Academic literature on the topic 'Resiliency, group therapy'

Aims: One of the most essential causes of mortality in the world is cardiovascular disease. Biological backgrounds and physical risk factors, types of stress and distress, ineffective interaction strategies, stressful life events, as well as low levels resiliency contribute to the start and severity of the disease are some features of this disease. The present research tends to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Guided Mental Imagery (GSI) on the resiliency in cardiovascular patients referring to cardiac rehabilitation ward through 2018-2019. Methods & Materials: This study is a quasi-experimental with pretest-posttest and follow-up with control group. The research samples were 45 participants selected using available method and completed the Conner-Davidson Resiliency Scale (CD-RIS). Interventions consisted of 8 sessions of 60 minutes each (ACT group) and 10 sessions of 45 minutes each (GSI group). Data analysis was performed using repeated measurement covariance analysis and Bonferroni test in SPSS v. 22 software. Findings: The research findings showed the effectiveness of the two treatments of ACT and GSI on the increase in resiliency of cardiovascular patients. In other words, the results of Bonferroni test indicate the more effectiveness of ACT than GSI in increasing resiliency is in cardiovascular patients (P<0.005). Therefore, it can be concluded that ACT, by focusing on psychological flexibility, is more effective than GSI on Resilience. Conclusion: According to the results of this study, the ACT with the main acceptance factor, may expand the concept of acceptance by believing in lack of control over life in cardiovascular patients, and increase their resiliency. A one-month follow-up of the results showed its sustainability and strength.

Abstract Introduction There is a dearth of research on the impact of pre-treatment assessment effort and symptom exaggeration on the treatment outcomes of Veterans engaging in trauma-focused therapy, handicapping therapists providing these treatments. Research suggests a multi-method approach for assessing symptom exaggeration in Veterans with posttraumatic stress disorder (PTSD), which includes effort and symptom validity tests, is preferable. Symptom exaggeration has also been considered a “cry for help,” associated with increased PTSD and depressive symptoms. Recently, research has identified resilience as a moderator of PTSD and depressive symptom severity and an important predictor of treatment response among individuals with PTSD. Thus, it is important to examine the intersection of symptom exaggeration, resilience, and treatment outcome to determine whether assessment effort and symptom exaggeration compromise treatment response. Materials and Methods We recruited Veterans, aged 18–50 who served during the Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) era, from mental health clinics and fliers posted in a large Veterans Affairs Medical Center. Veterans met inclusion criteria if they were diagnosed with PTSD via a clinician-administered assessment. Sixty-one Veterans consented to participate and self-selected into a cognitive processing therapy (CPT) group or treatment-as-usual. We offered self-selection because low recruitment rates delayed treatment start dates and were consistent with a Veteran-centered care philosophy. Veterans were assessed before and after treatment to determine the impact of assessment effort and symptom exaggeration scores on measures of PTSD and depressive symptoms and resilience. This study examined whether assessment effort failure and symptom exaggeration were associated with compromised psychotherapy outcomes in Veterans with PTSD undergoing CPT group. We hypothesized that a pattern of responding consistent with both effort and symptom exaggeration would result in higher (ie, more severe) pre- and post-treatment scores on PTSD and depressive symptom outcome measures and lower resiliency when compared to Veterans providing good effort and genuine responding. Hypotheses were evaluated using bivariate correlation analyses, analysis of variance, and chi-square analyses. Results Pre-treatment scores on measures of PTSD and depressive symptoms were higher among Veterans whose pattern of responding was consistent with poor assessment effort and symptom exaggeration; these Veterans also scored lower on a measure of resiliency. At post-treatment, there were no differences between Veterans displaying good and failed effort testing on measures of PTSD and depressive symptoms or in whether they completed treatment. Post-treatment resiliency scores remained significantly lower in those with failed effort testing. Conclusion These results suggest that Veterans with PTSD whose validity testing scores are indicative of poor effort and symptom exaggeration may be less resilient but may still complete a CPT group treatment and benefit from treatment at a rate comparable to Veterans who evidence good assessment effort and genuine symptom reporting pre-treatment. These findings also challenge the assumption that pre-treatment assessment effort failure and symptom exaggeration accurately predict poor effort in trauma-focused psychotherapy.

Introduction: The purpose of this study was to compare the effectiveness of narrative therapy and rational emotive behavior therapy on Resilience in women with breast surgery experience. Methods: This was a semi-experimental study with a pretest-posttest, controlled design with follow-up. The study population consisted of all women with breast cancer who were undergoing postmastectomy radiotherapy in Tabriz in 2018. In total, 30 women were selected by a purposive sampling method, and divided into three groups of narrative therapy, rational emotive behavior therapy, and control. The intervention groups received their respective treatments over 8 sessions of 1.5 hours. The groups were assessed using the Connor-Davidson Resilience Scale before, after, and four months after the treatment. Results: The mean postintervention resilience scores for the narrative therapy and rational emotive behavior therapy groups (66.4 and 79.9, respectively) were significantly greater compared with the control group (51.9) (P < 0.001). Similar results were observed at the 4-mont follow-up indicating a lasting effect. Also, the effect of rational emotive behavior therapy on resilience was greater than that of narrative therapy both after the intervention and at 4-month follow-up (P < 0.001). Conclusion: Narrative therapy and rational emotive behavior therapy increased resiliency in women with breast surgery experience.

Background and aims: The present study aimed to determine the effect of acceptance and commitment therapy on perceived stress, resilience, and the quality of life in thalassemia major patients in Lordegan during 2015-2016. Methods: This semi-experimental study used the pre-test and post-test designs with a control group and period. The samples included 40 patients with thalassemia major who referred to Lordegan Shohada hospital, were selected by the purposeful sampling technique based on the inclusion and exclusion criteria, and were randomly assigned to experimental and control groups. The experimental group received eight-week sessions of the acceptance and commitment-based therapy, while the control group received no intervention until the end of the study. The data were collected by the perceived stress questionnaire (Cohen et al), Researcher Conner and Davison Resilience Scale, and the World Health Organization Quality of Life (SF-26). Finally, the obtained data were analyzed using the SPSS software, repeated measure, and covariance tests Results: The results showed that there was a significant difference between the experimental and control groups in terms of the perceived stress, resilience, and the quality of life (P<0.001). In addition, based on the results, 66% of the changes in the perceived stress scores, 81% of the difference in the resiliency scores, and 75% of the difference in the quality of life scores were related to the impact of therapy based on the acceptance and group commitment. Further, the results of the analysis variance of the internal group revealed that the effect of therapy based on the acceptance and commitment on the perceived stress, resilience, and the quality of life had a significant difference in pretest, posttest, and follow-up stages. Conclusion: In general, the therapy based on the acceptance and commitment is found to be a useful practice in reducing the perceived stress while increasing the resilience and improving the quality of life in patients with thalassemia major.

e24079 Background: One of the most common concerns of cancer survivors is cancer-related cognitive impairment (CRCI), which affects an individual’s ability to return to work, school, or other life activities. The etiology of CRCI is poorly understood. Numerous studies have demonstrated a relationship between emotional distress and cognitive dysfunction, though the core psychological construct underlying this relationship has been elusive. Resilience, defined as the ability to function well despite adversity, reflects individual capacity to manage stress and reduce allostatic load. We hypothesized that low resilience contributes to stress-related cognitive symptoms in cancer survivors, and that improvement in resilience through the Relaxation Response Resiliency Program (3RP), a psychotherapy group that reduces emotional distress, would reduce cognitive symptoms in cancer survivors. Methods: Consistent with prior protocols, adult cancer survivors participated in the 3RP program, a 9-week resiliency mind-body group treatment led by psychologists and/or psychiatrists. Survivors completed measures of cognitive symptoms (Patient Reported Outcome Measure Information System – Cognitive function; PROMIS-Cog) and resilience (Current Experiences Scale; CES) before and after treatment. Pearson correlations evaluated relationships between resilience and cognition. Results: 46 cancer survivors (mean age = 57, 85% female, 94% White, 4% Asian, 2% Black) completed \ CES and PROMIS-Cog at therapy intake, with 41% of subjects reporting significant cognitive impairment at baseline (defined as scores of < 1.0 SD on PROMIS-Cog). There was a significant correlation between these two scales prior to treatment (r = 0.33; p = 0.025), indicating that subjects with lower resilience reported poorer cognition. Thus far, 13 survivors have completed the 8-week therapy program, with 46% of these patients reporting significant cognitive difficulties. The post-treatment correlation between resilience and cognition was nonsignificant (r = 0.19;p = ns). Treatment effects were operationalized by change scores (follow up – baseline) for CES and PROMIS-Cog. The relationship between CES and PROMIS-Cog change scores was positive but not significant with the small sample size (r = 0.35; p = 0.028). Conclusions: This preliminary study suggests that there is a relationship between resilience and cognition in cancer survivors. Improvements in resilience through the 3RP treatment may reduce cognitive symptoms, though further work is needed to determine the significance of this effect.

<p><strong>INTRODUCTION: </strong>The prevalence of diabetes, especially type II diabetes, is increasing in the world. It seems that psycho-cognitive factors such as perceived-stress and resiliency can play an important role in diabetes care. The aim of the present study is examining the effect of Acceptance and Commitment Therapy (ACT) on self-efficacy, perceived stress and resiliency in type II diabetes patients.</p><p><strong>METHODS:</strong> The method of this research was quasi-experimental (pre- test, post -test) with follow-up stages<strong>.</strong> The population includes women with type II diabetes that refer to Endocrine and Metabolism Research center, Isfahan university of Medical Sciences in 2014. Thirty two patients were selected by convenience sampling and they were randomly divided into two groups, namely experimental and control group (n1 =16, n2 = 16) and the follow-up stage was performed 3 months after the post test. Research tools consisted of questionnaires of self-efficacy (Sherer et al., 1982), perceived-stress (Cohen, Kamarck, &amp; Mermelstein, 1983) and resiliency (Connor &amp; Davidson, 2003). Term of ACT treatment was 8 sessions with one session every week in the experimental group and follow-up stage was performed three months after the post test.</p><p><strong>RESULTS: </strong>Results showed that after the treatment, the scores of self-efficacy and perceived-stress was reduced significantly compared to the control group (p&lt;0.05) in all stages, but in resiliency they did not show any significant differences with each other in post test stage. However, in follow-up stage, the scores were reduced significantly compared to the scores in the control group (p&lt;0.05).</p><p><strong>CONCLUSION: </strong>The results show that ACT can be useful for psycho-cognitive function in type II diabetes patients.</p>

Aims The caring of schizophrenia patients is a tiresome task for their families. This research aimed to examine the effectiveness of Acceptance and Commitment Therapy (ACT) on resilience, meaning in life, and family functioning in the caregivers of patients with schizophrenia. Methods & Materials This was a quasi-experimental study with a pretest-posttest and follow-up design and a control group. The study sample included 30 members of schizophrenia patients’ families, referring to 2 neurological and psychological rehabilitation centers in Isfahan Province, Iran. By the convenience sampling method, the experimental group received 8 ACT sessions weekly; however, the control group received no treatment. Both groups were assessed in three phases; pretest, posttest, and one-month follow-up. The assessment tools consisted of Connor-Davidson Resilience Scale, Stagger Meaning in Life Questionnaire, and McMaster Family Functioning Scale. The obtained data were analyzed in SPSS by repeated-measures Analysis of Variance (ANOVA). Findings The collected results indicated the significant difference of posttest and follow-up phases in terms of meaning in life and family functioning scores between the control and experimental groups (P<0.05). Furthermore, there was a significant difference in posttest resilience scores (P<0.05); however, there was no significant difference in the follow-up phase in this respect. Conclusion The collected results suggested that ACT was effective on the meaning of life, family functioning, and resiliency; thus, it could improve such variables in the caregivers of patients with schizophrenia.

The research objective of this qualitative case study was to explore how art interventions could be useful to teach at-risk adolescents how to identify with and develop, personal strengths and resilient qualities. The subjects in this study were receiving treatment in an outpatient mental health clinic for a variety of diagnoses and participated in a ten-week resiliency building art- therapy group. During the weekly sessions participants followed a specific protocol including psycho-education, art therapy interventions and processing of the art products. The art interventions were based on the literature and designed to develop personal strengths, self- reliance, self-discovery and communication, problem solving, flexibility, compassion and empathy, future planning and teamwork. The results indicate that at-risk adolescents are able to identify, discuss and develop solutions to their challenges using the art interventions and psycho- education and that the group art-therapy modality provides a unique tool to accelerate positive outcomes and resilience in an outpatient mental health setting.

This research is a qualitative art-based case study exploring the facilitation of resilience through the observation of a resiliency-building art therapy group with adolescents. The researcher was the subject and utilized both direct and participant observation of a ten-week resilience-based art therapy group to gain a better understanding of how an art therapy group in a school setting is run. Reflective art making that mirrored the art directives given in the group were incorporated by the researcher to gain a deeper and more personal understanding of the resilience building process. The literature review covers a broad range of resilience and a variety of methods for observing therapy. The weekly art directives were based on the resilience literature and designed to develop personal strengths, self-discovery, communication, self-reliance, problem solving, flexibility, and future planning. Themes identified within the analysis include: flexibility, structure, anxiety, cohesive relationships, and creativity. The researcher found that flexibility in the co-facilitators and structure in the art therapy program are key elements in a successful group. Through this study the researcher identified the usefulness of direct and participant observation of therapy for developing clinical skills and highly recommends both be included in therapeutic training programs.

This dissertation is a qualitative study of how vocal improvisation within music therapy groups may afford the construction of social resilience for in-patient adolescents in oncology wards. The study was conducted at the Pediatric Oncology Unit at the Steve Biko Academic Hospital in Pretoria. The case study involved six daily group music therapy sessions, with four to eight participants. The primary music therapy technique was vocal improvisation to assess how the participants perform themselves as resilient (or not). Excerpts of video recordings were analyzed through Gee’s (2005) suggestion for discourse analysis. Session notes were written as an additional data source to contextualize the excerpts. Through discourse analysis, four primary discourses were identified: participant as patient, participant as adolescent, cultural adolescent, and participant as Hip-hop musician. These enabled the participants to explore their performance of selves in various ways. It was concluded that vocal improvisation in group music therapy enabled the expression of lack of resilience, as it received those feeling less resilient and provided them with safety and containment. It also offered the participants a means of instant coping within the various discourses that were identified. Vocal improvisation in this context also afforded the participants a space to adapt to their challenges as they explored various types of participation by learning from past experiences/ways of being, and adjust accordingly. Finally, the participants could transform through the changing relationships within the group itself, and how these social changes offered a social environment that afforded the resilience of the whole group.
Mini Dissertation (MMus)--University of Pretoria, 2017.
Music
MMus (Music Therapy)
Unrestricted

O transtorno de pânico (TP) é uma condição crônica e recorrente, acompanhada por sintomas físicos e cognitivos que causam prejuízos à qualidade de vida e ao funcionamento psicossocial dos pacientes. Apesar do tratamento eficaz com medicamentos e terapia cognitivocomportamental (TCC), a recaída dos sintomas é frequente. A falha de enfrentamento ou coping de eventos estressores tem sido apontada como um gatilho desse desfecho. O protocolo atual de 12 sessões de TCC em grupo (TCCG) é específico para sintomas do TP, não abordando estratégias cognitivas de coping e de resiliência. O objetivo desta pesquisa foi o de avaliar a resposta em curto prazo ao acréscimo de estratégias de coping e de resiliência ao protocolo padrão de TCCG para o TP. Trata-se de um estudo de método misto, desenvolvido em duas etapas: primeiramente foi realizada uma pesquisa metodológica para o desenvolvimento e a avaliação da clareza de um protocolo com quatro sessões de TCCG, organizadas em um manual; a segunda etapa consistiu em um ensaio clínico controlado com pacientes com TP alocados aleatoriamente no grupo intervenção (TCCG padrão mais o acréscimo de quatro sessões de intervenções com técnicas cognitivas de estratégias de coping e resiliência) ou para o grupo controle (TCCG padrão). A gravidade dos sintomas do TP foi mensurada antes e depois da TCCG. Para identificar as estratégias de coping e de resiliência, foram aplicados o Inventário de Estratégias de Coping (IEC) e a Escala de Resiliência, respectivamente A qualidade de vida (QV) foi avaliada pela WHOQOL-bref. O estudo foi aprovado pelo Comitê de Ética em Pesquisa de Hospital de Clínicas de Porto Alegre (nº 140379). Após a elaboração do manual, um grupo-piloto de sete pacientes avaliou as quatro sessões e contribuiu com sugestões para a versão final. Na sequência, realizou-se o ensaio clínico com 100 pacientes selecionados e alocados 50 para cada grupo. Um total de 36 (72%) do grupo intervenção e 29 (58%) do controle concluiu as sessões de TCCG. Observou-se que ambos os grupos apresentaram melhora significativa dos sintomas do TP ao longo do tempo em todas as medidas de desfecho, porém sem interação tempo*grupo. Após a TCCG, os sintomas de ansiedade (pgrupo=0,016), depressão (pgrupo=0,025) e uso de benzodiazepínicos (ptempo*grupo<0,001) foram significativamente menores no grupo intervenção do que no grupo controle. Houve mudança significativa positiva nas estratégias de coping mais adaptativas e em todos os domínios da qualidade de vida (ptempo<0,001), embora sem diferença entre os grupos. Exceto para o domínio meio ambiente o aumento foi significativo considerando-se a interação tempo*grupo (ptempo*grupo=0,027). A resiliência apresentou um aumento significativo após a TCCG no grupo intervenção (pgrupo=0,041), com interação tempo*grupo (ptempo*grupo=0,027). Portanto, confirmou-se a efetividade da TCCG para melhora dos sintomas do TP, e adicionar as sessões ao protocolo padrão de TCCG mostrou-se uma medida viável e efetiva para melhorar a capacidade de resiliência e de aspectos da qualidade de vida dos pacientes com TP. Contudo, são necessários estudos de seguimentos para que se verifique os efeitos da intervenção em desfechos do TP como recaída.
Panic disorder (PD) is a chronic, recurrent condition characterized by physical and cognitive symptoms that are harmful to patients' quality of life (QOL) and psychosocial functioning. Despite the efficacy of drug treatment and cognitive-behavioral therapy (CBT), symptom relapse is common. Failure to cope with stressful events has been reported as a trigger for this outcome. The protocol with 12 sessions of cognitive-behavioral group therapy (CBGT) currently used for PD symptoms does not include coping and resilience strategies. This study aimed to assess short-term response to the addition of coping and resilience strategies to the standard CBGT protocol for PD. This mixed methods research was conducted in two phases: first, a methodological research was performed to develop and assess the clarity of a protocol with four CBGT sessions, organized in a handbook; second, a controlled trial was performed, in which patients with PD were randomly allocated to an intervention group (standard CBGT plus four sessions using cognitive techniques for coping and resilience) or a control group (standard CBGT). PD symptom severity was measured before and after CBGT. The Coping Strategies Inventory (CSI) and the Resilience Scale were used to identify coping and resilience strategies, respectively. QOL was assessed using the WHOQOL-bref. The study was approved by the Research Ethics Committee of the Hospital de Clínicas de Porto Alegre (protocol no. 140379) After the handbook was prepared, a pilot group of seven patients evaluated the four additional sessions and contributed with suggestions for the final version. The clinical trial was then conducted with 100 selected patients (50 patients in each group). Thirty-six (72%) patients in the intervention group and 29 (58%) controls completed the CBGT sessions. Both groups showed a significant improvement in PD symptoms in all outcome measures over time, but with no time*group interaction. After the CBGT sessions, anxiety symptoms (pgroup=0.016), depression (pgroup=0.025), and use of benzodiazepines (ptime*group<0.001) significantly decreased in the intervention group compared to the control group. There was a significant positive change in the more adaptive coping strategies and in all QOL domains (ptime<0.001), but with no between-group difference. Except for the environment domain, there was a significant increase considering time*group interaction (ptime*group=0.027). Resilience showed a significant increase after CBGT in the intervention group (pgroup=0.041), with time*group interaction (ptime*group=0.027). Therefore, the effectiveness of CBGT in improving PD symptoms was confirmed, and adding sessions to the standard CBGT protocol proved to be a feasible and effective measure to improve resilience and QOL aspects in patients with PD. However, follow-up studies are required to assess the effects of the intervention on PD outcomes such as relapse.
El trastorno de pánico (TP) es una condición crónica y recurrente, acompañada de síntomas físicos y cognitivos que perjudican la calidad de vida y el funcionamiento psicosocial del paciente. Pese al tratamiento eficaz con medicamentos y terapia cognitivo-conductual (TCC), la recurrencia de los síntomas es frecuente. La falla de afrontamiento o coping de eventos estresores ha sido apuntada como un disparador de este desenlace. El protocolo actual de 12 sesiones de TCC en grupo (TCCG) es específico para síntomas de TP y no trata de estrategias cognitivas de coping y de resiliencia. El objetivo de esta investigación fue evaluar la respuesta a corto plazo a la adición de estrategias de coping y de resiliencia al protocolo estándar de TCCG para TP. Se trata de un estudio con método mixto, desarrollado en dos etapas: primeramente, se realizó una investigación metodológica para el desarrollo y la evaluación da clareza de un protocolo con cuatro sesiones de TCCG, organizadas en un manual; la segunda etapa consistió en un ensayo clínico controlado con pacientes con TP asignados aleatoriamente al grupo intervención (TCCG estándar más cuatro sesiones de intervención con estrategias cognitivas de coping y resiliencia) o al grupo control (TCCG estándar). Se mensuró la gravedad de los síntomas de TP antes y después de la TCCG. Para identificar las estrategias de coping y de resiliencia, se aplicó el Inventario de Estrategias de Coping (IEC) e la Escala de Resiliencia, respectivamente. La calidad de vida (CV) se evaluó por la WHOQOL-bref. El estudio ha sido aprobado por el Comité de Ética en Investigación de Hospital de Clínicas de Porto Alegre (no. 140379) Tras la elaboración del manual, un grupopiloto de siete pacientes evaluó las cuatro sesiones y contribuyó con sugerencias para la versión final. A continuación, se realizó el ensayo clínico con 100 pacientes seleccionados y asignados en número de 50 para cada grupo. Un total de 36 (72%) pacientes del grupo intervención y 29 (58%) del grupo control concluyeron las sesiones de TCCG. Se observó que ambos grupos tuvieron una mejora significativa de los síntomas de TP a lo longo del tiempo en todas las medidas de desenlace, pero sin interacción tiempo vs. grupo. Tras la TCCG, los síntomas de ansiedad (pgrupo=0,016), depresión (pgrupo=0,025) y uso de benzodiazepínicos (ptiempo*grupo<0,001) fueron significativamente menores en el grupo intervención que en el grupo control. Hubo un cambio significativo positivo en las estrategias de coping más adaptativas y en todos los dominios de CV (ptiempo<0,001), pero sin diferencia entre los grupos. Excepto para el dominio medio ambiente, el aumento fue significativo, considerándose la interacción tiempo vs. grupo (ptiempo vs. grupo=0,027). La resiliencia presentó un aumento significativo tras la TCCG en el grupo intervención (pgrupo=0,041), con interacción tiempo vs. grupo (ptiempo vs. grupo=0,027). Así, se confirmó la efectividad de la TCCG para mejora de los síntomas de TP, y añadir las sesiones al protocolo estándar de TCCG se mostró una medida viable y efectiva para mejorar la capacidad de resiliencia y de aspectos de CV de los pacientes con TP. Sin embargo, son necesarios estudios de seguimiento para que se verifiquen los efectos de la intervención en desenlaces de TP como recurrencia.

O transtorno de pânico (TP) é uma condição crônica e recorrente que prejudica a qualidade de vida e o funcionamento psicossocial dos pacientes. O tratamento com medicamentos e a terapia cognitivo-comportamental (TCC) tem evidências comprovadas de eficácia. Entretanto, a recaída é frequente e a falha nas estratégias de enfrentamento (coping), ao lidar com eventos estressores, tem sido apontada como um gatilho deste desfecho. O protocolo de 12 sessões de TCC em grupo (TCCG), atualmente utilizado, é específico para sintomas do TP. Estudos que avaliam os efeitos de intervenções com técnicas cognitivas de estratégias de coping ainda não foram testados. Pretende-se, neste estudo, verificar se a TCCG padrão modifica as estratégias de coping dos pacientes com TP comparados a um grupo sem transtorno mental (artigo 1) e avaliar o efeito ao acréscimo de quatro sessões de reforço com técnicas cognitivas de estratégias de coping após a TCCG (artigo 2). Trata-se de um ensaio clínico com pacientes (n=48) que participaram das 12 sessões de TCCG para TP de 2006 a 2009, chamados novamente em 2010 e sorteados para o grupo de intervenção (4 sessões de reforço) ou para o grupo controle (2 reuniões educativas). A gravidade dos sintomas foi mensurada pelas escalas: Impressão Clínica Global (CGI), Escala de Gravidade do TP (PDSS), Inventário do Pânico, Hamilton-Ansiedade (HAM-A) e Inventário de Depressão de Beck (BDI). Para identificar as estratégias de coping e a resiliência foram aplicados o Inventário de Estratégias de Coping (IEC) e a Escala de Resiliência, respectivamente. A qualidade de vida (QV) foi avaliada pela WHOQOL-bref. Para o primeiro objetivo de avaliar a mudança das estratégias de coping, os instrumentos foram aplicados antes e após a TCCG e o grupo sem transtorno mental (n=75) respondeu o IEC. Para verificar o efeito das sessões de reforço, os instrumentos foram aplicados antes da intervenção e após o término (1, 6 e 12 meses) por avaliadores independentes. A TCCG padrão foi efetiva na redução dos sintomas do TP em todas as medidas de desfecho. No artigo 1, foi observado que os pacientes diminuíram significativamente o uso da estratégia de coping de confronto (p=0,039) e de fuga e esquiva (p=0,026) quando comparada com o início do tratamento. Porém, a fuga e esquiva após a TCCG não foi mais significativamente diferente (p=0,146) que o grupo sem transtorno mental. Também foi encontrado que o uso de estratégias mais adaptativas estava correlacionado à diminuição da ansiedade antecipatória e dos ataques de pânico. No Artigo 2, os resultados do efeito das quatro sessões de reforço demonstraram melhora significativa dos sintomas do TP, da ansiedade e de depressão em ambos os grupos, considerando desfecho tempo. Ocorreu aumento significativo no domínio de relações sociais da QV no grupo de intervenção, considerando a interação tempo*grupo, independentemente da melhora dos sintomas. Entretanto, não houve diferença significativa nas estratégias de coping e nos demais domínios da QV. As mudanças nos níveis de resiliência foram dependentes dos sintomas do TP, ansiedade e depressão, isto é, quanto menor a intensidade dos sintomas, maior foram os níveis de resiliência. Concluindo, as técnicas da TCCG padrão podem modificar as estratégias de coping, porém com exceção da fuga e esquiva, as estratégias continuam diferentes do grupo sem transtorno mental. A resposta ao acréscimo de sessões de reforço com técnicas específicas de coping melhora o domínio das relações sociais da QV ao longo do tempo, independentemente da diminuição dos sintomas. Por outro lado, o aumento dos níveis de resiliência foi dependente da melhora da intensidade dos sintomas do TP, ansiedade e depressão e a melhora destes sintomas foi significativa, porém não foi diferente entre os grupos intervenção e controle. A hipótese é que este resultado pode estar relacionado a fatores terapêuticos do formato de grupo tanto das sessões de intervenção quanto do controle. Portanto, estudos que investiguem a adição de técnicas cognitivas de coping durante a TCCG padrão e o efeito de fatores terapêuticos do formato de grupo ainda precisam ser realizados.
Panic disorder (PD) is a chronic and recurrent condition that impairs patients’ quality of life and psychosocial functioning. Treatment with medication and cognitive-behavioral therapy (CBT) has confirmatory evidence of efficacy. Nonetheless, relapse is frequent and failure on coping strategies, when dealing with stressful events, has been suggested as being the trigger of this outcome. The protocol of 12 cognitive-behavioral group therapy (CBGT) sessions, as currently used, is specific for PD symptoms. Studies assessing the effects of interventions with cognitive techniques of coping strategies have not been tested yet. The present study aims to verify if the standard CBGT changes PD patients’ coping strategies, when compared to the ones used by the group of individuals without mental disorders (Article 1), and to evaluate the effect of adding 4 booster sessions with cognitive techniques of coping strategies after CBGT (Article 2). This study is a controlled clinical trial with patients (n=48) who participated in the 12 CBGT sessions for PD from 2006 to 2009, who were assessed again in 2010 and assigned either for the intervention group (4 booster sessions) or the control group (2 educational sessions). Symptoms severity was measured by the following scales: Clinical Global Impression (CGI), PD Severity Scale (PDSS), Panic Inventory, Hamilton-Anxiety (HAM-A), and Beck Depression Inventory (BDI). To identify coping strategies and resilience, Coping Strategies Inventory (CSI) and Resilience Scale were applied. Quality of life (QoL) was assessed by WHOQoL-bref. For the first objective of assessing the change on coping strategies, the instruments were applied before and after CBGT, while the group of individuals without mental disorders (n=75) answered CSI. To analyze the impact of booster sessions, the instruments were applied before the intervention and after it was concluded (1, 6, and 12 months) by independent interviewers. Standard CBGT was effective in reducing PD symptoms in all outcome measures. In the Article 1, it was observed that the patients reduced significantly the use of confrontive (p=0.039) and escape and avoidance (p=0.026) coping strategies in comparison to the treatment onset. However, the escape and avoidance strategy after CBGT was not more significantly different (p=0.146) than the strategy used by the control group without mental disorders. It was also observed that the use of more adaptive strategies correlated to the reduction of anticipatory anxiety and panic attacks. In the Article 2, the results of the effect of 4 booster sessions showed significant improvement of PD, anxiety and depression symptoms in both groups, considering the outcome time. A significant increase on social relations domain of QoL was observed in the intervention group, considering interaction time*group, regardless of symptom improvement. However, there was no significant difference on coping strategies and other domains of QoL. Changes on resilience levels depended on PD, anxiety, and depression symptoms, that is, the smaller the symptoms intensity the higher the resilience levels were. In conclusion, standard CBGT techniques might change coping strategies, but, except for escape and avoidance ones, other strategies are still different from the ones used by the group without mental disorders. The response to adding booster sessions with specific coping techniques improves the social relations domain of QoL over time, regardless of the reduction of symptoms. On the other hand, the increase of resilience levels depended on the improvement of PD, anxiety, and depression symptoms intensity. The improvement of these symptoms was significant, but not different for intervention and control groups. The hypothesis is that this result may be related to therapeutic factors of the group therapy both in intervention and control sessions. Therefore, research investigating the addition of cognitive coping techniques during standard CBGT and the effect of therapeutic factors of group therapy is yet to be carried out.

博士
國立屏東科技大學
熱帶農業暨國際合作系
105
This study aims to probe into effectiveness of strength-based approach horticultural group on elementary school students’ resilience and subjective experience of group members. This study adopted both qualitative and quantitative methods. As to quantitative method, the researcher used pretest and posttest experiment design and treated 36 students as subjects. There were respectively 18 subjects in experimental group and control group. Experimental group joined the group once a week, 120 minutes for each time and a total of 10 times. Measurement tool was “Scale of Resilience for Primary School Students”. Pretest was conducted in two groups one week before group activity, posttest was conducted after the group activity, and track-test was conducted after the group activity three months later. As to research data, the researcher adopted descriptive statistics, analysis of covariance and Johnson-Neyman. After each activity, experimental group filled in unit feedback form; the last time, they filled in total feedback form. The researcher conducted individual interview on experimental group before and after group. Feedback and interview were included in qualitative analysis. The results of this study are as follows: 1. The effects of resilience (1) In posttest of resilience, inherent strength, social model, optimistic, interpersonal communication and problem solving ability, experimental group is significantly higher than control group. However, in posttest of external resource, parent resource, teacher resource, neighbor resource and self-efficacy, two groups are not significantly different. In posttest of friend resource, for pretest of lower score students, experimental group is significantly higher than control group. (2) In track-test of teacher resource and neighbor resource, experimental group is significantly higher than control group. However, in track-test of external resource, parent resource, optimistic and problem solving ability, two groups are not significantly different. In track-test of resilience, inherent strength, friend resource, social model, self-efficacy and interpersonal communication, for pretest of lower score students, experimental group is significantly higher than control group. Quantitative results show that the strength-based approach horticultural therapy significantly change students’ resilience in posttest, and significantly change lower scor students’ resilience in track-test. 2. Subjective experience of group members (1) The members perceived change factors classified as follows: self, emotion, attitude, and relationship, including 16 factors: increasing self-understanding and awareness; self-values enhancement; enhancing self-affirmation; thinking mode changes; frustration tolerance. Emotion including; positive emotions increase; emotional management ability enhances; becomes calm, dedicate and patient; attitude is active, responsible and hardworking; positive interpersonal behaviors increase; negative interpersonal behaviors reduce; a better relations with others; comfortable and cheerful to interact with people; empathy increases; and the ability of putting into groups. (2) There are two factors of group process promoting changes of members: therapeutic factors and interaction. Therapeutic factors include: group cohesion; emotional support; self-understanding and awareness; encouragement and confidence; access to new thinking and motivation; developing problem solving skills and coping skills; interpersonal learning; accomplishment; altruism; sense of release; inner self dialogue; and happy participation experience. Cooperation and interpersonal feedback are interaction factors. (3) Members’ dimensions include the motivations of members participating in the group, their expectation to group and expectation to horticultural therapy. Leaders’ dimensions include technology involved and leadership. (4) Group external dynamic factors include: members interact with others and members interact with plants outside the group activities. Negative factors discussed either. Qualitative results show that the programs play an effective role to combine both theory of counseling and practice of horticultural therapy, and its therapeutic factors are both universal and specific. The group process are the main axis for members’ change; group relationship as its core that contributed by both members and leaders; and group external dynamic factors produce continuous effects. According to the previous findings, this study proposes the suggestions as reference for future researchers and practical workers.

This study focuses on the feasibility of inculcating resilience skills in adolescents using the forum of group therapy. Resilience equals the ability to surmount life's obstacles and continue towards self-actualisation, regardless. The study was initiated by the writer's masters thesis, which delineated the profile and characteristics of resilient adolescents. The writer believed that an intervention programme to effect resilience was overdue. Adolescents were generally afforded therapy re-actively. If intervention was to be an exercise in wellness, rather than in repair, a pro-active intervention programme targeting resilience had to be designed. This study focuses on the provision of such a programme. The intervention programme is semi-structured and spans twelve one hour sessions. The intervention programme specifically targets adolescents, given the amplified vulnerability associated with this developmental phase. Should resilience be sabotaged during this phase of life, the repercussions are thought to be lasting. Group therapy was chosen as the forum for intervention, given its suitability to adolescents. Adolescents are peer-group-minded, suggesting that therapeutic intervention by means of group work, would be ideal, if competently lead. The personal attributes impacting on the ability to surmount life's challenges are targeted as an interrelated whole by the group therapy intervention programme involving an experimental group of six adolescents, who appear to have turned their backs on self- actualisation. A control group, which receives no intervention, provides a contrasting profile. The study aims to provide educational psychologists with an intervention programme and an in-depth understanding of the phenomenon of resilience, so that vulnerable youngsters might ultimately be therapeutically assisted to choose a more resilient attitude and behaviour. The results of the study suggest the feasibility of inculcating resilience skills. Four of the six group members in the experimental group show marked improvement. Of the remaining two members, one shows some amelioration of vulnerability. Furthermore, results suggest that personal choice underlies resilience, implying that resilience can be coached. Additionally, it would seem that schools can play a leading role in this coaching by facilitating intervention groups.
Psychology of Education
D. Ed. (Psychology of Education)

Resilience can be viewed as a process in which behaviors or attitudes can lead to a more positive outcome in the face of a traumatic stressor. Universal and targeted resilience training programs (e.g., primary and secondary prevention programs) can be adapted to complement evidence-based treatments (EBTs) for post-traumatic stress disorder (PTSD), tertiary interventions. Using a skill-focus for resilience may increase optimism and self-efficacy for individuals, and therefore, their engagement in the homework and self-examination required by EBTs. Resilience topics that seem especially fitting as an adjunct for treatment are (1) optimism, (2) relationship building, (3) cognitive skills, (4) energy management, (5) emotional regulation, and (6) PTG. The changes necessary for modifying content designed for a primary prevention audience, several group therapy considerations, and the timing of resilience training relative to EBTs are elucidated. Potential research areas are discussed.

This book address nine unique and overlapping special populations of students whose life circumstances put them at greater risk for poor mental health outcomes and school failure: students who are homeless, students living in foster care, students involved with the juvenile justice system, students who are LGBTQ, students who are pregnant or parenting, students who are gifted, students with incarcerated parents, students in military families, and students who are at risk for school failure and dropout. Many of these students demonstrate incredible resilience in spite of their life circumstances, but they need mental health support to manage the impact of victimization, unstable living situations, and social stigma, among other challenges. Each chapter examines relevant background information regarding one population of students, provides specific counseling strategies and techniques to address students’ needs and promote resilience, and offers resources and strategies for supporting students beyond the counseling office. Individual and group counseling are addressed, as well as advanced counseling techniques, including cognitive-behavioral therapy, solution-focused brief therapy, and motivational interviewing.

There are still medical providers who believe palliative care medicine is limited to care of the dying. It is actually devoted to relief of suffering at every stage of life. Comprehensive management of patients with serious illness, including the relief of their symptoms, impacts their lives and those of their families, significant others, and caregivers, including healthcare providers. The knowledge and skills inherent in this medical specialty enables them all to grow and fosters resilience in their lives. Patient centered care is the best model that incorporates team practice with physicians and other healthcare professionals, and this is a cornerstone of palliative care medicine. Furthermore, PAs are compassionate listeners who provide comprehensive diagnosis and treatment of vulnerable patient populations across the life span and in all healthcare settings. Among medical providers involved in palliative care medicine, PAs are the only group whose accreditation requirements incorporate this knowledge and training. This text represents a new resource for PAs, clinicians, researchers, and educators of the profession to further facilitate its expansion into palliative and serious illness care. PAs are thereby poised to reduce the workforce shortage of healthcare professionals in palliative care medicine.

AbstractFemale- and male-headed rural households have unequal opportunities in climate change adaptation. Efforts in climate change adaptation in regions with deeply entrenched sociocultural norms should also account for the varied gender components of climate change. The broad objective of this study is to integrate gender issues into climate change adaptation thereby distilling lessons and evidence for policymakers on how to approach the necessary transformation of gender relations in climate change interventions. The study employed focus group discussions to uncover the structural factors undermining women’s adaptive capacity, thereby making them vulnerable to climate change impacts. In addition to this, in-depth interviews were also conducted. For the in-depth interviews, 27 farmers were sampled using a snowballing method, while four focus groups were carried out differently for male and female farmers. Ten extension personnel and ten representations from the ministry of agriculture were also surveyed using in-depth interviews. Results from the study showed that female farmers in the region were more vulnerable to climate change as a result of the deeply rooted cultural systems and unwarranted assumptions about women. Findings also suggested that women with high adaptive capacity were less vulnerable to climate impacts. We conclude that gender-responsive climate change adaptation is important in achieving balanced relations that will ensure climate resilience in more equitable and nonhierarchical ways.

The COVID-19 pandemic has claimed thousands of victims worldwide. To deal with loss is a formidable challenge for all, especially those who experienced losing their loved ones. The grief elaboration process is complex, and the pandemic adds some specific challenges, such as the restrictions to funerals and farewell rituals or the impossibility of saying goodbye due to the sanitary measures. This chapter presents a group psychological intervention aimed at people who lost their relatives to COVID-19. The therapeutic groups were carried out virtually through six sessions and brought together people from all over Brazil. Narrative therapy was the theoretical model adopted. The participants mentioned the moment of diagnosis as decisive for experiencing the disease\'s terminality and anguish, promoting guilt and anxiety in the family. In the group, the participants found space to share the painful experience, and throughout the sessions, they were able to develop coping resources. They mentioned strategies, such as activating the family and social support network, recalling legacies and moments they shared with the deceased, and elaborating farewell rituals adapted to the pandemic circumstances. The participants evaluated the group intervention as very important for reframing the pain of loss and restoring future projects since they counted on the help and inspiration of the other participants who went through this painful experience in similar circumstances.

This rapid review summarises the evidence on the ways in which social inequalities and discrimination affect the risk of famine or severe food insecurity. Looking at the risk at the national and sub-national level, gender and other horizontal inequities can affect a society’s risk of violent conflict and therefore food insecurity, while fragile livelihoods associated with ethnic marginalisation can impact regional food security. At the individual and household level, there is a lack of disaggregated data on people’s social characteristics and famines. There is a broader literature on the impact of systemic discrimination (based on gender, age, disability, sexuality, and ethnic identity) on individuals’ and households’ livelihoods and assets, thereby increasing their vulnerability to food insecurity. A key finding from the literature is the gender gap, with women more at risk of being food insecure than men. Also, some ethnic groups are highly vulnerable particularly in conflict-related famines; starvation is used as a warfare tactic in political and ethnic conflicts. There is evidence of how social inequalities heighten individuals’ risks during food crises and famines, including through exposure to protection threats, while limiting their access to essential services and humanitarian assistance. A broad range of measures seeks to address the multi-dimensional ways in which social inequalities affect vulnerability and resilience to food insecurity.