Theo. K. Bouman

The gap between research and clinical practice, known as the scientist-practitioner gap, poses a persistent challenge in clinical psychology. Although existing research suggests that effective engagement with research can be challenging for clinicians, there is limited understanding of the specific barriers, obstacles, and potential solutions as perceived by clinicians themselves. In this focus group study, we explored junior clinicians' perceptions, attitudes, and interactions with clinical research, specifically targeting Dutch mental health psychologists following postgraduate training (n = 32). Through reflexive thematic analysis, we investigated their relation to research in clinical psychology, their perceived value of research, barriers to engagement, and suggestions for the future. Clinicians reported multiple barriers including difficulties in accessing, understanding, and applying research in practice, as well as skepticism about its relevance. We summarize clinicians’ personal opinions and motivations regarding research, systemic issues such as insufficient organizational support, research priorities not matching demands in practice, and methodological limitations of conventional psychotherapy research. With this study, we stressed the need for enhanced communication between researchers and clinicians, methodological considerations, and greater inclusion of clinicians’ perspectives in research processes.

Background: Mental health problems among university students are prevalent, and the availability of online mental health services in Indonesia has increased. However, implementation strategies are still in their early stages of development. This study aimed to explore the experiences and perspectives of Indonesian university students and psychologists regarding online mental health services. Methods: Semi-structured online interviews were conducted with 21 participants (10 university students and 11 psychologists) in Indonesia between September and December 2022. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis to develop an interpretive understanding of patterns of meaning across the dataset. Results: Through reflexive thematic analysis, we generated four themes: (1) fostering engagement and autonomy, reflected in participants’ accounts of feeling more control over time and choices and enhancing engagement through digital innovation; (2) therapeutic limits in digitally mediated care, including the missing human touch, disrupted therapeutic space, and barriers to complex care online; (3) challenges in implementation and delivery, comprising infrastructure gaps undermining care and service variation without standardization; and (4) designing for engagement and trust, covering accessible and easy to engage with, feeling supported in digital care, cultural and personal fit, and tailoring therapeutic approaches to individual needs. Across themes, differences in emphasis were observed, with students often highlighting emotional safety, usability, and flexibility, while psychologists tended to emphasize concerns related to assessment limitations, clinical standards, and the provision of comprehensive care. Both groups underscored the importance of culturally responsive and adaptable service models aligned with Indonesian social norms and values. Conclusions: The findings suggest that while several factors influencing the implementation of online mental health services in Indonesia align with international evidence, context-specific considerations remain important. Designing culturally responsive, accessible, and supportive services may enhance the relevance and sustainability of online mental health care in Indonesia and other low- and middle-income settings.

Background: The Intolerance of Uncertainty Scale short version (IUS-12) has proven to be a robust self-report measure to assess intolerance of uncertainty. While previous psychometric analyses of the IUS-12 have established a stable two-factor structure corresponding to the prospective and inhibitory factors of intolerance of uncertainty, recent studies suggest that the bifactor model may better explain its factor structure. Objective: The current study aimed to adapt and validate the IUS-12 in a Mexican population culturally. Method: The study consisted of a convenience non-probabilistic community sample of 405 adults between 18 and 70 years. Results: Confirmatory factor analyses supported a bifactor model and good internal consistency. Invariance testing indicated partial invariance across women and men. Convergent validity tests showed that the IUS-12 was related to measures of worry, as well as depression and anxiety. Conclusion: These findings provide evidence for the reliability and validity of the adapted version of the IUS-12 in Mexico.

The current systematic review sought to identify quantitative empirical studies that focused on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination, and their relation with depression and post-traumatic stress disorder (PTSD). The overall research aim was to examine the relationship between these transdiagnostic factors and their relation with depression and PTSD symptoms. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Out of the 768 articles initially identified, 55 met the inclusion criteria for the current review. The results determined that intolerance of uncertainty is indirectly related to depression and PTSD symptoms, mainly through other factors including emotion dysregulation and rumination. Additionally, emotional dysregulation is a significant predictor of both depression and PTSD symptoms. Rumination is a robust factor related to depression and PTSD symptoms, this relationship was significant in cross-sectional and longitudinal studies. This review provides evidence on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination in the relationship with depression and PTSD symptoms.

Background: The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited. Objective: To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands. Methods: We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019–December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat. Findings: Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference −0.25; 95% CI −0.385 to −0.122; p=0.0001, Cohen’s d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen’s d=0.42), anxiety (p=0.001, Cohen’s d=0.27), PTSD symptoms (p=0.0005, Cohen’s d=0.39) and self-identified problems (p=0.03, Cohen’s d=0.26), but not on impairment (p=0.084, Cohen’s d=0.21). Conclusions: PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit. Clinical implications: Peer-provided psychological interventions should be considered for scale-up in HICs.

Cognitive behaviour therapy (CBT) is considered to be the most empirically supported treatment in the Western world. However, many authors emphasize the need for cultural adaptations of CBT for patients in a non-Western context. Before considering such adaptations, it is important to investigate the reasons and the degree to which this type of treatment should be adapted. One important factor is the acceptability of CBT by local health care consumers in non-Western countries, for which there is only very limited empirical evidence. This explorative study aimed to investigate the acceptability of CBT’s principles and specific interventions in Indonesia. Lectures and video clips were developed, demonstrating various mainstream CBT principles and procedures. These were presented to 32 out-patients and mental health volunteers from various Indonesian community health centres (Puskesmas), who were asked to rate to what extent they considered the presented materials to be acceptable in accordance with their personal, family, cultural and religious values. Acceptance in all four value domains was rated as very high for the general features of CBT, as well as for the content of the video clips. There were no significant differences in acceptability between the value domains. The presented study suggests that mainstream CBT applications, which are slightly culturally adapted in terms of language, therapist–patient interaction and presentation, might resonate well with consumers in community health centres in Indonesia.Key learning aims(1) Adapting CBT to non-Western patients should be based on empirical evidence.(2) The potential need for adaptation of CBT might depend on the acceptability of unadapted CBT.(3) Acceptability is assumed to be related to patients’ values.