counseling

咨询
  • 文章类型: Journal Article
    随着人口老龄化和60岁以上人群的大量增长,特别是这些人群的心理问题在医疗保健和社会层面上越来越重要。老年人的担忧之一,这会显著影响他们的心理健康,是对不可避免的死亡或死亡焦虑的恐惧。这篇综合综述通过提供与死亡焦虑相关的因素的全面综合以及减轻死亡焦虑的有效干预措施,解决了老年人死亡焦虑的问题。使用PRISMA指南对相关文章进行了系统筛选。对选定的46篇文章进行了内容和主题分析,从中出现了五个关键主题:人口因素,心理和社会心理因素,精神和宗教因素,死亡提醒,有效的干预措施。该综述有助于死亡率学领域,并提供了有关老年人护理的临床见解。
    With the aging of the population and the substantial surge of individuals above the age of 60, psychological concerns particular to this population have come to hold more weight on the healthcare and social levels. One of the concerns of older adults, which can significantly influence their psychological well-being, is the fear of inevitable mortality or death anxiety. This integrative review tackles the subject of death anxiety among older adults by providing a comprehensive synthesis of the factors associated with death anxiety and the effective interventions to mitigate it. A systematic screening of relevant articles was conducted using the PRISMA guidelines. Content and thematic analysis of 46 selected articles were performed, from which five key themes emerged: demographic factors, psychological and psychosocial factors, spiritual and religious factors, death reminders, and effective interventions. The review contributes to the field of thanatology and offers clinical insights into the care of older adults.
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  • 文章类型: Journal Article
    目的:为斜头症定制的处方头盔可能会给家庭带来巨大的经济负担,特别是在没有保险的情况下。这项研究旨在确定影响该疗法众包活动成功的因素。
    方法:GoFundMe活动是通过搜索“plagiocephaly”和“婴儿头盔”等术语来收集的。\“两名审阅者分析了每个营销活动的变量,包括人口统计数据,故事元素,和照片特征。使用单变量逻辑回归来确定每个变量对成功的影响,定义为达到运动目标的≥75%,显著性为p≤0.05。
    结果:分析了2011年至2022年的活动数据。最初的搜索产生了1464个广告系列;其中413个符合最终纳入标准。平均而言,竞选活动筹集了2005美元(范围:0-7799美元),并要求3151美元(范围:160-30,000美元)。总的来说,228(54%)取得成功,167(40%)达到了他们的目标,和35(8%)没有筹集资金。从所需的1301317美元中筹集了总计828256美元。平均报告年龄为6个月(范围:2-17m)。与成功相关的重要因素是军事隶属关系,提供多个图像,包括报价成本,提供活动更新,表明了一种紧迫感,斜颈的诊断,并提及未经治疗的可能并发症。筹集额外的治疗资金,多个头盔,和无关的医疗费用对成功产生负面影响。在竞选活动之间观察到种族差异。此外,各战役之间存在地区差异。
    结论:对于一些因头盔疗法而经历经济困难的家庭来说,众包可能是一项成功的努力。这项研究强调了目前头盔治疗的医疗保健覆盖范围内的差距,并确定了影响众筹活动的各种因素。
    OBJECTIVE: Custom prescription helmets for plagiocephaly may be a significant financial burden for families, especially when not covered by insurance. This study aims to identify factors that influence the success of crowdsourcing campaigns for this therapy.
    METHODS: GoFundMe campaigns were collected by searching terms such as \"plagiocephaly\" and \"baby helmet.\" Two reviewers analyzed each campaign for variables, including demographic data, story elements, and photo characteristics. Univariate logistic regression was used to determine each variable\'s impact on success, defined as attaining ≥75% of a campaign goal and significance of p ≤ 0.05.
    RESULTS: Campaign data from 2011 to 2022 were analyzed. Initial search yielded 1464 campaigns; among these 413 met final inclusion criteria. On average, campaigns raised $2005 (range: $0-$7799) and requested $3151 (range: $160-$30,000). In total, 228 (54%) achieved success, 167 (40%) met their goal, and 35 (8%) raised no funds. A total of $828,256 was raised from the requested $1,301,317. The average reported age was six months (range: 2-17 m). Significant factors associated with success were military affiliation, providing multiple images, including a quoted cost, providing campaign updates, indicating a sense of urgency, diagnosis of torticollis, and mentioning possible complications without treatment. Raising additional funds for therapy, multiple helmets, and unrelated medical costs negatively impacted success. Racial disparities were observed between campaigns. Additionally, regional differences were noted between campaigns.
    CONCLUSIONS: Crowdsourcing can be a successful endeavor for some families experiencing financial hardships from helmet therapy. This study highlights current gaps within healthcare coverage for helmet treatment and identifies various factors influencing crowdfunding campaigns.
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  • 文章类型: Journal Article
    为了解决心血管疾病(CVD)妇女在避孕咨询和避孕方面缺乏明确性的问题,本研究旨在对心血管疾病女性的避孕咨询和随后的避孕方法进行系统评价和荟萃分析.在六个数据库中的搜索确定了1228篇文章,包括11项研究(2580名参与者)。避孕咨询的总患病率为63%,在个别研究中,从36%到94%不等。注意到咨询的交付和文件不一致,以及缺乏有关妊娠并发症的知识和对CVD严重程度的误解。对于避孕摄取(n=5),合并患病率为64%(95%置信区间,45到82%)。还发现患有CVD的女性使用不太有效的方法以及不推荐的方法(例如,具有绝对或相对禁忌症的参与者之间的联合激素方法)。改善心血管疾病妇女的避孕咨询和选择不仅可以根据其生殖目标和偏好增强心血管疾病妇女的知识和决策,而且可以减少高风险的意外怀孕和不良妊娠结局。
    To address the lack of clarity regarding contraceptive counselling and uptake of contraception among women with cardiovascular disease (CVD), this study aimed to conduct a systematic review and meta-analysis on contraceptive counselling and the subsequent uptake of contraception among women with CVD. A search across six databases identified 1228 articles, with 11 studies (2580 participants) included. The pooled prevalence of contraceptive counselling was 63%, varying from 36 to 94% in individual studies. Inconsistent delivery and documentation of counselling were noted, along with a lack of knowledge about pregnancy complications and misconceptions regarding CVD severity. For contraceptive uptake (n = 5), the pooled prevalence was 64% (95% confidence interval, 45 to 82%). Women with CVD were also found to use less effective methods as well as methods not recommended for their condition (e.g., combined hormonal methods among participants with absolute or relative contraindications). Improving contraceptive counselling and choices for women with CVD can not only enhance knowledge and decision-making for women with CVD in line with their reproductive goals and preferences but reduce high-risk unintended pregnancies and adverse pregnancy outcomes.
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  • 文章类型: Journal Article
    背景:在最近的出版物中,患COPD(慢性阻塞性肺疾病)的吸烟者的百分比达到40-50%。
    结论:烟草烟雾仍然是COPD的主要病因,尽管与吸烟相关的流量限制是相当主观的。对于持续吸烟的患者来说,全科医生(GP)和肺科医师应该能够将戒烟计划作为COPD治疗的重要组成部分.这篇叙述性文章旨在提供科学依据,帮助医疗保健专业人员开发这种疗法;考虑到这一目标,作者分析了最新的文献。
    结论:只有3%的吸烟者在没有得到任何支持的情况下尝试戒烟。有效的戒烟方法是咨询和药物治疗,which,结合在一起,成功率为24%。尽管没有强有力的科学证据证明戒烟的治疗新颖性,然而,建议将文献更新为新设备和新的数字疗法。
    BACKGROUND: The percentage of smokers who develop COPD (Chronic Obstructive Pulmonary Disease) peaks at 40-50% in most recent publications.
    CONCLUSIONS: Tobacco smoke remains the main cause of COPD, though smoking-related limitation of the flow is rather subjective. For patients who keep on smoking, general practitioners (GPs) and pulmonologists should be able to offer smoking cessation programs as an important part of COPD treatment. This narrative article aims to provide the scientific basis to help healthcare professionals develop this therapy; with this aim in mind, the authors have analyzed the most recent literature.
    CONCLUSIONS: Only 3% of smokers who try to quit without availing themselves of any support succeed. Effective smoking cessation methods are counselling and pharmacotherapy, which, combined together, are credited with a 24% success rate. Although there are no therapeutic novelties with strong scientific evidence for smoking cessation, it is however advisable to keep the literature updated to new devices and new digital therapies.
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  • 文章类型: Journal Article
    目标:工作场所是戒烟计划和激励措施的合适区域。进行这项研究是为了确定工作场所干预措施对工作个体戒烟的有效性。
    方法:在2013年至2022年之间以英文发表的所有研究都在PubMed进行了搜索,科学直接,Scopus,WebofScience,和CINAHL数据库。荟萃分析基于PRISMA2020。研究方案在PROSPERO注册。随机效应模型被应用于荟萃分析过程,和Hedges\'g用于计算效果大小。
    结果:在纳入的研究中,11项随机对照试验,8项为整群随机对照试验.在不同的工作部门,各种干预措施,如动机/个人访谈,团体咨询,电话辅导,基于网络的培训,正念冥想,并实施了金融干预措施。这些干预措施单独进行或与一种或多种其他干预措施组合进行。干预措施通常具有短期效果,财务激励或支持是积极激励干预措施的因素。在工作场所尝试戒烟的联合效应大小(Hedges\'g)为1.171。研究之间的异质性是显著的(Q=199.762,p=0.015,I2=80.477%)。未检测到发表偏倚。
    结论:我们确定在工作场所应用戒烟干预措施具有很大的效果。我们建议根据工作组的需要,考虑和规划这些干预措施提高有效性的长期影响。
    OBJECTIVE: Workplaces are suitable areas for smoking cessation programs and incentives. This study was carried out to determine the effectiveness of interventions in the workplace for smoking cessation in working individuals.
    METHODS: All studies published in English between 2013 and 2022 were searched in Pub Med, Science Direct, Scopus, Web of Science, and CINAHL databases. Meta-analysis was based on PRISMA 2020. The study protocol was registered with PROSPERO. A random effects model was applied to the meta-analysis processes, and Hedges\' g was used to calculate the effect size.
    RESULTS: Of the included studies, 11 were randomized controlled trials, and 8 were cluster randomized controlled trials. In different working sectors, various interventions such as motivational/individual interviews, group counseling, telephone coaching, web-based training, mindfulness meditation, and financial interventions were implemented. These interventions were carried out alone or in combination with one or more other interventions. The interventions generally have short-term effects, and financial incentives or supports were the factors that positively motivate the interventions. The joint effect size of attempts to quit smoking in the workplace (Hedges\' g) was 1.171. Heterogeneity between studies was significant (Q = 199.762, p = 0.015, I2 = 80.477%). No publication bias was detected.
    CONCLUSIONS: We determined that smoking cessation interventions applied in the workplace have a large effect. We recommend that the long-term effects of increasing effectiveness of these interventions be considered and planned in line with the needs of working groups.
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  • 文章类型: Journal Article
    精神健康状况研究通常依赖于对所研究人群的简化主义文化假设以及从大多数人群中验证的工具。在详尽回顾阿米什人精神健康状况研究的有限主体时,我们发现研究通过方法学方案得到了很好的执行,但是研究结果在普适性上不一致或有限,仪器的有效性仍然存在争议,对阿米什人文化和宗教动态的研究调查是有限的。来自俄亥俄州一个相当大的阿米什人社区的案例研究说明了各种意识形态,尤其是古老的阿米什人宗教神学,科学心理学,福音派新教徒-在阿米什人中产生了关于定义和治疗精神健康状况的人口内部争议,这表明,民族宗教信徒的精神健康状况研究和诊断应更好地说明内部文化-宗教动态。为了对阿米什人的文化和宗教如何影响精神健康状况做出一些断言,未来的研究应包括对目标人群的文化和宗教动态的研究前调查,包括来自治疗师和精神科医生的更细致入微的病例报告,包括不同时间和地点的复制研究,刻意关注上下文因素。
    Mental health conditions research often relies on reductionist cultural assumptions about the population studied and instruments validated from majority populations. In exhaustively reviewing the limited body of Amish mental health conditions research, we find that studies are well-executed by methodological protocols but that findings are inconsistent or limited in generalizability, instrument validity remains contested, and study investigation into Amish cultural and religious dynamics is limited. A case study from a sizeable Amish community in Ohio illustrates how various ideologies-notably old Amish religious theology, the scientific-psychological, and the Evangelical Protestant-have generated population-internal controversies among the Amish over defining and treating mental health conditions, suggesting that mental health conditions research and diagnosis of ethnic religious adherents should better account for internal cultural-religious dynamics. In order to make some assertions about how Amish culture and religion impacts mental health conditions, future research should include pre-study investigations into the targeted population\'s cultural and religious dynamics, consist of more nuanced case reports from therapists and psychiatrists, and include replication studies at different times and places, with deliberate attention to contextual factors.
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  • 文章类型: Journal Article
    背景:关于戒烟的非常简短的建议(VBA;≤3分钟)在与吸烟患者进行简短的医疗互动中是实用且可扩展的。本研究旨在综合VBA用于戒烟的有效性,并总结实施策略。
    方法:我们搜索了针对戒烟的随机对照试验,并比较了Medline的VBA与不吸烟建议或不接触的对照试验,Embase,CINAHL,科克伦图书馆,PsycInfo数据库,六个中文数据库,从开始到2023年9月30日,两个试验注册中心ClinicalTrials.gov和WHO-ICTRP。建议的分级,评估,发展,评估框架用于评估荟萃分析结果证据的确定性。结果是在治疗开始后至少6个月自我报告的长期戒烟,早于治疗开始后6个月,并停止尝试。使用频率随机效应模型将效应大小计算为95%CI的风险比(RR)。
    结果:纳入了来自15篇文献(n=26,437)的13项随机对照试验。有中度确定性证据表明,与对照组相比,VBA在校正模型中≥6个月时显着增加了自我报告的戒烟率(校正风险比ARR1.17,95%CI:1.07-1.27)。敏感性分析显示,当通过生化验证验证禁欲时,结果相似(n=6项研究,RR1.53,95%CI0.98-2.40)。有高确定性证据表明VBA在<6个月时显著增加禁欲(ARR1.22,95%CI:1.01-1.47)。对戒烟尝试的影响证据(ARR1.03,95%CI0.97-1.08)的确定性非常低。
    结论:在临床环境中提供的VBA可有效增加自我报告的戒烟,为临床实践中更广泛的采用提供支持。
    BACKGROUND: Very brief advice (VBA; ≤ 3 min) on quitting is practical and scalable during brief medical interactions with patients who smoke. This study aims to synthesize the effectiveness of VBA for smoking cessation and summarize the implementation strategies.
    METHODS: We searched randomized controlled trials aiming at tobacco abstinence and comparing VBA versus no smoking advice or no contact from Medline, Embase, CINAHL, Cochrane Library, PsycInfo databases, six Chinese databases, two trial registries ClinicalTrials.gov and WHO-ICTRP from inception to September 30, 2023. Grading of Recommendations, Assessment, Development, and Evaluations framework was used to assess the certainty of the evidence of the meta-analytic findings. The outcomes were self-reported long-term tobacco abstinence at least 6 months after treatment initiation, earlier than 6 months after treatment initiation, and quit attempts. Effect sizes were computed as risk ratio (RR) with 95% CI using frequentist random-effect models.
    RESULTS: Thirteen randomized controlled trials from 15 articles (n = 26,437) were included. There was moderate-certainty evidence that VBA significantly increased self-reported tobacco abstinence at ≥ 6 months in the adjusted model (adjusted risk ratio ARR 1.17, 95% CI: 1.07-1.27) compared with controls. The sensitivity analysis showed similar results when abstinence was verified by biochemical validation (n = 6 studies, RR 1.53, 95% CI 0.98-2.40). There was high-certainty evidence that VBA significantly increased abstinence at < 6 months (ARR 1.22, 95% CI: 1.01-1.47). Evidence of effect on quit attempts (ARR 1.03, 95% CI 0.97-1.08) was of very low certainty.
    CONCLUSIONS: VBA delivered in a clinical setting is effective in increasing self-reported tobacco abstinence, which provides support for wider adoption in clinical practice.
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  • 文章类型: Journal Article
    妇女有能力控制自己的生育能力,并在需要时拥有自己想要的孩子,这是国际公认的人权。五十多年来,这项权利一直是低收入和中等收入国家计划生育计划背后的推动力。一旦认识到病毒从母亲向婴儿垂直传播的风险,艾滋病毒的流行就给这些努力增加了更大的紧迫性。2013年,我们发表了一份关于艾滋病毒感染妇女计划生育咨询有效性证据的系统综述,强调艾滋病毒相关行为。在此更新的评论中,我们检查了23项研究,主要来自撒哈拉以南非洲。我们发现的证据反映了为整合向妇女提供的服务所做的努力。这些表明,提供避孕服务,包括加强咨询和支持,在感染艾滋病毒的妇女接受护理的艾滋病毒诊所,随后使用现代避孕方法的可能性增加了四倍。这些研究反映了更多关注妇女的计划生育决策和行为,而较少关注与艾滋病毒相关的行为。在这种值得注意的差异的可能原因中,我们包括艾滋病毒抗逆转录病毒治疗的广泛覆盖。这一进展显然改变了以可能尚未得到充分认识的方式整合计划生育和艾滋病毒服务的理由和方法。结果,然而,是有益的:为希望控制生育的妇女提供更多的计划生育服务,以及在计划生育服务和艾滋病毒服务之间建立更平等的伙伴关系,以追求提供综合服务以满足妇女需求的共同目标。
    Women\'s ability to control their fertility and have the number of children they want when they want them is an internationally recognized human right. This right has been the driving force behind family planning programs in low- and middle-income countries for more than five decades. The HIV epidemic added greater urgency to those efforts once the risk of vertical transmission of the virus from mothers to their infants was recognized. In 2013, we published a systematic review of the evidence of effectiveness of family planning counseling for women living with HIV, emphasizing HIV related behaviors. In this updated review, we examined 23 studies, primarily from sub-Saharan Africa. The evidence we uncovered reflected efforts to integrate services provided to women. These showed that providing contraceptive services, including intensified counseling and support, in the HIV clinics where women living with HIV received their care increased the likelihood of subsequent use of modern contraception by as much as fourfold. These studies reflected a greater focus on women\'s family planning decisions and behaviors and less focus on HIV-related behaviors. Among the possible causes of this noted difference we include the widespread coverage of antiretroviral treatment for HIV. This advance has apparently changed the rationale and the approach to integrating family planning and HIV services in ways that may not have been fully appreciated. The results, however, are beneficial: greater coverage of family planning for women who wish to control their fertility and a more equal partnership between family planning services and HIV services in pursuit of the mutual goal of providing integrated services to meet women\'s needs.
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  • 文章类型: Journal Article
    寻求护理的跨性别和性别多元化(TGD)青年人数继续增加,需要就性别确认医疗干预措施对生育能力的潜在长期影响进行全面咨询。这篇叙述性综述的目的是检查与生育相关的知识,态度,和决策(包括影响决策的因素,决定后悔,和决策工具)在TGD青年中。我们搜索了PubMed,PsycInfo和谷歌学者原创,同行评审研究调查TGD青年对生育力和生育力保护的态度和知识,关于生育咨询和生育保护决策的观点,以及生育相关的决策工具。我们回顾了106项研究,其中8项纳入了这篇叙述性综述。四项研究评估了TGD青年对生育力和生育力保护的知识和态度,关于生育咨询和生育保护决策的三个审查观点,三人讨论了决策工具的开发。主要发现是:1)许多TGD青年意识到性别确认治疗的潜在生育相关影响,但仍有未满足的信息需求,2)一些TGD青年报告对未来的亲生父母感兴趣,以及目前对亲生父母身份不感兴趣的人,许多人承认他们的愿望可能会随着时间的推移而改变,3)关于生育率和生育率保护的持续讨论至关重要,4)决策工具正在开发中。总之,TGD青年及其照顾者应持续接受,全面的生育咨询,和决策工具可能有助于在每个青年的性别确认护理旅程中促进这些讨论和决策。
    UNASSIGNED: Transgender and gender diverse (TGD) youth demonstrate low utilization of fertility preservation before medical and surgical gender-affirming interventions. However, a significant number of TGD youth have goals for parenthood and/or recognize that their attitude toward future family-building goals may change over time. In this narrative review, we conclude that TGD young people should have ongoing opportunities to discuss their family-building goals and options for fertility preservation. Validated decision tools can help facilitate these discussions.
    UNASSIGNED: The number of transgender and gender diverse (TGD) youth seeking care continues to increase, necessitating comprehensive counseling about potential long-term effects of gender-affirming medical interventions on fertility. The objective of this narrative review was to examine fertility-related knowledge, attitudes, and decision-making (including factors influencing decisions, decision regret, and decision tools) among TGD youth. We searched PubMed, PsycInfo, and Google Scholar for original, peer-reviewed research investigating TGD youth attitudes and knowledge of fertility and fertility preservation, perspectives on fertility counseling and fertility preservation decision-making, as well as fertility-related decision tools. We reviewed 106 studies; eight were included in this narrative review. Four studies assessed TGD youth knowledge and attitudes of fertility and fertility preservation, three examined perspectives on fertility counseling and fertility preservation decision-making, and three discussed development of decision tools. Key findings were that: (1) many TGD youth are aware of potential fertility-related impacts of gender-affirming treatments, but there are still unmet informational needs, (2) some TGD youth report an interest in future biological parenthood, and of those who are not currently interested in biological parenthood, many acknowledge their desires may change over time, (3) ongoing discussions about fertility and fertility preservation are critical, and (4) decision tools are in development. In conclusion, TGD youth and their caregivers should receive ongoing, comprehensive fertility counseling and decision tools may be helpful to facilitate these discussions and decisions in each youth\'s gender-affirming care journey.
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  • 文章类型: Systematic Review
    有有限的心理支持可用于帮助患有痴呆症的人处理他们的状况的情绪后果。焦虑和抑郁在这个人群中很常见,然而,咨询和心理治疗干预的使用并没有很好的记录。目的本系统评价旨在了解目前有关治疗性咨询对痴呆症患者情绪体验的作用和影响的知识。方法接受定性和定量研究设计进行综述。全面搜索主要的生物医学,使用护理和其他专科数据库访问2015-2022年间发表的文章.还搜索了审判登记册和学术期刊。包括43项原始研究:定性(n=15);RCT(n=9);其他设计(n=19);加上8项系统评价。结果大部分研究在欧洲进行,特别是英国,尽管来自全球的一系列国家都有代表。来自不同研究设计的综合证据表明,患有不同阶段痴呆症的人可以参与的一系列方式,并从中获得情感上的好处,治疗性咨询。确定的关键主题:(1)治疗咨询的情感和福祉益处;(2)没有一种适合所有人的方法-以人为本的价值观驱动的关系和量身定制的方法;(3)培训,监督和建立辅导员社区;(4)痴呆症患者参与治疗干预。结论我们从这个系统评价的发现表明,不同的治疗方法已经在痴呆诊断的不同阶段进行了测试。结果表明,治疗咨询作为一种支持性媒介的价值,可以帮助处理和应对痴呆症疾病发展轨迹中的困难情绪和感受。
    Introduction There is limited psychological support available to help people living with dementia to deal with the emotional consequences of their condition. Anxiety and depression are commonly experienced in this population, yet the use of counselling and psychotherapeutic interventions is not well documented. Aim This systematic review sought to understand the current knowledge on the role and impact of therapeutic counselling on the emotional experience of adults living with dementia. Methods Qualitative and quantitative research designs were accepted for review. A comprehensive search of the main biomedical, nursing and other specialist databases was performed to access articles published between 2015 and 2022. Trial registers and academic journals were also searched. 43 original studies were included: qualitative (n = 15); RCTs (n = 9); other designs (n = 19); plus eight systematic reviews. Results The majority of studies were conducted in Europe, the United Kingdom in particular, although a range of countries from across the globe were represented. The combined evidence from the different study designs suggest a range of ways that people living with different stages of dementia can participate in, and gain emotional benefit from, therapeutic counselling. Key themes identified: (1) The emotional and well-being benefits of therapeutic counselling; (2) No one size fits all - relational and tailored approaches driven by person-centred values; (3) Training, supervision and building community for counsellors; (4) Involvement of people with dementia in therapeutic interventions. Conclusions Our findings from this systematic review show that different therapeutic approaches have been tested with people at different stages of a dementia diagnosis. The results suggest the value of therapeutic counselling as a supportive medium to help with the processing and coping of difficult emotions and feelings across the trajectory of a dementia illness.
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