scholarly journals Supervisor practice when guiding therapists working with depression: the impact of supervisor and patient characteristics

2018 ◽  
Vol 11 ◽  
Author(s):  
Chloe Simpson-Southward ◽  
Glenn Waller ◽  
Gillian Hardy
Keyword(s):  
Clinical Supervision ◽  
Personal Characteristics ◽  
Patient Characteristics ◽  
Behavioural Therapy ◽  
Evidence Based ◽  
Clinical Supervisors ◽  
Cognitive Behavioural ◽  
Clinical Complexity ◽  
Consistent Manner ◽  
The Impact

AbstractCurrently recommended psychotherapies for depression are not always delivered in a consistent manner. There is an assumption that the use of clinical supervision will ensure reliable treatment and patient recovery. However, there is limited research supporting this assumption. This study explored the role of supervision in the treatment of depression. In particular, it examined how supervisors’ own characteristics and those of patients can influence the focus of supervision sessions. Clinical supervisors who worked with cognitive behavioural therapy (CBT) therapists treating depression cases were asked to indicate their supervision focus for three different patient vignettes. These vignettes varied in clinical complexity. Participants’ intolerance to uncertainty and their self-esteem were also assessed. Supervisors tended to focus their supervisees on the use of evidence-based therapeutic techniques for both straightforward and complex cases. However, their approach was less evidence-based for diffuse cases. Three supervisory types emerged: an ‘Alliance- and Technique-Focused’ group, a ‘Case Management-Focused’ group, and an ‘Unfocused’ group. Personal characteristics of the supervisors varied across the groups. The content of supervision sessions is influenced by factors from outside the therapy process. These factors might cause supervisors to avoid focusing on evidence-based aspects of therapy, thus feeding therapist drift. Suggestions are made for new supervision protocols that consider the supervisor's personal characteristics.

scholarly journals Let’s put the “T” back into CBT

2018 ◽  
Vol 23 (4) ◽  
pp. 240-245 ◽  
Author(s):  
James Binnie ◽  
Marcantonio Spada
Keyword(s):  
Clinical Practice ◽  
Cognitive Behavioural Therapy ◽  
Psychiatric Diagnosis ◽  
Design Methodology ◽  
Behavioural Therapy ◽  
Evidence Based ◽  
Content Type ◽  
Cognitive Behavioural ◽  
The Impact ◽  
Reductionist Approach

Purpose The purpose of this paper is to critique the current manner in which cognitive behavioural therapy (CBT) is delivered, with a focus on the impact of evidence-based practice. Design/methodology/approach This paper is based upon the experiences, ideas and clinical practice of the authors. Findings The reductionist approach based on psychiatric diagnosis is put forward as the mechanism by which CBT has gradually lost its status as a form of psychotherapy. Originality/value An alternative framework based on revitalising CBT as a client centred, problem-based and formulation driven form of therapy is put forward.

scholarly journals Remote delivery of CBT training, clinical supervision and services: in times of crisis or business as usual

2020 ◽  
Vol 13 ◽  
Author(s):  
Paul Cromarty ◽  
Dominic Gallagher ◽  
Julianne Watson
Keyword(s):  
Service Delivery ◽  
Clinical Supervision ◽  
Service Providers ◽  
Behavioural Therapy ◽  
List Type ◽  
Clinical Supervisors ◽  
Case Examples ◽  
Psychological Therapies ◽  
Remote Training ◽  
The Impact

Abstract The worldwide coronavirus pandemic has forced health services to adapt their delivery to protect the health of all concerned, and avoid service users facing severe disruption. Improving Access to Psychological Therapies (IAPT) services in particular are having to explore remote working methods to continue functioning. Australian IAPT services have utilised remote delivery methods and disruptive technologies at their core from inception. This was to maintain fidelity and clinical governance across vast distances but has allowed training, supervision and service delivery to continue virtually uninterrupted through coronavirus restrictions. On this basis, key recommendations for remote working are outlined. Remote methods are defined as (1) real time delivery, (2) independent delivery and (3) blended delivery. These are applied across three broad areas of remote training, remote clinical supervision and remote service delivery. Recommendations may be of great benefit to IAPT training institutions, clinical supervisors and service providers considering a move towards remote delivery. Challenges, adaptations and examples of applying remote methods are outlined, including case examples of methods applied to low-intensity and high-intensity cognitive behavioural therapy. Remote methods can safeguard service continuity in times of worldwide crisis and can contribute to reducing the impact of increased mental health presentations post-COVID-19. Key learning aims (1) To understand the core areas of remote training, clinical supervision and service delivery. (2) To review and distinguish between three broad methods of remote working. (3) To understand how to plan remote working via key recommendations and case examples.

scholarly journals Evaluating the Impact of Training Health Professionals to Deliver Brief Motivational and Skills-Based Interventions for Cannabis Use Disorder

2012 ◽  
Vol 2 ◽  
Author(s):  
Dion Alperstein ◽  
Jan Copeland
Keyword(s):  
Clinical Training ◽  
Health Workers ◽  
Clinical Skills ◽  
Cannabis Use ◽  
Evidence Based ◽  
Transfer Of Knowledge ◽  
Evidence Based Treatment ◽  
Cognitive Behavioural ◽  
The Impact

Background: While there is considerable evidence that brief motivational and skills-based interventions for substance use are effective, little is known regarding the transfer of knowledge from research to practice. This study aims to evaluate the effectiveness of two half-day didactic clinical training workshops for allied health workers, which did not incorporate feedback or supervision, via independent follow-up three months post training.Methods: In total, 1322 participants attended either or both of the evidence-based treatment workshops run by the National Cannabis Prevention and Information Centre. Of those participants, 495 (37%) completed an online follow-up evaluation three months later regarding their use of the newly learnt intervention(s).Results: At follow-up, 270 (54.5%) participants had an opportunity to use the skills and 144 (53.3%) of those participants reported having used the clinical skills taught in the workshop. Of those who used one of the interventions, 90 (62.5%) participants reported their clients had reduced or quit their cannabis use. Furthermore, 43 (30%) of these participants had attempted to train others in the workplace in the techniques learnt in the workshop.Conclusion: Even a half-day didactic clinical training workshop on evidence-based brief cognitive–behavioural techniques delivered to clinicians working in the field can improve knowledge and confidence among clinicians and outcomes among their clients with cannabis use related problems.

The Efficacy of Traditional Cognitive Behavioural Therapy for Depressed Adults with Anhedonia: A Systematic Review

2021 ◽  
Vol 7 (5) ◽  
pp. 520-544
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Primary Outcome ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Eligibility Criteria ◽  
Cognitive Behavioural ◽  
System Therapy ◽  
Randomised Controlled ◽  
The Impact

To date, the impact of traditional cognitive behavioural therapy (CBT) on anhedonia in major depressive disorder (MDD) has yet been systematically evaluated. This systematic review aims to examine the efficacy of traditional CBT for depressed adults with anhedonia. A literature search for randomised controlled trials of traditional CBT in adults with MDD from inception to July 2020 was conducted in 8 databases. The primary outcome was the levels of anhedonia. Ten studies with adults with MDD met the eligibility criteria. Our results indicate that traditional CBT is as effective as euthymic therapy, positive psychology therapy, self-system therapy,and medications for anhedonia in depression. Besides, our data provide further support for the development of augmented CBT to optimise treatment outcome for depressed adults with anhedonia. Received 11th June 2021; Revised 2nd September 2021; Accepted 20th September 2021

Treatment of anxiety disorders

2020 ◽  
pp. 961-966
Author(s):  
David S. Baldwin ◽  
Nathan T.M Huneke
Keyword(s):  
Anxiety Disorders ◽  
Previous Treatment ◽  
Patient Characteristics ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Physical Symptoms ◽  
Need For Treatment ◽  
Cognitive Behavioural ◽  
Choice Of Treatment ◽  
Characteristic Features

The personal and societal burden associated with anxiety disorders is considerable, but many individuals who might benefit from treatment are not recognized. Recognition relies on awareness of psychological and physical symptoms common to all anxiety disorders, and accurate diagnosis on identifying specific features of particular disorders. The need for treatment is determined by the severity and persistence of symptoms, the impact of symptoms on everyday life, the presence of coexisting depressive symptoms, and other features such as response to previous treatment approaches. Patient characteristics and patient and doctor preferences influence the choice of treatment. There is much overlap between anxiety disorders in evidence-based and effective therapies (such as the prescription of a selective serotonin reuptake inhibitor or a course of individual cognitive behavioural therapy), but there are also important differences, so it helps to be familiar with the characteristic features and evidence base for each condition.

scholarly journals ‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Katherine Newman-Taylor
Keyword(s):  
Behavioural Therapy ◽  
Illustrative Case ◽  
Imagery Task ◽  
List Type ◽  
Short Term ◽  
Cognitive Behavioural ◽  
Imagery Rescripting ◽  
Illustrative Case Study ◽  
The Impact

Abstract People with psychosis do not have routine access to trauma-focused cognitive behavioural therapy (CBT) interventions such as imagery rescripting (IR), partly due to clinical caution. This case study describes the use of a simple imagery task designed to engender ‘felt security’, as a means of facilitating IR with a woman struggling with distressing memory intrusions, linked to her voices and paranoia. We assessed the impact of the felt security task, which was used before IR to enable Kip to engage in reprocessing of her trauma memories, and again after IR so that she would leave sessions feeling safe. The brief imagery task was effective in improving felt security before IR sessions. Felt security then reduced during IR, when distressing material was recalled and reprocessed, and increased again when the task was repeated. It is not yet clear whether trauma-focused interventions such as IR need to be routinely adapted for people with psychosis. In the event that individuals express concerns about IR, if the person’s formulation indicates that high levels of arousal may trigger an exacerbation of voices, paranoia or risk, or where clinicians are otherwise concerned about interventions likely to increase emotional arousal in the short term, the felt security task may facilitate safe and effective reprocessing of trauma memories. This in turn may increase access to trauma-focused CBT for people with psychosis. Key learning aims (1) To understand that people with psychosis need access to trauma-focused CBT. (2) To be familiar with a simple attachment-based imagery task designed to foster ‘felt security’. (3) To learn that this task may facilitate imagery rescripting in people with psychosis.

Future research directions in children and hoarding

2020 ◽  
Vol 45 (3) ◽  
pp. 175-181
Author(s):  
Andrew G. Guzick ◽  
Sophie C. Schneider ◽  
Eric A. Storch
Keyword(s):  
Childhood Development ◽  
Future Research ◽  
Systematic Research ◽  
Evidence Based ◽  
Research Directions ◽  
Hoarding Disorder ◽  
Cognitive Behavioural ◽  
Evidence Based Treatments ◽  
Future Research Directions ◽  
The Impact

Abstract Despite a rapidly growing understanding of hoarding disorder (HD), there has been relatively limited systematic research into the impact of hoarding on children and adolescents. The goal of this paper is to suggest future research directions, both for children with hoarding behaviours and children living in a cluttered home. Key areas reviewed in this paper include (1) the need for prospective studies of children with hoarding behaviours and those who grow up with a parent with HD; (2) downward extensions of cognitive-behavioural models of adult HD that emphasise different information processing and behavioural biases in youth HD; (3) developmental research into the presentation of emerging HD in childhood compared with adulthood presentations of the disorder, with consideration of typical childhood development and unique motivators for childhood saving behaviours; (4) developmentally sensitive screening and assessment; and (5) the development of evidence-based treatments for this population. The paper concludes with a discussion of methodological suggestions to meet these aims.

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