scholarly journals Cognitive Behaviour Therapy for Psychosis: The Impact of Therapist Training and Supervision

2012 ◽  
Vol 81 (3) ◽  
pp. 194-195 ◽  
Author(s):  
Craig Steel ◽  
Nicholas Tarrier ◽  
Daniel Stahl ◽  
Til Wykes
2017 ◽  
Vol 46 (2) ◽  
pp. 148-167 ◽  
Author(s):  
Neil Carrigan ◽  
Leon Dysch ◽  
Paul M. Salkovskis

Background: Multiple sclerosis (MS) is commonly associated with psychological complications. Previous research by Hayter and colleagues (2016) found that in patients with MS, health anxiety (HA) can account for part of the variance in quality of life (QoL) independent of physical and cognitive impairment caused by the disease. MS patients with HA perceived their intact physical and cognitive performance as impaired relative to those without HA and attributed the impairment to MS. These misperceptions might be useful targets in the treatment of HA in MS using cognitive behaviour therapy (CBT). Aims: Study 1 sought to replicate the main findings from Hayter et al. (2016). Study 2 examined the impact of HA-focused CBT in a case series. Method: In Study 1, twenty participants with MS were screened for HA and assigned to either a high or low HA group. They completed assessments of cognitive and physical functioning before rating their performance on these tasks, followed by measures of QoL, mood and physical disability. Four participants in the high HA group subsequently received six sessions of CBT using a consecutive AB case series in Study 2. Results: Study 1 replicated the main findings from the earlier study. In Study 2, three of the four patients who received treatment showed substantial improvements in HA and mood and all showed improvement in QoL. Conclusion: Given the high rates of HA in MS patients and its impact on QoL, this case series suggests that a brief CBT intervention could significantly improve patients’ wellbeing.


2017 ◽  
Vol 47 (8) ◽  
pp. 1478-1488 ◽  
Author(s):  
F. L. Challacombe ◽  
P. M. Salkovskis ◽  
M. Woolgar ◽  
E. L. Wilkinson ◽  
J. Read ◽  
...  

BackgroundThere is increasing recognition that perinatal anxiety disorders are both common and potentially serious for mother and child. Obsessive–compulsive disorder (OCD) can be triggered or exacerbated in the postpartum period, with mothers reporting significant effects on parenting tasks. However, there is little evidence concerning their effective treatment or the impact of successful treatment on parenting.MethodA total of 34 mothers with OCD and a baby of 6 months old were randomized into either time-intensive cognitive–behaviour therapy (iCBT) or treatment as usual (TAU). iCBT took place after randomization at 6 months postpartum and was completed by 9 months. Maternal symptomatology, sensitivity in mother–infant interactions and parenting were assessed at baseline and reassessed at 12 months postpartum. At 12 months attachment was also assessed using Ainsworth's Strange Situation Procedure. A healthy control group of mothers and infants (n = 37) underwent the same assessments as a benchmark.ResultsiCBT was successful in ameliorating maternal symptoms of OCD (controlled effect size = 1.31–1.90). However, mother–infant interactions were unchanged by treatment and remained less sensitive in both OCD groups than a healthy control group. The distribution of attachment categories was similar across both clinical groups and healthy controls with approximately 72% classified as secure in each group.ConclusionsiCBT is an effective intervention for postpartum OCD. Sensitive parenting interactions are affected by the presence of postpartum OCD and this is not improved by successful treatment of OCD symptoms. However, the overall attachment bond appears to be unaffected. Longitudinal studies are needed to explore the impact of postpartum OCD as the child develops.


2016 ◽  
Vol 44 (6) ◽  
pp. 625-639 ◽  
Author(s):  
Luke H. Schneider ◽  
Heather D. Hadjistavropoulos ◽  
Y. Nichole Faller

Background: A previous study of therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) for generalized anxiety (Paxling et al., 2013) identified eight distinct therapist behaviours in ICBT (task reinforcement, self-efficacy shaping, task prompting, alliance bolstering, psychoeducation, empathetic utterances, deadline flexibility, and self-disclosure). It is unknown how generalizable these behaviours are across ICBT programs. Aims: We systematically examined the frequency of these eight therapist behaviours and additional newly identified behaviours in e-mails sent to patients during the course of ICBT for depressive symptoms. We also conducted exploratory analyses to examine relationships between therapist behaviours, symptom improvement, and therapeutic alliance. Method: Data was obtained from a previously published open trial (Hadjistavropoulos et al., 2014). A total of 1013 e-mails sent from therapists (n = 24) to patients (n = 41) during ICBT for depressive symptoms were analyzed. Therapist behaviours were correlated with symptom change scores and ratings of therapeutic alliance at mid- and post-treatment. Results: Therapist behaviours described by Paxling et al. were reliably identified in the e-mails using qualitative content analysis; the frequencies of these behaviours differed, however, from the Paxling et al. study and three additional therapist behaviours were identified (administrative statements, questionnaire feedback, asking clarifying questions). Several therapist behaviours (e.g. administrative statements, task prompting) were associated with lower symptom improvement at post-treatment. Questionnaire feedback and task reinforcement were associated with higher patient ratings of therapeutic alliance. Conclusions: The study provides partial support for the generalizability of therapist-assistance across ICBT programs. Experimental research is needed to examine the impact of varying therapist-assistance on patient outcomes.


2004 ◽  
Vol 32 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Elizabeth E. Taylor ◽  
Nicholas W. Read ◽  
Helen M. Hills

Conventional medical treatment is often ineffective in the management of Irritable Bowel Syndrome (IBS). Although controlled trials of psychotherapy and hypnotherapy have been shown to be effective, psychological interventions are not widely available. The aim of this study was to assess the feasibility of the clinical provision of combined group cognitive-behaviour therapy (CBT) and hypnotherapy delivered by 13 therapists using a standardized protocol. Attempts were also made to disseminate the programme by patient graduates. A session-by-session instruction manual was compiled and the protocol was tested in a pilot group. Thereafter a total of 158 patients in 23 different groups took part in the 16-session intervention. Attrition rate was very low. Significant improvements in both gastrointestinal and psychosocial symptoms were observed following the intervention. The results suggest that professionally led group psychotherapy and hypnotherapy is a feasible option for the treatment of sufferers of IBS and increased efforts should be made in the training and supervision of user facilitators.


2021 ◽  
Author(s):  
Christiaan Vis ◽  
Annet Kleiboer ◽  
Mayke Mol ◽  
Claus Duedal Pedersen ◽  
Tracy Finch ◽  
...  

Abstract Background. Internet-based Cognitive Behaviour Therapy (iCBT) services for depression have been implemented in routine care in 14 European regions. This study aimed to advance understanding of the nature and value of organisational implementation climate in implementing iCBT services from the perspectives of implementers and service deliverers.Methods. A mixed method approach was applied. Based on concept mapping, a workshop with implementers was conducted to qualitatively conceptualise organisational implementation climate conducive to optimizing iCBT use in routine practice. Mental health service deliverers involved in the provision of iCBT services were invited to participate in a cross-sectional survey assessing levels of satisfaction and usability of iCBT, and of the organisational implementation climate. Associations between satisfaction, usability and implementation climate were explored.Results. 16 implementers representing 14 service delivery organisations participated in the workshop. The top-3 characteristics of a strong organisational implementation climate included: (1) clear roles and skills of implementers, (2) feasible implementation targets, and (3) a dedicated implementation team. The top-3 tools for creating a good implementation climate included: (1) job performance feedback, (2) progress monitoring in achieving implementation targets, and (3) guidelines for assessing the impact of iCBT. 111 respondents (73% female) completed the survey. Respondents were generally satisfied delivering iCBT services (MCSQ = 9.11, SD = 1.96, range = 3-15, n = 108) and found their usability slightly below average (MSUS = 63.76, SD = 15.53, range = 0-100, n = 103). They regarded their organisational implementation climate as supportive in implementing iCBT services (MICS = 43.21, SD = 5.62, range = 12-60, n = 89). Organisational implementation climate was weakly associated with usability (r = 0.25, p =.03) and moderately with satisfaction (r = .51, p £ .00).Conclusions. Organisational implementation climate as part of the wider organisational context in which implementation processes take place, is a relevant factor to implementers and service deliverers in implementing iCBT in routine care. The qualitative conceptual findings align with the quantitative approach applied in this study for measuring organisational implementation climate. Implementers can use various practical tools to shape organisational implementation climate to increase acceptance and improve implementation of iCBT in mental health care.


2020 ◽  
Vol 10 (2) ◽  
pp. 199-213
Author(s):  
Fiona Mathieson ◽  
Jennifer Jordan ◽  
Maria Stubbe

Abstract Metaphors are common in psychotherapy. The last decade has seen increasing interest in the use of metaphor in cognitive behaviour therapy (CBT), with attention to client metaphors being asserted as a way of enhancing CBT. However, prior to this current research there was very little research on the use of metaphor in CBT sessions, and no studies have examined how to train therapists in this skill. This article discusses four studies that provide a preliminary empirical basis for the exploration of metaphors in CBT. The first study evaluated the reliability and utility of an approach to metaphor identification. The second study explored how clients and therapists co-construct metaphors, contributing to development of a shared language in early therapy sessions and identified a range of responses to each other’s metaphors. The third study explored the effect of training CBT therapists to intentionally bring client metaphors into case conceptualisations in terms of building therapeutic alliance and collaboration, along with an exploration of preference for metaphoric language. The fourth study explored the impact of the metaphor training on therapist confidence, awareness and use of metaphors, based on therapist self-report ratings and reflections on their ongoing application of learning over a three month period. These findings suggest that it is possibly to conduct empirical research on metaphor in CBT, with metaphor having potential as an important therapy process1 variable.


2021 ◽  
pp. 135910452110138
Author(s):  
Katharina Schlimm ◽  
Maria Loades ◽  
Emily Hards ◽  
Shirley Reynolds ◽  
Monika Parkinson ◽  
...  

Background: Parents are key to helping their adolescent child access psychological therapy for mental health problems such as depression. However, little is known about how parents experience their child’s psychological therapy. We aimed to explore parents’ experiences of their adolescent child’s cognitive behaviour therapy for depression. Method: We applied Thematic Analysis (TA) to qualitative data from in-depth interviews with parents ( N = 16) whose adolescent child was randomly allocated to CBT in a large multisite RCT for adolescent depression (the IMPACT trial). Interviews were conducted at the end of treatment. Results: We generated two main themes: parents’ perceptions of the adolescent’s journey through therapy, and parents’ perceptions of the therapeutic setting and process. Each included four sub-themes. Parents talked about key factors that impacted on their child’s progress through treatment, including the adolescent’s readiness for therapy and the adolescent-therapist relationship. Conclusion: Parents’ insights confirm the foundations of what is considered good clinical practice of CBT for adolescent depression, including tailoring therapy to the adolescent, and establishing a strong adolescent-therapist relationship. Parents recognised that, for CBT to be helpful, their child had to be willing to engage in therapy and able to develop a trusting relationship with their therapist.


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