Mental health in substance misuse patients in Wales

2019 ◽  
Vol 18 (4) ◽  
pp. 269-278 ◽  
Author(s):  
John Barry Sims
Keyword(s):  
Mental Health ◽  
Clinical Outcomes ◽  
Substance Misuse ◽  
Psychological Interventions ◽  
Evidence Based ◽  
Behaviour Therapy ◽  
Apparent Lack ◽  
Content Type ◽  
Co Morbidity ◽  
Cognitive Behaviour

Purpose The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as defined in DSM 5 with reference to common mental health disorders. It also examines differences in the numbers of appropriately trained cognitive behaviour therapy (CBT) therapists and highlights the lack of provision of CBT reflected in the much smaller number of accredited therapists in Wales compared to other parts of the UK. Design/methodology/approach This population was identified by way of an audit of data collected via the out-patient clinics conducted by the author. Findings The paper identifies a high proportion of patients who attended SMSs as having complex psychological need as a consequence of co-morbidity. Research limitations/implications The results of the audit may have limitations but the implications from the findings suggest potential value in looking more at clinical outcomes following evidence-based psychological interventions. Practical implications A conclusion from the findings is suggested value in a more structured approach to looking at clinical outcomes. Originality/value This audit was undertaken in North Wales. There is no IAPT or matrix-structured Level II CBT training programmes available in Wales. The audit identifies the need for more evidence-based psychological interventions such as CBT linked to the development of such services. The apparent lack of political will to change the status quo is also highlighted as a problem.

Psychological interventions for adults with autism spectrum disorders: a review

2015 ◽  
Vol 1 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Debbie Spain ◽  
Laura Harwood ◽  
Lucy O'Neill
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorders ◽  
Autism Spectrum ◽  
Psychological Interventions ◽  
Behaviour Therapy ◽  
Treatment Protocols ◽  
Content Type ◽  
Cognitive Behaviour ◽  
Spectrum Disorders ◽  
The Impact

Purpose – Adults who have autism spectrum disorders (ASD) experience a range of core and co-morbid characteristics which impede daily functioning and quality of life. Children and adolescents with ASD derive clinically meaningful benefits from psychological interventions, including those designed to reduce socio-communication deficits and mental health conditions. Relatively little is known about the effectiveness of these interventions for the adult ASD population. The paper aims to discuss this issue. Design/methodology/approach – A selective search of English language, peer-reviewed publications was undertaken, in order to summarise the empirical data pertaining to psychological interventions for adults with high-functioning ASD (HF-ASD). Findings – Thus far, social skills interventions, cognitive behaviour therapy techniques, and mindfulness-based approaches have been researched most extensively. Interventions have primarily sought to: reduce the impact of core ASD characteristics; enhance skills; and improve co-morbid mental health symptoms. Methodological and clinical heterogeneity render it difficult to generalise study findings across population samples, but overall, interventions appear to be associated with reductions in co-morbid symptom severity, and improved functioning. Research limitations/implications – Further studies that seek to improve functioning, reduce co-morbid characteristics, and enhance the propensity for attaining and maintaining independence are now needed. Practical implications – Adaptations to standard treatment protocols are likely required in order to enhance engagement and optimise treatment gains. Originality/value – This is one of the first reviews to focus specifically on psychological interventions for adults with HF-ASD.

Training frontline community agency staff in dialectical behaviour therapy: building capacity to meet the mental health needs of street-involved youth

2017 ◽  
Vol 12 (2) ◽  
pp. 121-132 ◽  
Author(s):  
Elizabeth McCay ◽  
Celina Carter ◽  
Andria Aiello ◽  
Susan Quesnel ◽  
Carol Howes ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Dialectical Behavior Therapy ◽  
Mental Health Outcomes ◽  
Evidence Based ◽  
Community Agency ◽  
Behaviour Therapy ◽  
Agency Staff ◽  
Content Type ◽  
Youth Outcomes

Purpose The purpose of this paper is to evaluate the effectiveness of the dialectical behavior therapy (DBT) training which was provided to community agency staff (N=18) implementing DBT in the community with street-involved youth. Design/methodology/approach Staff participated in a multi-component approach to training which consisted of webinars, online training, self-study manuals, and ongoing peer consultation. To evaluate assess the effectiveness of the training, questionnaires assessing evaluating DBT skills knowledge, behavioral anticipation and confidence, and DBT skills use, were completed at baseline, immediately post-training, four to six months post-training, and 12-16 months post-training. Additionally, the mental health outcomes for youth receiving the DBT intervention are reported to support the effectiveness of the training outcomes. Findings Results demonstrate that the DBT skills, knowledge, and confidence of community agency staff improved significantly from pre to post-training and that knowledge and confidence were sustained over time. Additionally, the training was clinically effective as demonstrated by the significant improvement in mental health outcomes for street-involved youth participating in the intervention. Practical implications Findings suggest that this evidence-based intervention can be taught to a range of staff working in community service agencies providing care to street-involved youth and that the intervention can be delivered effectively. Originality/value These findings help to close the knowledge-practice gap between evidence-based treatment (EBT) research and practice while promoting the implementation of EBT in the community to enhance positive youth outcomes.

scholarly journals Coping with cognitive behaviour therapy for psychosis, adapting it for another culture, and community inclusion

2015 ◽  
Vol 19 (3) ◽  
pp. 107-113
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Active Role ◽  
Qualitative Studies ◽  
Social Model ◽  
Service Users ◽  
Behaviour Therapy ◽  
Community Groups ◽  
Content Type ◽  
Cognitive Behaviour

Purpose – The purpose of this paper is to highlight what helps and what is difficult about cognitive behaviour therapy for psychosis (CBTp) in relation to recovery and social inclusion, how it can be adapted for a non-western culture, and how inclusion in communities in which people feel comfortable can help their recovery. Design/methodology/approach – Three journal articles are described. The first summarises six small qualitative studies involving interviews with UK service users about what they found helpful and challenging about CBTp. The second article reports on a pilot trial of CBTp adapted for the culture in Pakistan, where families are seen as more involved in service users’ care. The third article describes USA-based participants’ engagement with different communities as part of their recovery. Findings – UK service users appreciated feeling equal to their therapist in CBTp, receiving an understandable explanation of their difficulties, and support for gradual steps towards activities they valued. However, it was difficult revisiting traumatic pasts to understand their difficulties, and UK mental health culture may hamper taking an active role in treatment. In Pakistan, CBTp can be successfully adapted to include a key family member and local spiritual beliefs. In a USA context, service users developed competencies in community groups they valued, and these could be minority or service user communities where people felt comfortable and could make a contribution. Originality/value – The experiences of service users of CBTp are rarely collated from several qualitative studies, and important themes came from doing so. It may be important to understand current barriers to doing CBTp homework and the effect of some aspects of mental health services on people’s readiness to take an active role. Studies of adapting CBTp for non-western cultures are rare, but it seemed successful in Pakistan, adopting a bio-psycho-spiritual-social model. The qualitative study of people’s engagement in US community groups highlights the importance of not dismissing engagement in minority groups for people’s recovery, rather than only the “wider” community.

How acceptance and commitment therapy changed the perspective on support provision for staff working with intellectual disability

2016 ◽  
Vol 10 (1) ◽  
pp. 59-73 ◽  
Author(s):  
Mauro Leoni ◽  
Serafino Corti ◽  
Roberto Cavagnola ◽  
Olive Healy ◽  
Stephen J. Noone
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Well Being ◽  
Future Research ◽  
Evidence Based ◽  
Third Generation ◽  
Behaviour Therapy ◽  
Content Type ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Cognitive Behaviour

Purpose – The purpose of this paper is to present a review on evidence-based intervention concerning the reduction of stress/burnout and the improvement of wellbeing for professionals working with people with intellectual disabilities (IDs). Design/methodology/approach – Theoretical models and literature related to stress reduction are reviewed from a classical cognitive behaviour therapy (CBT) approach up to the novel contribution of the third generation of cognitive-behavioural therapies, with a specific focus on contextual behavioural sciences and acceptance and commitment Therapy (ACT). Findings – Despite the improvement of CBT-based interventions in reducing risk factors for stress and burnout, the limitations of a problem-solving approach when applied to challenging environments like those of direct support to persons with ID, are still large. Interventions based on the core processes and the related techniques of ACT appear to be promising in promoting the well being of paid carers reducing the risk of burnout, and increasing psychological flexibility. Such factors can increase the ability to clarify personal and professional values, as well as the opportunities to act consistently with such values and achieve greater social reinforcement in the work environment. Research limitations/implications – The limitations of the existing research are presented and discussed. There are several aspects that future research should address in order to promote staff training protocols that could be extensively applied with preventive aims. Organisations could take the available procedures and methodologies and implement these evidence-based practices within existing training. Originality/value – The research on the application of ACT and third generation of behavioural approaches to the wellbeing and behaviour of staff supporting persons with IDs remains limited. The present paper is the first narrative review on this topic.

A feasibility and pilot trial of computerised cognitive behaviour therapy for depression in adolescents: lessons learned from planning and conducting a randomised controlled trial

2016 ◽  
Vol 21 (3) ◽  
pp. 193-199 ◽  
Author(s):  
Lucy Tindall ◽  
Danielle Varley ◽  
Barry Wright
Keyword(s):  
Mental Health ◽  
Research Team ◽  
Controlled Trial ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Behaviour Therapy ◽  
Content Type ◽  
Cognitive Behaviour ◽  
Computerised Cognitive Behaviour Therapy ◽  
Randomised Controlled

Purpose The purpose of this paper is to focus upon the challenges faced by a research team when conducting a computerised cognitive behaviour therapy (CCBT) trial for adolescents with low mood/depression and how solutions were sought to eliminate these difficulties in future child and adolescent mental health clinical research. Design/methodology/approach The authors have presented a number of problems faced by the research team when conducting a randomised controlled trial (RCT) concerning adolescents with low mood/depression. Findings From examining the problems faced by the research team, the authors have provided key pieces of advice for prospective adolescent mental health RCTs. This advice includes developing clear project plans, setting strategies to encourage and maintain study information in the community and support recruitment, and keeping your organisation appraised of study needs and network and involve governance departments, IT and finance departments in these discussions early. Originality/value RCTs, particularly those focusing on child and adolescent mental health, can face a number of difficulties throughout its stages of completion (from protocol development to follow-up analysis). Studies involving the use of technologies add a layer of complexity to this. This review will be of value to researchers aiming to run a high-quality RCT concerning child and adolescent mental health.

scholarly journals A framework for psychological interventions in Autism Spectrum Disorder

2018 ◽  
Author(s):  
Joachim Diederich
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Treatment Options ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Psychological Interventions ◽  
Behaviour Therapy ◽  
Research Perspective ◽  
Psychological Techniques ◽  
Cognitive Behaviour

Psychological interventions for autism spectrum disorder (ASD) aim at shaping behaviour by use of classical or instrumental conditioning or try to address co-morbid mental health conditions by use of cognitive behaviour therapy or other approaches. Few psychological interventions directly address deficits in ASD such as social communication issues or repetitive behaviours. The objective here is to provide a framework for psychological interventions that directly address core deficits within the spectrum and also help with mental health and behavioural issues closely associated with it. From a research perspective, the framework allows the identification of gaps where additional psychological techniques are required and facilitates strategies for empirical research. For the clinical practitioner, a structure for psychological interventions is provided in order to facilitate the search for treatment options.

Trainingmodels for Psychiatry in Primary Care: A New Frontier

2005 ◽  
Vol 13 (3) ◽  
pp. 296-301
Author(s):  
Rachael Murrihy ◽  
Mitchell K. Byrne
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Focus Groups ◽  
Cognitive Behaviour Therapy ◽  
Psychological Treatment ◽  
Training Model ◽  
Group Supervision ◽  
Evidence Based ◽  
Behaviour Therapy ◽  
Cognitive Behaviour

Objective: Under policies implemented by the Australian Government, the success of community mental health care has increasingly relied upon general practitioners (GPs) assuming an enhanced role in the delivery of evidence-based psychological treatment. In undertaking this role, it is crucial that GPs significantly build upon limited training in evidence-based psychological therapies such as cognitive behaviour therapy (CBT). This pilot study investigates the potential role of CBT group supervision as a training model. Method: Two groups of GPs (n = 9) and one comparison group of psychiatric registrars (n = 4) completed eight 1.5 h sessions of CBT group supervision over an 8month period. Pre- to post-training measures were taken of GP performance (skills, knowledge and confidence) and the mental health outcomes of their patients. On the completion of group supervision, focus groups were conducted for in-depth feedback. Results: Randomization tests indicated that GPs' confidence and knowledge in using CBT had improved over the course of group supervision. Results from focus groups confirmed that GPs' CBT skills had improved. Conclusions: Findings suggest that group supervision is a promising training model for psychiatry in primary care. Cognitive behaviour therapy should be replaced, however, with a briefer therapy model, such as brief CBT, better suited to a general practice environment. Future research needs to replicate these findings on a larger scale.

scholarly journals Understanding Black and Minority Ethnic service user's experience of racism as part of the assessment, formulation and treatment of mental health problems in cognitive behaviour therapy

2019 ◽  
Vol 12 ◽  
Author(s):  
Andrew Beck
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Mental Health Problems ◽  
Cumulative Risk ◽  
Health Problems ◽  
Service Users ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Engagement Process ◽  
Minority Ethnic

AbstractExperiences of racism can be a cumulative risk factor for developing mental health problems. Cognitive Behaviour Therapists working with Black and Minority Ethnic (BME) service users should be confident in their ability to establish the necessary rapport to ask about these experiences and be able to incorporate this information into longitudinal formulations and as part of maintenance cycles. This paper sets out guidelines as to how to do this as part of a wider engagement process.

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