Cognitive behavioural therapy for psychogenic non-epileptic seizures in the context of mild intellectual disability: a case study

2020 ◽  
Vol 14 (6) ◽  
pp. 287-297
Author(s):  
Peter Robert Diamond ◽  
Claire Delaney

Purpose There is a growing evidence base for cognitive behavioural therapy (CBT) as a treatment for psychogenic non-epileptic seizures (PNES) in the general population. Despite the relatively high proportion of individuals with PNES who have an intellectual disability (ID) there is a paucity of literature on the use of CBT for PNES in this population. The purpose of this paper is to describe the use of an adapted CBT approach to treat PNES in a woman with mild ID. Design/methodology/approach The intervention used a CBT approach that included both the client and her mother, her primary care giver, throughout the therapy sessions. It involved 13 1-hour sessions over 20 weeks. Findings Over the course of the intervention the client experienced a reduction in seizure activity. Both the client and her mother reported increases in her perceived ability to cope with the seizures. Originality/value This report describes an adapted CBT-based intervention for individuals with PNES in the context of ID. It is the first report to include the involvement of a care-giver in adapting this approach for individuals with ID.

Author(s):  
Karina Lovell

Chapter 27 discusses LI interventions using the telephone, and aims to provide the rationale, evidence base, challenges, solutions and practical application of delivering low intensity psychological (mainly cognitive behavioural therapy) interventions by telephone.


2003 ◽  
Vol 183 (2) ◽  
pp. 98-99 ◽  
Author(s):  
Douglas Turkington ◽  
David Kingdon ◽  
Paul Chadwick

When does a therapeutic intervention become an accepted part of standard clinical practice? Is it when there is sufficient research evidence? But what constitutes ‘sufficient’? What about available resources and acceptability to patients? Do we have to wait until the National Institute for Clinical Excellence pronounces? A convincing evidence base for family work in schizophrenia (Kuipers, 2000) has existed for many years but has been poorly implemented (Anderson & Adams, 1996). Will cognitive-behavioural therapy (CBT) for psychosis suffer the same fate? Which professional group will champion such an implementation? The evidence for other psychological treatments is less robust. Psychoeducation may prolong time to relapse and improve insight but at the cost of increasing suicidal ideation (Carroll et al, 1998). Personal therapy (Hogarty et al, 1997) may be of value but is contra-indicated for patients who are living alone in the community. Psychodynamic approaches are advocated (Mace & Margison, 1997) but most psychiatrists do not support their use in practice, owing to lack of evidence of efficacy.


2019 ◽  
Vol 14 (3) ◽  
pp. 186-198
Author(s):  
Peter Thomas Garwood ◽  
Alexander Hassett

Purpose The last two decades have seen an increase in service user involvement (SUI) in the training of Mental Health Professionals (MHP). There is developing empirical support for SUI in MHP training, however, there is no published research into SUI in the training of Cognitive Behavioural Therapists. The purpose of this paper is to explore cognitive behavioural therapy (CBT) trainees’ experience of SUI in their training. The study focuses on how an individual service user (SU) led training session is experienced and how this differs to routine CBT training. Design/methodology/approach Semi-structured interviews were conducted with six participants. Transcripts of the interviews were analysed using interpretative phenomenological analysis. Findings Data revealed three superordinate themes: first, predisposing influences on learning; second, factors associated with emotional processing of experience; and third, impact upon learning outcomes. The results suggest that participants’ appraisal of their learning from SUI maybe influenced by how they accommodate the emotional impact of the experience. Originality/value The paper makes recommendations for educators on courses involving service users (SUs), acknowledges the study’s methodological limitations and suggests areas for future research.


2018 ◽  
Vol 23 (4) ◽  
pp. 240-245 ◽  
Author(s):  
James Binnie ◽  
Marcantonio Spada

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.


2003 ◽  
Vol 9 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Graeme Whitfield ◽  
Chris Williams

The evidence base for cognitive–behavioural therapy (CBT) for depression is discussed with reference to the review documentTreatment Choice in Psychological Therapies and Counselling (Department of Health). This identifies the need to deliver evidence-based psychosocial interventions and identifies CBT as having the strongest research base for effectiveness, but does not cover how to deliver CBT within National Health Service settings. The traditional CBT model of weekly face-to-face appointments is widely offered, yet there is little evidence to support these traditions in the outcome literature. Reducing face-to-face contact by introducing self-help into treatment may be one method of improving access. The SPIRIT course is discussed which teaches how to offer core cognitive–behavioural skills using structured self-help materials.


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