scholarly journals The Relationship between Competence and Patient Outcome with Low-Intensity Cognitive Behavioural Interventions

2017 ◽  
Vol 46 (1) ◽  
pp. 101-114 ◽  
Author(s):  
Amanda Branson ◽  
Pamela Myles ◽  
Mishka Mahdi ◽  
Roz Shafran
Keyword(s):  
Patient Outcome ◽  
Well Being ◽  
Anxiety And Depression ◽  
Dissemination And Implementation ◽  
Behavioural Interventions ◽  
Low Intensity ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
The Relationship ◽  
Cognitive Behavioural Interventions

Background: Little is understood about the relationship between therapist competence and the outcomes of patients treated for common mental health disorders. Furthermore, the evidence is yet to extend to competence in the delivery of low-intensity cognitive behavioural interventions. Understanding this relationship is essential to the dissemination and implementation of low-intensity cognitive behavioural interventions. Aims: The aim of this study was to explore the relationship between Psychological Well-being Practitioner (PWP) competence and patient outcome within the framework of the British government's Improving Access to Psychological Therapies (IAPT) initiative. Method: Forty-seven PWPs treating 3688 patients participated. Relationships between PWP scores on three observed standardized clinical examinations and reliable change in patients’ symptoms of anxiety and depression were explored at two time points: during the year-long training phase, and over a 12-month follow-up. Results: Results indicated that patients treated by qualified PWPs achieved superior outcomes than those treated by trainees. Little support was found for a general association between practitioner competence in delivering low-intensity cognitive behavioural interventions and patient outcome, either during or post-training; however, significantly more patients of the most competent PWPs demonstrated reliable improvement in their symptoms of anxiety and depression than would be expected by chance alone and fewer deteriorated compared with those treated by the least competent PWPs. Conclusion: Results were indicative of a complex, non-linear relationship, with patient outcome affected by PWP status (trainee or qualified) and by competence at its extremes. The implications of these results for the dissemination and implementation of low-intensity cognitive behavioural interventions are discussed.

scholarly journals Competences Required for the Delivery of High and Low-Intensity Cognitive Behavioural Interventions for Chronic Fatigue, Chronic Fatigue Syndrome/ME and Irritable Bowel Syndrome

2014 ◽  
Vol 42 (6) ◽  
pp. 760-764 ◽  
Author(s):  
Katharine A. Rimes ◽  
Janet Wingrove ◽  
Rona Moss-Morris ◽  
Trudie Chalder
Keyword(s):  
Irritable Bowel Syndrome ◽  
Chronic Fatigue Syndrome ◽  
High Intensity ◽  
Chronic Fatigue ◽  
Behavioural Interventions ◽  
Low Intensity ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Irritable Bowel ◽  
Cognitive Behavioural Interventions

Background: Cognitive behavioural interventions are effective in the treatment of chronic fatigue, chronic fatigue syndrome (sometimes known as ME or CFS/ME) and irritable bowel syndrome (IBS). Such interventions are increasingly being provided not only in specialist settings but in primary care settings such as Improving Access to Psychological Therapies (IAPT) services. There are no existing competences for the delivery of “low-intensity” or “high-intensity” cognitive behavioural interventions for these conditions. Aims: To develop “high-intensity” and “low-intensity” competences for cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS. Method: The initial draft drew on a variety of sources including treatment manuals and other information from randomized controlled trials. Therapists with experience in providing cognitive behavioural interventions for CF, CFS/ME and IBS in research and clinical settings were consulted on the initial draft competences and their suggestions for minor amendments were incorporated into the final versions. Results: Feedback from experienced therapists was positive. Therapists providing low intensity interventions reported that the competences were also helpful in highlighting training needs. Conclusions: These sets of competences should facilitate the training and supervision of therapists providing cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS. The competences are available online (see table of contents for this issue: http://journals.cambridge.org/jid_BCP) or on request from the first author.

scholarly journals A pilot practice-based outcomes evaluation of low-intensity cognitive behavioural interventions delivered by postgraduate trainees to children and young people with mild to moderate anxiety or low mood: an efficient way forward in mental health care?

2021 ◽  
Vol 14 ◽  
Author(s):  
Gavin Lockhart ◽  
Christina Jones ◽  
Victoria Sopp
Keyword(s):  
Mental Health ◽  
Young People ◽  
Evidence Base ◽  
Anxiety And Depression ◽  
Graduate Level ◽  
Post Intervention ◽  
Children And Young People ◽  
Behavioural Interventions ◽  
Low Intensity ◽  
Cognitive Behavioural

Abstract Anxiety and depression affect a significant number of children and young people (CYP) and can have a far reaching and long-lasting impact. Cognitive behavioural (CB) interventions can be effective for treating anxiety and depression in CYP but are difficult to access. Recent government policy in England seeks to train a non-traditional graduate workforce to deliver a range of CB interventions for mild to moderate anxiety and depression to CYP, in community settings. This practice-based evaluation aimed to estimate the effectiveness of CB interventions delivered by postgraduate trainees undertaking training in a range of CB interventions for mild to moderate anxiety and depression whilst on placement in schools or community Child and Adolescent Mental Health Services (CAMHS). Self- and parent-reported routine outcome measures (ROMS) were completed pre- and post-intervention, including measures of symptom severity, symptom impact and goal achievement. Significant improvements were demonstrated across all self and parent-reported measures post-intervention, with mean scores falling firmly in the non-clinical range, a significant reduction in the proportion of CYP in the clinical range on measures, and predominantly medium to large effect sizes. Results are promising in terms of the capacity to train a graduate workforce to deliver a range of low-intensity CB interventions to CYP experiencing mild to moderate depression or anxiety-based difficulties in either CAMHS or school settings, increasing capacity across the system. The current practice-based evaluation also supports the potential effectiveness of current training models/programmes. Further research is needed in terms of long-term outcomes and to compare outcomes between settings, interventions, and demographic groups. Key learning aims (1) To understand the potential prevalence rates of mental health difficulties in children and young people in England, and their wider impact. (2) Critical awareness of the evidence base for cognitive and behavioural interventions for depression and anxiety in children and young people. (3) Awareness of gaps in access to evidence-based psychological interventions for children and young people in England. (4) Knowledge of emerging graduate-level low-intensity psychological practitioner roles in England. (5) Awareness of the emerging evidence base for the estimated effectiveness of low-intensity cognitive and behavioural interventions delivered to children and young people by graduate-level practitioners in schools and community mental health settings.

scholarly journals Case-Series Evaluating a Transdiagnostic Cognitive-Behavioural Treatment for Co-occurring Anxiety Disorders

2014 ◽  
Vol 43 (6) ◽  
pp. 744-758 ◽  
Author(s):  
Freda McManus ◽  
Gavin Clark ◽  
Kate Muse ◽  
Roz Shafran
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Well Being ◽  
Behavioural Intervention ◽  
Behavioural Interventions ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention ◽  
Axis I ◽  
Cognitive Behavioural Interventions

Background: Patients with anxiety disorder diagnoses commonly have more than one anxiety diagnosis. While cognitive-behavioural interventions have proven efficacy in treating single anxiety disorder diagnoses, there has been little investigation of their efficacy in treating co-occurring anxiety disorders. Aims: To evaluate the efficacy of a transdiagnostic cognitive-behavioural intervention for treating co-occurring anxiety disorders. Method: An A-B single case study design (N = 6) was used to evaluate the efficacy of a 12 to 13-session modular transdiagnostic cognitive-behavioural intervention for treating co-occurring anxiety disorders across patients with at least two of the following diagnoses: GAD, Social Phobia, Panic Disorder and/or OCD. Results: Five of the six participants completed treatment. At posttreatment assessment the five treatment completers achieved diagnostic and symptomatic change, with three participants being diagnosis free. All participants who completed treatment no longer met criteria for any DSM-IV-TR Axis-I diagnosis at the 3-month follow-up assessment, and demonstrated reliable and clinically-significant improvements in symptoms. Across the participants, statistically significant improvements from pre to postintervention were found on measures of anxiety, depression and general well-being, and all improvements were maintained at 3-month follow-up. Conclusions: Results suggest that transdiagnostic cognitive behavioural interventions can be of benefit to patients with co-occurring anxiety disorders.

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