‘You should always look at the washing machine without actually being in it!’ Thematic framework analysis of patients’ understanding of transdiagnostic cognitive behaviour therapy and its mechanisms

Sighvatsson, Magnús Blöndahl; Šalkovskis, Paul M.; Sigurðsson, Engilbert; Valdimarsdottir, Heiðdís; Þórsdóttir, Fanney; Sigurðsson, Jón Friðrik

doi:10.1111/papt.12220

Cited by 6 publications

(1 citation statement)

References 23 publications

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“…Given the validity issues of diagnostic categories ( 44 ), a disorder-specific focus can limit research and lead to conceptual difficulties and possible difficulties within the therapeutic relationship ( 45 , 46 ). For this reason, understanding the mechanisms by which therapeutic interventions achieve a meaningful change ( 47 ) may be more relevant for clinicians and services offering psychological support across diagnostic boundaries in the perinatal period.…”

Section: Introductionmentioning

confidence: 99%

“Finding my voice again” - women’s experiences of psychological therapy in perinatal secondary care settings: a qualitative study

O’Brien,

Gregg,

Wittkowski

2024

Front. Psychiatry

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IntroductionAlthough women often experience mental health comorbidities in the perinatal period, the evidence-base for psychological therapy across diagnostic boundaries in the perinatal period remains limited. As there is a need to understand experiences of therapy, irrespective of diagnosis, to inform intervention provision, the aims of this study were to explore women’s experiences of psychological therapy for perinatal mental health difficulties and to identify the mechanisms that women attributed to the most significant therapeutic change for themselves and/or the mother-infant relationship.MethodSemi-structured interviews were conducted with 16 women who received therapy within specialist perinatal community mental health settings in the Northwest of England, the UK. Interview data were analysed using reflexive thematic analysis.ResultsOne overarching theme entitled participant life stories were at the heart of therapy was identified alongside three other main themes: 1.) We’re in this together – therapeutic bond and establishing a coherent sense of self, 2.) Surfing the urge to ‘fix’ feelings – Sitting with emotions improved regulation and 3.) Seeing myself in a new light – Shifting self-blame to self-compassion enhanced self-efficacy. Theme 1 consisted of three subthemes. Participants described the quality of the therapeutic relationship as the fundamental foundation to (re)connecting with their needs, values and boundaries, which improved their sense of agency, self-esteem, therapeutic engagement and self-understanding. Shifting emotional avoidance to emotional engagement improved their self-regulation. Considering alternative factors that could have contributed to their experiences helped them to defuse self-blame and enhance self-compassion. Finally, changes in their mental health led to positive relational changes in their relationship with their infant and improved communication with partners.DiscussionSensitivity, engagement and responsivity experienced in the therapist-woman relationship was reported to be mirrored in the mother-infant relationship. Developing a coherent sense of self and self-regulation skills both appeared to heighten women’s self-compassion and empathy for their infants, which also seemed to improve their ability to tolerate uncertainty and mixed emotions within themselves and their infants. The mechanisms of change in the perinatal period are important to consider at a stakeholder, therapist and service management level to parsimoniously and best meet the needs of women and the mother-infant relationship.

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Section: Introductionmentioning

confidence: 99%

“Finding my voice again” - women’s experiences of psychological therapy in perinatal secondary care settings: a qualitative study

O’Brien,

Gregg,

Wittkowski

2024

Front. Psychiatry

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Youth Top Problems and Early Treatment Response to the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents

Milgram

Tonarely

Ehrenreich–May

2021

Child Psychiatry Hum Dev

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Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders

Garcia-Lopez,

Jimenez-Vazquez,

Muela-Martinez

et al. 2023

Curr Psychol

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Despite ample evidence for transdiagnostic interventions in clinical populations and in universal prevention approaches, there are only a few controlled trials examining their role for indicated prevention. This study is the first randomized controlled trial to assess the effectiveness of a brief, 8-session group version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), called PROCARE-I (Preventive Transdiagnostic Intervention for Adolescents at Risk for Emotional Disorders-Indicated), delivered online, and including a booster session, in reducing symptoms of anxiety and depression in adolescents compared to an active control condition. Sixty-four adolescents (53% identifying as female) with elevated levels of anxiety and/or depression were randomly assigned to either the 8-week PROCARE-I or the active control condition. Self-report, parent, and clinician measures were collected before and after the interventions, at the 6-month follow-up, and 1 month after the booster session. After the intervention, participants in the PROCARE-I group showed improved scores on 9 of the 13 primary and secondary outcome measures, including reduction of anxiety and mood symptomatology, level of risk of developing emotional disorders, resilience, as well as increase of psychological flexibility, and emotional regulation. In contrast, those in the control group showed improvements in only 2 of the 13 outcome measures. After the booster session, significant differences were found between the PROCARE-I and control condition on measures of overall anxiety and depression symptoms, emotional risk, resilience, and quality of life. Low dropout rates and limited incidence of emotional disorders were observed at follow-ups. The interventions were well-accepted, with high satisfaction rates.

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‘You should always look at the washing machine without actually being in it!’ Thematic framework analysis of patients’ understanding of transdiagnostic cognitive behaviour therapy and its mechanisms

Cited by 6 publications

References 23 publications

“Finding my voice again” - women’s experiences of psychological therapy in perinatal secondary care settings: a qualitative study

“Finding my voice again” - women’s experiences of psychological therapy in perinatal secondary care settings: a qualitative study

Youth Top Problems and Early Treatment Response to the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents

Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders

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