Social anxiety disorder (SAD) involves an intense fear of negative evaluation and avoidance of social situations. Emotion-focused therapy (EFT) is an emerging SAD treatment. Still, little is known about client differences in engagement with experiential EFT techniques and whether therapist-observed resistance to these techniques corresponds with therapeutic change. The present study describes a two-case series where two emerging adults with SAD from an Indian university setting received 10 weekly sessions of EFT for social anxiety (EFT-SA). A clinical psychologist diagnosed both participants using ICD-11 criteria alongside elevated Social Interaction Anxiety Scale scores. Participants completed standardized questionnaires measuring social anxiety, emotion regulation, interpersonal functioning, and self-compassion. Assessment was conducted at baseline, termination, and at 3- and 6-month follow-ups. Session-level clinical documentation of engagement and therapist-observed resistance to experiential tasks was also assessed. Both clients improved descriptively across measures; SIAS change was reliable only at 6 months, and scores stayed above clinical cutoffs. Notably, Client B, despite greater clinician-observed resistance to experiential techniques, showed larger gains in self-compassion. This discrepancy is consistent with process research showing that clinicians’ real-time impressions of resistance often did not correspond with treatment outcome. Clinically, this points to visible reluctance toward an experiential technique not being, on its own, a sign of global treatment disengagement, and suggests therapists may benefit from distinguishing reluctance toward a specific technique from broader disengagement from therapy. Findings are preliminary and descriptive, drawn from unstandardized clinician observations in two cases, and should be read as hypothesis-generating rather than as evidence of efficacy.
Background: Halfway homes provide transitional support for persons with mental illness moving from institutional care to community living. However, there is limited evidence from India on how residents experience recovery and rehabilitation within these settings. Hence, this study was done to explore the lived experiences of persons with mental illness residing in a halfway home, understand its role in rehabilitation and recovery, and identify factors influencing rehabilitation outcomes. Methods: A qualitative study was conducted among residents of a government-run halfway home. Data were collected through in-depth interviews with eight purposively selected residents who had lived in the facility. Interviews explored experiences of rehabilitation, daily functioning, social relationships, occupational engagement, future aspirations, and barriers to reintegration. Data were analyzed using thematic analysis following Braun and Clarke’s approach. Results: Five themes emerged: transition from institutional dependence to everyday autonomy; work, routine, and reconstruction of identity; relearning daily living and functional independence; social support, family estrangement, and reintegration challenges; and hope and future aspirations. Participants described halfway home as a space that promoted autonomy, privacy, mobility, and participation in everyday life. Work and structured routines contributed to identity reconstruction and purpose. Recovery was facilitated by peer and institutional support, while stigma, family estrangement, and medication-related challenges remained important barriers. Conclusions: Halfway homes play a vital role in promoting recovery, autonomy, and community reintegration among persons with mental illness and represent an important component of recovery-oriented mental health services in India.
Background: Transgender individuals in India face elevated levels of health disparities rooted in social stigma, institutional discrimination, family rejection, and structural exclusion. The study aims to explore factors influencing health, psychosocial outcomes, and help-seeking behavior among transgender individuals in the Bangalore Urban Area. Method: An analytical mixed-methods design, triangulating a quantitative cross-sectional assessment with qualitative thematic analysis. One hundred transgender individuals were recruited purposively via NGO networks and community settings. Instruments included the WHOQOL-BREF, the self-reporting questionnaire (SRQ-20), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Transgender Identity Stigma Questionnaire (TISQ). Ten key stakeholders participated in semi-structured in-depth interviews. Statistical analyses comprised Spearman correlations, Kruskal–Wallis tests with Bonferroni post hoc corrections, and one-way ANOVA, with thematic analysis used for qualitative data. Results: Moderate-to-high psychological distress was found in 35.4% of trans women and 33.3% of trans men. Felt normative stigma was higher than enacted stigma (Mean 24.79 vs. 13.58). Overall quality of life was moderate, with social relationships highest and physical health the lowest. Social support was significantly positively associated with all WHOQOL-BREF domains ( r = 0.56, p < .01); mental distress negatively predicted all QoL domains. Family support significantly predicted psychological ( H = 20.95, p < .001) and environmental QoL ( H = 18.60, p < .001). Conclusions: Stigma, economic marginalization, and institutional mistrust collectively undermine mental health and quality of life. Peer networks and NGOs serve as primary protective and help-seeking conduits. Gender-affirming healthcare reforms, mandatory provider sensitization, and sustained community-led support are urgently needed.
Background: Delirium is an acute neuropsychiatric syndrome characterized by disturbances in attention, awareness, and cognition. It is highly prevalent among hospitalized patients but remains under-recognized, particularly in its hypoactive form. Consultation-liaison psychiatry (CLP) services are pivotal for early identification, yet detailed clinical profiles from Indian tertiary-care settings are sparse. Methods: This hospital-based cross-sectional study enrolled 94 adult inpatients referred for acute confusional states between October 2022 and April 2024. We used the Delirium Rating Scale-Revised-98 (DRS-R-98), the Richmond Agitation-Sedation Scale (RASS), and the Delirium Etiology Checklist (DEC). Data were analyzed using descriptive statistics, Chi-square tests, and one-way ANOVA. Statistical significance was set at p < .05. Results: The mean age was 59.29 ± 16.12 years; 81.9% were male. Severe impairment was most frequent in attention (52.1%), short-term memory (50.0%), and orientation (48.9%). Hyperactive delirium was predominant (81.9%). The cohort’s mean total DRS-R-98 score was 21.94 ± 8.12. Increasing age showed a significant association with delirium subtype ( F = 5.68, p = .005), with mixed and hypoactive presentations occurring in older patients. Metabolic/endocrine disturbances (91.5%) and systemic infections (40.4%) were the leading etiological contributors. Conclusions: Delirium in CLP referrals is characterized by marked cognitive impairment, predominance of hyperactive presentation, and multifactorial etiology. The over-representation of hyperactive cases likely reflects referral bias. Structured assessment tools and routine screening are essential for early detection, particularly of hypoactive delirium. Future multicenter prospective studies are warranted.
Background: Sexual health is strongly influenced by sociocultural beliefs, yet evidence on sexual knowledge, attitudes, and practices among tribal men in India remains limited. This study explored these aspects among men from the Jawadhi Hills, a tribal community in southern India. Methods: A descriptive phenomenological qualitative study was conducted using seven focus group discussions involving 55 men aged 18–60 years, including migrant workers, teachers, and community representatives. Participants were recruited through multistage and purposive maximum variation sampling. Discussions were audio-recorded, transcribed, translated, and analyzed manually using inductive thematic analysis. Results: Mobile phones and social media were the predominant sources of sexual information. Participants demonstrated basic awareness of contraception and sexually transmitted infections but held several misconceptions regarding semen, masturbation, menstruation, fertility, and male contraception. Traditional gender norms, menstrual restrictions, and community sanctions against extramarital relationships strongly influenced attitudes and practices. While digital media had increased access to sexual information, it also appeared to reinforce myths and misinformation. Limited privacy within households and conflicting beliefs about substance use and sexual performance further shaped their sexual behaviors. Conclusions: Sexual knowledge among tribal men reflects a complex interplay of traditional cultural beliefs and expanding digital exposure. Persistent misconceptions and gaps in reproductive health literacy highlight the need for culturally appropriate, community-based sexual health education that addresses local beliefs while promoting evidence-based practices.
