GROUP EXPOSURE IN VIVO FOR AGORAPHOBICS (1974): A MULTIFACETED PILOT STUDY AND ITS IMPACT ON SUBSEQUENT AGORAPHOBIA RESEARCH

2000 ◽  
Vol 28 (4) ◽  
pp. 335-351 ◽  
Author(s):  
Iver Hand
Keyword(s):  
Data Quality ◽  
Information Quality ◽  
Relevant Information ◽  
Scientific Paper ◽  
Future Research ◽  
Behavioural Intervention ◽  
Behaviour Therapy ◽  
High Data ◽  
Cognitive Behavioural

This paper reviews the research in agoraphobia in four areas: (i) Is the group application of exposure in vivo really the most effective treatment for agoraphobia? (ii) Does high group cohesion really increase the power of group exposure? (iii) Was the exposure mode applied in this study actually the first cognitive-behavioural intervention in behaviour therapy of anxiety disorders? (iv) How often do agoraphobics really suffer from marital discord, and how does this affect the outcome of short-term, massed exposure-treatment? It describes the development of concepts and the evolution of knowledge, but it also points out the redundancies, misunderstandings and pitfalls in research that have hindered progress. This paper does not deal with the data quality of the studies reviewed; sometimes high data quality does not result in high information quality, and vice versa. This is therefore not a scientific paper but a non-comprehensive journey through the recent history of research in behaviour therapy for agoraphobia. It is hoped to give practice-relevant information for clinicians and some new ideas for future research.

Development and Evaluation of a Cognitive Behavioural Intervention for Chronic Post-Stroke Insomnia

2018 ◽  
Vol 46 (6) ◽  
pp. 641-660 ◽  
Author(s):  
Katie Herron ◽  
Lorna Farquharson ◽  
Abigail Wroe ◽  
Annette Sterr
Keyword(s):  
Sleep Onset ◽  
Community Dwelling ◽  
Post Treatment ◽  
Dysfunctional Attitudes ◽  
Future Research ◽  
Behavioural Intervention ◽  
Sleep Onset Latency ◽  
Post Stroke ◽  
Cognitive Behavioural

Background:Cognitive behavioural therapy for insomnia (CBTI) has been successfully applied to those with chronic illness. However, despite the high prevalence of post-stroke insomnia, the applicability of CBTI for this population has not been substantially researched or routinely used in clinical practice.Aims:The present study developed a ‘CBTI+’ protocol for those with post-stroke insomnia and tested its efficacy. The protocol also incorporated additional management strategies that considered the consequences of stroke.Method:A single-case experimental design was used with five community-dwelling individuals with post-stroke insomnia. Daily sleep diaries were collected over 11 weeks, including a 2-week baseline, 7-week intervention and 2-week follow-up. The Insomnia Severity Index, Dysfunctional Attitudes and Beliefs About Sleep Scale, Epworth Sleepiness Scale, Fatigue Severity Scale and Stroke Impact Scale were administered pre- and post-treatment, as well as at 2-week follow-up.Results:At post-treatment, three participants no longer met diagnostic criteria for insomnia and all participants showed improvements on two or more sleep parameters, including sleep duration and sleep onset latency. Three participants showed a reduction in daytime sleepiness, increased quality of life and reduction in unhelpful beliefs about sleep.Conclusions:This study provides initial evidence that CBTI+ is a feasible and acceptable intervention for post-stroke insomnia. Furthermore, it indicates that sleep difficulties in community-dwelling stroke populations are at least partly maintained by unhelpful beliefs and behaviours. The development and delivery of the CBTI+ protocol has important clinical implications for managing post-stroke insomnia and highlights directions for future research.

The Cost of Child Behaviour Therapy: The First Step to Demonstrating Cost-effectiveness

1996 ◽  
Vol 13 (2) ◽  
pp. 124-135 ◽  
Author(s):  
Mervyn Jackson ◽  
Ray Wilks
Keyword(s):  
Cost Effectiveness ◽  
Total Duration ◽  
Clinical Problem ◽  
Treatment Programs ◽  
Future Research ◽  
Behaviour Therapy ◽  
Face To Face ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
The Cost

There has been extensive debate over the last three decades about which professional groups should receive government-funded rebates in the mental health field. Cognitive-behaviour therapists appear to be in the best position to demonstrate clinical efficacy, but have failed to demonstrate cost-effectiveness of cognitive-behaviour therapy. There is a need to demonstrate the cost of behaviour therapy as the first step in determining the cost-effectiveness of behaviour therapy compared to the traditional (medical-based) interventions. Using archival data from a university-based psychology clinic specialising in cognitive-behavioural interventions with child and adolescent problems, the present research determined the cost of successful treatment programs with the clinic's major referral areas: nocturnal enuresis, behaviour management, and education-based problems. Analysing 77 cases, it was found that there were significant between group differences in the number and total duration of face-to-face interviews, in the number of other contacts between therapist and client, in total therapist time, and in the estimated average cost of cases. There emerged different treatment patterns for each clinical problem, and these were reflected in costing. A number of research and methodological issues are explored. Implications for future research on cost-effectiveness and the subsequent collection of comparative data across clinics and a variety of clinical problem areas are discussed.

A Preliminary Investigation into the Existence of a Hypervigilance Subtype of Auditory Hallucination in People with Psychosis

2013 ◽  
Vol 43 (1) ◽  
pp. 52-62 ◽  
Author(s):  
Lucy Garwood ◽  
Guy Dodgson ◽  
Vicki Bruce ◽  
Simon McCarthy-Jones
Keyword(s):  
Auditory Hallucination ◽  
Preliminary Investigation ◽  
Structured Interview ◽  
Intervention Strategies ◽  
Auditory Hallucinations ◽  
Future Research ◽  
Behavioural Intervention ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention ◽  
The Individual

Background: The phenomenological heterogeneity of auditory hallucinations (AHs) means individual models struggle to account for all aspects of the experience. One alternative is that distinct subtypes of AHs exist, with each requiring their own unique explanatory model and tailored cognitive behavioural intervention strategies. Aims: This exploratory study tested for the presence of one specific potential AH-subtype, hypervigilance hallucinations (HV-AHs). Method: Four specific aspects of the phenomenology of AHs (chosen on the basis of the predicted phenomenology of HV-AHs) were assessed using a semi-structured interview in 32 individual AHs taken from reports from 15 patients with psychosis. Results: Cluster analysis (at the level of the individual AH-experience) offered support for the existence of a distinct HV-AH subtype, characterized by hearing threatening, externally-located voices when attention was externally-focused. Other clusters identified all shared the contrasting properties of occurring in quiet contexts when patients’ attention was internally focused. Conclusions: The results offered tentative support for the existence of an HV-AH subcategorization and justifies future research in larger samples. Potential implications for models of AHs are also considered.

scholarly journals Cognitive Behavioural Therapy for Japanese Children and Adolescents with Anxiety Disorders: A Pilot Study

2012 ◽  
Vol 40 (3) ◽  
pp. 271-285 ◽  
Author(s):  
Shin-ichi Ishikawa ◽  
Naoyasu Motomura ◽  
Yasuo Kawabata ◽  
Hidetaka Tanaka ◽  
Sakie Shimotsu ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Japanese Children ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Self Talk ◽  
Future Challenges

Background: Thirty-three Japanese children and adolescents diagnosed with an anxiety disorder participated in individual or group Cognitive Behaviour Therapy (CBT) that was modelled after evidence-based intervention programs developed in Western countries. Method: The treatment consisted of: (a) building rapport and education; (b) identifying emotions and recognizing cognitive self-talk; (c) challenging anxious self-talk; (d) developing an anxiety hierarchy and in vivo exposures; and (e) planning for future challenges. Results: Three months following treatment, 20 of the 33 children and adolescents (60.91%) no longer met criteria for their principal anxiety disorders and 16 (48.48%) were free from all anxiety disorders. Self-reported anxiety, depression, and cognitive errors also decreased significantly from pre- to post-treatment and these gains were maintained at 3-month follow-up. For the most part, similar outcomes were found in both the group and individual formats of CBT. Conclusions: This study provides preliminary support for the transportability of CBT in both an individual and group format to Japan.

ASSESSING THERAPIST ADHERENCE TO COGNITIVE-BEHAVIOUR THERAPY FOR PSYCHOSIS

2002 ◽  
Vol 30 (3) ◽  
pp. 329-339 ◽  
Author(s):  
Mike Startup ◽  
Mike Jackson ◽  
Emma Pearce
Keyword(s):  
Rating Scale ◽  
Collaborative Study ◽  
Preliminary Evidence ◽  
Behavioural Therapy ◽  
Future Research ◽  
Behaviour Therapy ◽  
Therapist Adherence ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Adherence Scale

Recently, several RCTs have provided preliminary evidence that cognitive-behavioural therapy (CBT) is effective in the treatment of people suffering from schizophrenia. However, none of these trials has provided complete demonstrations of therapist adherence. Since no suitable scale existed already, the authors devised the Cognitive Therapy for Psychosis Adherence Scale (CTPAS). The main aim of the present research was to test whether the 12 items of this scale could be rated reliably. Ratings were made on 29 sessions of CBT for schizophrenia by two raters independently and their agreement was found to be at least adequate on 10 of the items of the CTPAS. Ratings were also made on relevant items of the Collaborative Study Psychotherapy Rating Scale and agreement was found to be more than adequate for three factor-based subscales derived from these items. The results suggest therapist adherence to CBT for psychosis can be rated reliably and that the CTPAS is likely to be useful in future research on this form of treatment.

Cognitive Behaviour Therapy and Depressive Relapse: Justified Optimism or Unwarranted Complacency?

1994 ◽  
Vol 22 (1) ◽  
pp. 1-11 ◽  
Author(s):  
John W. Ludgate
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Unipolar Depression ◽  
Future Research ◽  
Recurrent Depression ◽  
Behaviour Therapy ◽  
Addictive Disorders ◽  
After Care ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Major Treatment

The magnitude of the problem of relapse and recurrence in depression is outlined and it is contended that this is now the major treatment issue facing clinicians. Studies demonstrating a longer term prophylactic effect of Cognitive Behaviour Therapy (CBT) are briefly reviewed and it is concluded that these methods have significantly impacted on relapse rates in unipolar depression. Nevertheless, it is argued that there is little cause for complacency due to the still significant rate of relapse which is found with CBT. While promising cognitive behavioural methods have been developed in the field of addictive disorders, there is a clear need for similar clinical advances in the area of recurrent depression. Some strategies which may have potential for promoting maintenance and preventing relapse are briefly outlined. The importance of developing a coherent model for assessing relapse risk and guiding decisions regarding treatment and after care strategies is emphasized. Lastly, future research directions in this important area are briefly considered.

SHORT TERM DURABILITY OF A COGNITIVE BEHAVIOURAL INTERVENTION IN PSYCHOSIS: EFFECTS FROM A PILOT STUDY

2004 ◽  
Vol 32 (1) ◽  
pp. 117-121 ◽  
Author(s):  
Pauline L. Hall ◽  
Nicholas Tarrier
Keyword(s):  
Pilot Project ◽  
Self Esteem ◽  
Psychotic Symptoms ◽  
Future Research ◽  
Small Scale ◽  
Behavioural Intervention ◽  
Cognitive Behavioural ◽  
Self Worth ◽  
Cognitive Behavioural Intervention

Low self-esteem in psychosis is common and has been found to be significantly related to a number of clinical variables and to symptom severity. This report describes the follow-up evaluation of a simple time-limited cognitive behavioural intervention aimed to improve feelings of low self-worth in the treatment of psychotic symptoms. A previous small scale pilot project found encouraging results for the efficacy of the novel intervention following its delivery and at 3-month follow-up. This report examines the benefits of the technique at 12 months following delivery of the intervention. These preliminary results suggest that the intervention may promote improved levels of self-esteem, psychotic symptomatology and social functioning over the longer term. Implications for practice and future research are discussed.

scholarly journals Current Stroke Burden in Ghana: A Comprehensive Systematic Review Protocol

2021 ◽  
Author(s):  
Joseph Attakorah ◽  
Kofi Boamah Mensah ◽  
Ebenezer Wiafe ◽  
Varsha Bangalee ◽  
Frasia Oosthuizen
Keyword(s):  
Systematic Review ◽  
Relevant Information ◽  
Scientific Paper ◽  
Future Research ◽  
Final Report ◽  
Local Policy ◽  
Eligibility Criteria ◽  
Health Authorities ◽  
Incidence And Mortality ◽  
Registration Number

Abstract IntroductionThere is a lack of data summarizing the current burden of stroke in Ghana. The establishment of data on the current burden, incidence, and mortality of stroke in this country may guide decision-making toward interventions to curb the stroke burden. This protocol aims to describe the methods for a systematic review of the literature on the incidence, prevalence, and mortality of strokes in Ghana.Methods and Design We will perform a comprehensive search strategy of relevant abstracts and articles published from 1st May 2013 to 31st May 2020, related to prevalence or incidence or mortality in Ghana. Relevant articles will be searched from electronic databases including MEDLINE (PubMed), CINAHL (EBSCO), Web of Science, and PsycINFO (EBSCOhost). Full text of eligible studies will be included if they estimated one of the following epidemiological measures: burden, incidence and mortality. Studies that will meet the eligibility criteria will be assess for overall study quality, reliability and risk of bias, using design-specific criteria. We will appraise the included studies' reporting and methodology quality and perform a quantitative summary of reported outcomes where applicable.DiscussionExisting knowledge on the incidence or prevalence, or mortality of strokes in Ghana are limited. This review aims to present relevant information that will inform local policy on cardiovascular diseases and future research. The final report of this protocol, in the form of a scientific paper, will be published in a peer-reviewed journal and findings will be submitted to relevant health authorities. We also plan to update the review in the future to monitor changes and guide health service and policy solutions.Trial registration number: https://doi.org/10.17605/OSF.IO/MW3H8

Cognitive Behaviour Therapy For Auditory Hallucinations Without Concurrent Medication: A Single Case

1994 ◽  
Vol 22 (3) ◽  
pp. 259-264 ◽  
Author(s):  
Anthony P. Morrison
Keyword(s):  
Single Case ◽  
Auditory Hallucinations ◽  
Behavioural Intervention ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
End Of Treatment ◽  
Cognitive Behaviour ◽  
Cognitive Behavioural Intervention ◽  
Concurrent Medication

A 38 year old patient with auditory hallucinations was treated with a brief cognitive-behavioural intervention without concurrent medication. This intervention was based upon the theory of Bentall (1990a, b) and the methods of Haddock, Bentall and Slade (1993). The patient's ratings for frequency of hallucinations and distress caused were significantly reduced at end of treatment, and her belief in the reality of these voices was correspondingly diminished. These gains were maintained at one and three month follow-up.

An Examination of the Power of the Voices in Predicting the Mental State of People Experiencing Psychosis

2001 ◽  
Vol 18 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Sara Lucas ◽  
Tracey Wade
Keyword(s):  
Mental State ◽  
Depressive Symptomatology ◽  
Psychiatric Symptoms ◽  
Medication Compliance ◽  
Small Sample ◽  
Future Research ◽  
Behaviour Therapy ◽  
Psychiatric Symptomatology ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

AbstractCognitive-behavioural models of psychosis have been widely discussed in the literature, with a focus on the beliefs about the voices that are a component of auditory hallucinations. This study examines the ability of beliefs about the voices to predict the course of psychiatric symptomatology in psychosis over a 1-month period, compared with changes in depressive symptomatology. Thirty people with schizophrenia or schizo-affective disorder participated in this study. Their mental state functioning, depression, and beliefs about their voices were assessed in interview. Mental state functioning and depression were assessed again after 1 month, in addition to antipsychotic medication compliance over the previous month (rated by self and the psychiatrist). The strongest predictor of a worsening of psychiatric symptoms over the month was increased depression in the previous month. Using p < 0.1 criteria to offset possible Type II errors in the small sample, a person's belief that their voices were very powerful was also predictive of psychiatric deterioration. The ways in which beliefs about the power of the voices can be challenged in cognitive-behaviour therapy with psychosis is discussed, as are directions for future research.

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