scholarly journals Changes in care costs associated with cognitive behavioural therapy for psychosis delivered in routine clinical practice

2019 ◽  
Vol 29 (5) ◽  
pp. 605-610 ◽  
Author(s):  
Bryony Sheaves ◽  
Emmanuelle Peters ◽  
Daniel Stahl ◽  
Louise Johns
Keyword(s):  
Clinical Practice ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Routine Clinical Practice ◽  
Cognitive Behavioural ◽  
Care Costs

scholarly journals If formulation is the heart of cognitive behavioural therapy, does this heart rule the head of CBT therapists?

2013 ◽  
Vol 6 ◽  
Author(s):  
Michael Zivor ◽  
Paul M. Salkovskis ◽  
Victoria B. Oldfield
Keyword(s):  
Clinical Practice ◽  
Cognitive Behavioural Therapy ◽  
Reference Group ◽  
Behavioural Therapy ◽  
Routine Clinical Practice ◽  
Training And Supervision ◽  
Cognitive Behavioural ◽  
Empirical Level ◽  
Group A ◽  
Level Of Training

AbstractCognitive behavioural therapy (CBT) is an empirically grounded approach which typically relies on formulation to guide the shape and course of therapy. Cognitive formulation is widely advocated but poorly understood at an empirical level. This study aimed to characterize how clinicians understand the structure and uses of formulation and how they report on using it in their clinical practice relative to an expert reference group. A total of 124 clinicians in routine clinical practice completed a questionnaire, which assessed their clinical use and understanding of formulation. For some aspects of the questionnaire a comparison with a reference group, 15 highly specialist CBT therapists, was used. High levels of self-rated expertise were noted and at levels comparable to that of the highly specialist group. Participants rated themselves as less capable in terms of their formulation skills relative to their self-rating in CBT overall. Formulation is typically rated as important by those with some professional commitment to CBT. There may be some gaps in the way formulation is applied in clinical practice that should be addressed at the level of training and supervision.

scholarly journals Assessing competence in cognitive-behavioural therapy

2008 ◽  
Vol 193 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Andrew J. A. Keen ◽  
Mark H. Freeston
Keyword(s):  
Clinical Practice ◽  
Case Studies ◽  
Cognitive Behavioural Therapy ◽  
Clinical Work ◽  
Behavioural Therapy ◽  
High Stakes ◽  
Cognitive Behavioural ◽  
Reliable Assessment

BackgroundPostgraduate courses on cognitive-behavioural therapy (CBT) assess various competencies using essays, case studies and audiotapes or videotapes of clinical workAimsTo evaluate how reliably a well-established postgraduate course assesses CBT competenciesMethodData were collected on two cohorts of trainees (n=52). Two examiners marked trainees on: (a) two videotapes of clinical practice; (b) two case studies; and (c) three essaysResultsEssay examinations were more reliable than case studies, which in turn were more reliable than videotaped assessments. The reliability of the latter two assessments was considerably lower than that commonly expected of high-stakes examinations. To assess reliably standard CBT competencies, postgraduate courses would need to examine about 5 essays, 12 case studies and 19 videotapesConclusionsReliable assessment of standard competencies is complex and resource intensive. There would need to be a marked increase in the number of samples of clinical work assessed to be able to make reliable judgements about proficiency

scholarly journals Digital cognitive behavioural therapy for insomnia and primary care costs in England: an interrupted time series analysis

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0146
Author(s):  
Chris Sampson ◽  
Eleanor Bell ◽  
Amanda Cole ◽  
Christopher B Miller ◽  
Tracey Marriott ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Cognitive Behavioural Therapy ◽  
Interrupted Time Series ◽  
Behavioural Therapy ◽  
Interrupted Time Series Analysis ◽  
Cognitive Behavioural ◽  
Before And After ◽  
Quasi Experimental ◽  
Care Costs

BackgroundSleepio is an automated digital programme that delivers cognitive behavioural therapy for insomnia (dCBT-I). Sleepio has been proven effective in improving sleep difficulties. However, evidence for the possible impact of Sleepio use on health care costs in the United Kingdom has not previously been developed.AimWe sought to identify the effect of a population-wide rollout of Sleepio in terms of primary care costs in the National Health Service (NHS) in England.Design & settingThe study was conducted in the Thames Valley region of England, where access to Sleepio was made freely available to all residents between October 2018 and January 2020. The study relies on a quasi-experimental design, using an interrupted time series to compare the trend in primary care costs before and after the rollout of Sleepio.MethodWe use primary care data for people with relevant characteristics from nine general practices in Buckinghamshire. Primary care costs include general practice contacts and prescriptions. Segmented regression analysis was used to estimate primary and secondary outcomes.ResultsFor the 10,704 patients included in our sample, the total saving over the 65-week follow-up period was £71,027. This corresponds to £6.64 per person in our sample or around £70.44 per Sleepio user. Secondary analyses suggest that savings may be driven primarily by reductions in prescribing.ConclusionSleepio rollout reduced primary care costs. National adoption of Sleepio may reduce primary care costs by £20 million in the first year. The expected impact on primary care costs in any particular setting will depend on the uptake of Sleepio.

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.

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