scholarly journals The Infinity Formulation: how transdiagnostic behaviours and endeavours for behavioural change serve to maintain co-morbid mental health presentations

2021 ◽  
Vol 14 ◽  
Author(s):  
Alison Bennetts
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Cognitive Biases ◽  
Behavioural Change ◽  
Psychological Theory ◽  
Primary Treatment ◽  
Future Research ◽  
List Type ◽  
Cognitive Behavioural ◽  
Co Morbidity

Abstract Treatment recommendations for mental health are often founded on diagnosis-specific models; however, there are high rates of co-morbidity of mental health presentations and growing recognition of the presence of ‘transdiagnostic processes’ (cognitive, emotional or behavioural features) seen across a range of mental health presentations. This model proposes a novel conceptualisation of how transdiagnostic behaviours may maintain co-morbid mental health presentations by acting as a trigger event for the cognitive biases specific to each presentation. Drawing on existing evidence, psychological theory and the author’s clinical experience, the model organises complex presentations in a theory-driven yet accessible manner for use in clinical practice. The model offers both theoretical and clinical implications for the treatment of mental health presentations using cognitive behavioural approaches, positing that transdiagnostic behaviours be the primary treatment target in co-morbid presentations. Key learning aims (1) To understand the strengths and limitations of existing transdiagnostic CBT formulation models. (2) To learn about a novel, transdiagnostic and behaviourally focused formulation for use in clinical practice. (3) To understand how to use the tool in clinical practice and future research.

scholarly journals Stress and burnout in Improving Access to Psychological Therapies (IAPT) trainees: a systematic review

2021 ◽  
Vol 14 ◽  
Author(s):  
Joel Owen ◽  
Louise Crouch-Read ◽  
Matthew Smith ◽  
Paul Fisher
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Future Research ◽  
List Type ◽  
Dual Roles ◽  
Eligibility Criteria ◽  
Psychological Therapies ◽  
Current State

Abstract For more than a decade, Improving Access to Psychological Therapies (IAPT) has been training a new workforce of psychological therapists. Despite evidence of stress and burnout both in trainee mental health professionals, and qualified IAPT clinicians, little is known about these topics in IAPT trainees. Consequently, this systematic review sought to establish the current state of the literature regarding stress and burnout in IAPT trainees. Electronic databases were searched to identify all published and available unpublished work relating to the topic. On the basis of pre-established eligibility criteria, eight studies (including six unpublished doctoral theses) were identified and assessed for quality. This review identifies that research into the experience of IAPT trainees is under-developed. Existing evidence tentatively suggests that IAPT trainees may experience levels of stress and burnout that are higher than their qualified peers and among the higher end of healthcare professionals more generally. The experience of fulfilling dual roles as mental health professionals and university students concurrently appears to be a significant source of stress for IAPT trainees. More research regarding the levels and sources of stress and burnout in IAPT trainees is urgently needed to confirm and extend these findings. Recommendations for future research in the area are given. Key learning aims (1) To establish the current state of the literature regarding stress and burnout in IAPT trainees. (2) To raise practitioner, service and education-provider awareness regarding the levels and perceived sources of stress and burnout in IAPT trainees. (3) To make recommendations regarding future research on the topic.

The prevalence and co-morbidity of subthreshold psychiatric conditions

2004 ◽  
Vol 34 (4) ◽  
pp. 613-622 ◽  
Author(s):  
PETER M. LEWINSOHN ◽  
STEWART A. SHANKMAN ◽  
JEFFREY M. GAU ◽  
DANIEL N. KLEIN
Keyword(s):  
Clinical Practice ◽  
Adolescent Depression ◽  
Internalizing Disorders ◽  
Externalizing Disorders ◽  
Diagnostic Interview ◽  
Future Research ◽  
Co Morbidity ◽  
Psychiatric Conditions ◽  
Dsm Iv ◽  
Males And Females

Background. In previous studies of subthreshold conditions, co-morbidity has been largely ignored. The purpose was to examine rates of co-morbidity among subthreshold disorders and between subthreshold and full-syndrome disorders for the major non-psychotic classes of disorders from DSM-IV.Method. Participants came from the Oregon Adolescent Depression Project (mean age=16·6 years; females=52·1%). On the basis of a diagnostic interview (K-SADS), participants were assigned to eight subthreshold disorders (MDD, bipolar, eating, anxiety, alcohol use, substance use, conduct, ADHD).Results. Of the 1704 adolescents in the analyses, 52·5% had at least one subthreshood disorder. Of those, 40·0% had also experienced a co-morbid subthreshold condition, and 29·9% of those had a second co-morbid subthreshold condition. Of those with a subthreshold, 36·4% also had a full syndrome. The subthreshold forms of externalizing disorders were co-morbid with each other. As expected, subthreshold anxiety was co-morbid with subthreshold MDD but subthreshold anxiety was also co-morbid with subthreshold alcohol, conduct, and ADHD. The pattern of co-morbidities was nearly identical for males and females.Conclusions. The hypotheses that externalizing disorders would be co-morbid with other externalizing disorders and that internalizing disorders would be co-morbid with other internalizing disorders was partially supported. Co-morbidities between subthreshold disorders and between subthreshold disorders and full syndrome should impact future research and clinical practice. The assessment of subthreshold disorders needs to include the assessment of other subthreshold and full-syndrome conditions.

A test of the interpersonal-psychological theory of suicidal behaviour in a sample of mental health outpatients

2018 ◽  
Vol 49 (3) ◽  
pp. 430-445 ◽  
Author(s):  
Sarojini Naidoo ◽  
Steven Collings
Keyword(s):  
Mental Health ◽  
Suicidal Behaviour ◽  
Suicide Ideation ◽  
Psychological Theory ◽  
Interactive Effects ◽  
Future Research ◽  
Cross Sectional ◽  
Theoretical Predictions ◽  
Cross Sectional Design ◽  
Interpersonal Psychological Theory

Suicidality is a growing mental health problem, with statistics for South Africa being in line with global estimates. There has, however, been relatively little empirical advancement in the conceptualization of suicidal behaviour in recent years. Joiner’s interpersonal-psychological theory of suicidal behaviour is a relatively new theory that appears to hold promise for advancing our understanding of the mechanisms that underlie suicidal behaviour. The theory proposes that people die by suicide because they want to and because they can. This study sought to test two key hypotheses of the interpersonal-psychological theory of suicidal behaviour using a cross-sectional design and a sample of 239 mental health outpatients. Consistent with theoretical predictions, levels of suicidal ideation were significantly predicted by the interactive effects of high levels of thwarted belongingness and perceived burdensomeness in the presence of high levels of hopelessness in relation to both of these distressing states; with estimates of risk for suicide being most strongly predicted by the interactive effects of suicide ideation and an acquired capability for suicide. These findings are discussed in terms of their implications for theory, practice, and future research.

scholarly journals Describing the recovery experiences of not criminally responsible clients living in the community

2021 ◽  
Author(s):  
Irene Boldt
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Critical Role ◽  
Future Research ◽  
Forensic Mental Health ◽  
Process Of Change ◽  
Recovery Experiences ◽  
Not Criminally Responsible ◽  
Qualitative Descriptive

This study describes the recovery experiences of persons who have been found not criminally responsible on account of a mental disorder (NCRMD). A qualitative descriptive methodology was used to elicit the recovery experiences of five participants. The overarching theme that arose from the data was ‘Experiencing and understanding recovery in the forensic mental health system (FMHS) as a dynamic process of change,’ and the major themes that emerged out of the overarching theme are: ‘Recovering in the FMHS,’ ‘the Critical Role of Medication,’ ‘the Significance of Relationships,’ ‘the Importance of Helping Yourself,’ and ‘Navigating Challenges.’ The results of this inquiry reveal that the participants’ experiences of recovery are greatly influenced by their involvement in the FMHS. This study offers a preliminary understanding of how recovery is experienced by NCRMD clients who reside in the community and suggests implications for clinical practice and education, as well as future research and theory.

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.

Explaining Differences in Mental Health Between Married and Cohabiting Individuals

2005 ◽  
Vol 68 (3) ◽  
pp. 239-257 ◽  
Author(s):  
Kristen Marcussen
Keyword(s):  
Mental Health ◽  
Alcohol Use ◽  
Marital Status ◽  
Relationship Quality ◽  
Psychological Theory ◽  
Coping Resources ◽  
Future Research ◽  
Social Psychological ◽  
Health Differences ◽  
Status Differences

Research on the relationship between cohabitation and mental health tends to ignore social psychological factors that help explain mental health differences between the married and the unmarried, including coping resources and perceived relationship quality. In this paper I draw on social psychological theory and research to clarify differences in depression and alcohol use between married and cohabiting individuals. Using data from the National Survey of Families and Households, I examine the independent and combined influences of socioeconomic status, coping resources, and relationship quality to account for marital status differences in distress. I find that marital status differences in coping resources and relationship quality help explain the gap in depression, but not in alcohol use, between married and cohabiting individuals. I also find that social selection is not responsible for marital status differences in distress. The implications of these findings for future research on cohabitors' mental health are discussed.

scholarly journals A Systematic Review of Unpublished and Non-Refereed Music Therapy Mental Health Papers Found via Google Scholar

2018 ◽  
Vol 18 (2) ◽  
Author(s):  
Melody R Peterson ◽  
Michael J Silverman
Keyword(s):  
Mental Health ◽  
United States ◽  
Systematic Review ◽  
Clinical Practice ◽  
Music Therapy ◽  
The United States ◽  
Google Scholar ◽  
Future Research ◽  
Mental Health Literature ◽  
Doctoral Dissertations

As Google Scholar searches yield unpublished papers, it may inadvertently impact the perception of the music therapy literature for clinicians, researchers, and service users. Therefore, the purpose of this systematic review was to identify and analyze the current literature comprised of unpublished and non-refereed papers regarding music therapy and mental health from January 2000 to September 2017 located via Google Scholar. After establishing inclusion and exclusion criteria, papers were identified using a variety of combinations of music therapy and mental health keywords. Twenty-one papers met inclusion criteria. Sixteen papers were master’s theses and five were doctoral dissertations. Almost half of the papers (n = 8) involved adolescents with mental health diagnoses. Although not all papers contained data, more papers contained qualitative data (n = 10) than quantitative data (n = 3). The unpublished music therapy and mental health literature may represent a valuable resource for guiding clinical practice and research. As the majority of authors were affiliated with universities outside the United States, perhaps there is greater interest in mental health outside the United States. It is concerning that many identified papers required additional login credentials. Implications for clinical practice, limitations, and suggestions for future research are provided.

Comparison of Diagnostic Guidelines for Juvenile Bipolar Disorder

2007 ◽  
Vol 41 (6) ◽  
pp. 479-484 ◽  
Author(s):  
Catherine Cahill ◽  
Tanya Hanstock ◽  
Rajeev Jairam ◽  
Philip Hazell ◽  
Garry Walter ◽  
...  
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Clinical Practice ◽  
Clinical Excellence ◽  
Systematic Search ◽  
Future Research ◽  
Child Psychiatric ◽  
Key Features ◽  
Paediatric Bipolar Disorder

The purpose of the present paper was to compare currently available diagnostic guidelines for juvenile bipolar disorder with respect to utility in research and clinical practice. A systematic search of psychiatric, medical and psychological databases was conducted using the terms ‘juvenile bipolar disorder’, ‘paediatric bipolar disorder’ and ‘guidelines’. Three main sets of guidelines issued by the National Institute of Health and Clinical Excellence (UK), The National Institute of Mental Health (USA) and Child Psychiatric Workshop (USA) were found. There were key differences in the recommendations made by each regarding the diagnosis and symptomatic presentation of juvenile bipolar disorder. Although the diagnosis of juvenile bipolar disorder is gaining increased recognition, its definition remains controversial. It is recommended that clinicians and researchers need to develop diagnostic guidelines that have clinical salience and can be used for future research by incorporating key features of those that are currently available.

A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety

2019 ◽  
Vol 12 ◽  
Author(s):  
S. Milne ◽  
C. Lomax ◽  
M. H. Freeston
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Biases ◽  
Cognitive Model ◽  
Intolerance Of Uncertainty ◽  
Future Research ◽  
Threat Appraisal ◽  
List Type ◽  
Relationship Of ◽  
Conceptual Foundations

Abstract The development and conceptual relationship of the constructs of threat appraisal (TA) and intolerance of uncertainty (IU) are explored in the context of anxiety disorders. A narrative review tracking the development of these constructs and their relationship is undertaken. There is some evidence to suggest that the interaction between the components of threat appraisal (probability × cost) may partially account for or provide a theoretical framework which explains presenting levels of anxiety. Furthermore, research suggested that IU is a construct which contributes to a broad range of anxiety disorders. It was concluded that distinctive cognitive biases linked with IU – such as interpreting ambiguous and uncertain (both positive and negative) information as highly concerning – suggests that IU is interpreted negatively independent of threat appraisal. These findings mean a number of issues remain unclear, including whether IU in anxiety-provoking situations is sufficient in itself – independent of threat appraisal – in eliciting high levels of anxiety. Additionally, it is unclear whether threat appraisal and IU act as independent constructs, or more in an interactive manner in anxiety. To achieve further clarity on these issues, methodological recommendations for future research are made. Key learning aims (1) To understand the conceptual foundations of TA and IU in the cognitive model of anxiety. (2) To understand the empirical evidence supporting the role of both TA and IU in anxiety. (3) To appreciate the potential relationship between these concepts in anxiety.

scholarly journals Cognitive behavioural therapy for worry in young individuals with at-risk mental states: a preliminary investigation

2019 ◽  
Vol 12 ◽  
Author(s):  
Andrea Pozza ◽  
Sandro Domenichetti ◽  
Davide Dèttore
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Psychiatric Care ◽  
Mental States ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Future Research ◽  
Cognitive Behavioural ◽  
At Risk Mental States

Abstract Cognitive behavioural therapy (CBT) is a first-line strategy in reducing or delaying risk of transition to psychosis among young individuals with at-risk mental states (ARMS). However, there is little knowledge about its effects on other outcomes associated with ARMS. No study on CBT for ARMS has assessed worry, an important process associated with this condition. The present study investigated changes in worry at immediate post-treatment and 14-month follow-up after CBT for young individuals with ARMS seeking psychiatric care in mental health services. Thirty-seven young individuals (mean age = 26 years, SD = 6.07; 22.20% female) seeking psychiatric care in mental health services and classified as reporting ARMS through the Comprehensive Assessment of At-Risk Mental States were included. The Positive And Negative Syndrome Scales (PANSS) and Penn State Worry Questionnaire (PSWQ) were administered at baseline, post-treatment, and follow-up. CBT consisted of 30 weekly individual 1-hour sessions based on a validated CBT for ARMS manual enriched with components targeting worry [psychoeducation, problem-solving, (meta)cognitive restructuring, behavioural experiments]. Seven participants (18.91%) at follow-up had cumulatively made transition to psychosis. Repeated measures ANOVA with post-hoc pairwise comparisons showed significant changes in PSWQ scores from baseline to post-treatment and from baseline to follow-up; PSWQ scores remained stable from post-treatment to follow-up. This is the first study investigating changes in worry after CBT for ARMS, which appears to be a promising strategy also for this outcome. Future research with a larger sample size and control group may determine whether changes in worry are also associated with reduced transition risk. Key learning aims (1) To understand CBT evidence and procedures for young individuals with ARMS. (2) To reflect on the current limitations in the literature on CBT for ARMS. (3) To understand the importance and clinical implications of assessing worry in ARMS. (4) To focus on changes in worry as an outcome after CBT for ARMS. (5) To reflect on future research directions on the role of worry in CBT for ARMS.

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