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Digital technology profoundly impacts family dynamics, posing challenges for therapists. This article explores how excessive technology use affects family interactions, illustrated through three case studies. The aim is to highlight the implications of overuse rather than the inherent properties of technology. Using Bowen family systems therapy and socioculturally attuned family therapy, a blending of these systemic approaches, the therapist designed targeted interventions to address excessive technology use within diverse family systems. Interventions shifted pre‐intervention attitudes and technology‐related beliefs, where family members viewed technology as either a source of conflict or an integral part of daily life. Six 90‐minute family therapy sessions were conducted where families, with varied pre‐intervention perspectives on technology, transitioned towards technology moderation, fostering digital mindfulness and offline family activities. Understanding and addressing the interplay between technology and family dynamics are crucial. Cultural considerations and sensitivity towards generational, ethnic and technological cultural differences were emphasised. An immigrant family and their first‐generation American children exemplify the intersection of cultural identity, generational technology gap and technology integration, advocating for socioculturally attuned therapeutic approaches. [ABSTRACT FROM AUTHOR]

The aim of this study was the effectiveness of systematic differentiation training based on systemic family therapy on marital boredom and communication patterns of women referring to counseling centers in Najafabad in 1399. The research method was quasi-experimental pre-test-post-test. The statistical population of the study was all women referred to counseling centers in Najafabad. The sampling method used in this study was purposeful available sampling method that finally 30 people were selected. 15 people in the experimental group and 15 people in the control group were randomly assigned. The tools used for data collection included the Marital Boredom Questionnaire (Pines 1996), the Communication Patterns Questionnaire (Christensen and Salawi 1984) and the Differentiation Therapy Training Package (based on Bowen's system theory). Data analysis was performed using 24SPSS software at two levels of descriptive and inferential statistics. At the inferential level, analysis of covariance was used. The results of analysis of covariance showed that systematic differentiation training based on systemic family therapy has an effect on marital boredom (P

Introduction: Cervical cancer, while highly preventable, remains an international public health challenge especially in under resourced regions. Although early-stage cervix confined cancers are often amenable to surgical resection, larger tumors deemed locally advanced cervical cancer (LACC) necessitate systemic therapy as part of chemoradiation therapy. Moreover, systemic therapy is the standard therapeutic approach for those presenting with primary metastasis or recurrence. Areas covered: While several agents have been approved to treat recurrent cervical cancer including checkpoint inhibitors as well as both biomarker agnostic and specific antibody drug conjugates, the development of agents added to chemoradiation has been less fruitful. Until recently, the addition of novel therapies to chemoradiation has been negative in terms of improving outcomes; however, results of a recent Phase III clinical trial (NCT 04221945) in LACC demonstrated that the addition of pembrolizumab to standard of care chemoradiation was associated with an improvement in progression-free survival and resulted in an FDA approval for this therapy. This observation led to the first change in treating LACC since the early 2000s. Expert Opinion: Improvements in systemic therapy both alone and in combination with chemoradiation for cervical cancer have been realized. Ongoing research is needed for therapeutic options following immunotherapy. [ABSTRACT FROM AUTHOR]

Astrophysicists and cosmologists seriously propose that our universe, with its three dimensions and local physical bylaws, is one of an infinite number of parallel universes. This paper discusses the relevance of these ideas for contemporary systemic family therapy, such as thinking about the therapist's positioning in relation to the family. Ideas such as the anthropic principle suggest each meeting of a therapist and family forms a unique systemic entity or singularity with its own universe of by‐laws peculiar to a location in time and space. We are like travellers between parallel family therapy universes where the therapist's epistemology, theory or model is less important than how therapists and clients position themselves towards each other. This ecological positioning encompasses contextual, emotional, cultural, ethical and spiritual belief systems. [ABSTRACT FROM AUTHOR]

The aim of this paper is to examine the experiences and views of parents whose child lived with type 1 diabetes (T1DM) and eating disorder (ED), specifically 'diabulimia' and the professional support offered to them. Interpretative phenomenological analysis (IPA) was employed as a methodology to explore the experience of three parents (mothers) living in the United Kingdom, regarding their chronically ill children. Four themes emerged from the analysis: battling, blaming, surviving and loss. These were interpreted through the lens of systemic theory. Within the framework of the results and the discussion, further research and the provision of systemic family therapy for children, parents and families in both paediatric and adolescent‐to‐adult transition diabetes clinics is recommended. [ABSTRACT FROM AUTHOR]

Objective: To synthesise young person and family member perspectives on processes of change in family therapy for anorexia nervosa (AN), including systemic family therapy and manualised family-based treatments, to obtain an understanding of what helps and hinders positive change. Method: A systematic search of the literature was conducted to identify qualitative studies focussing on experiences of therapeutic change within family therapies for AN from the perspectives of young people and their families. Fifteen studies met inclusion criteria and underwent quality appraisal following which they were synthesised using a meta-synthesis approach. Results: Six overarching themes were generated: "A holistic focus on the young person's overall development"; "The therapeutic relationship as a vehicle for change"; "The therapist's confinement to a script and its impact on emotional attunement"; "A disempowering therapeutic context"; "Externalisation of the eating disorder (ED)"; and "The importance of family involvement". Positive change was helped by understanding and support given to the young person's overall development including their psychological, emotional, social and physical wellbeing, positive therapeutic relationships, relational containment within the family system and externalising conversations in which young people felt seen and heard. Positive change was hindered by inflexibility in the treatment approach, counter-effects of externalisation, negative experiences of the therapist, a narrow focus on food-intake and weight, as well as the neglect of family difficulties, emotional experiences, and psychological factors. Conclusions: Positive change regarding the young person's eating-related difficulties ensued in the context of positive relational changes between the young person, their family members, the therapist and treatment team, highlighting the significance of secure and trusting relationships. The findings of this review can be utilised by ED services to consider how they may adapt to the needs of young people and their families in order to improve treatment satisfaction, treatment outcomes, and in turn reduce risk for chronicity in AN. Plain English summary: This review synthesises the views of young people and their family members regarding their perspectives of therapeutic change within family therapies for Anorexia Nervosa (AN), including both manualised eating disorder-focussed family therapy models (family-based treatment; FBT and AN-focussed family therapy; FT-AN), as well as systemic family therapy (SyFT), to understand which aspects of these treatment approaches are helpful versus hindering to recovery from an eating disorder (ED). Parental involvement was crucial in facilitating the restoration of physical health through the process of parents taking temporary responsibility for the young person's eating behaviours until they can feed themselves again. However, treatment often failed to acknowledge and address the psychological and emotional difficulties that made the young person vulnerable to developing AN, as well as the psychological distress caused by increasing food-intake and weight. A positive therapeutic relationship in which families felt well supported by their therapist was important in providing containment during a time of familial strain and instability, yet there was a need for greater flexibility and individualisation within manualised ED-focussed family therapy approaches, particularly FBT. The findings highlight the importance of eliciting the young person's voice to enhance their personal agency in treatment and the value of therapeutic space to improve family functioning and enhance family unity. Lastly, they illuminate the need for manualised ED-focussed family therapy models to allow space for the therapist to emotionally attune to young people and families in order to contain their experience of distress. [ABSTRACT FROM AUTHOR]

Stereotactic body radiotherapy is a highly effective form of radiation therapy for palliation of bone metastases, but it can also lead to rare but severe side effects, such as myonecrosis. According to the literature, the incidence of myonecrosis after stereotactic body radiotherapy is low and mostly dose dependent. It is crucial to consider the potential impact of immunotherapy and other systemic therapies in the assessment. The course of radiation myonecrosis can vary, and corticosteroids or vascular endothelial growth factor inhibitors may potentially play a role in its treatment. Herein, we report two patients presenting with myonecrosis after stereotactic body radiotherapy for bone metastasis. [ABSTRACT FROM AUTHOR]

"Outcome Measures and Evaluation in Counseling and Psychotherapy" by Chris Evans and Jo-anne Carlyle is a book that explores the topic of outcome measures and their evaluation in counseling and psychotherapy. The authors use clear and accessible language to explain complex concepts, making the content enjoyable and easy to understand. They provide practical advice, resources, and case studies to help readers implement outcome measures in their own practices. The book emphasizes the importance of understanding the goals and context of outcome measurement and encourages constructive communication and critique in the field. [Extracted from the article]

Objective: Marital burnout is one of the factors related to the marital conflicts, so the present study was conducted with the aim of determining the effectiveness of systemic family therapy on marital conflicts and marital burnout in couples. Methods: The ongoing study adopted a semi-experimental research design consisting of pre)test and post-test measurements with a control group. The target population for this investigation comprised married women seeking assistance at the counseling center in the second educational district of Baharestan in 2023. Following specific eligibility criteria, 30 married women were selected randomly and divided into two groups: 15 individuals in the control group and 15 individuals in the experimental group. The research instruments utilized were Sanai Zaker's Marital Conflict Questionnaire (2000) and the Couple Burnout Measure (CBM) (Pines, 1996). Results: Data analysis involved the application of multivariate and univariate analysis of covariance to examine the hypotheses using SPSS version 22 software. The findings indicated that the implementation of family therapy proved to be efficacious in diminishing marital conflicts and burnout among married women. Conclusions: In conclusion, systemic family therapy emerges as a viable intervention for couples experiencing conflict. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psychotherapie Forum is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sexual and gender identity self-disclosure, also known as 'coming out', is a decision-making journey that is part of the lived experience of the LGBTQIA + population. While navigating the coming out journey is unique for each LGBTQIA + individual, however, this community shares higher risks of experiencing certain constraints. These constraints, namely familial rejection, substance use, and psychological distress, are often felt once members of this community begin the "coming out" process. The purpose of this manuscript is to provide clinicians with a theoretical understanding of Internal Family Systems therapy (IFS) and explore a proposed application of the theory to aid LGBTQIA + clients in the "coming out journey". The theory's key concepts can be utilized to address the constraints placed upon this population, as well as promoting self-actualization. Further, the promotion of affirming therapy services is both critical and timely as recent political changes have negatively impacted the LGBTQIA + community. This paper will outline a case study where an LGBTQIA + client examines their identity self-disclosure process through IFS treatment phases. We will also propose a clinical intervention that will aim to further the experiential nature of therapy and aid in the process of becoming Self-led. [ABSTRACT FROM AUTHOR]

Objective: This study explored the perceptions, lived experiences, and coping approaches of women who live with spouses who have alcohol use disorder (AUD) in response to implicit and explicit messages from professionals and others in their environment. Background: Women who live with a spouse with AUD are affected by their spouses' behavior and experience high levels of mental stress. These women are viewed as problem‐solvers and rescuers, on the one hand, or as enablers and "codependents" on the other. These attitudes may reflect society's ideas of women's gender‐related caretaking role. Method: Semistructured interviews were conducted with 12 women whose spouses had a diagnosis of lifetime AUD. Results: Content analysis yielded three themes regarding the kinds of messages the women received: responsible and guilty, distanced and silenced, and reinforced and supported. The women indicated internalization of these messages and expressed they felt guilty, ashamed, and excluded, but in some cases, strengthened. Conclusion: Society and the people around these women bear responsibility for the negative images they internalize. Implications: Awareness of the implicit and explicit messages conveyed to these women is needed. Specific interventions should be designed to validate their difficulties and support them. [ABSTRACT FROM AUTHOR]

Difficulties in various cognitive functions are common observations in people experiencing anxiety. However, limited research has investigated the effects of psychotherapy on abnormal cognitive functioning. This study assessed whether psychotherapy-related reductions of anxiety result in improvements of cognitive functioning as well. Fifty-four participants with high self-reported anxiety, divided into two experimental groups (N = 28 and N = 26), and 27 non-anxious control participants (N = 27) completed a battery of memory tasks and anxiety questionnaires in three consecutive time points. In experimental group 1, participants started systemic family therapy immediately after the first time point, while, in experimental group 2, participants begun the same type of therapy three months later at the second time point. The results showed that, compared to control participants, at the beginning of the experiment, participants in the experimental groups had significantly lower memory performance, along with higher anxiety. Psychotherapy had a beneficial effect on anxiety symptoms and cognitive performance, with significant changes occurring only after intervals of treatments. These results show that psychotherapy is effective not only in reducing anxiety symptoms but on cognitive functioning as well. This improvement might be linked to the release of cognitive resources previously absorbed by worrisome thoughts, facilitated by a heightened protection from interference. [ABSTRACT FROM AUTHOR]

Coxiella burnetii is the causative agent in Q fever, a zoonotic disease. Ocular manifestations of this disease are extremely rare and have been infrequently reported. In this report, we describe a rare case of chorioretinitis in a patient incompletely treated for Q fever. We highlight the unique ocular manifestation with multimodal imaging, and the importance of a thorough history and prompt and correct treatment of the disease with systemic therapy. [Ophthalmic Surg Lasers Imaging Retina 2024;55:412–414.] [ABSTRACT FROM AUTHOR]

Systemic practice can be a rich source of fuel for services, nourishing clinicians and families. To us, systemic thinking supports the creation of space, taking pause, being with and seeing the bigger picture. It is about multiplicity, of idea, of voices, of people and cultures coming together to make sense together. In a culture which is struggling under the weight of austerity, the pandemic and ongoing limitations of practice due to staff shortages and limited resources at a time of extreme demand, we need something to open ourselves and our clients to new possibilities and build trust and safety. This paper will describe systemic family therapy within a secondary care community mental health team. You will hear the voice of Jo, a consultant clinical psychologist and systemic psychotherapist and Funmi, an assistant psychologist in the team. We will discuss decision-making in this work and explore the experiences of the reflecting team, highlighting the value of a systemic approach in secondary adult mental health. The straightest route is not always the most effective or nourishing, sometimes it takes the windy path to get the richest source of progress. [ABSTRACT FROM AUTHOR]

This article describes the implementation of Open Dialogue, an integrative approach drawn from systemic family therapy, dialogical theory, and social constructionism, across a range of mental health services within an NHS Trust. Reflections are given from staff working in Early Intervention in Psychosis and Acute Inpatient services, on the experience of training and the feasibility of implementing this approach. The conclusion draws together the learning gained and challenges experienced, as well as identifying areas for future development. [ABSTRACT FROM AUTHOR]

This article explores the resurgence of psychedelic medicine and its potential applications in mental health care. It discusses the historical use of psychedelics in various cultures and the recent scientific interest in their therapeutic potential. The focus is on psilocybin and ketamine, two specific psychedelic medicines, and their use in evidence-based treatment strategies. The article also examines the interaction between psychedelics, nature, and healing. It provides an overview of the research conducted on psilocybin and ketamine, highlighting their potential benefits in treating conditions such as smoking cessation, cancer-related anxiety, major depressive disorder, and eating disorders. The mechanisms of action for these substances are discussed, including pharmacological, brain network level, psychosocial, and behavioral effects. The article concludes with a personal account of the author's experience studying a unique model of psychedelic-assisted therapy that combines ketamine, group therapy, Internal Family Systems therapy, and integration activities. The Internal Family System (IFS) therapy approach is a non-pathologizing method that helps individuals use their inner resources and self-compassion to treat symptoms of various conditions, including depression, anxiety, and substance abuse. This therapy is particularly effective for trauma treatment. A study on Group Ketamine-Assisted Psychotherapy (GroupKAP) found that participants experienced significant reductions in mental distress and improvements in self-leadership after engaging in IFS-centered group therapy combined with ketamine treatment. The study also highlighted the importance of group therapy and the potential benefits of combining psychedelic [Extracted from the article]

This study evaluated the outcomes of patients with non-clear cell renal cell carcinoma (RCC) and RCC with sarcomatoid features receiving systemic treatment. We conducted a single-center retrospective analysis of 251 patients with advanced RCC receiving systemic therapy. Overall, patients with nonclear cell histology and RCC with sarcomatoid features had worse overall survival compared to those with clear cell histology. Background: Patients with nonclear cell renal cell carcinoma (RCC) and RCC with sarcomatoid differentiation have been under-represented in clinical trials. This study evaluates the outcomes and treatment patterns of patients with nonclear cell RCC and RCC with sarcomatoid features compared to those with clear cell RCC receiving systemic therapy. Methods: A single-center retrospective analysis of patients with advanced or metastatic RCC receiving systemic therapy was conducted. Patients were divided into groups based on histology: nonclear cell RCC, clear cell RCC, and RCC with and without sarcomatoid features. The primary endpoint was overall survival (OS) for each group calculated from the date of diagnosis of advanced or metastatic RCC to the date of last follow-up or death. Additionally, an exploratory analysis was conducted by nonclear cell t ype and t ype of first-line treatment. Results: Overall, 251 patients were included, with most treated before 2018. First-line therapies included vascular endothelial growth factor monotherapy (68.5%), immunotherapy monotherapy (7.6%), immunotherapy combination therapy (16.7%), or other treatments (7.2%). Overall survival was shorter for patients with nonclear cell RCC compared to clear cell RCC (39.2 months vs. 81.1 months, hazard ratio (HR), 1.60, 95% Confidence Interval 1.0, 2.6, P = .04). Additionally, OS for patients with sarcomatoid differentiation was shorter compared to patients without sarcomatoid differentiation (43.4 vs. 75.0 months, HR 1.5, 95% CI 0.8, 2.6, P = .20). Conclusion: We demonstrate inferior outcomes among patients with advanced or metastatic nonclear cell RCC and RCC with sarcomatoid differentiation receiving systemic treatment. Further prospective studies are warranted testing immunotherapy combinations and novel treatments in patients with nonclear cell RCC. [ABSTRACT FROM AUTHOR]

This paper introduces the Attachment Mapping Protocol (AMP), which is an assessment and treatment tool for use in individual psychotherapy, systemic family therapy and multifaith spiritual care, using a bio-psycho-social-spiritual model of care. Attachment theory has a long and significant history in psychology, with an evolving relationship within the above clinical domains. A central aim of this paper will be to recognize and affirm the extension of attachment theory beyond the traditional parameters of nascent parental, guardianship bonds and individual, developmental psychology, to reveal a much broader spectrum of valid attachment considerations for mental health and spiritual well-being. A case study will be applied to the interviewing instrument to demonstrate its utility for broadening assessment beyond attachment figures to include surrogate attachments of other persons, places and things. A model of spiritual discernment derived from the Spiritual Exercises of Ignatius of Loyola will undergird this larger worldview of attachment considerations. [ABSTRACT FROM AUTHOR]

Globally, gastric cancer is a major cause of cancer mortality, with a 5-year survival rate of 32% for locally advanced and metastatic gastric cancer (A/MCG). This systematic literature review summarized the clinical, safety, and humanistic outcomes associated with systemic regimens administered as a first-line therapy for A/MGC. The search included articles published in English in PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and the American Society of Clinical Oncology meeting library, from inception to April 2022. Phase II and III randomized controlled trials (RCTs) conducted among western populations diagnosed with stage III and IV A/MGC were included. Two investigators independently reviewed the studies, conducted data extraction, and assessed risk of bias in accordance with PRISMA guidelines. Twenty-four randomized controlled trials totaling 8705 patients were included. Median overall survival ranged from 5.0 to 13.1 months, median progression-free survival ranged from 2.0 to 7.7 months, and objective response ranged from 13.0 to 64.1%. Two studies reported high quality-of-life outcomes. Grade 3 and 4 adverse events were reported in most studies. This review provides a comprehensive overview of first-line systemic therapy outcomes in western populations with A/MGC. With the evolving treatment landscape of A/MGC, an improvement in clinical outcomes can be seen in recently published RCTs with immunotherapies. The potential of new targeted treatments and immunotherapies may present more favorable forthcoming options for treating A/MGC. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author explores the evolution of family therapy from the 1980s to the present day, highlighting key theoretical shifts and contributions by influential figures such as Evan Imber-Black. Topics covered include the rise of feminist perspectives, collaborative language approaches, and narrative therapy, as well as Imber-Black's significant impact on the field as a teacher, mentor, and advocate.

Objective: The therapeutic options for metastatic pheochromocytomas/paragangliomas (mPPGLs) include chemotherapy with cyclophosphamide/vincristine/dacarbazine (CVD), temozolomide monotherapy, radionuclide therapies, and tyrosine kinase inhibitors such as sunitinib. The objective of this multicenter retrospective study was to evaluate and compare the responses of mPPGLs including those with pathogenic variants in succinate dehydrogenase subunit B (SDHB), to different systemic treatments. Design: This is a retrospective analysis of treatment responses of mPPGL patients (n = 74) to systemic therapies. Methods: Patients with mPPGLs treated at 6 specialized national centers were selected based on participation in the ENSAT registry. Survival until detected progression (SDP) and disease-control rates (DCRs) at 3 months were evaluated based on imaging reports. Results: For the group of patients with progressive disease at baseline (83.8% of 74 patients), the DCR with first-line CVD chemotherapy was 75.0% (n = 4, SDP 11 months; SDHB [n = 1]: DCR 100%, SDP 30 months), with somatostatin peptide receptor-based radionuclide therapy (PPRT) 85.7% (n = 21, SDP 17 months; SDHB [n = 10]: DCR 100%, SDP 14 months), with 131I-meta-iodobenzylguanidine (131I-MIBG) 82.6% (n = 23, SDP 43 months; SDHB [n = 4]: DCR 100%, SDP 24 months), with sunitinib 100% (n = 7, SDP 18 months; SDHB [n = 3]: DCR 100%, SDP 18 months), and with somatostatin analogs 100% (n = 4, SDP not reached). The DCR with temozolomide as second-line therapy was 60.0% (n = 5, SDP 10 months; SDHB [n = 4]: DCR 75%, SDP 10 months). Conclusions: We demonstrate in a real-life clinical setting that all current therapies show reasonable efficacy in preventing disease progression, and this is equally true for patients with germline SDHB mutations. [ABSTRACT FROM AUTHOR]

Intimate Partner Violence (IPV) or Domestic Violence (DV) affects the mental health of women. Systemic family therapy has been found to help bring change in a couple's relationship and the cessation of violence in the relationship, provided both couples are motivated by the therapy to preserve the marital relationship. This article presents a case of offering brief tailor-made individual intervention as well as couple therapy for a woman with depression experiencing violence. [ABSTRACT FROM AUTHOR]

I believe that this use of JMFT content is making an impact on how people practice, teach, or learn systemic family therapy, but that it is the kind of "impact" i.e. more difficult to determine compared to a physical citation of a particular article. Seeing more international representation means more readers of JMFT and more researchers thinking of JMFT as an appropriate outlet for their work. 6 Table JMFT's top-cited articles in the calendar year 2022 (inclusive of articles published before and during the impact factor period (2020-2021). Perhaps the most significant thing that happened within the pages of JMFT in 2022 was the continuation of the trend set by my predecessors, to do a decade-review of all the systemic family therapy outcome research. [Extracted from the article]

Although clinicians, educators and parents have been alarmed by the decline in the mental health of children and adolescents commensurate with the Covid‐19 pandemic, statistics indicate there has been a downward spiral over the last decade. This has been evident in the overall increase in suicide rates for young people. For legal and mental health professionals working in the Family Court system, this has provided unique challenges. Most vulnerable has been those children and adolescents embroiled in high conflict divorces, especially those exhibiting parent child contact problems. This article focuses upon that population exhibiting parent child contact problems, and their treatment, specifically Family Intensive Intervention. Building Family Resilience is an Intensive family treatment program that has had to address this deterioration in child and adolescent mental health and increase in suicidality. The role of social media in both exacerbating and/or ameliorating mental health issues is explored. Key points for the family court community: In 2021 the Surgeon General declared a youth mental health crisis, yet it is 2023 and access to mental health care is still difficult to obtain.The rate of suicide in children has increased during the last decade, and is the second leading cause of death in the United States for young people between the ages of 15 and 24.The paucity of mental health providers is particularly problematic in the forensic arena, especially in treating families in which there are Parent Child Contact Problems (PCCP).Often the PCCP cases linger in litigation for years, and effective outpatient treatments are no longer indicated. At this juncture, Intensive Family Interventions may be required.The impact of social media is often considered a contributing factor to the adolescent mental health crisis, and has led to the filing of lawsuits against social media companies. [ABSTRACT FROM AUTHOR]

Aims: To explore the views and experiences of educational psychologists (EPs) using Reflecting Teams (RT; see Andersen, 1987) via an online virtual platform, as a new approach to practice within one local authority (LA) educational psychology service (EPS). Methods: This exploratory research was based on a case study design (Yin, 2018) and, using Engeström’s (1999, 2015) cultural-historical activity theory (CHAT) as an analytical tool, sought to capture and explore how members of one LA EPS as a unique social context, used RT in practice via an online meeting platform, over the course of one academic school session. Nine members of the EPS responded to open-ended questions on an online survey after one month of using the RT method. Six EPS members responded to the same survey after ten-months implementation of the RT method. Data were interpreted through thematic analysis (Braun & Clarke, 2006, 2019, 2020) and CHAT, to explore participants’ views and experiences of their RT activity. Findings: CHAT analysis identified seven contradictions in relation to EPs’ perceptions of their Reflecting Teams activity: ‘learning vs. implementing’ (object of activity), ‘stakeholder-oriented vs. practitioner-oriented’ (outcome), ‘protected time’ vs. ‘not enough time’ (rules), ‘equitable participation’ (roles), ‘safety vs. vulnerability’ (roles), ‘actual community vs. ideal community’ (community), and ‘online platforms vs. in-person meetings (tools)’. EPs reported that Reflecting Teams provided: support with complex problems and challenges in EP casework and practice; peer-support from colleagues; and enhanced staff wellbeing. Time, training, resources, distribution of roles and the importance of ensuring a sense of safety, were highlighted as factors that mediated EPs’ experience of the Reflecting Teams method. Limitations: Findings reflect the experiences of a small sample of participants from an EPS in one local context. Conclusions: The study represents a unique example of the use of Andersen’s (1987) Reflecting Teams method, as an approach to systemic practice and family therapy, applied within the context of EP practice. CHAT provided a valuable framework which offered an insightful and nuanced interpretation of participants’ perceptions and reflections of their engagement in RT as a novel process for professional learning in one LA EPS. [ABSTRACT FROM AUTHOR]

The number of studies conducted on the family, which has great importance in the life of the individual and society, is increasing. The need for studies on the establishment, continuity, and protection of the family has increased with the rapid change in family structure and the increasing divorce rates in recent years. Family therapy helps family members to deal with and solve their problems with a holistic perspective. The present study aimed to uncover the effectiveness of Spiritually-directed Family Counseling in complex family problems. Developed by Kılınçer, the "Family Therapy Model Using Satir Transformational Systemic Therapy with the Focus on Spiritual Practices of Islam" is a semi-structured model created by integrating the spiritual-religious sources in Islam with Satir transformational systemic therapy. The study was conducted in 11 sessions with a nuclear family with one child who applied with complex problems such as infidelity, bipolar disorder, cancer, childhood traumas, relationship problems, porn addiction, violence, and suicide attempt. As a result of the therapy, it was found that spirituality-directed family counseling can lead to changes in the family at the first level (less fighting, less anger, calmness, etc.) and at the second level (for the couple to forgive and understand each other internally, opening up more space for each other's feelings, expectations and longings, etc.). [ABSTRACT FROM AUTHOR]

Immunotherapy and targeted therapies have been shown to considerably improve long-term survival outcomes in metastatic melanoma patients. Real-world evidence on the uptake of novel therapies and outcomes for this patient population in Canada are limited. We conducted a population-based retrospective cohort study of all metastatic melanoma patients diagnosed in Alberta, Canada (2015–2018) using electronic medical records and administrative data. Information on BRAF testing for patients diagnosed in 2017 or 2018 was obtained through chart abstraction. In total, 434 metastatic melanoma patients were included, of which 110 (25.3%) were de novo metastatic cases. The median age at diagnosis was 66 years (IQR: 57–76) and 70.0% were men. BRAF testing was completed for the majority of patients (88.7%). Among all patients, 60.4%, 19.1%, and 6.0% initiated first-line, second-line, and third-line systemic therapy. The most common therapies were anti-PD-1 and targeted therapies. The two-year survival probability from first-line therapy, second-line therapy, and third-line therapy was 0.50 (95% CI: 0.44–0.57), 0.26 (95% CI: 0.17–0.40), and 0.14 (95% CI: 0.40–0.46), respectively. In the first-line setting, survival was highest for patients that received ipilimumab or ipilimumab plus nivolumab, while targeted therapy had the highest survival in the second-line setting. This study indicates that novel therapies improve survival in the real world but a considerable proportion of patients do not receive treatment with systemic therapy. [ABSTRACT FROM AUTHOR]

Background: Many women with early-stage breast cancer are predicted to be at sufficiently low risk for recurrence that they may forego chemotherapy. Nevertheless, some low-risk women will experience a local recurrence, and for them the risk of death increases significantly thereafter. The utility of initiating chemotherapy at the time of local recurrence has not been adequately addressed. The purpose of this study is to identify, in a hospital-based series of patients with early-stage breast cancer who were not treated with chemotherapy, those factors which predict death post local recurrence. Methods: We identified 135 women who were diagnosed with early-stage breast cancer (node-negative, <5 cm) and who did not receive chemotherapy at diagnosis and who developed a local recurrence. They were diagnosed between 1987 and 2000 and treated at Women's College Hospital. For each patient, we abstracted information on the initial cancer (age at diagnosis, tumour size, tumour grade, ER status, PR status, HER2 status, lympho-vascular invasion, type of surgery, use of radiotherapy, tamoxifen and chemotherapy), the time from initial diagnosis to local recurrence and treatment at recurrence. The Kaplan–Meier method was used to estimate the ten-year actuarial risk of breast cancer death post recurrence. A Cox proportional hazards model was used to estimate multivariate hazard ratios for the various factors. Results: Among the 135 women in the cohort, the mean time from initial diagnosis to local recurrence was 7.8 years (range: 0.3 to 22.6 years). A total of 38 of the 135 women (28.1%) died of breast cancer a mean of 5.3 years after experiencing the local recurrence (range: 0.3 to 17 years). The ten-year breast cancer survival post local recurrence was 71% and the 15-year survival was 65%. In a multivariate analysis, it was found that factors that were significantly associated with death after local recurrence were (1) PR-negative status, (2) young age at diagnosis (<40 years) and (3) time to local recurrence less than 2 years. Nine percent of women received chemotherapy at the time of local recurrence. Conclusions: For breast cancer patients with a low baseline risk of mortality, the risk of death after an isolated local recurrence is substantial. Systemic treatment at the time of local recurrence needs further study. [ABSTRACT FROM AUTHOR]

Objective: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), mean platelet volume (MPV), and systemic immune inflammation index (SII) are recently used as indicators of inflammation. NLR, PLR, MLR, and MPV have been evaluated in many studies in patients with schizophrenia and bipolar disorder. However, there are no studies investigating SII. This study aims to evaluate NLR, PLR, MLR, MPV, and SII values and complete blood count elements in patients hospitalized with diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode by comparing them with the control group. Methods: A total of 149 patients who were hospitalized with diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode and who met the inclusion criteria were included in our study where the control group was composed of 66 healthy individuals. White blood cell (WBC), neutrophil, lymphocyte, platelet, and monocyte counts were obtained retrospectively from complete blood counts at the time of admission, based on which NLR, PLR, MLR, and SII were calculated. Results: In this study, higher NLR, PLR, and SII values and lower MPV and lymphocyte counts were observed in schizophrenia patients compared to the control group. NLR, PLR, and SII values and neutrophil counts were higher in patients with bipolar disorder compared to the control group. Lower MPV values were found in patients with schizophrenia compared to patients with bipolar disorder. Conclusion: Simple inflammatory and SII values in our study indicate the presence of low-grade systemic inflammation in schizophrenia and bipolar disorder. [ABSTRACT FROM AUTHOR]

The Editor of JMFT discusses the state of research in systemic family therapy. [ABSTRACT FROM AUTHOR]

This paper presents a case study that explores the application of systemic family therapy in working with children who are victims of violence within their family. The case study focuses on the Johnson family, comprising a father, mother, and their two children, who sought therapy after a traumatic incident of domestic violence. The therapeutic approach utilized a systemic family therapy framework, aiming to address the complex dynamics resulting from the violence and its impact on family members. The goals include providing a safe environment for children to process their experiences, enhancing communication, promoting non-violent parenting, and strengthening the family's support network. The interventions involved individual sessions with the children, family sessions, psychoeducation, and collaborative goal setting. Throughout the therapy process, significant improvements were observed, including enhanced communication, improved emotional well-being for the children, non-violent parenting strategies, and the development of a support network. The findings of this case study highlight the effectiveness of systemic family therapy in promoting healing, fostering healthy relationships, and creating a nurturing environment for children affected by family violence. [ABSTRACT FROM AUTHOR]

The article focuses on Family Myths, a forgotten novel by Adam Ważyk, a member of the Kraków Avant-Garde. Zdunik analyzes "family myths" in the context of social changes that resulted from the First World War, as depicted in the novel. He discusses the reception of the work in relation to the historical and literary categories of a memoir and bildungsroman. This helps recognize the "family myth" as a cognitive category, which organizes the way the characters perceive reality, especially everyday family life. In Ważyk's novel, the "family myth" has a similar function to its psychological counterpart, well known in the family systems therapy. In both cases, it helps come to terms with a difficult and neurotic reality. In other words, these conservative, traditional beliefs, or the eponymous "myths", help one adapt to the ever-changing world. Paradoxically, however, the family myth plays a role in creating that very neurosis, as it traps the characters in their formulaic ways of perceiving the world, hampering individual development which is necessary to keep up with changing social mores. To address this problem, Zdunik examines the story of two characters in Ważyk's novel, Ewa Karcz and Karol Karcz. He calls the first myth "the myth of resistance to puberty", as it shows how the female protagonist, despite her emancipatory gestures (running away from her family home, getting married young, getting pregnant), is unable to become an independent individual. In the case of Karol Karcz, the "myth of pseudoinitiation" is conspicuous in his becoming romantically involved with a maid, Zenobia Ożarowska. Karcz, however, does not opt for a mature relationship; he takes advantage of Zenobia, thus legitimizing male power. [ABSTRACT FROM AUTHOR]

Objective To examine as secondary analyses the effect the FAMily-Oriented Support (FAMOS) family therapy program on reducing parent-reported medical traumatic stress in the sub-sample of pediatric cancer survivors, age 2–5 years. Methods The FAMOS study was a national multicenter randomized controlled trial with all four pediatric oncology departments in Denmark (Clinicaltrials.gov [NCT02200731]). Families were randomized in parallel design (1:1) to intervention or usual care. The FAMOS program includes seven home-based psychotherapeutic sessions and is based on family systems therapy to address the individuals in the family system using cognitive behavioral, problem-solving and goal-setting techniques. Questionnaires were completed by parents at baseline, 6, and 12 months. In linear mixed-effects models, the effect of FAMOS on reducing children's trauma-related behavior after 6 and 12 months was examined in 62 children (31 in the intervention and 29 in the control group, respectively). It was also examined if a trauma-related behavior effect was mediated through reduced symptoms of depression in mothers and fathers, respectively. Results On average, children in the intervention group experienced significantly larger decreases in trauma-related behaviors at 6 and 12 months than the control group (predicted mean difference –3.89, p  = .02 and –6.24, p  = .003, respectively). The effect on trauma-related behavior was partly mediated through reduced symptoms of depression in mothers, but not fathers. Conclusions Adding to previously reported positive effects of the FAMOS intervention on parents' symptoms of post-traumatic stress and depression, significant improvements were found in young children's trauma related-behavior. Further research is needed to develop therapy for children with cancer. [ABSTRACT FROM AUTHOR]

Background: In the ATLANTIS study, second-line lurbinectedin/doxorubicin did not improve overall survival (OS), however patients with a chemotherapy-free interval (CTFI) of ≥180 days had an improved progression free survival (PFS). The objective of this retrospective study was to identify the proportion of real-world small cell lung cancer (SCLC) patients who are suitable for lurbinectedin-based therapy based on these criteria. Methods: A retrospective study of all SCLC referred to BC Cancer between 2012 and 2017 was conducted. Patient demographics, staging, treatment, and survival data were collected retrospectively. Baseline characteristics were compared using descriptive statistics. OS was calculated using Kaplan–Meier curves. Statistically significant p-value was <0.05. Results: A total of 1048 patients were identified. Baseline characteristics: median age 68 years, 47% male, 61% current smoking status, 68% extensive disease. Best supportive care was received by 22%. First-line systemic therapy was platinum doublet for 71% of the population. Second-line systemic therapy was delivered to 22%. Of the 219 patients who received second-line systemic therapy after platinum doublet, 183 patients had a CTFI of ≥90 days and 107 patients had a CTFI of ≥180 days. Patients originally treated as limited stage disease, received platinum doublet as second line, received thoracic radiation (RT) or prophylactic cranial irradiation (PCI) were more likely to have a CTFI of ≥90 and ≥180 days. Conclusion: In our real-world SCLC population, only 21% of the SCLC population received second-line therapy after platinum doublet with 17% achieving CTFI of ≥90 days and 10% CTFI of ≥180 days. Based on this retrospective review, only a small fraction of platinum-treated patients would be preferentially offered lurbinectedin in the second-line setting. [ABSTRACT FROM AUTHOR]

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