Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear how and why the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review (Nstudies = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: “embodiment,” “concretization,” and “symbolism and metaphors.” The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.
DOCUMENT
Abstract Objectives The aim of this review is to establish the effectiveness of psychological relapse prevention interventions, as stand-alone interventions and in combination with maintenance antidepressant treatment (M-ADM) or antidepressant medication (ADM) discontinuation for patients with remitted anxiety disorders or major depressive disorders (MDD). Methods A systematic review and a meta-analysis were conducted. A literature search was conducted in PubMed, PsycINFO and Embase for randomised controlled trials (RCTs) comparing psychological relapse prevention interventions to treatment as usual (TAU), with the proportion of relapse/recurrence and/or time to relapse/recurrence as outcome measure. Results Thirty-six RCTs were included. During a 24-month period, psychological interventions significantly reduced risk of relapse/recurrence for patients with remitted MDD (RR 0.76, 95% CI: 0.68–0.86, p<0.001). This effect persisted with longer follow-up periods, although these results were less robust. Also, psychological interventions combined with M-ADM significantly reduced relapse during a 24-month period (RR 0.76, 95% CI: 0.62–0.94, p = 0.010), but this effect was not significant for longer follow-up periods. No meta-analysis could be performed on relapse prevention in anxiety disorders, as only two studies focused on relapse prevention in anxiety disorders. Conclusions In patients with remitted MDD, psychological relapse prevention interventions substantially reduce risk of relapse/recurrence. It is recommended to offer these interventions to remitted MDD patients. Studies on anxiety disorders are needed.
DOCUMENT
This paper proposes and showcases a methodology to develop an observational behavior assessment instrument to assess psychological competencies of police officers. We outline a step-by-step methodology for police organizations to measure and evaluate behavior in a meaningful way to assess these competencies. We illustrate the proposed methodology with a practical example. We posit that direct behavioral observation can be key in measuring the expression of psychological competence in practice, and that psychological competence in practice is what police organizations should care about. We hope this paper offers police organizations a methodology to perform scientifically informed observational behavior assessment of their police officers’ psychological competencies and inspires additional research efforts into this important area.
MULTIFILE
Closing the loop of products and materials in Product Service Systems (PSS) can be approached by designers in several ways. One promising strategy is to invoke a greater sense of ownership of the products and materials that are used within a PSS. To develop and evaluate a design tool in the context of PSS, our case study focused on a bicycle sharing service. The central question was whether and how designers can be supported with a design tool, based on psychological ownership, to involve users in closing the loop activities. We developed a PSS design tool based on psychological ownership literature and implemented it in a range of design iterations. This resulted in ten design proposals and two implemented design interventions. To evaluate the design tool, 42 project members were interviewed about their design process. The design interventions were evaluated through site visits, an interview with the bicycle repairer responsible, and nine users of the bicycle service. We conclude that a psychological ownership-based design tool shows potential to contribute to closing the resource loop by allowing end users and service provider of PSS to collaborate on repair and maintenance activities. Our evaluation resulted in suggestions for revising the psychological ownership design tool, including adding ‘Giving Feedback’ to the list of affordances, prioritizing ‘Enabling’ and ‘Simplification’ over others and recognize a reciprocal relationship between service provider and service user when closing the loop activities.
DOCUMENT
Artikel proefschrift Jos Dobber verschenen in Frontiers in Psychiatry 24 maart 2020: Background: Trials studying Motivational Interviewing (MI) to improve medication adherence in patients with schizophrenia showed mixed results. Moreover, it is unknown which active MI-ingredients are associated with mechanisms of change in patients with schizophrenia. To enhance the effect of MI for patients with schizophrenia, we studied MI's active ingredients and its working mechanisms. Methods: First, based on MI literature, we developed a model of potential active ingredients and mechanisms of change of MI in patients with schizophrenia. We used this model in a qualitative multiple case study to analyze the application of the active ingredients and the occurrence of mechanisms of change. We studied the cases of fourteen patients with schizophrenia who participated in a study on the effect of MI on medication adherence. Second, we used the Generalized Sequential Querier (GSEQ 5.1) to perform a sequential analysis of the MI-conversations aiming to assess the transitional probabilities between therapist use of MI-techniques and subsequent patient reactions in terms of change talk and sustain talk. Results: We found the therapist factor “a trusting relationship and empathy” important to enable sufficient depth in the conversation to allow for the opportunity of triggering mechanisms of change. The most important conversational techniques we observed that shape the hypothesized active ingredients are reflections and questions addressing medication adherent behavior or intentions, which approximately 70% of the time was followed by “patient change talk”. Surprisingly, sequential MI-consistent therapist behavior like “affirmation” and “emphasizing control” was only about 6% of the time followed by patient change talk. If the active ingredients were embedded in more comprehensive MI-strategies they had more impact on the mechanisms of change. Conclusions: Mechanisms of change mostly occurred after an interaction of active ingredients contributed by both therapist and patient. Our model of active ingredients and mechanisms of change enabled us to see “MI at work” in the MI-sessions under study, and this model may help practitioners to shape their MI-strategies to a potentially more effective MI.
DOCUMENT
Objective To synthesise qualitative studies on women’s psychological experiences of physiological childbirth. Design Meta-synthesis. Methods Studies exploring women’s psychological experiences of physiological birth using qualitative methods were eligible. The research group searched the following databases: MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX and Psychology and Behavioural Sciences Collection. We contacted the key authors searched reference lists of the collected articles. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Results Eight studies involving 94 women were included. Three third order interpretations were identified: ‘maintaining self-confidence in early labour’, ‘withdrawing within as labour intensifies’ and ‘the uniqueness of the birth experience’. Using the first, second and third order interpretations, a line of argument developed that demonstrated ‘the empowering journey of giving birth’ encompassing the various emotions, thoughts and behaviours that women experience during birth. Conclusion Giving birth physiologically is an intense and transformative psychological experience that generates a sense of empowerment. The benefits of this process can be maximised through physical, emotional and social support for women, enhancing their belief in their ability to birth and not disturbing physiology unless it is necessary. Healthcare professionals need to take cognisance of the empowering effects of the psychological experience of physiological childbirth. Further research to validate the results from this study is necessary.
DOCUMENT
While criminality is digitizing, a theory-based understanding of the impact of cybercrime on victims is lacking. Therefore, this study addresses the psychological and financial impact of cybercrime on victims, applying the shattered assumptions theory (SAT) to predict that impact. A secondary analysis was performed on a representative data set of Dutch citizens (N = 33,702), exploring the psychological and financial impact for different groups of cybercrime victims. The results showed a higher negative impact on emotional well-being for victims of person-centered cybercrime, victims for whom the offender was an acquaintance, and victims whose financial loss was not compensated and a lower negative impact on emotional well-being for victims with a higher income. The study led to novel scientific insights and showed the applicability of the SAT for developing hypotheses about cybercrime victimization impact. In this study, most hypotheses had to be rejected, leading to the conclusion that more work has to be done to test the applicability of the SAT in the field of cybercrime. Furthermore, policy implications were identified considering the prioritization of and approach to specific cybercrimes, treatment of victims, and financial loss compensation.
MULTIFILE
Extending the lifespan of products can be approached in several ways. One promising way is to give users a greater sense of ownership of the products that are used. In the context of Product Service Systems (PSS), products are often used temporarily, shared with others, and offered through a technology-mediated environment. Not much is known about psychological ownership in this context. To evaluate psychological ownership affordances as an intermediate knowledge tool in the context of PSS, we started a case study focused on a bicycle sharing service of The Student Hotel (TSH). The central question was how a design approach, based on psychological ownership, can help to redesign the bicycle-service of TSH to contribute to extended lifespans of the bicycles. This resulted in ten exemplary designs as project outcomes and two implemented design interventions in a TSH branch. All project members and stakeholders (app supplier X-bike and Roetz-bikes mechanics) and students of Eindhoven University of Technology (TU/e) and Utrecht University of Applied Sciences (HU) (n=42) were interviewed on process efficiency, process quality and design quality at the end of the collaboration. We performed a qualitative analysis to identify when and how the team members applied the design tool, how these obstructed or supported the design process, and if the team members show shared understanding of the behavioral and/or social consequences of their decisions. The results show both top-down and bottom-up insights, leading to four suggestions for adapting the existing model as an intermediate knowledge tool: (1) being more goal-oriented, (2) consider a hierarchy of affordances, (3) consider to add a new affordance and (4) recognize a more active role of the service provider.
DOCUMENT
Abstract: Background: Little is known about frailty among patients hospitalized with heart failure (HF). To date, the limited information on frailty in HF is based on a unidimensional view of frailty, in which only physical aspects are considered when determining frailty. The aims of this study were to study different dimensions of frailty (physical, psychological and social) in patients with HF and the effect of different dimensions of frailty on the incidence of heart failure. Methods: The study used a cross-sectional design and included 965 patients hospitalized for heart failure and 164 healthy controls. HF was defined according to the ESC guidelines. The Tilburg Frailty Indicator (TFI) was used to assess frailty. Probit regression analyses and chi-square statistics were used to examine associations between the occurrence of heart failure and TFI domains of frailty. Results: Patients diagnosed with frailty were 15.3% more likely to develop HF compared to those not diagnosed with frailty (p < 0.001). An increase in physical, psychological and social frailty corresponded to an increased risk of HF of 2.9% (p < 0.001), 4.4% (p < 0.001) and 6.6% (p < 0.001), respectively. Conclusions: We found evidence of the association between different dimensions of frailty and incidence of HF.
DOCUMENT
Background: For patients with coronary artery disease (CAD), smoking is an important risk factor for the recurrence of a cardiovascular event. Motivational interviewing (MI) may increase the motivation of the smokers to stop smoking. Data on MI for smoking cessation in patients with CAD are limited, and the active ingredients and working mechanisms of MI in smoking cessation are largely unknown. Therefore, this study was designed to explore active ingredients and working mechanisms of MI for smoking cessation in smokers with CAD, shortly after a cardiovascular event. Methods: We conducted a qualitative multiple case study of 24 patients with CAD who participated in a randomized trial on lifestyle change. One hundred and nine audio-recorded MI sessions were coded with a combination of the sequential code for observing process exchanges (SCOPE) and the motivational interviewing skill code (MISC). The analysis of the cases consisted of three phases: single case analysis, cross-case analysis, and cross-case synthesis. In a quantitative sequential analysis, we calculated the transition probabilities between the use of MI techniques by the coaches and the subsequent patient statements concerning smoking cessation. Results: In 12 cases, we observed ingredients that appeared to activate the mechanisms of change. Active ingredients were compositions of behaviors of the coaches (e.g., supporting self-efficacy and supporting autonomy) and patient reactions (e.g., in-depth self-exploration and change talk), interacting over large parts of an MI session. The composition of active ingredients differed among cases, as the patient process and the MI-coaching strategy differed. Particularly, change talk and self-efficacy appeared to stimulate the mechanisms of change “arguing oneself into change” and “increasing self-efficacy/confidence.”
DOCUMENT
