Objective: This study aimed to develop an updated brief self-report post-session measure, suitable for collecting systematic feedback on clients' session reactions in the context of measurement-based care (MBC). Method: The Session Reactions Scale-3 (SRS-3; 33 items) was developed by extending and adjusting the Revised Session Reactions Scale. In Study 1, the psychometric properties of the SRS-3 were tested on N = 242 clients. In Study 2, a brief version of the SRS-3 (SRS-3-B; 15 items) was developed using a combination of conceptual, empirical, and pragmatic criteria. In Study 3, the psychometric properties of the SRS-3-B were tested on a new sample of N = 265 clients. Results: Exploratory factor analysis supported the use of the SRS-3-B as a two-factor (helpful reactions, hindering reactions) or unidimensional (overall session evaluation) instrument. The SRS-3-B was meaningfully related to another process measure (Individual Therapy Process Questionnaire) both on the item and factor levels. Conclusions: The SRS-3-B is a reliable process measure to elicit rich and clinically meaningful feedback from clients within the MBC context and as a research instrument to assess the helpful and hindering aspects of therapy sessions.
- MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- psychometrie MeSH
- psychoterapie * metody MeSH
- vztahy mezi zdravotnickým pracovníkem a pacientem * MeSH
- zpráva o sobě MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: A considerable number of clients report adverse or unwanted effects of psychological treatments. This study aimed to synthesize the findings of qualitative studies focused on what clients perceive as negative experiences in psychotherapy. METHOD: A database search was conducted to find primary studies, and a qualitative meta-analysis was used to aggregate the findings on the kinds of negative experiences psychotherapy clients reported. RESULTS: A total of 936 statements were extracted from 51 primary studies and categorized into 21 meta-categories, some of which were further divided into subcategories. These meta-categories covered clients' experiences, which fell into four broad clusters: therapists' misbehaviour, hindering aspects of the relationship, poor treatment fit, and negative impacts of treatment. CONCLUSION: Clients' negative experiences of psychotherapy are a vast and heterogeneous area, the breadth of which is not captured by any single study. By synthesizing the findings of many primary studies, this meta-analysis represents the most comprehensive summary of these experiences to date.
- MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- psychoterapie * MeSH
- vztahy mezi zdravotnickým pracovníkem a pacientem * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
Mechanisms of change represent the cornerstone of the therapeutic process. This study aimed to investigate how network models could be used to test mechanisms of change at a group level. A secondary aim was to investigate which of the several hypothesized mechanisms (emotion regulation, interoceptive awareness, and acceptance) are related to changes in psychological well-being. The sample comprised adult patients suffering from psychological disorders (N=444; 70% women) from 7 clinical sites in the Czech Republic who were undergoing groupbased multicomponent treatment composed mainly of psychodynamic psychotherapy (lasting from 4 to 12 weeks depending on the clinical site). Data were collected weekly using the multidimensional assessment of interoceptive awareness, emotion regulation skills questionnaire, chronic pain acceptance questionnaire-symptoms and outcome rating scale. A lag-1 longitudinal network model was employed for exploratory analysis of the panel data. The pruned final model demonstrated a satisfactory fit. Three networks were computed, i.e., temporal, contemporaneous, and between-person networks. The most central node was the modification of negative emotions. Mechanisms that were positively associated with well-being included modification, readiness to confront negative emotions, activity engagement, and trust in bodily signals. Acceptance of negative emotions showed a negative association with well-being. Moreover, noticing bodily sensations, not worrying, and self-regulation contributed indirectly to changes in well-being. In conclusion, the use of network methodology to model panel data helped generate novel hypotheses for future research and practice; for instance, well-being could be actively contributing to other mechanisms, not just a passive outcome.
- Publikační typ
- časopisecké články MeSH
Objective Negative effects (NEs) in group treatments remain an under-researched area. This study aimed to explore the prevalence of various types of NEs in a multicomponent group-based treatment and to determine their predictors. Method: A total of 330 patients participating in a multicomponent group-based treatment were recruited across seven clinical sites. At the end of treatment, the Negative Effects Questionnaire (NEQ) was used to measure NEs. Item-level descriptive analysis was conducted to explore the prevalence of various types of NEs, and structural equation modeling was used to determine predictors of these NEs. Results: The most frequently reported type of NEs was the worsening of symptoms, and the single most frequently reported item was the resurfacing of unpleasant memories. Predictors of NEs included the overall distress level, alexithymia, attachment avoidance, low working alliance, problem actuation, and worse outcomes; psychological mindedness was a protective factor. Conclusion: Patients who experience higher levels of distress at the beginning of treatment, who perceive the group working alliance as problematic, and who experience high in-session emotional arousal related to their problem seem to be especially prone to reporting NEs. Furthermore, the findings do not support the assumption that NEs are a prerequisite for therapeutic change.Trial registration: ISRCTN.org identifier: ISRCTN13532466.
- MeSH
- deprese * psychologie MeSH
- lidé MeSH
- prevalence MeSH
- průzkumy a dotazníky MeSH
- psychický stres * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Cíl. Škála Chronic Pain Acceptance Questionnaire (20položková verze) měřící přijetí chronické bolesti byla adaptována k měření přijetí obecných chronických obtíží pacientů klinických zařízení: Chronic Pain Acceptance Questionnaire – Symptoms. Tato studie popisuje českou adaptaci plné a zkrácené (CPAQ-S) verze škály. Vzorek. Finální vzorek sestával z 368 pacientů (71 % žen) ze sedmi klinických zařízení v České republice. Hypotézy. Předpokládaná dvoufaktorová struktura (Zapojení do aktivit navzdory bolesti a Ochota snášet symptomy) byla testována společně s dalšími teoreticky relevantními modely. Statistické analýzy. Byla použita ordinální konfirmační a následná explorační faktorová analýza. Výsledky. Žádný z testovaných faktorových modelů CPAQ-S-20 nebyl podpořen daty. Využití explorační faktorové analýzy nepřineslo žádnou přidanou informační hodnotu. Empiricky odvozená osmipoložková verze škály (CPAQ-S-8) byla charakterizována poměrně dobrými psychometrickými vlastnostmi i po zachování očekávané dvoufaktorové struktury tj., Zapojení do aktivit navzdory bolesti a Ochota snášet symptomy. Limity. Zatímco heterogenitu vzorku je možné vnímat jako silnou stránku studie, heterogenita různých typů obtíží, jimiž pacienti ve vzorku trpěli, mohla způsobit neuspokojivé fungování škály.
Objective. The Chronic Pain Acceptance Questionnaire – Symptoms (CPAQ-S, 20 items) measures patients’ acceptance of their symptoms. The questionnaire was created by reframing the Chronic Pain Acceptance Questionnaire-20 (CPAQ-20). This study describes the Czech validation of the full and short CPAQ-S forms. Sample and settings. The final sample consisted of 368 patients (71% female) recruited at seven clinical sites in the Czech Republic. Hypotheses. A hypothesized two-dimensional factor structure (Activity Engagement and Symptom Willingness) was tested together with other theoretically relevant factor solutions. Statistical analyses. An ordinal confirmatory and exploratory factor analysis were employed. Results. None of the theory-driven factor structures were confirmed in the CPAQ-S-20, and exploratory factor analysis did not yield any satisfactory factor solution. However, an eight-item version (CPAQ-S-8) was derived based on the factor analysis that was characterized by good psychometric properties even when retaining important facets of the expected two-factor structure (i.e., Activity Engagement and Symptom Willingness). Limitations. While the sample heterogeneity was conceived as a strength of the study, an underlying noninvariance across different types of complaints could have caused unsatisfactory functioning of the scale.
OBJECTIVE: Understanding the client perspective is important for the provision of psychotherapy. The significant events paradigm, within which clients report on the most significant events of a therapy session immediately after the session, represents a useful means to explore clients' in-session experience. METHOD: The aim of this study was to investigate what types of client-identified impacts are reported in qualitative studies on helpful and hindering events in psychotherapy. Seventeen primary studies focusing on client-identified helpful and hindering events were identified through database searches and subsequent manual searches. The data were subjected to qualitative meta-analysis. RESULTS: The descriptions of event impacts were classified into 12 helpful (e.g., gaining a new perspective on the self; feeling heard, understood, and accepted; and feeling engaged in the therapeutic process) and eight hindering (e.g., lacking guidance from the therapist and feeling emotionally overwhelmed) impact meta-categories. CONCLUSION: The findings provide an update to a previous meta-analysis by identifying several new categories of helpful event impacts and by categorizing hindering event impacts.
- MeSH
- emoce MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- psychoterapie * MeSH
- vztahy mezi zdravotnickým pracovníkem a pacientem * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
The Emotion Regulation Skills Questionnaire (ERSQ, 27 items) is an instrument designed to measure nine emotion regulation skills. This study examined the psychometric properties and longitudinal network structure of the Czech translation of the ERSQ in the clinical sample (primarily mood or neurotic disorders). Czech patients N = 427 completed the ERSQ weekly during treatment. The data were analyzed using confirmatory factor analysis (CFA) and network modeling. The CFA supported an eight-dimensional factor solution (with merged Acceptance and Tolerance subscales). The subscales' internal consistency ranged from ωh = .669 (Bodily sensations) to ωh = .859 (Acceptance/Tolerance). The factor structure was invariant across genders, two age groups, and seven measurement waves (invariance tested as an assumption for network analysis). The longitudinal network model indicated the existence of perceptive and modulatory clusters of emotional regulation skills and revealed the central role of Modification, Bodily sensations, and Readiness for confrontation in emotional regulation. The Czech translation of the ERSQ is a psychometrically sound instrument comparable to the original version. Despite the high internal consistency of the total score (ωtot = .910), the ERSQ is not recommended for use as a unidimensional instrument. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
- MeSH
- dospělí MeSH
- emoční regulace * MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- psychometrie MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Medically unexplained physical symptoms (MUPS) are a frequent phenomenon. Understanding adults and adolescents' lived experience with MUPS is essential for providing adequate care, yet a rigorous synthesis of existing studies is missing. Objective: This study aimed to summarize findings from primary qualitative studies focused on adults' and adolescents' experience of living with MUPS. Design: Qualitative studies were searched in the PsycINFO, PsycARTICLES, and Medline databases and manually. A total of 23 resources met the inclusion criteria and were subjected to a qualitative meta-summary. Results: Eight themes were found across the set of primary studies, namely, the need to feel understood, struggling with isolation, 'sense of self' in strain, facing uncertainty, searching for explanations, ambivalence about diagnosis, disappointed by healthcare, and active coping. Conclusion: The eight themes represent the core struggles adults' and adolescents' with MUPS face in their lives, psychologically and socially. Although these themes appear to be universal, the analysis also revealed considerable variability of experience in terms of expectations from healthcare professionals, attitude towards formal diagnoses, ability to cope with the illness, or potential to transform the illness experience into personal growth. Addressing this diversity of needs represents a significant challenge for the healthcare system.
- MeSH
- afekt MeSH
- dospělí MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- mladiství MeSH
- pacienti bez organického nálezu * MeSH
- poskytování zdravotní péče MeSH
- somatoformní poruchy * diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Understanding psychological mechanisms of change is essential to advance treatments for patients suffering from medically unexplained physical symptoms (MUPS). This study aimed to test the role of selected change mechanisms (incl. interoceptive awareness, emotional regulation skills, symptom acceptance, relational needs satisfaction, clarification of meaning, working alliance, and group cohesion) in the modification of patients' somatic symptom intensity and well-being. N = 290 patients suffering from MUPS participated in a multi-component group-based treatment at seven clinical sites. Data were collected weekly. Multi-level modeling was used to test cross-lagged relationships between the hypothesized mechanisms and outcomes in terms of Granger causality (with lags of 1, 2, and 3 weeks). None of the mechanisms predicted a time-lagged change in outcomes in the expected direction. In fact, there was a consistent pattern of negative time-lagged relationships (i.e., an increase in a mechanism predicted worsening of the outcome). Findings consistent with the hypothesized role of the mechanisms were found only in concurrent relationships between mechanisms and outcomes. This study did not support time-lagged relationships under the condition of weekly measurement and many methodological factors remain to be considered (e.g., a finer time resolution).
Cíl. Narativní koncept obohatil kromě psychologie a psychoterapie také medicínu. V zahraničí došlo ke vniku vzdělávacích programů v narativní medicíně zaměřených na rozvoj narativních dovedností u studentů medicíny a začínajících lékařů. V této souvislosti text představuje pojem narativní citlivosti. Cílem explorativní studie bylo identifikování fazet narativní citlivosti u studentů medicíny a posouzení změn v narativní citlivosti u těchto studentů v průběhu pregraduálního studia. Soubor a metody. V rámci smíšené explorativní studie byla od dospělých účastníků výzkumu získána data v podobě písemných výpovědí v reakci na podnětovou fotografii nejprve ve druhém ročníku pregraduálního studia medicíny (N = 50) a posléze v pátém ročníku (N = 42). Data byla analyzovaná metodou tematické analýzy s prvky konsensuálního kvalitativníhovýzkumu. Byl vytvořen kódovací systém s cílem identifikování fazet narativní citlivosti. Četnost témat byla kvantifikována v každém ročníku zvlášť a k posouzení statistické významnosti změny v narativní citlivosti u studentů během tří let studia byl použit Fisherův test. Výsledky. Během textové analýzy bylo identifikováno devět témat relevantních ke konceptu narativní citlivosti. Četnost témat naznačila pokles narativní citlivosti u studentů medicíny mezi druhým a pátým ročníkem pregraduálního studia. Nicméně explorativní design studie a malý soubor neumožnily učinit definitivní závěr týkající se posouzení změny narativní citlivosti v čase. Závěr. Navzdory limitům studie výsledky vyvolávají pochybnosti o výsledcích pregraduálního studia medicíny založeném na biomedicínském modelu. Studie podporuje argumenty pro větší důraz na rozvoj komunikačních dovedností včetně narativní citlivosti u budoucích lékařů během studia medicíny.
Objective. The paper introduced the concept of narrative sensitivity. The study aimed to identify the facets of narrative sensitivity (NS) in medical students and assess the changes in NS during undergraduate medical education. Methods. A mixed-method study was designed to explore NS. Data was collected from a group of students in their second year (N=50) and then in their fifth year (N=42) of their undergraduate education. The data was analysed using thematic analysis in accordance with consensual qualitative research. A coding system was developed to identify and refine the facets of NS. The theme frequencies were counted for each year separately and Fisher’s exact test was conducted to assess the statistical significance of NS change between both years. Results. Nine themes related to NS were identified in the data. The frequency of themes indicated a trend towards a decline in NS between the second and fifth years of undergraduate education. However, the exploratory nature of this study and the small sample size did not allow any definitive conclusions regarding changes over time. Conclusions. The findings raised doubts about the outcome of undergraduate education based on a narrow biomedical perspective. The study supported the arguments for giving emphasis on the training of communication skills including narrative sensitivity during medical education.
