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Unemployment and precarious employment have been treated as liminal states where people’s everyday lives are rendered into an “in-between” position, a place where the uncertainty of meaning and decision-making prevail. Liminality has also been applied as a way of understanding a changing social world, implying a transformation in consciousness emanating from prolonged indeterminism. To develop a clearer understanding of coping with liminal status, we used a narrative futuring approach (i.e., a reflexive practice to elicit narratives from the viewpoint of a desired future). Twenty “letters from the future” were written by unemployed and precariously employed young adults with higher education degrees living in Crete. The letters engaged the participants in the process of critical reflection, where they imagined eutopian lifeworlds by attempting to place the prevalent “crisis story” in the background, embracing or confronting liminal status. Implications focus on how the narrative future-making approach can be applied to disentangle the complexities involved in understanding liminal states and their inherent transformative potential where both personal, interpersonal, and the broader social and societal context come into awareness.

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. 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. 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. 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. Breaking 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.

Futures consciousness (FC), considered to be the basis for human anticipation, is important for its role in facing uncertainties and delineating alternative courses of action. This is especially so for emerging adults, who are traversing a life stage fraught with uncertainty and complexity. The COVID-19 pandemic as a high-impact event may trigger modes of engaging with the future to become more explicit. Through critical engagement with the 5-dimensional FC model (Ahvenharju, Minkkinen, & Lalot, 2018), we develop a methodology for qualitatively assessing FC. We analyze how emerging Dutch and Greek adults narrate FC dimensions (time perspective, agency beliefs, openness to alternatives, systemic awareness, concern for others) in letters written from the perspective of a desired post-Corona future. Results show that emerging adults, although caught-up in a subjective timeframe in which the pandemic is enduring, think beyond immediate concerns. They do so in a way that conveys some attribution of agency and systemic awareness. Openness to alternatives is shown using several sophisticated linguistic devices. When further developed, the methodology will enable educators and futurists to support individual's imagination of possible and preferred futures. This may contribute to resilient people and societies in and beyond times of economic, health, and environmental crises.

Contains fulltext : 282409.pdf (Publisher’s version ) (Open Access) The covid-19 global syndemic has upended societies worldwide and concomitantly united the world in a shared experience of lockdowns, social distancing, and economic upheaval. In the face of great uncertainty, dystopian realities, and binding government edicts, people's everyday lives, sense of agency, actions, and interactions changed forcibly. Importantly, it has disrupted many practices and routines essential for (re)constituting a sense of belonging, an important element of personhood and individual wellbeing. Using the "Letters from the Future" method, we investigate how individuals imagine and present themselves in the future to navigate this social change. We ask "How do letter writers construct a sense of belonging in a future of their own imagining?" To answer this question, we combine discourse- and text analysis with network analysis to examine 47 letters that Greek participants wrote during the Spring 2020 lockdown. We explore how individuals present and introduce their future self, what topos this self inhabits and what expressions, values, and practices they perform and negotiate as they reflect on and navigate their relational worlds. By and large, Greek letter writers recognize that inequities and injustices paved the way for the syndemic and express a pressing need for societal transformation. 14 p.

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 also differed between the five countries but the differences between countries were more pronounced for women than for men. In conclusion, causal beliefs were multifaceted among laypersons and shared basic characteristics with empirically derived risk factors. The more pronounced differences for women suggest that potential gender effects should be considered in cross-cultural research.

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 also differed between the five countries but the differences between countries were more pronounced for women than for men. In conclusion, causal beliefs were multifaceted among laypersons and shared basic characteristics with empirically derived risk factors. The more pronounced differences for women suggest that potential gender effects should be considered in cross-cultural research.

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 reorganize their recollections, reestablish self-continuity by integrating their ICU experiences, and authored restitution narratives.

The potential for a critical realist community psychology in the Greek context is not yet apparent. In this article, we present the results of a qualitative study that adheres to critical realism and community psychology principles. The study's focus is the lives of members of the 12 Clubs of Families with Alcohol-related Problems (CFAP) that operate on Crete. The empirical material was derived from fieldwork notes, minutes from CFAP weekly meetings, and interviews provided by 13 CFAP members. Participants conceptualized the path from alcohol addiction to sobriety as a transition from a world of falsehood and deceit ("fractured reflexivity") to a world of truth and communalism ("communicative reflexivity"). The article argues that CFAP's "regime of truth" prioritizes communicative reflexivity as the desirable mode of reflexivity, while at the same time contributing to an ambivalent political stance towards the oppressive structural arrangements that promote addiction.

The efficiency of interventions in addiction is associated with the processes of practitioners’ professional development. Identity formation is studied extensively for clinical professions but litt...

Few studies to date have investigated trauma training programs for healthcare workers who serve refugees. The purpose of this pilot study was to investigate the feasibility of a Train-the Trainer (...

Psychotherapy’s impact and effectiveness have been explored through the use of quantitative research methods such as standardised inventories and scales measuring mainly behavioural and overt aspects of the psychotherapeutic encounter and symptom reduction. Nonetheless, change in psychotherapy is a complex, multifaceted phenomenon, requiring open-ended investigation to reveal the beneficial factors that are part of the process. This paper will demonstrate how Interpretative Phenomenological Analysis (IPA) can be applied in studying the psychotherapy process’s favourable aspects from the client’s perspective. We argue that IPA’s epistemological underpinnings and methods for collecting and analysing data can contribute to the study of psychotherapy’s impact. A case of a woman confronting the challenges of multiple sclerosis and illness symptomatology by undergoing psychodynamic psychotherapy is presented and analysed drawing on IPA guidelines.

The present study examines whether attitudes of mental health professionals (MHPs) towards severe mental illness are associated with professional quality of life. The Attitudes towards Severe Mental Illness (ASMI), the Maslach Burnout Inventory (MBI), and the Professional Quality of Life Scale-5 (ProQOL-5) were completed by 287 MHPs in Greece (25.4% males, 74.6% females). The results indicate that MHPs hold predominantly positive attitudes towards people with severe mental illness. Nonetheless, MHPs' attitudes are deemed to be stereotypical according to ASMI concerning treatment duration, prospects of recovery, and whether patients are similar to other people. Higher scores in emotional exhaustion, depersonalization, compassion fatigue and ProQOL-5 burn out dimension were significantly associated with MHPs' unfavorable attitudes, whereas higher scores in compassion satisfaction and personal accomplishment were associated with MHPs' positive attitudes. Assessing compassion fatigue, compassion satisfaction and burnout levels could help identify the processes involved in the development or maintenance of MHPs' stigmatizing attitudes.

Background The mental healthcare treatment gap (mhcGAP) in adult populations has been substantiated across Europe. This study formed part of MentALLY, a research project funded by the European Commission, which aimed to gather qualitative empirical evidence to support the provision of European mental healthcare that provides effective treatment to all adults who need it. Methods Seven focus groups were conducted with 49 health professionals (HPs), including psychologists, psychiatrists, social workers, general practitioners, and psychiatric nurses who worked in health services in Belgium, Cyprus, Greece, the Netherlands, Norway and Sweden. The focus group discussions centered on the barriers and facilitators to providing quality care to people with mild, medium, and severe mental health problems. Analyses included deductively and inductively driven coding procedures. Cross-country consensus was obtained by summarizing findings in the form of a fact sheet which was shared for triangulation by all the MentALLY partners. Results The results converged into two overarching themes: (1) Minding the treatment gap: the availability and accessibility of Mental Health Services (MHS). The mhcGAP gap identified is composed of different elements that constitute the barriers to care, including bridging divides in care provision, obstacles in facilitating access via referrals and creating a collaborative ‘chain of care’. (2) Making therapeutic practice relevant by providing a broad-spectrum of integrated and comprehensive services that value person-centered care comprised of authenticity, flexibility and congruence. Conclusions The mhcGAP is comprised of the following barriers: a lack of funding, insufficient capacity of human resources, inaccessibility to comprehensive services and a lack of availability of relevant treatments. The facilitators to the provision of MHC include using collaborative models of primary, secondary and prevention-oriented mental healthcare. Teamwork in providing care was considered to be a more effective and efficient use of resources. HPs believe that the use of e-mental health and emerging digital technologies can enhance care provision. Facilitating access to a relevant continuum of community-based care that is responsive coordinated and in line with people’s needs throughout their lives is an essential aspect of optimal care provision.

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.

This article adopts a pragmatic‐communicative approach, derived from Gregory Bateson's cybernetic theory, to the Greek Referendum Vote of 2015. Applying this approach, we interpret the Referendum as a double‐bind situation. Our research question is twofold: (1) How do potential Greek voters discursively construct the Referendum? (2) How do they respond to the communicative situation posed? A total of 124 written narratives, “Letters from the Future,” written by 99 participants, were collected during the days prior to the vote. Their letters focused on a desired future situation after a YES or a NO vote outcome. Qualitative analysis showed how the letters were used to appropriate the Referendum query in a unique and deeply personalized manner. Moreover, we identified four types of responses to the ambivalent query: confirmation, rejection, disconfirmation, and meta‐communication. These responses are indicative of the psychological and emotional burden posed by the query and of ways people responded to the query. In conclusion, we reflect on the importance of recognizing the psychological dimension of the vote, the role of narratives from the future for personal and social transformation, and the wider relevance of the proposed future‐making, pragmatic approach to other Referendum situations.

In this study, we aim to contribute to the field of critical health communication research by examining how notions of mental health and illness are discursively constructed in newspapers and magazines in six European countries and how these constructions relate to specific understandings of mental health literacy. Using the method of cluster-agon analysis, we identified four terminological clusters in our data, in which mental health/illness is conceptualized as “dangerous,” “a matter of lifestyle,” “a unique story and experience,” and “socially situated.” We furthermore found that we cannot unambiguously assume that biopsychiatric discourses or discourses aimed at empathy and understanding are either exclusively stigmatizing or exclusively empowering and normalizing. We consequently call for a critical conception of mental health literacy arguing that all mental health news socializes its audience in specific understandings of and attitudes toward mental health (knowledge) and that discourses on mental health/illness can work differently in varying contexts. publishedVersion

RECONSTRUCTING PAST AND FUTURE TO CREATE NEW EXPERIENCE The reconstruction of past and future is a central topic of research in both psychological and historical science. Psychological research on time perspective indicates that while imagining the future and remembering the past are common processes people engage in, some people are more disposed to orient toward the future than others (Boniwell and Zimbardo; Vowinckel et al). Imagining the future is similar to remembering the past in the sense that both processes involve an interpretation from the point of view of the present. Life review, that is, a structured form of reminiscence, is based on the principle that the meaning of past actions and events as well as the self can be rewritten. This notion of "rewriting the self" (Freeman) is based on an analogy between life and story. In the narrative approach we adopt here, the self is defined as an evolving story (McAdams), which is multivoiced (Hermans and Kempen), and validated in social interaction (Gergen). In telling, writing, and sharing stories about themselves and their life world people constitute who they are and are not; what they desire, seek, and imagine; going beyond the present; and integrating cultural memory and historical consciousness (Brockmeier 79). More particularly, life review draws on strategies to revise the self in such a way that more acceptance and integration of negative life events and more authorship of the life story is achieved (Westerhof and Bohlmeijer). Narrative futuring, for example, a guided process of writing from the future to the present (i.e., letters from the future) can be viewed as the future-oriented counterpart of life review (Sools et al., "Mapping Letters from the Future"). An important function of incidentally occurring future imagination in everyday life, but even more so of its structured extension narrative futuring, is to guide present thought and action (Sools and Mooren). Narrative futuring offers a way to reconstruct the self in light of desired ends in a process that involves the articulation of values and goals, and the means to achieve them. Hence, looking forward and looking back both depart from the present, but serve different functions. While the construction of the past and the future share "present-centeredness," according to theoretical historian Koselleck "these are not symmetrical complementary concepts [...] Experience and expectation, rather, are of different orders" (260). While the past makes up a "space of experience," the future should be more accurately conceptualized as a "horizon of expectation," which "directs itself to the not-yet, to the nonexperienced, to that which is to be revealed" (259). The assumption that the future cannot be experienced in the same way as the past has been dominating narrative theory and argumentation about the construction of past and future. The argument includes, "There is a crucial formal difference between images and stories recollected and those projected. Those recollected are capable of high definition, a large measure of completeness. An image of the future is vague and sketchy, a story incomplete and thin" (Crites 164-65). Narrative futuring, however, presents an alternative in which the future can become, at least partially, an experience (Sools et al., "Mapping Letters from the Future", Tromp, and Mooren). This future-made present is achieved by constructing a future self as if realized, with a vivid portrayal of the future self "as an experiencing subject" (Crites 167). By bringing future and present into a single imaginative and experiential plane, the potential of the "penetration of the horizon of expectation" necessary for the creation of new experience (Koselleck 260) comes closer into view. After all, a future that is fully founded upon past experience will result in the recurrence of that experience in the present. The unexpected, filled with an element of surprise, may create new experience. …

The main body of research on addiction and pathological narcissism has focused on the study of their co-occurrence by applying Diagnostic and Statistical Manual of Mental Disorders ( DSM) definitions for these clinical phenomena or by assessing trait narcissism in substance-dependent populations. Clinically informed comprehensive conceptualizations of narcissism which focus on its phenomenological range from vulnerability to grandiosity have not been applied in studying the specific narcissistic disturbances that underlie the relationship between these comorbid conditions. Aiming to examine this relationship, this study compared the presence of pathological narcissism, and more specifically narcissistic grandiosity and vulnerability, in substance-dependent individuals in treatment with individuals from the general population. Comparisons indicate that substance-dependent individuals experience significant narcissistic disturbances more likely related to vulnerability than grandiosity. Shame, rage, and self-esteem contingent upon external validation comprise the intrapsychic and interpersonal vulnerability. Implications for the clinical conceptualization of pathological narcissism as well as for substance dependence treatment interventions are discussed.

The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.

The overriding aim of this paper is to analyse Greek adolescents' digital video making and sharing, the voices they represent in their videos, the dialogical interactions they evoke, and how this activity relates to their everyday lives as they traverse the crises that have taken hold in their country. A focused search of YouTube content was conducted which yielded five videos for analysis. These texts were ‘re-read’ using multimodal analysis and the resulting ‘texts-on-texts’ were analysed using thematic analysis. Via the creation of YouTube videos young people visually convey and communicate their representations of the crises and provide a rich analysis of how the following themes define their lived-experiences: (a) ‘unoccupied youth and occupied dreams yield a sacrificed generation’; (2) ‘blanket condemnation of powerbrokers, their messengers, and mesmerizing mediums’; and, (3) ‘hypnagogia and the insidious enslavement of the psyche’.

Public health and in particular mental health have been severely affected by the multitude of socioeconomic crises experienced by people in Greece. The severe austerity programmes, have reduced access to health services and increased demand for publically funded health care. This paper presents a case study focusing on the impact of these measures on the lives of mental health providers in one prefecture in Crete. Focus group methodology was applied and the data were analysed using thematic analysis. Analyses revealed three superordinate themes that converge at many levels and appear to be going counter to the circumstances: firstly, ‘forging partnerships for mental health’; secondly, ‘extending our reach’; and thirdly ‘transformations in professional identity through praxis’. These themes are discussed using the words of the participants and the relevant literature.

Objective: Contemporary psychotherapy research has focused mainly on practitioners' training and education. The impact of training on professional development and the application of therapeutic skills have been the primary foci of the empirical literature. The aim of this paper is to present the experiences of seven family therapy trainees regarding their personal paths toward the development of professional identity as they underwent training in systemic psychotherapy. Method: In-depth interviews were conducted and analysed using Interpretative Phenomenological Analysis. Results & Conclusions: Seven themes were identified: The Quest, Developing by Relating, Learnings, Personification of Training, Use of Self, Self-Care and Empowerment, and Reflecting on the Role of the Therapist. The findings are discussed with regard to the development of the ‘therapist as a person’, gaining acknowledgement and autonomy, and the development of a community of therapeutic practice.

The aim of the present study was to examine the psychometric properties of the Greek version of Family Adaptability and Cohesion Evaluation Scales IV (FACES IV) Package. The original FACES IV displays a six-factor structure with two balanced scales—Balanced Cohesion and Balanced Flexibility—and four unbalanced scales—Disengaged, Enmeshed, Rigid, and Chaotic—and has been shown to have satisfactory internal and test–retest reliability. A total of 584 family members agreed to participate in the study. The findings indicated that the Greek version displays similar factor structure to the original version. Cronbach’s α coefficients for the six scales ranged from .59 to .79. The test–retest correlation coefficients ranged between .94 and .97. The Family Communication Scale and the Family Satisfaction Scale demonstrated high internal consistency and test–retest reliability. Thus, the Greek version of the FACES IV Package appears to be a valid and reliable instrument to be used in both research and clinical assessment of family functioning.

The present study brought together and examined two related, but distinct, concepts rooted in positive psychology, namely subjective wellbeing (SWB) and character strengths. It sought to assess the impact of a number of demographic and other sociological and psychological factors, including physical and mental health, on emerging adults’ outlook on life. This study also set out to validate and investigate the levels of wellbeing and character strengths in the context of a more collective, Mediterranean culture; that of Greece. Three hundred and twelve male and female students from two Greek Universities participated in the study, which consisted of a questionnaire battery, including measures of subjective wellbeing, character strengths and mental and physical health. Youths were found to have a positive outlook on life. Wisdom, courage and transcendence appeared to be the most salient among their character strengths, since character strengths were each highly and positively correlated with the wellbeing subscales of environmental mastery, purpose in life and self-acceptance. Good physical and mental health were positively related to, and reliably predicted different aspects of, both wellbeing and character strengths; nevertheless, mental health appeared to affect and predict more aspects of wellbeing and character strengths than physical health. The significance of the above findings for the field of positive psychology is discussed.

This article describes a therapeutic technique called co-creating the sequence of meanings. The technique was developed within the Greek therapeutic context, incorporating traditional Greek approaches such as reflexive therapeutic techniques and applying them to contemporary Greek family issues and situations. Greek socio-cultural context and relevant psychotherapeutic theoretical approaches are described, as well as contemporary therapeutic issues that shaped the development of the technique. The role of the therapist and general principals underpinning the technique are discussed as central to its effective use. The four stages of the technique itself are described in detail including excerpts from transcribed therapy sessions, followed by a complete case example demonstrating each stage within the context of a family therapy session. General advantages and limitations in the application of the technique are also outlined.

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 characteristics that had an impact on the participants' lives. The 3-month family support programme intended to introduce ‘philosophical dialogues’ as means to developing personal and communal understandings of what makes life worth living. The programme was developed and implemented on Crete under the auspices of a non-profit community organization appropriately named ‘The Lyceum for Women’. The features of the programme that contributed and enhanced the participants' tendencies to become not passive targets but active partners and stakeholders in the process will be clarified, as will the conceptualization and approach. Of the 45 evaluation protocols that were analysed the following themes were most important for the participants: ‘Group as-a-whole process’—the sense of sharing and development understandings in a ‘parea’ (in-group); ‘relational outcomes’—feeling of belonging, ‘reciprocated kindness’, and giving of self to others; personal and emotional outcomes-self-efficacy and empowerment; knowledge outcomes-learning about positive emotions and enjoying the simple things in life; and group facilitator outcomes-sharing stories, ‘gives of self to the community’. Copyright © 2007 John Wiley & Sons, Ltd.

The present study aimed to evaluate a path analytic model accounting for caregivers' psychological distress that takes into account perceived family cohesion and flexibility, expressed emotion and caregiver's burden associated with the presence of mental illness in the family. 50 first-episode and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers participated in the study. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Structural equation modelling was used to evaluate the direct and indirect effects of family dynamics on caregivers' psychological distress. The results showed that neither family cohesion nor family flexibility exerted significant direct effects on caregivers' psychological distress. Instead, the effect of flexibility was mediated by caregivers' criticism and family burden indicating an indirect effect on caregivers' psychological distress. These results apply equally to caregivers of first episode and chronic patients. Family interventions aiming to improve dysfunctional family interactions by promoting awareness of family dynamics could reduce the burden and improve the emotional well-being of family caregivers.

Background The aim of the present study was to investigate whether dysfunctional family functioning contributes to relapse over a two-year follow-up period in patients experiencing their first episode of psychosis (FEP) and chronic patients with psychosis. Methods The sample consisted of 100 remitted patients (50 FEP and 50 chronic) diagnosed with schizophrenia (82%) or bipolar disorder with most recent episode manic severe with psychotic features (18%) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), expressed emotion (FQ), family burden (FBS) and caregivers’ psychological distress (GHQ-28). Relapse was defined as patient rehospitalisation due to acute psychotic exacerbation, while number, length, and type of hospitalisations were also evaluated. Results Dysfunctional family functioning in terms of cohesion and flexibility was not found to be a significant risk factor for relapse in psychosis. High expressed emotion, as indexed primarily by increased levels of criticism rather than emotional over-involvement, was associated with increased risk of relapse and shorter time to relapse (HR = 0.48, 95% CI: 0.24, 0.98, p = 0.043). Similarly, high levels of family burden were related to shorter time to relapse (HR = 0.47, 95% CI: 0.23, 0.95, p = 0.037), whereas there was no significant difference in survival curves based on caregivers’ psychological distress. No significant interaction effect of illness chronicity was observed in the aforementioned associations. Conclusion These findings highlight caregivers’ criticism and burden of care as long-term predictors of the course of psychosis from the early stages of the illness and later on. In contrast, unbalanced levels of cohesion and flexibility in the family, as well as caregivers’ high emotional over-involvement and psychological distress do not appear to be factors that contribute to patient relapse. Family psychoeducational interventions focusing at ameliorating caregivers’ negativity toward the patient, and easing the burden of care should be considered as means in reducing relapse.

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 purpose of this article is to present the results of the survey we have conducted on the use of psycho-logical tests, assessments and measurements in Greek psychologists in the role of a counsellor. The questions we have addressed are: (1) Which tests and measurements are used? (2) How useful do professionals consider these tests? And, (3) what are the reasons for using these instruments? The findings of the survey are discussed within the context of the cultural conditions – both ‘internal and external’ – to psychology as a discipline that impact upon the use of psychological measurements.

Background:Studies on determinants affecting family functioning of patients with psychosis are still limited in Greece.Aim:The aim of this study was to describe the socio-demographic and clinical characteristics associated with family functioning in patients with schizophrenia and bipolar disorder in Crete, Greece.Methods:A total of 100 patients and their caregivers agreed to participate in the study. Family functioning was assessed in terms of cohesion, adaptability, communication and satisfaction dimensions (Family Adaptability and Cohesion Evaluation Scale IV Package), expressed emotion (Family Questionnaire), family burden (Family Burden Scale) and caregivers’ psychological distress (General Health Questionnaire-28). Multivariate linear regression models were implemented to examine the associations between each one of the family measures and different social and clinical characteristics.Results:With regard to the caregivers’ characteristics, gender, employment status, origin, residence, financial status, relation to the patient, contact with the patient and family structure were among the most significant determinants of family functioning. Also, patients’ socio-demographic characteristics, including age, education, origin, residence and employment status, as well as illness-related factors, such as onset of mental illness, number of hospitalisations, last hospitalisation, longer hospitalisation and clinical diagnosis impacted intrafamilial relationships.Conclusion:The results of this study suggest that a number of social and clinical factors contributed to the family environment of patients with psychosis. Identifying the determinants of family functioning in psychosis is instrumental in developing understandings regarding the factors which may contribute to the rehabilitation or relapse of the patient and the support required to strengthen positive family interactions.

The present study aimed to investigate possible differences in family environment among patients experiencing their First Episode of Psychosis (FEP), chronic patients and controls. Family cohesion and flexibility (FACES-IV) and psychological distress (GHQ-28) were evaluated in families of 50 FEP and 50 chronic patients, as well as 50 controls, whereas expressed emotion (FQ) and family burden (FBS) were assessed in families of FEP and chronic patients. Multivariable linear regression analysis, adjusted for confounders, indicated impaired cohesion and flexibility for families of FEP patients compared to controls, and lower scores for families of chronic patients compared to those of FEP patients. Caregivers of chronic patients scored significantly higher in criticism, and reported higher burden and psychological distress than those of FEP patients. Our findings suggest that unbalanced levels of cohesion and flexibility, high criticism and burden appeared to be the outcome of psychosis and not risk factors triggering the onset of the illness. Furthermore, emotional over-involvement both in terms of positive (i.e. concern) and negative behaviors (i.e. overprotection) is prevalent in Greek families. Psychoeducational interventions from the early stages of the illness should be considered to promote caregivers' awareness regarding the patients' illness, which in turn, may ameliorate dysfunctional family interactions.

Expressed emotion (EE) has proved to be an established factor in short-term relapse in schizophrenia. The aim of the present study was to examine the psychometric properties of the Greek version of the Family Questionnaire (FQ), a brief self-report questionnaire measuring the EE status of relatives of patients with schizophrenia in terms of criticism (CC) and emotional overinvolvement (EOI). The translated and adapted 20-item FQ was administered to 176 family caregivers of patients with schizophrenia and bipolar disorder. Caregivers' burden (Family Burden Scale) and psychological distress (General Health Questionnaire-28) were also evaluated. The findings indicated that the Greek version displays a two-factor structure with two subscales of EE—CC and EOI—with 10 items each, similarly to the original version. The convergent validity of the subscales was highly supported by correlations with caregivers' burden and psychological distress. The Cronbach's α coefficient measuring internal consistency for the two scales were 0.90 for CC and 0.82 for EOI. The test–retest correlation coefficients measuring reproducibility were 0.99 and 0.98 for CC and EOI, respectively. The Greek version of the FQ appears to be a valid and reliable instrument to be used in both research and clinical assessment of family EE.

The influential role of family in the outcome of chronic schizophrenia is well documented. However, there has been relatively little research on the intrafamilial relationships of people experiencing their first episode of psychosis (FEP), a point in time when most of the changes in family dynamics are observed. The aim of this article is to present a review of the literature focusing on the family environment of FEP patients. We carried out a computerized literature search on MEDLINE and PsycINFO (1990–2013), and a manual search of references of pertinent articles. In total, 27 studies investigating expressed emotion (EE) and family burden (FB) in FEP were identified and fulfilled the inclusion criteria. Similar to chronic patients, a high prevalence of high-EE in carers of FEP patients was reported. High-EE status appears to be independent of the patient’s illness-related characteristics, but dependent of relatives’ attributions. In contrast to chronic patients, low levels of FB and psychological distress among family members of FEP patients were observed indicating that in the early stages of the illness family involvement is not yet associated with significant disruption in their lives. Studies assessing FB in chronic patients have found a well-established link of FB with patient’s illness-related factors, but in FEP patients the families’ appraisal of FB is more closely associated with their coping mechanisms. Further studies evaluating family functioning in terms of cohesion and adaptability will shed light on the intrafamilial relationships in FEP patients which may be associated with the long-term outcome of this chronic illness.

An exploratory study sought to reconcile certain contradictions regarding the role of mothers as presented in the social science literature through probing subjective accounts of mothers in the rapidly changing social milieu of Greece. Previous research that has focused on motherhood in Greek society has highlighted how women who become mothers have been given iconic status. However, modern Cretan mothers are increasingly faced with novel challenges. The subjective perceptions of motherhood of Cretan women attending a community group which focused on parenting were probed. Qualitative analysis was carried out on the written narrative accounts. Participants’ responses corresponded to the following levels of narrative analysis: personal, interpersonal/transgenerational, and societal-ideological. Narratives revealed that mothers were experiencing high levels of personal and interpersonal dissonance which impinged upon their identities and challenged them in their roles as mothers. The women’s narrative accounts underscored the emotional and social importance of having achieved the coveted role of being a mother, the stressful and pressure inducing social context which mandates how the mothering role should be enacted, and dialectics between the personal, intergenerational and social levels of experience. The implications of these findings are discussed with regard to identity and relatedness within the family and how social and professional constructs of mothering lag behind social changes.

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.

In this chapter, we describe several community-focused initiatives that may be the stirrings of community psychology (CP) in Greece. Although CP has not ‘officially’ set hold in our country with regard to academic training, professional organizations, and journals, it may be accurate to say that its existence is evident through the many initiatives, programs, and actions that have been developed and applied in many communities throughout the country. It is the services offered by mental health centers, programming for parents, the prevention and health promotion initiatives made possible by the centers for prevention of drug use, and the community volunteer actions that focus on different social issues and community concerns that can be ‘interpreted’ as CP in Greece. The chapter describes the history of these community initiatives, their characteristics, their theoretical underpinnings, and how they relate to the discipline and the practices of CP as they are described in the international literature.