The Perceived Impact of Parental Depression on the Narrative Construction of Personal Identity: Reflections from Emerging Adults

This paper presents a narrative analysis of emerging adults’ perceptions of the impact of parental depression on themselves as they reflected back on their lives in their natal home. Archived interview narratives were analyzed from sixteen respondents from a preventive intervention study of depression in families. The perceptions of parental depression and the perceived impact of parental depression were found to fall into five perspectives: resistance (no impact), negativity (being disadvantaged), ambivalent perspectives (disadvantaged but also sensitized), acceptance (reconciling with loss), and, compassion (sensitivity and caregiving). The findings from the narratives indicated that the perceived impacts of parental depression spanned a spectrum of responses, not all of which were negative. Emerging adults with their own history of depression reported a more resistant or negative perceived impact of parental depression, and more boys than girls narrated perceived negative impacts of parental depression on the self. These perspectives on parental depression derived from the narratives offer clinicians and family therapists a means of understanding the impact of depression on emerging adults’ sense of self. Implications of language usage, such as tense and coherence, are also discussed

Using meta-synthesis to support application of qualitative methods findings in practice: a discussion of meta-ethnography, narrative synthesis, and critical interpretive synthesis

Meta-synthesis refers to a range of approaches by which existing qualitative studies in healthcare can bereviewed and compared. There is increasing use of meta-synthesis to ensure the clinical applicability offindings from qualitative studies, in healthcare generally, and in the creative arts therapies specifically.Qualitative method research can sometimes lack immediate clinical relevance, as such studies usuallyfocus on the experiences of a small number of participants. Additionally, the results are often presented ingreat detail; finely elaborated, and described conceptually. Findings reported in this way can be engaging,and even emotionally compelling, however the utility of these outcomes for clinical practice can belimited. Meta-synthesis of multiple studies aims to ensure that findings from qualitative methods studiescan be more easily, and effectively, applied in health and social care programs. Three approaches to metasynthesisare briefly presented here; meta-ethnography, narrative synthesis, and critical interpretivesynthesis. A procedure for presentation of meta-synthesis reviews is provided

IMPLICATIONS OF NATIONAL TRENDS IN DIGITAL MEDIA USE FOR ART THERAPY PRACTICE

This paper presents an overview of national trends in visual art-making and art sharing using digital media, and, the authors’ reflections on the implications of these findings for art therapy practice. These findings were based on a secondary analysis of the 2012 Survey of Public Participation in the Arts administered by the National Endowment for the Arts. Survey findings indicated that increasing proportions of people in the United States are using digital media for creating, archiving, and sharing their art. Reflections by the authors on these findings include support for increase in use of digital media by art therapists for their own art and the need for research about, and, education on best practices for use of digital media

Art therapy for PTSD and TBI: A senior active duty military service member’s therapeutic journey

AbstractArt therapy is increasingly being accepted as a form of complementary and integrative care for military veterans affected by trauma and injuries in the line of duty. Less is known, however, about the applications of art therapy for co-morbid traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). In addition, most studies to date have focused on art therapy with veterans (former military service members) rather than with active duty service members; furthermore, there are no studies that have examined the unique context of PTSD in senior military personnel. This case study presents the therapeutic process through art therapy in the case of a senior active duty military service member (with chronic PTSD and TBI), in the context of an integrated model of care that included medical and complementary therapies

Active-duty military service members’ visual representations of PTSD and TBI in masks

Active-dutymilitary service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, servicemembers participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combatand mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery

From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies:A Scoping Review

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 how and why 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 (Nstudies = 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

Which method is best for the induction of labour?: A systematic review, network meta-analysis and cost-effectiveness analysis

Background: More than 150,000 pregnant women in England and Wales have their labour induced each year. Multiple pharmacological, mechanical and complementary methods are available to induce labour. Objective: To assess the relative effectiveness, safety and cost-effectiveness of labour induction methods and, data permitting, effects in different clinical subgroups. Methods: We carried out a systematic review using Cochrane methods. The Cochrane Pregnancy and Childbirth Group’s Trials Register was searched (March 2014). This contains over 22,000 reports of controlled trials (published from 1923 onwards) retrieved from weekly searches of OVID MEDLINE (1966 to current); Cochrane Central Register of Controlled Trials (The Cochrane Library); EMBASE (1982 to current); Cumulative Index to Nursing and Allied Health Literature (1984 to current); ClinicalTrials.gov; the World Health Organization International Clinical Trials Registry Portal; and hand-searching of relevant conference proceedings and journals. We included randomised controlled trials examining interventions to induce labour compared with placebo, no treatment or other interventions in women eligible for third-trimester induction. We included outcomes relating to efficacy, safety and acceptability to women. In addition, for the economic analysis we searched the Database of Abstracts of Reviews of Effects, and Economic Evaluations Databases, NHS Economic Evaluation Database and the Health Technology Assessment database. We carried out a network meta-analysis (NMA) using all of the available evidence, both direct and indirect, to produce estimates of the relative effects of each treatment compared with others in a network. We developed a de novo decision tree model to estimate the cost-effectiveness of various methods. The costs included were the intervention and other hospital costs incurred (price year 2012–13). We reviewed the literature to identify preference-based utilities for the health-related outcomes in the model. We calculated incremental cost-effectiveness ratios, expected costs, utilities and net benefit. We represent uncertainty in the optimal intervention using cost-effectiveness acceptability curves. Results: We identified 1190 studies; 611 were eligible for inclusion. The interventions most likely to achieve vaginal delivery (VD) within 24 hours were intravenous oxytocin with amniotomy [posterior rank 2; 95% credible intervals (CrIs) 1 to 9] and higher-dose (≥ 50 μg) vaginal misoprostol (rank 3; 95% CrI 1 to 6). Compared with placebo, several treatments reduced the odds of caesarean section, but we observed considerable uncertainty in treatment rankings. For uterine hyperstimulation, double-balloon catheter had the highest probability of being among the best three treatments, whereas vaginal misoprostol (≥ 50 μg) was most likely to increase the odds of excessive uterine activity. For other safety outcomes there were insufficient data or there was too much uncertainty to identify which treatments performed ‘best’. Few studies collected information on women’s views. Owing to incomplete reporting of the VD within 24 hours outcome, the cost-effectiveness analysis could compare only 20 interventions. The analysis suggested that most interventions have similar utility and differ mainly in cost. With a caveat of considerable uncertainty, titrated (low-dose) misoprostol solution and buccal/sublingual misoprostol had the highest likelihood of being cost-effective. Limitations: There was considerable uncertainty in findings and there were insufficient data for some planned subgroup analyses. Conclusions: Overall, misoprostol and oxytocin with amniotomy (for women with favourable cervix) is more successful than other agents in achieving VD within 24 hours. The ranking according to safety of different methods was less clear. The cost-effectiveness analysis suggested that titrated (low-dose) oral misoprostol solution resulted in the highest utility, whereas buccal/sublingual misoprostol had the lowest cost. There was a high degree of uncertainty as to the most cost-effective intervention

Using meta-synthesis to support application of qualitative methods findings in practice: A discussion of meta-ethnography, narrative synthesis, and critical interpretive synthesis

Meta-synthesis refers to a range of approaches by which existing qualitative studies in healthcare can be reviewed and compared. There is increasing use of meta-synthesis to ensure the clinical applicability of findings from qualitative studies, in healthcare generally, and in the creative arts therapies specifically. Qualitative method research can sometimes lack immediate clinical relevance, as such studies usually focus on the experiences of a small number of participants. Additionally, the results are often presented in great detail; finely elaborated, and described conceptually. Findings reported in this way can be engaging, and even emotionally compelling, however the utility of these outcomes for clinical practice can be limited. Meta-synthesis of multiple studies aims to ensure that findings from qualitative methods studies can be more easily, and effectively, applied in health and social care programs. Three approaches to metasynthesis are briefly presented here; meta-ethnography, narrative synthesis, and critical interpretive synthesis. A procedure for presentation of meta-synthesis reviews is provided