The Mental Elf

05/02/2026

If you support people with OCD: 30% don't respond to or drop out of CBT. What options exist for them? 🔍

Meta-analysis of 46 studies tested mindfulness and acceptance programmes:
📊 Large reductions in OCD symptoms
📊 Performed as well as CBT
📊 Better than medication
📊 Improved depression, anxiety and quality of life

Why this matters:
For people who experience shame about their OCD, approaches emphasising acceptance rather than "fixing" thoughts may feel less stigmatising .

The limitation: Short follow-up in most trials. For a lifelong condition, we need to know if benefits last.

Worth noting for anyone who hasn't found success with standard treatment - other evidence-based options may be emerging.

Read the full blog: https://buff.ly/38IDfoK

04/02/2026

If you treat depression: decades of disappointing anti-inflammatory trials may not mean the hypothesis is wrong - just that we've been testing it poorly 🧠

New meta-analysis shows anti-inflammatories work when targeting people with elevated inflammation:
📊 Reduced depression and anhedonia
📊 Effect sizes similar to SSRIs

The problem? Previous trials recruited everyone with depression, not just those with inflammation. Positive effects got buried.

Around 25-33% of people with depression show measurable inflammation. Worth considering whether some patients need different tools.

Read the full blog: https://buff.ly/EidzTwN

03/02/2026

🎧 ReSET Podcast - Final Episode - answers important questions for schools:

Why is prevention essential when treatment can't meet demand?
What does the evidence tell us about long-term benefits?
How do schools navigate the overwhelming landscape of interventions?
What makes prevention work in practice, not just in theory?

Professor Peter Fonagy explains why preventing mental health problems directly enables learning: "When children are stuck in anxiety or mistrust, they can't learn effectively. Prevention creates the conditions where education can actually happen."

Professor Essi Viding shares the promising ReSET trial findings and what makes this intervention different—it's not just effective, it's acceptable and deliverable in real schools.

Dr Jess Deighton tackles the implementation challenge: "Schools are bombarded by 'shampoo ad interventions' that mention science but lack evidence. We need to help them ask the right questions."

Dr Roslyn Law reminds us that prevention isn't an add-on—it's about creating a culture where strong relationships are the first line of defence.

🎧 Listen wherever you get your podcasts

🔗 Visit the ReSET project website for more resources (being updated with lots of useful content over the coming weeks) https://resetproject.co.uk/the-reset-podcast/

03/02/2026

If you support autistic adults: are you distinguishing burnout from depression in your assessments?

This matters because treatment approaches are completely different:
📊 Burnout responds to sensory rest and reducing masking
📊 Depression responds to behavioural activation
📊 Get it wrong and you risk making things worse

New study validated a burnout measure for autistic adults. It distinguished burnout from depression reliably - which is crucial for clinical decisions.

But here's the question it raises: does a specific questionnaire add value over simply asking someone "are you burnt out right now?" Individual conversation might tell you more.

69% of autistic adults have experienced burnout at least once. The study found it strongly linked to camouflaging - the exhausting work of masking autistic traits.

Worth reflecting on: what helps the person more - quantifying their experience or listening to it?

Read the full blog: https://buff.ly/JLvgfpf

02/02/2026

Non-physical domestic violence in childhood has stronger links to adult mental health than physical violence 🏠

What they found:

Childhood exposure to intimidation/control associated with:
📊 2x the odds of PTSD
📊 1.6x the odds of GAD and cannabis use
📊 1.5x the odds of self-harm

Childhood exposure to property/pet damage associated with:
📊 1.7x the odds of severe alcohol use disorder
📊 1.5x the odds of PTSD
📊 Increased odds of smoking, depression and binge drinking

In contrast, physical violence and threats showed few independent associations after accounting for other childhood maltreatment.

Important limitations: Cross-sectional design limits causal conclusions. Retrospective reporting could be affected by recall bias. Sample only from Australia.

The findings emphasise urgent need to acknowledge non-physical forms of domestic violence as harmful. Children are recognised as victims in UK and Australian legislation, but support availability remains a postcode lottery.

Read the full blog: https://buff.ly/UgyVhp7

30/01/2026

New clinical guidelines for peripartum depression developed by international experts 🤰
What they recommend:

Prevention:
📊 Psychological interventions (CBT, interpersonal therapy)
📊 Psychosocial support (home visits, telephone support)
📊 Physical activity (at least 90 minutes weekly)
📊 Insufficient evidence for antidepressants or supplements

Screening:
📊 Universal screening recommended when systems ensure timely referral to trained professionals
📊 Screening can reduce symptoms when combined with treatment protocols

Treatment:
📊 CBT recommended
📊 Antidepressants assessed on individual risk-benefit ratio
📊 ECT strongly recommended for life-threatening, therapy-resistant severe PPD

Important limitations: Only included English studies from high-income countries. No recommendations for fathers due to lack of evidence - a significant gap.

The guidelines include 44 recommendations based on review of 145 systematic reviews.

Read the full blog: https://buff.ly/0xe4fTb

29/01/2026

Can schools support children's mental health after natural disasters? This meta-analysis provides some answers 🌍

What they found:
📊 School interventions reduced PTSD symptoms immediately (large effect), with effects persisting at follow-up
📊 Depression reduced immediately and short-term, but not long-term
📊 Anxiety reduced immediately (large effect)
📊 Shorter, more frequent sessions over longer periods worked best
📊 Could be delivered by teachers, psychologists or other trained professionals

Important limitations: High heterogeneity between studies limits reliability. Studies with high risk of bias showed large effects, while those with fewer concerns showed smaller, non-significant effects.

The review didn't examine whether interventions were universal or targeted, or timing after disaster - both crucial for clinical guidelines. More high-quality evidence needed before changing practice.

Read the full blog: https://buff.ly/YnL8JoQ

28/01/2026

How does menstruation affect autistic people's mental health? This scoping review reveals significant unmet healthcare needs

What they found:
📊 Increased mood changes, aggression, self-injury and sensory overload around menstruation
📊 Higher rates of menstrual disorders (painful periods, heavy bleeding, irregular cycles)
📊 Autistic individuals less likely to access gynaecological care despite high distress
📊 Healthcare barriers included lack of professional awareness, communication challenges and stigma

Many autistic people struggled to describe pain or discomfort, leading to under-recognition of distress and delayed care.

Important limitations: Most studies were small samples or case reports from USA/UK. The review didn't assess whether studies involved autistic people in their design.

The findings highlight urgent need for inclusive, autism-informed reproductive healthcare that addresses communication differences and sensory needs.

Read the full blog: https://buff.ly/7b2sfRU

27/01/2026

What do children with trauma histories think of Dyadic Developmental Psychotherapy? This qualitative study explored their experiences 🧸

What they found:
📊 Attunement and emotional connection mattered most - children described therapists as "telepathic"
📊 Playfulness and flexibility helped children feel safe
📊 Caregivers as active "co-therapists" was valued
📊 Trust took time - all children initially felt mistrust

Important limitations: Only included children who completed treatment successfully, creating bias toward positive experiences. Small sample (six children) limits generalisability.

The study used innovative play-based methods (story enactment, drawings, emotion stickers) to help children express experiences without direct questioning.

Read the full blog: https://buff.ly/w7kVEJ2

Ana Veic critiques a qualititative study assessing the experience of receiving dyadic developmental psychotherapy among children with developmental trauma.

27/01/2026

🎙️ NEW PODCAST: RESET Episode 3 - Social Relationships and Mental Health
If you've ever watched a teenager withdraw from friends when they're struggling - or seen peer conflict make their anxiety worse - this episode explains why.

Mental health and relationships aren't separate issues. They're completely intertwined.
When young people struggle emotionally, they withdraw socially. This isolation makes their mental health worse, which makes it harder to maintain friendships. It's a cycle that spirals in both directions.

But here's the hopeful part: Research shows that ONE close, positive friendship can buffer against serious mental health problems. Young people don't need to be popular or at the top of the social hierarchy - they just need one genuine connection.

This episode explores:
- Why peer relationships become so crucial during adolescence
- How social hierarchies get established in the first DAYS of secondary school
- The difference between ME strategies (managing your own emotional state) and WE strategies (changing what's happening in relationships)
- How whole-school approaches can shift social norms by working with influential students

Whether you're a teacher, parent, or anyone working with young people, this conversation offers practical approaches grounded in research.

🎧 Listen on YouTube: https://buff.ly/aRlHqEk
Or wherever you get your podcasts!

Next week: Episode 4 pulls everything together - prevention, evidence, and how schools can make this work.

26/01/2026

Do antipsychotics slow down thinking? This study investigated their cognitive effects 🧠

What they found:
📊 Both antipsychotics (amisulpride and aripiprazole) slowed working memory speed
📊 People took longer to recall information, but accuracy wasn't affected
📊 No effect on attention, response inhibition, mood or alertness

This suggests the cognitive impact is specific to working memory, not a general "slowing."

Both traditional blockers and newer partial agonists showed similar effects.
Important limitations: Study was in healthy adults without schizophrenia, so findings may not translate directly to clinical populations. Only 7 days of medication, so longer-term effects unclear.

The findings provide causal evidence that antipsychotics affect working memory processes, which matters for supporting people taking these medications long-term.

Read the full blog: https://buff.ly/6r9wdxv

22/01/2026

"The word race is only mentioned once in the DBT manual – and it's in the context of a white person observing racism and feeling disgusted. The white gaze of observing racism is privileged over the actual experience of a person of colour."

This video features crucial insights from Riya Gosrani, Thelma Kokroko, Michaela Swales, and Jenifer Dylan about decolonizing DBT and making it work for everyone.

Key insights:
🌟 DBT is effective and evidence-based – but wasn't written with Black, Indigenous, and people of colour in mind
🌟 Cultural nuances matter: some interpersonal effectiveness skills can't be used with elders without being perceived as rude
🌟 White therapists need to acknowledge systemic racism and practice cultural humility
🌟 This is ongoing, bottom-up work informed by people of colour who've undergone DBT

Whether you're delivering DBT, managing services, or working with people with complex emotional needs – this video will challenge your practice.

All interviews were conducted by André Tomlin from the Mental Elf at the British and Irish Group for the Study of Personality Disorder Annual Conference in Liverpool in 2025.