The practice and research of cognitive behavioural therapy in Egypt: a review of the current status

2020 ◽  
Vol 13 ◽  
Author(s):  
Reham Aly ◽  
Hisham Ramy ◽  
Shanaya Rathod
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Arab World ◽  
Behavioural Therapy ◽  
Current Status ◽  
Evidence Based ◽  
List Type ◽  
Cultural Variations ◽  
Western Countries ◽  
Mixed Response ◽  
Cognitive Behavioural

Abstract Cognitive behavioural therapy (CBT) is generally defined as a short-term, problem-oriented psychotherapy that focuses on modifying dysfunctional emotions, thoughts and actions. In clinical practice, CBT consists of a number of cognitive and behavioural techniques that aim to help patients suffering from psychological disorders. The practice of CBT is well established in Western countries. In non-Western countries, CBT is still in the process of being established as the evidence-based psychotherapy. Despite being the heart of the Arab world, the development and practice of psychotherapy in Egypt in general, and CBT specifically, is still emerging. The training and practice of CBT has received a mixed response in Egypt. In practical settings, evidence-based CBT is subject to individual and cultural variations and adaptations. Many local studies examining the efficacy of CBT in psychiatric disorders among different population groups in Egypt have been conducted. Unfortunately, many of these studies have not been published and therefore have missed the opportunity for international recognition. The current review aims to explore the practice of CBT with a specific focus on national research of efficacy and adaptability of CBT for different populations in Egypt. Key learning aims (1) Current status of the practice and education of CBT in Egypt. (2) Body of research conducted on CBT in Egypt. (3) Needs and recommendations for further development of CBT provision in Egypt.

Critical issues in cognitive behavioural therapy (CBT) with gender and sexual minorities (GSMs)

2022 ◽  
Vol 15 ◽  
Author(s):  
Sérgio A. Carvalho ◽  
Paula Castilho ◽  
Daniel Seabra ◽  
Céu Salvador ◽  
Daniel Rijo ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioural Therapy ◽  
Minority Stress ◽  
Sexual Minorities ◽  
Clinical Work ◽  
Behavioural Therapy ◽  
List Type ◽  
Cognitive Behavioural ◽  
Critical Issues ◽  
Societal Structure

Abstract In a cisheteronormative culture, gender and sexual minorities (GSMs) may experience additional challenges that get in the way of a meaningful life. It is crucial that clinicians are mindful of these challenges and cognizant about the specificities of clinical work with GSMs. This article points out how societal structure interferes with mental health, and clarifies what clinicians must take into account when using affirmative cognitive behavioural therapy (CBT) interventions. Knowledge of up-to-date terminology and use of affirmative language are the first steps that contribute to clients’ experience of respect, which is paramount for the development of a good therapeutic relationship. Considering a conceptual framework of minority stress to understand vulnerability in GSM, specificities in formulation and key psychological processes are discussed. Moreover, guidelines and practical tools for intervention are presented within a CBT approach. Some reflections on therapists’ own personal biases are encouraged, in order to increase the efficacy of interventions. Key learning aims After reading this article you will be able to: (1) Recognize the uniqueness of gender and sexual minorities (GSM) stressors in broad and specific contexts, and their impact on mental health. (2) Identify the underlying key processes and specificities in therapeutic work with GSMs, from a CBT perspective. (3) Recognize the importance of a culturally sensitive approach in affirmative CBT interventions.

scholarly journals A qualitative study of patients’ experiences and acceptance of computerised cognitive behavioural therapy in primary care, Scotland

2021 ◽  
Vol 14 ◽  
Author(s):  
Eliane Du ◽  
Ethel Quayle ◽  
Hamish Macleod
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Information Dissemination ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Computer Assisted ◽  
List Type ◽  
Access To Treatment ◽  
Cognitive Behavioural ◽  
Qualitative Exploration ◽  
The Impact

Abstract Computerised cognitive behavioural therapy (CCBT) has been made available within the National Health Service (NHS) across Scotland as an alternative treatment for mild to moderate anxiety and depression. However, the provision of CCBT services is still limited in the NHS, possibly affecting delivery of this computer-aided therapy to patients and inhibiting acceptance and uptake of this intervention. This paper reports on the qualitative exploration of patients’ experiences and acceptance of one CCBT programme delivering computer-assisted therapy (Beating the Blues: BTB), examining particularly the point of referral, access to treatment, and support. Thematic analysis was conducted on semi-structured face-to-face and email interviews with 33 patients at different NHS organisations across Scotland. Data analysis generated six key themes which illustrated patients’ experiences relating to referral and access to the treatment, and the challenges they faced: (1) information dissemination; (2) expectations and the impact of waiting for BTB; (3) impact of locations on experience of BTB; (4) preference for home access; (5) desire for better human support; and (6) desire for additional application support features. The findings highlighted that better methods of implementing and delivering such CCBT services together with the design of the technological interventions are vital to the success of these services. Key learning aims (1) To understand the service models and methods of implementing and delivering one CCBT programme (BTB) in routine care; (2) To learn about user experiences of accessing and using BTB; and (3) To learn about the implications and factors that might have influenced uptake and understand the implications.

A cognitive behavioural therapy (CBT) approach for working with strong feelings of guilt after traumatic events

2021 ◽  
Vol 14 ◽  
Author(s):  
Kerry Young ◽  
Zoe J. Chessell ◽  
Amy Chisholm ◽  
Francesca Brady ◽  
Sameena Akbar ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Traumatic Event ◽  
Behavioural Therapy ◽  
List Type ◽  
Traumatic Memory ◽  
Post Traumatic Stress ◽  
New Information ◽  
Cognitive Behavioural ◽  
Post Traumatic ◽  
Imagery Techniques

Abstract This article outlines a cognitive behavioural therapy (CBT) approach to treating feelings of guilt and aims to be a practical ‘how to’ guide for therapists. The therapeutic techniques were developed in the context of working with clients with a diagnosis of post-traumatic stress disorder (PTSD); however, the ideas can also be used when working with clients who do not meet a diagnosis of PTSD but have experienced trauma or adversity and feel guilty. The techniques in this article are therefore widely applicable: to veterans, refugees, survivors of abuse, the bereaved, and healthcare professionals affected by COVID-19, amongst others. We consider how to assess and formulate feelings of guilt and suggest multiple cognitive and imagery strategies which can be used to reduce feelings of guilt. When working with clients with a diagnosis of PTSD, it is important to establish whether the guilt was first experienced during the traumatic event (peri-traumatically) or after the traumatic event (post-traumatically). If the guilt is peri-traumatic, following cognitive work, this new information may then need to be integrated into the traumatic memory during reliving. Key learning aims (1) To understand why feelings of guilt may arise following experiences of trauma or adversity. (2) To be able to assess and formulate feelings of guilt. (3) To be able to choose an appropriate cognitive technique, based on the reason for the feeling of guilt/responsibility, and work through this with a client. (4) To be able to use imagery techniques to support cognitive interventions with feelings of guilt.

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.

A questionnaire-based qualitative study of therapist views on computerized CBT

2016 ◽  
Vol 9 ◽  
Author(s):  
J. Newton ◽  
E. C. Sundin
Keyword(s):  
Qualitative Study ◽  
Therapeutic Relationship ◽  
Cognitive Behavioural Therapy ◽  
Thematic Analysis ◽  
Evidence Based Practice ◽  
Behavioural Therapy ◽  
Evidence Based ◽  
Cognitive Behavioural ◽  
Pros And Cons ◽  
Structured Questionnaire

AbstractFew studies have explored therapists’ views on computerized cognitive behavioural therapy (cCBT) and this study aimed to provide an in-depth understanding of accredited therapists’ views on cCBT's role in treating depression. Twelve therapists constituted this self-selected sample (eight female, four male). Mean age was 52 years (range 46–61). The data obtained from a semi-structured questionnaire were analysed using thematic analysis. Three themes were identified and discussed: (1) the standardized nature of cCBT for depression, (2) the importance of the therapeutic relationship in cCBT, and (3) the pros and cons with cCBT as an alternative to CBT. The therapists in this study emphasized that innovations in CBT delivery formats (e.g. internet-based, computerized) show promise. However, participants expressed some views that clash with the evidence-based viewpoint. More work is needed to improve the implementation of evidence-based practice and policy.

Transition to cognitive behavioural therapy from different core professional backgrounds: three grounded theory studies

2020 ◽  
Vol 13 ◽  
Author(s):  
Matthew D. Wilcockson
Keyword(s):  
Grounded Theory ◽  
Clinical Practice ◽  
Coping Strategies ◽  
Cognitive Behavioural Therapy ◽  
High Intensity ◽  
Behavioural Therapy ◽  
List Type ◽  
Cognitive Behavioural ◽  
Mandatory Requirement ◽  
The Impact

Abstract Aim: Transition between roles is widely recognised to be a complex process that involves training, socialisation into the new culture, exiting a previous role culture, and dealing with the transition process itself, and dealing with loss of identity and initial incompetence in the new role. Moving from core profession to high intensity (CBT) therapist is an example of such a role transition. As a result, complete transition is not guaranteed, which may affect completeness of learning, and how CBT is practiced post qualification. It is recognised in a number of studies that professional cultures are present in professions such as nursing and counselling, and these professions may have different filters for viewing CBT, and different training needs. Method: A grounded theory analysis (Glaserian) of each of three core professions’ (mental health nurses, counsellors, and an unprofessionalised group) reflective reports (7 per profession) was undertaken, incorporating information from their learning journals throughout the year independently of each other. The reflective reports incorporate reflections on the process of transition and learning, and is a mandatory requirement of the course. Through an inductive process described in the article, a theory of transition was developed for each group. Results: Three different theories of transition are presented. Nurses absorbed knowledge but resisted practice changes, especially being clinically observed. Practice changes occurred through behavioural consequences and cognitive dissonance and reflection is structured and compartmentalised generally. The conflict between counselling and CBT is felt more deeply emotionally but resolved through experiencing ‘self as client’ for most counselling participants. Practice conflicts are mostly resolved with this group, but some ideological ones are not. The KSA group have a relatively smooth transition unaffected by previous experiences. Inability to use previous coping strategies for dealing with distress is influential, inducing crises for the nursing and counselling groups. Implications: Learning is delayed by trying to avoid clinical practice, and excessive identification only with the aspects of CBT that fit with existing identity and practice with nursing and counselling groups. Adaptations to training may be beneficial to enforce observation of practice at an earlier stage to drive change. The nursing role does appear to undermine learning. Reflection does eventually drive the learning process as noted in other studies, but this does not occur spontaneously with nurses or counsellors. Identification with the new role appears influential in a relatively complete change, which is consistent with theory. Recommendations to adopt CBT coping strategies early in the training are made, as is a session of individual support to address profession-based conflicts. Potential implications for the evidence base are noted. Transitional models provide a framework for educators and students. Key learning aims (1) To appreciate the importance of successful role transitions and their effect on future practice. (2) To become familiar with the key issues in transitioning between different core professions and an IAPT high-intensity role. (3) To critically reflect on personal experience in transitioning to cognitive behavioural therapy, and the impact it has had on clinical practice.

scholarly journals Cultural adaptations of cognitive behavioural therapy for Latin American patients: unexpected findings from a systematic review

2020 ◽  
Vol 13 ◽  
Author(s):  
Maria Elena Hernandez Hernandez ◽  
Glenn Waller ◽  
Gillian Hardy
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Latin American ◽  
Methodological Quality ◽  
Behavioural Therapy ◽  
Retention Rates ◽  
List Type ◽  
Cultural Adaptations ◽  
Culturally Adapted ◽  
Cognitive Behavioural ◽  
Latin American Countries

Abstract The current literature extensively recommends making cultural adaptations to psychological therapies, in order to address the differences in values, beliefs and attitudes that patients from different ethnic groups might hold. Although this approach has shown positive outcomes in some settings, it is not well established yet whether such adaptations are needed for all therapies and in all cultures. Therefore, the main aim of this study was to systematically review the literature regarding culturally adapted and ‘conventional’ cognitive behavioural therapy (CBT) for Latin American patients, within Latin American and non-Latin American countries. Sixty empirical studies regarding the effectiveness of culturally adapted and conventional CBT were included in this review. The included studies were carried out in Latin American and non-Latin American countries. The information from all studies was synthesized and assessed, including intervention effect sizes, patient retention rates, methodological quality of the papers, and the type of cultural adaptation made to the therapy. There were no differences between the sets of studies in terms of effectiveness, retention rates, methodological quality, or proportion of statistically significant interventions. Most of the cultural adaptations were peripheral or unspecified. The evidence to date indicates that both conventional and culturally adapted CBT offer the same benefits for Latin American patients in terms of effectiveness and retention rates. Rather than focusing on cultural adaptations, clinicians are encouraged to improve the way they deliver CBT through training and supervision. Key learning aims (1) Cultural adaptations of CBT do not seem to offer any significant benefits to conventional, non-adapted CBT in Latin American patients. (2) Most of the adaptations made to CBT for Latin American patients are either peripheral or not disclosed. (3) We discuss the implications of adapting CBT for Latin American patients when there is no apparent need to do so.

scholarly journals Internet-assisted cognitive behavioural therapy for non-cardiac chest pain: a pilot and feasibility study

2021 ◽  
Vol 14 ◽  
Author(s):  
Terje Thesen ◽  
Egil Jonsbu ◽  
Egil W. Martinsen ◽  
Joseph A. Himle ◽  
Frode Thorup ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Retention Rate ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
List Type ◽  
Structured Interviews ◽  
Cognitive Behavioural

Abstract Nearly half of patients with non-cardiac chest pain (NCCP) experience significant complaints after a negative cardiac evaluation, at considerable costs for society. Due to the lack of treatment capacity and low interest for psychological treatment among patients with somatic complaints, only a minority receive effective treatment. The aim of this study was to assess the feasibility and usefulness of internet-assisted cognitive behavioural therapy (I-CBT), including encouragement of physical activity for this condition. Ten patients with NCCP received a six-session I-CBT intervention with minimal support from a therapist. Questionnaires assessing cardiac anxiety, fear of bodily sensations, depression, interpretation of symptoms, frequency of chest pain and impact of chest pain symptoms were collected at baseline, post-treatment and at 3-month follow-up. Semi-structured interviews employing a phenomenological hermeneutic approach assessed the participants’ experience of the intervention. Quantitative results showed clear improvements in several measures both at end of treatment and at 3-month follow-up. The retention rate was 100% and client satisfaction was high. The intervention was feasible to implement in a cardiac setting. This setting made it easier for patients to accept a psychological approach. Qualitative interviews revealed that the participants felt respected and taken care of, and they obtained a better understanding of their chest pain and how to cope with it. This pilot study yielded promising results regarding feasibility, clinical effect and patient satisfaction from a brief I-CBT intervention for NCCP in a cardiac setting. These results indicate that a randomized controlled trial with a larger sample size is warranted. Key learning aims (1) Feasibility of internet-assisted cognitive behavioural therapy (I-CBT) for non-cardiac chest pain (NCCP). (2) How NCCP patients experience I-CBT. (3) Possible effects of I-CBT. (4) How I-CBT can be delivered at the Cardiac Department.

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