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\"Group work presents the therapist with many situations, considerations, and, ultimately, decisions that are unique to the practice of group psychotherapy. Complex Dilemmas in Group Therapy includes advice and insights from more than fifty of the most eminent group therapists in the world and is edited by two leading thinkers and practitioners in the field. In its pages clinicians will find expert guidance on some of the most difficult situations group therapists face, and they'll come away from the book with a host of practical strategies for facilitating their work as well as deeper and broader understanding of the overarching ideas that underpin the practice of successful group therapy\"-- Provided by publisher.

Building and expanding on concepts presented in his previous volumes (Relational Group Psychotherapy: From Basic Assumptions to Passion, and Resistance, Rebellion and Refusal in Groups: The 3Rs), Richard M. Billow presents a coherent and innovative model of group psychotherapy. Developing Nuclear Ideas: Relational Group Psychotherapy offers, in experiential terms and with vivid examples, a theoretical and technical approach to understand and organise dynamic group process and drive it towards satisfying the goal of all therapy, the hunger for emotional truth. By developing nuclear ideas, the therapist and the group itself go about the task of containing and making sense of the perceptions, conceptions, affects, and enactments present in all groups. The volume also addresses the impact of thought-limiting, action-orientated polemic ideas. Integrating contemporary theory with cutting edge technique, the author focuses on the personal nature of the intersubjective process, locating the therapist's experience in the centre of the transformational intensity of group life.

There are multiple meanings to the term group-as-a-whole and all have a contribution. This book emphasizes that the therapist ideally listens with the fourth ear, not only attending to the latent communication of each individual, but also listening for the shared theme of the whole group. Ferreting out the underlying theme that the entire group is dealing with, the common group tension, provides a valuable opportunity for each individual to change the underlying issues that impair his or her relationships. In addition, the author provides a wide ranging coverage of theoretical, clinical, and training issues. These include a clarification of the confusing, but all-important conception of projective identification as well as a contribution to the understanding of the similarities and differences between group and individual psychotherapy. He presents a special perspective on why groups are particularly indicated in dealing with narcissistic pathology and also explores the effect of the therapist's narcissism on his patients. Finally, he emphasizes that therapists' participation as members of experiential groups is an essential part of their training.

Only for ergodic processes will inferences based on group-level data generalize to individual experience or behavior. Because human social and psychological processes typically have an individually variable and time-varying nature, they are unlikely to be ergodic. In this paper, six studies with a repeated-measure design were used for symmetric comparisons of interindividual and intraindividual variation. Our results delineate the potential scope and impact of nonergodic data in human subjects research. Analyses across six samples (with 87–94 participants and an equal number of assessments per participant) showed some degree of agreement in central tendency estimates (mean) between groups and individuals across constructs and data collection paradigms. However, the variance around the expected value was two to four times larger within individuals than within groups. This suggests that literatures in social and medical sciences may overestimate the accuracy of aggregated statistical estimates. This observation could have serious consequences for how we understand the consistency between group and individual correlations, and the generalizability of conclusions between domains. Researchers should explicitly test for equivalence of processes at the individual and group level across the social and medical sciences.

Most people with mental health disorders fail to receive timely access to adequate care. US Hispanic/Latino individuals are particularly underrepresented in mental health care and are historically a very difficult population to recruit into clinical trials; however, they have increasing access to mobile technology, with over 75% owning a smartphone. This technology has the potential to overcome known barriers to accessing and utilizing traditional assessment and treatment approaches. This study aimed to compare recruitment and engagement in a fully remote trial of individuals with depression who either self-identify as Hispanic/Latino or not. A secondary aim was to assess treatment outcomes in these individuals using three different self-guided mobile apps: iPST (based on evidence-based therapeutic principles from problem-solving therapy, PST), Project Evolution (EVO; a cognitive training app based on cognitive neuroscience principles), and health tips (a health information app that served as an information control). We recruited Spanish and English speaking participants through social media platforms, internet-based advertisements, and traditional fliers in select locations in each state across the United States. Assessment and self-guided treatment was conducted on each participant's smartphone or tablet. We enrolled 389 Hispanic/Latino and 637 non-Hispanic/Latino adults with mild to moderate depression as determined by Patient Health Questionnaire-9 (PHQ-9) score≥5 or related functional impairment. Participants were first asked about their preferences among the three apps and then randomized to their top two choices. Outcomes were depressive symptom severity (measured using PHQ-9) and functional impairment (assessed with Sheehan Disability Scale), collected over 3 months. Engagement in the study was assessed based on the number of times participants completed active surveys. We screened 4502 participants and enrolled 1040 participants from throughout the United States over 6 months, yielding a sample of 348 active users. Long-term engagement surfaced as a key issue among Hispanic/Latino participants, who dropped from the study 2 weeks earlier than their non-Hispanic/Latino counterparts (P<.02). No significant differences were observed for treatment outcomes between those identifying as Hispanic/Latino or not. Although depressive symptoms improved (beta=-2.66, P=.006) over the treatment course, outcomes did not vary by treatment app. Fully remote mobile-based studies can attract a diverse participant pool including people from traditionally underserved communities in mental health care and research (here, Hispanic/Latino individuals). However, keeping participants engaged in this type of \"low-touch\" research study remains challenging. Hispanic/Latino populations may be less willing to use mobile apps for assessing and managing depression. Future research endeavors should use a user-centered design to determine the role of mobile apps in the assessment and treatment of depression for this population, app features they would be interested in using, and strategies for long-term engagement. Clinicaltrials.gov NCT01808976; https://clinicaltrials.gov/ct2/show/NCT01808976 (Archived by WebCite at http://www.webcitation.org/70xI3ILkz).

Purpose To evaluate the effectiveness of Culturally Adapted Cognitive-Behavioral Therapy (CA-CBT) compared to standard CBT in alleviating depression in college students. Methods A randomized trial was conducted on college students with mild to moderate depression. The CA-CBT group (21 students) received a group CA-CBT intervention incorporating idioms, while the standard CBT group (20 students) received a standard group-based CBT intervention. Both group interventions were conducted once a week, with each session lasting one and a half hours, for a total duration of eight weeks. Eighteen students from the standard CBT group and 12 from the CA-CBT group completed the trial. Depressive symptoms, cognitive distortions, emotional regulation, and CBT understanding were assessed at baseline, week five, post-treatment, and three months after post-treatment using validated scales. Data were analyzed using repeated measures ANOVA, t-tests, and chi-square tests via SPSS 26.0. Results The repeated measures ANOVA results for the pre-treatment and post-treatment showed a significant interaction effect of time and intervention and a significant main effect of time for the sleep disturbance factor of the Hamilton Depression Rating Scale. However, only the main effect of time was significant for all other variables. T-tests indicated that the CA-CBT group had significantly lower Hamilton scores at follow-up compared to the standard CBT group. Meanwhile, the standard CBT group had significantly better CBT understanding post-treatment. Except for the above two items, no other significant difference were found by T-test. Conclusions Compared with standard CBT, the CA-CBT group that incorporates idioms is beneficial for college students with depressive symptoms to continue to achieve relief for a certain period of time after the end of treatment. Specifically, this relief may be reflected in the improvement of sleep problems. However, CA-CBT did not better improve participants’ emotion regulation, understanding of cognitive behavioral therapy, or reduction of cognitive distortions.At the same time, the CA-CBT group did not perform better than the standard CBT group in terms of dropout rate, treatment satisfaction, recommendation, and re-use rate. Trial registration The trial was registered on the Chinese Clinical Trial Registry (No. ChiCTR2300074752|| http://www.chictr.org.cn/ ) on August 15, 2023.

PurposeAlthough the short-video-based application TikTok and its AI-enhanced technology have achieved enormous success and reshaped the user experience, few studies have focused on the user experience in the TikTok context. This study adopts a technology affordance theory lens to identify the main mechanisms contributing to the user experience in the short-video platform context while including user experience level and video length as moderating effects.Design/methodology/approachThis study collected 401 valid questionnaires from TikTok users and used the structural equation modeling approach to examine the proposed research model.FindingsThree technology affordances (perceived effortlessness, perceived recommendation accuracy, and perceived recommendation serendipity) contribute to TikTok users' optimal flow experience. Multi-group analysis results further indicate that individuals react differently to the same stimuli as their experience level increases. Finally, video length critically influences the impact of technology affordances on users' cognitive responses.Originality/valueAs a burgeoning industry, the mechanisms enabling short-video platforms to engage users remain unclear to practitioners and researchers. Thus, this study's technology affordance lens provides necessary insights into how TikTok's innovative and advanced technologies contribute to user flow experience from a context-dependent perspective. Furthermore, given that most existing studies have neglected possible variations in user preferences when investigating the effects of technology, this study enriches the existing literature by employing user experience level and video length as moderators.

PurposeThis study aims to examine how three perceived interactivity attributes of massive open online courses (MOOCs), namely, perceived active control, perceived synchronicity and perceived two-way communication, impact individuals' engagement and continuance intention of MOOCs through the stimulus-organism-response (S-O-R) lens and how that effect differs between male and female users.Design/methodology/approachDrawing upon S-O-R as an overarching theoretical framework, this study conducted an empirical study in China and collected 294 valid questionnaires from online learners. Structural equation modeling approach was used to examine the proposed research model.FindingsEmpirical results suggest that perceived active control, perceived synchronicity and perceived two-way communication are significant stimuli of individuals' continuance intention of MOOCs, and the influences of perceived active control and perceived synchronicity are partially or fully mediated by engagement on the platform. Multi-group analysis results further indicate that perceived synchronicity has a stronger influence on engagement on the platform for males, while perceived active control and perceived two-way communication are more salient in stimulating engagement on the platform for females.Practical implicationsResearch findings from the present study can serve as the foundation to guide MOOCs’ administrators to respond to the needs of participants through interactivity designed into the platform and shed light on possible key solutions of high dropout rates in MOOCs.Originality/valueThis study uncovers the mediating mechanism of affective engagement between interactivity and continuance intention in the emerging context of the latest online learning platform MOOCs and reveals the behavioral differences between females and males regarding their affective reactions to the three interactivity attributes.

Bracketing (also called epoche) is fundamental in phenomenological philosophy and is a widely recognized practice in phenomenological and other qualitative research methodologies. Bracketing definitions, types, and procedures still generate debate among contemporary phenomenological methodologists and other qualitative researchers. The purpose of this paper is to contribute to the dialogue about the topic of bracketing with empirical research on one of its forms. In this study, we analyzed self-reflection reports of doctoral students who had engaged in a bracketing interview and subsequent group analysis. Our results show that the bracketing process can be an educational and revelatory experience for the novice researcher including heightening awareness of their presuppositions and other commonly discussed benefits in the literature. An unanticipated finding includes the powerful effect of bracketing as a springboard to developing a researcher identity. Being understood and validated by the research group was a unique experience for participants that helped to dispel student feelings of being an impostor and/or inadequately prepared to conduct doctoral research. Implications for improving the bracketing process for novice researchers include clear communication prior to bracketing and explicit instruction on research journaling.

After the acute treatment phase, breast cancer patients often experience low quality of life and impaired mental health, which could potentially be improved by offering cognitive behavioural therapy (CBT) and addressing exercise and dietary habits. However, CBT and other behavioural interventions are rarely available beyond the acute treatment phase. Internet-based interventions could bridge such treatment gaps, given their flexibility and scalability. In this randomized controlled trial (RCT), we investigated the effects of such an intervention (\"Optimune\") over three months. This RCT included 363 female breast cancer survivors (age range = 30-70), recruited from the community, who had completed the active treatment phase. Inclusion criteria were: breast cancer diagnosis less than 5 years ago and acute treatment completion at least 1 month ago. Participants were randomly assigned to (1) an intervention group (n = 181), in which they received care as usual (CAU) plus 12-month access to Optimune immediately after randomization, or (2) a control group (n = 182), in which they received CAU and Optimune after a delay of 3 months. Primary endpoints were quality of life (QoL), physical activity, and dietary habits at three months. We hypothesized that intervention group participants would report better QoL, more physical activity, and improved dietary habits after 3 months. Intention-to-treat (ITT) analyses revealed significant effects on QoL (d = 0.27, 95% CI: 0.07-0.48) and dietary habits (d = 0.36, 95% CI: 0.15-0.56), but the effect on physical exercise was not significant (d = 0.30; 95% CI: 0.10-0.51). These findings suggest the effectiveness of Optimune, a new CBT-based Internet intervention for breast cancer survivors, in facilitating improvements in quality of life and dietary habits. Efforts to disseminate this intervention more broadly may be warranted. ClinicalTrials.gov, NCT03643640. Registered August 23rd 2018, https://clinicaltrials.gov/ct2/show/NCT03643640.