scholarly journals P053 Management of insomnia by Australian psychologists

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A38-A38
Author(s):  
J Haycock ◽  
E Hoon ◽  
A Sweetman ◽  
L Lack ◽  
N Lovato
Keyword(s):  
Health Care Professionals ◽  
Well Being ◽  
Behavioural Therapy ◽  
Depression And Anxiety ◽  
Further Training ◽  
Structured Interviews ◽  
First Line ◽  
Cognitive Behavioural ◽  
Insomnia Treatment

Abstract Introduction Insomnia is the most common sleep disorder, 10–30% of adults have regular difficulties falling and/or staying asleep that cause significant daytime impairments. General Practitioner (GP) clinical guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as the first-line treatment rather than medications. However, most GPs do not have the time or training to administer CBTi, and consequently, many patients are prescribed sedative-hypnotic medicines. Psychologists have training in CBT and may be well placed to deliver behavioural therapy for insomnia. However, the amount of sleep-specific training, and knowledge of CBTi among Australian psychologists remains unknown. Identifying key barriers and enablers in the management of insomnia within psychology provides a first step in engaging with psychologists about the delivery of evidence-based insomnia treatment. Methods This qualitative study used a pragmatic inductive approach. Semi-structured interviews were conducted with 26 Australian psychologists. Interviews included case study scenarios to provide an in-depth exploration of psychologists’ knowledge and skills in the management of insomnia, and attitudes towards further training in CBTi. Interview transcripts were analysed using thematic analysis to identify themes. Results Preliminary themes identified in the data include; psychologists believe sleep is important for general well-being, insomnia is usually seen as secondary to other co-morbid disorders such as depression and anxiety that are the focus of treatment, most psychologists surveyed lack training and knowledge in CBTi. Discussion Most Australian psychologists are not well prepared to manage insomnia effectively with CBTi. Along with other primary health care professionals, psychologists need training in the management of insomnia.

scholarly journals Emotional Well Being with Daoism and Chinese Medicine

2019 ◽  
Vol 4 (7) ◽  
Keyword(s):  
Clinical Practice ◽  
Chinese Medicine ◽  
Cognitive Behavioural Therapy ◽  
Well Being ◽  
Behavioural Therapy ◽  
Depression And Anxiety ◽  
Emotional Pain ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Medicine History

What has become apparent in clinical practice is the amount of people who are struggling with emotional pain and lack of direction, contentment or purpose in their life. Taoism, Buddhism which was part of Chinese Medicine history have developed tools, concepts and beliefs in the understanding of self and emotional well-being, which can give people a more compassionate view with the complexities of life for themselves and others. What is alarming is the amount of people on medication for depression and anxiety, which has increased considerably over the last few years. Cognitive Behavioural Therapy (CBT), self- help books and mindful meditation incorporate principles of Daoism and Buddhism in there techniques and theories.

scholarly journals Θετικές παρεμβάσεις στη Γνωσιακή-Συμπεριφορική Ψυχοθεραπεία

2020 ◽  
Vol 19 (3) ◽  
pp. 297
Author(s):  
Πασχαλία Μυτσκίδου ◽  
Βλοντάκης Ιωάννης
Keyword(s):  
Anxiety Disorders ◽  
Well Being ◽  
Behavioural Therapy ◽  
Depression And Anxiety ◽  
Cognitive Behavioural ◽  
Preliminary Validation ◽  
Life Therapy ◽  
Hope Therapy

Cognitive-Behavioural Therapy (CBT) is a well-established, evidence-based psychotherapy. Although it is the therapy of choice for both depression and anxiety disorders, many patients remain symptomatic after termination of their treatment, while relapses are not uncommon in the long-term follow-ups. Over time, different techniques have beenproposed in order to enrich cognitive-behavioural psychotherapy and increase its effectiveness. From the field of Positive Psychology, three psychotherapeutic strategies, Well-Being Therapy, Hope Therapy and Quality of Life Therapy, have been applied as additional ingredients in cognitive-behavioral packages. They are applied either as relapse prevention or as therapeutic strategies, in patients with affective and anxiety disorders who failed to respond to standard psychotherapeutic treatments. This paper presents the clinical and conceptual framework, as well as the structure and application of each strategy. Their potential clinical usefulness and results of preliminary validation studies are presented. Finally, their contribution in enriching the effectiveness of CBT is discussed.

scholarly journals Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047212
Author(s):  
Anke de Haan ◽  
Caitlin Hitchcock ◽  
Richard Meiser-Stedman ◽  
Markus A Landolt ◽  
Isla Kuhn ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Risk Of Bias ◽  
Randomised Trials ◽  
First Line ◽  
Cognitive Behavioural ◽  
Individual Participant ◽  
Behavioural Therapies ◽  
First Line Treatment

IntroductionTrauma-focused cognitive behavioural therapies are the first-line treatment for posttraumatic stress disorder (PTSD) in children and adolescents. Nevertheless, open questions remain with respect to efficacy: why does this first-line treatment not work for everyone? For whom does it work best? Individual clinical trials often do not provide sufficient statistical power to examine and substantiate moderating factors. To overcome the issue of limited power, an individual participant data meta-analysis of randomised trials evaluating forms of trauma-focused cognitive behavioural therapy in children and adolescents aged 6–18 years will be conducted.Methods and analysisWe will update the National Institute for Health and Care Excellence guideline literature search from 2018 with an electronic search in the databases PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials and CINAHL with the terms (trauma* OR stress*) AND (cognitive therap* OR psychotherap*) AND (trial* OR review*). Electronic searches will be supplemented by a comprehensive grey literature search in archives and trial registries. Only randomised trials that used any manualised psychological treatment—that is a trauma-focused cognitive behavioural therapy for children and adolescents—will be included. The primary outcome variable will be child-reported posttraumatic stress symptoms (PTSS) post-treatment. Proxy-reports (teacher, parent and caregiver) will be analysed separately. Secondary outcomes will include follow-up assessments of PTSS, PTSD diagnosis and symptoms of comorbid disorders such as depression, anxiety-related and externalising problems. Random-effects models applying restricted maximum likelihood estimation will be used for all analyses. We will use the Revised Cochrane Risk of Bias tool to measure risk of bias.Ethics and disseminationContributing study authors need to have permission to share anonymised data. Contributing studies will be required to remove patient identifiers before providing their data. Results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration numberCRD42019151954.

To Jurassic Park via Australia: A case study showing how dramatherapy enabled the creation and maintenance of embodied metaphors to support recovery from early psychosis

Dramatherapy ◽  
2020 ◽  
Vol 41 (1) ◽  
pp. 37-49
Author(s):  
Louise Combes ◽  
Lauren A Bradley
Keyword(s):  
Alcohol Misuse ◽  
Behavioural Therapy ◽  
Drama Therapy ◽  
Supported Accommodation ◽  
Life Challenges ◽  
Cognitive Behavioural ◽  
Communication Difficulties ◽  
Residential Rehabilitation ◽  
Early Intervention In Psychosis

This case study shows how Dramatherapy can engage clients with communication difficulties, which exclude them from standard mental health pathways in early intervention in psychosis services. Deliberately prioritising the client’s newfound modes of expression to shape the narrative within, it is evident Dramatherapy processes; embodiment, projection and role enabled this client to create and then inhabit his own playful metaphors. These metaphors continued to facilitate every-day life challenges. During his Dramatherapy relationship, the client within this case study transitioned from supported accommodation to his own property, progressed to residential rehabilitation for alcohol misuse and finally engaged in cognitive behavioural therapy. From feedback interviews we know he continued to create and use his own protective metaphors 10 months after drama therapy ended. He returned to education as part of his plan to seek appropriate employment and was discharged to his GP.

Library services enriching community engagement for dementia care: The Tales & Travels Program at a Canadian Public Library as a case study

2021 ◽  
pp. 096100062110651
Author(s):  
Jiamin Dai ◽  
Joan C. Bartlett ◽  
Karyn Moffatt
Keyword(s):  
Public Libraries ◽  
Public Library ◽  
Well Being ◽  
Dementia Care ◽  
Future Research ◽  
Library Services ◽  
Structured Interviews ◽  
Community Based ◽  
People With Dementia

Growing dementia-friendly library services are contributing to community-based dementia care. Emerging community programs in libraries and museums provide notable opportunities for promoting engagement and inclusivity, but these programs have yet to receive in-depth assessments and analyses to guide future research and practice. This paper presents a case study examining a social and storytelling program for people with dementia run by a Canadian public library. It investigates two research questions: How can public library programs contribute to community-based dementia care? And what are public libraries’ strengths and challenges in running programs for people with dementia? The study involves participant observations of the program and semi-structured interviews with people with dementia, caregivers, and program facilitators (librarians and Alzheimer Society coordinators). Through thematic analysis of fieldnotes and transcripts, the study reveals how this inclusive platform supports engagement, fosters relationships, helps caregivers, and reaches broader communities. This research further uncovers the librarians’ diversified roles as demonstrated through their collaboration with professionals, preparation and research, and facilitation of the sessions. This paper advances librarianship research on enriching community-based dementia care, including furthering inclusivity and engagement and extending accessible library services. By analyzing library programming for the dementia community and assessing its strengths and challenges, the paper highlights librarians’ awareness of the community’s evolving needs and their collaboration with other professionals. It offers practical insights on useful resources and emerging best practices that will hopefully inspire other initiatives in which information professionals can help improve the well-being of vulnerable populations.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals ‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Katherine Newman-Taylor
Keyword(s):  
Behavioural Therapy ◽  
Illustrative Case ◽  
Imagery Task ◽  
List Type ◽  
Short Term ◽  
Cognitive Behavioural ◽  
Imagery Rescripting ◽  
Illustrative Case Study ◽  
The Impact

Abstract People with psychosis do not have routine access to trauma-focused cognitive behavioural therapy (CBT) interventions such as imagery rescripting (IR), partly due to clinical caution. This case study describes the use of a simple imagery task designed to engender ‘felt security’, as a means of facilitating IR with a woman struggling with distressing memory intrusions, linked to her voices and paranoia. We assessed the impact of the felt security task, which was used before IR to enable Kip to engage in reprocessing of her trauma memories, and again after IR so that she would leave sessions feeling safe. The brief imagery task was effective in improving felt security before IR sessions. Felt security then reduced during IR, when distressing material was recalled and reprocessed, and increased again when the task was repeated. It is not yet clear whether trauma-focused interventions such as IR need to be routinely adapted for people with psychosis. In the event that individuals express concerns about IR, if the person’s formulation indicates that high levels of arousal may trigger an exacerbation of voices, paranoia or risk, or where clinicians are otherwise concerned about interventions likely to increase emotional arousal in the short term, the felt security task may facilitate safe and effective reprocessing of trauma memories. This in turn may increase access to trauma-focused CBT for people with psychosis. Key learning aims (1) To understand that people with psychosis need access to trauma-focused CBT. (2) To be familiar with a simple attachment-based imagery task designed to foster ‘felt security’. (3) To learn that this task may facilitate imagery rescripting in people with psychosis.

scholarly journals Nursing and no Drug for the Management of Insomnia Treatment

2019 ◽  
Vol 18 (2) ◽  
pp. 512-532 ◽  
Author(s):  
Raquel Baides Noriega ◽  
Sara Noriega Camporro ◽  
Alicia Maria Inclán Rodríguez
Keyword(s):  
Complementary Therapy ◽  
Pharmacological Interventions ◽  
First Line ◽  
Pharmacological Management ◽  
Cognitive Behavioural ◽  
Management Procedures ◽  
Hygiene Measures ◽  
Insomnia Treatment ◽  
And Training ◽  
Primary Care Nursing

Introducción: El insomnio es definido como la incapacidad para iniciar y/o mantener el sueño. Es el trastorno del sueño más frecuente y puede producir consecuencias para la salud en todas las dimensiones. Las medidas no farmacológicas han mostrado mejor efecto a largo plazo para el manejo del insomnio, por lo que el uso de fármacos debe restringirse como segunda línea de tratamiento.Metodología: Con objeto de conocer procedimientos no farmacológicos para el manejo del insomnio desde Enfermería de Atención Primaria, se realizó una revisión bibliográfica a través de fuentes primarias y secundarias. Resultados: Como primera línea de tratamiento destacan las terapias conductuales y cognitivo-conductuales asociadas a la educación para la salud y medidas de higiene de sueño. Según algunos estudios, nueve consultas de 30 minutos, con intervenciones no farmacológicas, reducirían el insomnio crónico con efectividad del 70 al 80%. Además existen terapias alternativas que asociadas como terapias complementarias pueden ayudar al manejo del insomnio con nivel de evidencia suficiente.Conclusiones: Las medidas no farmacológicas deben utilizarse como primera línea de tratamiento. Sin embargo, en nuestro país, apenas se prescriben y existe un alto consumo de fármacos destinados a solucionar este problema, con las consiguientes consecuencias para la salud que producen. Para poder abordar la situación se considera fundamental una mejora de los recursos humanos profesionales y formación al respecto. Introduction: Insomnia is defined as the inability to initiate or maintain sleep. It is the most common sleep disorder and can produced consequences for health in all aspect. Non-pharmacological measures have shown better effect in the long management of insomnia, so the use of drugs should be restricted as a second-line treatment.Methodology: In order to learn about non-pharmacological management procedures of insomnia from primary care nursing, we conducer a literature review through primary and secondary sources.Results: As first line treatment include therapies behavioural and cognitive-behavioural associated with education for health and the sleep hygiene measures. According to some studies, nine 30-minute, non-pharmacological interventions queries, reduce chronic insomnia with effectiveness of 70 to 80%. Also there are alternative therapies such as the use of valerian to associate as complementary therapy can help the Management of insomnia with good level of evidence.Conclusions: Non- pharmacological measures should be used as a first line of treatment. However in our country to penalties are prescribed and there is high consumption of drugs for this problem, with the resulting consequences for the health of tolerance and dependence producing the maintained consumption of these dugs. Addressing the situation is considered essential to an improvement of the professional human resources and training.

scholarly journals Treating Patients With Co-occurring Autism Spectrum Disorder and Substance Use Disorder: A Clinical Explorative Study

2019 ◽  
Vol 13 ◽  
pp. 117822181984329 ◽  
Author(s):  
Sissel Berge Helverschou ◽  
Anette Ræder Brunvold ◽  
Espen Ajo Arnevik
Keyword(s):  
Autism Spectrum Disorder ◽  
Substance Use ◽  
Well Being ◽  
Behavioural Therapy ◽  
Autism Spectrum ◽  
Group Supervision ◽  
Post Treatment ◽  
Spectrum Disorder ◽  
Outpatient Clinics ◽  
Cognitive Behavioural

Background: Substance use disorders (SUDs) have been assumed to be rare in individuals with autism spectrum disorder (ASD). Recent research suggests that the rates of SUD among individuals with ASD may be higher than assumed although reliable data on the prevalence of SUD in ASD are lacking. Typical interventions for SUD may be particularly unsuitable for people with ASD but research on intervention and therapy are limited. Methods: This study addresses ways of improving services for individuals with ASD and SUD by enhancing the competence of professionals in ordinary SUD outpatient clinics. Three therapists were given monthly ASD education and group supervision. The participants were ordinary referred patients who wanted to master their problems with alcohol or drugs. Four patients, all men diagnosed with ASD and intelligence quotient (IQ) ⩾ 70 completed the treatment. The participants were given cognitive behavioural therapy (CBT) modified for their ASD over a minimum of 10 sessions. The therapies lasted between 8 and 15 months. Standardised assessments were conducted pre- and post-treatment. Results: Post-treatment, 2 participants had ended their drug and alcohol abuse completely, 1 had reduced his abuse, and 1 still had a heavy abuse of alcohol. Physical well-being was the most prevalent reported positive aspect of drug or alcohol use, whereas the experience of being left out from social interaction was the most frequent negative aspects of intoxication. Conclusions: CBT may represent a promising treatment option for individuals with ASD and SUD. The results suggest that patients’ symptoms can be reduced by providing monthly ASD education and group supervision to therapists in ordinary SUD outpatient clinics. This group of patients need more sessions than other client groups, the therapy has to be adapted to ASD, ie, direct, individualised, and more extensive. Moreover, the patients need psychoeducation on ASD generally, social training, and support to organise several aspects of their lives and some patients need more support than can be provided in an outpatient clinic.

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