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PurposeA metastatic cancer diagnosis is associated with high levels of distress in patients and caregivers, which may be alleviated by mindfulness interventions. Research on scalable, tailored, online mindfulness training programs is needed. We sought to test the feasibility and acceptability of a remotely delivered 8-week mindfulness-based intervention, Being Present 2.0 (BP2.0).MethodsWe performed a single-arm feasibility study of BP2.0 among patients with any metastatic gastrointestinal cancer receiving chemotherapy, with or without an informal caregiver. Participants were instructed to practice mindfulness using pre-recorded guided meditations 5 times per week using a study-specific website and to attend a weekly live, interactive virtual meeting facilitated by a trained instructor. The web-based platform enabled direct measurement of adherence.ResultsThe study enrolled 46 of 74 (62%) patients contacted, together with 23 caregivers (69 participants total), from May to October 2018. Median patient age was 52 (range 20-70 years), 39% were male, 67% non-Hispanic white, 65% had colorectal cancer, and 78% lived outside of San Francisco. The top reasons cited for participation were to reduce stress/anxiety and learn how to meditate. Mean baseline National Comprehensive Cancer Network Distress Thermometer (NCCN DT) scores were 4.7 (patients) and 5.8 (caregivers). The study discontinuation rate was 20% (eight patients and six caregivers). Among the remaining 55 participants, 43 (78%) listened to at least one audio recording and/or attended at least one virtual meeting, although adherence data was incomplete. The retention rate was 71%, with 39 participants completing at least one follow-up assessment. In post-intervention qualitative interviews, 88% of respondents reported a positive experience. Compared to baseline, participants reported significantly reduced post-intervention NCCN DT scores (mean 3.1; P = .012).ConclusionThe BP2.0 online mindfulness-based program is feasible and acceptable for patients with metastatic gastrointestinal cancer and caregivers. These results will guide plans for a follow-up efficacy study. ClinicalTrials.gov Identifier: NCT03528863.

BackgroundPsilocybin therapy has shown promise as a rapid-acting treatment for depression, anxiety, and demoralization in patients with serious medical illness (e.g., cancer) when paired with individual psychotherapy. This study assessed the safety and feasibility of psilocybin-assisted group therapy for demoralization in older long-term AIDS survivor (OLTAS) men, a population with a high degree of demoralization and traumatic loss.MethodsSelf-identified gay men OLTAS with moderate-to-severe demoralization (Demoralization Scale-II ≥8) were recruited from the community of a major US city for a single-site open-label study of psilocybin-assisted group therapy comprising 8-10 group therapy visits and one psilocybin administration visit (0·3-0·36 mg/kg po). Primary outcomes were rate and severity of adverse events, and participant recruitment and retention. The primary clinical outcome was change in mean demoralization from baseline to end-of-treatment and to 3-month follow-up assessed with a two-way repeated measures ANOVA. Trial registration: Clinicaltrials.gov (NCT02950467).FindingsFrom 17 July 2017 to 16 January 2019, 18 participants (mean age 59·2 years (SD 4·4)) were enrolled, administered group therapy and psilocybin, and included in intent-to-treat analyses. We detected zero serious adverse reactions and two unexpected adverse reactions to psilocybin; seven participants experienced self-limited, severe expected adverse reactions. We detected a clinically meaningful change in demoralization from baseline to 3-month follow-up (mean difference -5·78 [SD 6·01], ηp 2 = 0·47, 90% CI 0·21-0·60).InterpretationWe demonstrated the feasibility, relative safety, and potential efficacy of psilocybin-assisted group therapy for demoralization in OLTAS. Groups may be an effective and efficient means of delivering psychotherapy pre- and post-psilocybin to patients with complex medical and psychiatric needs.FundingCarey Turnbull, Heffter Research Institute, NIMH R25 MH060482, NIH UL1 TR001872, River Styx Foundation, Saisei Foundation, Sarlo Foundation, Stupski Foundation, Usona Institute, US Department of Veterans Affairs (Advanced Neurosciences Fellowship and IK2CX001495).

The primary objective of this qualitative study was to explore the therapeutic trajectories of individuals undergoing psilocybin-assisted group therapy. This interpretive phenomenological analysis focused on an enriched study sample of gay-identified cisgender men (n = 9) with human immunodeficiency virus diagnosed before 1996 and clinically significant trauma symptoms. Microphenomenological interviews were carried out 1 day after participants' individual psilocybin sessions to elicit fine-grained descriptions of the psilocybin-assisted treatment. Two major thematic change processes were identified using Interpretive Phenomenological Analysis. During their psilocybin sessions, participants reported transitioning out of habitual, evaluative modes of processing and into mindful, experiential modes of processing (from "autopilot" to "meta-aware"). Freed from their emotionally avoidant tendencies, participants were able to process and release previously disowned feelings (grief, shame) and access relational and self-transcendent feelings and prosocial attitudes (joy, gratitude, love, care, compassion). The treatment also supported processes of meaning-making and the realization of posttraumatic growth (in psychological, relational, spiritual dimensions) as participants integrated past traumas into their life narratives and identities (from "trauma-dominant" to "growth-dominant"). These findings suggest that administering adjunctive group therapy with psilocybin may enhance the effectiveness of trauma processing by reinforcing social cohesion, safety, trust, and belonging. These data provide the first empirical suggestion of psilocybin's efficacy in alleviating trauma symptoms in a group-facilitated format and provide a deeper understanding of the potential psychological change processes involved in this novel treatment approach. [ABSTRACT FROM AUTHOR]

The authors describe an instructional model designed to promote interdisciplinary collaboration among students pursuing master's degrees in social work and journalism. This unique model involved active collaboration among social work and journalism graduate students and faculty to create a single-issue magazine focused on a diverse range of social welfare issues. After describing the development and format of the model as well as requisite resources, the authors discuss emergent learning opportunities for both groups of students, including identification of role tensions between the 2 professions, deepened understanding of the social work profession and its associated roles, and methods for collaboration to advance the social justice purposes of both professions.

Introduction: Considering the relevance of the emotional state, it is necessary to understand how daily stimuli can modulate the emotions. Animated short films are common stimuli, but it is unknown how they can modulate the emotional state. The study aimed to evaluate: how participants' emotional state changed after watching animated short films with positive or negative emotional valence in an online experiment; the relationship between participants' baseline score on an Emotional Intensity Scale and their potential change in the main emotion after watching the films; and the association between the initial main emotion valence and the potential change in this emotion with participants' sociodemographic information. Methods: A sample of 2,269 participants recruited during COVID-19 pandemic were randomly assigned to either watch a negative or positive animated short film. Results: The results showed that, after watching a film with negative valence, participants were in a more negative emotional state than at baseline and compared with those who watched the film with positive valence. Also, individuals who had a negative baseline emotion and maintained the same emotion after the film had presented higher baseline emotional state scores (more negative emotion) than those who changed their emotions. In addition, the individuals who kept the baseline emotion had an association with age, marital status, level of education and psychiatric disorders, use of medication, and emotional awareness, while the individuals who changed the baseline emotion had an association with age, gender, and following or not social distancing recommendations. Conclusion: Baseline emotional state may influence the response to animated short films and sociodemographic characteristics are associated with the initial main emotion valence and its potential change in this emotion. [ABSTRACT FROM AUTHOR]

Empathy is a multifaceted skill and asset for health care providers. This paper uses current neuroscience literature of empathy to generate nuanced theory of how empathy can be blocked by personal stress and aversion among health care professionals. Current training approaches for educating sustainable empathy are reviewed in depth. The final part of the paper provides suggestions on how to spread empathy education farther and wider across medical education. [ABSTRACT FROM PUBLISHER]

Prior research indicates that human service care providers experience higher levels of chronic workplace stress and burnout than workers in other professions. Despite the documented need for support, there remains a dearth of research on appropriate training interventions for these workers. In addition, although human service work requires interpersonal connection and can be intrinsically rewarding, research on stress and burnout has overshadowed the study of empathy and meaning to help providers in human service settings. Juvenile justice officers (JJOs), who have the important and stressful job of working closely with incarcerated youth populations, have been especially understudied. This article explores stress among JJOs and training interventions through a review of the literature and presentation of original case study data. The case study includes qualitative analysis of (a) interpersonal stress through a new lens of empathy and meaning and (b) the development and delivery of a pilot training program targeted to help JJOs reduce stress and facilitate empathy and meaning. The conclusion addresses opportunities to support JJOs in managing interpersonal stress and finding meaning in their work. [ABSTRACT FROM AUTHOR]