Paranoia in the Therapeutic Relationship in Cognitive Behavioural Therapy for Psychosis

2014 ◽  
Vol 43 (4) ◽  
pp. 490-501 ◽  
Author(s):  
Caroline Lawlor ◽  
Katherine Hall ◽  
Lyn Ellett
Keyword(s):  
Therapeutic Relationship ◽  
Thematic Analysis ◽  
Cognitive Behaviour Therapy ◽  
Structured Interview ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Psychotic Experience ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Therapy Sessions

Background and aims: This study explored therapists’ and clients’ experiences of paranoia about the therapist in cognitive behaviour therapy. Method: Ten therapists and eight clients engaged in cognitive behaviour therapy for psychosis were interviewed using a semi-structured interview. Data were analyzed using thematic analysis. Results: Clients reported experiencing paranoia about their therapist, both within and between therapy sessions. Therapists’ accounts highlighted a number of dilemmas that can arise in responding to clients’ paranoia about them. Conclusions: The findings highlight helpful ways of working with clients when they become paranoid about their therapist, and emphasize the importance of developing a therapeutic relationship that is radically collaborative, supporting a person-based approach to distressing psychotic experience.

Cognitive Behaviour Therapy for Obsessive-compulsive Disorder

2017 ◽  
Author(s):  
Victoria Bream ◽  
Fiona Challacombe ◽  
Asmita Palmer ◽  
Paul Salkovskis
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Family Involvement ◽  
Cognitive Behaviour Therapy ◽  
Behavioural Therapy ◽  
Illustrative Case ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

Obsessive-compulsive disorder (OCD) can be a very disabling and distressing problem. Cognitive behavioural therapy (CBT) has been shown to be very effective in helping people to overcome OCD. OCD is a highly heterogeneous disorder, often complicated by contextual factors, and therapists are often left wondering how to apply their knowledge of treatment to the particular problems as they face them in clinical practice. This book guides the reader through understanding the background to and principles of using CBT for OCD in a clear practical ‘how to’ style. It also elucidates the particular challenges and solutions in applying CBT for OCD using illustrative case material and guidance on formulation-driven intervention. The book also addresses commonly occurring complexities in the treatment of OCD; for example, working with comorbidity, perfectionism, shame, and family involvement in symptoms. Throughout the book, tips are provided on receiving and giving supervision to troubleshoot commonly encountered problems. This book provides a guide to improved practice for clinicians at all levels of experience.

Therapy Contamination as a Measure of Therapist Treatment Adherence in a Trial of Cognitive Behaviour Therapy versus Befriending for Psychosis

2013 ◽  
Vol 43 (3) ◽  
pp. 314-327 ◽  
Author(s):  
Sarah Bendall ◽  
Kelly Allott ◽  
Martina Jovev ◽  
Marie-Josee Marois ◽  
Eoin J. Killackey ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
The Other ◽  
First Episode ◽  
Behaviour Therapy ◽  
Fine Grained ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Therapy Sessions

Background: High quality randomized controlled trials (RCT) of psychotherapeutic interventions should ensure that the therapy being tested is what is actually delivered. However, contamination of one therapy into the other, a critical component of treatment adherence, is seldom measured in psychotherapy trials of psychosis. Aims: The aim of the study was to determine whether a purpose-designed measure, the ACE Treatment Integrity Measure (ATIM) could detect therapy contaminations within a controlled trial of cognitive behavioural therapy (CBT) versus Befriending for first-episode psychosis and to compare the ATIM to a more traditional adherence measure, the Cognitive Therapy Scale (CTS). Method: Therapy sessions were audio-recorded and at least one therapy session from 53 of the 62 participants in the RCT was rated by an independent rater using the CTS and ATIM. Results: Ninety-nine therapy sessions were rated. All Befriending sessions and all but three CBT sessions were correctly identified. The ATIM showed that 29 of the 99 (29%) sessions were contaminated by techniques from the other therapy. Within the CBT sessions, 19 of the 51 sessions (37%) were contaminated by one or more Befriending techniques. Of the Befriending sessions, 10 of 48 (21%) were contaminated by ACE techniques. The mean CTS score was higher in the CBT than the Befriending group. Conclusions: The ATIM was able to detect contaminations and revealed more meaningful, fine-grained analysis of what therapy techniques were being delivered and what contaminations occurred. The study highlights the benefit of employing purpose-designed measures that include contamination when assessing treatment adherence.

COGNITIVE-BEHAVIOURAL THERAPY FOR PEOPLE WITH LEARNING DISABILITIES

1998 ◽  
Vol 26 (4) ◽  
pp. 315-322 ◽  
Author(s):  
Biza Senfert Kroese
Keyword(s):  
Learning Disabilities ◽  
Cognitive Behavioural Therapy ◽  
Cognitive Behaviour Therapy ◽  
Behavioural Therapy ◽  
Psychological Problems ◽  
Behaviour Therapy ◽  
Client Group ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Wide Range

A substantial literature now exists that indicates that cognitive-behaviour therapies are effective for a wide range of psychological problems (See Hawton, Salkovskis, Kirk, & Clark, 1989). However, it is only very recently that cognitive-behaviour therapists have considered people with learning disabilities as suitable clients for this particular approach. The present paper describes some of the challenges that are encountered when applying cognitive-behaviour therapy to this client group.

scholarly journals Manualised Cognitive Behaviour Therapy for Anorexia Nervosa: Use of Treatment Modules in the ANTOP Study

2018 ◽  
Vol 7 (11) ◽  
pp. 398 ◽  
Author(s):  
Gaby Resmark ◽  
Brigid Kennedy ◽  
Maria Mayer ◽  
Katrin Giel ◽  
Florian Junne ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Secondary Analysis ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Duration Of Illness ◽  
Cognitive Behavioural ◽  
Outpatient Intervention ◽  
Cognitive Behaviour ◽  
Pros And Cons

Standardised treatment manuals facilitate therapy planning and enhance comparability for research purposes. Within the Anorexia Nervosa Treatment of Out Patients (ANTOP) study, the largest multisite outpatient intervention trial in anorexia nervosa (AN) to date, manualised enhanced cognitive-behavioural therapy (CBT-E) was offered as one treatment modality. The manual consisted of 9 modules, of which Motivation, Nutrition, Formulation and Relapse Prevention were compulsory. Homework worksheets were provided, to ensure the transfer of therapeutic improvements to daily life. This study investigated the use of modules and worksheets in order to explore practice styles of trained therapists in the treatment of AN. This secondary analysis was based on log-sheets (n = 2604) CBT-E therapists completed after each session. Frequencies of modules and worksheets used across all sessions were calculated. Relationships, such as that between use of module and duration of illness, were examined. The most commonly used module was Motivation. In patients with longer illness duration, the module Self Esteem seemed to be particularly important. The worksheet Scales, balancing the pros and cons of AN, was prioritised by therapists. The results underline the importance of motivational work in the treatment of AN, including validating the ambivalence experienced by most AN patients. With increasing duration of illness, resource-oriented elements, such as self esteem stabilisation, should be of focus.

scholarly journals Effectiveness of Transdiagnostic Cognitive Behaviour Therapy for Anxiety and Depression in Adults: A Systematic Review and Meta-analysis

2016 ◽  
Vol 44 (6) ◽  
pp. 673-690 ◽  
Author(s):  
Philip Andersen ◽  
Paul Toner ◽  
Martin Bland ◽  
Dean McMillan
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Cognitive Behaviour Therapy ◽  
Meta Analysis ◽  
Grey Literature ◽  
Anxiety And Depression ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Effectiveness Data

Background: Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. Aims: The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. Method: A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Results: Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness data. Conclusions: Quality assessment of the primary studies indicated a number of methodological concerns that may serve to inflate the observed effects of transdiagnostic approaches. Although there are positive signs of the value of transdiagnostic CBT, there is as yet insufficient evidence to recommend its use in place of disorder-specific CBT.

Cognitive behaviour therapy for eating disorders

2012 ◽  
pp. 1298-1304
Author(s):  
Zafra Cooper ◽  
Rebecca Murphy ◽  
Christopher G. Fairburn
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
General Management ◽  
Not Otherwise Specified ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

The eating disorders provide one of the strongest indications for cognitive behaviour therapy. This bold claim arises from the demonstrated effectiveness of cognitive behaviour therapy in the treatment of bulimia nervosa and the widespread acceptance that cognitive behaviour therapy is the treatment of choice. Cognitive behaviour therapy is also widely used to treat anorexia nervosa although this application has not been adequately evaluated. Recently its use has been extended to ‘eating disorder not otherwise specified’ (eating disorder NOS), a diagnosis that applies to over 50 per cent of cases, and emerging evidence suggests that it is just as effective with these cases as it is with cases of bulimia nervosa. In this chapter the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. The data on the efficacy and effectiveness of the treatment are considered in the chapters on anorexia nervosa and bulimia nervosa (see Chapters 4.10.1 and 4.10.2 respectively), as is their general management.

How does supervision aid cognitive behaviour therapy skill development? Perspectives of CBT trainees: a thematic analysis

2020 ◽  
Vol 13 ◽  
Author(s):  
Stephanie Murr ◽  
Leeanne Nicklas ◽  
Sean Harper
Keyword(s):  
Clinical Supervision ◽  
Negative Feedback ◽  
Thematic Analysis ◽  
Cognitive Behaviour Therapy ◽  
Skill Development ◽  
List Type ◽  
Negative Consequences ◽  
Behaviour Therapy ◽  
Theory To Practice ◽  
Cognitive Behaviour

Abstract Eleven cognitive behaviour therapy (CBT) trainees in Scotland were interviewed regarding their experiences of clinical supervision and its impact on their skill development. Using thematic analysis, the authors developed four main themes: Linking Theory to Practice, Mirroring CBT in Supervision, The Expert Supervisor, and Trainees’ Reluctance to Give Negative Feedback. Clinical supervision was essential in helping trainees to link theory to practice; particularly through audio recordings, discussing formulations, and modelling and role-play. A CBT-specific approach to supervision and a CBT expert supervisor were also identified as valuable to learning. Trainees were reluctant to give negative feedback to supervisors, fearing negative consequences. The findings inform supervision practice. Key learning aims Readers of this paper will be able to: (1) Describe trainees’ most valued elements of CBT supervision. (2) Determine key learning methods in CBT supervision. (3) Explain the value of modality specific CBT supervision. (4) Articulate the context of supervision in CBT training and consider mutual feedback as a method to address identified challenges.

scholarly journals Cognitive-behavioural therapy effects on employment-related outcomes for individuals with mental illness: A systematic review

2014 ◽  
Vol 40 (2) ◽  
Author(s):  
Kim Minjoo ◽  
Elias Mpofu ◽  
Kaye Brock ◽  
Michael Millington ◽  
James Athanasou
Keyword(s):  
Mental Illness ◽  
Scoping Review ◽  
Cognitive Behaviour Therapy ◽  
Methodological Quality ◽  
Work Participation ◽  
Behaviour Therapy ◽  
People With Mental Illness ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

Orientation: To identify the effects of interventions in cognitive-behaviour therapy (CBT) on employment-related outcomes world-wide for individuals with mental illness.Research purpose: A search of the relevant literature was conducted through PsychInfo, Medline, Scopus and Google Scholar™, covering the period between 1995 and August 2011. The methodological quality of included studies was assessed using the criteria from Evidence Based Library and Information Practice (EBLIP). Eleven studies met the inclusion criteria.Motivation for the study: Evidence is needed on best practices to support work participation by people with mental illness. Effective cognitive-behavioural intervention might enhance their personal control over participation in employment aside from systemic or policy-oriented interventions.Research approach, design and method: A scoping review was done to map trends in the evidence for CBT as an intervention to support employment participation by people with mental illness. A scoping review is exploratory, the evidence of which lays the basis for subsequent studies. The methodological quality of included studies was assessed using the EBLIP Critical Appraisal Checklist.Main findings: Cognitive-behaviour therapy was an effective intervention approach for better work productivity, longer work hours, higher re-employment rate and enhanced mental health for individuals with mental illness.Practical/managerial implications: Cognitive-behaviour therapy is a promising strategy for industrial and organisational psychologists dealing with people who have a mental illness. It enhances employment and maintains work adjustment. Additional clinical trials in diverse populations and contexts will further establish its efficacy.Contribution/value-add: This scoping review aggregated the preliminary evidence for the efficacy of cognitive-behaviour therapy as a work-participation intervention for people with mental illness.

Depression, Mastery and Number of Group Sessions Attended Predict Outcome of Patients with Panic and Agoraphobia in a Behavioural/Medication Program

1994 ◽  
Vol 39 (5) ◽  
pp. 283-288 ◽  
Author(s):  
Rudy Bowen ◽  
Maxine South ◽  
Don Fischer ◽  
Terah Looman
Keyword(s):  
Group Therapy ◽  
Cognitive Behaviour Therapy ◽  
Demographic Variables ◽  
Personal Knowledge ◽  
Predictors Of Outcome ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Poor Outcomes ◽  
Therapy Sessions

From a list of 214 patients suffering from panic and agoraphobia and who had been treated with cognitive behaviour therapy, 30 patients who had very good outcomes and 32 who had poor outcomes were selected. The groups were selected by the nurse therapist and psychiatrist on the basis of personal knowledge of the patients. The distinction into good and poor outcome groups was confirmed by the results of a follow-up questionnaire completed by the patient. Of several clinical and demographic variables which had been hypothesized, to be predictors of outcome, only depression, as measured by the Beck Depression Inventory, mastery, as measured by the Pearlin Mastery Scale and the number of group therapy sessions attended predicted outcome. Levels of depression and mastery might be clinically modifiable variables which affect the outcome of treatment for patients with panic and agoraphobia.

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