scholarly journals Culture and therapist self-disclosure

2019 ◽  
Vol 12 ◽  
Author(s):  
Peter Phiri ◽  
Shanaya Rathod ◽  
Mary Gobbi ◽  
Hannah Carr ◽  
David Kingdon
Keyword(s):  
Drop Out ◽  
List Type ◽  
Behaviour Therapy ◽  
Data Set ◽  
Self Disclosure ◽  
Psychological Therapies ◽  
Cognitive Behaviour ◽  
Lay Members ◽  
Poor Outcomes ◽  
The Impact

AbstractCognitive behaviour therapy (CBT) as a treatment for schizophrenia and psychotic-related disorders has been shown to have significantly greater drop-out rates in clients of black and minority ethnic (BME) groups. This has resulted in poor outcomes in treatments. Our recent qualitative study thus aimed to develop culturally sensitive CBT for BME clients. The study consisted of individual in-depth 1:1 interviews with patients with a diagnosis of schizophrenia, schizo-affective, delusional disorders or psychosis (n = 15) and focus groups with lay members (n = 52), CBT therapists (n = 22) and mental health practitioners (n = 25) on a data set of 114 participants. Several themes emerged relating to therapist awareness on culturally derived behaviours, beliefs and attitudes that can influence client response and participation in therapy. The current paper aims to explore one of these themes in greater detail, i.e. client-initiated therapist self-disclosure (TSD). Using thematic analysis, the paper highlights key elements of TSD and how this could impact on therapist’s reactions towards TSD, the therapeutic alliance and ultimately, the outcomes of therapy. The findings appear to show that TSD has significant relevance in psychological practice today. Some BME client groups appear to test therapists through initiating TSD. It is not the content of TSD they are testing per se, but how the therapist responds. Consequently, this requires therapists’ cognisance and sensitive responses in a manner that will nurture trust and promote rapport. Further investigation in this area is suggested with a recommendation for guidelines to be created for clinicians and training.Key learning aims(1)To develop a dialogue and practice with confidence when addressing issues of self-disclosure with diverse populations.(2)To appreciate the impact therapist self-disclosure has in early stages of engagement, in particular when working with patients from BME communities.(3)To understand the impact and role of self-disclosure as initiated by patients.(4)To increase therapist awareness on cultural differences in self-disclosure and develop ways to address this in therapy.(5)To challenge therapists to adapt psychological therapies to diverse cultures and be cognisant that ‘one size does not fit all’.

Internet-delivered Cognitive Behaviour Therapy for Depressive Symptoms: An Exploratory Examination of Therapist Behaviours and their Relationship to Outcome and Therapeutic Alliance

2016 ◽  
Vol 44 (6) ◽  
pp. 625-639 ◽  
Author(s):  
Luke H. Schneider ◽  
Heather D. Hadjistavropoulos ◽  
Y. Nichole Faller
Keyword(s):  
Depressive Symptoms ◽  
Therapeutic Alliance ◽  
Cognitive Behaviour Therapy ◽  
Qualitative Content Analysis ◽  
Post Treatment ◽  
Symptom Improvement ◽  
Behaviour Therapy ◽  
Self Disclosure ◽  
Cognitive Behaviour ◽  
The Impact

Background: A previous study of therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) for generalized anxiety (Paxling et al., 2013) identified eight distinct therapist behaviours in ICBT (task reinforcement, self-efficacy shaping, task prompting, alliance bolstering, psychoeducation, empathetic utterances, deadline flexibility, and self-disclosure). It is unknown how generalizable these behaviours are across ICBT programs. Aims: We systematically examined the frequency of these eight therapist behaviours and additional newly identified behaviours in e-mails sent to patients during the course of ICBT for depressive symptoms. We also conducted exploratory analyses to examine relationships between therapist behaviours, symptom improvement, and therapeutic alliance. Method: Data was obtained from a previously published open trial (Hadjistavropoulos et al., 2014). A total of 1013 e-mails sent from therapists (n = 24) to patients (n = 41) during ICBT for depressive symptoms were analyzed. Therapist behaviours were correlated with symptom change scores and ratings of therapeutic alliance at mid- and post-treatment. Results: Therapist behaviours described by Paxling et al. were reliably identified in the e-mails using qualitative content analysis; the frequencies of these behaviours differed, however, from the Paxling et al. study and three additional therapist behaviours were identified (administrative statements, questionnaire feedback, asking clarifying questions). Several therapist behaviours (e.g. administrative statements, task prompting) were associated with lower symptom improvement at post-treatment. Questionnaire feedback and task reinforcement were associated with higher patient ratings of therapeutic alliance. Conclusions: The study provides partial support for the generalizability of therapist-assistance across ICBT programs. Experimental research is needed to examine the impact of varying therapist-assistance on patient outcomes.

scholarly journals The ‘branding’ of IAPT and private cognitive behaviour therapy services in England

2021 ◽  
Vol 14 ◽  
Author(s):  
David Veale ◽  
Chloe Bowles ◽  
Mara Avramescu
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Psychological Therapy ◽  
Brand Names ◽  
List Type ◽  
Brand Name ◽  
Behaviour Therapy ◽  
Psychological Therapies ◽  
Cognitive Behaviour ◽  
Significant Difference ◽  
The Uk

Abstract Over the past decade, provision of cognitive behaviour therapy has expanded massively in the UK, both within the private sector and through the Improving Access to Psychological Therapies (IAPT) programme. Our aim in this study was to explore and compare the brand names adopted by IAPT and private CBT services. We obtained the names of all the IAPT and private services in England and created a word cloud for each sector. There was no significant difference in the proportion of services that adopted a brand name (72% of IAPT services vs 67% of the private services). In those with a brand name, IAPT services were significantly more likely than private services to contain positive words, and to have a theme of togetherness and collaboration. However, private services were more likely to include a psychological therapy in their name and have a theme of efficacy compared with IAPT. The most common keywords in IAPT services were ‘talking’ and ‘thinking’. IAPT services use a variety of euphemisms such as ‘talking’ for a psychological therapy. There is no theme for ‘doing’ in the IAPT or private services, despite behavioural interventions being one of the most common therapeutic components. The brand names in IAPT are overwhelmingly positive and convey the hope of a good outcome. They do not include the experience of difficult emotions, such as sadness and fear during therapy. We found just one private service that evoked the history of CBT named after Vic Meyer. Perhaps we will have some Clark and Layard centres in the years to come! Key learning aims After reading this paper, the reader should: (1) Recognise the importance of a brand name in shaping service user expectations. (2) Understand the differences between how private CBT and IAPT services present themselves to the public. (3) Recognise the omission of words conveying an active ‘doing’ theme in IAPT and private CBT service names.

Patient Treatment Adherence in Cognitive Behaviour Therapy for Acute Psychosis: The Role of Recovery Style and Working Alliance

2005 ◽  
Vol 34 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Mike Startup ◽  
Noeline Wilding ◽  
Sue Startup
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Drop Out ◽  
Patient Treatment ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
The Impact ◽  
Drop Outs ◽  
Late Stages

Treatment non-adherence is a common problem in mental health services but little is known about non-adherence to psychological therapy for psychosis. The main aim of the present study was to investigate the role of patients' recovery style and the therapeutic alliance in provoking or forestalling patient drop-out from cognitive behaviour therapy (CBT) for psychosis. Ratings were made by two independent observers on 29 recordings of sessions from a controlled trial of CBT for psychosis. Sessions of 10 patients who dropped out of treatment prematurely were matched with sessions of 10 patients who stayed in. Another nine sessions were selected at random from the middle and late stages of treatment so that the sample was representative of all sessions in the trial. Patients who dropped out of treatment, compared with those who stayed in, were less engaged in treatment, showed less agreement with their therapists, and had a sealing-over recovery style before they dropped out but did not differ in their therapeutic bonds. The results suggest that the premature termination of the drop-outs was not provoked by the therapists but was due to the patients' lack of curiosity about their psychotic episodes and minimization of the impact of their illness.

Therapy discontinuation in a primary care psychological service: why patients drop out

2020 ◽  
Vol 13 ◽  
Author(s):  
Aisan Ghaemian ◽  
Mahdi Ghomi ◽  
Miles Wrightman ◽  
Colm Ellis-Nee
Keyword(s):  
Drop Out ◽  
Treatment Withdrawal ◽  
List Type ◽  
Structured Interviews ◽  
Group Settings ◽  
Psychological Therapies ◽  
Psychological Service ◽  
Wide Range ◽  
Key Factor ◽  
Therapy Services

Abstract The present study aimed to explore patients’ experience with an Improving Access to Psychological Therapies (IAPT) service, and to investigate the reasons for discontinuing their treatment. A qualitative approach was adopted using thematic analysis of semi-structured interviews carried out with 818 patients attending for treatment in Talking Change from November 2015 to January 2019, retrospectively. The five main themes that emerged from the study were: ‘Felt better’, ‘Issues with group settings’, ‘Therapeutic alliance breakdown’, ‘Miscommunication’ and ‘Impracticalities’. The qualitative study uncovered a wide range of reasons for people who had dropped out from their treatment. The findings mainly emphasised general dissatisfaction and inconvenient appointments. However, improvement in symptoms of depression and anxiety was also identified as a key factor among patients who discontinued their treatment. This recovery is known as ‘progress withdrawal’ in which patients withdraw from treatment early due to good therapeutic progress. We present clinical and procedural implications arising from these themes. Key learning aims (1) To explore what can cause discontinuation of therapy. (2) To obtain the experience of people who have received treatment and dropped out from Talking Change Psychological Therapy services. (3) To explore whether people recovered as part of the treatment withdrawal and what may have helped towards that recovery.

scholarly journals From the margins to the NICE guidelines: British clinical psychology and the development of cognitive behaviour therapy for psychosis, 1982–2002

2021 ◽  
pp. 095269512110277
Author(s):  
David J. Harper ◽  
Sebastian Townsend
Keyword(s):  
Clinical Psychology ◽  
Cognitive Behaviour Therapy ◽  
Systems Approach ◽  
Participant Observation ◽  
Clinical Excellence ◽  
Behaviour Therapy ◽  
Psychological Therapies ◽  
Historical Factors ◽  
Cognitive Behaviour ◽  
Social Technologies

Although histories of cognitive behaviour therapy have begun to appear, their use with people with psychosis diagnoses has received relatively little attention. In this article, we elucidate the conditions of possibility for the emergence of cognitive behaviour therapy for psychosis (CBTp) in England between 1982 and 2002. We present an analysis of policy documents, research publications and books, participant observation, and interviews with a group of leading researchers and senior policy actors. Informed by Derksen and Beaulieu’s articulation of social technologies, we show how CBTp was developed and stabilised through the work of a variety of overlapping informal, academic, clinical, professional, and policy networks. The profession of clinical psychology played a key role in this development, successfully challenging the traditional ‘division of labour’ where psychologists focused on ‘neurosis’ and left ‘psychosis’ to psychiatry. Following Abbott's systems approach to professions, we identify a number of historical factors that created a jurisdictional vulnerability for psychiatry while strengthening the jurisdictional legitimacy of clinical psychology in providing psychological therapies to service users with psychosis diagnoses. The National Institute for Health and Clinical Excellence played a significant role in adjudicating jurisdictional legitimacy, and its 2002 schizophrenia guidelines, recommending the use of psychological therapies, marked a radical departure from the psychiatric consensus. Our analysis may be of wider interest in its focus on social technologies in a context of jurisdictional contestation. We discuss the implications of our study for the field of mental health and for the relationship between clinical psychology and psychiatry.

scholarly journals TERAPI CYBERBULLYING BERBASIS REKREASI

2020 ◽  
Vol 1 (2) ◽  
pp. 1711
Author(s):  
Elizabeth Clara ◽  
Franky Liauw
Keyword(s):  
Generation X ◽  
Digital Technology ◽  
Building Design ◽  
Special Treatment ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Negative Effect ◽  
Use Of The Internet ◽  
Concept Building ◽  
The Impact

A lot of new problem arise as the result of the development of information and digital technology that leads to the use of the Internet by millennials, namely cyberbullying. Cyberbullying hasn’t been solved by the millennials even the though the causes has been known. This problem also affects the other generations such as generation X and generation Z also feel the impact. To be more spesific, the definition of cyberbullying is the development of bullying from the traditional way to using digital devices. This is important because until now this problem still underestimated and hasn't received any special treatment even though the bullying cause a lot off negative effect such as depression which lead to suicide. This statement supported by the Kaspersky Lab's researchThe problem is 20% of people who witness of cyberbullying and 7% of the cases of those involved in bullying. Cyberbullying Theracreation project is designed to raise the awareness of cyberbullying in the community targeting the bullier. Theracreation are created from the word combination of theraphy and recreation. it’s related to the used solution method of the project called cognitive behaviour therapy (CBT). It’s combined with spatial experience in architecture and digital technology which consists of VR so that the therapy process is carried out without having to deal directly with a psychologist. The benefits of this therapeutic system can be done at any time in a predetermined location so that improving the community's process of cyberbullying can be done effectively. For the design concept, emphasize on the improvements in the community the concept building which blend with the level difference building design and focusing the activities at one center point. AbstrakSebagai hasil dari perkembangan teknologi informasi dan digital yang mengarah pada penggunaan Internet secara berlebihan oleh generasi millenial muncul masalah yaitu intimidasi dunia maya atau lebih dikenal dengan cyberbullying. Cyberbullying sendiri tidak terpaku pada generasi milenial saja melainkan generasi lainnya seperti generasi X dan generasi Z. Cyberbullying merupakan pengembangan perilaku bullying dari cara tradisional ke penggunan perangkat digital. Untuk menangani kasus tersebut diajukanlah proyek Cyberbullying Theracreation atau Terapi Cyberbullying berbasis rekreasi yang difokuskan untuk membangun cyberbullying awareness dalam masyarakat khususnya pelaku cyberbullying. Karena sampai sekarang belum kasus ini masih disepelekan dan belum mendapat perlakuan khusus. Hal tersebut didukung oleh hasil penelitian Kaspersky Lab. Cyberbullying dapat menimbulkan pemikiran tentang bunuh diri, terkadang bertahan hingga dewasa. Bahayanya 20% dari orang-orang yang menyaksikan bullying secara online dan di 7% kasus mereka bahkan berpartisipasi dalam kasus bullying. Theracreation sendiri berasal dari pengabungan kata terapi (therapy) dan rekreasi (recreation) ini mengacu pada metode yang digunakan yaitu terapi rekreasi berprogram terapi kognitif perilaku (CBT) yang dipadukan dengan unsur arsitektur (pengalaman ruang) dan teknologi digital berupa VR sehingga proses terapi dilakukan tanpa harus berhadapan langsung dengan psikolog. Keuntungan dari sistem terapi ini adalah terapi bisa dilakukan kapanpun di lokasi yang sudah ditentukan sehingga dalam proses meningkatkan empati masyarakat terhadap cyberbullying bisa dilakukan secara efektif. Dalam desainnya, dengan tetap menekankan peningkatan empati dalam masyarakat dciptakan konsep arsitektur yang berbaur sehingga perbedaan level pada bangunan tersamarkan dan memusatkan aktivitas pada 1 titik pusat.

scholarly journals Patient experience of Guided self-help CBT intervention for VoicEs (GiVE) delivered within a pilot randomized controlled trial

2020 ◽  
Vol 13 ◽  
Author(s):  
Cassie M. Hazell ◽  
Orla Kelly ◽  
Sorcha O’Brien ◽  
Clara Strauss ◽  
Kate Cavanagh ◽  
...  
Keyword(s):  
Patient Experience ◽  
Controlled Trial ◽  
Pilot Trial ◽  
List Type ◽  
Behaviour Therapy ◽  
Hearing Voices ◽  
Self Help ◽  
Cognitive Behaviour ◽  
Therapy Sessions ◽  
Trial Participants

Abstract Access to cognitive behaviour therapy for those with psychosis (CBTp) remains poor. The most frequently endorsed barrier to implementation is a lack of resources. To improve access to CBTp, we developed a brief form of CBTp that specifically targets voice-related distress. The results of our pilot trial of guided self-help CBT for voices (GiVE) suggest that the therapy is both acceptable and beneficial. The present study aims to explore the subjective patient experience of accessing GiVE in the context of a trial. We interviewed nine trial participants using the Change Interview and a mixed methods approach. Most participants reported at least one positive change that they attributed to GiVE. We extracted five themes: (1) changes that I have noticed; (2) I am not alone; (3) positive therapy experiences; (4) I want more therapy; and (5) helping myself. The themes indicate that participating in the GiVE trial was generally a positive experience. The main areas in which participants experienced changes were improved self-esteem, and the ability to cope with voices. Positive changes were facilitated by embracing and enacting ‘self-help’ and having support both in and out of the therapy sessions. The findings support the use of self-help materials with those distressed by hearing voices, but that support both within and outside the clinical setting can aid engagement and outcomes. Overall, the findings support the continued investigation of GiVE. Key learning aims (1) To explore participants’ experience of accessing GiVE as part of a trial. (2) To identify what (if any) changes participants noticed over the course of the GiVE trial. (3) To identify what participants attribute these changes to.

How does supervision aid cognitive behaviour therapy skill development? Perspectives of CBT trainees: a thematic analysis

2020 ◽  
Vol 13 ◽  
Author(s):  
Stephanie Murr ◽  
Leeanne Nicklas ◽  
Sean Harper
Keyword(s):  
Clinical Supervision ◽  
Negative Feedback ◽  
Thematic Analysis ◽  
Cognitive Behaviour Therapy ◽  
Skill Development ◽  
List Type ◽  
Negative Consequences ◽  
Behaviour Therapy ◽  
Theory To Practice ◽  
Cognitive Behaviour

Abstract Eleven cognitive behaviour therapy (CBT) trainees in Scotland were interviewed regarding their experiences of clinical supervision and its impact on their skill development. Using thematic analysis, the authors developed four main themes: Linking Theory to Practice, Mirroring CBT in Supervision, The Expert Supervisor, and Trainees’ Reluctance to Give Negative Feedback. Clinical supervision was essential in helping trainees to link theory to practice; particularly through audio recordings, discussing formulations, and modelling and role-play. A CBT-specific approach to supervision and a CBT expert supervisor were also identified as valuable to learning. Trainees were reluctant to give negative feedback to supervisors, fearing negative consequences. The findings inform supervision practice. Key learning aims Readers of this paper will be able to: (1) Describe trainees’ most valued elements of CBT supervision. (2) Determine key learning methods in CBT supervision. (3) Explain the value of modality specific CBT supervision. (4) Articulate the context of supervision in CBT training and consider mutual feedback as a method to address identified challenges.

Group therapists: combine alliance building with paying specific attention to the patient’s perception

2020 ◽  
Vol 13 ◽  
Author(s):  
Beate Muschalla
Keyword(s):  
Group Process ◽  
Therapy Group ◽  
Group Session ◽  
List Type ◽  
Behaviour Therapy ◽  
Technical Performance ◽  
Cognitive Behaviour ◽  
Group Sessions ◽  
Patient’S Perception ◽  
Alliance Building

Abstract In slow-open groups as well as therapies of less than ten sessions, each group session holds importance. Patients, therapists and co-therapists have different perspectives and may gain different experiences from a group session. This study investigates the perspectives of patients, therapists and co-therapists on alliance, new insights and therapist techniques in the same group session. Do the three actors perceive these group aspects similarly or differently? Which group aspects are related with the outcome coping? One hundred and forty-nine sessions of a cognitive behaviour therapy group have been investigated. Patients, therapists and co-therapists gave ratings on their perceived alliance, group topics and insights as well as therapists’ technique competency. Concerning new insights, there was concordance between patients and co-therapists (r = .211, p < .05). Concerning alliance, there was a concordance between patients and therapists (r = .327, p < .01). Therapists focusing on alliance building was associated with lower patient outcomes in terms of work coping (β = –.391). The quality of therapeutic techniques was the same in groups with higher and lower outcomes. Patients’ perception of whether they felt good in the group session was explanative for session outcome, while therapists’ perceptions and context conditions (supervision, number of participants) was not. Patients, therapists and co-therapists have different perspectives on the same group therapy session. Patients’ perceptions are associated with session outcomes. A lower session outcome must not be associated with a poor technique performance of the therapist. Therapists should not only be aware of alliance building and correct technical performance, but they must also be aware of patients’ perceptions of the group process and outcome. Key learning aims The present research is the first evaluation of group session aspects and session outcomes in rehabilitation patients with work anxieties in slow-open groups. We will learn: (1) Whether patients’, therapists’ and co-therapists’ perceptions of the same group session are similar or different; (2) Whether group sessions that result in worse outcomes are different from group sessions resulting in a better outcome; (3) Which aspects of the group session are predictive for a better outcome.

Depression, Mastery and Number of Group Sessions Attended Predict Outcome of Patients with Panic and Agoraphobia in a Behavioural/Medication Program

1994 ◽  
Vol 39 (5) ◽  
pp. 283-288 ◽  
Author(s):  
Rudy Bowen ◽  
Maxine South ◽  
Don Fischer ◽  
Terah Looman
Keyword(s):  
Group Therapy ◽  
Cognitive Behaviour Therapy ◽  
Demographic Variables ◽  
Personal Knowledge ◽  
Predictors Of Outcome ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Poor Outcomes ◽  
Therapy Sessions

From a list of 214 patients suffering from panic and agoraphobia and who had been treated with cognitive behaviour therapy, 30 patients who had very good outcomes and 32 who had poor outcomes were selected. The groups were selected by the nurse therapist and psychiatrist on the basis of personal knowledge of the patients. The distinction into good and poor outcome groups was confirmed by the results of a follow-up questionnaire completed by the patient. Of several clinical and demographic variables which had been hypothesized, to be predictors of outcome, only depression, as measured by the Beck Depression Inventory, mastery, as measured by the Pearlin Mastery Scale and the number of group therapy sessions attended predicted outcome. Levels of depression and mastery might be clinically modifiable variables which affect the outcome of treatment for patients with panic and agoraphobia.

Sign in / Sign up

Export Citation Format

Share Document