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 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.

Patient experience of supported computerized CBT in an inner-city IAPT service: a qualitative study

2019 ◽  
Vol 12 ◽  
Author(s):  
Ramesh P. Perera-Delcourt ◽  
Gemma Sharkey
Keyword(s):  
Inner City ◽  
Patient Experience ◽  
Structured Interview ◽  
Behavioural Therapy ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
State Of Mind ◽  
The Uk ◽  
Evidence Based Therapy ◽  
Qualitative Exploration

AbstractComputerized cognitive behavioural therapy (cCBT) has been developed to address economic and clinical issues around limited access to evidence-based therapy. Supported cCBT (variously termed iCBT or eCBT) has been developed to address issues with the effectiveness of, and engagement with, cCBT. There has been no in-depth qualitative exploration of the patient experience of eCBT within the UK, which might aid improving its effectiveness. The aim of this study was to explore patient experience of eCBT in one inner-city National Health Service (NHS) Improving Access to Psychological Therapies (IAPT) service using a semi-structured interview and Thematic Analysis methodology. Ten patients took part. Six main themes were identified: (1) Being Offered eCBT; (2) How eCBT Compares with Self-help; (3) The Patient's State of Mind; (4) The Relationship with the Supporter; (5) Preferring to Talk; (6) eCBT's Value as a Treatment. Participants in this study indicated a preference for face-to-face talking therapy, but were clear that they could form a therapeutic relationship via asynchronous messaging. They reported clinical benefit from the eCBT programme and online relationship, and acknowledged that accessing this immediately was valuable. Issues around the process of selecting patients for eCBT, including with regard to acknowledging or mitigating any negative emotional effects of eCBT, and how to offer and support users with it, are discussed.

scholarly journals Interventions for cannabis misuse

2006 ◽  
Vol 12 (6) ◽  
pp. 432-439 ◽  
Author(s):  
Clementine Maddock ◽  
Michelle Babbs
Keyword(s):  
Relapse Prevention ◽  
Psychotic Disorders ◽  
Illicit Drug ◽  
Significant Proportion ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Pharmacological Treatments ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
The Uk

Cannabis is the most commonly used illicit drug in the UK and a significant proportion of users have symptoms of dependence. In addition, there are a number of adverse consequences of use, including an association with psychotic disorders. Thus there is a need for effective treatment of cannabis misuse. Psychological therapies have been developed based on principles of motivational interviewing, cognitive–behavioural therapy and relapse prevention. The evidence base for these therapies is explored in this review, and studies targeting both adult users and young people are considered. Possible new pharmacological treatments are also discussed.

scholarly journals Recent advances in psychological therapies for eating disorders

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 702 ◽  
Author(s):  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Psychological Therapies ◽  
Time Period ◽  
Cognitive Behavioural ◽  
Novel Approaches ◽  
Family Based Treatment ◽  
Family Based ◽  
Further Development

Recent years have seen substantial consolidation and development of the evidence base for psychological therapies for eating disorders. This review summarises the key changes over that time period. Specific forms of cognitive behavioural therapy and family-based treatment have consolidated and extended their positions as treatments of choice despite the development of novel approaches. However, there is still a significant need for further development and testing to improve recovery rates, particularly in anorexia nervosa.

scholarly journals Group cognitive–behavioural therapy for anxiety and depression

2010 ◽  
Vol 16 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Graeme Whitfield
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Current Evidence ◽  
Anxiety And Depression ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Current Evidence Base ◽  
Group Cbt

SummaryCognitive–behavioural therapy (CBT) is a psychological treatment approach that can be delivered not only on a one-to-one basis but also to groups and in self-help formats. However, the evidence base supporting individual CBT is more extensive than the research regarding group CBT. This is likely to influence the choice of services that develop in the Improving Access to Psychological Therapies (IAPT) programme for the treatment of depression and anxiety disorders in primary care in England. This article outlines the different forms that group CBT takes, the way in which it may benefit people and the current evidence base supporting its use for anxiety and depression. It also outlines the advantages of group or individual CBT and describes those patients who appear to be best suited to a specific delivery.

Face-to-face versus Video Teleconference Group Cognitive Behavioural Therapy for Anxiety and Related Disorders: A Preliminary Comparison: Thérapie cognitivo-comportementale de groupe en personne contre par vidéo téléconférence pour l’anxiété et les troubles connexes: une comparaison préliminaire

2021 ◽  
pp. 070674372110273
Author(s):  
Irena Milosevic ◽  
Duncan H. Cameron ◽  
Melissa Milanovic ◽  
Randi E. McCabe ◽  
Karen Rowa
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Symptom Improvement ◽  
Face To Face ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Group Cbt ◽  
Delivery Formats

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.

scholarly journals Clinical practice guidelines for insomnia disorder

2017 ◽  
Vol 59 (3) ◽  
pp. 45-51
Author(s):  
Lucille Malan ◽  
Nokuthula Dlamini
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Treatment Options ◽  
Early Morning ◽  
Behavioural Therapy ◽  
Pharmacological Therapy ◽  
Chronic Insomnia ◽  
First Line Therapy ◽  
Insomnia Disorder ◽  
Cognitive Behavioural ◽  
Falling Asleep

Insomnia disorder is defined as difficulty in falling asleep, maintaining sleep, and early morning awakenings. Common daytime consequences experienced are fatigue, mood instability and impaired concentration. In chronic insomnia these symptoms persist over a period of at least three months. Chronic insomnia can also be a symptom of a variety of disorders. The pathophysiology of insomnia is theorised as a disorder of nocturnal and daytime hyper-arousal as a result of increased somatic, cortical and cognitive activation. The causes of insomnia can be categorized into situational, medical, psychiatric and pharmacologically-induced. To diagnose insomnia, it is required to evaluate the daytime and nocturnal symptoms, as well as psychiatric and medical history. The Diagnostic and Statistical Manual 5 Criteria (DSM-5) also provides guidelines and criteria to be followed when diagnosing insomnia disorder. Goals of treatment for insomnia disorder are to correct the underlying sleep complaint and this, together with insomnia symptoms, their severity and duration, as well as co-morbid disorders will determine the choice of treatment. In the majority of patients, insomnia can be treated without pharmacological therapy and cognitive behavioural therapy is considered first-line therapy for all patients with insomnia. The most common pharmacological insomnia treatments include benzodiazepines and benzodiazepines receptor agonists. To avoid tolerance and dependence, these hypnotics are recommended to be used at the lowest possible dose, intermittently and for the shortest duration possible. A combination of cognitive behavioural therapy and pharmacological treatment options is recommended for chronic insomnia.

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.

Supporting low intensity interventions using the telephone

2010 ◽  
pp. 275-280 ◽  
Author(s):  
Karina Lovell
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Practical Application ◽  
Low Intensity ◽  
Cognitive Behavioural ◽  
Therapy Interventions

Chapter 27 discusses LI interventions using the telephone, and aims to provide the rationale, evidence base, challenges, solutions and practical application of delivering low intensity psychological (mainly cognitive behavioural therapy) interventions by telephone.

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.

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