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BackgroundSocial media is an integral part of human social life. More than 90% of young people use social media daily. Current theories, models, and measures are primarily based on face-to-face conceptions, leaving research out of sync with current social trends. This may lead to imprecise diagnoses and predictions. ObjectiveTo develop a theoretically based empirical model of current social interfaces to inform relevant measures. MethodsA three-stage, qualitative, data-collection approach included anonymous individual Post-it notes, three full-class discussions, and 10 focus groups to explore 82 adolescents’ relational practices. Data analysis followed a meaning-condensation procedure and a field-correspondence technique. ResultsWe developed an empirical model that categorizes adolescents’ social interactions into five experiential positions. Four positions result from trajectories relating to social media and face-to-face social interaction. Positions are described by match or mismatch dynamics between preferred and actual social platforms used. In matched positions, individuals prefer and use both face-to-face and social media platforms (position 1), prefer and use face-to-face platforms (position 2), or prefer and use social media platforms (position 3). In mismatched positions, individuals prefer face-to-face interactions but use social media platforms (position 4) or prefer social media but use face-to-face platforms (position 5). We propose that matched positions indicate good social functioning while mismatched positions indicate serious social challenges. ConclusionsWe propose a model that will expand previous unidimensional social interaction constructs, and we hypothesize that the described match and mismatch analyses provide conceptual clarity for research and practical application. We discuss prediction value, implications, and model validation procedures.

Background: Psychosis is a condition which often starts early in life and leaves a significant mark on a young person's life. It is usually regarded and discussed from a professional point of view. This study sheds light on the lived experiences of young adults who go through a process of developing their first episode of psychosis. Methods: Interviews were carried out with 10 young adults, aged 19–32 years, 3–12 months after contact with an early detection team for psychosis and were diagnosed as having had a first episode of psychosis. Through a reflexive team-based method, data were put through a preliminary analysis and analyzed line-by-line. Results: We developed three main themes: 1) "A stressful life situation", which refers to the period before the psychotic experience. 2) "A peculiar feeling" to describe the psychotic experience, and 3) "Redefining the meaning of psychosis", which points to how developing psychosis was understood in hindsight. Discussion: We discuss how early labeling and stigma may impact the young adults' meaning-making processes. Moreover, we question the conventional psycho-educational approach and call for a more open and dialogical way to interact with young adults who experience and try to make sense of their first episode of psychosis. [ABSTRACT FROM AUTHOR]

In this reflexive thematic analysis, we explore 17 psychotherapists' accounts of work-related regrets. Based on individual interviews with experienced clinical psychologists, we report how they describe these regrets as emotionally intense experiences with potential for development. To communicate how participants view work-related regrets to impact on their clinical practice, we formulated an overarching theme called "holding on to regret as a kind of enrichment." Three subthemes summarize different aspects of this process: (a) increased awareness; (b) working to accept and model fallibility; and (c) the process of making changes based on regret experiences. We discuss our findings in relation to theory and research, and explore methodological strengths and limitations. [ABSTRACT FROM AUTHOR]

Background: The first-person experiences of people diagnosed with borderline personality disorder (BPD) is an important area of research. It can support clinical and ethical practice, and nuance and expand on insights offered by diagnostic and treatment-oriented research approaches. In this study, we aimed to develop knowledge about how persons who were recently diagnosed with BPD experience being in relationships with themselves and others. Methods: We conducted in-depth life-world interviews with 12 women recently diagnosed with BPD. The interviews focused on their lived experiences of relationships to self and others. All participants gave their informed consents to participate. We analysed the data with a structured approach to reflexive thematic analysis, conducted as a team-based approach. Results: We extracted an overarching theme, "Reaching for firm holdings", that is the most abstract interpretation of participants' experiences. The five subordinate themes ("Captive of emotions", "Keeping undeservedness at bay", "Distrusting oneself", "Dependence as stability" and "The uncertainty of reaching out") are specific constituents of the overarching theme, and provide detail and variations across individual accounts. Conclusions: The results suggest that the experience of relationship to self and others of people recently diagnosed with BPD entails feeling insecure, unsafe and frightened. We report five themes that describe ways participants seek to cope with this situation. The results indicate that their experiences encompass turning to others, or to objects, for feelings of safety. As such, the experience of relationship to self and others in the context of receiving a BPD diagnosis seemed to entail finding and evolving strategies to protect a vulnerable self. Self-harm, suicide attempts and addiction all seemed to be ways of handling and tolerating chaotic and frightful emotions. One major limitation of our study is that only people who identified as female were recruited to participate in the study. [ABSTRACT FROM AUTHOR]

In 2015, the Norwegian Regional Health Authorities introduced the possibility for people with psychotic disorders to choose medication-free services, with music therapy as a treatment option. This study aimed to explore the health care workers' perspectives on challenges and possibilities of music therapy within these services. This is a qualitative study by an interdisciplinary research team, including experts by experience. Ethnographic notes provide data from participant observation with one patient using music therapy, describing what music therapy can be "a case of". Focus group discussions (FGDs) with health care workers, including music therapists, explore their experiences with music therapy and medication-free treatment. These were transcribed and analyzed using systematic text condensation in a stepwise, iterative process involving co-authors to ensure reflexivity. The summary from the participant observation provides the reader with background information on how music therapy can unfold in mental health care. The informants from the FGDs described music therapy as having a high degree of treatment flexibility providing a continuous process of choices. The collaborative choices both among staff members as well as between patient and staff were experienced as important for treatment outcome. Patients worsening or stagnating increased the significance of contingent choices. The strengths of music therapy, such as its acceptability and flexibility, also represent challenges, including dilemmas of prioritization, challenges when ending therapy, and the need for close collaboration when assessing a patient's worsening. There is a potential for improving the implementation of music therapy into the existing health care teams. [ABSTRACT FROM AUTHOR]

Objective: Routine outcome monitoring and clinical feedback systems might be beneficial for adolescent psychotherapy processes. Methods: Clinicians (n = 34) and adolescent clients (n = 22) aged 14–19 from seven different outpatient clinics located in Norway participated in the study. Adolescents were interviewed in individual in‐depth interviews (n = 7) or in four adolescent‐only focus groups (n = 15), clinicians participated in seven clinician‐only focus groups. Results: We report two core domains, (1) feedback about the therapeutic relationship and (2) feedback about the therapeutic work. Seven subthemes specify the functionality that participants need in a feedback system. Conclusion: Adolescents and therapists requested a feedback system that was relationally oriented, supported collaborative action, and was personalized to the needs of the individual adolescent. The research indicates that a clinical feedback system should have idiographic, as well as nomothetic, components. A clinical feedback system for adolescents should monitor experiences of personal autonomy and the quality of the therapeutic relationship. [ABSTRACT FROM AUTHOR]

Background: The literature on antipsychotic medication in psychosis lack systematization of the empirical knowledge base on patients' subjective experiences of using antipsychotic drugs. Such investigations are pivotal to inform large-scale trials with clinically relevant hypotheses and to illuminate clinical implications for different sub-groups of individuals. Aims: To re-analyze and summarize existing qualitative research literature on patient perspectives of using antipsychotic medication. Method: A systematic literature search was performed in September 2018 (Protocol registration no. CRD42017074394). Using an existing framework of meta-analyzing qualitative research, full text evaluation was conducted for 41 articles. Thirty-two articles were included for the final synthesis. Results: Four meta-themes were identified: (1) short-term benefits; (2) adverse effects and coping processes; (3) surrender and autonomy; (4) long-term compromise of functional recovery. Conclusions: While largely positive about acute and short-term use, patients are more skeptical about using antipsychotic drugs in the longer term. The latter specifically relates to processes of functional and social recovery. The clinical conversations about antipsychotic medication need to include evaluations of contexts of patient experience level, patient autonomy processes, patient values and risk preferences, and patient knowledge and knowledge needs in addition to assessing the severity of symptoms of psychosis. [ABSTRACT FROM AUTHOR]

Background: The perceived benefits of drug use are not currently integrated into the treatment of substance use disorder. This omission appears paradoxical and is unsubstantiated by empirical research. As the perceived benefits of drug use are catalysts for drug initiation, relapse and continuous use, increased knowledge about these benefits seems crucial to efficacious treatment. Aims: To investigate the perceived benefits of drug use in substance use disorder. Method: The study is a phenomenological-hermeneutical investigation using thematic analysis of interviews with 30 long-term recovered adult service users. Results: Our thematic analysis resulted in three themes and several sub-themes: (1) Benefits of drug use; (2) Necessity of intense experiences; and (3) Importance of being unconventional. Conclusions: Findings indicate that the benefits of non-problematic and problematic drug use are motivated by similar individual and social needs. An absolute distinction between problematic and non-problematic drug use thus seems arbitrary and potentially counterproductive for clinical practice. The benefits of drug use should be researched as a possible add-on treatment module, as this knowledge may be of significant clinical value in treatment frameworks. [ABSTRACT FROM AUTHOR]

Social factors seem to play an important role in people's recovery processes, yet little attention has been given to such aspects in relation to early psychosis. In this study, we explored how young adults with first episode psychosis experienced relationships inside and outside the mental healthcare services related to their early recovery processes. We interviewed ten young adults who had been in contact with an early detection team for psychosis. The analysis involved thematic and reflexive team-based methods and drew on hermeneutic–phenomenological perspectives. We identified two themes concerning relationships with professionals: 1) being seen as a unique person with preferences and 2) getting help when you are lost. We came across three additional themes, this time, in relation to family and friends: 3) supportive family networks, 4) they cannot understand everything, and 5) different kinds of friendships. Our findings revealed that people both within and outside mental healthcare services were seen as essential (for better or worse) and often played complementary roles. [ABSTRACT FROM AUTHOR]