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- Hybelius, Jonna, 1993-, et al.
(författare)
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A unified Internet-delivered exposure treatment for undifferentiated somatic symptom disorder : single-group prospective feasibility trial
- 2022
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Ingår i: Pilot and Feasibility Studies. - : Springer Science and Business Media LLC. - 2055-5784. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure-based psychological treatment appears to have beneficial effects for several patient groups that commonly report distress related to persistent somatic symptoms. Yet exposure-based treatment is rarely offered in routine care. This may be because existing treatment protocols have been developed for specific symptom clusters or specific unwanted responses to somatic symptoms, and many clinics do not have the resources to offer all these specialised treatments in parallel. In preparation for a randomised controlled trial, we investigated the feasibility of a new and unified Internet-delivered exposure treatment (OSF.io: cnbwj) for somatic symptom disorder regardless of somatic symptom domain (e.g. cardiopulmonary, fatigue, gastrointestinal, pain), combination of unwanted emotions (e.g. anger, anxiety, fear, shame) and whether somatic symptoms are medically explained or not. We hypothesised that a wide spectrum of subgroups would show interest, that the treatment would be rated as credible, that adherence would be adequate, that the measurement strategy would be acceptable and that there would be no serious adverse events.Methods: Single-group prospective cohort study where 33 self-referred adults with undifferentiated DSM-5 somatic symptom disorder took part in 8 weeks of unified Internet-delivered exposure treatment delivered via a web platform hosted by a medical university. Self-report questionnaires were administered online before treatment, each week during treatment, post treatment and 3 months after treatment.Results: Participants reported a broad spectrum of symptoms. The Credibility/Expectancy mean score was 34.5 (SD = 7.0, range: 18–47). Participants completed 91% (150/165) of all modules and 97% of the participants (32/33) completed at least two exposure exercises. The average participant rated the adequacy of the rationale as 8.4 (SD = 1.5) on a scale from 0 to 10. The post-treatment assessment was completed by 97% (32/33), and 84% (27/32) rated the measurement strategy as acceptable. The Client Satisfaction Questionnaire mean score was 25.3 (SD = 4.7, range: 17–32) and no serious adverse events were reported. Reductions in subjective somatic symptom burden (the Patient Health Questionnaire 15; d = 0.90) and symptom preoccupation (the somatic symptom disorder 12; d = 1.17) were large and sustained.Conclusions: Delivering a unified Internet-delivered exposure-based treatment protocol for individuals with undifferentiated somatic symptom disorder appears to be feasible.
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| 2. |
- Jederud, Sandra
(författare)
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New manifestations of the practice-theory dilemma – consequences of ‘the practice turn’ in teacher education
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis comprises four studies that concern the specific part of practicum within teacher education, its relation to the university-based components and how new organizational ideas entail different consequences for student teachers’ opportunities for learning the profession. The overall purpose is to analyze policies related to learning in practice and shed light on what implications are involved when reorganizing Swedish teacher education within the ‘practice turn’. More explicitly, the purpose is to illuminate two manifestations of a more practice-based teacher education – paired practicum within specific practice schools and work-integrated teacher education, where student-teachers are employed as teachers while attending courses at university. Two concepts of knowledge are used as the main theoretical framework; spectator knowledge and participant knowledge, and the concept of boundary crossing and enfolded learning mechanisms. The data are extracted from policy documents regarding the two latest teacher education reforms in 2001 and 2009, as well as from interviews with different parties pertaining within the above two manifestations of the practice turn. Study I concerns whether there are signs of a practice turn in national policy regarding teacher education and how this is addressed in local policy. The study focuses on what is expressed regarding the opportunities student teachers are provided with in order to learn the profession of teaching. Study II explores how pre-school student teachers perceive their opportunities for learning within paired practicum at specific practice schools. Study III also addresses paired practicum within specific practice schools, but data is collected from mentors within upper secondary school regarding their perception of this way of organizing practice. Finally, Study IV concerns a work-integrated teacher education programme and how teacher educators perceive students´ opportunities for learning when they move between the contexts of work and university. The results mainly show that there is an ambivalence concerning what should be given the most value regarding student teachers´ opportunities for learning. Findings also show that the manifestations of ‘the practice turn’ imply a shifting of positions for student-teachers as well as mentors and university teachers. The four studies also identify that the organizational structures of practice have implications for what opportunities for learning students are provided with. Thus, structural changes regarding practice within teacher education enfold that adequate curriculum changes are needed. Furthermore, changes at an organizational level at university, at the connected specific practice schools, and in the workplaces where work-integrated student-teachers are employed are needed.
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