27 research outputs found
‘Shutting the world out’: an Interpretative Phenomenological Analysis exploring the paternal experience of parenting a young adult with a developmental disability
Background: An in-depth exploration of the experience of midlife fathers of developmentally disabled young adults (aged 19-32 years) was motivated by a dearth of research in this area (McKnight, 2015).
Method: Five fathers participated in semi-structured interviews which were subjected to interpretative phenomenological analysis (Smith, Flowers and Larkin, 2009).
Results: The final thematic structure comprises four inter-related themes. They demonstrate a high degree of concern for children’s well-being; the joy adult children confer on their father’s lives as well as the difficulties men experience in response to the limited opportunities available to their offspring. Importantly findings also illustrate the way in which men struggle to contend with painful emotion
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The therapeutic relationship in Cognitive Behaviour Therapy with depressed adolescents: a qualitative study of good-outcome cases
Objectives. This paper aimed to explore client experiences of the therapeutic
relationship among adolescents with good outcomes after receiving Cognitive Behaviour
Therapy (CBT) for moderate to severe depression.
Design. This was a qualitative study employing Interpretative Phenomenological
Analysis (IPA).
Methods. As part of a randomized clinical trial, 77 adolescents with moderate to severe
depression were interviewed using a semi-structured interview, which was audiorecorded. Five of these interviews, with adolescents aged 14–18 years who completed
CBT and had good outcomes, were purposively sampled and analysed using IPA.
Results. The findings indicated that a positive therapeutic relationship was fostered with
therapists who respected the adolescents’ autonomy and sense of individuality, while
offering experiences of emotional closeness and connection. This was achieved by
balancing the dual roles of being ‘friendly’ and affable, with being a ‘professional expert’
thereby embodying a collaborative and egalitarian approach.
Conclusions. The therapeutic relationship in CBT can help to motivate adolescents to
engage with cognitively and emotionally challenging tasks. By providing an understanding
of what helps and hinders the development of a positive therapeutic relationship, the
current findings offer important insight into how therapists can foster positive
relationships with depressed adolescents. This knowledge will make it more likely that
adolescents will engage in the treatment process and in turn experience greater
therapeutic gains
The experience of sleep problems for adolescents with depression in short-term psychological therapy
A growing body of literature demonstrates a strong relationship between sleep disturbances and depression in adolescence. In spite of this, few studies have explored how adolescents with depression experience sleep problems. The present study aimed to qualitatively explore the experience of sleep problems in adolescents with depression, including their understanding of how a psychological therapy impacted on these sleep difficulties. The sample included 12 adolescents with sleep disturbances who had been offered treatment for depression through a large, multi-centre, randomised controlled trial. Semi-structured interviews conducted after treatment and 1-year post treatment were analysed using thematic analysis. Two main themes were identified. Both themes demonstrated how an overarching desire to escape impacted the adolescents’ sleep in distinct ways; ‘thinking about the ‘bad stuff’’ was characterised by ruminative thinking, which prevented sleep, whereas ‘sleep as an escape’ indicated a desire to sleep excessively due to feelings of helplessness. Overall, the findings demonstrate a nuanced relationship between sleep and depression in adolescence, and imply that the underlying meaning of the sleep difficulties for each young person should be considered in the delivery of therapy for adolescent depression
On Lange and Ryan's plotting technique for diagnosing non-normality of random effects
For linear mixed models, Lange and Ryan's plot [Lange, N., Ryan, L., 1989. Assessing normality in random effects models. Ann. Statist. 17, 624-642] was derived for diagnosing random effect distributions. We show it is sensitive to both non-normality of random effects and mis-specified mean models, and thus may be more useful as a general diagnostic.Linear mixed models Random intercept Random slope Diagnostics
Meaning and medication: a thematic analysis of depressed adolescents’ views and experiences of SSRI antidepressants alongside psychological therapies
Abstract Background Adolescence is a key period of risk for the emergence of Major Depressive Disorder (MDD). The prescription of selective serotonin re-uptake inhibitors (SSRIs) for the treatment of depression in adolescents is an issue of worldwide controversy, and evidence regarding their safety and efficacy is inconclusive. In the UK, NICE guidelines have recently recommended offering SSRIs to adolescents alongside psychological therapy or on their own if therapy is refused. Thus, SSRIs are increasingly becoming a major component of treatment for adolescents. This study qualitatively explored adolescents’ views and experiences of SSRIs within their accounts of engaging in a psychological therapy for depression, particularly focusing on meanings they attached to medication-use. Methods The qualitative study reports data from semi-structured interviews conducted 12-months post-treatment with 12 adolescents who were clinically referred and treated for depression as part of the IMPACT trial. The interviews were analysed using Thematic Analysis. Results Four themes were identified: ‘a perceived threat to autonomy’, ‘a sign of severity’, ‘a support, not a solution’, and ‘an ongoing process of trial and error’. Conclusions This study highlights the value of bringing adolescents’ voices into the broader debate on the use of antidepressants in their age group and in the development of future guidelines. Future implications for research and clinical practice are discussed
The therapy process with depressed adolescents who drop out of psychoanalytic psychotherapy: an empirical case study
Psychotherapy dropout is a common phenomenon in youth mental health, often due to dissatisfaction with treatment. However, little is known about the therapeutic processes that precede dropout due to dissatisfaction. This mixed-methods empirical case study aimed to explore the therapeutic process of a 12-session, prematurely ended therapy with a young person with depression in short-term psychoanalytic psychotherapy (STPP). The Adolescent Psychotherapy Q-set (APQ), an empirically validated process measure, was used as a framework for qualitative analysis exploring the therapy process over time. Analysis of APQ ratings of the 12 sessions found a productive patient-therapy dyad working collaboratively to understand the young person’s experiences and emotions. Following an initial phase of the young person presenting as emotional and vulnerable, she became increasingly ambivalent about continuing in psychotherapy. A lively and argumentative period exploring the young person’s ambivalence and increased sense of well-being culminated in eventual dropout. This study suggests that even in a strong, collaborative working relationship with an engaged young person, ambivalence around dependency and vulnerability can threaten treatment completion. Therapists’ enhanced sensitivity to relevant processes that precede therapy dropout have the potential to improve engagement of young people in psychotherapy, which may optimise outcomes