scholarly journals Practitioners’ experiences of working collaboratively with interpreters to provide CBT and guided self-help (GSH) in IAPT; a thematic analysis

2018 ◽  
Vol 11 ◽  
Author(s):  
Lumka Tutani ◽  
Clare Eldred ◽  
Catherine Sykes
Keyword(s):  
Thematic Analysis ◽  
Behavioural Therapy ◽  
Structured Interviews ◽  
Psychological Therapies ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Communication Difficulties ◽  
Physical Health Problems ◽  
Collaborative Working ◽  
Culture And Language

AbstractWithin IAPT (Improving Access to Psychological Therapies), cognitive behavioural therapy (CBT) is offered to all clients regardless of gender, religion, culture and language. Hence, the demand for working with interpreters to facilitate communication during therapy in IAPT has increased. This study explored the experience of therapists working with interpreters to facilitate communication in psychological therapies with clients with mild to moderate anxiety and depression including those with co-morbid physical health problems. Thirteen participants, including six CBT therapists and seven Psychological Wellbeing Practitioners (PWPs) working in an NHS IAPT service, were interviewed. A qualitative approach, using semi-structured interviews and thematic analysis (Braun and Clarke, 2006), was implemented. The following four major themes were identified from the participants’ accounts: negotiating a three-way communication, difficulties in expressing empathy, a lack of shared understanding and working creatively with interpreters. During this collaborative working new understandings of engaging emerged leading participants to view this work as possible.

scholarly journals General practitioner referral of older patients to Improving Access to Psychological Therapies (IAPT): an exploratory qualitative study

2018 ◽  
Vol 42 (3) ◽  
pp. 115-118 ◽  
Author(s):  
Noel Collins ◽  
Laurie Corna
Keyword(s):  
Older Adults ◽  
General Practitioner ◽  
Thematic Analysis ◽  
Older Patients ◽  
Watchful Waiting ◽  
Behavioural Therapy ◽  
Clinical Implications ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Willingness To Refer

Aims and methodTo understand general practitioner (GP) reticence to refer older patients to a local Improving Access to Psychological Therapies (IAPT) service providing mostly cognitive–behavioural therapy (CBT)-based interventions. Semi-structured, hour-long interviews were conducted with eight GPs and then analysed by modified grounded theory and thematic analysis.ResultsGP views regarding the treatability of older adults with CBT influenced their willingness to refer to a CBT-based IAPT service. Perceptions of local IAPT assessment processes being distressing and onerous to older patients also motivated referral inaction. GPs expressed a preference to treat depressed older patients themselves (with medication and psychological approaches such as watchful waiting).Clinical implicationsAny strategy to increase referral rates of older adults to CBT-based IAPT services should address local GP concerns regarding assessment processes and the effectiveness of offered treatments.Declaration of interestNone.

scholarly journals The evidence base for cognitive—behavioural therapy in depression: delivery in busy clinical settings

2003 ◽  
Vol 9 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Graeme Whitfield ◽  
Chris Williams
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Clinical Settings ◽  
Face To Face ◽  
Psychological Therapies ◽  
Department Of Health ◽  
Self Help ◽  
Cognitive Behavioural

The evidence base for cognitive–behavioural therapy (CBT) for depression is discussed with reference to the review documentTreatment Choice in Psychological Therapies and Counselling (Department of Health). This identifies the need to deliver evidence-based psychosocial interventions and identifies CBT as having the strongest research base for effectiveness, but does not cover how to deliver CBT within National Health Service settings. The traditional CBT model of weekly face-to-face appointments is widely offered, yet there is little evidence to support these traditions in the outcome literature. Reducing face-to-face contact by introducing self-help into treatment may be one method of improving access. The SPIRIT course is discussed which teaches how to offer core cognitive–behavioural skills using structured self-help materials.

scholarly journals Treating Depression and Anxiety with Digital Cognitive Behavioural Therapy for Insomnia: A Real World NHS Evaluation Using Standardized Outcome Measures

2016 ◽  
Vol 45 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Annemarie I. Luik ◽  
Sophie Bostock ◽  
Leanne Chisnall ◽  
Simon D. Kyle ◽  
Nicky Lidbetter ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Cognitive Behavioural Therapy ◽  
Generalized Anxiety Disorder ◽  
Behavioural Therapy ◽  
Generalized Anxiety ◽  
Depression And Anxiety ◽  
Psychological Therapies ◽  
Self Help ◽  
Cognitive Behavioural

Background: Evidence suggests that insomnia may be an important therapeutic target to improve mental health. Aims: Evaluating changes in symptoms of depression and anxiety after supported digital cognitive behavioural therapy (dCBT) for insomnia delivered via a community-based provider (Self Help Manchester) of the Improving Access to Psychological Therapies (IAPT) service. Method: Supported dCBT for insomnia was delivered to 98 clients (mean age 44.9 years, SD 15.2, 66% female) of Self Help Manchester. All clients received six support calls from an eTherapy coordinator to support the self-help dCBT. During these calls levels of depression (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder, GAD-7) were determined. Results: Depression (Mdifference-5.7, t(70) = 12.5, p < .001) and anxiety [Generalized Anxiety Disorder-7 (GAD-7), Mdifference-4.1, t(70) = 8.0, p < .001] were reduced following supported dCBT for insomnia. This translated into an IAPT recovery rate of 68% for depression and anxiety. Conclusions: These results suggest that dCBT for insomnia alleviates depression and anxiety in clients presenting with mental health complaints in routine healthcare.

To Jurassic Park via Australia: A case study showing how dramatherapy enabled the creation and maintenance of embodied metaphors to support recovery from early psychosis

Dramatherapy ◽  
2020 ◽  
Vol 41 (1) ◽  
pp. 37-49
Author(s):  
Louise Combes ◽  
Lauren A Bradley
Keyword(s):  
Alcohol Misuse ◽  
Behavioural Therapy ◽  
Drama Therapy ◽  
Supported Accommodation ◽  
Life Challenges ◽  
Cognitive Behavioural ◽  
Communication Difficulties ◽  
Residential Rehabilitation ◽  
Early Intervention In Psychosis

This case study shows how Dramatherapy can engage clients with communication difficulties, which exclude them from standard mental health pathways in early intervention in psychosis services. Deliberately prioritising the client’s newfound modes of expression to shape the narrative within, it is evident Dramatherapy processes; embodiment, projection and role enabled this client to create and then inhabit his own playful metaphors. These metaphors continued to facilitate every-day life challenges. During his Dramatherapy relationship, the client within this case study transitioned from supported accommodation to his own property, progressed to residential rehabilitation for alcohol misuse and finally engaged in cognitive behavioural therapy. From feedback interviews we know he continued to create and use his own protective metaphors 10 months after drama therapy ended. He returned to education as part of his plan to seek appropriate employment and was discharged to his GP.

scholarly journals Randomised controlled trial of cognitive behavioural therapy in COPD

2018 ◽  
Vol 4 (4) ◽  
pp. 00094-2018 ◽  
Author(s):  
Karen Heslop-Marshall ◽  
Christine Baker ◽  
Debbie Carrick-Sen ◽  
Julia Newton ◽  
Carlos Echevarria ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Anxiety Subscale

Anxiety is an important comorbidity in chronic obstructive pulmonary disease (COPD). We investigated if cognitive behavioural therapy (CBT), delivered by respiratory nurses, reduced symptoms of anxiety and was cost-effective.Patients with COPD and anxiety were randomised to CBT or self-help leaflets. Anxiety, depression and quality of life were measured at baseline, 3, 6 and 12 months. A cost-effectiveness analysis was conducted from a National Health Service hospital perspective and quality-adjusted life-years estimated using the EuroQol-5D questionnaire.In total, 279 patients were recruited. Group mean change from baseline to 3 months in the Hospital Anxiety and Depression Anxiety Subscale was 3.4 (95% CI 2.62–4.17, p<0.001) for the CBT group and 1.88 (95% CI 1.19–2.55, p<0.001) in the leaflet group. The CBT group was superior to leaflets at 3 months (mean difference in the Hospital Anxiety and Depression Anxiety Subscale was 1.52, 95% CI 0.49–2.54, p=0.003). Importantly, the CBT intervention was more cost-effective than leaflets at 12 months, significantly lowering hospital admissions and attendance at emergency departments.CBT delivered by respiratory nurses is a clinically and cost-effective treatment for anxiety in patients with COPD relative to self-help leaflets.

scholarly journals Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study

BJPsych Open ◽  
2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Barry Wright ◽  
Lucy Tindall ◽  
Rebecca Hargate ◽  
Victoria Allgar ◽  
Dominic Trépel ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Pilot Study ◽  
Cognitive Behavioural Therapy ◽  
Care Pathway ◽  
Intervention Group ◽  
Behavioural Therapy ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Randomised Controlled

Background Computerised cognitive–behavioural therapy (CCBT) in the care pathway has the potential to improve access to psychological therapies and reduce waiting lists within Child and Adolescent Mental Health Services, however, more randomised controlled trials (RCTs) are needed to assess this. Aims This single-centre RCT pilot study compared a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression at referral to evaluate the clinical and cost-effectiveness of CCBT (trial registration: ISRCTN31219579). Method The trial ran within community and clinical settings. Adolescents (aged 12–18) presenting to their primary mental health worker service for low mood/depression support were assessed for eligibility at their initial appointment, 139 met inclusion criteria (a 33-item Mood and Feelings Questionnaire score of ≥20) and were randomised to Stressbusters (n = 70) or self-help websites (n = 69) using remote computerised single allocation. Participants completed mood, quality of life (QoL) and resource-use measures at intervention completion, and 4 and 12 months post-intervention. Changes in self-reported measures and completion rates were assessed by group. Results There was no significant difference between CCBT and the website group at 12 months. Both showed improvements on all measures. QoL measures in the intervention group showed earlier improvement compared with the website group. Costs were lower in the intervention group but the difference was not statistically significant. The cost-effectiveness analysis found just over a 65% chance of Stressbusters being cost-effective compared with websites. The 4-month follow-up results from the initial feasibility study are reported separately. Conclusions CCBT and self-help websites may both have a place in the care pathway for adolescents with depression.

scholarly journals Coping During Covid-19 Workbook

2021 ◽  
Author(s):  
Eamon Aswad ◽  
Keith Gaynor
Keyword(s):  
Mental Health ◽  
Coping Skills ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
Medical Support ◽  
Self Help ◽  
Cognitive Behavioural ◽  
The World ◽  
Mental Health Difficulties ◽  
Behavioural Strategies

2020 saw the world affected by an unprecedented pandemic. Alongside the healthrisks, the COVID-19 pandemic has created mental health difficulties for a largenumber of people. Many people are feeling anxious or depressed, in ways that they might never have before.This eight module Cognitive Behavioural Therapy Workbook is designed to support those who are struggling with symptoms of anxiety and depression because of the COVID-19 crisis. This workbook has been created to provide psycho-education and self-help techniques to manage COVID-19 related distress.The workbook includes a variety of cognitive and behavioural strategies including;mindfulness exercises, gradual exposure to feared situations, physical coping skills, reducing unhelpful behaviours that contribute to anxiety (e.g. avoidance), reducing worry, maintaining identity and testing out beliefs about COVID-19.It is recommended that this workbook can be completed by anyone who is over the age of eighteen. The Coping During COVID-19 Workbook doesn’t replace formal psychological or medical support but may be an additional resource.

scholarly journals Evaluation of a Trauma-Focused CBT Training Programme for IAPT services

2017 ◽  
Vol 45 (5) ◽  
pp. 467-482 ◽  
Author(s):  
Hannah Murray
Keyword(s):  
Training Programme ◽  
Behavioural Therapy ◽  
Routine Practice ◽  
Post Traumatic Stress ◽  
Training Interventions ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Co Morbidity ◽  
Early Life Trauma ◽  
Post Traumatic

Background: Therapists in Improving Access to Psychological Therapies (IAPT) services are often expected to treat complex presentations of post-traumatic stress disorder (PTSD), such as individuals with multiple, prolonged or early life trauma histories and significant co-morbidity, for which they have received minimal training. Although high recovery rates for PTSD have been demonstrated in randomized controlled trials, these are not always replicated in routine practice, suggesting that training interventions are required to fill the research–practice gap. Aims: This study investigated the outcomes of a therapist training programme on treating PTSD with trauma-focused cognitive behavioural therapy (TF-CBT). Method: Twenty therapists from ten IAPT services participated in the training, which consisted of workshops, webinars and consultation sessions over a 6-month period. Results: Feedback indicated that participants found the training highly acceptable. PTSD knowledge and self- and supervisor-rated competence on TF-CBT measures improved following the training and improvements were maintained a year later. Client outcomes on a PTSD measure improved following the training. Participants reported attempts to disseminate learning from the course back to their teams. Conclusions: The findings indicate that the training programme was successful in improving TF-CBT knowledge, skills and outcomes for IAPT therapists. Tentative support for training ‘trauma experts’ within IAPT services was found, although institutional constraints and staff turnover may limit the sustainability of the model.

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