Christopher A. Pepping

A Systematic Review of Randomized Controlled Trials of Animal-Assisted Therapy on Psychosocial Outcomes

ABSTRACT The use of animal-assisted interventions (aaIs) to achieve psychological benefits has expanded rapidly over the last few years. However, this is a vastly under-researched area, and the research to date has been largely descriptive, in the form of case studies, or has used only small groups of participants with no control condition. Remarkably few studies have utilized gold standard randomized controlled designs. The aim of the present review was to examine the current state of the literature in regard to only randomized controlled trials (RCts) examining the psychosocial benefits of aaIs, which is a necessary step in order to move the field forward. A search of relevant databases was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISma) guidelines. A total of 66,180 articles were identified at the outset; this was reduced to eight articles (involving 7 studies), following the removal of duplicates (39,377), unrelated titles (26,525), and those that did not meet inclusion criteria (270). Findings from the present review suggest that aaIs may be of benefit to a wide range of individuals, including children with autism, and adults with psychological disorders, including schizophrenia. However, further research using well-designed RCts is required to more definitively explore what specific types of aaI are beneficial for specific populations. Recommendations for future research are provided.

A Systematic Review of Randomized Controlled Studies of Art Therapy

Abstract This review article examines current knowledge about the efficacy of art therapy based on the findings of 8 randomized controlled trials (RCTs) conducted with adult populations from 2008–2013 that met a high standard of rigor. Of these studies, all but one reported beneficial effects of art therapy. Review findings suggest that art therapy may benefit a range of individuals, including older adults, war veterans, and prison inmates. However, there is a need for further research using RCTs to examine more conclusively art therapy outcomes and the specific populations in which art therapy interventions offer greatest benefit.

Review: Is Parent–Child Attachment a Correlate of Children’s Emotion Regulation and Coping?

Attachment theorists have described the parent–child attachment relationship as a foundation for the emergence and development of children’s capacity for emotion regulation and coping with stress. The purpose of this review was to summarize the existing research addressing this issue. We identified 23 studies that employed validated assessments of attachment, which were not based on self-report questionnaires, and separated the summary into findings for toddlers/preschool, children, and adolescents. Although most associations were weak and only a minority of the multiple possible associations tested was supported in each study, all studies (but one) reported at least one significant association between attachment and emotion regulation or coping. The evidence pointed to the regulatory and coping problems of toddlers showing signs of ambivalent attachment or the benefits of secure (relative to insecure) attachment for toddlers, children, and adolescents. Toddlers who showed signs of avoidant attachment relied more on self-related regulation (or less social-oriented regulation and coping), but it was not clear whether these responses were maladaptive. There was little information available regarding associations of ambivalent attachment with school-age children’s or adolescents’ emotion regulation. There were also few studies that assessed disorganized attachment.Attachment theorists have described the parent–child attachment relationship as a foundation for the emergence and development of children’s capacity for emotion regulation and coping with stress. ...

Immediate Effect of Couple Relationship Education on Low-Satisfaction Couples: A Randomized Clinical Trial Plus an Uncontrolled Trial Replication

Couple relationship education (RE) usually is conceived of as relationship enhancement for currently satisfied couples, with a goal of helping couples sustain satisfaction. However, RE also might be useful as a brief, accessible intervention for couples with low satisfaction. Two studies were conducted that tested whether couples with low relationship satisfaction show meaningful gains after RE. Study 1 was a three-condition randomized controlled trial in which 182 couples were randomly assigned to RELATE with Couple CARE (RCC), a flexible delivery education program for couples, or one of two control conditions. Couples with initially low satisfaction receiving RCC showed a moderate increase in relationship satisfaction (d=0.50) relative to the control. In contrast, couples initially high in satisfaction showed little change and there was no difference between RCC and the control conditions. Study 2 was an uncontrolled trial of the Couple Coping Enhancement Training (CCET) administered to 119 couples. Couples receiving CCET that had initially low satisfaction showed a moderate increase in satisfaction (g=.44), whereas initially highly satisfied couples showed no change. Brief relationship education can assist somewhat distressed couples to enhance satisfaction, and has potential as a cost-effective way of enhancing the reach of couple interventions.

A systematic review of the efficacy of equine-assisted interventions on psychological outcomes

Much research attests to the beneficial effects of equine interventions on physical development and ability. However, less is known about the possible psychological benefits of horse activities, such as therapeutic riding or interactions with horses. Although there is public consensus that horses can have psychological benefits, it is an under-researched area and conclusions are largely based on anecdotal data. The little empirical evidence that is available about the efficacy of equine-assisted interventions on psychological outcomes tends to be mixed and is often difficult to interpret due to the lack of rigorous research designs. The purpose of this review was to examine the current state of the literature regarding the psychological effects of equine-assisted interventions, and to make recommendations for future research. Findings from this review suggest that equine-assisted interventions hold much promise, particularly in terms of child/adolescent social and behavioural issues, and perhaps adult affective disorders. However, the current state of the literature does not allow us to definitively conclude that equine-assisted interventions are efficacious. Well-designed randomised controlled trials are greatly needed in this area, as it is an appreciation of the need to standardise and document equine-assisted interventions and outcomes in future research.

The association between state attachment security and state Mindfulness.

Recent research suggests that attachment and mindfulness are related, though the nature of this association is unclear. Here we present two studies examining whether there is a causal relationship between state attachment and state mindfulness. Study 1 investigated the effects of experimentally increasing state mindfulness on state attachment security. State mindfulness was successfully enhanced, but this led to no change in state attachment security. Study 2 investigated the effects of experimentally enhancing state attachment security on state mindfulness. State attachment security was successfully enhanced, but this did not lead to any change in state mindfulness. These findings suggest that there is not a direct, immediate causal relationship between state attachment and state mindfulness as a result of brief experimental manipulations. Future research should examine these associations in longer term interventions.

Mindfulness and Couple Relationships

Being in a satisfying romantic relationship is one of the strongest predictors of overall life satisfaction and well-being. In the present chapter, we examine the possibility that mindfulness may be beneficial to romantic relationships. To date, most of the scientific literature has examined whether mindfulness enhances individual well-being and functioning or reduces individual distress. However, more recently, there has been increasing focus on the potential benefits of mindfulness for interpersonal outcomes. We begin with a review of the available theoretical and empirical evidence pertaining to the influence of dispositional mindfulness on couple relationship processes and discuss a range of potential mechanisms that might explain why mindfulness may facilitate healthy relationships, including enhanced emotion regulation, increased acceptance, and greater capacity to engage in self-change to enhance the relationship. We then discuss the use of mindfulness-based interventions to enhance couple relationships and alleviate couple relationship distress. We conclude with a discussion of the clinical utility of mindfulness for use with distressed couples and outline directions for future research.

A tailored compassion-focused therapy program for sexual minority young adults with depressive symotomatology: study protocol for a randomized controlled trial

BackgroundLesbian, gay, and bisexual (LGB) men and women represent one of the highest-risk populations for depressive symptomatology and disorders, with young LGB adults being at greatest risk. To date, there have been no randomized controlled trials (RCT) to specifically target depressive symptoms in young LGB adults. This is despite research highlighting unique predictors of depressive symptomatology in this population. Here we outline a protocol for an RCT that will test the preliminary efficacy of a tailored compassion-focused therapy (CFT) intervention for young LGB adults compared with a self-directed cognitive behavioral therapy (CBT) program with no specific tailoring for LGB individuals.MethodsThe CFT intervention consists of 8 units with self-directed reading and activities tailored to LGB young adults, and 8 x weekly 1-hour consultations with a therapist. The CBT intervention consists of 8 units with self-guided reading and activities, with 1 x 1-hour session with a therapist at the mid-point of therapy. Fifty LGB individuals with scores of 13 or above on the Beck Depression Inventory-II will be randomized to either the CFT or CBT condition. The primary outcome measure is depressive symptomatology. Secondary outcome measures are symptoms of anxiety, suicidal ideation, internalized homophobia, self-compassion, and shame and guilt proneness. Assessments will occur at pre-intervention, post-intervention, and at 3-month post-intervention.DiscussionThis study is an RCT to test the preliminary efficacy of an LGB-tailored compassion-focused intervention for young LGB adults with depressive symptomatology. If this intervention is efficacious, this could begin to address the substantial mental health disparities amongst sexual minorities.Trial registrationACTRN12616001018404. Prospective registration, registered 02/08/2016.

Can we predict failure in couple therapy early enough to enhance outcome

Feedback to therapists based on systematic monitoring of individual therapy progress reliably enhances therapy outcome. An implicit assumption of therapy progress feedback is that clients unlikely to benefit from therapy can be detected early enough in the course of therapy for corrective action to be taken. To explore the possibility of using feedback of therapy progress to enhance couple therapy outcome, the current study tested whether weekly therapy progress could detect off-track clients early in couple therapy. In an effectiveness trial of couple therapy, 136 couples were monitored weekly on relationship satisfaction and an expert derived algorithm was used to attempt to predict eventual therapy outcome. As expected, the algorithm detected a significant proportion of couples who did not benefit from couple therapy at Session 3, but prediction was substantially improved at Session 4 so that eventual outcome was accurately predicted for 70% of couples, with little improvement of prediction thereafter. More sophisticated algorithms might enhance prediction accuracy, and a trial of the effects of therapy progress feedback on couple therapy outcome is needed.

Couple interventions for same-sex couples: A consumer survey.

The present article examined couple service utilization in adults in same-sex relationships, as well as satisfaction with couple services, and preferences regarding content, delivery, and tailoring of services. Couples accessed services relatively infrequently and were generally dissatisfied with the usefulness of such services. Most participants (87%) endorsed the importance of couple interventions being tailored specifically for same-sex couples. Concerns such as financial constraints and time limitations were identified as barriers to accessing services, in addition to stigma-related barriers such as fear of discrimination and a lack of appropriately trained practitioners to work with same-sex couples. It is expected that the findings of the present article can inform future research and practice and help to improve the relationships of same-sex couples.