Psychological therapies are effective for managing multiple sclerosis (MS) symptoms such as depre... more Psychological therapies are effective for managing multiple sclerosis (MS) symptoms such as depression, pain and fatigue. Cognitive behavioural therapy (CBT), mindfulness and other theory‐led approaches have been applied and were found to have moderate effects. The present study adopts a patient‐led approach to investigate people with MS' (PwMS) experiences of psychological therapies and the change processes they identify. In this naturalistic, mixed‐methods design, semistructured interviews were conducted and three questionnaires were administered to 20 PwMS at two different times. Qualitative data collection and analysis followed the interpretative phenomenological analysis (IPA) guidelines, and quantitative data were analysed using paired t tests. Four superordinate themes described the participants' experiences of change as related to their psychological therapy: from despair to relief; from feeling their body as alien to becoming acquainted with an unpredictable new bod...
International Journal of Environmental Research and Public Health
Laypersons’ causal beliefs about mental disorders can differ considerably from medical or psychos... more Laypersons’ causal beliefs about mental disorders can differ considerably from medical or psychosocial clinicians’ models as they are shaped by social and cultural context and by personal experiences. This study aimed at identifying differences in causal beliefs about post-traumatic stress disorder (PTSD) by country and gender. A cross-sectional, vignette-based online survey was conducted with 737 participants from Germany, Greece, Ecuador, Mexico, and Russia. Participants were presented with a short unlabeled case vignette describing a person with symptoms of PTSD. Causal beliefs were assessed using an open-ended question asking for the three most likely causes. Answers were analyzed using thematic analysis. Afterwards, themes were transformed into categorical variables to analyze differences by country and by gender. Qualitative analyses revealed a wide range of different causal beliefs. Themes differed by gender, with women tending to mention more external causal beliefs. Themes ...
Background: Recent empirical literature on autoimmune diseases has focused extensively on the imp... more Background: Recent empirical literature on autoimmune diseases has focused extensively on the implementation and evaluation of psychosocial interventions. Psychotherapy and counselling processes for multiple sclerosis (MS) have gained special attention given the cognitive and behavioral dimensions of the symptoms as well as their unpredictable course. The current study aims to gain a deeper understanding of the meaning making processes for persons with MS (PwMS) who are in psychotherapy treatment. Method: The sample of this study consisted of ten PwMS who described their experience of the illness and of psychotherapy of choice through semi-structured interviews. Data collection and analysis adhered to Interpretative Phenomenological Analysis guidelines. Results: The results revealed that PwMS struggled with understanding the initial symptoms, contemplated taking medication, and related symptom development to psychological factors such as depression. Participants were preoccupied wit...
Survivors of the intensive care unit (ICU) report an aggregate of burdensome memories. ICU diarie... more Survivors of the intensive care unit (ICU) report an aggregate of burdensome memories. ICU diaries have been proposed to address the psychological impact of ICU treatment. Twenty-six participants wrote about their ICU experiences in three successive sessions, while in the second session, they were presented with a dairy derived from their medical records. Using inductive thematic analysis in the first and third narratives, we explore how participants initially describe their ICU experience and how they process it after the intervention. Participants described a martyrdom experience, including being emotionally distressed, disorientated, and physically trapped that provoked a quest for any available interpersonal support. A vacuum-like state permeated their existence, impacted their sense-making ability, and the proximity to death uniquely characterized this experience. After intervention, participants made small but significant changes in their written narratives. They appeared to r...
As a theme for theoretical psychology, Doing psychology under New Conditions implies a complex co... more As a theme for theoretical psychology, Doing psychology under New Conditions implies a complex context and shifting background against which our conceptual, philosophical and critical work is briefly foregrounded. As the contributors to this edition of the conference proceedings show, new connections are forged between previously independent intellectual activities, political allegiances and solidarities shift and change, and previously unanticipated situations require new responses. The papers in the volume highlight changes to the environments in which psychology operates that are not merely re-iterations of previous theoretical topics.
PURPOSE Research on breaking bad news (BBN) in healthcare has mostly focused on the doctor-patien... more PURPOSE Research on breaking bad news (BBN) in healthcare has mostly focused on the doctor-patient interaction during a single consultation. However, it has been increasingly recognised that BBN is a wider process that also involves other healthcare professionals. This qualitative study explored non-medical1 healthcare professionals' involvement in BBN to newly diagnosed patients with motor neurodegenerative conditions in the UK. MATERIALS AND METHODS 19 healthcare professionals working with people with motor neurone disease, multiple sclerosis, Parkinson's disease or Huntington's disease took part in individual, semi-structured interviews which were analysed using thematic analysis. RESULTS Four themes were constructed: dealing with the diagnostic aftermath, unpacking the diagnosis, breaking bad news as a balancing act and empowering patients to regain control over their health and lives. Participants reported being broadly involved in BBN by supporting patients with negative diagnostic experiences, re-iterating diagnostic information and helping patients understand the impact of their condition. The challenges of effectively breaking bad news and how these difficult conversations could help empower patients were also emphasised. CONCLUSIONS BBN was a critical and challenging aspect of healthcare professionals' clinical work with newly diagnosed patients with motor neurodegenerative conditions. Besides providing information, BBN was perceived as a way to educate patients, encourage them to make decisions and prepare for the future.Implications for rehabilitationBreaking bad news is a potentially under-recognised but significant aspect in the neurorehabilitation of neurodegenerative conditions.Listening to patients' stories about a long and occasionally unsatisfactory diagnostic journey and allowing them to express their frustration can be critical in regaining patients' trust and building a relationship with them.Newly diagnosed patients have not always received adequate information about their condition at diagnosis or they might have not understood or retained that information. It is, therefore, essential that patients' understanding of their condition is assessed, misconceptions are cleared and appropriate information about the nature and impact of the diagnosis is provided.Irrespective of the length of experience, breaking bad news was perceived as a multi-faceted, challenging, stressful and emotionally demanding task.Formal support and specialised training on breaking the bad news that addresses the incurable, unpredictable and progressive nature of motor neurodegenerative conditions could help professionals with this challenging task.
Journal of Social Work Practice in the Addictions, 2019
The efficiency of interventions in addiction is associated with processes of practitioners' profe... more The efficiency of interventions in addiction is associated with processes of practitioners' professional development. Identity formation is studied extensively for clinical professions but little research focuses on social workers working in addiction settings. This study examined the experience of social workers working in a community treatment network in Greece. Fifteen interviews were conducted with 11 women and 4 men, ranging between 29-47 years οf age, who worked in different centers within the network. Data were analyzed following the guidelines of Interpretative Phenomenological Analysis, offering in-depth examinations of people's lived experience. The results delineate a series of transformations in professional identity comprising a process of biographization. The participants highlighted intrapersonal and relational factors that influence this process which leads to selfunderstanding and engagement with the therapeutic community. The results contribute to deciphering the factors that influence social workers' experience in their professional identity formation in substance abuse treatment contexts.
Purpose The purpose of this paper is to focus on how mental health professionals involved in the ... more Purpose The purpose of this paper is to focus on how mental health professionals involved in the therapeutic treatment of children in public mental health facilities in Greece experience and talk about the impact of the socioeconomic crises on the psychotherapeutic process. Design/methodology/approach In all, 21 semi-structured interviews were conducted and phenomenologically informed thematic analysis was used in analysing the data. Findings The results coalesced into two all-encompassing thematic structures articulating the following: first, the socioeconomic crises have permeated society and therapeutic praxis like a torrential and chronic rain storm. This has resulted in a deluge in demand for therapeutic services within the public mental health sector; second, mental health professionals describe their positioning and work as “a constant tug-of-war” where they are inundated and often overwhelmed with work, find themselves identifying with service users and taking on several roles simultaneously, and being challenged to find solutions often in dire and complex situations. They describe how creativity and flexibility are in demand in their day-to-day interactions and if they are to intervene in place of a health and welfare system that is faltering. Doing therapeutic work under such circumstances appears to be both emotionally onerous and stimulating with regard to conceptualising new ways of intervening in such complex psychosocial situations. Research limitations/implications The study is limited in that only mental health professionals presented their experiences and service users were not included. The findings do highlight how severe austerity policies impact mental health services and peoples’ lives. Practical implications The study has implications for policy regarding the provision and organisation of mental health services in contexts where crises and economic turmoil prevail. Social implications The results associate severe austerity with major changes in family and community life. Originality/value The paper provides insights and implications on how mental health services are impacted by socioeconomic conditions.
In recent years, researchers and policymakers have emphasised the importance of understanding the... more In recent years, researchers and policymakers have emphasised the importance of understanding the complex relationships between Water, Energy, Food and Ecosystems (WEFE). The primary reason for capturing these complexities is to understand how decisions made in the water, food and energy sectors can affect one another. Crucially, biodiversity and ecosystem services (E) play a mediating role in these relationships by making material and non-material contributions to all other sectors (W, E, F). The Nexus approach has been widely used for capturing these interdependencies and identifying opportunities for increasing efficiency, reducing trade-offs and building synergies for sustainable resource use across the WEFE nodes. One challenge in using this framework is the need to harmonise the technical and managerial dimensions of the WEFE interlinkages with the perceptions and priorities of local populations directly involved in the use and management of resources. This paper presents a methodological framework that seeks to integrate the perspectives of experts, practitioners and local stakeholders on the WEFE Nexus through the combined application of the Delphi and Focus Group methods. In this paper, the municipality of Apokoronas in Crete, Greece has served as the case in point. The combined framework allowed us to explore the Nexus understanding at the local level and was instrumental in the identification of initiatives for more integrated resource management. The triangulation of results captured the differences in priorities between practitioners and the local community at large, but also, more specifically, it pointed to discrepancies within groups and across WEFE sectors. The outcomes of this paper demonstrate that awareness and learning play a central role in Nexus actions to overcome conflicts and perceived inequalities, and to internalise solutions. The inclusion of the ecosystems node in the traditional WEF Nexus encouraged participants to contemplate the pivotal role of ecosystems in supporting the rest of the WEF sectors.
Psychological therapies are effective for managing multiple sclerosis (MS) symptoms such as depre... more Psychological therapies are effective for managing multiple sclerosis (MS) symptoms such as depression, pain and fatigue. Cognitive behavioural therapy (CBT), mindfulness and other theory‐led approaches have been applied and were found to have moderate effects. The present study adopts a patient‐led approach to investigate people with MS' (PwMS) experiences of psychological therapies and the change processes they identify. In this naturalistic, mixed‐methods design, semistructured interviews were conducted and three questionnaires were administered to 20 PwMS at two different times. Qualitative data collection and analysis followed the interpretative phenomenological analysis (IPA) guidelines, and quantitative data were analysed using paired t tests. Four superordinate themes described the participants' experiences of change as related to their psychological therapy: from despair to relief; from feeling their body as alien to becoming acquainted with an unpredictable new bod...
International Journal of Environmental Research and Public Health
Laypersons’ causal beliefs about mental disorders can differ considerably from medical or psychos... more Laypersons’ causal beliefs about mental disorders can differ considerably from medical or psychosocial clinicians’ models as they are shaped by social and cultural context and by personal experiences. This study aimed at identifying differences in causal beliefs about post-traumatic stress disorder (PTSD) by country and gender. A cross-sectional, vignette-based online survey was conducted with 737 participants from Germany, Greece, Ecuador, Mexico, and Russia. Participants were presented with a short unlabeled case vignette describing a person with symptoms of PTSD. Causal beliefs were assessed using an open-ended question asking for the three most likely causes. Answers were analyzed using thematic analysis. Afterwards, themes were transformed into categorical variables to analyze differences by country and by gender. Qualitative analyses revealed a wide range of different causal beliefs. Themes differed by gender, with women tending to mention more external causal beliefs. Themes ...
Background: Recent empirical literature on autoimmune diseases has focused extensively on the imp... more Background: Recent empirical literature on autoimmune diseases has focused extensively on the implementation and evaluation of psychosocial interventions. Psychotherapy and counselling processes for multiple sclerosis (MS) have gained special attention given the cognitive and behavioral dimensions of the symptoms as well as their unpredictable course. The current study aims to gain a deeper understanding of the meaning making processes for persons with MS (PwMS) who are in psychotherapy treatment. Method: The sample of this study consisted of ten PwMS who described their experience of the illness and of psychotherapy of choice through semi-structured interviews. Data collection and analysis adhered to Interpretative Phenomenological Analysis guidelines. Results: The results revealed that PwMS struggled with understanding the initial symptoms, contemplated taking medication, and related symptom development to psychological factors such as depression. Participants were preoccupied wit...
Survivors of the intensive care unit (ICU) report an aggregate of burdensome memories. ICU diarie... more Survivors of the intensive care unit (ICU) report an aggregate of burdensome memories. ICU diaries have been proposed to address the psychological impact of ICU treatment. Twenty-six participants wrote about their ICU experiences in three successive sessions, while in the second session, they were presented with a dairy derived from their medical records. Using inductive thematic analysis in the first and third narratives, we explore how participants initially describe their ICU experience and how they process it after the intervention. Participants described a martyrdom experience, including being emotionally distressed, disorientated, and physically trapped that provoked a quest for any available interpersonal support. A vacuum-like state permeated their existence, impacted their sense-making ability, and the proximity to death uniquely characterized this experience. After intervention, participants made small but significant changes in their written narratives. They appeared to r...
As a theme for theoretical psychology, Doing psychology under New Conditions implies a complex co... more As a theme for theoretical psychology, Doing psychology under New Conditions implies a complex context and shifting background against which our conceptual, philosophical and critical work is briefly foregrounded. As the contributors to this edition of the conference proceedings show, new connections are forged between previously independent intellectual activities, political allegiances and solidarities shift and change, and previously unanticipated situations require new responses. The papers in the volume highlight changes to the environments in which psychology operates that are not merely re-iterations of previous theoretical topics.
PURPOSE Research on breaking bad news (BBN) in healthcare has mostly focused on the doctor-patien... more PURPOSE Research on breaking bad news (BBN) in healthcare has mostly focused on the doctor-patient interaction during a single consultation. However, it has been increasingly recognised that BBN is a wider process that also involves other healthcare professionals. This qualitative study explored non-medical1 healthcare professionals' involvement in BBN to newly diagnosed patients with motor neurodegenerative conditions in the UK. MATERIALS AND METHODS 19 healthcare professionals working with people with motor neurone disease, multiple sclerosis, Parkinson's disease or Huntington's disease took part in individual, semi-structured interviews which were analysed using thematic analysis. RESULTS Four themes were constructed: dealing with the diagnostic aftermath, unpacking the diagnosis, breaking bad news as a balancing act and empowering patients to regain control over their health and lives. Participants reported being broadly involved in BBN by supporting patients with negative diagnostic experiences, re-iterating diagnostic information and helping patients understand the impact of their condition. The challenges of effectively breaking bad news and how these difficult conversations could help empower patients were also emphasised. CONCLUSIONS BBN was a critical and challenging aspect of healthcare professionals' clinical work with newly diagnosed patients with motor neurodegenerative conditions. Besides providing information, BBN was perceived as a way to educate patients, encourage them to make decisions and prepare for the future.Implications for rehabilitationBreaking bad news is a potentially under-recognised but significant aspect in the neurorehabilitation of neurodegenerative conditions.Listening to patients' stories about a long and occasionally unsatisfactory diagnostic journey and allowing them to express their frustration can be critical in regaining patients' trust and building a relationship with them.Newly diagnosed patients have not always received adequate information about their condition at diagnosis or they might have not understood or retained that information. It is, therefore, essential that patients' understanding of their condition is assessed, misconceptions are cleared and appropriate information about the nature and impact of the diagnosis is provided.Irrespective of the length of experience, breaking bad news was perceived as a multi-faceted, challenging, stressful and emotionally demanding task.Formal support and specialised training on breaking the bad news that addresses the incurable, unpredictable and progressive nature of motor neurodegenerative conditions could help professionals with this challenging task.
Journal of Social Work Practice in the Addictions, 2019
The efficiency of interventions in addiction is associated with processes of practitioners' profe... more The efficiency of interventions in addiction is associated with processes of practitioners' professional development. Identity formation is studied extensively for clinical professions but little research focuses on social workers working in addiction settings. This study examined the experience of social workers working in a community treatment network in Greece. Fifteen interviews were conducted with 11 women and 4 men, ranging between 29-47 years οf age, who worked in different centers within the network. Data were analyzed following the guidelines of Interpretative Phenomenological Analysis, offering in-depth examinations of people's lived experience. The results delineate a series of transformations in professional identity comprising a process of biographization. The participants highlighted intrapersonal and relational factors that influence this process which leads to selfunderstanding and engagement with the therapeutic community. The results contribute to deciphering the factors that influence social workers' experience in their professional identity formation in substance abuse treatment contexts.
Purpose The purpose of this paper is to focus on how mental health professionals involved in the ... more Purpose The purpose of this paper is to focus on how mental health professionals involved in the therapeutic treatment of children in public mental health facilities in Greece experience and talk about the impact of the socioeconomic crises on the psychotherapeutic process. Design/methodology/approach In all, 21 semi-structured interviews were conducted and phenomenologically informed thematic analysis was used in analysing the data. Findings The results coalesced into two all-encompassing thematic structures articulating the following: first, the socioeconomic crises have permeated society and therapeutic praxis like a torrential and chronic rain storm. This has resulted in a deluge in demand for therapeutic services within the public mental health sector; second, mental health professionals describe their positioning and work as “a constant tug-of-war” where they are inundated and often overwhelmed with work, find themselves identifying with service users and taking on several roles simultaneously, and being challenged to find solutions often in dire and complex situations. They describe how creativity and flexibility are in demand in their day-to-day interactions and if they are to intervene in place of a health and welfare system that is faltering. Doing therapeutic work under such circumstances appears to be both emotionally onerous and stimulating with regard to conceptualising new ways of intervening in such complex psychosocial situations. Research limitations/implications The study is limited in that only mental health professionals presented their experiences and service users were not included. The findings do highlight how severe austerity policies impact mental health services and peoples’ lives. Practical implications The study has implications for policy regarding the provision and organisation of mental health services in contexts where crises and economic turmoil prevail. Social implications The results associate severe austerity with major changes in family and community life. Originality/value The paper provides insights and implications on how mental health services are impacted by socioeconomic conditions.
In recent years, researchers and policymakers have emphasised the importance of understanding the... more In recent years, researchers and policymakers have emphasised the importance of understanding the complex relationships between Water, Energy, Food and Ecosystems (WEFE). The primary reason for capturing these complexities is to understand how decisions made in the water, food and energy sectors can affect one another. Crucially, biodiversity and ecosystem services (E) play a mediating role in these relationships by making material and non-material contributions to all other sectors (W, E, F). The Nexus approach has been widely used for capturing these interdependencies and identifying opportunities for increasing efficiency, reducing trade-offs and building synergies for sustainable resource use across the WEFE nodes. One challenge in using this framework is the need to harmonise the technical and managerial dimensions of the WEFE interlinkages with the perceptions and priorities of local populations directly involved in the use and management of resources. This paper presents a methodological framework that seeks to integrate the perspectives of experts, practitioners and local stakeholders on the WEFE Nexus through the combined application of the Delphi and Focus Group methods. In this paper, the municipality of Apokoronas in Crete, Greece has served as the case in point. The combined framework allowed us to explore the Nexus understanding at the local level and was instrumental in the identification of initiatives for more integrated resource management. The triangulation of results captured the differences in priorities between practitioners and the local community at large, but also, more specifically, it pointed to discrepancies within groups and across WEFE sectors. The outcomes of this paper demonstrate that awareness and learning play a central role in Nexus actions to overcome conflicts and perceived inequalities, and to internalise solutions. The inclusion of the ecosystems node in the traditional WEF Nexus encouraged participants to contemplate the pivotal role of ecosystems in supporting the rest of the WEF sectors.
Journal of Community & Applied Social Psychology, 2007
Abstract Although family support programmes have been in place for several decades in Greece very... more Abstract Although family support programmes have been in place for several decades in Greece very little attention has been paid to evaluating the effectiveness of such endeavours, the techniques that influence their outcomes and the receptiveness to their messages. The purpose of this paper is to give an overview of research findings collected during the first qualitative research phase of a community mental health promotion project. The research was conducted in order to delineate programme outcomes and the ...
Aims and MethodThere have been a variety of instruments developed for evaluating family functioni... more Aims and MethodThere have been a variety of instruments developed for evaluating family functioning, but no specific measure has emerged as appropriate for routine clinical use. The Family Adaptability and Cohesion Evaluation Scale (FACES) was viewed as a useful tool for a period, but has been less popular of late. This paper looks at its use in families with two very different types of problem to assess its discriminatory ability.ResultsMothers with depression whose children were not showing mental health difficulties reported a very different pattern of family functioning from those whose children were showing chronic school refusal.Clinical ImplicationsThe FACES is capable of discriminating between different patterns of family functioning. Its ease of administration, and the information it provides, should recommend it for wider use in clinical settings.
This article presents the findings of a research initiative which explored Greek teachers' pe... more This article presents the findings of a research initiative which explored Greek teachers' perceptions and understandings on what constitutes social and emotional competencies and how these competencies can best be enhanced within the classroom. In-depth interviews were conducted with 24 elementary school teachers in two different geographical areas of Greece. The interviews were transcribed and analysed in light of existing literature on Social and Emotional Learning (SEL) and Emotional Intelligence (EI). The teachers acknowledged a complex and interactive model of abilities, competencies and ‘psychic virtues’ and a dynamic interaction of the child and his or her context. The findings highlight the significant role the sociocultural context plays in understanding and conceptualizing social and emotional competencies.
The European Journal of Counselling Psychology, 2009
This paper describes the design (process and content), implementation, and evaluation of a progra... more This paper describes the design (process and content), implementation, and evaluation of a program module developed to sensitize elementary school students to issues related to disability. The objectives of the activities were to enable the students to gain factual and practical information about people with disabilities and the barriers (physical, psychological, social-emotional) they encounter. Another objective of the program was to help students and teachers examine their own attitudes toward disabilities, their stereotypes, and rejection mechanisms and stigmatization tendencies. The program evaluation outcomes suggest that students were sensitized to issues related to disability and reported more positive attitudes toward their disabled counterparts.
The global financial recession that many countries have encountered during the past several year... more The global financial recession that many countries have encountered during the past several years has brought to the forefront human rights issues especially for people facing social and economic exclusion and living without access to basic health care. Cuts in public health spending, costs shifting to patients and the exponential rise in the number of uninsured people have led to the deterioration in public health. These policies have mobilized political action by health care professionals culminating in the development of volunteer run solidarity schemes. In order to explore the solidarity agenda and the social justice and health care philosophies of all involved in the first Social Solidarity Clinic (SSC) founded in Greece a three phase study was conducted: 1) participatory observation and volunteering at the Clinic, 2) quantitative demographic data analysis, and 3) interviews and analyses of the policy charter that all SSCs abide by. Qualitative and quantitative data analysis provided results which indicated that the SSC a) eliminates disparities in health provision; b) enhances general health; c) detects community’s health needs; and d) provides a framework for assessing the consequences of the health care crisis. Thus, the overall clinic’s contribution is in line with health related “functionings”. However, several challenges in the Clinic’s praxis were identified. A theoretical inquiry is outlined regarding the utility of Community-Based Participatory Research (CBPR) in overcoming these challenges and in developing community health capabilities.
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