Дисертації з теми "Mind body intervention"

Comorbid chronic insomnia was found highly prevalent in breast cancer patients. It also persisted through survivorship. Negative emotions upon diagnosis and during the course of cancer treatment might complicate the underlying mediating factors between stress and insomnia found in non-cancer population. Cognitive Behavioural Therapy (CBT) has been evidenced in improving insomnia. With the appreciation of Mindfulness training in improving cognitive flexibility and rumination, a novel treatment approach integrating CBT and mindfulness—Mind-Body Intervention (MBI) was developed. 　　　There were three objectives in the research. Firstly, prevalence data on insomnia and clinical profile of Hong Kong Chinese breast cancer survivors were obtained. Secondly, the mediating roles of negative emotions, hyperarousal, pre-sleep arousals in the relationship between perceived stress and insomnia were examined. Thirdly, the effects of CBT and MBI for breast cancer survivors with insomnia were investigated. 　　　In the first study, 1049 women who survived from non-metastatic breast cancer were invited to complete a survey on stress, mental health, arousals and insomnia. Those who met psychophysiological insomnia were invited to participate in the second study, which was a multisite randomized controlled trial. The 73 participants were allocated to CBT (n=24), MBI (n=27) or waiting list control, WLC (n=22). Both treatments were five weekly-session group therapies. Outcomes on insomnia, mental health, arousals, dysfunctional beliefs, quality of life and mindfulness, were obtained on baseline, post-treatment, 3-month and 6-month follow-ups. 　　　Results of the first study revealed 34.6% of the participants suffered from clinical insomnia, while 15.1%, 27.4% and 12.8% endorsed moderate to extremely severe depression, anxiety and stress respectively. Duration of insomnia was correlated with insomnia severity. Hyperarousal was found moderating cognitive ore-sleep arousal and anxiety, these in turn, together with depression mediated the relationship between perceived stress and insomnia severity. Results of the second study supported the hypothesis both CBT and MBI improved insomnia and other psychological symptoms, while WLC did not. After treatment, significant decreases of 59 and 67 minutes of total wake time per night were found for CBT and MBI respectively. Sleep efficiency values significantly increased in CBT (12.2%) and MBI (12.7%). Moderate to large effect sizes and clinically significant differences were found in most sleep and psychological variables. Generally, CBT produced larger effect sizes than MBI on post-treatment. The therapeutic gains were found sustaining through 3-month to 6-month follow-ups in both treatments. However, the effect sizes of CBT were on the declining trend, while those of MBI were more stable. 　　　The results suggested that insomnia and anxiety were frequently experienced in breast cancer even after completing the medical treatments. The longer the survivors suffered from insomnia, the higher the severity was found. In additional to the cognitive pre-sleep arousal, the important mediating roles of depression and anxiety imply that insomnia treatments should incorporate strategies designed to help in decreasing rumination/worry before bedtime and improving mental health conditions. The findings also provided initial evidence for the efficacy of MBI as a viable treatment for insomnia. More vigorous randomized controlled trial and the long-term efficacy could be further studied.
published_or_final_version
Clinical Psychology
Doctoral
Doctor of Psychology

This dissertation focused on advancing the current research on the connection between physical and psychological health. This study focused on two psychotherapy groups that integrate mind-body practices in the form of yoga, meditation, and relaxation. These groups were ongoing and are held once a week for one hour in an urban outpatient mental health clinic. Participants in these groups attended consistently for approximately 1-4 years and experienced a wide-range of trauma and chronic pain symptoms. Because the groups were active and running for several years, this study followed a qualitative research approach to comprehensively capture the participants’ subjective experience. Understanding the experience of these particular clients could prove to be advantageous to the field of psychology as it will help to elucidate the individual’s experience of an integrated mind-body modality for trauma and pain treatment. Using phenomenological interviews, this study explored the subjective experience of individuals in these groups. In-depth interview questions focused on participants’ reactions to the mind-body interventions for combined physical and psychological symptom relief.

Infertility is a frequently occurring chronic health condition, which often persists throughout the reproductive years. Heightened anxiety symptoms often are comorbid with infertility diagnoses. Women experiencing infertility, and particularly those with anxiety symptoms, characterize an emerging population that deserves special attention. However, women experiencing infertility have identified barriers to seeking psychotherapy (e.g., fears of being dismissed from fertility treatment and/or stigmatized). Consequently, women diagnosed with infertility need a psychotherapy that not only can reduce these symptoms, but can also be private and convenient. The current study translated an empirically tested in-person mind/body protocol into an internet-based intervention to suit the needs of this population. Seventy-one women were randomly assigned to the intervention or a wait-list control. At the close of the study, only three participants had completed the intervention. At mid-assessment, relative to the wait-list group, the intervention group had a lower level of depressive symptoms and, for those with elevated anxiety symptoms at baseline, a lower level of anxiety symptoms. The findings suggest that even a partially completed internet-based intervention can reduce the anxiety and depressive symptoms of women with a diagnosis of infertility.

Background. Primary and secondary prevention trials have shown that implantable cardioverter-defibrillators (ICD) reduce the risk of cardiac death, but concerns have been raised regarding the psychological well-being of ICD patients. Anxiety can affect a significant proportion of these patients, but there is limited information about prevalence and determinants of anxiety after the implementation of the more recent guidelines for ICD implantation. Several behavioral interventions have been effective in improving anxiety in these patients, however the efficacy of mindfulness-based interventions (MBI) has not been investigated in ICD patients, and there is limited information regarding the characteristics of pre-intervention, “dispositional” mindfulness in patients with cardiovascular disease never exposed to mindfulness training. The aims of this dissertation project were: 1) To determine the feasibility of a randomized clinical trial of a phone-administered, mindfulness-based training program, as measured by recruitment and retention rates, treatment adherence and fidelity; 2) To evaluate the current baseline prevalence and determinants of anxiety in the study population and 3) To describe the correlates of dispositional mindfulness in the study population. Methods. The study was conducted at the Electrophysiology Service at the UMass Memorial Medical Center. All consecutive patients who recently underwent an ICD procedure or received ICD shocks were screened for eligibility to participate in a pilot randomized controlled trial in which an eight session, phone-delivered, weekly MBI was compared to a usual care condition. Assessments were performed at baseline and post-intervention. A cross-sectional design was used for aims 2 and 3. Anxiety was assessed using the Hospital Anxiety and Depression Scale; a shortened version of the Five Facets of Mindfulness questionnaire was used to evaluate mindfulness. Results. Thirty patients (21 M, 9 F; mean age 63.1 ±10.3 years) were enrolled in the study. The methods ultimately adopted to screen, recruit, and retain study participants were feasible to conduct and satisfactory to ICD outpatients, and the study intervention was safe. Phone delivery resulted in excellent retention rates and limited costs. Assessments of treatment fidelity showed that the content of the intervention was delivered as intended in almost 100% of cases. The study findings do not show a decrease in the overall prevalence of anxiety in ICD patients compared with earlier cohorts; anxiety was associated with young age, low socio-economic status and previous psychological morbidity, but not with ICD-related factors including prior shock delivery. Finally, baseline mindfulness was most strongly associated with previous psychological morbidity (in particular, depression), and current anxiety symptoms. Conclusion. Psychological morbidity appears to be the major determinant of anxiety in the patients currently enrolled in the study. Dispositional mindfulness is inversely associated with current anxiety and depression and with prior psychological morbidity, supporting the hypothesis of a modulating role of mindfulness on the processing of negative emotions. A phone-delivered, individual MBI is feasible, acceptable to patients and can be adequately delivered by trained instructors. The findings from this dissertation work support the need for larger clinical trials of MBI in ICD patients.

Background. Primary and secondary prevention trials have shown that implantable cardioverter-defibrillators (ICD) reduce the risk of cardiac death, but concerns have been raised regarding the psychological well-being of ICD patients. Anxiety can affect a significant proportion of these patients, but there is limited information about prevalence and determinants of anxiety after the implementation of the more recent guidelines for ICD implantation. Several behavioral interventions have been effective in improving anxiety in these patients, however the efficacy of mindfulness-based interventions (MBI) has not been investigated in ICD patients, and there is limited information regarding the characteristics of pre-intervention, “dispositional” mindfulness in patients with cardiovascular disease never exposed to mindfulness training. The aims of this dissertation project were: 1) To determine the feasibility of a randomized clinical trial of a phone-administered, mindfulness-based training program, as measured by recruitment and retention rates, treatment adherence and fidelity; 2) To evaluate the current baseline prevalence and determinants of anxiety in the study population and 3) To describe the correlates of dispositional mindfulness in the study population. Methods. The study was conducted at the Electrophysiology Service at the UMass Memorial Medical Center. All consecutive patients who recently underwent an ICD procedure or received ICD shocks were screened for eligibility to participate in a pilot randomized controlled trial in which an eight session, phone-delivered, weekly MBI was compared to a usual care condition. Assessments were performed at baseline and post-intervention. A cross-sectional design was used for aims 2 and 3. Anxiety was assessed using the Hospital Anxiety and Depression Scale; a shortened version of the Five Facets of Mindfulness questionnaire was used to evaluate mindfulness. Results. Thirty patients (21 M, 9 F; mean age 63.1 ±10.3 years) were enrolled in the study. The methods ultimately adopted to screen, recruit, and retain study participants were feasible to conduct and satisfactory to ICD outpatients, and the study intervention was safe. Phone delivery resulted in excellent retention rates and limited costs. Assessments of treatment fidelity showed that the content of the intervention was delivered as intended in almost 100% of cases. The study findings do not show a decrease in the overall prevalence of anxiety in ICD patients compared with earlier cohorts; anxiety was associated with young age, low socio-economic status and previous psychological morbidity, but not with ICD-related factors including prior shock delivery. Finally, baseline mindfulness was most strongly associated with previous psychological morbidity (in particular, depression), and current anxiety symptoms. Conclusion. Psychological morbidity appears to be the major determinant of anxiety in the patients currently enrolled in the study. Dispositional mindfulness is inversely associated with current anxiety and depression and with prior psychological morbidity, supporting the hypothesis of a modulating role of mindfulness on the processing of negative emotions. A phone-delivered, individual MBI is feasible, acceptable to patients and can be adequately delivered by trained instructors. The findings from this dissertation work support the need for larger clinical trials of MBI in ICD patients.

The researcher aimed to determine the effect of a dance and movement intervention on the perceived emotional well-being and self-esteem of a group of in-patient adolescents in Weskoppies Psychiatric Hospital. A quantitative study, using a quasi-experimental design, was carried out using the positive and negative affect scale for children (PANAS-C) and the Rosenberg self-esteem scale to measure the two independent variables, namely perceived emotional well-being and self-esteem. There were four participants in the experimental group and six in the control group. A between-group comparison was made between the pre-test and post-test scores of the two groups. Both groups completed the positive and negative affect scale for children (PANAS-C) and the Rosenberg self-esteem scale at which point the experimental group took part in a two week, twelve session, dance and movement intervention program. After two weeks both groups once again completed these two measures. Although the results were statistically non-significant, effect size and outcome patterns pointed to an improvement in these two variables due to the intervention program.
Dissertation (MA)--University of Pretoria, 2010.
Psychology
unrestricted

The purpose of this study is to examine the potential for yoga to contribute to sustainability objectives via pro-social and environmental attitudes and behaviours. It locates core principles and concepts embedded within the meaning of the term interconnectedness in both western and eastern histories of ideas, with particular emphasis on yoga, integralism, and ecological theory. It evaluates and investigates yoga's potential toward recognition or realisation of a non-dualist paradigm of interconnectedness that might invoke social and environmental change. It explores how a tripartite model of yoga understands interconnectedness at a deeper level than the mechanistic worldview, and could support proactive measures toward a more fair, just, and sustainable world. It locates cultural barriers to yoga's potential for a pro-environmental and pro-social worldview and lifestyle, suggesting options to advance yoga's ecological values by improved education and scholarship. To access suitable models, the study learnt and practiced traditional teachings, applied them to contemporary issues and sought perspectives from under-represented sources. To answer research questions on how yoga can benefit contemporary issues, it also critically reflected on how scholarship impacts upon the communities from which the knowledge is obtained. The project contributes new knowledge on interconnectedness, its meaning and historic cultural context. It contributes a novel epistemic and methodological framework consistent with traditional knowledge, particularly relevant for progress on culturally appropriate scholarship in yoga studies. The project is the first of its kind to deeply explore the meanings of the word interconnectedness. It is one of the most committed attempts to date to seek out a doctrinal model from the traditions that can embrace both transcendent and immanent aspects of yoga in both theory and practice toward a coherent eco-yoga model. In doing so it engages with a wide lacuna between rhetorical appeals to yoga as a sustainability praxis and mind body intervention by supplementing existing theory with some of the traditional knowledge to explain how yoga works, and how it can help to meet sustainability objectives like cultivating an interconnected worldview. The project calls to seriously examine the legacy of colonial classification systems and methodological issues in the representation of yoga cultures. It appeals for the review of academic conventions among yoga scholars and for the prioritisation of sincere regard for the impact of scholarship on yoga’s intangible cultural heritage value, particularly considering yoga’s protection under UNESCO.

This paper introduces the Bodymind model of Art Therapy and delineates the processes through which it has salutary effects on individuals coping with a variety of health related challenges. The goal of this model is to articulate how activation, reorganization, growth and reintegration of the self can emerge from bodymind processes activated by art therapy. It provides a framework for the conduct of research that will test the key theoretical mechanisms through which art therapy benefits clients. We expect this model to be a spring board for discussion, debate and development of the profession of art therapy. Furthermore, we hope readers can use this model to conduct sound mechanistic studies. This paper can inform social scientists and medical professionals on the manner in which art making can contribute to health.

Globally, it is estimated that 50 million people are currently living with dementia, which is expected to reach 75 million by the end of this decade. Recently, there has been increasing interest in the use of lifestyle interventions to delay both the onset and progression of dementia following a growing list of failed pharmaceutical trials. Habitual physical activity is one such target for lifestyle intervention due to promising longitudinal evidence linking higher levels of physical activity with greater cognition, slower cognitive decline and decreased risk of developing Alzheimer’s disease and all-cause dementia. Physical activity itself is associated with various clinical characteristics that are amenable to exercise intervention in older adults, including but not limited to, physical function, strength, muscle mass, cognition, psychological health, and functional independence. Robust anabolic exercise such as progressive resistance training (PRT) is a promising intervention which can augment cognition in healthy older as well many of the associated clinical characteristics that are significantly influenced by the catabolic processes observed within dementia, such as sarcopenia, frailty and malnutrition. However, the relationship between cognition and physical activity, and extent to which these clinical characteristics are modifiable following robust anabolic exercise, remain largely unanswered. Thus, the aims of this thesis are to (1) characterise levels of physical activity and sedentary time in populations with varying degrees of cognitive impairment, (2) evaluate the relationship between physical activity and sedentary behaviour with cognition across the cognitive spectrum, and subsequently (3) evaluate the effects of robust anabolic exercise on change in cognition and changes in physical activity and sedentary behaviour, and whether these changes are related to each other. To investigate these aims, we have evaluated two very different cohorts along the cognitive impairment spectrum: mild cognitive impairment (MCI) and Lewy body dementia (LBD). Specifically, MCI represents a stage of cognitive impairment where there is minimal functional impairment in daily activities, and where there is not necessarily an underlying pathological process causing impairment. Conversely, LBD represents a severe, rapidly progressing form of dementia with significant pathological underpinning that results in extensive cognitive, psychiatric, movement and autonomic symptoms. The relationship between physical activity and cognition, and subsequent response to intervention may differ with increasing disease severity, frailty, and functional limitations. Therefore, this thesis was able to rigorously evaluate these associations across the spectrum of cognitive impairment. There was a range of relevant of scientific methodologies and study designs included throughout this thesis in order to address these aims. The seven chapters of this thesis include a systematic review, cross-sectional observational studies, a randomised controlled trial, a protocol with rationale, a novel pilot study, and a thorough case report. Collectively, these chapters have provided a comprehensive picture of both the levels of physical activity and cognition in older adults with cognitive impairment, as well as their association with a diverse range of modifiable clinical characteristics. These findings provide robust rationale for the use of anabolic exercise in these cohorts to address modifiable aspects of their chronic diseases and geriatric syndromes, most notably frailty and disability. Lastly, the novelty of our findings provide a foundation for future investigations to further explore these associations within other types of cognitive impairment and refine effective interventions to attenuate cognitive decline and the risk of dementia.

This portfolio contains work which was submitted as part of the practitioner Doctorate (PsychD) in psychotherapeutic and counselling psychology at the University of Surrey. It comprises of three dossiers which reflect the three aspects of the training course; academic, therapeutic and research works. The academic dossier contains two essays. The first an essay focusing on how the understanding of attachment experiences is important to the practice of psychodynamic psychotherapy, and counselling psychology. The second essay presents the implications of homework assignments for the process and therapeutic relationship within a cognitive behavioural framework. The therapeutic dossier reflects years two and three of the training course and contains brief placement descriptions of my psychodynamic and cognitive behavioural clinical placements. The dossier also contains a final clinical paper which includes reflections of my personal and professional training in counselling psychology across a period of SlX years. The research dossier contains three pieces of work completed over the last three years of training. The first a literature review which explores the psychological impact of hair loss on self image and identity in women who have experienced chemotherapy treatment for breast cancer. It offers a discussion on how psychotherapeutic interventions which leave out the body and touch could be incorporated with touch therapies namely massage to provide a more holistic intervention for individuals with this chronic illness which may implicate the body. The second is a research project exploring women's experiences of hair loss as a result of treatment for breast cancer and their use of mind and body interventions. This was a qualitative project using Interpretative phenomenological analysis. The third piece of work is also a qualitative research project focusing on how psychotherapists of varying orientations and who have chronic health condition manage their own health status when working psychotherapeutically with clients.

Background. A sizable amount of individuals in the community are presented with various kinds of physical and mental health problems which are either undetected, untreated or inadequately treated, due to the limitations on the availability and accessibility of the services in the existing health care system, or to other social and personal reasons. The current study evaluated the effectiveness of a newly developed modality of health-enhancing treatment---the Mindfulness-based Dejian Mind-Body Intervention, as compared to that of a Group Psychoeducational Treatment, in alleviating depressive mood and improving physical health of adult individuals in the community.
Conclusions. Findings of the current study suggest that compared with the Group Psychoeducational Treatment, Dejian Mind-Body Intervention might be more effective in enhancing the emotional and physical health of community individuals presented with moderate to severe depressive mood and/or problems with bowel functioning.
Method. Forty adult volunteers with various degree of depressive mood and physical problems who expressed interest in receiving either Dejian Mind-Body Intervention or Group Psychoeducational Treatment were recruited in the current study. They were matched for gender, age, education and level of depression, and were randomly assigned to either treatment group.
Results. Both the Dejian Mind-Body Intervention and Group Psychoeducation Treatment were effective in bringing about a significant reduction in depressive mood iv among treatment completers. However, differential effectiveness emerged among those presented with moderate to severe depressive mood, where Dejian Mind-Body Intervention resulted in significantly greater treatment-related reduction in depressive mood compared with the Group Psychoeducational Treatment. Besides, Dejian Mind-Body Intervention brought about significant increase in an objective QEEG measure of positive affect, and improvements in physical health (i.e., bowel functioning) that were not evidenced in the Group Psychoeducation Treatment.
Tsui, Jin Ching.
Adviser: Agnes S.Y. Chan.
Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3799.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2008.
Includes bibliographical references (leaves 62-68).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

背景: 近代不少西方的實證心理治療方法都開始採納東方源來已久的身心治療，來醫治常見的情緒病，例如：抑鬱症，效果最為顯著。這個發展趨勢正好回應現存醫療制度及資源的限制，或其他社會文化及個人所造成的障礙。本研究旨在檢視一種促進身心健康的中國禪宗身心治療方法 － 以「德建身心療法」對比於 「認知行為治療法」及「等候對照組」，在治療一羣抑鬱症患者的抑鬱情緒、腦功能的改善及其身体健康等的療效。
研究方法: 在一個精神科門診部內，研究員召集了75 名成人的抑鬱症患者。他們都是有不同程度的抑鬱情緒或身體健康問題，同時有興趣參加為期十節的「德建身心療法」或「認知行為治療法」。 在對照基本資料後 (如年齡、學歷、抑鬱程度，初患或復發) ，他們被隨機分派到「德建身心療法」、「認知行為治療法」或「等候對照組」中。治療前及治療後，抑鬱症患者都會接受情緒、腦功能、健康狀況及腦電波的評估。
結果: 整體而言，相對於「等候對照組」，「德建身心療法」及「認知行為治療」更有效地減低患者的抑鬱症狀。此外，「德建身心療法」更帶來一些其他組別所末見的療效；包括有效地提昇患者的專注力、記憶、執行功能、腸道功能及睡眠質素。再者、研究亦發現「德建身心療法」的參加者，在有關正面情緒和專注力的兩個客觀量化腦電波(QEEG)指數上有顯著的攀升。意外地，在短短的十星期後「德建身心療法」參加者使用抗抑鬱药的份量亦有效地減少。
總結: 本研究的結果顯示中國的禪宗身心治療方法 －「德建身心療法」在治療抑鬱症患者的情緒捆纏、腦功能失衡、睡眠及腸道功能、提升正面情緒及專注力的量化腦電波指數都有明顯的功效。
BACKGROUND: There are growing interests and encouraging findings of adapting and developing Mind-Body Intervention into evidence-based group treatment for common mental disorders such as depression. The advancement is a partial response to the limitations on the availability and accessibility of the existing treatment in the current health care system for depression, and/or a partial response to the socio-cultural and personal reasons in different communities. The present study aimed to evaluate the effectiveness of a newly developed Chinese Chan-based treatment the Dejian Mind-Body Intervention (DMBI), as compared to the groups of Cognitive-behavioural Therapy (CBT) and Wait-list control, in alleviating depressive mood and improving physical health of adult depressive patients.
METHOD: Seventy-five patients with the diagnosis of Major Depressive Disorder were recruited in the current study. They were stratified for age, education, level of depression, course of illness before random assignment to receive either 10-session DMBI or CBT, or placed on a wait-list. Pre-post measurements included primary outcome measures on psychiatrists’ rating and self-evaluated mood scores (HRSD and BDI) and secondary outcome measures on performance in different neuropsychological assessment (Executive function, Attention, Memory). The three groups also compared among different sleep (SOL, TST, and WASO), gastrointestinal parameters as well as neurophysiological QEEG indices.
RESULTS: Both the DMBI and CBT groups demonstrated significant reduction in depressive psychopathology after intervention. However, the DMBI group but not the CBT or Wait-list control groups demonstrated significant improvement in attention, verbal memory, executive function, gastrointestinal health and overall sleep quality. Besides, Dejian Mind-Body Intervention brought about significant increase in objective QEEG measures of positive affect and attention that were not evidenced in the other two groups. Participants in the DMBI group also demonstrated significant reduction in the use of anti-depressant after the end of 10-week treatment.
CONCLUSIONS: Findings of the current study suggested that a Chinese Chan-based Dejian mind-body intervention has positive effects on improving the mood and health conditions of individuals with depression.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Wong, Yun Ping.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2012.
Includes bibliographical references (leaves 79-109).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese; some appendixes also in Chinese.
ABSTRACT --- p.iii
CHINESE ABSTRACT --- p.v
ACKNOWLEDGEMENTS --- p.vii
TABLE OF CONTENTS --- p.ix
LIST OF TABLES --- p.x
LIST OF FIGURES --- p.xii
LIST OF APPENDICES --- p.xiii
LIST OF FIGURES --- p.xii
Chapter CHAPTER I: --- INTRODUCTION --- p.1
PURPOSES OF THE PRESENT STUDY --- p.26
Chapter CHAPTER II: --- METHODS --- p.29
Chapter CHAPTER III: --- RESULTS --- p.47
Chapter CHAPTER IV: --- DISCUSSION --- p.68
GENERAL DISCUSSION --- p.70
CLINICAL IMPLICATIONS --- p.76
LIMITATION AND SUGGESTIONS FOR FUTURE DIRECTION --- p.77
REFERENCES --- p.79
TABLES --- p.110
FIGURES --- p.124
APPENDICES --- p.128

Indiana University-Purdue University Indianapolis (IUPUI)
Major Depressive Disorder is a prevalent and pervasive problem in the United States, and this mental disorder disproportionately affects adolescents of color. In particular, there is little research understanding how Hispanic/Latinx adolescents utilize and engage with mental health services, such as psychotherapy, to reduce their symptoms of depression, including factors that are positively and negatively related to engagement. As such, the aims of this study were to understand whether there were any relationships between presenting characteristics of adolescents seeking therapy for depression and their subsequent engagement with therapeutic services, with a focus on analyses examining trends in Hispanic/Latinx adolescents. To investigate these aims, we utilized data from a pilot study in which adolescents (n=42) received a mind-body intervention for depression called Mind-Body Skills Groups. We examined possible relationships between depression severity, age, Hispanic/Latinx background, and their interactions with engagement, as measured by attendance rates, self-reported motivation, and at-home skills practice. We hypothesized that high depression severity, high age, and being Hispanic/Latinx would all negatively influence engagement; we also hypothesized the depression-engagement and age-engagement relationships would be moderated by Hispanic/Latinx background. Results revealed initial relationships between lower age and being Hispanic/Latinx with higher attendance rates; depression severity was not related to attendance. When these relationships were further analyzed using hierarchical regression, no significant relationships between predictor and outcomes variables, as well as their interactions, were discovered. In an exploratory analysis investigating factors of adolescent depression using subscales, greater interpersonal problems predicted higher attendance rates. Results are interpreted relative to limitations of the small sample size and possible measurement concerns within this study, including a discussion of possible ways to improve related studies on Hispanic/Latinx youth in the future.

Increasing prevalence and severity of undergraduate psychopathology, combined with heightened burden on college campus counseling centers and the potential for sustained distress and self-harm, has necessitated comprehensive, vertically integrated on-campus mental health services. Initiatives include preventive interventions that: 1) foster resilience and adaptive coping, 2) ameliorate sub-threshold symptoms of pathology as secondary prevention, and 3) foster well-being and meaningful student experiences for greater fulfillment and thriving. A growing body of supportive data has led to some expansion of mental health and wellness services on college campuses, including the use of spiritually integrated mind-body practices to promote well-being. While college campuses’ wellness initiatives show promise, structured spiritual-mind-body (SMB) interventions have yet to be formally tested in either open or controlled clinical trials. The primary aim of this open-trial pilot study was to evaluate the feasibility and acceptability of an eight-session SMB-integrated wellness intervention, Awakened Awareness for Adolescents (AA-A), adapted specifically for late adolescent (ages 18 - 25) college students from Awakened Awareness for adults (AA) to support spiritual development and individuation. A secondary aim was to obtain preliminary data on changes in undergraduate students’ mental health and spiritual well-being across the AA-A intervention. Participants consisted of 77 non-clinically-referred undergraduates aged 18 - 24, who attended an average of M = 5.75 (SD = 1.42) out of the eight sessions. Measures included common psychopathology symptoms, spiritual well-being, psychological, and psychosocial variables using validated self-report assessments. Additionally, we explored the effect of spiritual well-being variables’ change scores as predictors of post-AA-A psychopathology symptom scores, controlling for pretest symptom scores. Differential effects between participants with high and low baseline depression symptoms were examined on outcome measures. Preliminary findings support the feasibility and acceptability of the AA-A intervention for college student’s mental health and spiritual well-being. Results include significant reductions in depression, anxiety, post-traumatic stress (PTS) symptoms, and significant improvements in numerous spiritual well-being, psychological, and psychosocial variables. Further, a recovery process from high rates of PTS symptomatology and spiritual decline may be initiated by SMB interventions that foster enhanced spiritual perception and build awareness of personal and relational spirituality.

Text in Afrikaans
Every person yearns to function as an independent and integrated human being who experiences inner peace and wholeness. The search for a way of life that leads to wisdom and life knowledge has continued through the centuries and according to Hancock (2005:8) it began as early as 40 000 years ago. This research study takes up this search, describing human wholeness from a spiritual, philosophical and psychological perspective, in the context of specific essential characteristics. Together with this, applicable therapeutic approaches were researched to structure an intervention model to achieve wholeness. Wholeness therapy is an eclectic approach based on medical hypnoanalysis with added aspects of the rational-emotive behavioural therapy of Albert Ellis, choice theory of William Glasser and Victor Frankl’s logotherapy. By means of qualitative research a case study from a psychological practice was described, in which a person was enabled to experience wholeness through wholeness therapy which is described in full.
Educational Studies
D.Ed. (Sielkundige Opvoedkunde))

Movement in Gestalt therapeutic intervention, using structured activities and free improvisations, is a successful alternative to punishing adolescents with disruptive behavioural tendencies in the classroom. An overview of the existing literature regarding the therapeutic value of movement in Gestalt therapeutic intervention for adolescents with disruptive behavioural tendencies is firstly presented. Various techniques supporting the adolescent in his quest to achieve equilibrium, ultimately improving his relationships with others and his environment, are described. A case study, involving eight adolescents with disruptive behavioural tendencies in group therapy follows, which indicates that movement in Gestalt therapy is an alternative to punishment. In the light hereof it is suggested that movement in Gestalt therapy could be implemented successfully in the formal school environment. This form of intervention can contribute to the adolescent's growth, his ability to communicate and his relationships with self, others and the environment, culminating in improved behavioural tendencies.
Social Work
M. Diac. (Play Therapy)

Facilitating forgiveness: an NLP approach to forgiving is an attempt at uncovering features of the blocks that prevent people to forgive. These blocks to forgiveness can be detected in the real life situations of the six individuals who told me their stories. The inner thoughts, feelings and the subsequent behaviour that prevented them from forgiving others is clearly uncovered in their stories. The facilitation process highlights the features that created the blocks in the past thus preventing forgiveness to occur. The blocks with their accompanying features reveal what needs to be clarified or changed in order to eventually enable the hurt individuals to forgive those who have hurt them. The application of discourse analysis to the stories of hurt highlights the links between the real life stories of the individuals within their contexts with regard to unforgiveness to the research findings of the existing body of knowledge, thereby creating a complexly interwoven comprehensive understanding of the individuals' thoughts, feelings, and behaviours in conjunction with their developmental phases within their socio-cultural contexts. Neuro-linguistic-programming (NLP) is the instrument with which forgiving is facilitated in the six individuals who expressed their conscious desire to forgive, because they were unable to do so on their own. Their emotions had the habit of keeping them in a place in which they were forced to relive the hurtful event as if it were happening in the present. Arresting the process of reliving negative emotions requires a new way of being in this world. The assumption that this can be learnt is based on the results from a previous study, in which forgiveness was uncovered by means of the grounded theory approach as a cognitive process (Von Krosigk, 2000). The results from the previous research in conjunction with the results and insights from this research study are presented in the form of a grounded theory model of forgiveness.
Psychology
D. Litt. et Phil. (Psychology)

This research journey examines the process of co-creating, along with my co-travellers (research participants), a more holistic approach to trauma debriefing. Whilst incorporating elements of Mitchell's (1983) Critical Incidence Stress Debriefing model (C.I.S.D.), our point of difference has been to adopt a narrative pastoral approach. This was achieved by introducing spirituality and narrative therapy practices. Our research pathway has been further shaped by adopting a qualitative research approach within a postmodern, social construction discourse. My research curiosity was invited by both the mind, body and soul divide expressed in psychology; and the healing possibilities of spirituality I have witnessed in both my own and in the lives of others. While my co-travellers predominantly preferred to express their spirituality in terms of Christianity, our narrative pastoral approach to trauma debriefing is offered to people of all religious persuasions.
Practical Theology
M.Th. (with specialisation in Pastoral therapy)