Background: In order to support efforts to prevent bullying, more needs to be understood about students' own explanations of bullying in their everyday school lives. In-depth qualitative analysis can contribute important insights regarding insider perspectives in terms of how students understand and explain the social interaction patterns of bullying. Purpose: The aim of the study was to examine, in detail, how a small sample of lower secondary school students explain why bullying happens and to develop a grounded theory analysis based on the students' perspectives. Method: The participants in the study were 17 Swedish lower secondary school students aged between 13 and 15 years. A total of 17 qualitative interviews and 3 follow-up interviews were conducted. Grounded theory methods based on a constructivist position were used to explore and analyse the data. Findings: The findings are based on data collected from young people who had witnessed bullying. The analysis of their explanations of why bullying happens resulted in six categories: social positioning, victim constructing, bullying normalising, rule diffusion, rule resistance and cultural ideals. These categories are interrelated, and the core process of bullying was identified as social positioning. The analysis suggested that the main concern of those who engage in bullying is to gain and maintain a high social status. Victims, in turn, were socially constructed as 'different' and 'wrong', and were connected with a low-status position. Conclusions: The study draws attention to the need for students' understandings of bullying to be consideredfor example, through student consultations. It is hoped that the current findings could be helpful as a starting point when investigating students' perspectives and giving students a voice in bullying prevention approaches at school.

Background In recent decades, stress-related disorders have received more attention, with an increasing prevalence, especially within the working population. The internet provides new options for broad dissemination, and a growing body of evidence suggests that web-based interventions for stress might be effective. However, few studies have examined the efficacy of interventions in clinical samples and work-related outcomes. Objective The aim of this study was to evaluate the efficacy of an internet-based cognitive behavioral intervention for stress-related disorders integrating work-related aspects (work-focused and internet-based cognitive behavioral therapy [W-iCBT]), compared with a generic internet-based cognitive behavioral therapy (iCBT) group and a waitlist control (WLC) group. Methods In this trial, 182 employees, mainly employed in the health care, IT, or educational sector, who fulfilled the criteria for a stress-related disorder, were randomized to a 10-week W-iCBT (n=61, 33.5%), generic iCBT (n=61, 33.5%), or WLC (n=60, 33%). Self-rated questionnaires on perceived stress, burnout, exhaustion, and other mental health– and work-related outcomes were administered before and after the treatment and at 6- and 12-month follow-ups. Results Compared with the WLC group, participants of the W-iCBT and iCBT groups showed an equal and significant reduction in the primary outcome (Shirom-Melamed Burnout Questionnaire [SMBQ]) from pretreatment to posttreatment assessment (Cohen d=1.00 and 0.83, respectively) and at the 6-month follow-up (Cohen d=0.74 and 0.74, respectively). Significant moderate-to-large effect sizes were also found in the secondary health- and work-related outcomes. The W-iCBT was the only group that exhibited significant effects on work ability and short-term sickness absence. Short-term sickness absence was 445 days lower than the WLC group and 324 days lower than the iCBT intervention group. However, no significant differences were found in terms of work experience or long-term sick leave. Conclusions The work-focused and generic iCBT interventions proved to be superior compared with the control condition in reducing chronic stress and several other mental health–related symptoms. Interestingly, effects on work ability and short-term sickness absence were only seen between the W-iCBT intervention and the WLC groups. These preliminary results are promising, indicating that treatments that include work aspects may have the potential to accelerate recovery and reduce short-term sickness absence because of stress-related disorders. Trial Registration ClinicalTrials.gov NCT05240495; https://clinicaltrials.gov/ct2/show/NCT05240495 (retrospectively registered)

Objective: To evaluate the feasibility and efficacy of ACTenhanced Group Behavior Therapy (AEGBT) for mixed diagnosis groups including patients with trichotillomania (TTM) and skin-picking disorder (SPD) in routine psychiatric care.Method: Adult patients (N = 40) with TTM and/or SPD received 10 weeks of AEGBT followed by five booster sessions. The primary outcome measure for TTM was the Massachusetts General Hospital Hairpulling Scale (MGH-HPS) and for SPD the Skin Picking Scale-Revised (SPS-R), assessed at posttreatment and at booster sessions.Results: Results showed significant reductions in hair pulling and skin-picking severity from baseline to posttreatment and large effect sizes at posttreatment. Improvements remained significant at the 12-month follow-up for patients with SPD, but not for patients with TTM. Group attendance was high and few patients dropped out from treatment. The group format enabled therapists to see 25% more patients compared with an individual format. Conclusion:The results provide initial support for the feasibility and efficacy of an adapted treatment approach for TTM and SPD.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

BACKGROUND In the recent decade, stress-related disorders have received more attention, with an increasing prevalence, especially within the working population. Internet provides new options for broad dissemination and a growing body of evidence suggest that internet-based interventions for stress might be effective. Yet, few studies have examined the efficacy of interventions in clinical samples and on work-related outcomes. OBJECTIVE The aim of the current study was to evaluate the efficacy of an internet-based cognitive–behavioural intervention for stress-related disorders integrating work-related aspects (W-iCBT), compared with a generic iCBT and a waitlist control group (WLC). METHODS In this trial, 182 employees, mainly employed in the healthcare, IT or educational sector, who fulfilled the criteria for a stress-related disorder, were randomized to a 10-week W-iCBT (n=61), generic iCBT (n=61) or WLC (n=60). Self-rated questionnaires on perceived stress, burnout, exhaustion and other mental-health and work-related outcomes were administered pre- and post-treatment, and at a six- and 12-months follow-up. RESULTS Compared to WLC, participants of the W-iCBT and iCBT showed equal and significant reduction on the primary outcome (SMBQ) from pre to post assessment (d=1.00 and 0.83 respectively) and at the six months follow-up (d=0.74 and 0.74). Significant moderate-to-large effect sizes were also found on the secondary health and work-related outcomes. The W-iCBT was the only group who exhibited significant effects on work ability and sickness absence. Sickness absence was 445 days (7.29 days per participant) lower compared to the WLC and 324 days (5.31 days per participant) compared to the iCBT intervention. However, no significant differences were found on work experience or long-term sick leave. CONCLUSIONS The work-focused and generic iCBT interventions proved to be superior and equally effective compared to the control condition in reducing chronic stress and several other mental health related symptoms. Interestingly, effects on work ability and sickness absence were only seen between the work-focused iCBT intervention and the WLC. These preliminary results are promising, as they provide further evidence that treatments that integrate work-aspects has great potential in accelerating both recovery and reduce sickness absence due to stress-related disorders. CLINICALTRIAL The study was registered at Clinical trials (clinicaltrials.gov) number NCT05240495.