Spiritually integrated psychotherapy

There is growing recognition that it is important to understand how spirituality is related to mental health and distress, and how it can be integrated into psychotherapy. Spiritually integrated psychotherapy (SIP) involves the adaptation of secular psychotherapies in order to be more culturally sensitive and client-centred to spiritually and religiously inclined clients. Literature shows that SIPs are at least as effective as conventional psychotherapy for treating different mental disorders, and cognitive behavioural therapy (CBT) is the most widely investigated clinical modality that has been adapted to include spiritual content. The objective of this chapter is to describe the adaptation of traditional CBT techniques by integrating spirituality to enhance cognitive restructuring, behavioural activation, coping, psychoeducation, and to facilitate greater motivation for treatment. Several practical examples are given, including the use of meditation and prayer in the treatment process.

Multifactor Regression Models of Adherence to Treatment in Patients with Schizophrenia and Schizophrenic Spectrum Disorders and Their Relatives

Purpose: formation of multifactor regression models of adherence to treatment of patients with schizophrenia and schizophrenic spectrum disorders and their family members to identify the relationship with socio-demographic, clinical, psychological characteristics, family environment factors and the quality of psychiatric care in order to develop measures to improve the compliance of these groups.Patients and methods: the study involved 107 patients (44 men and 63 women), with diagnoses of schizophrenia (F.20), schizoaffective (F.25) and schizotypal disorders (F.21), eligible the ICD-10 criteria, as well as 105 of their relatives (27 men and 78 women). The following methods were used: сlinical and psychopathological, psychometric, psychological, statistical (correlation and regression analysis), methods of system analysis, method of hierarchy analysis.Results: regression models were built and factors positively or negatively influencing adherence to treatment in groups of patients and their relatives, formed depending on gender differences, awareness of the disease or its denial, as well as on the clinical characteristics of patients, were identified. Gender factors affecting adherence to treatment in men include social functioning, education and income; for women — the motivation for treatment and characteristics of family relationships. In the groups of patients and their relatives, selected depending on the awareness of the disease or its denial, the dominant factors influencing compliance were the duration of the disease, the frequency of hospitalizations, patients’ disability, the level of education of relatives, forgetfulness of taking medications, etc. In groups, depending on the clinical characteristics of patients, the compliance of patients and relatives was influenced by the age of the patient, the level of motivation for treatment of patients and their relatives, the employment of patients and the level of their social functioning, conflict, hostile relations in the family and a number of other factors.Conclusion: knowledge of the factors that affect the adherence to treatment of schizophrenia patients and their family members will contribute to the development of practical measures to improve it. Psychosocial interventions have been proposed to increase adherence to treatment in patients with schizophrenia and schizophrenic spectrum disorders and their families.

Correlates of motivation for treatment among alcohol service users in Uganda

Purpose Given the scarce literature on alcohol use disorders (AUD) and their treatment in developing countries, this paper aims to explore motivation levels and their correlates among alcohol service users in two residential treatment centres in Kampala, Uganda. This study how motivation levels of Ugandan alcohol service users compare with those from American studies; and the specific factors affecting internal and external motivation in the Ugandan context. Design/methodology/approach The motivation for treatment was measured among 100 individuals entering AUD treatment using the Texas Christian University (TCU) Treatment needs and Motivation scale. The WHOQoL–BREF, Addiction Severity Index–6 and Hopkins Symptoms Check List–37 were used to measure addiction severity, quality of life (QoL) and psychopathology, respectively. Correlates of motivation were identified using linear regression analyses. Findings Ugandan service users demonstrated low treatment motivation in the treatment needs a domain. While addiction severity (recent heavy alcohol use) and participating in private treatment were associated with higher internal and external motivation, deterioration in physical and environmental QoL, depressive symptoms and lower education were linked with higher internal motivation. Research limitations/implications Different elements affect domains of treatment motivation, requiring attention for clients’ unique needs as influenced by their background, addiction severity, QoL, psychological needs and contextual factors (e.g. treatment setting). Further studies are needed to explore additional correlates of motivation for treatment among alcohol service users in Uganda and to assess the longitudinal impact of motivation on treatment outcomes. Originality/value Although motivation has been extensively studied, clinicians are challenged in understanding and explaining motivational dynamics given the multiplicity of factors influencing change-related decisions and behaviours and the diversity in substance-using populations. This need is even bigger in non-Western societies as cultural differences may require differential therapeutic management. This is one of the first studies measuring motivation for AUD treatment in a low-income country and offers insight for understanding motivation dynamics in similar settings.

The subjective concept of morbidity: its assessment and connection with the motivation for treatment in persons who underwent psychosis

Medication compliance and motivation for treatment, as adaptive- compensatory reactions of patients to the awareness of the fact of their own ill- being, are based on subjective perception of the disorder. To date, there is a shortage of objective methods for assessing the subjective concept of morbidity in psychotic patients.160 inpatients with psychosis in anamnesis were examined: nosologically according ICD-10 80%—F2, 11%—F3, 9%—F0. A self-questionnaire was adapted to the Russian language for determining the subjective meaning and significance of psychosis (Susi). The results of its internal and external (when compared with data on the severity of productive and negative symptoms, subjective assessment of the severity of the condition and treatment motivation of patients) validation are presented.Conclusions. The applicability of the concept of subjective morbidity in patients with mental disorders is shown. The role of the subjective attitude to the disease in case of its perception as a destructive life event is associated in patients with a violation of the structure of motivation for treatment. On the contrary, the ability of patients to form a subjective meaning of the disease can be considered as a guarantee of more intense therapeutic motivation.

The Warrior’s Journey Intervention: A Chaplain-Led Motivational, Preparatory Exercise for Enhancing Treatment Success

Outcome literature has shown poor treatment engagement in efficacious, evidence-based post-traumatic stress disorder (PTSD) programs among returning veterans with combat-related psychological symptoms and calls for the development of motivational, preparatory exercises that circumvent stigma-related barriers and are delivered before or during the orientation phase of treatment. The psychological states of hope, meaning, and guilt have been found to impact motivation for treatment and the development and maintenance of post-trauma pathology and symptom severity. Given a chaplain’s less stigmatized role, as compared to mental health providers, and proficiency in assessing these states and providing interventions that mediate change, often before a veteran is enrolled in a PTSD treatment program, this paper introduces a brief, chaplain-led, preparatory exercise called the “Warrior’s Journey Intervention” (WJI). This narrative based, meaning-making exercise is designed to improve motivation for treatment and mitigate post-trauma symptoms by impacting hope, meaning, and guilt through use of a universally shared, metaphoric story of trauma recovery. A case study will demonstrate use of the intervention, observe its effects, and analyze mechanisms of change. Research is recommended at the end of the article to test the hypothesis that the intervention promotes motivation for treatment and reduces symptoms of PTSD and Moral Injury (MI). A standardized manual for the exercise is available from author.

Evaluation of Motivation for the Treatment of Drug Addicts with Personality Disorders

Lack of motivation for the treatment of drug addiction is associated with dropout and relapses. Further, personality disorders (PD) have traditionally been linked to low motivation and therapeutic failure. Thus, the present study aims to analyze the structure of the Motivation for Treatment Questionnaire (MTQ–8), as well as to determine differences in motivation due to the presence of PD and the impact of psychological adjustment on motivation. The sample included 125 patients (84% male) who started a treatment for their addiction to cocaine and alcohol. Rasch analysis was applied for the first objective, and means contrast and regression analysis for the others. The two subscales of the MTQ–8 fit the Rasch model, with appropriate psychometric characteristics when merging Items 5 and 7. The presence of PD was not associated with reduced motivation. Motivation for treatment was greater when abstinence was less than three weeks, and psychological distress predicted motivation for treatment. The present study confirms that MTQ–8 subscales are suitable for measuring motivation for treatment and readiness for change in drug-dependent patients. It is noted that the presence of PD should not be associated with a lower level of motivation, and that psychological distress influences motivation.

PELATIHAN CAREGIVER ODHA DI JAKARTA DENGAN MEDIA AUDIOVISUAL

Edukasi bagi caregiver ODHA tidak selalu diberikan dengan lengkap mengingat kurangnya tenaga kesehatan yang mendampingi dan belum terstandarnya metode pendampingan caregiver. Tujuan kegiatan adalah meningkatkan pengetahuan caregiver pasien HIV/AIDS melalui film edukasi. Sasaran kegiatan adalah pelaku rawat pasien HIV AIDS di Jakarta sebanyak 10 orang. Metode kegiatan yang digunakan berupa pemberian edukasi bagi caregiver mengenai urgensi pengobatan dan motivasi kepatuhan berobat serta testimoni dari role model. Sebanyak 10 orang caregiver terlibat dalam pelatihan. Sebagian besarnya laki-laki (90%), berusia 35-35 tahun (90%), dan berpendidikan menengah (60%). Dari pelatihan didapatkan rata-rata pengetahuan meningkat dari cukup menjadi baik. Evaluasi terhadap video berdurasi 6 menit yang dibuat adalah diperlukannya animasi yang lebih banyak dan perlu menampilkan pasangan ODHA di sesi testimoni role model. Diharapkan pengabdian masyarakat ini dapat menjadi solusi bagi tenaga kesehatan dalam menyampaikan pendidikan kesehatan untuk pelaku rawat HIV AIDS Kata kunci: media, edukasi, caregiver, ODHA. Abstract Education for HIV caregivers is not always provided in full considering the lack of health workers who assist and have not yet standardized caregiver assistance methods. The purpose of the activity is to improve caregiver knowledge of HIV / AIDS patients through educational films. The target of the activity was 10 people caring for HIV AIDS patients in Jakarta. The method of activity used was in the form of providing education for caregivers regarding the urgency of treatment and motivation for treatment compliance and testimony of role models. A total of 10 caregivers were involved in the training. Most are male (90%), aged 35-35 years (90%), and middleclass education (60%). From the training, the average knowledge increased from fair to good. The evaluation of the 6-minute video that was made was the need for more animations and needed to present HIV partners in a testimonial role model session. It is hoped that this community service can be a solution for health workers in delivering health education for HIV/AIDS caregivers Keywords: media, education, caregiver, HIV.

OVERWEIGHT IN CHILDREN AND ADOLESCENTS: CLINICAL VARIABLES, MOTIVATIONAL AND FAMILY PSYCHOSOCIAL RISK

This study evaluated the relationships between anthropometric, dietary, motivational, and psychosocial variables among children and adolescents with overweight and non-alcoholic fatty liver disease (NAFLD). We evaluated 45 participants (6-17 years) in anthropometric terms, nutritional consumption, motivation for treatment, and family psychosocial risk by using statistical analyses (Student’s t-Test or Chi-Square). It was detected that 37.8% of the families had a high psychosocial risk, 82.2% were obese, 33.3% with NAFLD, high motivation (93.3%), but low adherence to treatment (2.4%). Participants with NAFLD presented higher psychosocial risk, significantly greater obesity severity, waist and neck circumference, and Body Mass Index. They reported lower adherence to treatment, high carbohydrate consumption, ultra-processed products, high energy density, and low fiber, with poor nutritional quality. Interventions should consider the motivation for treatment and psychosocial risks, especially in cases with NAFLD.

Assessing Patient Motivation for Treatment: A Systematic Review of Available Tools, Their Measurement Properties, and Conceptual Definition

Background and PurposeMotivation is often reported by clinicians and researchers as a key factor related to treatment and health outcomes. This systematic review aims to (a) Identify and critically appraise tools that measure patient motivation for treatment and (b) determine how these tools define and evaluate motivation.MethodsLibrary databases and the search engine Google Scholar were examined. Identified tools measuring patient motivation for treatment and reported measurement properties were selected.Results14 peer-reviewed articles covering 12 different tools made the final selection. Quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and a new measure checklist. Reliability evidence was predominantly estimated using internal consistency; validity evidence was limited, and responsiveness was seldom examined. Overall, quality ratings were poor or inadequately reported and serious methodological limitations were identified. A lack of conceptual foundation quality ratings as tools did not apply a theory related to motivation or have a clear definition of the construct of patient motivation.ConclusionsA significant gap exists of available tools with adequate measurement properties that use relevant theoretical frameworks.