#NPsychPick of the Month: Mood Tracker: A Randomized Controlled Trial of a Self-Monitoring Intervention for Emotional Distress After Traumatic Brain Injury

Mood Tracker: A Randomized Controlled Trial of a Self-Monitoring Intervention for Emotional Distress After Traumatic Brain Injury.

Sherer, Mark PhD; Juengst, Shannon PhD; Sander, Angelle M. PhD; Leon-Novelo, Luis PhD; Liu, Xiangyi MS; Bogaards, Jay MA; Chua, Wilma BBA; Tran, Kim MA

#NPsychPick of the Month

Abstract

Objective:

Persons with traumatic brain injury (TBI) frequently experience emotional distress (ED) manifested in anxiety and depression. However, they may not access mental health services due to external (eg, access, transportation, and cost) or internal (eg, stigma and discomfort with traditional counseling) barriers. Based on substantial literature indicating that self-monitoring can ameliorate several health conditions, we conducted a randomized, parallel group, wait-list control (WLC) trial of a self-monitoring intervention to decrease ED after TBI.

Setting:

Community in the southwestern United States.

Participants:

Persons with medically documented complicated mild, moderate, and severe TBI.

Design:

About 127 participants were randomized in blocks of 6 to an active treatment (AT) group, wherein they completed multiple assessments of ED each week over a 6-week period via a smartphone app, or a WLC group in a parallel group, controlled trial. Participants received weekly support calls to promote self-monitoring of ED using ecological momentary assessment.

Main Measures:

ED (Patient Health Questionnaire—9 and Generalized Anxiety Disorder—7), Satisfaction with Life Scale, and Participation Assessment with Recombined Tools—Objective.

Results:

Analysis of the primary study outcome at 6 weeks after initiation of treatment for the AT group did not demonstrate that self-monitoring was effective in decreasing ED as compared to the WLC group. Brief support calls made weekly to promote compliance with self-monitoring were effective in achieving the target number of self-assessments. About 80% of support calls lasted less than 5 minutes. Greater ED was associated with lower life satisfaction and lower participation indicating the importance of addressing ED in persons with TBI.

Conclusion:

Additional work is needed to develop nontraditional interventions to circumvent barriers that prevent persons with TBI from accessing care for ED. Brief support calls may be an effective, low-cost intervention to improve compliance with self-monitoring or self-management interventions.

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Psychedelic-assisted Psychotherapy in 3-D: Acceptance, Connectedness, and Defensiveness

#NPsychPick of the Month: Psychedelic-assisted Psychotherapy in 3-D: Acceptance, Connectedness, and Defensiveness: Neuropsychoanalysis: Vol 25, No 2.

Psychedelic-assisted Psychotherapy in 3-D: Acceptance, Connectedness, and Defensiveness.

Lawrence Fischman.

#NPsychPick of the Month

Abstract

As psychiatry weighs a move from a categorical to a dimensionally-based classification system, clinical research and treatment paradigms may shift towards identifying which dimensions of mental health can improve treatment outcomes across a broad range of diagnostic categories. Psychedelic-assisted psychotherapy, which is currently in clinical trials for a wide range of conditions from PTSD to tobacco dependency, holds promise for just such a dimensional approach to treatment. Anecdotal reports and qualitative studies have hinted at its potential for decreasing defensiveness and increasing feelings of acceptance and connectedness. In this theoretical paper, I draw upon ideas and research with psychedelics, infant observation, social psychology, and psychoanalysis to explain why psychedelic-assisted psychotherapy is especially well-suited for addressing these dimensions of mental health. Because studies already support the use of psychedelic-assisted psychotherapy in one dimensionally-based application – the treatment of existential anxiety in patients with cancer – I begin with a look at psychological models of defensiveness in relation to the fear of death. I then use the models of Winnicott, Stern, Carhart-Harris/Friston and others to discuss the experiences of awe, omnipotence, and creativity within ordinary and psychedelic states, and touch on a fourth dimension of mental health, authenticity. I suggest psychedelic-assisted psychotherapy may be viewed as a transitional space ideally suited for working through experiences of disconnection through the process of illusion-disillusionment, allowing gradual acceptance. I conclude with a summary of how acceptance, connectedness, and defensiveness are related to each other and to one’s sense of self.

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Chasing the Numinous: Hungry Ghosts in the Shadow of the Psychedelic Renaissance

#NPsychPick of the Month – Chasing the numinous: Hungry ghosts in the shadow of the psychedelic renaissance. Helge Michael Osterhold, Gisele Fernandes-Osterhold. Wiley Library August 2023.

Chasing the Numinous: Hungry Ghosts in the Shadow of the Psychedelic Renaissance.

Helge Michael Osterhold, Gisele Fernandes-Osterhold.

#NPsychPick of the Month

Abstract

In recent years a renewed scientific, public and commercial interest in psychedelic medicines can be observed across the globe. As research findings have been generally promising, there is hope for new treatment possibilities for a number of difficult-to-treat mental health concerns. While honouring positive developments and therapeutic promise in relation to the medical use of psychedelics, this paper aims to shine a light on some underlying psycho-cultural shadow dynamics in the unfolding psychedelic renaissance. This paper explores whether and how the multi-layered collective fascination with psychedelics may yet be another symptom pointing towards a deeper psychological and spiritual malaise in the modern Western psyche as diagnosed by C. G. Jung. The question is posed whether the West’s feverish pursuit of psychedelic medicines—from individual consumption to entheogenic tourism, from capitalist commodification of medicines and treatments to the increasing number of ethical scandals and abuse through clinicians and self-proclaimed shamans—is related to a Western cultural complex. As part of the discussion, the archetypal image of the Hungry Ghost, known across Asian cultural and religious traditions, is explored to better understand the aforementioned shadow phenomena and point towards mitigating possibilities.

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Effects of animal-assisted therapy on social behaviour in patients with acquired brain injury: a randomised controlled trial. Scientific Reports, 2019.

Effects of animal-assisted therapy on social behaviour in patients with acquired brain injury: a randomised controlled trial.

Karin Hediger, Stefan Thommen, Cora Wagner, Jens Gaab & Margret Hund-Georgiadis. Nature: Scientific Reports, volume 9, Published: 09 April 2019.
https://www.nature.com/articles/s41598-019-42280-0

Abstract
Animal-assisted therapy (AAT) is increasingly used to address impaired social competence in patients with acquired brain injury. However, the efficacy of AAT has not been tested in these patients. We used a randomised, controlled within subject trial to determine the effects of AAT on social competence in patients undergoing stationary neurorehabilitation. Participants received both AAT sessions and paralleled conventional therapy sessions. The patients’ social behaviour was systematically coded on the basis of video recordings of therapy sessions. Moreover, mood, treatment motivation and satisfaction was measured during each therapy session. We analysed 222 AAT and 219 control sessions of 19 patients with linear mixed models. Patients showed a significantly higher amount of social behaviour during AAT. Furthermore, patients’ positive emotions, verbal and non-verbal communication, mood, treatment motivation and satisfaction were increased in the presence of an animal. Neutral emotions were reduced but no effect was found regarding negative emotions. Our results show that AAT increases aspects of social competence and leads to higher emotional involvement of patients with acquired brain injury, reflected in higher social engagement, motivation and satisfaction during a therapeutic session.

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