Although psychological interventions can be used to improve chronic pain management, underserved individuals (i.e., racially minoritized and socioeconomically disadvantaged) may be less likely to engage in such services. The purpose of this study was to examine whether offering a psychological intervention for chronic pain in a primary care clinic could be a method in which to successfully engage underserved patients.

There were 220 patients with chronic pain in a primary care clinic located in a socioeconomically and racially diverse city who were approached to discuss enrolment in a pilot randomized controlled trial of a five-session psychological intervention for chronic pain. Patients were introduced to the study by their primary care provider using the warm handoff model. We compared whether there were sociodemographic differences between those who enrolled in the study and those who declined to enrol.

There were no differences between those who enrolled and those who declined enrolment with regard to race, age, insurance type, and household income. However, females were more likely to enrol in the study compared to males.

Recruiting patients to participate in a trial of a psychological intervention for chronic pain in a primary care clinic appeared to be effective for engaging Black patients, patients with lower income, and those with government insurance. Thus, offering a psychological intervention for chronic pain in a primary care clinic may encourage engagement among racially minoritized individuals and those with lower socioeconomic status.

Despite high levels of psychological distress, mental health service use among Syrian refugees in urban settings is low. To address the mental healthcare gap, the World Health Organization developed group problem management plus (gPM+), a scalable psychological intervention delivered by non-specialist peer facilitators. The study aimed to evaluate the effectiveness of gPM+ in reducing symptoms of depression and anxiety among Syrian refugees in Istanbul, Türkiye.

A randomized controlled trial was conducted among 368 distressed (Kessler Psychological Distress Scale, K10 > 15) adult Syrian refugees with impaired functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16). Participants were recruited between August 2019 and September 2020 through a non-governmental organization providing services to refugees. Participants were randomly allocated to gPM+ and enhanced care as usual (gPM+/E-CAU) (184 participants) or E-CAU only (184 participants). Primary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist (HSCL-25)) at 3-month follow-up. Secondary outcomes were post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5; PCL-5), functional impairment (WHODAS 2.0), and self-identified problems (psychological outcome profiles).

Intent-to-treat analyses showed no significant effect of gPM+ on symptoms of anxiety, depression, PTSD and self-identified problems. Yet, there was a significant reduction in functional impairment in gPM+/E-CAU compared to E-CAU at 3-month follow-up (adjusted mean difference 1.66, 95 % CI 0.04, 3.27, p = 0.045, d = 0.19). Post-hoc subgroup analyses among participants with probable baseline depression or anxiety showed that there was a small but significant reduction in depression (adjusted mean difference −0.17, 95 % CI −0.32, −0.02, p = 0.028, d = 0.27) and anxiety (adjusted mean difference −0.21, 95 % CI −0.37, −0.05, p = 0.009, d = 0.30) symptoms comparing gPM+/E-CAU to E-CAU only at 1-week post assessment, but not at 3-month follow-up. There was a significant difference between conditions on functional impairment at 3-month follow-up, favouring gPM+/E-CAU condition (adjusted mean difference −1.98, 95 % CI −3.93, −0.02, p = 0.048, d = 0.26).

In this study in an urban setting in Türkiye, gPM+ did not alleviate symptoms of depression and anxiety among Syrian refugees experiencing psychological distress and daily living difficulties. However, participants with higher distress at baseline seemed to benefit from gPM+, but treatment gains disappeared in the long term. Current findings highlight the potential benefit of tailored psychosocial interventions for highly distressed refugees in volatile low-resource settings.

This study aimed to develop and articulate a logic model and programme theories for implementing a new cognitive–behavioural suicide prevention intervention for men in prison who are perceived to be at risk of death by suicide. Semi-structured one-to-one interviews with key stakeholders and a combination of qualitative analysis techniques were used to develop programme theories.

Interviews with 28 stakeholders resulted in five programme theories, focusing on: trust, willingness and engagement; readiness and ability; assessment and formulation; practitioner delivering the ‘change work’ stage of the intervention face-to-face in a prison environment; and practitioner training, integrating the intervention and onward care. Each theory provides details of what contextual factors need to be considered at each stage, and what activities can facilitate achieving the intended outcomes of the intervention, both intermediate and long term.

The PROSPECT implementation strategy developed from the five theories can be adapted to different situations and environments.

Dignity therapy (DT) is well-established in adults, and it might potentially benefit the younger population. This study aims to develop a pediatric family-based dignity therapy (P-FBDT) protocol for terminally ill children and their families.

A parallel mixed-methods design was used. The P-FBDT protocol was developed based on the adult DT, and meanwhile by taking children-specific dignity characteristics and Chinese family-oriented culture into consideration. The protocol was then evaluated and modified based on the quantitative and qualitative feedback from 2-round surveys of 14 pediatric oncology or pediatric palliative care experts.

The P-FBDT involves terminally ill children and their families in meaningful interactions including a series of conversations and creative activities, which will be recorded and then edited into a document-based generativity entity. The P-FBDT protocol was recognized as highly reasonable and the P-FBDT interview guide was endorsed as important, acceptable, clear, comprehensive, and suitable to be used in pediatric palliative care practice in Chinese culture (>90%). Potential benefits, possible challenges, and practical considerations of the P-FBDT were also proposed.

The P-FBDT was perceived to be potentially beneficial to terminally ill children and their families by engaging in a series of meaningful family interactions and creating a lasting memento to be preserved. The protocol needs to be pilot tested among terminally ill children and families for feasibility and potential efficacy in practice.

1. (1) Current evidence on the efficacy of psychological interventions for stroke survivors is limited.

2. (2) This case study describes the assessment, treatment and outcomes of post-stroke adjustment difficulties in a working-aged man using an ACT approach.

3. (3) Following six sessions of ACT delivered via telerehabilitation, the client no longer met clinical cut-off for psychological distress and depression. Moreover, his levels of psychological flexibility were comparable to non-clinical norms.

4. (4) Further exploration of psychological processes that facilitate post-stroke adjustment difficulties is recommended.

The effectiveness of neuropsychological rehabilitation is supported by the evidence found in previous reviews, but there is a lack of research regarding the effectiveness of remotely conducted neuropsychological rehabilitation. This review aimed to identify and evaluate the results of studies investigating the effectiveness of teleneuropsychological rehabilitation.

Relevant articles were extracted from electronic databases and filtered to include studies published in 2016 or later to focus on recent practices. Data were synthesized narratively.

A total of 14 randomized controlled studies were included in the synthesis (9 for children/adolescents, 5 for adults). The most common type of intervention was computerized cognitive training with regular remote contact with the therapist (seven studies). Regarding children and adolescents, the evidence for the effectiveness was found only for these types of interventions with improvements in cognitive outcomes. The results regarding the family-centered interventions were mixed with improvements only found in psychosocial outcomes. No support was found for the effectiveness of interventions combining cognitive and motor training. Regarding adults, all included studies offered support for the effectiveness, at least to some extent. There were improvements particularly in trained cognitive functions. Long-term effects of the interventions with generalization to global functioning remained somewhat unclear.

Remote interventions focused on computerized cognitive training are promising methods within teleneuropsychological rehabilitation. However, their impact on long-term meaningful, everyday functioning remained unclear. More research is needed to reliably assess the effectiveness of teleneuropsychological interventions, especially with more comprehensive approaches.

This narrative review updates the evidence base for cancer-related post-traumatic stress disorder (PTSD). Databases were searched in December 2021, and included EMBASE, Medline, PsycINFO and PubMed. Adults diagnosed with cancer who had symptoms of PTSD were included.

The initial search identified 182 records, and 11 studies were included in the final review. Psychological interventions were varied, and cognitive–behavioural therapy and eye movement desensitisation and reprocessing were perceived to be most efficacious. The studies were also independently rated for methodological quality, which was found to be hugely variable.

There remains a lack of high-quality intervention studies for PTSD in cancer, and there is a wide range of approaches to managing these conditions, with a large heterogeneity in the cancer populations examined and methodologies used. Specific studies designed with patient and public engagement and that tailor the PTSD intervention to particular cancer populations under investigation are required.

Previous meta-analyses of psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) did not investigate whether treatment efficacy is diminished when patients report multiple (versus single) traumas.

To examine whether efficacy of psychological interventions for paediatric PTSD is diminished when patients report multiple (versus single) traumas.

We systematically searched PsycInfo, MEDLINE, Web of Science and PTSDpubs on 21 April 2022 and included randomised controlled trials (RCTs) meeting the following criteria: (a) random allocation; (b) all participants presented with partial or full PTSD; (c) PTSD is the primary treatment focus; (d) sample mean age <19 years; (e) sample size n ≥ 20. Trauma frequency was analysed as a dichotomous (single versus ≥2 traumas) and continuous (mean number of exposures) potential moderator of efficacy.

Of the 57 eligible RCTs (n = 4295), 51 RCTs were included in quantitative analyses. Relative to passive control conditions, interventions were found effective for single-trauma-related PTSD (Hedges’ g = 1.09; 95% CI 0.70–1.48; k = 8 trials) and multiple-trauma-related PTSD (g = 1.11; 95% CI 0.74–1.47; k = 12). Psychotherapies were also more effective than active control conditions in reducing multiple-trauma-related PTSD. Comparison with active control conditions regarding single-event PTSD was not possible owing to scarcity (k = 1) of available trials. Efficacy did not differ with trauma exposure frequency irrespective of its operationalisation and subgroup analyses (e.g. trauma-focused cognitive–behavioural therapy only).

The current evidence base suggests that psychological interventions for paediatric PTSD can effectively treat PTSD in populations reporting single and multiple traumas. Future trials for PTSD following single-event trauma need to involve active control conditions.

Attention on harmful effects of psychological interventions for adult post-traumatic stress disorder (PTSD) has increased, yet a comprehensive meta-analysis is lacking.

To summarise incidences and relative risks of deterioration, adverse events (AEs) and serious adverse events (SAEs) in trials of psychological interventions for adult PTSD.

We searched MEDLINE, PsycInfo, Web of Science and PTSDpubs from inception to 21 April 2022 for sufficiently large (n ≥ 20) randomised controlled trials (RCTs) reporting on the incidence of harms.

We included 56 RCTs (4230 patients). Incidences of harms were generally low (0–5%). Psychological interventions were associated with decreased risk of deterioration relative to passive (RR = 0.21, 95% CI 0.15–0.28) and active control conditions (RR = 0.36, 95% CI 0.14–0.92). Decreased risk was even more pronounced in sensitivity analyses on trials exclusively delivering treatments face to face. When compared with other psychological interventions, trauma-focused cognitive–behavioural therapy (TF-CBT) was associated with decreased risk of SAEs (RR = 0.54, 95% CI 0.31–0.95) and with no differential risk of deterioration and AEs.

The current evidence base suggests that psychological interventions are safe for most adults with PTSD. In none of the analyses were psychological interventions associated with an increased risk of harm compared with control conditions. TF-CBT was found at least as safe as other psychological interventions. Individual face-to-face delivery might be the safest delivery format. However, more data are needed to draw firmer conclusions. We encourage research teams to routinely and thoroughly assess and report the incidence of harms and their causes.

The mounting evidence for effective delivery of psychological interventions by non-specialists in low- and middle-income settings has led to a rapid expansion of mental health and psychosocial support trainings globally. As such, there is a demand for strategies on how to train and implement these services to attain adequate quality. This study aims to evaluate the added value of a competency-driven approach to training of facilitators for a group intervention for children with severe emotional distress in Lebanon.

In a controlled before and after study, 24 trainees were randomly allocated to participate in either a competency-driven training (CDT) or training-as-usual (TAU) (1 : 1) for a psychological intervention for children with severe emotional distress. We assessed the change in demonstrated competencies, using standardised role-plays, before and after the training. Measures included the 13-item Working with children-Assessment of Competencies Tool (WeACT), the 15-item ENhancing Assessment of Common Therapeutic factors (ENACT) and the 6-item Group facilitation: Assessment of Competencies Tool (GroupACT). The trainer in the experimental arm used pre-training and during training competency assessment scores to make real-time adjustment to training delivery. Due to COVID-19 pandemic restrictions, all activities were done remotely.

CDT resulted in significantly better outcomes on increasing competencies on the WeACT (repeated measures analysis of variance; F(1, 22) = 6.49, p < 0.018) and on the GroupACT (Mann–Whitney U = 22, p < 0.003), though not statistically significant on the ENACT. There is no significant between-group difference on the reduction of harmful behaviours, mainly because both forms of training appear equally successful in eliminating such behaviours.

This proof-of-concept study demonstrates the potential of CDT, using standardised assessment of trainee competencies, to contribute to better training outcomes without extending the duration of training. CDT can result in up to 18% greater increase in adequate competency, when compared to TAU. The study also yields recommendations for further enhancing the benefits of competency-driven strategies. A fully powered trial is needed to confirm these findings.

Infertility is associated with Several negative reaction and emotional problems

Review of effective interventions for improving emotional risk factors In infertile and infertile patients undergoing treatment

A comprehensive narrative review of the studies was conducted. Databases such as Web of Science, Science Direct, Cochrane Library, Scopus, PubMed, including Medline, Clinical key, SID, MAGIRAN were retrieved from August 10 to December 8, 2020, with no time limit. After reviewing the abstract and the full text of the articles in terms of compliance with the purpose of the study, finally, 32 articles were selected for writing. The methodological quality of the articles was assessed based on Cochrane Risk of Bias

Interventions were divided into two subgroups of mind-body, and web-based CBT. mind-body interventions generally shows the anxiety,stress and depression reduction and Possible improvement in pregnancy rate But most of these programs require extensive financial resources The results of web based, showed that using online CBT approach can greatly reduce stress and anxiety, due to increased use of internet, non collaborative,cheap and private treatment of web based interventions, this method can be used as a way along with other treatments to reduce these negative reactions

According to the present study CBT methods, application and Internet-based interventions can be used as appropriate counseling methods in reducing stress, anxiety and improving pregnancy outcomes in infertile patients. This information can be used as a proper source to select appropriate counseling methods for health care providers, midwives and treatment staff involved in infertility patients

No significant relationships.

Children and young people with intellectual disability and/or Autism Spectrum Disorder (autism) experience higher rates of mental health problems, including depression, than their typically developing peers. Although international guidelines suggest psychological therapies as first-line intervention for children and young people, there is limited evidence for psychological therapy for depression in children and young people with intellectual disability and/or autism.

To evaluate the current evidence base for psychological interventions for depression in children and young people with intellectual disability and/or autism, and examine the experiences of children and young people with intellectual disability and/or autism, their families and therapists, in receiving and delivering psychological treatment for depression.

Databases were searched up to 30 April 2020 using pre-defined search terms and criteria. Articles were independently screened and assessed for risk of bias. Data were synthesised and reported in a narrative review format.

A total of 10 studies met the inclusion criteria. Four identified studies were clinical case reports and six were quasi-experimental or experimental studies. All studies were assessed as being of moderate or high risk of bias. Participants with intellectual disability were included in four studies. There was limited data on the experiences of young people, their families or therapists in receiving or delivering psychological treatment for depression.

Well-designed, randomised controlled trials are critical to develop an evidence base for psychological treatment for young people with intellectual disability and/or autism with depression. Future research should evaluate the treatment experiences of young people, their families and therapists.

The benefits of cognitive-behavioral treatment (CBT) and positive psychology therapy (PPT) in patients with cardiovascular disease are still not well defined. We assessed the efficacy of CBT and PPT on psychological outcomes in coronary artery disease (CAD) patients.

Randomized controlled trials evaluating CBT or PPT in CAD patients published until May 2018 were systematically analyzed. Primary outcomes were depression, stress, anxiety, anger, happiness, and vital satisfaction. Random effects meta-analyses using the inverse variance method were performed. Effects were expressed as standardized mean difference (SMD) or mean differences (MD) with their 95% confidence intervals (CIs); risk of bias was assessed with the Cochrane tool.

Nineteen trials were included (n = 1956); sixteen evaluated CBT (n = 1732), and three PPT (n = 224). Compared with control groups, depressive symptoms (13 trials; SMD −0.80; 95% CI −1.33 to −0.26), and anxiety (11 trials; SMD −1.26; 95% CI −2.11 to −0.41) improved after the PI, and depression (6 trials; SMD −2.08; 95% CI −3.22 to −0.94), anxiety (5 trials; SMD −1.33; 95% CI −2.38 to −0.29), and stress (3 trials; SMD −3.72; 95% CI −5.91 to −1.52) improved at the end of follow-up. Vital satisfaction was significantly increased at follow-up (MD 1.30, 0.27, 2.33). Non-significant effects on secondary outcomes were found. Subgroup analyses were consistent with overall analyses.

CBT and PPT improve several psychological outcomes in CAD patients. Depression and anxiety improved immediately after the intervention while stress and vital satisfaction improve in the mid-term. Future research should assess the individual role of CBT and PPT in CAD populations.

Although efficacious treatments for major depression are available, efficacy is suboptimal and recurrence is common. Effective preventive strategies could reduce disability associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel and safe intervention that attenuates biases associated with depression. This study investigated whether the delivery of a CBM programme designed to attenuate negative cognitive biases over a period of 1 year would decrease the incidence of major depression among adults with subthreshold symptoms of depression.

Randomised double-blind controlled trial delivered an active CBM intervention or a control intervention over 52 weeks. Two hundred and two community-dwelling adults who reported subthreshold levels of depression were randomised (100 intervention, 102 control). The primary outcome of interest was the incidence of major depressive episode assessed at 11, 27 and 52 weeks. Secondary outcomes included onset of clinically significant symptoms of depression, change in severity of depression symptoms and change in cognitive biases.

Adherence to the interventions was modest though did not differ between conditions. Incidence of major depressive episodes was low. Conditions did not differ in the incidence of major depressive episodes. Likewise, conditions did not differ in the incidence of clinically significant levels of depression, change in the severity of depression symptoms or change in cognitive biases.

Active CBM intervention did not decrease the incidence of major depressive episodes as compared to a control intervention. However, adherence to the intervention programme was modest and the programme failed to modify the expected mechanism of action.

Virtual reality (VR) may enhance the effectiveness of psychological interventions for acute pain. We conducted a meta-analysis to assess the efficacy and safety of VR-based interventions for pain associated with medical procedures.

We searched PubMed, EMBASE, the Cochrane Library, and PsycINFO until June 17th 2018. We identified randomized controlled trials (RCTs), comparing VR-based psychological interventions to usual care, for pain intensity (primary outcome) or affective and cognitive components of pain (secondary outcomes), assessed real-time or retrospectively. Two independent reviewers performed study selection and data extraction. Risk of bias was independently evaluated by three raters using the revised Cochrane Collaboration tool. A random-effects model using the Paule and Mandel estimator was used for pooling effect sizes.

27 RCTs (1452 patients) provided enough data for meta-analysis. Compared to usual care, VR-based interventions reduced pain intensity both real-time (9 RCTs, Hedges' g = 0.95, 95% CI 0.32–1.57) and retrospectively (22 RCTs, g = 0.87, 95% CI 0.54–1.21). Results were similar for cognitive (8 RCTs, g = 0.82, 95% CI 0.39–1.26) and affective pain components (14 RCTs, g = 0.55, 95% CI 0.34–0.77). There was marked heterogeneity, which remained similarly high in sensitivity analyses. Across domains, few trials were rated as low risk of bias and there was evidence of publication bias. Adverse events were rare.

Though VR-based interventions reduced pain for patients undergoing medical procedures, inferring clinical effectiveness is precluded by the predominance of small trials, with substantial risk of bias, and by incomplete reporting.

The case of a non-oncological patient at the end of his life, admitted to a Palliative Care Unit (PCU), is presented. After a failed attempt to place a central venous catheter (CVC) and another placement of a peripherally inserted central catheter (PICC), the patient exhibited high anxiety regarding a midline catheter (MC) and refused its placement, even though this was necessary for the administration of intravenous drugs to control dyspnea and other complex symptoms that he presented.

An intervention through clinical hypnosis for successful MC placement and symptom control is described.

Through clinical hypnosis and interdisciplinary teamwork, it was possible to place a MC, necessary for symptomatic control of a complex patient.

This case exemplifies hypnosis as a simple procedure that is easy to apply, accepted by the patient, and effective in the implementation of invasive procedures and symptom control in PCUs.