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.

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.

scholarly journals Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools

Autism ◽  
2020 ◽  
Vol 24 (4) ◽  
pp. 867-883 ◽  
Author(s):  
Sebastian B Gaigg ◽  
Paul E Flaxman ◽  
Gracie McLaven ◽  
Ritika Shah ◽  
Dermot M Bowler ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Cost Effective ◽  
Well Being ◽  
Behaviour Therapy ◽  
Self Help ◽  
Online Tools ◽  
Cognitive Behaviour ◽  
Autistic Adults

Anxiety in autism is an important treatment target because of its consequences for quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can ameliorate anxiety in autism but cost-effective delivery remains a challenge. This pilot randomised controlled trial examined whether online cognitive behaviour therapy and mindfulness-based therapy self-help programmes could help reduce anxiety in 54 autistic adults who were randomly allocated to either an online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme or a waitlist control group (n = 19). Primary outcome measures of anxiety, secondary outcome measures of broader well-being and potential process of change variables were collected at baseline, after programme completion, and then 3 and 6 months post-completion. Baseline data confirmed that intolerance of uncertainty and emotional acceptance accounted for up to 61% of self-reported anxiety across all participants. The 23 participants who were retained in the active conditions (14 mindfulness-based therapies, 9 cognitive behaviour therapies) showed significant decreases in anxiety that were maintained over 3, and to some extent also 6 months. Overall, results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools may provide a cost-effective method for delivering mental health support to those autistic adults who can engage effectively with online support tools. Lay abstract Anxiety in autism is an important target for psychological therapies because it is very common and because it significantly impacts upon quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can help autistic individuals learn to manage feelings of anxiety but access to such therapies remains problematic. In the current pilot study, we examined whether existing online cognitive behaviour therapy and mindfulness-based therapy self-help tools can help reduce anxiety in autistic adults. Specifically, 35 autistic adults were asked to try either an existing online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme while a further 19 autistic adults served as a waitlist comparison group. A first important finding was that 23 of the 35 (66%) participants who tried the online tools completed them, suggesting that such tools are, in principle, acceptable to many autistic adults. In addition, adults in the cognitive behaviour therapy and mindfulness-based therapy conditions reported significant decreases in anxiety over 3 and to some extent also 6 months that were less apparent in the waitlist group of participants. On broader measures of mental health and well-being, the benefits of the online tools were less apparent. Overall, the results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools should be explored further as a means of providing cost-effective mental health support to at least those autistic individuals who can engage effectively with such online tools.

The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review

2015 ◽  
Vol 20 (2) ◽  
pp. 54-64 ◽  
Author(s):  
Caroline Jennings ◽  
Olivia Hewitt
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Cognitive Behaviour Therapy ◽  
Evidence Base ◽  
Small Sample ◽  
Future Research ◽  
Behaviour Therapy ◽  
Content Type ◽  
Psychological Therapies ◽  
Cognitive Behaviour

Purpose – Cognitive behaviour therapy (CBT) is currently one of the recommended treatments for depression for the general population and guidance recommends that people with a learning disability should have access to the same treatments as people without a learning disability. The purpose of this paper is to identify, outline and evaluate current research on the effectiveness of CBT for depression for people with a learning disability. The clinical, service and research implications are considered. Design/methodology/approach – A systematic search was conducted and five relevant articles were identified for critical review. Findings – There is a limited but promising evidence base for the use of CBT for depression with people with learning disabilities. Research limitations/implications – The current review identified a number of methodological issues and future research should attempt to overcome these (e.g. small sample sizes and lack of controls). In particular, research should focus on determining the relative contribution of cognitive and behavioural techniques in producing a change in depressive symptoms. Practical implications – Services (including those provided as part of Improving Access to Psychological Therapies) should be offering CBT-based interventions for people with learning disabilities who are experiencing depression. Originality/value – This paper provides a comprehensive and up to date review of the current literature regarding the use of CBT for depression for people with a learning disability. This will be of value to clinicians working with people with a learning disability as well as those commissioning services.

scholarly journals A Feasibility Study of the Translation of Cognitive Behaviour Therapy for Psychosis into an Australian Adult Mental Health Clinical Setting

2020 ◽  
Vol 37 (1) ◽  
pp. 22-32
Author(s):  
Lee Beames ◽  
Esben Strodl ◽  
Frances Dark ◽  
Jennifer Wilson ◽  
Judith Sheridan ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Feasibility Study ◽  
Cognitive Behaviour Therapy ◽  
Public Mental Health ◽  
Individual Therapy ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Public Mental Health Services

AbstractThere is evidence that Cognitive Behaviour Therapy for Psychosis (CBTp) is an effective intervention for reducing psychotic symptoms. The recently updated Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines (RANZCP CPG) recommend CBTp for the therapeutic management of schizophrenia and related disorders. Translational research is required to examine how well CBTp can be applied into public mental health services. This feasibility study aimed to provide preliminary evidence on how acceptable, implementable, and adaptable individual or group CBTp may be within a public mental health service in Australia. Twenty-seven participants initially agreed to participate in the study with 16 participants being randomised to either group or individual therapy, 11 starting therapy and 7 completing therapy. The intervention involved approximately 20 h of manualised CBTp. Attendance was higher in the individual therapy. Subjective reports indicated that the therapy was acceptable to all completers. Participants who engaged in individual or group CBTp experienced a similar level of reduction in the severity of hallucinations and delusions. Individual CBTp may be a feasible, acceptable, and effective intervention to include in Australian public mental health services. A pilot trial is now required to provide further evidence for and guidance of how best to translate CBTp protocols to Australian mental health services.

Research Watch: therapists’ working conditions and their implications for service users’ social inclusion

2019 ◽  
Vol 23 (1) ◽  
pp. 5-11
Author(s):  
Sue Holttum
Keyword(s):  
Working Conditions ◽  
Social Inclusion ◽  
Additional Stress ◽  
Service Users ◽  
Behaviour Therapy ◽  
Content Type ◽  
Physical Conditions ◽  
The Social ◽  
Cognitive Behaviour ◽  
The Uk

Purpose The purpose of this paper is to highlight possible implications of therapists’ working conditions on social inclusion of service users. Design/methodology/approach A search was carried out for recent papers on cognitive behaviour therapy (CBT) therapists. Findings One study highlighted that over half of their sample of 201 UK therapists in Improving Access to Psychological Therapy (IAPT) services reported burnout. In a second study, in interviews with ten IAPT workers in inner London services, therapists said they had to fight for extra time to adapt CBT for people who had learning disabilities, and the additional stress made them feel less positive about working with these clients. A third study, on therapists working with people with multiple sclerosis, highlights the importance of adapting CBT for people with physical conditions. Originality/value Taken together, these three papers highlight concerning implications of current working conditions for many therapists working in IAPT services. They highlight that sources of stress include services’ rigid focus on targets and inability to make expected adjustments. With regard to the UK, this may be due to the current national service model, but it has implications for the social inclusion of some service users.

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