| 1. |
- Alfonsson, Sven, et al.
(författare)
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The Self-Compassion Scale-Short Form : Psychometric evaluation in one non-clinical and two clinical Swedish samples
- 2023
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 30:3, s. 631-642
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Tidskriftsartikel (refereegranskat)abstract
- Background: Self-compassion has been defined as the ability to be with one's feelings of suffering in a warm and caring way. Research has shown a negative association between self-compassion and mental illness, and that low self-compassion can make psychotherapeutic effects less likely. The ability to measure a patient's self-compassion in a fast and reliable way is therefore important in investigating effects of psychotherapies. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the Self-Compassion Scale-Short Form (SCS-SF) in both non-clinical (NC) and clinical samples.Methods: Cross-sectional data were gathered in a NC community sample (n = 1,089), an eating disorder (ED) sample (n = 253) and a borderline personality disorder (BPD) sample (n = 151). All participants were asked to complete a number of questionnaires, including the SCS-SF, and 121 participants in the NC sample repeated the assessment after 2 weeks for test-retest analysis.Results: Confirmatory factor analyses supported the first-order model suggested in previous research. Good internal consistency (Cronbach's alpha = 0.78-0.87) and test-retest reliability (intra-class correlation = 0.84) were demonstrated for the entire scale. Results also showed good convergent validity, demonstrating moderate negative associations between self-compassion and mental illnesses, as expected, and acceptable divergent validity, demonstrating weak positive associations between self-compassion and quality of life and mindfulness.Discussion: The correlations between the SCS-SF and the instruments used for validation were weaker in the clinical samples than the NC sample. This may be due to difficulties measuring these constructs or that the associations differ somewhat between different populations, which could warrant further research. The results added some support to the assumption that self-compassion may overlap with mindfulness yet still represents a distinct construct.Conclusions: Analyses of the SCS-SF provided evidence of adequate to good psychometric properties, supporting use of the scale's total sum score and a first-order factor structure. This is in accordance with previous evaluations of the SCS-SF, suggesting that it is a reliable and time-efficient instrument for measuring a general level of self-compassion. This may be important when evaluating psychotherapy and investigating self-compassion and its influence on psychiatric illness.
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| 2. |
- Beckman, Maria, et al.
(författare)
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A behaviour-based coding tool for assessing supervisors' adherence and competence : Findings from a motivational interviewing implementation study
- 2022
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 29:6, s. 1942-1949
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Tidskriftsartikel (refereegranskat)abstract
- Supervision seems to be an essential part of therapist training and thus also of implementing evidence-based practices. However, there is a shortage of valid and reliable instruments for objective assessment of supervision competence that include both global measures and frequency counts of behaviour—two essential aspects of supervisory competence. This study tests the internal consistency and inter-rater reliability of an assessment tool that includes both these measures. Additionally, strategies and techniques used by 10 supervisors in 35 Motivational interviewing supervision sessions are described. Codings were conducted after two separate coding training sessions. The internal consistency across the global measures was acceptable (α = 0.70; 0.71). After the second training, the inter-rater reliabilities for all frequency counts were in the moderate to good range, except for two that were in the poor range; inter-rater reliability for one of the four global measures was in the moderate range, and three were in the poor range. A prerequisite for identifying specific supervisor skills central to the development of therapist skills, teaching these skills to supervisors and performing quality assurance of supervision, is to create instruments that can measure these behaviours. This study is a step in that direction.
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| 3. |
- Carvalho, S. A., et al.
(författare)
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A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness
- 2022
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Ingår i: Clinical Psychology & Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 29:2, s. 524-541
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Tidskriftsartikel (refereegranskat)abstract
- Literature suggests that acceptance and commitment therapy (ACT) is effective in improving well-being and in reducing psychopathological symptoms commonly experienced by people with chronic illness (CI). Compassion-focused therapy (CFT) reduces psychological distress, especially in individuals with high levels of shame and self-criticism, but few studies have explored CFT in CI. Additionally, studies almost exclusively compared ACT and CFT with inactive controls (wait-list; treatment as usual). Also, there is an interest in developing cost-effective mental health solutions, such as low-intensity online psychological interventions. This randomized controlled trial (RCT) aimed to assess the acceptability and compare the efficacy of four-session online ACT (n = 25) and CFT (n = 24) interventions in a sample of people with CI. Results showed both interventions were acceptable, with attrition rates at post-intervention comparable to those found in similar studies (around 50%). Intention-to-treat analyses showed that participants presented significantly less illness-related shame, less uncompassionate self-responding and more valued living after the intervention, although no difference was found between conditions. Results were sustained at 3- and 6-month follow-up. Results did not find statistical differences between conditions through reliable change index (RCI). Correlation between demographics and RCI showed that, at post-intervention, younger participants presented more behavioural awareness, men presented more valued action, and participants with CI for shorter periods presented less uncompassionate self-responding and less anxiety. Results suggest that low-intensity (four sessions) online ACT and CFT are cost-effective approaches to promote mental health of individuals with CI. Results and limitations are thoroughly discussed.
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| 4. |
- Hesser, Hugo, 1982-
(författare)
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Identifying causal mechanisms in psychotherapy : what can we learn from causal mediation analysis?
- 2022
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 29:3, s. 1050-1058
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Tidskriftsartikel (refereegranskat)abstract
- Despite widespread interest in the development of process-based psychotherapies, little is still known about the underlying processes that underpin our most effective therapies. Statistical mediation analysis is a commonly used analytical method to evaluate how, or by which processes, a therapy causes change in an outcome. Causal mediation analysis (CMA) represents a new advancement in mediation analysis that employs causally-defined direct and indirect effects based on potential outcomes. These novel ideas and analytical techniques have been characterized as revolutionary in epidemiology and biostatistics, although they are not (yet) widely known among researchers in clinical psychology. In this paper, I outline the fundamental concepts underlying CMA, clarify the differences between the CMA approach and the traditional approach to mediation, and identify two important data analytical aspects that have been emphasized as a result of these recent advancements. To illustrate the key ideas, assumptions, and mathematical definitions intuitively, an applied clinical example from a previously published randomized controlled trial is used. CMA's main contributions are discussed, as well as some of the key challenges. Finally, it is argued that the most significant contribution of CMA is the formalization of mediation in a unified causal framework with clear assumptions.
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| 5. |
- Kanstrup, Marie, et al.
(författare)
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A single case series using visuospatial task interference to reduce the number of visual intrusive memories of trauma with refugees
- 2021
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 28:1, s. 109-123
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Tidskriftsartikel (refereegranskat)abstract
- The current worldwide so-called "refugee crisis" has led to an unprecedented increase in migration globally. Because of stigma and language barriers, mental health care for refugees is limited. There is a need for novel, scalable psychological interventions. We investigated whether a brief behavioural intervention involving a memory reminder cue and Tetris gameplay on a smartphone reduces intrusive memories in refugees using a single case (N= 4) ABAB withdrawal design. The baseline phase (A) included a no-intervention week; the intervention phase (B) included an in-person session with the researchers, comprised of the behavioural intervention followed by self-guided use in daily life the following week. All participants reported a decrease in intrusive memories after the intervention, as well as functional improvements (e.g., in concentration). Importantly, participants rated the intervention as feasible and acceptable. As one in-person session was effective in persistent intrusion reduction, ABAB proved not to be the optimal design as intrusions did not rebound in the withdrawal phase. Findings are promising and highlight the need for further evaluation of novel interventions for mental health problems in refugees.
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| 6. |
- Khan, Sammyh, 1979-, et al.
(författare)
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Making connections : Social identification with new treatment groups for lifestyle management of severe obesity
- 2020
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 27:5, s. 686-696
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Tidskriftsartikel (refereegranskat)abstract
- Groups are regularly used to deliver healthcare services, including the management of obesity, and there is growing evidence that patients' experiences of such groups fundamentally shape treatment effects. This study investigated factors related to patients' shared social identity formed within the context of a treatment group for the management of severe obesity. A cross-sectional survey was administered to patients registered with a UK medical obesity service and enrolled on a group-based education and support programme. Patients (N = 78; M-BMI = 48 on entry to the service) completed measures of group demographics (e.g., group membership continuity) and psychosocial variables (e.g., past experiences of weight discrimination) and reported their social identification with the treatment group. The results showed that patients identified with the treatment group to the extent that there was continuity in membership across the programme and they perceived themselves more centrally in terms of their weight status. Weight centrality was negatively associated with external social support and positively associated with experiences of weight discrimination. Group continuity was positively correlated with session attendance frequency. Patients presenting to clinical treatment services with severe obesity often do so after sustained weight loss failure and exposure to negative societal experiences. This study highlights that providing a treatment environment wherein these experiences can be shared with other patients may provide common ground for development of a new, positive social identity that can structure programme engagement and progression.
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| 7. |
- Larsson, Johannes, 1993-, et al.
(författare)
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Anger profiles among individuals seeking treatment for maladaptive anger : Associations with emotion regulation
- 2023
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 30:3, s. 599-610
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Tidskriftsartikel (refereegranskat)abstract
- Individuals who experience problems with anger represent a heterogeneous group. Identifying clinically relevant subtypes of anger may advance treatment research. In the current study, latent profile analysis (LPA) was conducted to explore if distinct subtypes of anger could be identified within a sample of individuals seeking treatment for maladaptive anger (N = 538; 55.4% females; mean age = 39.78, SD = 12.28). Furthermore, the utility of the empirical classification was examined based on differences in usage of emotion regulation strategies (cognitive reappraisal, expressive suppression, mindful emotion awareness and relaxation) across subtypes. Four anger profiles were identified in the best-fitted LPA model: Low Anger (n = 153, 28.4%), Anger In (n = 91, 16.9%), Moderate Anger (n = 193, 35.9%) and High Anger (n = 101, 35.5%). Results from the multinominal regression revealed that the use of emotion regulation differed across all profiles. Participants from the High Anger and Anger In profiles exhibited distinct patterns of dysfunctional emotion regulation. The results add to the increasing amount of evidence demonstrating a link between emotion regulation strategies and maladaptive anger. Clinical implications on how to tailor treatments for individuals with maladaptive anger are discussed.
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| 8. |
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| 9. |
- Nilsson, Magnus, et al.
(författare)
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Childhood maltreatment and self-hatred as distinguishing characteristics of psychiatric patients with self-harm: A comparison with clinical and healthy controls
- 2022
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Ingår i: Clinical Psychology & Psychotherapy. - : Wiley. - 1099-0879 .- 1063-3995. ; 29:5, s. 1778-1789
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Deliberate self-harm (DSH) is common in clinical populations. Childhood maltreatment (CM) and attitudes both towards oneself and towards DSH may be of importance for the development of DSH. This study aimed to test whether patients with DSH report more CM, more negative attitudes towards oneself and more positive attitudes towards DSH than a clinical and a healthy comparison group, and whether the effects of CM are mediated by negative attitudes towards oneself.Method: Females with DSH and psychiatric disorders (n = 34), females without DSH but with psychiatric disorders (n = 31) and healthy female individuals (n = 29) were compared regarding DSH, CM, attitudes towards the self and attitudes towards self-harm.Results: Females with DSH reported more emotional abuse and more self-hatred as compared to both comparison groups. The effect of emotional abuse was mediated by self-hatred. The DSH-group had significantly more positive attitudes towards DSH than the healthy comparison group.Conclusion: Self-hatred and CM in the form of emotional abuse may be distinguishing characteristics of female patients with DSH in psychiatric settings. The present results are compatible with the hypothesis that emotional abuse leads to DSH via self-hatred, but the cross-sectional nature of the study precludes any causal conclusions. The clinical utility of the results is discussed.
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| 10. |
- Swanson, Linda, et al.
(författare)
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Metacognitive training for negative symptoms : support for the cognitive model
- 2023
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 30:2, s. 486-490
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Tidskriftsartikel (refereegranskat)abstract
- Developing effective treatment options for negative symptoms of psychotic disorders remains a major unmet treatment need and area for further research. In a recent uncontrolled study by the main author, Metacognition Training (MCT) for negative symptoms was found to lead to fewer negative symptoms, less stigma and increased self-rated reflective ability. As the analysis examined negative symptoms as a whole, we here performed an additional analysis on individual negative symptom items as recent research has suggested that negative symptoms are best conceptualized through a five-factor model. It was found that the intervention led to changes specifically on sociality and blunted affect (with large effect sizes), which might reflect changes in both intrapersonal and interpersonal (meta)cognitive processes.
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