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European Review For Medical and... Oct 2023Supporting the psychological well-being of pregnant mothers is critical. The purpose of this study was to map the intervention to improve the psychological well-being of... (Review)
Review
OBJECTIVE
Supporting the psychological well-being of pregnant mothers is critical. The purpose of this study was to map the intervention to improve the psychological well-being of pregnant mothers.
MATERIALS AND METHODS
This research method uses a scoping review with five stages, i.e., problem identification, identification of relevant studies, study selection, data mapping, compiling, summarizing, and reporting results. A systematic search strategy was applied to check for relevant papers dated 2011 until 2021, based on Pubmed, Scopus, Web of Science, Cochrane, Science Direct, Google Scholar, and Grey Literature. PRISMA flowchart was used to select and summarize the studies, and the PCC framework was used for the search strategy. Criteria for inclusion were studies with pure experimental or quasi-experimental designs, focusing on improving women's psychological well-being or mental health, utilizing psychological well-being measures, and written in English with full-text availability.
RESULTS
From 32 articles, 56.24% used randomized control trials (RCT), 28.12% used quasi-experimental, 9.38% used experimental, and 3.13% used a clustered randomized trial and case study methods. 50% of the articles used developed countries, while the remaining 50% used developing countries. 12.50% of the articles used online or web-based for intervention, physical activities, and antenatal education, 9.38% used Cognitive Behavior Therapy (CBT), 21.85% used psychoeducation, 6.25% used mindfulness, Interpersonal Therapy (IPT), training-based, and 3.13% used psychodrama, relaxation, counseling, and happiness therapy. Intervention facilitators were engaged in 25% of the articles, no information regarding facilitators in another 25% of the articles, 21.85% engaged midwives, 12.50% engaged psychologists and physiotherapists, 6.25% engaged health workers, the researchers did 15.63%, and community workers and lectures did the remaining 3.13%.
CONCLUSIONS
Further empirical research to improve the psychological well-being of pregnant mothers needs to be done with a psychoeducational approach considering such communications, the role of the facilitator in intervention, and the research media used.
Topics: Female; Pregnancy; Humans; Psychological Well-Being; Mothers; Cognitive Behavioral Therapy; Mental Health; Evidence-Based Medicine; Randomized Controlled Trials as Topic
PubMed: 37916351
DOI: 10.26355/eurrev_202310_34161 -
Cureus Apr 2023Cognitive behavioural therapy (CBT) has heightened the need for internet-delivered intervention for depression with chronic diseases than a traditionally-based treatment... (Review)
Review
Cognitive behavioural therapy (CBT) has heightened the need for internet-delivered intervention for depression with chronic diseases than a traditionally-based treatment procedure, and the need for CBT as an internet-delivered intervention has increased because it scales down the stigma of proceeding to a therapist, saves travel time from different geographical areas, and increases access to the service. This study aimed to evaluate the contemporary evidence for the effectiveness of internet-delivered cognitive behavioural therapy (CBT) as a treatment option for depression with chronic illness (CVD, diabetes, chronic pain, cancer, and chronic obstructive pulmonary disease (COPD)) among adult populations in high-income countries. A systematic search strategy was devised based on selecting search terms, inclusion and exclusion criteria, and refinement processes. Electronic searches were conducted using databases related to healthcare and containing peer-reviewed literature: the Cumulated Index to Nursing and Allied Health Literature (CINAHL), the Excerpta Medica Database (Embase), the Medical Literature Analysis and Retrieval System Online (Medline), and PsycINFO. Key search terms were applied to all databases and combined using Boolean operators to maximise the efficiency of the search. This review included randomised controlled trials (RCTs) evaluating the adult population aged ≥18 years published from 2006-2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was employed to guide the review process. The initial search yielded 134 studies across all databases, which were refined, leading to 18 studies in the final review data set. This review suggests that internet-based CBT is an effective strategy for reducing depressive symptoms in patients with comorbid depression and chronic diseases.
PubMed: 37213982
DOI: 10.7759/cureus.37822 -
Healthcare (Basel, Switzerland) Mar 2023As a creative form of psychotherapy, drama appears to assist individuals in the COVID-19 pandemic and post-pandemic period in altering crisis conditions and challenging... (Review)
Review
Effectiveness of Drama-Based Intervention in Improving Mental Health and Well-Being: A Systematic Review and Meta-Analysis during the COVID-19 Pandemic and Post-Pandemic Period.
As a creative form of psychotherapy, drama appears to assist individuals in the COVID-19 pandemic and post-pandemic period in altering crisis conditions and challenging negative perspectives. Drama-based intervention is presented as an option for addressing mental health issues in clinical and general populations by utilising various multidisciplinary sources, such as psychodrama and role playing. In this study, a systematic review and meta-analysis were employed to assess the impact of drama on mental health and well-being during the COVID-19 pandemic and post-pandemic. Four electronic databases (PubMed, Cochrane, Web of Science, and ScienceDirect) were extensively searched from December 2019 to October 2022. Quality assessment and Risk of Bias tool of the Cochrane Collaboration were performed. Using a random effect model, standardised mean difference (SMD) values and 95% confidence intervals (CI) were calculated. In the final analysis, 25 studies involving 797 participants were included. The study revealed that drama-based interventions have the potential to improve mental health (e.g., trauma-related disorders) and well-being (e.g., psychological well-being), which could position drama as an adjunctive method of mental health care. This original review offered the newer, more comprehensive recommendations for drama-based intervention based on evidence.
PubMed: 36981496
DOI: 10.3390/healthcare11060839 -
Frontiers in Psychiatry 2021Almost a century after Jacob Levy Moreno pioneered the group practice of psychodrama, research in this area has flourished to include different sub-fields of study and...
Almost a century after Jacob Levy Moreno pioneered the group practice of psychodrama, research in this area has flourished to include different sub-fields of study and psychodramatic intervention for various psychological conditions. By making use of scientometric analysis, particularly document citation analysis and keyword analysis, this study maps out dominant research domains in psychodrama since its inception. From these findings, projections of future research trends and an evaluation of psychodrama research are discussed. Generally, there has been an increased adoption of technology to facilitate psychodrama practice, along with an increasing integration of psychodramatic principles with other psychotherapies. To improve research in this area, this paper recommends greater transparency in the reporting of materials, processes and data used in publications. Finally, we encourage embracing new technological methods such as neuroimaging to provide greater insight into mechanisms of change in psychodrama. The field of psychodrama remains full of potential and innovations to be developed.
PubMed: 34867562
DOI: 10.3389/fpsyt.2021.780542 -
Frontiers in Psychology 2021Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy)...
Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear and the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review ( = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: "embodiment," "concretization," and "symbolism and metaphors." The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.
PubMed: 34366998
DOI: 10.3389/fpsyg.2021.678397 -
International Journal of Environmental... Apr 2021The aim of this study was to carry out a systematic review of controlled clinical trials in order to identify both specific populations and social issues which may...
The aim of this study was to carry out a systematic review of controlled clinical trials in order to identify both specific populations and social issues which may benefit from the effective use of psychodrama psychotherapy. A search was conducted in the WoS, SCOPUS, PsychINFO, Medline, Academic Search Ultimate, ProQuest, and PubPsych databases, complemented by a manual search on relevant websites and in the reference lists of the selected studies. Randomized controlled trials (RCTs) and quasi-RCTs of group-based psychodrama psychotherapy were included. The Effective Public Health Practice Project (EPHPP) tool was adopted to assess the methodological quality of the included studies. The search identified 14 RCTs and one quasi-RCT evaluating the effects of group-based psychodrama psychotherapy. The total number of participants in the studies was 642 people. Seven studies were conducted in Turkey, two in the USA, two in Finland, one in Canada, one in Brazil, one in Italy, and one in Iran. The heterogeneity of the issues analyzed indicates that psychodrama improves the symptoms associated with a wide range of problems. Despite psychodrama's long history, most clinical trials in this field have been published this century, which suggests not only that this psychotherapeutic practice remains relevant today but also that it continues to attract substantial interest among the scientific community. Nevertheless, further research efforts are required to understand its potential benefits for psychosocial well-being.
Topics: Brazil; Canada; Controlled Clinical Trials as Topic; Finland; Humans; Iran; Italy; Psychodrama; Psychotherapy, Group; Turkey
PubMed: 33922138
DOI: 10.3390/ijerph18094442 -
The Cochrane Database of Systematic... Feb 2021Communication is a common element in all medical consultations, affecting a range of outcomes for doctors and patients. The increasing demand for medical students to be... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Communication is a common element in all medical consultations, affecting a range of outcomes for doctors and patients. The increasing demand for medical students to be trained to communicate effectively has seen the emergence of interpersonal communication skills as core graduate competencies in medical training around the world. Medical schools have adopted a range of approaches to develop and evaluate these competencies.
OBJECTIVES
To assess the effects of interventions for medical students that aim to improve interpersonal communication in medical consultations.
SEARCH METHODS
We searched five electronic databases: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and ERIC (Educational Resource Information Centre) in September 2020, with no language, date, or publication status restrictions. We also screened reference lists of relevant articles and contacted authors of included studies.
SELECTION CRITERIA
We included randomised controlled trials (RCTs), cluster-RCTs (C-RCTs), and non-randomised controlled trials (quasi-RCTs) evaluating the effectiveness of interventions delivered to students in undergraduate or graduate-entry medical programmes. We included studies of interventions aiming to improve medical students' interpersonal communication during medical consultations. Included interventions targeted communication skills associated with empathy, relationship building, gathering information, and explanation and planning, as well as specific communication tasks such as listening, appropriate structure, and question style.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane. Two review authors independently reviewed all search results, extracted data, assessed the risk of bias of included studies, and rated the quality of evidence using GRADE.
MAIN RESULTS
We found 91 publications relating to 76 separate studies (involving 10,124 students): 55 RCTs, 9 quasi-RCTs, 7 C-RCTs, and 5 quasi-C-RCTs. We performed meta-analysis according to comparison and outcome. Among both effectiveness and comparative effectiveness analyses, we separated outcomes reporting on overall communication skills, empathy, rapport or relationship building, patient perceptions/satisfaction, information gathering, and explanation and planning. Overall communication skills and empathy were further divided as examiner- or simulated patient-assessed. The overall quality of evidence ranged from moderate to very low, and there was high, unexplained heterogeneity. Overall, interventions had positive effects on most outcomes, but generally small effect sizes and evidence quality limit the conclusions that can be drawn. Communication skills interventions in comparison to usual curricula or control may improve both overall communication skills (standardised mean difference (SMD) 0.92, 95% confidence interval (CI) 0.53 to 1.31; 18 studies, 1356 participants; I² = 90%; low-quality evidence) and empathy (SMD 0.64, 95% CI 0.23 to 1.05; 6 studies, 831 participants; I² = 86%; low-quality evidence) when assessed by experts, but not by simulated patients. Students' skills in information gathering probably also improve with educational intervention (SMD 1.07, 95% CI 0.61 to 1.54; 5 studies, 405 participants; I² = 78%; moderate-quality evidence), but there may be little to no effect on students' rapport (SMD 0.18, 95% CI -0.15 to 0.51; 9 studies, 834 participants; I² = 81%; low-quality evidence), and effects on information giving skills are uncertain (very low-quality evidence). We are uncertain whether experiential interventions improve overall communication skills in comparison to didactic approaches (SMD 0.08, 95% CI -0.02 to 0.19; 4 studies, 1578 participants; I² = 4%; very low-quality evidence). Electronic learning approaches may have little to no effect on students' empathy scores (SMD -0.13, 95% CI -0.68 to 0.43; 3 studies, 421 participants; I² = 82%; low-quality evidence) or on rapport (SMD 0.02, 95% CI -0.33 to 0.38; 3 studies, 176 participants; I² = 19%; moderate-quality evidence) compared to face-to-face approaches. There may be small negative effects of electronic interventions on information giving skills (low-quality evidence), and effects on information gathering skills are uncertain (very low-quality evidence). Personalised/specific feedback probably improves overall communication skills to a small degree in comparison to generic or no feedback (SMD 0.58, 95% CI 0.29 to 0.87; 6 studies, 502 participants; I² = 56%; moderate-quality evidence). There may be small positive effects of personalised feedback on empathy and information gathering skills (low quality), but effects on rapport are uncertain (very low quality), and we found no evidence on information giving skills. We are uncertain whether role-play with simulated patients outperforms peer role-play in improving students' overall communication skills (SMD 0.17, 95% CI -0.33 to 0.67; 4 studies, 637 participants; I² = 87%; very low-quality evidence). There may be little to no difference between effects of simulated patient and peer role-play on students' empathy (low-quality evidence) with no evidence on other outcomes for this comparison. Descriptive syntheses of results that could not be included in meta-analyses across outcomes and comparisons were mixed, as were effects of different interventions and comparisons on specific communication skills assessed by the included trials. Quality of evidence was downgraded due to methodological limitations across several risk of bias domains, high unexplained heterogeneity, and imprecision of results. In general, results remain consistent in sensitivity analysis based on risk of bias and adjustment for clustering. No adverse effects were reported. AUTHORS' CONCLUSIONS: This review represents a substantial body of evidence from which to draw, but further research is needed to strengthen the quality of the evidence base, to consider the long-term effects of interventions on students' behaviour as they progress through training and into practice, and to assess effects of interventions on patient outcomes. Efforts to standardise assessment and evaluation of interpersonal skills will strengthen future research efforts.
Topics: Communication; Education, Medical; Empathy; Humans; Information Management; Interpersonal Relations; Medical History Taking; Non-Randomized Controlled Trials as Topic; Patient Satisfaction; Patient Simulation; Randomized Controlled Trials as Topic; Role Playing; Students, Medical
PubMed: 33559127
DOI: 10.1002/14651858.CD012418.pub2 -
The Psychiatric Quarterly Sep 2020This investigation reviews the effectiveness of anti-stigma interventions employed at educational institutes; to improve knowledge, attitude and beliefs regarding mental...
This investigation reviews the effectiveness of anti-stigma interventions employed at educational institutes; to improve knowledge, attitude and beliefs regarding mental health disorders among students. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guidelines were followed and protocol was registered in PROSPERO (CRD42018114535). Forty four randomized controlled trials were considered eligible after screening of 104 full-text articles against inclusion and exclusion criteria.Several interventions have been employed to tackle stigma toward psychiatric illnesses, including education through lectures and case scenarios, contact-based interventions, and role-plays as strategies to address stigma towards mental illnesses. A high proportion of trials noted that there was a significant improvement for stigma (19/25, 76%), attitude (8/11, 72%), helping-seeking (8/11, 72%), knowledge of mental health including recognition of depression (11/14, 78%), and social distance (4/7, 57%). These interventions also helped in reducing both public and self-stigma. Majority of the studies showed that the anti-stigma interventions were successful in improving mental health literacy, attitude and beliefs towards mental health illnesses.
Topics: Health Education; Health Knowledge, Attitudes, Practice; Humans; Mental Disorders; Mentally Ill Persons; Psychosocial Intervention; Role Playing; Social Stigma
PubMed: 32372401
DOI: 10.1007/s11126-020-09751-4 -
PloS One 2019Psychodrama is an experiential psychotherapy in which guided role-play is used to gain insights and work on personal and interpersonal problems and possible solutions....
BACKGROUND
Psychodrama is an experiential psychotherapy in which guided role-play is used to gain insights and work on personal and interpersonal problems and possible solutions. Despite the wealth of literature describing clinical work, psychodrama intervention research is relatively scarce compared to other psychotherapies and psychological interventions.
OBJECTIVE
For this reason we implemented the integrative approach to systematic review that authorizes the combination of publications with diverse methodologies and all types of participants, interventions, comparisons, and outcomes. Our aim was to produce a comprehensive summary of psychodrama intervention research in the last decade that critically evaluates methodological issues to inform future studies.
METHODS
We searched four major electronic databases (PsycINFO, PubMEd, Scopus by Elsevier, and Web of Science) for peer-reviewed articles on psychodrama interventions published in English between 1 January 2007 and 31 December 2017. The quality of qualitative and mixed methods studies was assessed on the basis of pre-established guidelines, and the risk of bias was assessed for all quantitative randomized control studies, consistent with the PRISMA protocol.
FINDINGS
The database search and a hand search resulted in 31 psychodrama intervention publications. Overall, these studies examined the effects of psychodrama on more than 20 different outcomes and most studies had adult clients. The next largest group was adolescents, whereas only two studies involved children. Thus psychodrama intervention research in the last decade suggests there are promising results in all methodologies, and highlights the need to enhance methodological as well as reporting quality and to theorize and examine modality-specific mechanisms that lead to therapeutic change. Recommendations to improve methodology, transparency, and specificity in reporting future psychodrama and other psychotherapy research are discussed.
Topics: Bias; Crisis Intervention; Humans; Psychodrama; Qualitative Research; Treatment Outcome
PubMed: 30779787
DOI: 10.1371/journal.pone.0212575 -
Frontiers in Psychology 2018The original theory of psychodrama proposed by Moreno in 1921 has been adjusted and re-interpreted by several authors over the last three decades. This resulted in the...
The original theory of psychodrama proposed by Moreno in 1921 has been adjusted and re-interpreted by several authors over the last three decades. This resulted in the proliferation of techniques whose definitions and contexts of application are unclear and poorly documented in the literature. The purpose of this review was three-fold: (1) to identify the psychodramatic techniques currently used for research and clinical purposes, (2) to extract and create a list of core techniques which are consensually used by psychodramatists, and which reflect the main principles of the Morenian theory of psychodrama, and (3) to propose an operationalised definition of the core psychodramatic techniques identified. To achieve this, a systematic review was conducted, according to the PRISMA guidelines (Moher et al., 2009). The search was conducted between June and September of 2012 in the main electronic databases (e.g., PubMed, Embase, PsychINFO) and using the following keywords: "psychodrama," "group psychotherapy," "experiential psychotherapy," "Moreno," "intervention," and "techniques." Fifty-six techniques were extracted from the 21 papers selected for review. Of these, a preliminary list of 30 techniques was selected, which was reduced to a total of 11 core techniques: soliloquy, double, mirror, role reversal, resistance interpolation, sculpture, social atom, intermediate objects, games, sociometry, role training. The credibility of this final core list was first checked with an expert in Morenian psychodrama, and later discussed with a network of 22 European psychodramatists to ensure full consensus. Overall, this review provides a contemporary framework for psychodramatists that reconciles the current approaches to psychodrama with the core techniques proposed by Moreno, and updates the definitions of these techniques, by merging the interpretations of different experts in the field. To have a list of core techniques which is consensually accepted from an international point of view is paramount not only for future research, but also for training purposes. The implications of this review for clinical practice are also discussed.
PubMed: 30087638
DOI: 10.3389/fpsyg.2018.01263