Processes for Systemic Cognitive-Behavioural Therapy with Children, Young People and Families

2005 ◽  
Vol 34 (2) ◽  
pp. 179-189 ◽  
Author(s):  
Nicky Dummett
Keyword(s):  
Young People ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Therapist Training ◽  
Future Research ◽  
Case Formulation ◽  
Health Practice ◽  
Clinical Process ◽  
Formal Evaluation ◽  
Cognitive Behavioural

In cognitive-behavioural therapy with children, young people and families, formulation-based practice ensures that interventions are based on underlying causative and maintaining processes. Importantly, however, developmental, attachment, family, systemic and other perspectives must be incorporated into therapy. This paper describes a template for systemic cognitive-behavioural formulation that facilitates incorporation of the necessary range of perspectives including processes more traditionally expressed through other psychotherapeutic modes of working. Case formulation based on this template is sufficiently comprehensive, yet simple enough to derive collaboratively and leads to a distinct clinical process for working with individuals, families and wider support systems. This generic formulation process is appropriate for use across the range of presentations encountered in child and adolescent mental health practice and provides a structure for therapist training. It requires formal evaluation and has implications for future research.

Cognitive–behavioural therapy with children, young people and families: from individual to systemic therapy

2010 ◽  
Vol 16 (1) ◽  
pp. 23-36
Author(s):  
Nicky Dummett
Keyword(s):  
Young People ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Support Network ◽  
Formal Evaluation ◽  
Cognitive Behavioural ◽  
Systemic Factors ◽  
Systemic Process ◽  
Mental Health Work ◽  
Individual Parent

SummaryIn recent decades there has been much interest in using cognitive–behavioural therapy (CBT) with children, young people and families. CBT is a collaborative approach, based on shared building of a hypothesis (the formulation) about causative and maintaining factors. When working with children, young people, their families and wider systems (e.g. a support network), therapy should incorporate interpersonal, family and systemic factors, together with developmental and attachment issues and phenomena more commonly expressed through other psychotherapeutic modalities. There is growing clinical experience that systemic cognitive–behavioural formulation can lead to systemic-process working on an individual, parent–child, family or wider-system basis. Formal evaluation of this approach is needed to consider where it fits among established psychotherapies in mental health work with young people and their families.

scholarly journals Socialization to the model in adolescent cognitive behavioural therapy: measurement and insights

2017 ◽  
Vol 10 ◽  
Author(s):  
Gerwyn Mahoney-Davies ◽  
Cara Roberts-Collins ◽  
Ailsa Russell ◽  
Maria Loades
Keyword(s):  
Young People ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Future Research ◽  
The Novel ◽  
Subjective Ratings ◽  
Limited Evidence ◽  
Behavioural Model ◽  
Cognitive Behavioural ◽  
Clinician Rating

AbstractSocializing a client to the cognitive behavioural model is advised in almost every cognitive behavioural therapy (CBT) textbook, but there is limited evidence for whether socialization is measurable or important. The aim of the study was to pilot a written and interview-based measure of socialization to investigate whether socialization to the model can be measured in a sample of young people who have completed CBT. Sixteen participants (mean age 14.9 years, 75% female) completed a semi-structured socialization interview and a novel written measure of socialization. Treating clinicians were asked to provide subjective ratings of participant socialization. The structure and content of these measures was examined. A moderate but non-significant correlation was found between the novel written measure of socialization and clinician rating of socialization (r = .37). The concept of ‘socialization’ is not well understood and the socialization interview presented mixed, unclear results. This may be due to issues with the design, but may also be that socialization, as currently understood, is more complex than can be captured in this way. The important aspect of this study is introducing the concept of measuring socialization and factors that may be important in future research. Socialization to the model is an important construct within CBT but at present is a challenging concept to measure. Future research will need to focus on operationalizing the concept further and refining measures so that it can be accurately captured. Understanding which therapist and client behaviours contribute to the process of socialization could conceivably improve outcomes, but this cannot be done until this area is understood more fully.

Determining What is Important in a Good Formulation

2007 ◽  
Vol 35 (3) ◽  
pp. 325-333 ◽  
Author(s):  
Alyson Flitcroft ◽  
Ian Andrew James ◽  
Mark Freeston ◽  
Amy Wood-Mitchell
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Case Formulation ◽  
Rater Reliability ◽  
Cognitive Behavioural ◽  
Q Sort

Research suggests that there is low inter-rater reliability between therapists when asked to formulate the same case and that there may be discrepancies in what is considered an essential part of a formulation. The present study aimed to explore the diversity of therapists' viewpoints regarding the purpose and essential features of a cognitive-behavioural therapy (CBT) case formulation of depression. A Q-sort methodology was used in order to render these beliefs operational. Seven experienced CBT therapists participated in the construction of 86 statements, capturing concepts considered relevant to a CBT formulation of depression. This Q-sort was then administered to 23 therapists, who rated these statements in terms of their importance using a Q-sort procedure. Three factors emerged, suggesting three dominant opinions as to the importance of features of a formulation. A “state” CBT factor, focusing on the “here and now”, accounted for most variance; followed by a second factor emphasizing “function and process” and a third factor emphasizing “trait” components. Whilst there was some agreement between what was considered to be least important in a formulation, the emergence of three distinct viewpoints suggests a lack of complete consensus amongst the therapists.

Applying the Clark-Wells Model of Social Phobia to Children: The Case of a “Dictation Phobia”

2005 ◽  
Vol 34 (1) ◽  
pp. 103-106 ◽  
Author(s):  
Sabine Ahrens-Eipper ◽  
Jürgen Hoyer
Keyword(s):  
Social Anxiety ◽  
Social Phobia ◽  
Children And Adolescents ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Case Formulation ◽  
Cognitive Behavioural ◽  
The Social ◽  
Positive Treatment ◽  
Overall Functioning

A specific type of social phobia – dictation phobia – was the main and unusual treatment problem in the cognitive-behavioural therapy for an 11-year-old schoolboy. For case formulation and treatment rationale, the social phobia model by Clark and Wells was used. The posttreatment assessment revealed clear positive treatment effects with respect to school grades, social anxiety and overall functioning. The model's applicability for children and adolescents is discussed.

scholarly journals A Pragmatic Pilot Study Of Cognitive Behavioural Therapy For Insomnia Among People Living With HIV

2021 ◽  
Author(s):  
Tyler Gordon Tulloch
Keyword(s):  
Pilot Study ◽  
Sleep Disturbance ◽  
Cognitive Behavioural Therapy ◽  
Thematic Analysis ◽  
Behavioural Therapy ◽  
Future Research ◽  
People Living With Hiv ◽  
Cognitive Behavioural ◽  
Living With Hiv ◽  
Insomnia Severity

The prevalence of insomnia among people living with HIV (PWH) is considerably higher than in the general population. Cognitive, behavioural, and biopsychosocial explanations for this elevated prevalence have been proposed, but there is a lack of consensus in the literature. Sleep disturbance is associated with disrupted immune functioning at the cellular level and increased risk of contracting infectious diseases; therefore, insomnia may be particularly problematic for PWH. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for insomnia, and is effective at treating insomnia among individuals with comorbid medical disorders. Surprisingly, no study has examined its efficacy among PWH. This pragmatic pilot study examined features of insomnia among 48 PWH and was the first study to examine sleep disturbance among PWH using American Academy of Sleep Medicine guidelines for evaluating chronic insomnia. On average, insomnia chronicity was 8.2 years and was of moderate severity. Psychiatric comorbidity was common, as were comorbid sleep disorders. Insomnia severity was associated with psychosocial variables including sleep effort, self-efficacy for sleep, depression, anxiety, stress, and social functioning-related quality of life. This study was also the first to examine safety, feasibility, acceptability, and intervention effects of CBT-I. These were examined among a subsample of 10 PWH using single-case interrupted time-series design. Thematic analysis was used to explore participant perceptions of CBT-I. Large effect sizes were observed for improvement in insomnia severity, sleep efficiency, and total wake time. Reliable and clinically significant reduction in insomnia severity was observed for all but one participant, and half met criteria for insomnia remission. Overall, CBT-I was an efficacious treatment for insomnia, and participant feedback was consistent with quantitative results. Participants viewed CBT-I as a safe and acceptable treatment for insomnia. Participant feedback identified preexisting needs, positive impacts and challenges of CBT-I, perceived mechanisms of change, and suggested modifications to tailor CBT-I for PWH. Given this preliminary support for the efficacy of CBT-I among PWH, future research should seek to demonstrate generalizability of these effects. Partnering with HIV community organizations may be important next step in conducting future research and increasing accessibility of CBT-I to PWH. Keywords: HIV, insomnia, cognitive behavioural therapy, pilot study, pragmatic trial, thematic analysis

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