BackgroundBurnout occurs when professionals use ineffective coping strategies to try to protect themselves from work-related stress. The dimensions of ‘overload’, ‘lack of development’ and ‘neglect’, belonging to the ‘frenetic’, ‘under-challenged’ and ‘worn-out’ subtypes, respectively, comprise a brief typological definition of burnout. The aim of the present study was to estimate the explanatory power of the different coping strategies on the development of burnout subtypes.MethodsThis was a cross-sectional survey with a random sample of university employees, stratified by occupation (n = 429). Multivariate linear regression models were constructed between the ‘Burnout Clinical Subtypes Questionnaire’, with its three dimensions –overload, lack of development and neglect– as dependent variables, and the ‘Coping Orientation for Problem Experiences’, with its fifteen dimensions, as independent variables. Adjusted multiple determination coefficients and beta coefficients were calculated to evaluate and compare the explanatory capacity of the different coping strategies.ResultsThe ‘Coping Orientation for Problem Experiences’ subscales together explained 15% of the ‘overload’ (p<0.001), 9% of the ‘lack of development’ (p<0.001), and 21% of the ‘neglect’ (p<0.001). ‘Overload’ was mainly explained by ‘venting of emotions’ (Beta = 0.34; p<0.001); ‘lack of development’ by ‘cognitive avoidance’ (Beta = 0.21; p<0.001); and ‘neglect’ by ‘behavioural disengagement’ (Beta = 0.40; p<0.001). Other interesting associations were observed.ConclusionsThese findings further our understanding of the way in which the effectiveness of interventions for burnout may be improved, by influencing new treatments and preventive programmes using features of the strategies for handling stress in the workplace.

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A pilot study of the effects of metacognition-oriented social skills training (MOSST) on social functioning in patients with schizophrenia spectrum disorders (SSDs) reported promising results. The main purpose of the current trial was to compare the effectiveness and potential benefits of MOSST vs conventional social skills training (SST). Single-blind randomized controlled trial with 2 groups of patients aged 18-65 with SSDs on partial hospitalization. Participants were randomly assigned (1:1) to receive 16 group sessions with MOSST or conventional SST, both in addition to standard care, over 4 months, with a 6-month follow-up. Psychosocial functioning, metacognition, and symptom outcomes were measured by blind assessors. Statistical analyses used mixed models to estimate treatment effects in each postrandomization time point. Thirty-six patients were randomly assigned to the MOSST group and 33 patients to the conventional SST group. Between-group differences were significant in favor of MOSST on Social and Occupational Functioning Assessment Scale (SOFAS) and Personal and Social Performance Scale (PSP) total scores at post-treatment and follow-up. Concerning PSP subscales, there were significant between-group differences in favor of MOSST at follow-up on socially useful activities, personal and social relationships, and disturbing and aggressive behaviors. Metacognition only improved following MOSST group. For people with SDDs, MOSST appears to have short- and long-term beneficial effects on social functioning and symptoms. Further studies are required to replicate the current results in other samples.

BackgroundOne-quarter of the world’s population will suffer from depression symptoms at some point in their lives. Mental health services in developed countries are overburdened. Therefore, cost-effective interventions that provide mental health care solutions such as Web-based psychotherapy programs have been proposed.ObjectiveThe intent of the study was to identify expectations regarding Web-based psychotherapy for the treatment of depression in primary care among patients and health professionals that might facilitate or hinder its effects.MethodsThe expectations of untreated patients and health professionals were examined by means of interviews and focus groups. There were 43 participants (20 patients with mild and moderate levels of depression, 11 primary care physicians, and 12 managers; 22 of them for interviews and 21 for groups). A thematic content analysis from the grounded theory for interviews, and an analysis of the discursive positions of participants based on the sociological model for groups were performed. Interpretations were achieved by agreement between three independent analysts.ResultsAll participants showed a good general acceptance of Web-based psychotherapy, appreciating possible advantages and improvements. Patients, physicians, and managers shared the same conceptualization of their expectations, although highlighting different aspects. Patients focused on the need for individualized and personalized interaction, while professionals highlighted the need for the standardization of the program. Physicians were concerned with extra workload, while managers were worried about optimizing cost-effectiveness.ConclusionsExpectations of the different participants can conflict with each other. Finding a balanced position among them is needed if we are to harmoniously implement effective Web-based interventions for depression in routine clinical practice.

ada vez que una persona consulta por problemas de salud mental, los clínicos nos enfrentamos con la amplitud de la experiencia humana que se despliega inmediatamente después de la primera pregunta obligada: ¿qué es lo que te ha motivado a venir a consulta? La singularidad de cada persona nos conecta a menudo con el inevitable dilema del psicoterapeuta. Las propuestas de intervención procedentes de las guías clínicas, fundamentadas en investigación nomotética, pueden resultar poco sensibles a las necesidades particulares de los pacientes (Castonguay, Constantino y Beutler, 2019a; Castonguay, Constantino y Xiao, 2019b; Goldfried y Wolfe, 1996). La intrincada relación entre investigación y práctica clínica es tan antigua como la propia psicoterapia (Cautin, 2011; Meehl, 1957). La dimensión más nuclear quizás subyace en el problema epistemológico de reconciliar los principios nomotéticos e idiográficos que definen respectivamente a la producción científica y al quehacer clínico. En rigor, este clivaje trasciende las fronteras de la psicoterapia y constituye un fenómeno presente en cualquier disciplina científica con pretensión de aplicabilidad (O'Donohue, 2013). En el presente trabajo trataremos de acercar a nuestro idioma un debate que principalmente se está produciendo en contextos anglosajones, pero que empieza a captar la atención de la comunidad científica y profesional hispanoparlante (Fernández-Álvarez y Castonguay, 2018). Se presentarán

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BackgroundIn preparation for a randomized controlled trial, a pilot study was conducted to investigate the feasibility, acceptability and effectiveness of a psychotherapy group based on metacognitive-oriented social skills training (MOSST).MethodsTwelve outpatients with schizophrenia were offered 16 group-sessions of MOSST. Effect sizes were calculated for changes from baseline to treatment end for both psychosocial functioning and metacognitive abilities measured by the Personal and Social Performance Scale (PSP) and the Metacognition Assessment Scale–Abbreviated (MAS–A) respectively.Results and discussionTen patients finished the full treatment protocol and nonsignificant moderate effect sizes were obtained on PSP and MAS–A scores. To date, this is the first study in Spain to suggest that outpatients with schizophrenia will accept metacognitive therapy for social skills training and evidence improvements in psychosocial functioning and metacognition.ConclusionDespite limitations inherent in a pilot study, including a small sample size and the absence of a control group, sufficient evidence of effectiveness was found to warrant further investigation.Trial registration ISRCTN10917911. Retrospectively registered 30 November 2016.

We conducted a pilot study to investigate the feasibility, acceptability and effectiveness of a grouppsychotherapy based on Metacognitive Interpersonal Therapy (MIT-G) for patients with personality disorders (PDs). Ten outpatients with PD diagnoses were offered 16 sessions of MIT-G delivered in group format. Effect sizes were calculated for changes in symptoms, interpersonal difficulties, and metacognition baseline to treatment end.. Nine patients finished the full treatment protocol with nonsignificant large effect sizes obtained for change in depression, metacognition, impulsiveness and interpersonal problems. This is the first study suggesting that MIT-G is acceptable to outpatients across the spectrum of PDs and is associated with improvements in clinical symptoms, social functioning and metacognition. Despite the limitations of a pilot study, evidence of MIT-G effectiveness is sufficient to warrant further investigation.