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Impact of a Single-Session of Havening

  • UK Civil Service


Introduction: In the UK, the economic cost of absenteeism, loss in productivity and the demand on health care services is considerable. A substantial amount of time off work certified by a doctor is due to common mental disorders. There is a need for rapid and effective interventions at step 2 of the care system.
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Thandi Gursimran1,
Tom Deborah2,
Gould Matthew3,
McKenna Paul 4,
Greenberg Neil1
1 Academic Department of Military
Mental Health at King’s College London,
2. Chartered Occupaonal Psychologist and
Managing Director of Human Systems,
Buckinghamshire, England
3. Consultant Chartered Clinical
Psychologist Corporate Psychology,
Emirates Group, Dubai
4. Behavioural Scienst (D.Phil), Wilshire
Blvd, Beverly HIlls, CA
Correspondence: Gursimran Thandi
Academic Department of Military Mental
Health, King’s College London, Weston
Educaon Centre, 3rd Floor 10 Cutcombe
Road, London SES 9RJ
Tel: (+44) 207848 5210
Impact of a Single-Session of
Introducon: In the UK, the economic cost of absenteeism, loss in producvity
and the demand on health care services is considerable. A substanal amount of
me o work cered by a doctor is due to common mental disorders. There is a
need for rapid and eecve intervenons at step 2 of the care system.
Objecve: The impact of a single-session of a brief intervenon, called Havening,
in addressing depression, anxiety and impaired funconing in the workplace are
The aim of this study was to explore the ecacy of a single-session of Havening in
improving self-reported impaired occupaonal funconing.
Methods: Twenty-seven parcipants completed the Paent Health Quesonnaire
depression module (PHQ-9), Generalised Anxiety Disorder Assessment (GAD-7)
and the Work and Social Adjustment Scale (WSAS) before, 1-week and 2-months
aer the Havening intervenon.
Results: The single-session of the Havening intervenon had a posive impact
on probable depression (PHQ-9), probable anxiety (GAD-7) and work and social
adjustment (WSAS) scores over me. The scores on all three measures improved
over me. A signicant eect for me was observed PHQ-9 2(2) =30.79 , p<0.001),
the GAD-7 (χ2(2) = 38.18, p<0.001) and the WSAS (χ2(2) = 22.62, p<0.001).
Conclusion: The single-session of Havening proved ecacious in reducing self-
reported symptoms on the PHQ-9, GAD-7 and the WSAS in a sample of parcipants
who reported being occupaonally impaired.
Keywords: Brief-intervenon; Anxiety; Depression; Occupaonal impairment;
Recent data suggest that around 15% of the population may
be affected by common mental health disorders, such as
depression, generalised anxiety disorder, panic disorder,
obsessive-compulsive disorder (OCD), post-traumatic stress
disorder (PTSD) and social anxiety disorder [1]. According to
the Office of National Statistics, the 1-week prevalence rates
were 4.4% for generalised anxiety disorder, 3.0% for PTSD and
2.3% for depression [2].
In industrialised nations, mental health disorders are the
leading cause of sickness-related absence [3]. In the UK,
47-61% of the total time off work certified by a doctor is
accounted for by common mental disorders [4] and 37% of
all claims for employment support allowance are due to
common mental disorders [5]. As a result, the economic cost
of absenteeism, loss in producvity and demand on health care
services is considerable [6].
These data have led to improved provision of psychological
therapies in the treatment of depression and anxiety to, at least
in part; help ensure that the pool of people who are t to work
is enlarged. One of the long-term aims of the improved provision
of psychological therapies is to reduce the cost of Incapacity
Benet leading to potenal savings for the Department of
Work and Pensions (DWP). Furthermore, the introducon of
new therapeuc provision, such as the Improving Access to
Psychological Therapies (IAPT) iniave, has aimed to overcome
the previously unbalanced provision of psychological therapy,
long waing mes, and lack of consistency in implemenng NICE
guidelines for depression and anxiety [7]. However, there is sll
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ISSN 1698-9465
Vol. 9 No. 5:1
Health Science Journal
ISSN 1791-809X
room for improvement in the provision of psychological therapies
including the need to explore the ecacy of brief intervenons [8].
Brief intervenons have proven to be eecve in depression,
anxiety and loss as well as substance use disorders, such as
harmful drinking [9]. The WHO Brief Intervenon Study Group
found that ve minutes of simple advice was as eecve as 20
minutes of counselling [10]. They help to ll the gap between
primary prevenon eorts and more intensive treatment for
individuals who have clinically signicant disorders such as
psychosis, depression associated with suicidality and serious
alcohol use disorders [11].
Havening is a novel brief intervenon being ulised in the
treatment of depression and anxiety. Havening aims to treat
depression and anxiety symptoms caused due to traumac
encoding of negave events [12] by using sensory input to alter
thoughts, mood and behaviour. During Havening, the negave
event and the associated emoonal state are recalled and the
praconer applies a gentle touch to the forearms, which is
coupled with distracng tasks. This process increases the levels of
serotonin which can disrupt reconsolidaon of the link between
the traumac memory of the event and the distress it causes [13].
Given the potenal versality of Havening in treang trauma
related mental health problems, [12] if shown to be eecve it
could be a useful therapy for step 2 of a stepped care system [1].
The aim of this study was to evaluate the impact of a single-
session of the Havening intervenon on self-reported symptoms
of probable depression, symptoms of probable anxiety and work
and social adjustment scores in a sample of parcipants who
reported being occupaonally impaired.
A snowball recruitment method was used whereby parcipants
were recruited, by a psychologist, who contacted individuals,
via email, who had reported being occupaonally impaired as a
result of depression and / or anxiety. Recipients of the email were
asked to pass it on to other professionals they knew who might
want to seek help for self-reported mental health problems.
It is not possible to ascertain how many people in total would
have received the recruitment email although the inial direct
approach was made to 37 individuals.
A between subjects design was used to test the impact of a
single administraon of Havening on the scores of self-reported
depression, anxiety and funconal impairment. Data were
collected before the Havening intervenon (T1), one week
aer the intervenon (T2) and two months aer (T3). The data
collected from parcipants were completely anonymous and it
is not possible to idenfy parcipants from the resulng arcle.
Parcipants, who reported being occupaonally impaired
due to depression or anxiety, were oered the opportunity to
receive a single-session of Havening to assist them in regaining
their occupaonal tness. According to the parcipants all self-
reported symptoms had persistently impaired their occupaonal
funconing. Parcipants completed the PRIME-MD Paent
Health Quesonnaire (PHQ-9), the PRIME-MD Generalised
Anxiety Disorder Assessment (GAD-7) and the Work and Social
Adjustment quesonnaires (WSAS).
The PHQ-9 is a measure of depressive symptoms oen used in
primary care; it enquires about each of the 9 DSM-IV depression
criteria as “0” (not at all) to “3” (nearly every day). The maximum
score of the PHQ-9 is 27; lower scores demonstrate lower levels
of depression. Scores of 5, 10, 15, and 20 represent cut-o points
for mild, moderate, moderately severe and severe depression
respecvely. The diagnosc validity of the 9-item PHQ-9 has been
established primary care and obstetrical sengs and studies show
that PHQ-9 scores > 10 have a sensivity of 88% and a specicity
of 88% for major depressive disorder. The internal consistency
of the PHQ-9 has been shown to be high. A study involving two
dierent paent populaons produced Cronbach alphas of 0.86
and 0.89 [14].
The GAD-7 is a self-report quesonnaire for screening generalised
anxiety disorder. GAD-7 has seven items which measure severity
of various signs of generalized anxiety disorder according to
reported response categories of “not at all,” “several days,”
“more than half the days,” and “nearly every day”. Scores of 5, 10
and 15 are cut-o points for mild, moderate, and severe anxiety
respecvely. Validaon studies have shown that the GAD-7 has
sensivity of 89% and specicity of 82% for generalized anxiety
disorder [15].
The WSAS is a simple 5-item paent self-report measure that
assesses the impact of a person’s mental health dicules on
their ability to funcon in terms of work, home management,
social leisure, private leisure and personal or family relaonships.
The WSAS asks parcipants to rate the extent to which their
problems were aecng work and social life. Validaon studies
of the WSAS have shown that it is a reliable and valid measure
of impaired funconing, with a reported Cronbach's alpha range
from 0.70 to 0.94 [16].
Havening is a protocol based intervenon and there are three
ways in which it can be delivered; facilitated Havening (directly
delivered by the therapist), facilitated self-Havening (therapist
present) and self-Havening (no therapist). This session used both
facilitated and facilitated self-Havening. The Havening facilitator
demonstrated the process on ve of the 30 parcipants.
Parcipants were asked to:
i. Find an exact word or phrase that represented their current
emoonal dicultly. Parcipants scaled the word/phrase
from 1-10, with 10 being the highest/most distressing score.
ii. Clear their mind or to think about something nice.
iii. Use both their hands to tap on both their collarbones whilst
opening and closing their eyes twice.
iv. Connue tapping, keep their head sll, and to move their
eyes fully to the le and to the right and then down to the
le and down to the right and nally in a full circle clockwise
and then an clockwise in front of their face, keeping their
head sll.
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v. Place their arms across their chest and close their eyes;
whilst their eyes were closed, the facilitator asked them to
imagine walking up a ight of stairs and to count out loud
from 1 to 20 with each step that they took.
vi. With consent, the facilitator (or the parcipants
themselves if self-Havening) gently rubbed the sides of
the parcipant’s arms, for the duraon of the counng,
whilst counng with them.
vii. Re-scale the emoon 1-10. And the procedure (ii – vi) was
repeated with the visual element and auditory element
changed slightly; i.e. instead of climbing up stairs it was to
visualise skipping over a rope and instead of counng 1-20
parcipants hummed Happy Birthday.
viii. Allow their arms drop and relax, to move their eyes in
circles and then to close their eyes, whilst the researcher
stroked the sides of their arms again 5 mes and used
the words “Let it Go” on the nal stroke. Finally the
parcipants were asked to open their eyes and scale the
feeling on 1-10 again. This was repeated unl the scale
was given 1-3.
Instrucons were given to the those parcipants who had not
experienced facilitated-Havening on how to conduct facilitated
self-Havening which was then carried out in pairs with the
facilitator ensuring that parcipants were comfortable with the
procedure. Havening connued unl parcipants felt that their
dicules had improved considerably (scoring three or less)
or did not improve any further. Parcipants were reminded to
complete their quesonnaire one week and two months aer the
Havening intervenon.
Data were collected using an online survey tool and then
transferred into SPSS for analysis. Due to the data not fullling the
assumpons of normality, and due to small numbers, the non-
parametric Freidman test, followed by Post-hoc Wilcoxon signed
rank tests using the Bonferroni correcon, was conducted to
compare scores at T1 (before Havening), T2 (one-week following
Havening) and T3 (two-months aer Havening). All analyses were
performed using SPSS for windows version 18.0.
The study had a follow-up rate of 86% with 27 parcipants
compleng the quesonnaire at all three me points. Sixty-
seven per cent of the parcipants reported that they had been
experiencing the occupaonal impairment for more than two
years and 22% reported having experienced the problem for
between one and two years (Table 1).
The results showed a signicant eect for me from T1 – T3 on
the PHQ-9 2(2) =30.79 , p<0.001), the GAD-7 (χ2(2) = 38.18,
p<0.001) and the WSAS (χ2(2) = 22.62, p<0.001). Post-hoc analysis
with Wilcoxon signed-rank tests was conducted with a Bonferroni
correcon applied, resulng in a signicance level set at p < 0.017.
Overall, parcipants reported an improvement on all mental
health measures, which were sustained at two months, aer the
Havening intervenon. Parcipants reported stascally signicant
changes in scores from before to one-week aer Havening on the
PHQ-9 (Z = -4.28, p <0.001), the GAD-7 (Z = -4.37, p <0.001), and
WSAS (Z = -3.56, p <0.001). A reducon in scores was reported
2-months aer the Havening treatment on the PHQ-9 (Z = -4.03,
p <0.001), the GAD-7 (Z = -4.29, p <0.001) and the WSAS (Z = -3.45,
p <0.001) (Table 2).
This report presents the results from a single-session of Havening
in treang self-reported depression, anxiety and occupaonal
impairment. The results demonstrate that a single-session of
Havening had a posive eect on reducing scores on the PHQ-9, GAD-
7 and WSAS. Parcipants reported that this improvement in scores
was sustained one-week and two-months aer the intervenon.
Age n (%)
25-29 1 (4)
30-34 1 (4)
35-39 3 (11)
40-49 11 (41)
50+ 11 (41)
Marital status
Married 13 (48)
Living with a partner 3 (11)
In a long-term
relaonship 1 (4)
Single 4 (15)
Separated 1 (4)
Divorced 4 (15)
Widowed 1 (4)
Employment status
Employed 13 (48)
Self-employed 7 (26)
Rered 3 (11)
Unemployed 4 (15)
Duraon of
A month – a year 3 (11)
One – two years 6 (22)
More than two years 18 (67)
Table 1 Demographic details of Havening sample.
Note: Number and percentage, may not add up to 100%
Scales Friedman test Wilcoxon Signed-Ranks test P Value
(vs. T1)
T2 T3
x2(2), p-value z, p-value z, p-value
PHQ-9 30.79, 0.00*** -4.28, 0.00*** -4.03, 0.00***
GAD-7 38.18, 0.00*** -4.37, 0.00*** -4.29, 0.00***
WSAS 22.62, 0.00*** -3.56, 0.00*** -3.45, 0.00***
Table 2 Friedman test and post-hoc Wilcoxon Signed-Ranks test with
Bonferroni correcon to test for signicant changes in scores from T1
– T3.
Note: Wilcoxon Signed-Rank Test using Bonferroni adjustment (new p
value: 0.05/3 = 0.017), *** p <0.001, ** p<0.01, * p<0.05, n.s = non-
4This article is available in:
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Vol. 9 No. 5:1
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These ndings are in line with previous evaluaons of a similar
psychosensory therapy. A randomised controlled trial compared
the eecveness of psychosensory therapy, which included
an extrasensory smulus in the form of tapping alongside
diaphragmac breathing, for specic phobias, such as insects,
rats and spiders. Following a single session of diaphragmac
breathing, paents who received this psychosensory therapy
showed an improvement in their phobias which was sustained
over me [17]. Similarly, in a randomised trial of 5000 paents,
psychosensory therapy was more eecve in treang common
mental health problems than Cognive Behaviour Therapy (CBT)
or medicaon. Furthermore, at one-year follow-up, the paents
receiving the psychosensory treatment were less prone to
relapse or paral relapse than those receiving CBT or medicaon
[18]. However, it must be noted that the evaluaon by Andrade
and colleagues [18] was limited in its generalisability by informal
record-keeping, subjecve outcome assessments, and variables
that were not rigorously controlled.
The results of this study suggest that Havening might be a suitable
therapy in step 2 of the care system given the posive impact
of a single-session which can be self-facilitated. Systemac
reviews for anxiety and depression [19] have evaluated various
aspects of self-help intervenons and have endorsed their use
as intervenons for mild to moderate anxiety and depression.
Furthermore, some self-help therapies for depression have been
shown to have an enduring eect at follow-up [20]. Guided self-
help intervenons have been imbedded within the mental health
services, in the form of IAPT, which provide assessments and oer
brief self-help intervenons, cognive restructuring and support
with computerised CBT programmes.
Our data show that the Havening intervenon may well be
capable of rapidly improving depression, anxiety and impaired
funconing through a single-session. Furthermore, the eects
of the therapy were not short-lived as our results showed that
parcipants reported sustained improvement up to two-months
aer the Havening process. Since the Havening technique is
simple enough to administer to subjects and teach them how to
re-administer it during future episodes of distress, it could oer
a substanal advantage over more complicated intervenons
which can only be delivered by high trained therapists over
mulple sessions if more robust, comparave trials of Havening
connue to demonstrate that it is eecve.
Limitaons of the Study
This study is limited by its small sample size, lack of control
group and that the sample selecon was opportunisc which
is therefore likely to be non-representave of the working
populaon. Furthermore, the parcipants were all healthcare
professionals who are likely to be more engaged and open to
psychotherapy. Given the limitaons of this study the results
should be regarded as preliminary.
The single-session of the Havening intervenon resulted in
improved scores on the PHQ-9, GAD-7 and the WSAS and
these improvements were sustained over me. The Havening
intervenon could prove to be a useful and cost-eecve
intervenon for common mental disorders at step 2 of the care
© Under License of Creative Commons Attribution 3.0 License
ISSN 1698-9465
Vol. 9 No. 5:1
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ISSN 1791-809X
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... Warm, friendly touches of appreciation make others feel esteemed and valued, activating several physiological mechanisms that promote well-being (Jakubiak & Feeney, 2017), and ameliorate negative perceptions of loneliness (Heatley Tejada et al., 2020). Such benefits of nurturing touch have been harnessed by an innovative psychological intervention known as Havening; a psychosensory technique that integrates psychological techniques, such as positive selfaffirmations, with nurturing touch (Cizmic et al., 2018;Hodgson et al., 2020;Thandi et al., 2015). Havening uses the power of touch to cultivate healthy processing of traumatic events, distressing memories, and/or disturbing thoughts. ...
... This therapeutic method was first developed by Dr Ron Ruden (see Ruden, 2018) and is currently practiced worldwide with anecdotally impressive outcomes. However, very little empirical evidence exists to support its efficacy (Cizmic et al., 2018;Hodgson et al., 2020;Thandi et al., 2015). Indeed, to our knowledge, the present study represents the first empirical support for the importance of nurturing touch in Havening for psychological well-being. ...
... To our knowledge only three peer-reviewed, published empirical studies exist of Havening. Thandi et al. (2015) showed that a single Havening session resulted in an improvement (at 2 months follow-up) in depression, anxiety, and impact of psychological problems on work and social functioning. However, their design did not use any control condition. ...
Objective: Havening is a psychosensory therapeutic technique that purportedly harnesses the power of touch to stimulate oxytocin release and facilitate adaptive processing of distressing thoughts/memories. Although Havening is used in clinics worldwide, with anecdotal evidence, very few empirical studies exist to support its efficacy or mechanism of action. The present study is the first to investigate the effects of Havening Touch on subjective distress, mood, brain function, and well-being. Method: Participants (n = 24) underwent a single session of Havening, in response to a self-reported distressing event. Mood and resting-state electroencephalography were assessed prior to, and immediately following, the session. Psychological health was assessed at baseline and 2 weeks follow-up via an online self-report questionnaire. Results: There was a greater reduction in subjective units of distress during sessions that included Havening Touch (H+) than sessions that did not include Havening Touch (H−). Electroencephalography results showed an increase in beta and a reduction in gamma activity in H+. Both groups showed reduction in negative mood states immediately following the session and better psychological health at follow-up. Conclusions: Findings suggest both touch and nontouch components of the intervention have therapeutic potential, and that Havening Touch may accelerate a reduction in distress during a single Havening session.
... Taxing the working memory reduces the distress of the memory and acts as a barrier to memory retrieval (Gunter & Bodner, 2008), this inhibits outflow of the neurotransmitter glutamate in the basolateral complex which contributes to emotional distress cycles associated with repetitive memory retrieval (Ruden, 2011) and cultivates neurochemical resilience. Gursimran et al. (2015) assessed the efficacy of a single session HT intervention in 27 health workers with a history of anxiety and/or depression related occupational health impairment. Three validated self-assessment questionnaires were employed to assess anxiety, depression, and functional impairment. ...
Identifying the associations between health and personality has been a focus for psychophysiological research. Type D personality is associated with predisposition to physical and psychological ill-health. This statistician-blind parallel-group controlled trial (intervention group vs. waiting list control group) examined the impact of Havening Techniques on the Type D constituents of negative affect (NA) and social inhibition (SI). One hundred twenty-five adult (18+ years) participants in the United Kingdom (72 females, 53 males) completed the Type D Scale-14 (DS14) measure of Type D personality at baseline (T1), 24-hours (T2), and at 1-month (T3). Forty participants in the treatment group received additional stress biomarker assessment of heart rate, blood pressure, and salivary cortisol. Type D caseness remained stable in the waiting list participants ( n = 57). In the treatment group ( n = 68); NA, SI, and total scores decreased from T1 to T2 ( p < .001, p < .001, and p < .001, respectively), and from T2 to T3 ( p = .004, p < .001, and p < .001, respectively), significantly transmuting to non-caseness ( p < .001 for T1 to T2; p = .025 for T2 to T3). Between T1 and T2, decreases in cortisol ( p < .001), diastolic blood pressure ( p < .001), and systolic blood pressure ( p < .001) were demonstrated. Heart rate fell nonsignificantly between T1 and T2 ( p = .063), but significantly from T1 to T3 ( p = .048). The findings of this study indicate the potential mutability of the psychophysiological illness-prone characteristics of Type D personality.
... Extrapolating from clinical reports I wonder whether in some instances their residual distress might be due to the failure of therapists to provide touch. The psychiatrist Bar-Levav (1998), for example, has used touch to reverse life-long depression (see also experiment involving touch by Gursimran et al., 2015). ...
... In this article the results of a quantitative between-subjects experimental design, in which the PHQ-9, GAD-7 and WSAS were used for the purpose to test the impact of a single administration of Havening on the scores of self-reported depression, anxiety, and functional impairment are presented (Gusimrand et al., 2015). Havening is a newer CAM technique developed by Dr. Ronald Ruden (2011), based on the scientific theories of neuroplasticity, and includes combined methods used in Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR) and Healing Touch. ...
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This is aliterature review examines the data presented in a series of empirical articles on the use of Complementary and Alternative Medicine (CAM) techniques used in increasing numbers by patients in the geriatric and cancer patient populations. The review of five CAM modalities identified as Havening, Mindfulness, Reiki, T’ai Chi, and Self-Compassion are known to be used among these populationsin an effort to manage disease and pain as well as reducing symptoms of depression and anxiety without pharmaceutical intervention. Findings on efficacy these five CAM modalities are presented, as well as implications for further research are discussed. Keywords: Complementary AND Alternative Medicine, Havening, Mindfulness, Reiki, T’ai Chi, Self-Compassion
Poor outcomes associated with increased perioperative opioid use have led investigators to seek alternative pain management modalities after total joint arthroplasty. Nonpharmacological approaches, such as electroceuticals, have shown promise. The purpose of this study was to evaluate the effects of "havening," a specific form of psychosensory therapy, on postoperative pain scores and narcotic consumption. In this prospective, randomized controlled trial, the authors compared 19 patients who underwent psychosensory therapy with 22 patients who served as the control group. Visual analog scale scores were collected preoperatively, every day during the hospitalization, and at approximately 1-month follow-up. Narcotic consumption during hospitalization was converted into daily morphine milligram equivalents and compared between the cohorts. In addition, postoperative complications, emergency department visits, and readmissions were compared between the cohorts. No difference in visual analog scale pain scores was reported between cohorts on postoperative day 1 (P=.229), at discharge (P=.434), or at 1-month follow-up (P=.256). Furthermore, there was no significant variance in mean daily morphine milligram equivalents (P=.221), length of stay (P=.313), postoperative complications (P=.255), 90-day readmissions (P=.915), and emergency department visits (P=.46) between the cohorts. This study showed that psychosensory therapy was not effective in reducing pain or narcotic consumption following total joint arthroplasty. Nonetheless, future studies assessing the role of psychosensory therapeutic interventions among patients after total joint arthroplasty are warranted to better understand the clinical implications of innovative therapies aimed at alleviating pain. [Orthopedics. 201x; xx(x):xx-xx.].
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How can vibrotactile stimuli be used to create a technology-mediated somatic learning experience? This question motivates this practice-based research, which explores how the Feldenkrais Method and cognate neuroscience research can be applied to technology design. Supported by somaesthetic philosophy, soma-based design theories, and a critical acknowledgement of the socially-inflected body, the research develops a systematic method grounded in first- and third-person accounts of embodied experience to inform the creation and evaluation of design of Haplós, a wearable, user-customisable, remote-controlled technology that plays methodically composed vibrotactile patterns on the skin in order to facilitate body awareness—the major outcome of this research and a significant contribution to soma-based creative work. The research also contributes to design theory and somatic practice by developing the notion of a somatic learning affordance, which emerged during course of the research and which describes the capacity of a material object to facilitate somatic learning. Two interdisciplinary collaborations involving Haplós contribute to additional fields and disciplines. In partnership with experimental psychologists, Haplós was used in a randomised controlled study that contributes to cognitive psychology by showing that vibrotactile compositions can reduce, with statistical significance, intrusive food-related thoughts. Haplós was also used in Bisensorial, an award-winning, collaboratively developed proof-of-concept of a neuroadaptive vibroacoustic therapeutic device that uses music and vibrotactile stimuli to induce desired mental states. Finally, this research contributes to cognitive science and embodied philosophy by advancing a neuroscientific understanding of vibrotactile somaesthetics, a novel extension of somaesthetic philosophy.
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A new therapy for phobias, PTSD, addictive behaviors and other psychological issues was first described by Dr. Roger Callahan and involves thought activation of the problem followed by tapping on certain acupoints in a specific sequence. In addition, a gamut procedure involving further tapping, eye movements and following simple commands is used. He calls his method Thought Field Therapy. In most cases, the problems were reportedly cured in a matter of minutes. We theorize about the neuroanatomical and neurophysiological mechanisms underlying the success of this technique.
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To systematically review the literature on the Chinese translations of the Alcohol Use Disorders Identification Test (AUDIT) and their cross-cultural applicability in Chinese language populations. We identified peer-reviewed articles published in English (n = 10) and in Chinese (n = 11) from 1980 to September 2009, with key words China, Chinese and AUDIT among PubMed, EBSCO, PsycInfo, FirstSearch electronic databases and two Chinese databases. Five teams from Beijing, Tibet, Taiwan and Hong Kong reported their region-specific translation procedures, cultural adaptations, validity (0.93-0.95 in two versions) and reliability (0.63-0.99). These Chinese translations and short versions demonstrated relatively high sensitivity (0.880-0.997) and moderate specificity (0.709-0.934) for hazardous/harmful drinking and alcohol dependence, but low specificity for alcohol dependence among Min-Nan Taiwanese (0.58). The AUDIT and its adaptations were most utilized in workplace- and hospital-settings for screening and brief intervention. However, they were under-utilized in population-based surveys, primary care settings, and among women, adolescents, rural-to-urban migrants, the elderly and minorities. Among 12 studies from mainland China, four included both women and men, and only one in Tibet was published in English. There is a growing amount of psychometric, epidemiologic and treatment research using Chinese translations of the AUDIT, much of it still unavailable in the English-language literature. Given the increase in burden of disease and injury attributable to alcohol use in the Western Pacific region, the use of an internationally comparable instrument (such as the AUDIT) in research with Chinese populations presents a unique opportunity to expand clinical and epidemiologic knowledge about alcohol problem epidemics.
In preliminary clinical trials involving more than 29,000 patients from 11 allied treatment centers in South America during a 14-year period, a variety of randomized, double-blind pilot studies were conducted. In one of these, approximately 5,000 patients diagnosed at intake with an anxiety disorder were randomly assigned to an experimental group (tapping) or a control group (Cognitive Behavior Therapy/medication) using standard randomization tables and, later, computerized software. Ratings were given by independent clinicians who interviewed each patient at the close of therapy, at 1 month, at 3 months, at 6 months, and at 12 months. The raters made a determination of complete remission of symptoms, partial remission of symptoms, or no clinical response. The raters did not know if the patient received CBT/medication or tapping. They knew only the initial diagnosis, the symptoms, and the severity, as judged by the intake staff. At the close of therapy: 63% of the control group were judged as having improved.
Objective: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. Measurements: The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. Results: As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. Conclusion: In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
NICE has developed a guideline on the identification of common mental health disorders (CMHDs) and on pathways to care for these disorders.1 These CMHDs include: The prevalence of CMHDs in the community is around 15%, and even higher, around 20%, among people attending general practice. The costs of CMHDs are high. They are estimated to cause 1 in 5 days lost from work in Britain.2 There are problems with access to care and with identification of people with CMHDs. In the 2007 household survey of adult psychiatric morbidity only 38% of people with CMHDs had asked their GP for help, and only 24% were receiving treatment (14% medication; 5% counselling; and 5% both).3 The aim of the NICE guideline is to improve access to services, improve the recognition and identification of CMHDs, and provide advice on developing care pathways. There is a need for greater clarity around the indications for treatment and referral of CMHDs, including severity, duration, associated disability, and other factors likely to affect responses to drug and psychological treatments. A more systematic approach to organising care pathways is needed, including the consideration of developing ‘stepped care’ systems and ‘collaborative care’ across the primary and secondary care sectors of the NHS. The guideline also brings together in one place advice from existing NICE guidelines on referral for and treatment of the disorders. These are guidelines on depression in adults,4 depression with chronic physical health problems,5 GAD and panic disorder,6 antenatal and postnatal mental health,7 OCD,8 and PTSD.9 The individual guidelines already developed cover treatment, but vary in their coverage of identification, assessment, and appropriate referral. ### Identification The guideline states that practitioners should be …