The author has not supplied his/her declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

The schizophrenia is a frequent mental disorder. The symptoms affect the emotions, cognition, perception and other aspects of the behaviour. In the last years have been developed different interventions and psychological treatments in order to improve the personal and social functioning of these patients. Among the new proposals is the called “third wave”.

Determine the efficacy of third generation therapies in the treatment of schizophrenia.

We have performed a systematic review of the existing bibliography in PubMed/Medline, Cochrane and Dialnet, using the combination of different keywords “acceptance and commitment therapy, mindfulness, psychosis, schizophrenia, third wave of therapies, based cognitive therapy”.

The based cognitive therapy for the psychosis (CBT) was designed for the treatment of the residual symptoms of schizophrenia, however in the present there are over 30 randomized trial publications were is evaluated the efficacy of CBT in psychosis, on positive and negative symptoms, functionality and affectivity. It is most effective in acute episodes.

The treatment with the third generation therapies reduces the positive symptoms of schizophrenia and improves depressive and anxiety symptoms. The CBT and the mindfulness are the most studied. There are scientifically therapeutic options for the treatment of patients with schizophrenia in combination with pharmacotherapy.

The authors have not supplied their declaration of competing interest.

The use of psychotherapy is an important part of treating psychiatric disorders, in combination with medication taking. However, despite its importance, psychotherapy is still underused from individuals with psychiatric problems in Greece.

To examine the use of psychotherapy, among psychiatric outpatients, in the last four years.

To investigate whether there are differences in the use of psychotherapy, in combination with medications, to treat psychiatric disorders, from 2012 to 2015.

In this study participated 5,551 patients, 2,760 males (49.7%) and 2,791 females (50.3%). The mean age was 45.54. Convenience sampling method was used and participants were recruited from the General Hospital of Nikaia, ‘Ag. Panteleimon’, in Athens, Greece, from 01/01/2012 to 31/12/2015. SPSS software was used to analyse the data.

There were significant differences between the four years (2012–2015) with regard to the use of psychotherapy, in combination with medications, from psychiatric patients as χ2 (21): 753.057, P < 0.001. More specifically, only 0.1% of psychiatric patients undertook psychotherapy in addition to taking medications, in 2012, and this increased to 2.7%, in 2013, 13.8% in 2014 and 18.6% in 2015.

There was an increase in the use of psychotherapy, in combination with medication taking, during the four last years, from 2012–2015. However, the percentage of patients undertaking both psychotherapy and taking medications is still low. This has important clinical implications as the use of psychotherapy plays a significant role in achieving optimal health outcomes of psychiatric patients.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

There is ongoing debate about about both the value of psychotherapy in psychotic disorders and the best type of psychotherapy to use if necessary.

We conducted narrative psychotherapy with 18 adults, all diagnosed as having bipolar disorder with psychotic features and/or schizo-affective disorder. Outcome data consisted of the Positive and Negative Symptom Scale, the Clinical Global Impressions Scale, the Young Mania Rating Scale, the Hamilton Anxiety and Depression Scales, the My Medical Outcome Profile, Version 2(MYMOP2), and the Outcome Rating Scales of Duncan and Miller. We compare the outcomes of our patients to those of a matched comparison group receiving conventional psycho-education and cognitive behavioural therapy. Patients were seen for a minimum of 16 weeks over an average of 22 weeks. Average age was 31.5 years with a standard deviation of 8.1 years.

The narrative therapy group showed statistically significant reductions in all outcome measures compared to the conventional treatment group. They continued treatment significantly longer and had fewer re-hospitalizations. They were less distressed by voices.

A narrative psychotherapy approach using dialogical theory and therapy ideas is a reasonable approach for the psychotherapy of psychosis. Review of psychotherapy notes showed that narrative approaches allowed the therapist to align with the patient as collaborator in considering the story presented and was therefore less productive of defensiveness and self-criticism than conventional approaches. The therapy included techniques for negotiating changes in illness narratives, identity narratives, and treatment narratives that were more conducive of well-being and recovery.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Interaction with time is a fundamental human characteristic that varies significantly in situations of severe chronic disease. Multiple sclerosis (MS) refers to medical conditions with severe damage to the nervous system, which have poor prognosis for patients.

To explore the relation between clinical variants of multiple sclerosis and time perspective in MS patients for goals of psychological interventions.

A total of 104 MS inpatients (25 men and 79 women aged 19 to 64) filled out Russian version of Zimbardo time perspective inventory (ZTPI) developed by A. Sircova, E.T. Sokolova, and O.V. Mitina, 2008. Seventy-three patients were diagnosed for relapsing-remitting multiple sclerosis (RRMS) and 31 patients for secondary progressive multiple sclerosis (SPMS).

Analyzing the difference in ZTPI values in MS patients one could notice that RRMS patients showed a greater focus on positive past, while SPMS patients indicated a higher priority on the future. No gender specifics were identified in MS patients with different clinical variants of the disease (P > 0.05).

The data revealed could be related to the fact that SPMS patients having more severe clinical variant of MS were forced to the issues of living with the disease planning. They were ready to assess and to prepare for possible negative consequences of the disease. They also sought the most efficient use of available resources for their own future and future of their loved ones. The resulting evidence can be used to determine clinical targets for psychological interventions in MS patients.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Nuns undertaking psychotherapeutic treatment are a particular group of patients. As human beings, they experience similar emotions, everyday worries, crises and difficulties as everyone else during social interaction, but at the same time they fill a special role in society. Presented behaviours, reactions to stressful situations, unaccepted emotional states that appear to be maladaptive, are often intensified by the rules of monastery life.

The aim of this investigation was to uncover the most significant issues in terms of the specificity of therapeutic work with nuns.

The subjects were 12 patients (nuns) with the diagnosis of depressive-anxiety disorder (F41.2 according to ICD-10 criteria). Over the course of the last 10 years (since 2005) we observed the therapy processes of 12 nuns. The psychotherapy group consists of 12 patients at our ward. Every time there was only one nun in the group.

This study gives an overview of issues and problems reported by the nuns: their sex significantly determines their position in the community of consecrated sociality, their obligations to perform specific work, the rules to follow as well as the resulting consequences for the functioning of mental health.

In the process of psychotherapy is important and necessary to distinguish between theological and psychological aspects, between what is secular and what is spiritual. The psychotherapy group's as well as the therapist's perception of a nun is of special importance as it is sometimes difficult to distinguish between her social role and her needs, desires, difficulties and conflicts as a human being.

The authors have not supplied their declaration of competing interest.

The outcome questionnaire (OQ-45) has been one of the most frequently used instrument to measure clinical outcomes in psychotherapy. Probably due to its subscale structure, its applicability for a variety of disorders and life struggles, its sensitivity to change by repeated measurements and its predictive ability. Given its popularity, OQ-45 has been translated into several languages.

As the Spanish version has not been published, through this poster it is going to show the reliability and the dimensional structure of the OQ-45.

One hundred and thirty-nine patients in clinical settings have completed the Spanish version. Three different confirmatory factor analysis have been calculated to analyze the construct validity.

The Cronbach Alpha of the instrument was adequate .92, but also, in the three dimensions: symptoms distress (.90), interpersonal relations (.78) and social role (.66). Through the CFA was proved that the Four-factor bi-level model structure [χ2(900) = 3930.47, P < .001, AGF = .86, CFI = .91, RMSEA = .061(.049 to .073)]suited appropriately, in fact, more properly than the three-factor correlated or the three-factor with a second order factor models.

The three-factor bi-level model structure of the OQ-45 is confirmed indicating an empirically and clinically relevant measure of client functioning. In this model each item loaded on one of the three subscales originally created. Besides, each item also captures common variance represented by the general factor of overall maladjustment, where this factor may indicate the degree to which respondents are functionally impaired. Thus, OQ-45 is an instrument that could be used for monitoring treatment efficacy and for making informed decisions about clinically significant changes.

The authors have not supplied their declaration of competing interest.

Most reactions to grief are adaptive. However, there is the possibility that some individuals present a complicated grief disorder, where there is a pathological intensification of symptoms lasting more than 6 months, deserving special treatment.

Evaluate the effectiveness of two types of intervention in complicated grief: group intervention (GI) and cognitive-narrative (CN) therapy.

Patients in a complicated grief process were selected (n = 70), and distributed in three groups: cognitive–narrative therapy group (CNTG), group intervention group (GIG) and a control group (CG). Inclusion criteria: adults, with a reference to mourning situation, with personal meaning, for over six months and results in ICG ≥30points (cutoff). The Inventory of Complicated Grief (ICG), the Center for epidemiologic studies depression scale (CES-D) and the trauma questionnaire (ICD-11) were used. Follow-up was performed 3 months after the end of each intervention. Data analysis was performed using the statistical package from social sciences (SPSS 20).

With respect to complicated grief symptoms (CGx) and depression symptoms (Dx) there were statistically significant differences between the CNTG and the CG, but not with the GIG. There was no statistically significant effect in post-traumatic symptoms (PTx), even though both interventions had a slight decrease. When the CNTG and the GIG were directly compared, there was only a statistically significant difference between PTx.

In our single center cohort, CNTG was a more effective intervention in complicated grief patients for CGx and Dx reduction. For PTx, no intervention was superior. Larger multi-center studies are needed to validate these results.

The authors have not supplied their declaration of competing interest.

Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are a subgroup of conditions including obsessive-compulsive disorder (OCD), tic disorders, pre-pubertal and sudden onset, temporal association between streptococcal infections and associated neurological abnormalities. Some strategies were developed, including the use of antibiotic prophylaxis to prevent streptococcal-triggered exacerbations, and immunomodulatory interventions for the management of acute symptoms. Cognitive-behavioral therapy (CBT), which has been demonstrated to be the first-line treatment for OCD, can be a valid adjuvant during the difficult course of PANDAS to target acute symptoms and prevent exacerbations.

The study presented a case of a patient with PANDAS treated with antibiotic medication and CBT as augmentation.

The 11-year-old patient (Y-BOCS pre-test score = 32), had been hospitalized for three weeks for acute onset of PANDAS. The clinical picture consisted of asthenia, contamination fears and washing compulsions, separation anxiety, severe depression and anxiety. Pharmacotherapy involved risperidone 2 mg/die and sertraline 250 mg/die for five months combined with antibiotic prophylaxis for two years. The CBT intervention started at discharge from hospital and included psycho-education on anxiety, intensive exposure and response prevention (2 hour sessions three times a week) for twelve months, cognitive restructuring, diffusion and mindfulness for the subsequent twelve months.

Anxiety and OCD symptoms substantially improved. The patient gradually started school again. Post-test score was 11 on the Y-BOCS.

Along with psychiatric and antibiotic medications, CBT may be a valid augmentation strategy for PANDAS to reduce risk of exacerbations and enhance symptom improvement. Limitations are discussed.

The author has not supplied his/her declaration of competing interest.

Supervision is the systematic guidance of a therapist by a supervisor. It is a basic part of training and ongoing education in cognitive behavioral therapy (CBT). Self-reflection and ethical reflection are an important part of supervision.

The Pubmed database was searched for articles using the keywords supervision in CBT, therapeutic relations, ethics, transference, counter transference, schema therapy, dialectical behavioral therapy, acceptance and commitment therapy.

We discuss conceptual aspects related to supervision and the role of self-reflection and ethical reflection. The task of supervision is to increase the value of the therapeutic process in the client's best interest. Establishing the supervisor-supervisee relationship is based on principles similar to those in the therapeutic relationship. Additionally, supervision is oriented towards increasing the therapist's competencies. The CBT therapist's core competencies involve good theoretical knowledge, professional behavior towards clients, ability to use specific therapeutic strategies for maintaining the therapeutic relationship, sensitivity to parallel processes and accomplishment of changes, and adherence to ethical norms. Given the fact that during supervision, the supervisee may be at any stage of his/her training, supervision must take into consideration where the therapist is in his/her training and development and what he/she has or has not learnt.

Both the literature and our experience underscore the importance of careful supervision of cognitive behavioral therapy. Numerous approaches are used in supervision, which is associated with the abilities to self-reflect and to realize transference and counter transference mechanisms.

The authors have not supplied their declaration of competing interest.

Psychotherapy is the most preferable intervention for personality disorder patients and group psychotherapy offers the possibility to increase the self-perception through resonance and mirroring processes. When a group is disorganized and emotionally tensioned generates regressive movements, which make it a basic assumption group.

To highlight the change of a group of patients after the inclusion of a new patient named Margherita.

The patients were included within the group run by two psychotherapists after a cluster B personality disorder's clinical diagnosis (except for antisocial personality disorder), confirmed by SCID II and by a set of individual interviews aimed to prepare the patient to the inclusion within the group.

Margherita, from the first sessions, showed the tendency to coercively polarize the attention on herself through themes of discouragement and helplessness, posing a threat for the members’ identity and resulting in a disorganization of the work group, which became a basic assumption group.

The temporary disorganization of the group with the consequent regression to a worse functioning condition has subsequently allowed to revitalize the group and to avoid its dissolution. After the temporary regression, indeed, the work group was restored and started again to function even based on the new patient's problems.

The authors have not supplied their declaration of competing interest.

Clinical death is etiologically non-specific state of reversible cessation of blood circulation and breathing, the two necessary criteria to sustain life. Serious consequences in form of anxiety and/or depression can remains after recovery.

Male patient 55 y/o with no prior history of psychiatric difficulties, who experienced clinical death after cardiac infarction. Reanimation was successful and he was discharged with minimal if any cardiac consequences. During the hospitalization in Coronar unit he reacted with major depression, and aftermath with disabilitating anxiety and panic attacks followed by avoidant behavior, obsessive thoughts, social withdrawal, and consequently, very poor quality of life, regardless of the favorable outcome of somatic (cardiac) illness. The patient did not wanted psychiatric medications, so EMDR treatment was introduced. We assess negative cognition: why do I have to die twice? “Subjective unit of disturbance regarding the traumatic event (SUD) was 9”. Adhering to the EMDR protocol, the therapist helped the patient to re-process the traumatic event (the very moment when he was told that “he was died”). Complete desensitization and reprocessing were accomplished, SUD was 0, VoC was 7. Patient reached pre-morbid level of psychosocial functioning, doing his demanding job, and enjoying his social life.

Near death experience has high traumatic potential with serious psychological consequences. EMDR is efficious treatment for variety of anxiety disorders caused by psychologic trauma due to physical illness.

The authors have not supplied their declaration of competing interest.

In psychosis, the capacity of symbolization is lost to different extents and patients live in a concrete world of objects. Moreover, the lack of boundaries between self/other, inside/outside severely impairs the capacity of these patients to understand and recognize reality from the delusional dimension.

Working through psychotic concreteness and accessing a first subjectivation of this experience, that leads to the development of a first symbolization.

Achieving the possibility to access a first symbolization and begin a delicate process of appropriation of the emotional experience with the establishment of the boundaries between inside/outside.

The use of “pliable media”, such as drawing, as therapeutic mediation allows a partial defraction of the violent transferential dynamics from the therapist and let unsymbolized material to emerge less destructively in the treatment fostering a first figurability.

The Squiggle game as “pliable medium” facilitates a first encounter in the therapeutic relationship and represents a primal transitional area that allows a gradual working through process to take place where the establishment of the boundaries between inside/outside could begin.

We suggest that the use of “pliable media” in the early stages of the psychotherapy of psychotics can significantly favor a first encounter between patient and therapist and, at the same time, provides the first experience of a transitional space where a working through process leading to first representations can take place.

The authors have not supplied their declaration of competing interest.

Emotional avoidance is a target process, offered by modern psychotherapies. Emotional exposure is often difficult to put in place when there is a major cognitive and behavioral avoidance. Education on emotional processes is necessary but often insufficient during individual follow-up.

The longitudinal study seeks to verify whether work on exposure and emotional identification influences the decreased level of anxiety and depression.

Introduction of interoceptive exposition in psychotherapy decreases the frequency of emotional avoidance.

Group psychotherapy composed of two modules: interoceptive exposure and emotional identification was proposed to patients with anxiety and depressive disorders. A group of 6 participants was evaluated at three times: T0 before the start of the group, T1 post-module 1 and T2 post-group. Assessments of HAMA anxiety, MADRS depression, QEC cognitive avoidance, UPPS impulsivity, MCQ-30 metacognition and emotional regulation REQ-21 have been proposed.

Significant differences were observed between pre- and post-intervention scores (Friedman test). The HAMA anxiety rate (P = 0.006) and the MADRS depression (P = 0.047) decreased. Participants in the group were less likely to use QEC thought substitution (P = 0.009) and urgency in their UPPS reactions (P = 0.03). Moreover, their external dysfunction REQ. 21 decreases (P = 0.03).

Faced with emotional avoidance, work on emotional identification requires prior interoceptive exposure. It is a first stage of work that involves sensitizing to the presence of emotional bodily sensations. Group work facilitates exposure to emotion and its identification; decentration leading to emotional intensity decrease. The work on the interoceptive exhibition facilitates the emotional exposure while participating in the deactivation of the associative emotional network.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.