scholarly journals IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings

2020 ◽  
Vol 13 ◽  
Author(s):  
Graham R. Thew
Keyword(s):  
Evidence Base ◽  
Routine Care ◽  
Current Evidence ◽  
List Type ◽  
Face To Face ◽  
Internet Interventions ◽  
Psychological Therapies ◽  
Current Evidence Base ◽  
Online Format ◽  
The Right

Abstract Compared with the traditional face-to-face format, therapist-guided internet interventions offer a different approach to supporting clients in learning skills to manage and overcome mental health difficulties. Such interventions are already in use within IAPT (Improving Access to Psychological Therapies) and other routine care settings, but given their potential to deliver treatment more efficiently and therefore increase availability and access to evidence-based interventions, their use is likely to increase significantly over the coming years. This article outlines what is meant by therapist-guided internet interventions and why an online format is thought to be advantageous for clients, therapists, services, and communities more broadly. It reviews the current evidence in the context of common therapist beliefs about internet-based treatment. It aims to identify gaps where further research is required, particularly in relation to the broader implementation of these treatments in IAPT and other routine clinical services. Specifically, it emphasises the importance of choosing the right programmes, providing adequate therapist training in their use, and considering practical and organisational issues, all of which are likely to determine the success of implementation efforts. Key learning aims (1) To understand what therapist-guided internet interventions are and their potential advantages. (2) To understand the current evidence base for these interventions. (3) To learn where further research is needed with regard to both the interventions themselves, and to their broader implementation in IAPT.

scholarly journals Interventions for challenging behaviour in intellectual disability

2014 ◽  
Vol 20 (3) ◽  
pp. 184-192 ◽  
Author(s):  
Afia Ali ◽  
Jessica Blickwedel ◽  
Angela Hassiotis
Keyword(s):  
Intellectual Disability ◽  
Evidence Base ◽  
Current Evidence ◽  
List Type ◽  
Challenging Behaviour ◽  
Pharmacological Treatments ◽  
Current Evidence Base ◽  
The Individual

SummaryChallenging behaviour is common in intellectual disability but it is difficult to diagnose and manage. It can adversely affect the quality of life of the individual and cause the breakdown of community placements, resulting in hospital admission. This article discusses the aetiology of challenging behaviour (including the complex relationship with mental illness), diagnostic problems, the current evidence base in relation to psychosocial and pharmacological treatments, and service delivery.LEARNING OBJECTIVES•Understand the aetiological basis of challenging behaviour.•Understand the role of functional analysis.•Appreciate the evidence base in relation to the psychological and pharmacological treatment of challenging behaviour.

scholarly journals Cognitive analytic therapy at 30

2014 ◽  
Vol 20 (4) ◽  
pp. 258-268 ◽  
Author(s):  
Anthony Ryle ◽  
Stephen Kellett ◽  
Jason Hepple ◽  
Rachel Calvert
Keyword(s):  
Public Mental Health ◽  
Evidence Base ◽  
Current Evidence ◽  
Personal Construct ◽  
List Type ◽  
National Guidelines ◽  
Wide Range ◽  
Current Evidence Base ◽  
Analytic Therapy ◽  
Cognitive Analytic Therapy

SummaryCognitive analytic therapy (CAT) was formalised in 1984 by Anthony Ryle. It facilitated the clinical integration of psychodynamic therapy and personal construct/cognitive psychology. It is a brief, user-friendly relational therapy, applicable to the wide range of psychological problems typically seen in public mental health settings. It has recently been included in national guidelines for the treatment of personality disorder in the National Health Service. CAT provides a coherent model of development and psychopathology, which centrally views the self as both socially formed and embedded. Owing to its core relational grounding, CAT is being increasingly applied to team contexts/systems, enabling a ‘common language’ for team formulation/practice. It is also being successfully delivered as a group therapy. This article describes the development and unique features of the CAT model, analyses the current evidence base and identifies potential future directions for the model.LEARNING OBJECTIVESBe able to describe the core principles of the CAT approach.Appreciate the evidence base for CAT.Understand CAT's place today among talking therapies.

scholarly journals Mindfulness-based interventions in secure settings: challenges and opportunities

2013 ◽  
Vol 19 (3) ◽  
pp. 191-200 ◽  
Author(s):  
Dumindu Witharana ◽  
Gwen Adshead
Keyword(s):  
Mental Healthcare ◽  
Evidence Base ◽  
Mechanisms Of Action ◽  
Current Evidence ◽  
Psychological Treatments ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Current Evidence Base ◽  
Challenges And Opportunities ◽  
Recent Developments

SummaryPsychological treatments in secure settings have traditionally been based on psychodynamic and cognitive–behavioural approaches. Recent developments, supported by an emerging evidence base, have generated a significant amount of interest in mindfulness-based psychological therapies and their utility in diverse areas of mental healthcare. In this article we analyse the current evidence base and describe possible mechanisms of action of mindfulness-based psychological approaches. On the basis of the evidence, we advocate a cautious but positive approach to using mindfulness-based interventions in secure services.

scholarly journals A systematic scoping review of psychological therapies for psychosis within acute psychiatric in-patient settings

2018 ◽  
Vol 213 (2) ◽  
pp. 490-497 ◽  
Author(s):  
Pamela Jacobsen ◽  
Kathleen Hodkinson ◽  
Emmanuelle Peters ◽  
Paul Chadwick
Keyword(s):  
Outcome Measures ◽  
Scoping Review ◽  
Psychotic Disorders ◽  
Evidence Base ◽  
Allocation Concealment ◽  
Current Evidence ◽  
Psychological Therapies ◽  
Affective Symptoms ◽  
Wide Range ◽  
Current Evidence Base

BackgroundPeople with psychotic disorders account for most acute admissions to psychiatric wards. Psychological therapies are a treatment adjunct to standard medication and nursing care, but the evidence base for such therapies within in-patient settings is unclear.AimsTo conduct a systematic scoping review of the current evidence base for psychological therapies for psychosis delivered within acute in-patient settings (PROSPERO: CRD42015025623).MethodAll study designs, and therapy models, were eligible for inclusion in the review. We searched PubMed, PsycINFO, EThOS, ProQuest, conference abstracts and trial registries.ResultsWe found 65 studies that met criteria for inclusion in the review, 21 of which were randomised controlled trials (RCTs). The majority of studies evaluated cognitive–behavioural interventions. Quality was variable across all study types. The RCTs were mostly small (n<25 in the treatment arm), and many had methodological limitations including poorly described randomisation methods, inadequate allocation concealment and non-masked outcome assessments. We found studies used a wide range of different outcome measures, and relatively few studies reported affective symptoms or recovery-based outcomes. Many studies described adaptations to treatment delivery within in-patient settings, including increased frequency of sessions, briefer interventions and use of single-session formats.ConclusionsBased on these findings, there is a clear need to improve methodological rigour within in-patient research. Interpretation of the current evidence base is challenging given the wide range of different therapies, outcome measures and models of delivery described in the literature.Declaration of interestNone.

The development of safer walking technology: a review

2015 ◽  
Vol 9 (2) ◽  
pp. 100-115 ◽  
Author(s):  
Esmé Wood ◽  
Gillian Ward ◽  
John Woolham
Keyword(s):  
Decision Making ◽  
Social Care ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
People With Dementia ◽  
Published Evidence ◽  
Health And Social Care ◽  
Current Evidence Base ◽  
The Right

Purpose – The purpose of this paper is to gain a greater understanding of the development of safer walking technology for people with dementia through contemporary literature. Design/methodology/approach – A two stage systematic approach to searching the literature was adopted. Initially this involved searching the literature to gain a broad overview of the development of safer walking technology and the context in which it has been developed. Then, this literature was examined in detail to look at published evidence surrounding the use of safer walking technology by people with dementia. These articles were quality appraised and a meta ethnographic approach taken to synthesis of the findings. Findings – There is a small but growing body of literature within this field. Whilst there is only limited evidence to support the use of safer walking technologies for people with dementia, the evidence to date indicates great potential for its use. If provided with the right support and guidance, safer walking technology has the potential to increase freedoms and independence for people with dementia; gaining them improved access to outdoor spaces and environments to support their health and wellbeing. However, if the safer walking technology continues to be associated with only risk management it will not achieve this potential. Research limitations/implications – The published literature within this field is small and has limited generalisability as much of it was generated in recent years has been by the same small research teams, often reusing data sets. There is also very little research that examines the experience of actually using safer walking technology and even less which explores the views of people with dementia. It is evident that a greater breadth and depth of knowledge is needed within this field to develop a clearer understanding of how this technology is used and perceived by all stakeholders concerned. In particular the literature would benefit from greater consideration of the views and experiences of people with dementia themselves. Practical implications – For many people with dementia, health and social care professionals can play an important role in ensuring appropriate assessment and support in the decision-making process when using safer walking technology. However, greater support is needed in decision making for all people with dementia, especially those people not currently engaged with specialist services. Therefore greater awareness of the benefits and limitations of this technology is needed by all health and social care professionals as well as the general public. Originality/value – At the time of conducting this review the author is unaware of any other systematic search of literature or overview of research on the use of safer walking technology and its use by people with dementia. Despite this safer walking technology is growing in popularity, commonly recommended by health and social care practitioners and often marketed and purchased directly by people with dementia and their families. This review offers an insight into the development of the technology and the current evidence base for its use.

scholarly journals Translational and Implementation Research to Bridge Evidence and Implementation

2019 ◽  
Vol 75 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Klaus Kraemer ◽  
Kesso Gabrielle van Zutphen
Keyword(s):  
Implementation Research ◽  
Evidence Base ◽  
Nutritional Deficiencies ◽  
Current Evidence ◽  
Biological Research ◽  
Past Century ◽  
Double Burden ◽  
Current Evidence Base ◽  
The Right

Background: The role of science in guiding interventions and programs and contributing to progress in achieving global targets is undeniable. In public health nutrition, biological research in the past century focused largely on single nutrients and provided the basis for addressing nutritional deficiencies. This focus has now expanded to consider evidence including, but not limited, to knowledge about food, diet, behavior, context, and culture. The complex double burden of malnutrition will need to be addressed through a wider lens that appreciates the multiple and interrelated facets that underpin it. Summary: Despite the acknowledged importance of translational research in improving nutritional outcomes, significant gaps remain in the process leading from science to practice. This article sheds light on 2 examples that demonstrate this, namely, anemia and stunting. Further, much work is still required to translate the current evidence base into effective actions that result in impact at scale, pointing toward the need for more implementation research in nutrition. Key Messages: While discoveries may take time to surface and implementers are impatient to address the challenge at hand, it is essential to identify and deploy the best available evidence while continuously advancing the evidence base, and to seek the right balance between action and inaction.

scholarly journals Prevention strategies for adolescent depression

2014 ◽  
Vol 20 (2) ◽  
pp. 116-124 ◽  
Author(s):  
Cheryl Bennett ◽  
Rhys Bevan Jones ◽  
Daniel Smith
Keyword(s):  
Adolescent Depression ◽  
Signs And Symptoms ◽  
Evidence Base ◽  
Current Evidence ◽  
List Type ◽  
Prevention Strategies ◽  
Interpersonal Therapy ◽  
Theoretical Concepts ◽  
Wide Range ◽  
Current Evidence Base

SummaryDepression is missed more often in adolescents than in adults, partly because they present with symptoms different from those in adults and because many do not seek help. Early detection or the delay of onset can have a significant effect on a young person's development and social functioning. We briefly discuss diagnosis and screening instruments before presenting the wide range of educational and psychological preventive approaches developed for adolescent depression. Many of the latter are based on the cognitive-behavioural or interpersonal therapy models. We consider how clinicians might use the current evidence base to identify and prevent depression in adolescents, and outline the principles of management of the disorder.LEARNING OBJECTIVES•Identify signs and symptoms of adolescent depression and recognise the difficulties in making a diagnosis.•Recognise the risk factors for adolescent depression.•Appreciate the aims and theoretical concepts of prevention strategies for adolescent depression.

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.

scholarly journals Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

2020 ◽  
pp. 1-15
Author(s):  
Daniel Joseph Lamport ◽  
Claire Michelle Williams
Keyword(s):  
Systematic Reviews ◽  
Evidence Base ◽  
Epidemiological Studies ◽  
Cognitive Outcome ◽  
Current Evidence ◽  
Duration Of Treatment ◽  
Current Evidence Base ◽  
Cognitive Benefits ◽  
Meta Analyses ◽  
The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

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