From training to practice: a survey study of clinical challenges in implementing cognitive behavioural therapy in Norway

2015 ◽  
Vol 8 ◽  
Author(s):  
Annette Kjøge ◽  
Tone Turtumøygard ◽  
Torkil Berge ◽  
Terje Ogden
Keyword(s):  
Social Services ◽  
Behavioural Therapy ◽  
Survey Study ◽  
Implementation Barriers ◽  
Implementation Quality ◽  
Global Satisfaction ◽  
Supervision Training ◽  
Cognitive Behavioural ◽  
Training Programmes ◽  
The Relationship

AbstractThis study examines potential barriers to the implementation of CBT as perceived by therapists participating in the training programmes of the Norwegian Association for Cognitive and Behavioural Therapy (NACBT). Based on a questionnaire to members of the NACBT, a factor analysis identified five underlying dimensions of implementation barriers. A one-way analysis of variance was conducted to examine differences in how barriers were perceived by therapists working in medicine, mental health and social services. A multiple regression analysis was performed to examine the relationship between the barriers and the therapists’ global satisfaction with CBT. The five factor-based barriers identified were related to Therapeutic skills, Aspects of the workplace, Supervision, Training, and Clients. Problems related to Supervision and Therapeutic skills were reported to be the most important obstacles. Nurses and others working at psychiatric wards reported the largest number, and psychologists and others working with outpatients, reported the lowest number of barriers. The study highlights the importance of implementation quality in the process of linking training and practice of CBT in Norway. Even if aspects of the training programmes were perceived to be among the smallest threats to implementation, training was not sufficient in order for candidates to implement CBT in clinical practice.

Overcoming Alcohol Problems: Workbook for Couples

2015 ◽  
Author(s):  
Barbara S. McCrady ◽  
Elizabeth E. Epstein
Keyword(s):  
Alcohol Abuse ◽  
Family Relationships ◽  
Social Life ◽  
Romantic Relationship ◽  
Behavioural Therapy ◽  
Alcohol Problems ◽  
Cognitive Behavioural ◽  
The Individual ◽  
Treatment Contract ◽  
The Relationship

Alcohol abuse can have a devastating effect on a person's entire life, from work to social life to family relationships. The cycle of alcohol abuse is especially damaging when the individual is in a romantic relationship. When an individual in a relationship struggles with alcohol dependence, both partners suffer and the nature of the relationship can become stressful, dysfunctional, and sometimes violent. Cognitive-behavioural therapy (CBT) has been proven to be an extremely effective method of treating alcohol abuse problems. Designed to be used in conjunction with formal therapy, this Workbook provides couples with all the materials they need to work with their therapist in treatment. It includes a treatment contract for both partners to sign, forms for monitoring progress and recording drinking episodes, problem-solving and cognitive restructuring exercises, and a relapse prevention plan.

scholarly journals Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders

2016 ◽  
Vol 208 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Kathryn J. Lester ◽  
Susanna Roberts ◽  
Robert Keers ◽  
Jonathan R. I. Coleman ◽  
Gerome Breen ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Child Anxiety ◽  
Behavioural Therapy ◽  
Short Allele ◽  
Linear Mixed Effects ◽  
Cognitive Behavioural ◽  
Child Anxiety Disorders ◽  
Positive Treatment ◽  
The Relationship

BackgroundWe previously reported an association between 5HTTLPR genotype and outcome following cognitive–behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results, with most reporting no association between genotype and CBT outcome.AimsTo replicate the association between 5HTTLPR and CBT outcome in child anxiety from the Genes for Treatment study (GxT Cohort 2, n = 829).MethodLogistic and linear mixed effects models were used to examine the relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both cohorts were performed.ResultsThere was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2. Mega-analyses identified a significant association between 5HTTLPR and remission from all anxiety disorders at follow-up (odds ratio 0.45, P = 0.014), but not primary anxiety disorder outcomes.ConclusionsThe association between 5HTTLPR genotype and CBT outcome did not replicate. Short-allele homozygotes showed more positive treatment outcomes, but with small, non-significant effects. Future studies would benefit from utilising whole genome approaches and large, homogenous samples.

scholarly journals My care manager, my computer therapy and me: The relationship triangle in computerized cognitive behavioural therapy

2018 ◽  
Vol 11 ◽  
pp. 11-19 ◽  
Author(s):  
Kate Cavanagh ◽  
Bea Herbeck Belnap ◽  
Scott D. Rothenberger ◽  
Kaleab Z. Abebe ◽  
Bruce L. Rollman
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Care Manager ◽  
Cognitive Behavioural ◽  
The Relationship

scholarly journals Therapists’ attitudes to offering eCBT in an inner-city IAPT service: a survey study

2018 ◽  
Vol 11 ◽  
Author(s):  
Susanne F. Meisel ◽  
Helena Drury ◽  
Ramesh P. Perera-Delcourt
Keyword(s):  
Inner City ◽  
Survey Design ◽  
Treatment Options ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Survey Study ◽  
Design Data ◽  
Face To Face ◽  
Psychological Therapies ◽  
Cognitive Behavioural

AbstractDespite an emerging evidence base for the efficacy of supported computerized cognitive behavioural therapy (eCBT), uptake in services has been slow. Therapists’ beliefs about eCBT may constitute a barrier to offering eCBT to clients, but little research has investigated this topic. The aim of this study was to investigate therapist attitudes towards eCBT in one inner-city Improving Access to Psychological Therapies (IAPT) service using a survey design. Data were analysed using descriptive statistics. Thirty-three therapists took part in the study. Although 97% of participants reported that they knew ‘what eCBT involves’, and 62% reported that they were ‘confident to offer eCBT to clients’, only 10% endorsed that ‘there is a strong evidence-base to support the use of eCBT’. Two-thirds of the sample believed that eCBT ‘could be effective for mild and moderate mental health difficulties’, but most participants believed that eCBT would perform ‘worse’ or ‘much worse’ than face-to-face interventions for a range of disorders. Barriers to offering eCBT related predominantly to assumptions about client expectations of therapy, and perceived lack of a therapeutic relationship. Participants identified the provision of training on eCBT for those recommending treatment options to clients as a potential solution. Results from this study highlight therapists’ attitudes to eCBT that might contribute to low uptake rates of eCBT. Particularly, misperceptions about the evidence base for eCBT may be prevalent. Appropriate training and ongoing supervision for therapists are considered as interventions that may increase acceptance of eCBT as a valid treatment option.

scholarly journals Does a therapist's reflective ability predict the accuracy of their self-evaluation of competence in cognitive behavioural therapy?

2016 ◽  
Vol 9 ◽  
Author(s):  
Maria E. Loades ◽  
Pamela J. Myles
Keyword(s):  
Cognitive Therapy ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Self Evaluation ◽  
Training And Supervision ◽  
Cognitive Behavioural ◽  
Research Findings ◽  
The Relationship ◽  
Therapy Sessions ◽  
Level Of Agreement

AbstractAccurately evaluating how competently one is performing can be a precursor to seeking training and supervision, therefore contributing to safe, effective practice. Little is known about what predicts accurate self-evaluation. Prior research findings are inconsistent, with overestimation of self-rated competence in some studies and underestimation in others. We aimed to explore the relationship between therapists' reflective ability and the level of agreement between self-rated competence and competence rated by an experienced CBT assessor. Thirteen trainees undertaking a postgraduate CBT diploma submitted a series of recordings accompanied by self-ratings using the Cognitive Therapy Scale – Revised (CTS-R) and related written reflective analyses. Independent assessors marked the written analyses using a standardized marking scheme and rated the therapy sessions using the CTS-R. Trainees tended to overestimate or underestimate their competence in comparison to the independent assessors. The level of agreement between the assessors' ratings and self-evaluation of competence tended to improve during training, while reflective ability did not. Reflective ability was significantly related to level of agreement between self-rated and assessor-rated competence. Trainees do not consistently demonstrate the bias for overestimating their competence previously found in qualified therapists. During training, the tendency of an individual to over- or underestimate their competence may not remain stable, but tends to become more consistent with ratings undertaken by an experienced CBT assessor. Trainees who were rated as more reflective, tended to agree more closely with independent assessors on evaluation of competence. Therefore, enhancing reflective ability may help therapists to more accurately self-evaluate their competence.

Clinician and practice characteristics influencing delivery and outcomes of the early part of outpatient cognitive behavioural therapy for anorexia nervosa

2014 ◽  
Vol 7 ◽  
Author(s):  
Amy Brown ◽  
Victoria Mountford ◽  
Glenn Waller
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Therapeutic Alliance ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Effective Implementation ◽  
Practice Characteristics ◽  
Cognitive Behavioural ◽  
The Relationship

AbstractCognitive-behavioural therapy (CBT) can be effective for anorexia nervosa. However, there is evidence that the delivery of treatments for the eating disorders is inconsistent. This study examined evidence that clinician characteristics and practice can influence the effective implementation of CBT. The participants were 100 qualified clinicians who routinely offered outpatient CBT to adults with anorexia nervosa. They completed a survey of their demographic characteristics, level of anxiety, clinical practice in CBT for anorexia nervosa, and beliefs about the relationship between weight gain and therapeutic alliance in the early part of such treatment. Greater reported levels of weight gain were associated with the use of manuals, early focus on weight gain as a target, structured eating, and a belief that weight gain precedes a good working alliance. Clinician anxiety and early focus on the therapeutic alliance rather than structured eating were associated with poorer outcomes. These conclusions need to be tested within clinical and research settings. However, they suggest that clinicians should be encouraged to use manual-based approaches when treating anorexia nervosa using CBT, as focusing on techniques might result in the best possible outcome in this early part of treatment.

scholarly journals CHANGES TO AUTOMATIC THOUGHTS AND DYSFUNCTIONAL ATTITUDES IN GROUP CBT FOR DEPRESSION

2002 ◽  
Vol 30 (3) ◽  
pp. 351-360 ◽  
Author(s):  
Michele Furlong ◽  
Tian P. S. Oei
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Change ◽  
Behavioural Therapy ◽  
Automatic Thoughts ◽  
Dysfunctional Attitudes ◽  
Cognitive Behavioural ◽  
Cumulative Change ◽  
The Relationship ◽  
Group Cbt

The present study sought to clarify the role of cognitive change in Cognitive Behavioural Therapy (CBT) by examining the relationship between depression outcome and changes to automatic thoughts and dysfunctional attitudes at different points of therapy. Thirty patients suffering from Major Depression (MDD) or Dysthymia attended the 12 sessions of a group CBT program. Multiple regressions found total scores on the Automatic Thoughts Questionnaire (ATQ) and cumulative change scores on the Dysfunctional Attitudes Scale (DAS) to predict scores on the Beck Depression Inventory (BDI) at later stages of therapy, though neither form of cognition was predictive from earlier stages of therapy. Only scores on the ATQ were significantly related to both cognitive and somatic subscales of the BDI, indicating that automatic thoughts are more directly related to cognitive change than dysfunctional attitudes. Overall findings suggest that significant reductions in both automatic thoughts and dysfunctional attitudes are related to non-clinical levels of depressive symptoms at the end of the treatment.

Does intolerance of uncertainty mediate improvement in anger during group CBT for GAD? A preliminary investigation

2019 ◽  
Vol 47 (5) ◽  
pp. 585-593
Author(s):  
Judith M. Laposa ◽  
Katie Fracalanza
Keyword(s):  
Preliminary Investigation ◽  
Intolerance Of Uncertainty ◽  
Behavioural Therapy ◽  
Generalized Anxiety ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Preliminary Study ◽  
The Relationship ◽  
Treatment Improvement ◽  
Group Cbt

AbstractBackground:Individuals with generalized anxiety disorder (GAD) have elevated intolerance of uncertainty (IU) and anger, and IU mediates the relationship between GAD symptoms and anger.Aims:The current pilot study examined whether group cognitive behavioural therapy (CBT) improves anger in people with GAD, and the degree to which change in IU mediates improved anger.Method:Individuals diagnosed with GAD completed measures of worry, IU, and facets of anger, before and at the end of group CBT for GAD.Results:Worry, IU, and internally felt and outwardly expressed anger, reduced significantly over treatment, but anger control (inwardly and outwardly) did not. CBT for GAD led to improvement in both internally felt and outwardly expressed anger, even though anger is not directly targeted in this treatment. Improvement in IU significantly mediated improvement in internally felt and outwardly expressed anger.Conclusions:This preliminary study contributes to the literature on the importance of IU in understanding worry and other symptoms such as elevated anger, experienced by people with excessive worry.

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