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Analytic versus systemic group therapy for women with a history of child sexual abuse: 1-year follow-up of a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature259757
Source
Psychol Psychother. 2014 Jun;87(2):191-208
Publication Type
Article
Date
Jun-2014
Author
Henriette Elkjaer
Ellids Kristensen
Erik L Mortensen
Stig Poulsen
Marianne Lau
Source
Psychol Psychother. 2014 Jun;87(2):191-208
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Adult
Adult Survivors of Child Abuse - psychology
Child
Child Abuse, Sexual - psychology
Denmark
Epidemiologic Methods
Female
Group Processes
Humans
Intention to Treat Analysis
Interpersonal Relations
Outcome Assessment (Health Care) - statistics & numerical data
Psychotherapy, Group - methods
Abstract
This randomized prospective study examines durability of improvement in general symptomatology, psychosocial functioning and interpersonal problems, and compares the long-term efficacy of analytic and systemic group psychotherapy in women 1 year after completion of treatment for childhood sexual abuse.
Women (n = 106) randomly assigned to analytic or systemic psychotherapy completed the Symptom Checklist-90-R, Global Assessment of Functioning, Global Life Quality, Registration Chart Questionnaire, and Flashback Registration at pre-treatment, post-treatment, and at a 1-year follow-up.
Post-treatment gains were significant for both treatment modalities on all measures, but significantly larger after systemic therapy. Significant treatment response was maintained 1-year post-treatment, but different trajectories were observed: 1 year after treatment completion, improvements for analytic therapy were maintained, whereas they decreased after systemic therapy, resulting in no statistically significant difference in gains between the groups at the 1-year follow-up. Despite maintaining significant gains, more than half of the patients remained above cut-off for caseness concerning general symptomatology at post-treatment and at 1-year follow-up.
The findings stress the importance of long-term follow-up data in effect studies. Different trajectories were associated with the two treatments, but improvement in the two treatment groups did not differ significantly at the 1-year follow-up. Implications of the difference in trajectories for treatment planning are discussed.
Both analytic and systemic group therapy proved efficient in improving general symptomatology, psychosocial functioning, and interpersonal problems in women with a history of CSA and gains were maintained at a 1-year follow-up. Despite maintaining statistically significant gains at the 1-year follow-up, 54% of the patients remained above the cut-off for caseness with respect to general symptomatology, which may indicate a need for further treatment. Different pre-post follow-up treatment trajectories were observed between the two treatment modalities. Thus, while systemic group therapy showed a significantly better outcome immediately after termination, gains in the systemic treatment group decreased during follow-up, while gains were maintained during follow-up in analytic group therapy.
PubMed ID
24014477 View in PubMed
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Feedback versus no feedback in improving patient outcome in group psychotherapy for eating disorders (F-EAT): protocol for a randomized clinical trial.

https://arctichealth.org/en/permalink/ahliterature260672
Source
Trials. 2014;15:138
Publication Type
Article
Date
2014
Author
Annika Helgadóttir Davidsen
Stig Poulsen
Mette Waaddegaard
Jane Lindschou
Marianne Lau
Source
Trials. 2014;15:138
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Checklist
Clinical Protocols
Denmark
Disability Evaluation
Eating Disorders - diagnosis - psychology - therapy
Feedback, Psychological
Female
Humans
Male
Middle Aged
Patient compliance
Psychiatric Status Rating Scales
Psychotherapy, Group
Research Design
Severity of Illness Index
Social Behavior
Suicide - psychology
Time Factors
Treatment Outcome
Abstract
Continuous feedback on patient improvement and the therapeutic alliance may reduce the number of dropouts and increase patient outcome. There are, however, only three published randomized trials on the effect of feedback on the treatment of eating disorders, showing inconclusive results, and there are no randomized trials on the effect of feedback in group therapy. Accordingly the current randomized clinical trial, initiated in September 2012 at the outpatient clinic for eating disorders at Stolpegaard Psychotherapy Centre, aims to investigate the impact of continuous feedback on attendance and outcome in group psychotherapy.
The hypothesis is that continuous feedback to both patient and therapist on treatment progress and alliance will increase attendance and treatment outcome. The trial is set up using a randomized design with a minimum of 128 patients allocated to either an experimental or control group at a ratio of 1:1. The experimental group will receive standard treatment (systemic and narrative group psychotherapy) with feedback intervention, whereas the control group will receive standard treatment only. The participants are diagnosed with bulimia nervosa, binge eating disorder, or an eating disorder not otherwise specified, according to the DSM-IV. In the experimental group feedback to the participants, based on the Outcome Rating Scale (ORS) and the Group Session Rating Scale (GSRS), is actively added to standard treatment. The ORS assesses areas of life functioning known to change as a result of therapeutic intervention. The GSRS assesses key dimensions of effective therapeutic relationships. In the control group, the patients fill out the Outcome Rating Scale only, and feedback is not provided.The primary outcome is the rate of attendance to treatment sessions. The secondary outcome is the severity of eating disorder symptoms. Exploratory outcomes are the level of psychological and social functioning, and suicide or self-harm. This is measured with the ORS, Symptom Check List, WHO-Five Wellbeing Index, Sheehan Disability Scale and a modified version of the Self-Harm Inventory.
If the results will confirm the hypothesis, this trial will support feedback as a way to improve group treatment attendance for outpatients with eating disorders.
ClinicalTrials.gov identifier: NCT01693237.
Notes
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PubMed ID
24754974 View in PubMed
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No-shows, drop-outs and completers in psychotherapeutic treatment: demographic and clinical predictors in a large sample of non-psychotic patients.

https://arctichealth.org/en/permalink/ahliterature140671
Source
Nord J Psychiatry. 2011 Jun;65(3):183-91
Publication Type
Article
Date
Jun-2011
Author
Morten Fenger
Erik Lykke Mortensen
Stig Poulsen
Marianne Lau
Author Affiliation
Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark. Morten.Fenger@.regionh.dk
Source
Nord J Psychiatry. 2011 Jun;65(3):183-91
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Cross-Sectional Studies
Denmark
Educational Status
Female
Humans
Logistic Models
Male
Mental Disorders - psychology - therapy
Patient Dropouts - psychology - statistics & numerical data
Psychiatric Status Rating Scales
Psychotherapy - statistics & numerical data
Regression Analysis
Substance-Related Disorders - psychology - therapy
Unemployment - psychology - statistics & numerical data
Abstract
A primary challenge in mental health services is a high rate of non-attendance (i.e. no-show and drop-out) for patients referred to treatment for psychiatric disorders.
The aim of the present study was to assess the influence of demographic and clinical variables on mental health treatment attendance and to investigate differences in predictors for no-shows and drop-outs.
A naturalistic study of 2473 non-psychotic consecutive patients offered psychotherapeutic treatment at a community mental health centre in Denmark. Fifteen demographic and clinical variables were recorded at assessment. Bivariate and multiple logistic regression analyses were conducted to investigate the associations between these variables and no-show and drop-out.
Of the 2473 participants, 668 (27.0%) did not show up for treatment, whereas 290 (11.7%) dropped out of treatment. Regression analysis showed that the significant predictors of treatment no-show were: age below 25, no more than the compulsory 9 years of school education, no sick leave, a diagnosis of personality disorder, a Global Assessment of Functioning score (GAF) below 40 or above 70, no previous psychiatric/psychological treatment, no use of antidepressants and substance abuse. The significant predictors of treatment drop-out were: age below 45, no more than the compulsory 9 years of school education or up to 11 years of school education, no vocational/university education, unemployment and substance abuse.
No-show was predicted by both demographic and clinical factors, whereas drop-out was predicted by demographic factors and substance abuse as the only clinical factor. Results and strategies to reduce non-attendance are discussed.
Notes
Erratum In: Nord J Psychiatry. 2011 Jun;65(3):191
PubMed ID
20854221 View in PubMed
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A register-based study of long-term healthcare use before and after psychotherapy.

https://arctichealth.org/en/permalink/ahliterature259109
Source
Nord J Psychiatry. 2014 Oct;68(7):450-9
Publication Type
Article
Date
Oct-2014
Author
Morten Fenger
Erik Lykke Mortensen
Stig Poulsen
Marianne Lau
Source
Nord J Psychiatry. 2014 Oct;68(7):450-9
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adult
Community Mental Health Services - utilization
Delivery of Health Care - utilization
Denmark
Drug Utilization - statistics & numerical data
Female
Health Services Needs and Demand - statistics & numerical data
Hospitals, Psychiatric - utilization
Humans
Male
Mental Disorders - therapy
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Psychotherapy
Psychotropic Drugs - therapeutic use
Registries
Treatment Outcome
Abstract
Psychotherapeutic treatment for non-psychotic disorders is associated with significant reduction in patients' symptoms, and therefore it is believed that treatment improves health and decreases the need for additional healthcare. However, little is known about long-term changes in utilization of healthcare services.
To investigate long-term changes in utilization of public healthcare services for patients referred to psychotherapeutic treatment.
A pre-post study with 761 consecutive patients and 15,220 matched individuals in a matched population reference group. Data from a comprehensive set of healthcare services were collected from central registries for 4 years prior to intake and for 4 years after completion of treatment.
Of the 761 patients, 216 did not show up for treatment and 545 completed treatment. Completer patients achieved a substantial reduction in symptoms (effect size, ES = 0.99). However, completer patients increased their use of all healthcare services by 296% (ES = 0.58) in the 4th year pre-post comparison, while the reference group increased usage by 99% (ES = 0.23). Completer patients had significantly higher increase in contacts with psychiatric hospitals (P
PubMed ID
24274838 View in PubMed
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