The Melbourne Study of Psychoanalytic Psychotherapy III: Patients' and psychotherapists’ perspectives on progress and challenges

Qualitative exploration of the experience of psychoana-lytic psychotherapy complemented the quantitative eval-uation of mental health and life functioning improvements in the Melbourne Study of Psychoanalytic Psychotherapy. Twice-weekly treatment was offered to adults for 2years by the private sector Glen Nevis Clinic for Psychoanalytic Psychotherapy, established by the Victorian Association of Psychoanalytic Psychotherapists as a subsidized, low-cost community service over 8years. This paper is the second of two presenting the qualitative arm of the study, involv-ing in-depth narrative interviews with patients and psycho-therapists. Analysis of 143 transcripts further contributes to evidence of the Reach, Effectiveness, Adoption, Imple-men tation and Maintenance of psychoanalytic psycho-therapy in a community setting. The first qualitative paper reports themes concerning patient expectations of psycho-therapy and perspectives of both patients and psychother-apists on the experience and benefits of the treatment. This paper reports what was perceived by participants as facili-tative or challenging for therapeutic progress, illuminating how experiences of the nature of psychoanalytic psycho-therapy may have affected the Implementation, Effectivenessand Maintenance of the program. The most notable facilita-tive factors emerging were the exploratory, insight-oriented nature of the work, elements of the patient-psychotherapist relationship, and the frame of the treatment. Challenges were also often seen as inherent to Effectiveness; however, proposing the frame of 2-year treatment, as both an expecta-tion and a limit, probably inhibited program Reach, Adoptionand overall Implementation. The limitations and strengths of the qualitative arm of the research, together with implica-tions for further investigation, are discussed

The Melbourne Study of Psychoanalytic Psychotherapy II: Patients' and psychotherapists' perspectives on expectations, therapeutic experience and benefits

The naturalistic, longitudinal Melbourne Study of Psycho-analytic Psychotherapy was conducted in a subsidized community clinic established by the Victorian Association of Psychoanalytic Psychotherapists as a demonstration project operating over 8years. It offered lower SES adults twice-weekly psychoanalytic psychotherapy for 2years. An independent research program used the RE-AIM planning and evaluation framework to investigate the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. Complementary quantitative and qualitative methodologies studied mental health and general-life functioning outcomes and underlying processes of treatment. Two papers pres-ent the qualitative arm of the research, exploring the lived experience of the psychotherapy, reported contemporane-ously and retrospectively by patients and psychotherapists. This first paper details the qualitative design and methods employed. In-depth semi-structured narrative interviews during psychotherapy, upon completion at 2years, and at an additional 8-month follow-up point for patients, were conducted. Analysis of the narrative transcripts of 143 participant interviews revealed themes regarding patient expectations of treatment and the perceptions of both patients and psychotherapists of the long-term psychoana-lytic psychotherapy experience and its benefits. Narratives thus provided evidence of the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. The findings enrich understanding of the effective processes underlying the outcomes of the quantitative arm of the study reported separately. The second qualitative paper presents the find-ings concerning participants' experiences of facilitative and challenging aspects of the treatment, as well as the implica-tions of the qualitative findings overall

The Melbourne Study of Psychoanalytic Psychotherapy low‐cost clinic I: Implementation, mental health and life functioning gains

The Melbourne Study of Psychoanalytic Psychother-apy examined the implementation, lived experience, and perceived therapeutic gains of psychoanalytic psychother-apy in a low-cost, private-sector community clinic. A first in Australia, this 8-year demonstration project allowed natural-istic study of the impact and process of intensive, long-term, time-limited psychoanalytic psychotherapy delivered to self-referred adults by clinicians with a common theoretical frame of practice. Presented in three papers, the research employed the RE-AIM planning and evaluation framework, using complementary quantitative and qualitative methods, to study the psychotherapy service in terms of Reach, Effec-tiveness, Adoption, Implementation and Maintenance. This first paper reports the Reach of the program to be 67% for those presenting for assessment for psychoanalytic psycho-therapy, with Adoption of the full 2-year treatment program being 60%. Improvements in mental health and life function-ing provided quantitative evidence of Effectiveness for those completing the 2-year treatment program, with Maintenanceat 8-month follow-up. Patient age, gender and personality

Advancing Symptom Science Through Use of Common Data Elements

BACKGROUND: Use of common data elements (CDEs), conceptually defined as variables that are operationalized and measured in identical ways across studies, enables comparison of data across studies in ways that would otherwise be impossible. Although healthcare researchers are increasingly using CDEs, there has been little systematic use of CDEs for symptom science. CDEs are especially important in symptom science because people experience common symptoms across a broad range of health and developmental states, and symptom management interventions may have common outcomes across populations. PURPOSES: The purposes of this article are to (a) recommend best practices for the use of CDEs for symptom science within and across centers; (b) evaluate the benefits and challenges associated with the use of CDEs for symptom science; (c) propose CDEs to be used in symptom science to serve as the basis for this emerging science; and (d) suggest implications and recommendations for future research and dissemination of CDEs for symptom science. DESIGN: The National Institute of Nursing Research (NINR)-supported P20 and P30 Center directors applied published best practices, expert advice, and the literature to identify CDEs to be used across the centers to measure pain, sleep, fatigue, and affective and cognitive symptoms. FINDINGS: We generated a minimum set of CDEs to measure symptoms. CONCLUSIONS: The CDEs identified through this process will be used across the NINR Centers and will facilitate comparison of symptoms across studies. We expect that additional symptom CDEs will be added and the list will be refined in future work. CLINICAL RELEVANCE: Symptoms are an important focus of nursing care. Use of CDEs will facilitate research that will lead to better ways to assist people to manage their symptoms

North Carolina's Pediatric Obesity Clinician Reference Guide and Tool Kit

This poster presents the tools developed by clinicians treating childhood obesity in North Carolina. The history of the development of these tools is outlined at the end of the accompanying abstract submission to the 2009 CDC Weight of the Nation Conference

North Carolina's Pediatric Obesity Clinician Reference Guide and Tool Kit

This poster presents the tools developed by clinicians treating childhood obesity in North Carolina. The history of the development of these tools is outlined at the end of the accompanying abstract submission to the 2009 CDC Weight of the Nation Conference

Famille, vieillissement, territoire et innovation sociale

Ce numéro thématique s’intéresse aux principaux enjeux et défis associés au vieillissement démographique en regard de l’amélioration de l’inclusion sociale et de la qualité de vie des aînés. Les articles qui le composent mettent en exergue le remodelage du lien social entre les personnes âgées, le territoire, leur famille et l’ensemble de la société en s’appuyant sur divers cas au Québec et en France. Ceux-ci touchent la retraite en milieu agricole, les stratégies déployées face aux difficultés financières, les impacts du vieillissement sous la loupe de l’aménagement urbain, la démarche « Municipalités amies des aînés » et le soutien aux proches aidants. Enfin, trois articles Hors thème complètent ce numéro. Le premier traite de la séparation conjugale ; le deuxième du soutien parental dont bénéficient des jeunes trans ; le dernier s’intéresse aux relations de jeunes adultes ayant été exposés à de la violence conjugale dans leur enfance ou adolescence