/library/oar/handle/123456789/9153 2026-05-24T09:42:21Z /library/oar/handle/123456789/145982 Title: Mediators of outcome in adolescent psychotherapy and their implications for theories and mechanisms of change : a systematic review Authors: Taubner, Svenja; Ioannou, Yianna; Saliba, Andrea; Sales, Célia M. D.; Volkert, Jana; Protić, Sonja; Adler, Asta; Barkauskiene, Rasa; Conejo‑Cerón, Sonia; Di Giacomo, Dina; Mestre, Jose M.; Moreno‑Peral, Patricia; Mucha Vieira, Filipa; Pinheiro Mota, Catarina; Santos Henriques, Margarida Isabel Rangel; Røssberg, Jan Ivar; Stepisnik Perdih, Tjasa; Schmidt, Stefanie Julia; Zettl, Max; Ulberg, Randi; Heinonen, Erkki Abstract: Psychotherapeutic treatment of adolescents requires age-specific approaches and thus plausibly also involves different change mechanisms than adult psychotherapy. To guide further research and improve therapeutic outcomes for adolescents, we reviewed all RCTs investigating mechanisms of change in the psychological treatment of adolescents to identify the most promising age-, disorder- or treatment-specific mediators. Following the preferred reporting items for systematic reviews (PRISMA), 106 studies were included that reported 252 statistical mediation tests assessed with 181 different measures. Most often studied and significant mediators were cognitive, followed by family-related, and behavioral variables. Several mediators were identified to be promising for future investigations: changes in negative thoughts, dysfunctional beliefs and metacognitive skills; family functioning and parenting skills; as well as successful engagement in therapy activities and increased impulse control. Symptom change during therapy was least often a mediator for other therapeutic changes. Relational and emotional mediators were largely understudied, whereas peer-influence appeared a promising mediator for intervention outcomes. Adolescence-specific mediators were most commonly investigated. Majority of studied mediators were not disorder-specific. There was a tendency to mainly test change mechanisms of specific theoretical models without considering other possible change theories. Further, virtually no studies fulfilled all criteria for rigorously investigating mediation and only nine were classified with an overall good study quality. While bearing in mind the current limitations in study designs, methodological rigor and reporting, there appears to be substantial evidence for transdiagnostic age-specific change models in the psychological treatment of adolescents. For future research, need for consensus on a core set of transdiagnostic and transtheoretical mediators and measures is highlighted. These should address likely core mechanisms of change, as well as take into account age-relevant developmental challenges and biological markers. 2024-01-01T00:00:00Z /library/oar/handle/123456789/143993 Title: Navigating complexities : social workers’ experiences in providing mental health services to asylum seekers in Malta Abstract: In the recent years, Malta has received a high influx of asylum seekers. Most of these asylum seekers have gone through trauma, which impacts their mental health, which is further worsened by the difficulties faced even after arrival. Social workers are usually their first contact point of help. However, social workers often struggle to assist them due to various challenges. This study aims to capture the lived experiences of social workers in Malta who support asylum seekers with mental health challenges. IPA qualitative approach was employed. Data collection was done through semi-structured interviews with six social workers selected through purposive homogeneous sampling. Each interview lasted between 45 minutes and 1.5 hours, which was then transcribed in verbatim and analysed using thematic analysis. Findings indicate that uncertainty, lengthy asylum procedures, and inability to access services are major factors that increase mental health challenges of asylum seekers in Malta. Findings also reveal that challenges like limited resources, language barriers, and cultural differences affect the social workers’ ability to support their clients effectively. These challenges not only negatively affect service provision but also contribute to workforce issues like frequent staff turnover, high emotional stress, and high caseloads. Ultimately, this study underscores the importance of addressing cultural and language barriers, increasing resources and workplace support, and reforming policies and provides valuable recommendations to help reduce stigma and improve asylum seekers’ access to mental health services in Malta. Recommendations include greater involvement with interpreters and collaboration with relevant entities, establishing centralised service hub and specialised multidisciplinary team, simplifying the Mental Health Act and mental health care processes, and promoting continuous mental health care even for those who are under appeal or subsequent application process. Description: M.Sc.(Melit.) 2025-01-01T00:00:00Z /library/oar/handle/123456789/143992 Title: Educators' perspectives on non-suicidal self-injuries as experienced by secondary school students Abstract: Background: Mental health disorders among adolescents are estimated to affect 10% to 20% of this population. Additionally, Non-Suicidal Self-Injuries (NSSIs) are a growing concern for this demographic. Despite this alarming rise, no local study on the educators’ perspectives on NSSIs in secondary school students has been conducted to date. This study sought to explore educators’ perspectives on NSSIs experienced by secondary school students. The main objectives were to identify how participating educators viewed their roles in providing support to their students’ challenges in relation to NSSIs; to identify if NSSIs affect youngsters’ lives and academic performance; and to explore whether educators seek more professional development courses to be better equipped to support their students better. Design Methodology: A qualitative research design was used, following the principles underpinning Interpretative Phenomenological Analysis (IPA). Eight educators, three male and five female educators who taught at the Gozo College, Secondary School participated in the research study. Semi-structured interviews were used as a data collecting tool with a purposeful sample of (n=8). The eight in-depth interviews were audio-recorded and transcribed verbatim. IPA was used to analyse the collected data. Findings and Conclusion: The data analysis yielded three superordinate themes, namely emotional impact behind NSSI; factors related to NSSI; and the need and importance of mental health safety and awareness measures. This dissertation provided an opportunity for educator participants to share their experiences and discuss the way forward to promote better mental health and well-being to better support their students. Description: M.Sc.(Melit.) 2025-01-01T00:00:00Z /library/oar/handle/123456789/143991 Title: Mental health needs of children in Gozo : an exploratory study Abstract: Background: Childhood is a critical period for mental health, marked by rapid biological, psychological, and social development, as well as heightened vulnerability to environmental factors. While the importance of providing supportive environments is well recognised, mental health services in Gozo – like those in many international settings – continue to face challenges, particularly in ensuring consistent accessibility to services and resources. Aim: To explore the mental health needs of children in Gozo from the perspectives of healthcare professionals who work in a psychiatry department in Gozo. Design: A qualitative research design. Method: Five healthcare professionals were recruited through an intermediary who followed the inclusion and exclusion criteria. Data was collected through semi-structured interviews, and the data was analysed using Braun and Clarke’s thematic framework. Results: The findings identified four key themes: mental health services provisions: accessibility and adequacy, parental barriers in acknowledging and addressing children’s mental health, societal challenges children face in accessing mental health services, and empowering nurses and leaders in mental Health. The findings highlighted gaps in mental health services, resources, and training. It also identified the need for improved collaboration between healthcare and educational settings to reduce stigma and increase awareness. Conclusion: The study provided key insights into the mental health needs of children in Gozo from the professionals' perspectives. This emphasised the need for systemic improvements in service delivery, professional development, community engagement, and leadership. The results are intended to inform practice and policy, to help contribute to better mental health outcomes for children in Gozo. Description: M.Sc.(Melit.) 2025-01-01T00:00:00Z