What the patient wants: Addressing patients’ treatment targets in an integrative group psychotherapy programme

Kealy, David; Joyce, Anthony S.; Weber, Rainer; Ehrenthal, Johannes C.; Ogrodniczuk, John S.

doi:10.1111/papt.12174

Cited by 16 publications

(14 citation statements)

References 53 publications

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“…Patients typically do not only come to therapy to obtain relief from symptoms, but also to address other personal problems, which may include going back to work, solving intrapersonal issues, being a better parent, or stopping the fights with their partner or their boss. Addressing these problems of the patient can be regarded as one of the main goals of therapy.…”

Section: Patient‐defined Targets and Outcomes Of Psychotherapiesmentioning

confidence: 99%

Targets and outcomes of psychotherapies for mental disorders: an overview

2019

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It is not yet clear what mental disorders are and what are the causal pathways that lead to them. That makes it difficult to decide what the targets and outcomes of psychotherapies should be. In this paper, the main types of targets and outcomes of psychotherapies are described, and a brief overview is provided of some of the main results of research on these types. These include symptom reduction, personal targets and outcomes from the patient's perspective, improvement of quality of life, intermediate outcomes depending on the theoretical framework of the therapist, negative outcomes to be avoided, and economic outcomes. In line with the dominance of the DSM and ICD systems for diagnoses, most research has been focused on symptom reduction. This considerable body of research, with hundreds of randomized trials, has shown that for most mental disorders effective psychotherapies are available. There is also research showing that psychotherapies can result in improvement of quality of life in most mental disorders. However, relatively little research is available on patient‐defined outcomes, intermediate outcomes, negative outcomes and economic outcomes. Patients, relatives, therapists, employers, health care providers and society at large each have their own perspectives on targets and outcomes of psychotherapies. The perspective of patients should have more priority in research, and a standardization of outcome measures across trials is much needed.

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Section: Patient‐defined Targets and Outcomes Of Psychotherapiesmentioning

confidence: 99%

Targets and outcomes of psychotherapies for mental disorders: an overview

2019

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“…This is followed by a series of groups including insight‐oriented psychotherapy, cognitive‐behavioural therapy and interpersonal skills‐oriented groups, as well as rehabilitative groups that include art, vocational and physical exercise interventions. Clients participate in one small psychodynamic group throughout their time in the programme, while rotating through all other groups; this “home group” aims to foster insight and self‐reflection and provides a consistent focus on the client′s individual treatment goals (Kealy, Joyce, Weber, Ehrenthal, & Ogrodniczuk, ). The interdisciplinary team consists of psychiatrists, occupational therapists, psychologists and psychiatric nurses, who collaborate to coordinate treatment.…”

Section: Methodsmentioning

confidence: 99%

Getting absorbed in group therapy: Absorption and cohesion in integrative group treatment

Kealy

McCloskey

Cox

et al. 2019

Couns and Psychother Res

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Background Absorption is a trait‐like dimension reflecting a tendency to immerse oneself in sensory and imaginative experiences. This characteristic has scarcely been investigated in group psychotherapy. The present study examined absorption in relation to clients′ experience of early group process, and as a moderator of group cohesion and improvement in psychiatric symptoms, in an integrative group treatment programme. Methods Participants included 81 clients, who completed an 18‐week programme of intensive, integrative, group treatment for personality dysfunction. Clients completed assessments of absorption and psychiatric symptom severity, and rated three aspects of group cohesion at week 5 of the programme. Results Absorption was significantly associated with stimulation from the group after controlling for severity of symptoms and personality dysfunction. Moderation analyses found a significant interaction effect for absorption and the stimulation component of group cohesion with regard to symptom improvement. Absorption thus had a moderating effect on the relationship between stimulation from the group and improvement in psychiatric symptoms; for clients with higher levels of absorption, stimulation from group therapy contributed significantly to reduced symptom severity at post‐treatment. Discussion Findings suggest that absorption may be a salient personality feature to consider in group therapy for clients with personality dysfunction. Conclusion Absorption may contribute to treatment outcome, in that clients′ absorption tendencies could interact with their enthusiasm for the group experience, thereby leading to reduced symptoms following intensive group treatment.

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“…• Although psychological mindedness is an important patient characteristic for interpretive therapy, the factors that contribute to individual goal achievement in supportive therapy remain unclear. atmosphere in their groups was uniquely predictive of improvement in target objective severity (Kealy, Joyce, Weber, Ehrenthal, & Ogrodniczuk, 2018). Given the aforementioned studies indicating links between process ratings and improvement in target objective severity, it is possible that the latter is influenced by psychological mindedness through its effect on the patient's contributions to the therapy process.…”

Section: Key Practitioner Messagementioning

confidence: 99%

“…One study of two types of individual therapy for patients with mixed diagnoses found that the distress tied to individual treatment goals—known as target objective severity—was associated with pretreatment expectancy for positive change, through the mediating effect of the therapeutic alliance (Joyce, Ogrodniczuk, Piper, & McCallum, ). Another study employing similar assessment of individual goal ratings, in an intensive group programme for personality dysfunction, found that patients' ratings of an engaged, working atmosphere in their groups was uniquely predictive of improvement in target objective severity (Kealy, Joyce, Weber, Ehrenthal, & Ogrodniczuk, ). Given the aforementioned studies indicating links between process ratings and improvement in target objective severity, it is possible that the latter is influenced by psychological mindedness through its effect on the patient's contributions to the therapy process.…”

Section: Introductionmentioning

confidence: 99%

Individual goal achievement in group psychotherapy: The roles of psychological mindedness and group process in interpretive and supportive therapy for complicated grief

Kealy

Piper

Ogrodniczuk

et al. 2018

Clin Psychology and Psychoth

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The ability to infer psychological meaning in behaviour—referred to as psychological mindedness—has been posited as a patient characteristic that contributes to the therapy process and consequently to therapeutic success. The present study was developed to examine the relationship between patients' psychological mindedness and improvement in patients' personal treatment goals in interpretive and supportive group therapies for complicated grief, along with patients' importance to group process. The study was conducted with a clinical sample of 109 patients (79% female; average 45 years old) receiving treatment for complicated grief. Patients provided severity of distress ratings for individual target objectives at pretreatment and posttreatment. Psychological mindedness was assessed prior to treatment using the video‐based, interviewer‐rated Psychological Mindedness Assessment Procedure. Patients' importance to the therapy process was rated by therapists and other patients in interpretive and supportive group therapy for complicated grief. Conditional process modelling tested whether psychological mindedness would contribute to patients' goal achievement through patients' importance to group process, moderated by type of therapy. A significant, conditional indirect effect was observed for psychological mindedness as a predictor of improvement in individual target objectives, through patients' importance to group process as rated by therapists, specifically in interpretive therapy. The findings indicate that patients' psychological mindedness significantly contributes to their achievement of individual goals through their contributions to group process in interpretive group therapy. Further research is needed to understand the facilitation of individual goal achievement in supportive therapy.

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What the patient wants: Addressing patients’ treatment targets in an integrative group psychotherapy programme

Cited by 16 publications

References 53 publications

Targets and outcomes of psychotherapies for mental disorders: an overview

Targets and outcomes of psychotherapies for mental disorders: an overview

Getting absorbed in group therapy: Absorption and cohesion in integrative group treatment

Individual goal achievement in group psychotherapy: The roles of psychological mindedness and group process in interpretive and supportive therapy for complicated grief

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