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.

scholarly journals Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools

Autism ◽  
2020 ◽  
Vol 24 (4) ◽  
pp. 867-883 ◽  
Author(s):  
Sebastian B Gaigg ◽  
Paul E Flaxman ◽  
Gracie McLaven ◽  
Ritika Shah ◽  
Dermot M Bowler ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Cost Effective ◽  
Well Being ◽  
Behaviour Therapy ◽  
Self Help ◽  
Online Tools ◽  
Cognitive Behaviour ◽  
Autistic Adults

Anxiety in autism is an important treatment target because of its consequences for quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can ameliorate anxiety in autism but cost-effective delivery remains a challenge. This pilot randomised controlled trial examined whether online cognitive behaviour therapy and mindfulness-based therapy self-help programmes could help reduce anxiety in 54 autistic adults who were randomly allocated to either an online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme or a waitlist control group (n = 19). Primary outcome measures of anxiety, secondary outcome measures of broader well-being and potential process of change variables were collected at baseline, after programme completion, and then 3 and 6 months post-completion. Baseline data confirmed that intolerance of uncertainty and emotional acceptance accounted for up to 61% of self-reported anxiety across all participants. The 23 participants who were retained in the active conditions (14 mindfulness-based therapies, 9 cognitive behaviour therapies) showed significant decreases in anxiety that were maintained over 3, and to some extent also 6 months. Overall, results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools may provide a cost-effective method for delivering mental health support to those autistic adults who can engage effectively with online support tools. Lay abstract Anxiety in autism is an important target for psychological therapies because it is very common and because it significantly impacts upon quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can help autistic individuals learn to manage feelings of anxiety but access to such therapies remains problematic. In the current pilot study, we examined whether existing online cognitive behaviour therapy and mindfulness-based therapy self-help tools can help reduce anxiety in autistic adults. Specifically, 35 autistic adults were asked to try either an existing online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme while a further 19 autistic adults served as a waitlist comparison group. A first important finding was that 23 of the 35 (66%) participants who tried the online tools completed them, suggesting that such tools are, in principle, acceptable to many autistic adults. In addition, adults in the cognitive behaviour therapy and mindfulness-based therapy conditions reported significant decreases in anxiety over 3 and to some extent also 6 months that were less apparent in the waitlist group of participants. On broader measures of mental health and well-being, the benefits of the online tools were less apparent. Overall, the results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools should be explored further as a means of providing cost-effective mental health support to at least those autistic individuals who can engage effectively with such online tools.

Therapy Contamination as a Measure of Therapist Treatment Adherence in a Trial of Cognitive Behaviour Therapy versus Befriending for Psychosis

2013 ◽  
Vol 43 (3) ◽  
pp. 314-327 ◽  
Author(s):  
Sarah Bendall ◽  
Kelly Allott ◽  
Martina Jovev ◽  
Marie-Josee Marois ◽  
Eoin J. Killackey ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
The Other ◽  
First Episode ◽  
Behaviour Therapy ◽  
Fine Grained ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Therapy Sessions

Background: High quality randomized controlled trials (RCT) of psychotherapeutic interventions should ensure that the therapy being tested is what is actually delivered. However, contamination of one therapy into the other, a critical component of treatment adherence, is seldom measured in psychotherapy trials of psychosis. Aims: The aim of the study was to determine whether a purpose-designed measure, the ACE Treatment Integrity Measure (ATIM) could detect therapy contaminations within a controlled trial of cognitive behavioural therapy (CBT) versus Befriending for first-episode psychosis and to compare the ATIM to a more traditional adherence measure, the Cognitive Therapy Scale (CTS). Method: Therapy sessions were audio-recorded and at least one therapy session from 53 of the 62 participants in the RCT was rated by an independent rater using the CTS and ATIM. Results: Ninety-nine therapy sessions were rated. All Befriending sessions and all but three CBT sessions were correctly identified. The ATIM showed that 29 of the 99 (29%) sessions were contaminated by techniques from the other therapy. Within the CBT sessions, 19 of the 51 sessions (37%) were contaminated by one or more Befriending techniques. Of the Befriending sessions, 10 of 48 (21%) were contaminated by ACE techniques. The mean CTS score was higher in the CBT than the Befriending group. Conclusions: The ATIM was able to detect contaminations and revealed more meaningful, fine-grained analysis of what therapy techniques were being delivered and what contaminations occurred. The study highlights the benefit of employing purpose-designed measures that include contamination when assessing treatment adherence.

Cognitive behaviour therapy and supportive therapy for bipolar disorders: relapse rates for treatment period and 2-year follow-up

2011 ◽  
Vol 42 (7) ◽  
pp. 1429-1439 ◽  
Author(s):  
T. D. Meyer ◽  
M. Hautzinger
Keyword(s):  
Survival Time ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Supportive Therapy ◽  
Psychosocial Treatment ◽  
Control Group ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Therapy Sessions ◽  
Relapse Rates

BackgroundThe efficacy of adjunctive psychosocial interventions such as cognitive behaviour therapy (CBT) for bipolar disorder (BD) has been demonstrated in several uncontrolled and controlled studies. However, these studies compared CBT to either a waiting list control group, brief psycho-education or treatment as usual (TAU). Our primary aim was to determine whether CBT is superior to supportive therapy (ST) of equal intensity and frequency in preventing relapse and improving outcome at post-treatment. A secondary aim was to look at predictors of survival time.MethodWe conducted a randomized controlled trial (RCT) at the Department of Psychology, University of Tübingen, Germany (n=76 patients with BD). Both CBT and ST consisted of 20 sessions over 9 months. Patients were followed up for a further 24 months.ResultsAlthough changes over time were observed in some variables, they were not differentially associated with CBT or ST. CBT showed a non-significant trend for preventing any affective, specifically depressive episode during the time of therapy. Kaplan–Meier survival analyses revealed that 64.5% of patients experienced a relapse during the 33 months. The number of prior episodes, the number of therapy sessions and the type of BD predicted survival time.ConclusionsNo differences in relapse rates between treatment conditions were observed, suggesting that certain shared characteristics (e.g. information, systematic mood monitoring) might explain the effects of psychosocial treatment for BD. Our results also suggest that a higher number of prior episodes, a lower number of therapy sessions and a diagnosis of bipolar II disorder are associated with a shorter time before relapse.

scholarly journals The feasibility of low-intensity psychological therapy for depression co-occurring with autism in adults: The Autism Depression Trial (ADEPT) – a pilot randomised controlled trial

Autism ◽  
2019 ◽  
Vol 24 (6) ◽  
pp. 1360-1372 ◽  
Author(s):  
Ailsa Russell ◽  
Daisy M Gaunt ◽  
Kate Cooper ◽  
Stephen Barton ◽  
Jeremy Horwood ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Behaviour Therapy ◽  
Treatment As Usual ◽  
Pilot Randomised Controlled Trial ◽  
Low Intensity ◽  
Self Help ◽  
Cognitive Behaviour ◽  
Randomised Controlled

Low-intensity cognitive behaviour therapy including behavioural activation is an evidence-based treatment for depression, a condition frequently co-occurring with autism. The feasibility of adapting low-intensity cognitive behaviour therapy for depression to meet the needs of autistic adults via a randomised controlled trial was investigated. The adapted intervention (guided self-help) comprised materials for nine individual sessions with a low-intensity psychological therapist. Autistic adults (n = 70) with depression (Patient Health Questionnaire-9 score ⩾10) recruited from National Health Service adult autism services and research cohorts were randomly allocated to guided self-help or treatment as usual. Outcomes at 10-, 16- and 24-weeks post-randomisation were blind to treatment group. Rates of retention in the study differed by treatment group with more participants attending follow-up in the guided self-help group than treatment as usual. The adapted intervention was well-received, 86% (n = 30/35) of participants attended the pre-defined ‘dose’ of five sessions of treatment and 71% (25/35) attended all treatment sessions. The findings of this pilot randomised controlled trial indicate that low-intensity cognitive behaviour therapy informed by behavioural activation can be successfully adapted to meet the needs of autistic people. Evaluation of the effectiveness of this intervention in a full scale randomised controlled trial is now warranted.

Do people with schizophrenia display theory of mind deficits in clinical interactions?

2004 ◽  
Vol 34 (3) ◽  
pp. 401-412 ◽  
Author(s):  
R. McCABE ◽  
I. LEUDAR ◽  
C. ANTAKI
Keyword(s):  
Theory Of Mind ◽  
Mental Health Professionals ◽  
Negative Symptoms ◽  
Experimental Studies ◽  
Chronic Schizophrenia ◽  
Mental States ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Clinical Interactions ◽  
Therapy Sessions

Background. Having a ‘theory of mind’ (ToM) means that one appreciates one's own and others' mental states, and that this appreciation guides interactions with others. It has been proposed that ToM is impaired in schizophrenia and experimental studies show that patients with schizophrenia have problems with ToM, particularly during acute episodes. The model predicts that communicative problems will result from ToM deficits.Method. We analysed 35 encounters (>80 h of recordings) between mental health professionals and people with chronic schizophrenia (out-patient consultations and cognitive behaviour therapy sessions) using conversation analysis in order to identify how the participants used or failed to use ToM relevant skills in social interaction.Results. Schizophrenics with ongoing positive and negative symptoms appropriately reported first and second order mental states of others and designed their contributions to conversations on the basis of what they thought their communicative partners knew and intended. Patients recognized that others do not share their delusions and attempted to reconcile others' beliefs with their own but problems arose when they try to warrant their delusional claims. They did not make the justification for their claim understandable for their interlocutor. Nevertheless, they did not fail to recognize that the justification for their claim is unconvincing. However, the ensuing disagreement did not lead them to modify their beliefs.Conclusions. Individuals with schizophrenia demonstrated intact ToM skills in conversational interactions. Psychotic beliefs persisted despite the realization they are not shared but not because patients cannot reflect on them and compare them with what others believe.

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