• Real-world effectiveness of self-administered transcranial direct current stimulation (tDCS) for depression: a retrospective cohort study

  Mu, Mu; Banazadeh, Aria; Cauchi, Michael; Griffiths, Chris (2026-04)

  Background Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by users at home. The retrospective analysis examined real-world usage and effectiveness of Flow tDCS treatment using data from 14,726 users collected by Flow Neuroscience AB between 2020 and 2024. Methods Self-reported user background information and Montgomery-Åsberg Depression Rating Scale Self (MADRS-S) scores up to week 50 of the treatment were analysed. Effectiveness metrics (remission, response, and relapse rates) were assessed at pre-treatment baseline followed by week 3, 6, 10, 15, 20, and 50. Repeated-measures ANOVA, post-hoc and between-subject analysis were used to examine the change in MADRS-S over time and the influence of user background factors. Outcomes The reported mean MADRS-S score decreased from a moderate level before treatment to a mild level at week 10 and then plateaued thereafter. Response and remission rates increased between week 3 and week 10, then stabilised through to week 50. A repeated measures ANOVA and post-hoc test reveal statistically significant differences (p < 0.0001) in MADRS-S scores across multiple time points. Reduction in reported depressive symptoms was observed during the initial weeks of treatment, these levels were maintained throughout the subsequent weeks. User adherence and background factors were significantly associated (p ≤ 0.005) with changes in MADRS-S scores during the first 10 weeks of treatment. Interpretations Users of self-administered Flow tDCS treatment reported a rapid initial improvement and long-term reduction of depressive symptoms. Observed variability in adherence and response across diverse user groups suggests potential benefits from personalised treatment protocols and support.
• Lamotrigine-induced DRESS syndrome with myelosuppression in a patient with bipolar disorder: case report

  Kelbrick, Marlene; Mustafa, Feras Ali; Wilson, Helen; Nyadzayo, Lynn; Ibrahim, David; Paduret, Gabriela (2026)

  Lamotrigine-induced DRESS syndrome is a potentially fatal drug reaction with variable clinical presentation and complications requiring early recognition and rapid response.
• Community sentence with mental health treatment requirement (MHTR): an exploration of offenders’ engagement, experience, and outcomes

  Walker, Kate; Griffiths, Chris; Coelho, Liv (2026)

  The Mental Health Treatment Requirement (MHTR) is a sentencing option for offenders where mental health is linked to offending and is delivered by clinical psychologists. An interpretative phenomenological analysis of interviews with 14 MHTR service users explored factors promoting engagement and perceived change. Three superordinate themes were identified: experiences of safety, support, and personal fit facilitating engagement; mechanisms of change through developing tools, insight, and emotional regulation; and shifts in identity, relationships, and lifestyle. Findings highlight the importance of a strong therapeutic alliance, individualized and flexible delivery, and suggest MHTRs can improve mental health, self-worth, and reduce reoffending.
• The impact of the mental health treatment requirement (MHTR) service on psychological distress, mental health recovery-related quality of life, and shame of individuals convicted of a criminal offence

  Griffiths, Chris; Walker, Kate; Coelho, Liv; Pinto, Regina; Sarai, Jasmine; Andrew, Megan; Hopkins-Young, Olivia; Giddings, Laura; Jiang, Harmony; House, Elliott; et al. (2025-08)

  Background: The Mental Health Treatment Requirement (MHTR) is a court sentencing option for individuals convicted of a criminal offence when there is a link between their mental health and offending which requires community-based treatment. To improve mental health and reduce reoffending, the MHTR service seeks to understand service users’ needs and goals and provides appropriate psychological therapy and connection with supportive community services. Aims: This study investigated the impact of an MHTR service on service users’ psychological distress, mental health recovery-related quality of life, and shame. Methods: The study design was open-label and did not have a control. Measures used were Clinical Outcomes in Routine Evaluation (CORE-34), Recovering Quality of Life (ReQoL-20), and Experience of Shame Scale (ESS). Participants: Twenty-one MHTR service user participants, thirteen males (62%) and eight females (38%). The ages ranged from 19 to 66 years, with an average age of 37 years. Results: At the end of the MHTR the CORE-34 and ReQol-20 scores significantly improved, with large effect sizes; all four CORE-34 domains (including “risk”) significantly improved. There was a significant improvement in ESS overall score with a moderate effect size; all three ESS domains significantly improved. CORE-34 reliable improvement was 76% and ReQoL-20 reliable improvement was 57%. CORE-34 remission rate was 24%. Conclusions: Improvements on the ReQoL-20 indicate the positive impact of MHTR on the individual’s mental health recovery, real-world functioning, and quality of life. CORE-34 improvements indicate a positive impact on reducing psychological distress and risk, which is associated with reducing reoffending. Improvements on the ESS indicate the positive impact of MHTR on reducing shame-related distress which is associated with reduced self-criticism, anger, and antisocial traits. Further research required has been identified. Evidence indicates that MHTR is effective in meeting its goals and should be appropriately resourced to meet demands.
• Implementation of AliveCor KardiaMobile electrocardiogram (ECG) 6-lead in an early intervention psychosis (EIP) service: a mixed-methods evaluation of completed ECGs outcomes and feedback from patients and staff

  Rogers, Rowena; Griffiths, Chris; Walker, Kate; Baukaite, Ema; Kelbrick, Marlene (2026-01)

  Background: Clinical guidance recommends that people with psychotic disorders are assessed for cardiovascular issues at least annually, at the start of antipsychotic medication and following medication changes such as dose changes and switching of antipsychotic medication. The AliveCor KardiaMobile 6-lead electrocardiogram (ECG) is a small, battery operated, hand-held portable ECG which has comparable accuracy to a 12-lead device and may be suitable, in particular for QTc monitoring, where it is not practical or preferable to use a 12-lead device. Purpose/Aim: To obtain patient and staff feedback on KardiaMobile and to quantify ECG completions within an early intervention in psychosis (EIP) service. Methods: A mixed-methods evaluation was undertaken, using patient and staff surveys, alongside data collection and analysis to report ECG completion. Results: The use of the KardiaMobile 6-lead in EIP was associated with improved ECG completion rates, enhanced compliance with antipsychotic monitoring guidance, and reduced patient refusal. Patient and staff feedback indicated that the KardiaMobile 6-lead was portable, accessible, easy and simple to use and was quicker, less intrusive, and more efficient than a standard 12-lead device. Conclusion: The findings support use of KardiaMobile 6-lead for better healthcare guidance compliance, safer prescribing, and better patient outcomes. By addressing the practical, emotional, and cultural barriers often associated with traditional portable ECGs, KardiaMobile fosters greater patient engagement and staff efficiency. A 12-lead device may be required in some cases and should be obtained at baseline if possible as it provides more comprehensive information and rules out pre-existing abnormalities, it is also indicated in specific clinical guidance. The addition of the KardiaMobile 6-lead offers flexibility and enhanced compliance with guidelines. It is essential that heart functioning assessment is undertaken to maximise compliance with guidelines, safety, and best patient outcomes, and that appropriate ECG assessment remains a priority of mental health services.
• Utilisation of group-based diabetes education programmes: perspectives of healthcare practitioners

  Lawal, Muili Olugbenga; Woodman, Anthony; Lawal, Farouk Ayodeji; Omobayo, Hameedat Olajumoke (2025)

  Background: Structured patient education (SPE) is a critical component of diabetes management, with the potential to reduce its physical, social, and economic burden. National and international guidelines emphasise the importance of raising awareness and equipping individuals with the knowledge and skills necessary for effective self-management. In the UK, practice nurses are central to this effort, playing a key role in identifying at-risk individuals and facilitating referrals to diabetes education programmes. However, non-attendance at these programmes remains a persistent challenge, undermining the impact of policy initiatives and service provision. Aim of the study: This study aimed to explore practice nurses’ perspectives on the factors contributing to non-attendance at diabetes education centres and to identify potential strategies to improve uptake. Methods: A qualitative approach was employed, involving semi-structured face-to-face interviews with eight practice nurses across six general practice (GP) surgeries in Southeast England. Data were analysed thematically to uncover key patterns and insights. Results: Findings reveal that barriers to attendance are multifaceted, encompassing personal, social, and systemic factors. These include limited patient understanding of the benefits of education, cultural and language differences, scheduling conflicts, and perceived relevance of the programmes. Conclusions: The results highlight the need for a coordinated, patient-centred approach that addresses these challenges through improved communication, flexibility in programme delivery, and enhanced interprofessional collaboration.
• 

  Liraglutide in mild to moderate Alzheimer’s disease : a phase 2b clinical trial

  Edison, Paul; Femminella, Grazia Daniela; Ritchie, Craig; Nowell, Joseph; Holmes, Clive; Walker, Zuzana; Ridha, Basil; Raza, Sanara; Livingston, Nicholas R; Frangou, Eleni; et al. (Nature Publishing Group, 2025)

  Liraglutide, a glucagon-like peptide 1 (GLP-1) agonist and antidiabetic drug, has shown neuroprotective effects in animal models. In this study, we aimed to evaluate the safety and efficacy of liraglutide in mild to moderate Alzheimer’s disease syndrome. ‘Evaluating liraglutide in Alzheimer’s disease’ (ELAD) is a multicenter, randomized, double-blind, placebo-controlled phase 2b trial in 204 participants with mild to moderate Alzheimer’s disease syndrome with no diabetes. Participants received daily injections of liraglutide or placebo for 52 weeks. They underwent fluorodeoxyglucose positron emission tomography, magnetic resonance imaging and detailed neuropsychometric evaluations. The primary outcome was a change in cerebral glucose metabolic rate. Secondary outcomes were safety and tolerability and cognitive changes. The primary outcome showed no significant differences in cerebral glucose metabolism (difference = −0.17; 95% confidence interval: −0.39 to 0.06; P = 0.14) between the two groups. The secondary outcome—score on the Alzheimer’s Disease Assessment Scale-Executive domain (ADAS-Exec)—performed better in liraglutide-treated patients compared to placebo (0.15; 95% confidence interval: 0.03−0.28; unadjusted P = 0.01). No significant differences were observed in Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) (−0.58; 95% confidence interval: −3.13 to 1.97; unadjusted P = 0.65) or Clinical Dementia Rating-Sum of Boxes (CDR-SoB) (−0.06; 95% confidence interval: −0.57 to 0.44; unadjusted P = 0.81) scores. Liraglutide was generally safe and well tolerated in non-diabetic patients with Alzheimer’s disease. ClinicalTrials.gov identifier: NCT01843075.
• Perceived training needs of mental health professionals to identify and respond to domestic abuse: a qualitative study

  Baukaite, Ema; Walker, Kate; Sleath, Emma (2025)

  Purpose This study aims to understand the training needs of mental health professionals in early access services to inform the development of evidence-based, inclusive and trauma-informed training for identifying and responding to domestic abuse (DA) within mental health settings. Design/methodology/approach A qualitative design was used, with semi-structured interviews (n = 20) and two focus groups (n = 8; n = 4) with professionals from two National Health Service Trusts. Reflexive thematic analysis was conducted from a constructionist perspective, with themes co-developed by researchers and a lived experience advisory panel. Findings There are six key themes that were identified: (1) knowledge about diverse service users; (2) recognising signs of DA, including subtle and non-physical forms; (3) sensitive questioning techniques; (4) preference for in-person, interactive learning; (5) accessible, regular and up-to-date training; and (6) the value of lived experience in training design and delivery. Professionals expressed a need for culturally competent, skills-based training that fosters confidence in identifying and responding to DA in complex clinical contexts. Practical implications Findings provide actionable insights for service leaders and educators in developing and embedding effective DA training within mental health services. Originality/value To the best of the authors’ knowledge, this is the first UK-based qualitative study to detail the training needs of mental health professionals in relation to identification and responding to DA in mental health settings. It highlights the importance of co-designed, experiential training that integrates lived experience and contextual nuance, addressing current gaps in both content and delivery format.
• Transcranial Direct Current Stimulation (tDCS) used at home for people with self-reported depression: impact on self-reported concentration problems

  Griffiths, Chris; Banazadeh, Aria; Mu, Mu (2025)

  Background: There is a high prevalence of concentration and cognitive functioning problems in people with depression. Research evidence indicates that transcranial direct current stimulation (tDCS) can improve cognitive functioning, and an aspect of cognitive functioning is the ability to concentrate. Flow FL-100 is a tDCS device self-administered at home. Purpose/Aim: To investigate the impact of 1, 2, 3, 6 and 10 weeks of Flow Neuroscience AB FL-100 tDCS use on self-reported concentration problems in people with depression, using the Montgomery-Åsberg Depression Rating Scale Self (MADRS-S) concentration problem question. Methods: A retrospective analysis of MADRS-S self-report data collected between 2020 and 2024. Results: Out of 20197 tDCS users with self-reported depression at baseline, 10,888 had concentration problems (53.9%). Among those who adhered to the tDCS protocol, the proportion who moved from having concentration problems to not having them was 29.3% at one week, 37% at two weeks, 45.2% at three weeks, 54.7% at six weeks, and 57.4% at ten weeks. Concentration problems strongly correlate with depression. Conclusion: The results show that tDCS can reduce concentration problems in those with self-reported depression. Some people experience concentration problems despite addressing lifestyle and environmental factors that can negatively affect concentration. There are negative side effects of some methods of improving concentration, for example, the use of stimulants. tDCS could be a valuable alternative approach to reducing concentration problems in people experiencing depression. Appropriately designed and powered randomised controlled trials (RCTs) are warranted to investigate the impact of tDCS on cognitive functioning and concentration.
• Alpha-Stim AID Cranial Electrotherapy Stimulation (CES) for anxiety in chronic breathlessness: a qualitative exploration of feasibility, usability, and acceptability

  Walker, Kate; Bleazard, Lucy; Griffiths, Chris; Riley, David; Faull, Christina (2025)

  Background: Anxiety is common in people living with chronic breathlessness. Cranial Electrotherapy Stimulation (CES) with the Alpha-Stim Anxiety, Insomnia, Depression (AID) has evidence of effectiveness in the treatment of anxiety disorders, but little is known about its feasibility, usability, and acceptability for people living with anxiety associated with chronic breathlessness. Aim: To explore individuals’ experiences of using Alpha-Stim AID to manage their anxiety associated with their breathlessness. Methods: Participants were recruited from two hospices, with advanced chronic respiratory disease and breathlessness and anxiety, and followed either a Set Dose Regime (SDR) or a Personalised Dose Regime (PDR). Semi-structured interview with 15 participants who had used Alpha-Stim AID (SDR and/or PDR) daily for eight weeks were analysed thematically using the predefined domains of feasibility, usability, and acceptability. Results: Feasibility: the Alpha-Stim AID was readily integrated into daily routines, providing a valued hour of calmness and fostering adherence to Alpha-Stim AID use. Usability: most participants reported benefits including reduced anxiety, improved mood, better sleep, and subtle mindset shifts such as cognitive reframing, although a minority reported limited impact. Acceptability: The device was perceived as simple to use and intuitive and associated with no or mild transient side effects, with PDR enhancing comfort, perceived control, and engagement. Conclusions: Alpha-Stim AID is a low-burden, well-tolerated adjunctive intervention for anxiety in people with breathlessness, with potential benefits extending beyond symptom relief. Future research should explore long-term effects, the mechanisms underpinning mindset change, and strategies for optimisingpersonalizing dosing regimens.
• “Hospital at home” mental health psychiatric hospital return to the community transition support: impact on self-reported wellbeing

  Griffiths, Chris; Jiang, Harmony (2025)

  Background: People who are discharged from mental health psychiatric hospitals often have low average levels of wellbeing and require support to improve wellbeing, enable mental health recovery, and facilitate successful transition back into the community to prevent mental health crisis and readmission. Low levels of wellbeing are linked to worse mental health symptoms, anxiety, and depression. Intervention: Hospital at Home is a two-week intervention that provides at-home support for people who are discharged from a mental health hospital or who are at risk of a mental health crisis and hospital admission. It is a trauma-informed, behaviour-change, and strengths-based approach; staff provide individualised practical and emotional support, identifying needs and goals to help individuals stabilise, build confidence, develop and apply coping strategies, recover, self-manage, connect with community-based services and resources, and reconnect with previous social contacts and activities. Purpose/aim: This study investigated the impact of Hospital at Home on wellbeing. The study addressed the question: “What is the impact of Hospital at Home transition support on self-reported psychological wellbeing?” Methods: An open-label patient cohort design with no control group was used. Pre- and post-intervention assessments were conducted using the self-report measure, the Short Warwick–Edinburgh Mental WellBeing Scale (WEMWBS). Participants were 102 Hospital at Home clients, 28 (27.5%) males and 74 (72.5%) females. The average age of the participants was 50.1 years (range 25 to 95 years; SD = 14.8). Results: Prior to the start of participation in Hospital at Home, 89% of participants reported low wellbeing, with only 11% reporting in the normal range of wellbeing. At the end of participation in Hospital at Home, 54% reported in the normal range of wellbeing and 2% in the high range of wellbeing. SWEMWBS scores significantly improved by 5.52 points (SD = 4.05) with a very large effect size (Cohen’s d = −1.36). SWEMWBS scores significantly improved in participants with a primary diagnosis of anxiety by 5.44 points (SD = 4.14) with a very large effect size (Cohen’s d = −1.31). SWEMWBS scores significantly improved in participants with a primary diagnosis of depression by 5.28 points (SD = 3.76) with a very large effect size (Cohen’s d = −1.40). SWEMWBS scores significantly improved in participants with a primary diagnosis of schizophrenia by 6.60 points (SD = 3.79) with a very large effect size (Cohen’s d = −1.74). Conclusion: Hospital at Home was found to be beneficial in terms of improving wellbeing, which is linked to improvements in mental health. The SWEMWBS results indicate improvements in optimism, self-efficacy, calmness, coping, clarity of thinking, closer connections with others, and personal agency, which can enhance a successful return to the community, mental health recovery, and reduce the risk of relapse and readmission. Hospital at Home is relatively low-cost and can be offered by all mental health providers. Further research is justified to support roll-out.
• Real-world evaluation of at-home cranial electrotherapy stimulation (CES) for the management of sleep, anxiety, depression, stress, quality of life, and self-efficacy

  da Silva, Ksenija Maravic; Broom, Clementine; Daly, Harvey; Griffiths, Chris; Willis, Andy; Bjekic, Jovana (2026-03-01)

  Background Direct-to-consumer neuromodulation technologies are transforming how sleep and mood disorders are self-managed outside clinical settings. Cranial electrotherapy stimulation (CES) is a low-intensity, portable intervention with growing accessibility but limited evidence in non-clinical populations and real-life contexts. This naturalistic cohort study investigated the effects of CES on sleep, anxiety, depression, stress, quality of life, and self-efficacy in a real-world, community-based setting. Methods Sixty adults agreed to use the Alpha-Stim AID CES device daily for 21 days (40–60 min/day). Validated self-report measures were completed at baseline, day 21 (end-of-treatment), and day 42 (follow-up). A subsample (n = 27) wore actigraphy devices to monitor objective sleep changes. Results By day 21, sleep quality significantly improved, with 48 % achieving insomnia remission and 50 % a reduction in daytime sleepiness. Actigraphy data corroborated subjective sleep improvements. Anxiety and depression remission rates were 72.3 % and 71.2 %, with improvements maintained three weeks post-intervention. Stress levels decreased, while self-efficacy, wellbeing, and quality of life improved, with moderate to large effect sizes. CES was rated as safe, acceptable, and easy to use: 48 % of participants preferred it over psychotherapy or medication. Discussion CES is a safe, self-administered intervention that benefits sleep, mental health, and quality of life. This study presents the first actigraphy evidence of CES effects on sleep in a diverse, non-clinical population. Findings support a novel framework for accessible, non-pharmacological interventions for sleep and wellbeing with sustained impact at three-week follow-up. Results have significant implications for sleep quality and mental health, especially for populations underserved by traditional healthcare.
• The use of the Structured Clinical Management (SCM) pathway in an inpatient setting: what has this meant for my recovery?

  Castledine, Sue (2025-04)

  Background: Despite inpatient treatment not being recommended for those with a diagnosis of personality disorder, this may at times be necessary. One of the primary goals of the Structured Clinical Management (SCM) pathway is to reduce unnecessary hospital admissions. The SCM protocol attempts to reflect best generic practice for emotionally unstable personality disorder (EUPD) in the UK focused upon the organisation of care and provision of a therapeutic framework. The aim of the current study was to explore patient experiences of the use of SCM principles of care within an inpatient setting. = Method: Semi-structured interviews were conducted with seven participants under the care of Northamptonshire Healthcare Foundation Trust (NHFT) who were identified through purposeful sampling. All participants were female with a primary diagnosis of EUPD, or with established difficulties in this area, and with exposure to at least two hospital admissions within the previous 12 months. Data was then explored and analysed qualitatively using thematic analysis. Results: Analysis revealed six themes: ‘patient involvement’, ‘a template for care’, ‘shared understanding’, ‘person-centred care’, ‘holding the hope’ and ‘support’. Perception of the quality of care seeming to be contingent upon these factors. Conclusion: Patient experiences of the SCM principles of care and their impact upon recovery within an inpatient setting were influenced by several factors. This included the delivery of person-centred care rather than a more ‘blanket’ approach to implementation. Clinical and research implications are discussed.
• How to treat someone suffering with PTSD following rape in adulthood

  Young, Kerry; Akbar, Sameena; Brady, Francesca; Burrows, Sophie; Chessell, Zoe J.; Chisholm, Amy; Dixon, Lucinda; Ellison, Menah Raven; Grey, Nick; Hall, Emily; et al. (2025)

  Cognitive behavioural therapists and practitioners often feel uncertain about how to treat post-traumatic stress disorder (PTSD) following rape and sexual assault. There are many myths and rumours about what you should and should not do. All too frequently, this uncertainty results in therapists avoiding doing trauma-focused work with these clients. Whilst understandable, this means that the survivor continues to re-experience the rape as flashbacks and/or nightmares. This article outlines an evidence-based cognitive behavioural therapy (CBT) approach to treating PTSD following a rape in adulthood. It aims to be a practical, ‘how to’ guide for therapists, drawing on the authors’ decades of experience in this area. We have included film links to demonstrate how to undertake each step of the treatment pathway. Our aim is for CBT practitioners to feel more confident in delivering effective trauma-focused therapy to this client group. We consider how to assess and formulate PTSD following a rape in adulthood, then how to deliver cognitive therapy for PTSD (CT-PTSD; Ehlers and Clark, 2000). We will cover both client and therapist factors when working with memories of rape, as well as legal, social, cultural and interpersonal considerations. Key learning aims To understand the importance of providing effective, trauma-focused therapy for survivors of rape in adulthood who are experiencing symptoms of PTSD. To be able to assess, formulate and treat PTSD following a rape in adulthood. How to manage the dissociation common in this client group. To be able to select and choose appropriate cognitive, behavioural and imagery techniques to help with feelings of shame, responsibility, anger, disgust, contamination and mistrust. For therapists to learn how best to support their own ability to cope with working in a trauma-focused way with survivors of rape and sexual violence.
• A literature search of psychological trauma related outcome measures for adult mental health services

  Dawood, Runa; Silva, Amanda Zambon Marques da; Reis, Ana Dulce Collado Vasques Marques dos (2025-09)

  It is important to measure the impact of psychological trauma within mental health services designed to treat individuals after traumatic experiences. However, there are challenges in capturing the impact of trauma and the recovery from it accurately whilst also considering patient preferences and expectations. This study aims to explore the range of pre-existing outcome measures of trauma symptomatology and determine the relative prevalence of these measures within related research. This is addressed through systematically searching literature for outcome measures available in the assessment of psychological trauma symptomatology across adult mental health populations. Databases Medline, CINAHL and PsychInfo were searched to find papers that described the use of measures within psychological trauma-specific outcome research. 228 articles were found after the exclusion criteria were applied. The most prevalence trauma-specific outcome measures utilised within the evidence base were versions of the Post-Traumatic Disorder Checklist (PCL) and the Clinician Administered PTSD Scale (CAPS). Non-trauma specific measures were also identified within this sample. This paper lists both trauma-specific and non-trauma specific measures found in order of prevalence. Consideration is given to the most frequent measures found. These findings provide insight into gold-standard measures for services wishing to implement outcome measures that will meaningfully capture recovery amongst trauma survivors. Practitioner points • The impact of trauma has challenges in its conceptualisation and measurement, and additional attention is needed to ensure that services are capturing helpful treatment outcomes. • Key measures used within trauma-specific research include gold standard PTSD and CPTSD measures as well as non-specific trauma measures. • Reviewing the measures most used in trauma research highlights the areas of most critical change within recovery after trauma therapy and therefore provides valuable insights into how service evaluation can capture meaningful change.
• A systematic review of interventions with families of trans people

  Chesters, Michaela; Pipkin, Alastair; Brett, Caroline E. (2025)

  Introduction Trans people experience poorer mental health than their cisgender counterparts, likely as a result of minority stress. Caregivers can contribute to minority stress through discrimination, rejection and lack of acceptance. Interventions with family members may provide a way to address conflict and lack of acceptance of gender within the family. Method A systematic review was conducted following PRISMA guidelines. Searches were conducted in PsycInfo, Embase, MEDLINE, Cinahl Plus and ProQuest Theses and Dissertations databases on 16 February 2024 to identify concepts relating to “transgender” and “family intervention.” Results Seven studies were included in the review. Four evaluated interventions relating to family therapy, two to caregiver support groups, and one to an online psychoeducational programme. Outcomes related to mental health were reported on most commonly with positive results; however, overall study quality was poor, and study designs varied. Discussion More studies on the efficacy of family-based interventions with trans people have been published in recent years. Due to heterogeneity, the conclusions that can be drawn from this review are limited. Recommendations are made for increasing the quality of future studies. The recent increase in studies assessing family interventions with trans people is an encouraging sign, and several interventions were identified that show promise in the ways they have adapted for the needs of trans people.
• Staff perceptions of the DIALOG tool and its use for early intervention in psychosis services

  Rose, Vienna; Ivins, Annabel (2025)

  Early intervention in psychosis (EIP) services aim to delay or prevent the onset of severe mental health issues, including psychosis, and provide a stepped care approach for people experiencing emerging psychotic symptoms. The DIALOG service user-rated outcome and experience measure is used routinely in EIP services and provides a comprehensive assessment of service users’ quality of life, care needs and treatment satisfaction. This service evaluation explored staff’s perceptions of using DIALOG in one EIP service. Data were collected from 20 staff members (including 12 nurses) via a survey and a focus group. Themes extrapolated from focus group data were feasibility, engagement and facilitation. Findings showed that staff felt confident using DIALOG regardless of the number of years they had worked in the EIP service and that DIALOG supported person-centred conversations with service users. However, there was variability in how frequently DIALOG was administered and some staff regarded it as a tick-box exercise.
• Put autistic women and girls at the heart: exploring the experiences of autistic women during diagnostic assessments in the UK

  Trundle, Grace; Alexander, Zoe; Chester, Verity (2025-03-24)

  Purpose It is suggested that autism assessments are not sensitive to the female autism presentation. Autistic women are often misdiagnosed or delayed in receiving their diagnosis. More guidance for assessing clinicians is required to improve the validity and effectiveness of autism diagnostic assessments of women. This study aims to explore the experiences of autistic women during their diagnostic assessments and understand what they considered important for diagnostic assessments of females. Design/methodology/approach A focus group with four adult autistic women was conducted, exploring their experiences and recommendations. Thematic analysis was used to identify overarching themes. Findings The main themes were 1) experience of the assessment; 2) gender-sensitive assessment content; and 3) clinician characteristics and skills. Participants made specific recommendations within these themes for how diagnostic assessments of females should be conducted. Originality/value This study differs from previous research by focusing on the experiences of autistic women specifically during diagnostic assessments and what they recommend for future assessments.
• Sexualities of trans and non-binary people during transition, a narrative synthesis implementing a post-humanist framework

  Voi, Sandro; Noltea, Lizette; Twist, Jos; Pipkin, Alastair; Ward, Luke; Dodgers, Steph (2025)

  Background Sexualities are considered a relevant factor to one’s wellbeing. However, research has often fragmented sexualities into discrete elements. Additionally, research within trans and non-binary (TNB) populations has historically been pathologizing. This systematic literature review is grounded in relational ontology, which prioritizes the interactions between elements, over the analysis of isolated identities Aim The aim of this review is to explore how the sexualities of TNB people change during transition and to understand their experiences of these changes. Methods The literature search was conducted using the databases Scopus, Ebsco, CHINAL Plus, Open Dissertations, and Google Scholar, employing search terms related to TNB sexualities and transition experiences. The review synthesized data from qualitative and mixed-methods studies. Despite some studies’ methodological limitations, the narrative synthesis provided a comprehensive examination of the subject. Results The review found that TNB people’s sexualities are fluid and contextually influenced, often undergoing significant changes during transition. These changes are shaped by complex interactions between individual, social, and relational factors. Discussion The findings highlight the need for further research using diverse methodologies and inclusive recruitment strategies to deepen the understanding of TNB sexualities. This research has implications for enhancing sexual health practices and policies to be more inclusive and supportive of TNB individuals, fostering a more comprehensive understanding of their sexual well-being.
• Enhancing the quality of systematic reviews and meta-analyses

  Strawbridge, Rebecca; Sharma, Deepika; Kisely, Steve; Cristea, Ioana A.; Young, Allan H.; Kaufman, Kenneth R. (2025-11)

  Systematic reviews and meta-analyses are often considered the highest level in evidence hierarchies, and therefore are often drawn upon when considering changes in policy. Despite journals implementing measures aiming to enhance the quality of systematic reviews they publish, the authorship raise concerns about the quality of existing and ongoing systematic reviews, particularly relating to transparency and bias minimisation. Building on the current guidelines, standards and tools, we suggest a 'meta checklist' which aims to maximise methodologically sound, unbiased and reproducible reviews of the best scientific quality while considering feasibility throughout the process.

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