The effectiveness of internet-delivered cognitive behavioural therapy for health anxiety in routine care

2020 ◽  
Vol 264 ◽  
pp. 535-542 ◽  
Author(s):  
Jill M. Newby ◽  
Hila Haskelberg ◽  
Megan J. Hobbs ◽  
Alison E.J. Mahoney ◽  
Elizabeth Mason ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Cognitive Behavioural

scholarly journals Protocol investigating the clinical outcomes and cost-effectiveness of cognitive–behavioural therapy delivered remotely for unscheduled care users with health anxiety: randomised controlled trial

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Shireen Patel ◽  
Sam Malins ◽  
Boliang Guo ◽  
Marilyn James ◽  
Joe Kai ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Clinical Outcomes ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
Unscheduled Care ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundHealth anxiety and medically unexplained symptoms cost the National Health Service (NHS) an estimated £3 billion per year in unnecessary costs with little evidence of patient benefit. Effective treatment is rarely taken up due to issues such as stigma or previous negative experiences with mental health services. An approach to overcome this might be to offer remotely delivered psychological therapy, which can be just as effective as face-to-face therapy and may be more accessible and suitable.AimsTo investigate the clinical outcomes and cost-effectiveness of remotely delivered cognitive–behavioural therapy (CBT) to people with high health anxiety repeatedly accessing unscheduled care (trial registration: NCT02298036).MethodA multicentre randomised controlled trial (RCT) will be undertaken in primary and secondary care providers of unscheduled care across the East Midlands. One hundred and forty-four eligible participants will be equally randomised to receive either remote CBT (6–12 sessions) or treatment as usual (TAU). Two doctoral research studies will investigate the barriers and facilitators to delivering the intervention and the factors contributing to the optimisation of therapeutic outcome.ResultsThis trial will be the first to test the clinical outcomes and cost-effectiveness of remotely delivered CBT for the treatment of high health anxiety.ConclusionsThe findings will enable an understanding as to how this intervention might fit into a wider care pathway to enhance patient experience of care.

A cognitive–behavioural therapy assessment model for use in everyday clinical practice

2002 ◽  
Vol 8 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Chris Williams ◽  
Anne Garland
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Clinical Skills ◽  
Health Anxiety ◽  
Antidepressant Medication ◽  
Bipolar Disorders ◽  
Behavioural Therapy ◽  
Assessment Model ◽  
Therapy Assessment ◽  
Compulsive Disorder ◽  
Cognitive Behavioural

Cognitive–behavioural therapy (CBT) is a shortterm, problem-focused psychosocial intervention. Evidence from randomised controlled trials and metaanalyses shows that it is an effective intervention for depression, panic disorder, generalised anxiety and obsessive–compulsive disorder (Department of Health, 2001). Increasing evidence indicates its usefulness in a growing range of other psychiatric disorders such as health anxiety/hypochondriasis, social phobia, schizophrenia and bipolar disorders. CBT is also of proven benefit to patients who attend psychiatric clinics (Paykel et al, 1999). The model is fully compatible with the use of medication, and studies examining depression have tended to confirm that CBT used together with antidepressant medication is more effective than either treatment alone (Blackburn et al, 1981) and that CBT treatment may lead to a reduction in future relapse (Evans et al, 1992). Generic CBT skills provide a readily accessible model for patient assessment and management and can usefully inform general clinical skills in everyday practice.

scholarly journals A Complex Interplay: Cognitive Behavioural Therapy for Severe Health Anxiety in Addison's Disease to Reduce Emergency Department Admissions

2017 ◽  
Vol 45 (4) ◽  
pp. 419-426 ◽  
Author(s):  
Jo Daniels ◽  
Elizabeth Sheils
Keyword(s):  
Emergency Department ◽  
Cognitive Behavioural Therapy ◽  
Single Case ◽  
Health Anxiety ◽  
Addison’S Disease ◽  
Behavioural Therapy ◽  
Adrenal Crisis ◽  
Addison's Disease ◽  
Complex Interplay ◽  
Cognitive Behavioural

Background: Addison's disease (AD) is a rare chronic illness caused by adrenocortical insufficiency. Due to the pivotal role of the regulating hormone cortisol in AD, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety in endocrinological disorders, however there is a paucity of research examining the complex interplay between AD and anxiety. Aims: This paper describes a single case study of a patient with severe health anxiety and co-morbid AD. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in AD can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. Method: A single case design was used, with pre- and post-measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Results: Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment. Conclusions: This preliminary study provides a sound rationale for further research into AD complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of AD, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.

scholarly journals A qualitative study of patients’ experiences and acceptance of computerised cognitive behavioural therapy in primary care, Scotland

2021 ◽  
Vol 14 ◽  
Author(s):  
Eliane Du ◽  
Ethel Quayle ◽  
Hamish Macleod
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Information Dissemination ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Computer Assisted ◽  
List Type ◽  
Access To Treatment ◽  
Cognitive Behavioural ◽  
Qualitative Exploration ◽  
The Impact

Abstract Computerised cognitive behavioural therapy (CCBT) has been made available within the National Health Service (NHS) across Scotland as an alternative treatment for mild to moderate anxiety and depression. However, the provision of CCBT services is still limited in the NHS, possibly affecting delivery of this computer-aided therapy to patients and inhibiting acceptance and uptake of this intervention. This paper reports on the qualitative exploration of patients’ experiences and acceptance of one CCBT programme delivering computer-assisted therapy (Beating the Blues: BTB), examining particularly the point of referral, access to treatment, and support. Thematic analysis was conducted on semi-structured face-to-face and email interviews with 33 patients at different NHS organisations across Scotland. Data analysis generated six key themes which illustrated patients’ experiences relating to referral and access to the treatment, and the challenges they faced: (1) information dissemination; (2) expectations and the impact of waiting for BTB; (3) impact of locations on experience of BTB; (4) preference for home access; (5) desire for better human support; and (6) desire for additional application support features. The findings highlighted that better methods of implementing and delivering such CCBT services together with the design of the technological interventions are vital to the success of these services. Key learning aims (1) To understand the service models and methods of implementing and delivering one CCBT programme (BTB) in routine care; (2) To learn about user experiences of accessing and using BTB; and (3) To learn about the implications and factors that might have influenced uptake and understand the implications.

scholarly journals Tailoring cognitive behavioural therapy to subtypes of voice-hearing using a novel tabletised manual: a feasibility study

2020 ◽  
pp. 1-15
Author(s):  
Guy Dodgson ◽  
Ben Alderson-Day ◽  
David Smailes ◽  
Faye Ryles ◽  
Claire Mayer ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Treatment Manual ◽  
Psychotic Experiences ◽  
Auditory Verbal Hallucinations ◽  
Recommended Treatment ◽  
Cognitive Behavioural ◽  
Early Intervention In Psychosis

Abstract Background: Cognitive behavioural therapy for psychosis (CBTp) is a recommended treatment for psychotic experiences, but its effectiveness has been questioned. One way of addressing this may be to tailor therapy materials to the phenomenology of specific psychotic experiences. Aim: In this study, we investigated the acceptability of a novel treatment manual for subtypes of ‘voice-hearing’ experiences (i.e. auditory verbal hallucinations). An uncontrolled, single-arm design was used to assess feasibility and acceptability of using the manual in routine care for people with frequent voice-hearing experiences. Method: The manual was delivered on a smart tablet and incorporated recent research evidence and theory into its psychoeducation materials. In total, 24 participants completed a baseline assessment; 19 started treatment, 15 completed treatment and 12 participants completed a follow-up assessment (after 10 sessions of using the manual). Results: Satisfaction with therapy scores and acceptability ratings were high, while completion rates suggested that the manual may be more appropriate for help with participants from Early Intervention in Psychosis services rather than Community Mental Health Teams. Conclusion: Within-group changes in symptom scores suggested that overall symptom severity of hallucinations – but not other psychosis features, or beliefs about voices – are likely to be the most appropriate primary outcome for further evaluation in a full randomised controlled trial.

Durability of the effects of cognitive–behavioural therapy in the treatment of chronic schizophrenia: 12-month follow-up

1999 ◽  
Vol 174 (6) ◽  
pp. 500-504 ◽  
Author(s):  
Nicholas Tarrier ◽  
Anja Witttkowskj ◽  
Caroline Kinney ◽  
Eilis McCarthy ◽  
Juue Morris ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Psychotic Symptoms ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
One Year

BackgroundPersistent drug-resistant psychotic symptoms are a pervasive problem in the treatment of schizophrenia.AimsTo evaluate the durability of the treatment effects of cognitive–behavioural therapy for chronic schizophrenia one year after treatment termination.MethodA comparison of clinical outcomes was made at one-year follow-up from a randomised trial of cognitive–behavioural therapy, supportive counselling and routine care alone in the treatment of chronic schizophrenia.ResultsSeventy out of the 72 patients (97%) who completed treatment were assessed at follow-up. There were significant differences between the three groups when positive and negative symptoms were analysed by means of ANCOVAs. Between-group comparisons indicated significant differences between cognitive–behavioural therapy and routine care at follow-up for positive symptoms. There was a trend towards significance for both cognitive–behavioural therapy and supportive counselling to be superior to routine care alone on negative symptoms.ConclusionsAt 12-month follow-up the significant advantage of cognitive– behavioural therapy compared to routine care alone remained.

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