Befriending versus CBT for Schizophrenia: A Convergent and Divergent Fidelity Check

2005 ◽  
Vol 34 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Derek Milne ◽  
Sarah Wharton ◽  
Ian James ◽  
Doug Turkington
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Symptom Improvement ◽  
Initial Symptom ◽  
Archival Data ◽  
Effective Interventions ◽  
Cognitive Behavioural ◽  
Speech Content

Befriending (BF) has received attention as a beneficial part of mental health care. For example, when compared with cognitive-behavioural therapy (CBT) for schizophrenia, BF was found to be as effective as CBT in terms of initial symptom improvement (Sensky et al., 2000). Why was the BF apparently so effective? Was the BF really a discrete and powerful intervention? Or was it simply an unrecognized aspect of regular CBT? We addressed these questions by first observing BF's convergence with “social support” (a plausibly discrete treatment) and, second, by examining its divergence from CBT, drawing on archival data. For the convergence prediction we correlated the speech content of therapists' in 10 BF sessions from the Sensky et al. study with previously published social support data from stylists working with people with severe mental health problems in a psychiatric hospital (Milne and Netherwood, 1997). For the second prediction the same 10 BF sessions were compared with a sample of 10 CBT sessions, also from the Sensky et al. study. The results indicated that BF was indeed significantly correlated (converged) with social support (r=0.7; p<.05), and also that it did differ (diverged) significantly from CBT (p<.05). As a treatment fidelity check, therefore, these findings indicate tentatively that the two treatments in the Sensky et al. (2000) study were appropriately implemented. As an analysis of effective interventions for schizophrenia, it cautiously suggests that “social support” merits serious attention, and is perhaps no mere placebo.

Psychiatry

2018 ◽  
Author(s):  
Isabel McMullen
Keyword(s):  
Mental Health ◽  
Psychiatric Illness ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Behavioural Therapy ◽  
Outpatient Clinics ◽  
Personal Stories ◽  
Cognitive Behavioural ◽  
The Uk ◽  
State Examination

Mental health problems are estimated to affect one in four people each year in the UK, making mental illness one of the commonest presentations to GP surgeries, outpatient clinics, and Emergency Departments. Yet many doctors and medical students feel uncertain about how to approach patients with a psychiatric disorder. The key to becoming a good psychiatrist lies in the clinical interview. There are few physical signs or investigations that allow doctors to diagnose psychiatric illness, so a detailed history and mental state examination are important. As a psychiatrist, you are in the privileged position of having patients tell you their personal stories, and the skill is in listening attentively and asking relevant questions to help to clarify parts of the story. The best way to practise these techniques is to watch experienced clinicians at work and to interview patients yourself. Obviously diagnosis is important, so you need to be aware of the types of symptoms that fit with each type of disorder, as well as the medical conditions that may mimic psychiatric illness. Investigations may be necessary to rule out other diseases, and you need to be able to request these appropriately. Psychiatrists have access to a range of treatments—medical (e.g. antidepressants), psychological (e.g. cognitive behavioural therapy), and physical (e.g. electroconvulsive therapy)—and you need to know which ones to recommend. Most of these treatments are delivered in conjunction with the multidisciplinary team, so you should be clear about the roles of each team member. Finally, there is overlap between psychiatry and the law, which can raise interesting ethical issues. It is sometimes necessary to treat a person against their will, for the safety of that person or others, so you need to know about mental health law. Psychiatrists are also often requested to provide a second opinion in difficult capacity assessments.

In Conversation… Reducing mental health problems in schools

2018 ◽  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioural Therapy ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Health Problems ◽  
Clinical Psychologist ◽  
Therapy Approach ◽  
Whole School ◽  
Cognitive Behavioural

Dr Sophie Browning is a Consultant Clinical Psychologist working on whole school approaches to mental health. In this podcast with psychology journalist Jo Carlowe, she discusses an innovative cognitive behavioural therapy approach for reducing anxiety and mental health problems in schools. You can listen to this podcast on SoundCloud or iTunes.

scholarly journals The Real Cost of Sickness-absence in Mental Health: A Cognitive Behavioural Perspective

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Dovey ◽  
S. Wilday
Keyword(s):  
Mental Health ◽  
Sickness Absence ◽  
Mental Health Problems ◽  
Cultural Beliefs ◽  
Social Contact ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
Real Cost ◽  
Cognitive Behavioural ◽  
The Individual

The number of employees experiencing psychological problems related to occupational stress has increased rapidly in Western countries and mental illness is now cited as one of the top three causes of certified sickness absence.Worldwide economic issues are now synthesising various cultural beliefs and behaviours and should Western factors have an influence then one could presume workplace mental health problems will increase worldwide. The presentation will focus on the literature pertaining to the potential function of sickness absence for the individual as well as the known maintenance factors for anxiety and depression from a CB perspective.The presentation will highlight that the basic CB premise of emotional disorder implicates the potential for an individuals response to symptoms to have a maintenance role in the course of both anxiety and depression. The potential impact of sickness absence for anxiety and depression via the loss of the benefits of employment (e.g. structure, activity and social contact) the potential for the development of sick role behaviour (e.g. reduced activity, social isolation) as well as the reinforcement of avoidant coping are considered significant.In conclusion the presenters propose that sickness absence for individuals with anxiety and/or depression can function as a maintenance factor for both disorders. The implications for the future use of sickness absence as a standalone intervention within this group will be discussed. The audience will have an opportunity to reflect on the potential effectiveness of cognitive behavioural therapy within the workplace

scholarly journals Addressing concerns about smoking cessation and mental health: theoretical review and practical guide for healthcare professionals

2020 ◽  
pp. 1-11
Author(s):  
Gemma M. J. Taylor ◽  
Amanda L. Baker ◽  
Nadine Fox ◽  
David S. Kessler ◽  
Paul Aveyard ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Evidence Based ◽  
Depression And Anxiety ◽  
Stop Smoking ◽  
Cognitive Behavioural

SUMMARY Smoking rates in people with depression and anxiety are twice as high as in the general population, even though people with depression and anxiety are motivated to stop smoking. Most healthcare professionals are aware that stopping smoking is one of the greatest changes that people can make to improve their health. However, smoking cessation can be a difficult topic to raise. Evidence suggests that smoking may cause some mental health problems, and that the tobacco withdrawal cycle partly contributes to worse mental health. By stopping smoking, a person's mental health may improve, and the size of this improvement might be equal to taking antidepressants. In this article we outline ways in which healthcare professionals can compassionately and respectfully raise the topic of smoking to encourage smoking cessation. We draw on evidence-based methods such as cognitive–behavioural therapy (CBT) and outline approaches that healthcare professionals can use to integrate these methods into routine care to help their patients stop smoking.

scholarly journals A smartphone-online intervention for youth diagnosed with major depressive disorders: Protocol for a randomized controlled trial. (Preprint)

2018 ◽  
Author(s):  
Paul Ritvo ◽  
Zafiris Daskalakis ◽  
George Tomlinson ◽  
Arun Ravindran ◽  
Renee Linklater ◽  
...  
Keyword(s):  
Mental Health ◽  
First Nations ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Cognitive Behavioural

BACKGROUND Seventy percent of mental health problems appear before the age of 25 years and when untreated can become long-standing, and significant, impairing multiple life domains (1). Although the problem is especially acute for youth from First Nations backgrounds, all Canadian youth aged 15- to 25 years are highly likely to experience mental health disorders, substance dependencies and suicide. Progress in the treatment of youth that capitalizes on tendencies to respond to online contacts strategically addresses mental health problems, particularly depressive disorders. OBJECTIVE We will conduct a randomized controlled trial (RCT), to compare online mindfulness-based cognitive behavioural therapy combined with standard psychiatric care vs. psychiatric care alone (wait-list controls) in youth diagnosed with major depressive disorder. We will enrol N = 168 subjects in the age range of 18-30 years, 50% of whom will be from First Nations backgrounds and the other 50% from all other ethnic backgrounds, equally stratified in two intervention groups and two (wait-list) control groups (42 subjects per group, where INT1 and CTL1 are FN background, and INT2 and CTL2 are non-FN background). METHODS In this RCT, the primary outcome will be self-reported depression on the Beck Depression Inventory II. Secondary outcomes include anxiety (Beck Anxiety Inventory), depression (Quick Inventory of Depressive Symptomatology, 24-item Hamilton Rating Scale for Depression (HRSD-24)), pain (Brief Pain Inventory) and mindfulness (Five-Facet Mindfulness Questionnaire). RESULTS Recruitment/retention rates will be assessed with estimates for the proportion of participants with complete data per outcome and time points divided by the total number of study participants. Variability of the main and interaction effects will be examined in the primary clinical outcome and each secondary outcome using separate repeated measures ANCOVA models, with Bonferroni corrections applied to the models applied. Hedges' g and associated confidence intervals will be calculated as an estimate of the effect size both over time (within groups) and between groups. Missing data will be evaluated on a case-by-case basis such that drop-outs will be excluded. CONCLUSIONS If results confirm hypotheses that youth can be effectively treated with online mindfulness-based cognitive behavioural therapy at reduced costs, effective services can be delivered more widely with less geographic restrictions. CLINICALTRIAL Clinical Trials.gov

scholarly journals COVID-19 Pandemic: Influence of Relationship Status on Stress, Anxiety, and Depression in Canada

2021 ◽  
pp. 1-26
Author(s):  
Nnamdi Nkire ◽  
Izu Nwachukwu ◽  
Reham Shalaby ◽  
Marianne Hrabok ◽  
Wesley Vuong ◽  
...  
Keyword(s):  
Mental Health ◽  
Text Messaging ◽  
Online Survey ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Relationship Status ◽  
Anxiety And Depression ◽  
Cognitive Behavioural ◽  
Patient Health ◽  
The Impact

ABSTRACT Objective: To examine the impact of relationship status on levels of stress, anxiety, and depression during the COVID-19 pandemic, to identify the relationship groups who are at greater risk, thereby facilitating channelling of appropriate support to these individuals. Methods: The sample was drawn from individuals who subscribed to the Text4Hope program, a cognitive behavioural therapy inspired text messaging service developed to support Albertans during the COVID-19 pandemic. A survey link was sent to the subscribers to ascertain their relationship status and assess psychopathology using the Perceived Stress Scale-10(PSS-10), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). Data analysis was carried out using SPSS-26 for descriptive statistics. Results: Within the first six weeks of the pandemic, 8,267 of 44,992 subscribers responded to the online survey giving a response rate of 19.4%. Mean scores on the PSS, GAD-7, and PHQ-9 were highest among those who were single and lowest amongst those who were widowed. Overall, mean scores on the PHQ-9 were higher in groups self-identified as separated or divorced in comparison to those with partners including the categories of married or cohabiting. Conclusions: Relationship status during the COVID-19 pandemic has an influence on the mental health of individuals. Our findings highlight relationship groups at risk of mental health problems during the pandemic and for whom treatments and mitigation should be targeted.

The use of transdiagnostic cognitive behavioural therapy for a patient with multi-morbidity: a case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Lisa Walshe ◽  
Chris Allen
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Mental Health Problems ◽  
Healthcare Services ◽  
Behavioural Therapy ◽  
Health Conditions ◽  
Physical And Mental Health ◽  
Cognitive Behavioural ◽  
Booster Sessions

Abstract Multi-morbidity, having more than two diagnosed health conditions, is becoming increasingly common within healthcare services. Approximately one third of these patients are likely to have a mental health condition. Those with multi-morbidity with physical and mental health conditions have poorer outcomes in terms of their health, increased mortality rates, and higher usage of healthcare services. This paper presents a case of a patient with multi-morbidity, with associated mental health conditions of anxiety and depression. She was seen as part of an integrated service which provides psychological support at home alongside the nursing team. The intervention used was based on transdiagnostic cognitive behavioural therapy (tCBT), provided over nine initial sessions and two additional booster sessions. Self-report measures were completed at intervals throughout the intervention and at follow-up. Improvements on the depression and anxiety measures were seen over the initial nine sessions, followed by a relapse at the 3-month follow-up. This was the result of a deterioration in physical health which led to a deterioration in mental health. The booster sessions mitigated further deterioration in mental health, despite the physical health worsening during this time. This case suggests that tCBT can be helpful in reducing anxiety and depression in people with multi-morbidity. However, additional booster sessions may be required as further physical deterioration can re-trigger core beliefs and result in further mental health problems. Key learning aims (1) Transdiagnostic CBT can be beneficial for patients with multi-morbidity. (2) Integrated care addressing both physical and mental health problems is beneficial for people with multi-morbidity. (3) Monitoring deterioration in physical health is important, as this has an impact on mental health and may need addressing through psychological support. (4) Formulation for people with multi-morbidity needs to include mental and physical health factors and their interaction.

The Real Cost of Sickness-absence in Mental Health: A Cognitive Behavioural Perspective

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Dovey ◽  
S. Wilday
Keyword(s):  
Mental Health ◽  
Sickness Absence ◽  
Mental Health Problems ◽  
Cultural Beliefs ◽  
Social Contact ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
Real Cost ◽  
Cognitive Behavioural ◽  
The Individual

The number of employees experiencing psychological problems related to occupational stress has increased rapidly in Western countries and mental illness is now cited as one of the top three causes of certified sickness absence.Worldwide economic issues are now synthesising various cultural beliefs and behaviours and should Western factors have an influence then one could presume workplace mental health problems will increase worldwide. The presentation will focus on the literature pertaining to the potential function of sickness absence for the individual as well as the known maintenance factors for anxiety and depression from a CB perspective.The presentation will highlight that the basic CB premise of emotional disorder implicates the potential for an individuals response to symptoms to have a maintenance role in the course of both anxiety and depression. The potential impact of sickness absence for anxiety and depression via the loss of the benefits of employment (e.g. structure, activity and social contact) the potential for the development of sick role behaviour (e.g. reduced activity, social isolation) as well as the reinforcement of avoidant coping are considered significant.In conclusion the presenters propose that sickness absence for individuals with anxiety and/or depression can function as a maintenance factor for both disorders. The implications for the future use of sickness absence as a standalone intervention within this group will be discussed. The audience will have an opportunity to reflect on the potential effectiveness of cognitive behavioural therapy within the workplace

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