EMPIRICALLY GROUNDED CLINICAL INTERVENTIONS: COGNITIVE-BEHAVIOURAL THERAPY PROGRESSES THROUGH A MULTI-DIMENSIONAL APPROACH TO CLINICAL SCIENCE

The current emphasis on Evidence Based Medicine (EBM) is both welcome as a bid to improve the empirical foundations of clinical practice and a cause for concern because it has the potential to distort the scientific approach that has underpinned the development of cognitive-behavioural approaches. It is suggested here that EBM needs to be seen in context; that is, as an approach that almost exclusively focuses on just one of the dimensions that have been and are crucial to the further development of Cognitive-Behavioural Treatments (CBT). EBM is particularly well suited to the development of Biological approaches to treatment, where treatments (and treatment development) are largely atheoretical. However, different considerations apply to CBT, where validated theory and linked research studies are key factors. It is suggested that relationship to evidence in CBT is best conceptualized in terms of Empirically Grounded Clinical Interventions. The parameters of such an approach are considered in relation to the Scientist Practitioner model that is prevalent in the field.

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Recent advances in psychological therapies for eating disorders

F1000Research ◽

10.12688/f1000research.7618.1 ◽

2016 ◽

Vol 5 ◽

pp. 702 ◽

Cited By ~ 12

Author(s):

Glenn Waller

Keyword(s):

Eating Disorders ◽

Evidence Base ◽

Behavioural Therapy ◽

Psychological Therapies ◽

Time Period ◽

Cognitive Behavioural ◽

Novel Approaches ◽

Family Based Treatment ◽

Family Based ◽

Further Development

Recent years have seen substantial consolidation and development of the evidence base for psychological therapies for eating disorders. This review summarises the key changes over that time period. Specific forms of cognitive behavioural therapy and family-based treatment have consolidated and extended their positions as treatments of choice despite the development of novel approaches. However, there is still a significant need for further development and testing to improve recovery rates, particularly in anorexia nervosa.

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Cognitive–behavioural therapy by psychiatric trainees: can a little knowledge be a good thing?

BJPsych Bulletin ◽

10.1192/pb.bp.113.046029 ◽

2015 ◽

Vol 39 (1) ◽

pp. 39-44

Author(s):

Eric Kelleher ◽

Melissa Hayde ◽

Yvonne Tone ◽

Iulia Dud ◽

Colette Kearns ◽

...

Keyword(s):

Cognitive Therapy ◽

Psychiatric Hospital ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Good Thing ◽

Clinical Implications ◽

Clinical Interventions ◽

Cognitive Behavioural ◽

The Mean

Aims and methodTo establish the competency of psychiatric trainees in delivering cognitive–behavioural therapy (CBT) to selected cases, following introductory lectures and supervision. Supervisor reports of trainees rotating through a national psychiatric hospital over 8.5 years were reviewed along with revised Cognitive Therapy Scale (CTS-R) ratings where available. Independent t-test was used to compare variables.ResultsStructured supervision reports were available for 52 of 55 (95%) trainees. The mean result (4.6, s.d. = 0.9) was at or above the accepted level for competency (≥3) for participating trainees. Available CTS-R ratings (n = 22) supported the supervisor report findings for those particular trainees.Clinical implicationsThis study indicates that trainees under supervision can provide meaningful clinical interventions when delivering CBT to selected cases. The costs of supervision need to be judged against these clinical gains.

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Attitudes and applications of chairwork amongst CBT therapists: a preliminary survey

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x21000052 ◽

2021 ◽

Vol 14 ◽

Author(s):

Matthew Pugh ◽

Tobyn Bell ◽

Glenn Waller ◽

Emma Petrova

Keyword(s):

Behavioural Therapy ◽

Therapeutic Change ◽

List Type ◽

Type Number ◽

Key Factors ◽

Qualitative Feedback ◽

Number Of Factors ◽

Cognitive Behavioural ◽

Quantitative Results ◽

Experiential Interventions

Abstract Chairwork refers to a collection of experiential interventions which utilise chairs, their positioning, movement, and dialogue to facilitate therapeutic change. Chair-based methods are used in several models of psychotherapy, including cognitive behavioural therapy (CBT). However, little is known about cognitive behavioural therapists’ use and attitudes towards chairwork. A mixed methods survey was conducted of 102 therapists who provided CBT. Overall, training in chairwork was weak amongst CBT therapists (35%). Quantitative results indicated that most therapists perceived chairwork to be clinically effective and consistent with the cognitive behavioural model, but did not feel competent using these methods. Perceived competence was highest amongst therapists who had been trained in chairwork and practised it frequently, but was unrelated to CBT accreditation or clinical experience. Qualitative feedback identified a number of factors that encouraged the use of chairwork (e.g. overcoming limitations associated with verbal restructuring methods), as well as inhibitors (e.g. therapist anxiety and limited access to training). These preliminary findings highlight a need for further research relating to cognitive behavioural chairwork and suggest that increased training in experiential interventions could go some way towards improving outcomes in CBT. Key learning aims As a result of reading this paper, readers should: (1) Understand cognitive behavioural therapists’ attitudes towards chairwork. (2) Appreciate therapists’ anxiety and avoidance in relation to chairwork. (3) Identify the key factors that facilitate or inhibit the use of cognitive behavioural chairwork.

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O Benefício da Terapia Cognitivo- Comportamental na Tontura Persistente Postural-Paroxística

Gazeta Médica ◽

10.29315/gm.v6i4.276 ◽

2019 ◽

Author(s):

Sara Machado ◽

José Neves ◽

Pedro Barreira ◽

Raquel Sanches ◽

José Luís Castro

Keyword(s):

Medical Association ◽

Cognitive Behavioural Therapy ◽

Practice Guidelines ◽

Evidence Based Medicine ◽

Behavioural Therapy ◽

National Guideline ◽

Evidence Based ◽

Phobic Postural Vertigo ◽

Cognitive Behavioural ◽

Based Medicine

INTRODUÇÃO: A tontura persistente postural-paroxística é uma entidade recentemente reconhecida, que engloba cerca de 10% dos doentes com queixas de tontura. O seu tratamento passa pela terapêutica farmacológica com inibidores seletivos da recaptação da serotonina, associada ou não a um programa de reabilitação vestibular. Tendo em conta a difícil gestão destes doentes e resistência ao tratamento convencional, coloca-se a hipótese do uso da terapia cognitivo-comportamental no tratamento desta patologia. O objetivo deste trabalho é determinar se existe benefício da terapia cognitivo-comportamental no tratamento da tontura persistente postural-paroxística.METODOLOGIA: Foi realizada uma pesquisa usando as palavras-chave “persistent postural perceptual dizziness”, “cognitive behavioural therapy”, “phobic postural vertigo”, nas seguintes bases de dados: National Guideline Clearinghouse, Canadian Medical Association Practice Guidelines InfoBase, DARE - Database of abstracts of reviews of effectiveness, Evidence-Based Medicine e PubMed. Foram ainda incluídos artigos referenciados na bibliografia da pesquisa inicial.RESULTADOS: Foram selecionados três artigos nas bases de dados. Foram incluídos dois artigos adicionais referenciados na bibliografia inicial. No total foram incluídos cinco artigos: dois estudos caso-controlo e três revisões de literatura.DISCUSSÃO: É consistente o benefício da terapia cognitivo-comportamental como parte de uma abordagem multidisciplinar. Foram reportadas, nestes doentes, melhoria das queixas de tontura, ansiedade e depressão. Verificou-se ainda melhoria do controlo postural e diminuição da dose de medicação necessária. Os efeitos da terapia cognitivo-comportamental a longo prazo são ainda pouco consistentes.CONCLUSÃO: A terapia cognitivo-comportamental parece ser uma opção terapêutica válida, em associação com outras medidas. Destaca-se a escassez de evidência científica nesta área, e a necessidade de estudos adicionais.

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Knowing our ‘ABCs’: self-reflection using cognitive-behavioural formulation of client–therapist interaction in work with a survivor of torture

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x15000203 ◽

2015 ◽

Vol 8 ◽

Author(s):

Faith Martin ◽

Sobia Khan

Keyword(s):

Interpersonal Skills ◽

Behavioural Therapy ◽

Cross Cultural ◽

Cultural Work ◽

Therapist Development ◽

Self Reflection ◽

Cognitive Behavioural ◽

The Impact ◽

Further Development ◽

Continue Therapy

AbstractSelf-reflection can aid therapist development, particularly interpersonal skills. It can be achieved through using cognitive-behavioural therapy techniques, for example, formulations of the therapist's cognitions and behaviours have been used to aid self-reflection. As interpersonal skills may be an area that benefits from self-reflection, an approach to formulating the interaction between client and therapist may be beneficial. This study reports the use of simple ‘antecedent-belief-consequence’ (ABC) formulations for the client and therapist to conceptualize their interaction. This description of a treatment failure focuses on cross-cultural work with a survivor of torture, where self-reflection may be particularly indicated to promote cultural competence and address the impact of the content on the therapist. ABC formulations for the client and therapist were completed and through this structured self-reflection, the therapist was able to identify the impact of her own beliefs on the process of therapy. This method identified areas for further development and generated hypotheses for how to continue therapy with this client. Using ABC formulations then may provide a useful and structured way to conduct self-reflection with explicit focus on the interaction between client and therapist.

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