received teleconferenced workshops and online resources (Connect step). The multi-technology delivery was feasible to implement, and reach was high, with barriers experienced at the Assess step but minimally experienced at the Reflect and Connect steps. Delivering the system via multiple forms of technology was rated as highly beneficial and enjoyable by young people. Players improved in self-reported prosocial behaviour, gratitude, and anxiety symptoms from pre- to post-program. Strong collaboration between researchers, organisational personnel, and community members is important for achieving these outcomes.

Self-reflection is often viewed positively; paradoxically, however, it is also associated with distress, potentially because of its relationship with rumination. Focusing self-reflection on positive themes may be one way to promote adaptive self-reflection. This study examined whether the disposition to engage in self-reflection motivates use of a journal containing positively focused writing prompts and moderates the benefit gained from it, specifically when rumination is controlled for. For 28 days, participants (N = 152) accessed an app-based mental health intervention containing various features, including the aforementioned journal. Outcomes of self-regulation and psychological wellbeing were assessed, controlling for time spent using other app features. As expected, journaling was associated with improvements in psychological wellbeing but only when baseline self-reflection was average or higher. Journaling was also initially associated with improvements in self-regulation, but this was diminished after controlling for time spent using other app features. Findings suggest self-reflection could be a strength for fostering wellbeing when it is directed in a positive way.

The inactive lifestyle of urban Indians has increased their risk of non-communicable diseases (NCDs). A qualitative study was designed to explore barriers and facilitators related to exercise participation among urban Indians. Underpinned by the developmental life course theory, nine focus group discussions (FGDs) were conducted with 29 women and 26 men residing in Mumbai, India. Focus groups were gender and age stratified. Both thematic analysis and content analysis techniques were used to analyse the data. While the lack of time was mentioned as a barrier by all groups, an unstructured schedule was mentioned specifically by women and awareness of physical health benefits emerged as the most popular facilitator for recreational physical activity. Based on the results of the FGDs, a pilot exercise intervention for sedentary women (N = 6) was conducted which consisted of a morning walk six days a week for 10 weeks. Post-intervention, an FGD was conducted to explore participants’ perspectives on their experience in the intervention. The participants reported that the intervention enhanced exercise self-efficacy and well-being. Exercise as relaxation, spousal support, and need for peers to exercise with emerged as primary themes during the follow-up FGD. These findings can inform the development of age and gender-specific as well as culturally appropriate interventions to facilitate active living.

Animal phobia is common in children, but it is also frequent in adults who maintain the problem throughout their lives. Eleven cases of animal phobia that were treated with progressive multimedia exposure are presented. The participants were two men and nine women (aged 19–27 years), with anxiety and avoidance problems in relation to various animals. A single-case A-B-Follow-up design was carried out, with concurrent control of several baselines; and a systematic between-subjects replication, with the same treatment repeated across different participants and types of phobias. A behavioural interview, phobia questionnaires, and Multimedia Behavioural Avoidance Test (M-BAT) with pictures and videos of animals, as well as heart rate, were used for assessment purposes. The intervention was the progressive multimedia exposure in four phases (photographs, videos, simulated animals, and live exposure), in addition to diaphragmatic breathing, and homework assignments. The results replicate the same efficacy in each of the participants, with statistically significant and clinical changes in their daily lives. Also, the data as a group show this success with a high Cohen's d effect size (between −1.63 and −30.03). We conclude with an appraisal of the usefulness of the procedure for adults with phobias who do not tolerate direct exposure.

While taking advantage of the educational benefits of smartphones, students also apply this device in inappropriate ways that cause certain disciplinary and educational problems. This study examines the effect of self-management training on smartphone dependence among male high school students. Methods: In this quasi-experimental study, data were collected using the Cell Phone Addiction Scale (Koo, 2009), which was completed by the trial and control groups before and after the educational intervention. After assessing their normal distribution, the data were analysed using the Chi-square test, the independent and paired t-tests, Mann–Whitney's U-test, and the Wilcoxon test at a significance level of p < .05. Results: The results showed significant post-intervention reductions in the mean score of smartphone dependence (35.10) and its three domains, including withdrawal/tolerance (14.80), life dysfunction (8.70), and compulsion/persistence (11.60), in the trial group compared to the controls (44.80, 16.2, 12.10, and 16.50) and also in the mean score of certain applications of smartphones (p < .05). Discussion and conclusions: Despite the existing limitations, the results confirmed the efficacy of self-management training in reducing smartphone dependence in the students. The implementation of this programme is recommended for reducing dependence and promoting the proper use of this device.