Antonio Iudici

Background: Mental health services face significant challenges in providing equitable care to ethnic minority and migrant populations. Despite the right to healthcare, disparities in service use among minority communities reflect not only practical barriers but also deeper issues of cultural compatibility between patients and health systems. Aim: This study aimed to provide a systematic overview of the main difficulties encountered by ethnic minority and migrant people when seeking psychological support from mental health services, with a specific focus on linguistic and communicative barriers and organisational and economic barriers. Methods: A scoping review was conducted using the SCOPUS database, searching for peer-reviewed studies focused on the European context. Studies were included if they addressed ethnic minorities’ experiences with mental health services from a user perspective and included primary research of any design. Studies focused exclusively on staff perspectives or not specifically addressing ethnic minorities’ help-seeking were excluded. Twenty studies met the inclusion criteria. A qualitative narrative synthesis was adopted, following PRISMA-ScR guidelines. Results: People with an ethnic or migrant background face specific and compounded barriers when seeking mental health support. Two main categories were identified: linguistic and communicative difficulties, including language distance, limited interpreter availability, and the gap between Western biomedical models and cultural frameworks of distress; and organisational and economic obstacles, including poor knowledge of available services, socioeconomic disadvantage, stigma, and institutional distrust. Discussion: These barriers are deeply structural and cannot be addressed through awareness campaigns alone. Increased access to services is not inherently beneficial unless accompanied by a fundamental transformation ensuring that care is culturally appropriate, safe, and genuinely responsive to minority communities’ needs. Distrust of mental health services may in part reflect a historically grounded and legitimate response to institutions whose practices have not always served the interests of minority groups. Conclusions: Reducing disparities in mental health care requires multi-level intervention, including inclusive policies, training of culturally competent professionals, and a critical rethinking of the models underpinning mental healthcare care. Future research should attend not only to the quantity of service use among minority populations but to the quality, cultural legitimacy, and safety of the care provided.

Background: Role-playing has been employed across diverse psychotherapeutic traditions, yet no comprehensive synthesis has examined contemporary applications with adult populations and analyzed which theoretical orientations have reported beneficial or positive outcomes and under what implementation modalities. Objective: This systematic review with narrative synthesis aimed to summarize empirical evidence (2015–2025) on the use of role-playing in adult psychotherapy, examining implementation patterns (clinical populations, design and duration, descriptions of role-playing procedures), therapeutic outcomes, and emerging trends across theoretical frameworks. Methods: Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed, PsycINFO, Scopus, and Web of Science for empirical studies published between January 2015 and May 2025. Eligible studies included adults (≥18 years) receiving psychotherapeutic interventions that incorporated role-playing or related enactment techniques (e.g., psychodrama, empty-chair technique, behavioral rehearsal), defined as therapeutic interventions in which the therapist assigns and guides the enactment of roles to foster psychological change. Results: Twenty-six studies met the inclusion criteria. Most (≈77–80%) adopted psychodramatic frameworks, primarily in group settings (73%), addressing conditions such as depression, trauma, substance use, chronic illness, dementia, fibromyalgia, infertility, and complicated grief. Across studies, consistent improvements were observed in symptom reduction, emotional regulation, interpersonal functioning, and empowerment, with preliminary evidence for psychophysiological changes (e.g., cortisol reduction, neural connectivity). Role-playing was most frequently conceptualized within psychodramatic or experiential models, but promising integrative applications combined psychodrama with cognitive-behavioral, emotion-focused, and person-centered approaches. Conclusion: Findings from this review suggest promising but preliminary evidence regarding the use of role-playing as a flexible and theoretically versatile intervention that can be adapted across clinical populations and orientations. Considering its reported beneficial effects across diverse clinical contexts, there is substantial potential for other therapeutic approaches to systematically integrate and investigate role-playing within their own theoretical frameworks. Future studies should therefore explore how role-playing can be used in different models of psychotherapy, employ rigorous designs, standardized outcome measures, and longitudinal assessments, and examine both in-session and out-of-session enactments to clarify processes of change and long-term effects.

One of the most important criticism about mental health services regards the difficult that people meet when looking for a psychological support from these services. These health problems concern every citizen, but even more so for people with an ethnic background who are more exposed to discrimination, stigma and marginalization than the majority population of a country. For this reason, we decided to conduct research on scientific material on this topic, focusing on articles that shed light on the perspective of users belonging to ethnic minorities. The selected articles refer to some countries belonging to the European Union. Furthermore, the research focused on the main barriers that users reported perceiving when accessing mental health services. This paper offers a review of Europe literature concerning the need to estimate the main critical issues for which ethnic or migrant people are not receiving an appropriate help from mental health services. Another important characteristic is that the work aims to give a voice to the people involved in this review, which is why only articles and works that noted the user’s own perspective were considered. Our work found that people with different cultural background face specific barriers when seeking help from mental health services, in particular, we noted two main barriers that will be specifically explained. The results show that people with ethnic or migrant background have to face more and specific critical aspects when seeking psychological help compared to the main population of a nation. In particular, the criticism of being discriminated includes the criticism of being treated differently, unequally or disparately compared to the majority of population of a country. Even today, ethnicity plays a significant role in determining how people receive mental health care. The perception of receiving unfair and often ethnocentric treatment and the underrepresentation of ethnic minority patients in clinical services indicate that ethnic minorities face significant unmet healthcare needs, which may further contribute to the socioeconomic difficulties that some minority groups already face.

Digital technologies such as the Internet, social media, and online games have become integral to an adult’s everyday life, yet their implications for health-related behaviors remain the subject of ongoing debate. While existing research has extensively examined risks and benefits of digital media use, evidence focused specifically on adult populations and on the psychological processes supporting health-oriented engagement remains fragmented. This systematic review with narrative synthesis, conducted in accordance with PRISMA 2020 guidelines, examined peer-reviewed studies published between 2015 and 2025 involving adults (≥18 years). Searches across PubMed, Scopus, Web of Science, and PsycINFO identified 27 eligible studies addressing spontaneous use of the Internet, social media, or online games in relation to actual health behaviors. Across studies, a consistent pattern emerged in which self-efficacy, health literacy, motivation, risk perception, and perceived social support were associated with the adoption of health-related behaviors, particularly physical activity, preventive practices, healthy eating, and health information seeking. However, the literature was characterized by a predominance of cross-sectional designs, a strong geographical concentration in East Asian contexts, and a marked imbalance across digital environments, with social media and informational Internet use being far more frequently studied than online games. Overall, the findings suggest that digital technologies are neither inherently beneficial nor harmful for adult health; rather, their effects depend on users’ psychological competencies and modes of engagement. By synthesizing evidence across digital contexts, this review proposes a competence-oriented framework that helps explain how everyday digital media use may translate into health-promoting behaviors in adulthood, while also highlighting critical gaps that future longitudinal, cross-cultural, and gaming-focused research should address.

Socioeconomic crises can deeply affect personal narratives and community dynamics, sometimes leading to acute mental health emergencies such as suicidal crises. These situations require structured interventions. Textual analysis, by addressing interactive and narrative dimensions, offers a valuable framework for crisis management and health promotion. This case report describes an individual whose economic and employment instability escalated into an acute suicidal emergency, marked by high and imminent risk, loss of agency, dependence on others, and intensifying suicidal ideation. The intervention employed the MADIT (Methodology of Computerized Analysis of Textual Data), using textual analysis to identify linguistic markers of suicidal intent, guide therapeutic dialog, and support clinical decision-making. The case outlines the user’s texts, the professional’s analysis of underlying narratives, ongoing and final assessments, and the therapeutic measures applied. It also includes the professional’s self-reflection on their engagement with the patient. Examining narrative processes enabled the design, monitoring, and evaluation of an effective intervention strategy. This approach values both the patient’s expressed content and the interactive process through which meaning is constructed in the therapeutic relationship, contributing to more effective crisis management. The case highlights the potential of textual analysis-based methodologies in managing suicidal emergencies, enhancing assessment accuracy, strengthening intervention, and promoting individual health and social cohesion. Overall, this structured yet flexible framework supports anticipation, monitoring, and management of biographical developments within emergency clinical contexts.

The increase in requests for certifications has created uncertainty and changes in the way minors are perceived in the school environment. The way in which schools categorize minors can influence their developmental path, facilitating or compromising their psychological and sometimes even clinical development. This article explores how teachers, parents, and child neuropsychiatry services in Italy identify and communicate a student's difficulty that may lead to a diagnostic certification of special educational needs (SEN). Drawing on an ethnopsychological perspective and employing semi-structured interviews with 46 participants, the study investigates the discursive and interactional dynamics underlying referral practices in schools. Using Critical Discourse Analysis (CDA), we examine how perceptions of nonconformity with educational norms become grounds for suspecting pathology, and how such perceptions are shaped by institutional expectations, professional uncertainty, and the search for legitimacy. The results reveal three specific conceptualizations of children: the needy child, the demanding child, and the child with strengths and weaknesses. Findings reveal that difficulties are often framed through comparisons with peers, failure to meet didactic standards, and behavioral non-adherence to school rules. Certification is frequently requested as a strategy for managing uncertainty or delegating responsibility to specialists. The results highlight a systemic inclination toward medicalising school diversity, exacerbated by communication gaps between schools, families, and health services. The study recommends clearer protocols, enhanced teacher training, and culturally sensitive approaches to promote inclusive and dialogic educational practices.

Introduction: The research project aims to explore the discourses and beliefs that students have towards the school psychologist. Recent historical and cultural events have brought to light existing difficulties and needs, due to the lack and inadequacy of resources, revealing a clear separation between the school context and that of daily life. The urgency and necessity of a coordinated psychological intervention that moves between the various levels of the school have been highlighted. Method: The research involved 70 high school students from various institutions. Through Harré’s discursive positioning analysis, it was possible to detect the configuration that students have regarding themselves and the school psychologist, and, above all, to understand the dynamics of the school community, which are reflected in the interaction between actors, creating particular scenarios of reality. Results: As a common background to the narratives, the image of the school psychologist emerged as a fundamental and necessary professional figure, whose constant presence in the school context is required. At the same time, various representations of the functions that the psychologist can assume emerged. The psychologist’s intervention proves useful not only in emergency situations and difficulties where moments of impasse and suffering manifest, but especially in the moments and events of daily life that take place at school through the promotion of well-being and support for adolescents. Discussion: This study is particularly important in the current context because by giving voice to students’ experiences and needs, it is possible for the school system to address and manage them. The research directs its usefulness to professionals who intend to carry out their work in the school context, offering important information on how to build an adequate psychological service at school.

The issue of gender variance in childhood and adolescence is increasingly relevant, as it challenges traditional binary gender norms and social structures. Children who express gender identities outside conventional expectations often disrupt these long-standing frameworks. For parents, raising a gender-variant child can be disorienting, requiring them to question their assumptions about gender. In Italy, there is a significant lack of awareness and resources regarding the needs of transgender and gender-variant minors, making it difficult for families to access resources or find appropriate support. This study involved interviewing Italian parents of gender-variant minors to explore how they came to understand their child’s gender identity and how they navigated this potentially unfamiliar situation. Through discourse analysis of the transcribed interviews, we examined how parents engage with their child’s gender variance. The goal was to investigate how parents configure gender variance and related needs, identifying the challenges they encountered in their role, and exploring the strategies they employed or proposed for supporting this developmental journey. The research highlights the importance of fostering a collaborative parent–child relationship in the co-construction of gender identity, rather than relying on self-referential or ideological approaches, or uncritically accepting binary gender conceptions. The study’s findings offer valuable insights to help parents better understand and anticipate the evolving needs of gender-variant children, while developing effective strategies to manage challenges, according to an affirmative approach to gender identity. These results can promote skills that allow parents to provide meaningful support, fostering a healthier and more inclusive environment for child’s identity development.

This study focuses on the process of Court-Appointed Expert Consultation (Consulenza Tecnica d’Ufficio, CTU) that parents involved in high-conflict separations must undergo. The CTU is an expert psychological assessment commissioned by the court to assist legal proceedings, aimed at providing judges with essential information for well-founded decisions. Given that this is a relatively new but rapidly growing field in Italy, also considering the increasing divorce rates, specific scientific literature on the subject is still limited. Therefore, the purpose of this research is to examine in greater depth how separated parents perceive and experience this process, considering the psychological aspects involved, their expectations, their evaluation of the investigation’s utility, and the motivations underlying their request. Through qualitative research based on semi-structured interviews, the results highlight that participants view the CTU as a useful decision-making tool for the judge, but also as a mediator and guardian of minors. However, parents often confuse the role of the CTU with that of a mediator. Many parents expect a “corrective” CTU for the other parent, based on the idea that the problem lies with the other party. Indeed, while the request primarily arises to protect the children, it is also aimed at countering the other parent. Parents described the process as a demanding but ultimately useful, offering opportunities for reflection and new insights. The CTU is ultimately seen as a “validation” of parental suitability and a tool for vindication, but also as not always resolving family conflicts. We believe these findings can be highly useful for the Courts that initiate the investigation, as well as for all professionals involved, including psychologists, lawyers, and juvenile judges.