scholarly journals From the margins to the NICE guidelines: British clinical psychology and the development of cognitive behaviour therapy for psychosis, 1982–2002

2021 ◽  
pp. 095269512110277
Author(s):  
David J. Harper ◽  
Sebastian Townsend
Keyword(s):  
Clinical Psychology ◽  
Cognitive Behaviour Therapy ◽  
Systems Approach ◽  
Participant Observation ◽  
Clinical Excellence ◽  
Behaviour Therapy ◽  
Psychological Therapies ◽  
Historical Factors ◽  
Cognitive Behaviour ◽  
Social Technologies

Although histories of cognitive behaviour therapy have begun to appear, their use with people with psychosis diagnoses has received relatively little attention. In this article, we elucidate the conditions of possibility for the emergence of cognitive behaviour therapy for psychosis (CBTp) in England between 1982 and 2002. We present an analysis of policy documents, research publications and books, participant observation, and interviews with a group of leading researchers and senior policy actors. Informed by Derksen and Beaulieu’s articulation of social technologies, we show how CBTp was developed and stabilised through the work of a variety of overlapping informal, academic, clinical, professional, and policy networks. The profession of clinical psychology played a key role in this development, successfully challenging the traditional ‘division of labour’ where psychologists focused on ‘neurosis’ and left ‘psychosis’ to psychiatry. Following Abbott's systems approach to professions, we identify a number of historical factors that created a jurisdictional vulnerability for psychiatry while strengthening the jurisdictional legitimacy of clinical psychology in providing psychological therapies to service users with psychosis diagnoses. The National Institute for Health and Clinical Excellence played a significant role in adjudicating jurisdictional legitimacy, and its 2002 schizophrenia guidelines, recommending the use of psychological therapies, marked a radical departure from the psychiatric consensus. Our analysis may be of wider interest in its focus on social technologies in a context of jurisdictional contestation. We discuss the implications of our study for the field of mental health and for the relationship between clinical psychology and psychiatry.

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.

An evaluation of group cognitive behaviour therapy for low self-esteem in primary care

2014 ◽  
Vol 7 ◽  
Author(s):  
Stuart Pack ◽  
Emma Condren
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Self Esteem ◽  
Evidence Base ◽  
Future Research ◽  
Depression And Anxiety ◽  
Behaviour Therapy ◽  
Psychological Therapies ◽  
Cognitive Behaviour ◽  
Group Programme

AbstractLow self-esteem is widely acknowledged to be associated with the phenomenology of a number of mental health diagnoses, including those which are treated under the umbrella of Improving Access to Psychological Therapies (IAPT) services. To evaluate the effectiveness of group Cognitive Behaviour Therapy (CBT) based on the work of Fennell in treating low self-esteem 50 participants attended a 10-week group programme. Pre- and post-group measures of depression, anxiety and self-esteem were compared using Mann–Whitney U tests. The results indicated that there was a statistically significant and clinically meaningful change across all pre- and post-group measures. Mean post-group measures indicated levels of depression and anxiety which were below caseness and a healthy level of self-esteem. Results indicated that gains were well maintained at 3-month follow-up. The results from this study highlight the effectiveness of group CBT for low self-esteem and thus contribute to the limited evidence base in this area. Results are discussed with consideration of the existing evidence base, implications for clinical practice, and future research.

scholarly journals Commentary on “The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review”

2015 ◽  
Vol 20 (2) ◽  
pp. 65-68
Author(s):  
Peter E. Langdon
Keyword(s):  
Systematic Review ◽  
Learning Disabilities ◽  
Cognitive Behaviour Therapy ◽  
Research Experience ◽  
Behaviour Therapy ◽  
Content Type ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
People With Intellectual Disabilities

Purpose – The purpose of this paper is to provide a commentary on “The use of cognitive-behaviour therapy to treat depression in people with learning disabilities: a systematic review”. Design/methodology/approach – Drawing on the literature, as well as both clinical and research experience, some reasons are outlined for the lack of attention given to psychological therapies to treat depression amongst people with intellectual disabilities (IDs). Findings – More research is needed, but existing evidence is promising regarding the effectiveness of adapted cognitive-behaviour therapy for depression amongst people with IDs. Originality/value – The commentary draws attention to the scope for developing a range of effective cognitive, behavioural and cognitive-behavioural treatments.

Can a ‘return-to-work’ agenda fit within the theory and practice of CBT for depression and anxiety disorders?

2010 ◽  
Vol 3 (1) ◽  
pp. 27-42 ◽  
Author(s):  
Matthew Wesson ◽  
Matthew Gould
Keyword(s):  
Anxiety Disorders ◽  
Return To Work ◽  
Clinical Excellence ◽  
Theory And Practice ◽  
Depression And Anxiety ◽  
Behaviour Therapy ◽  
Occupational Outcomes ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

AbstractHelping service users to return to work has emerged as a key therapeutic objective of the Improving Access to Psychological Therapies (IAPT) initiative. IAPT programmes implement National Institute for Health and Clinical Excellence (NICE) guidelines, especially cognitive behaviour therapy (CBT), for people suffering from anxiety and depression. However, relatively little research has been conducted to date into whether, or how, cognitive behavioural interventions can help individuals return to work. This paper reviews literature and research into CBT and occupational outcomes and considers whether a return-to-work agenda may jeopardize the therapeutic alliance which is suggested to be necessary for effective CBT. Moreover, through the use of clinical examples from our practice, we suggest ways in which employment issues might be integrated into CBT for depression and anxiety disorders. We conclude that a return-to-work agenda can be utilized during therapy while maintaining a collaborative and secure therapeutic relationship, especially, perhaps if work issues are embedded within the formulation. However, further research is needed, not only to determine whether CBT can help individuals return to work but also how CBT might best integrate a return-to-work agenda.

scholarly journals The ‘branding’ of IAPT and private cognitive behaviour therapy services in England

2021 ◽  
Vol 14 ◽  
Author(s):  
David Veale ◽  
Chloe Bowles ◽  
Mara Avramescu
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Psychological Therapy ◽  
Brand Names ◽  
List Type ◽  
Brand Name ◽  
Behaviour Therapy ◽  
Psychological Therapies ◽  
Cognitive Behaviour ◽  
Significant Difference ◽  
The Uk

Abstract Over the past decade, provision of cognitive behaviour therapy has expanded massively in the UK, both within the private sector and through the Improving Access to Psychological Therapies (IAPT) programme. Our aim in this study was to explore and compare the brand names adopted by IAPT and private CBT services. We obtained the names of all the IAPT and private services in England and created a word cloud for each sector. There was no significant difference in the proportion of services that adopted a brand name (72% of IAPT services vs 67% of the private services). In those with a brand name, IAPT services were significantly more likely than private services to contain positive words, and to have a theme of togetherness and collaboration. However, private services were more likely to include a psychological therapy in their name and have a theme of efficacy compared with IAPT. The most common keywords in IAPT services were ‘talking’ and ‘thinking’. IAPT services use a variety of euphemisms such as ‘talking’ for a psychological therapy. There is no theme for ‘doing’ in the IAPT or private services, despite behavioural interventions being one of the most common therapeutic components. The brand names in IAPT are overwhelmingly positive and convey the hope of a good outcome. They do not include the experience of difficult emotions, such as sadness and fear during therapy. We found just one private service that evoked the history of CBT named after Vic Meyer. Perhaps we will have some Clark and Layard centres in the years to come! Key learning aims After reading this paper, the reader should: (1) Recognise the importance of a brand name in shaping service user expectations. (2) Understand the differences between how private CBT and IAPT services present themselves to the public. (3) Recognise the omission of words conveying an active ‘doing’ theme in IAPT and private CBT service names.

IF THE EVIDENCE IS SO GOOD – WHY DOESN'T ANYONE USE THEM? A NATIONAL SURVEY OF THE USE OF COMPUTERIZED COGNITIVE BEHAVIOUR THERAPY

2004 ◽  
Vol 32 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Graeme Whitfield ◽  
Chris Williams
Keyword(s):  
National Survey ◽  
Cognitive Behaviour Therapy ◽  
Clinical Excellence ◽  
Behaviour Therapy ◽  
Face To Face ◽  
Self Help ◽  
Cognitive Behaviour ◽  
The Subject ◽  
Main Factors ◽  
The Uk

Computerized Self-help (CSH) has recently been the subject of a NICE (National Institute of Clinical Excellence) review. This increase in interest is also reflected in the increase in advertising for CSH programmes. We report a national survey of a random sample of 500 therapists accredited with the British Association for Behavioural and Cognitive Psychotherapies, which is the lead organization for CBT in the UK. A total of 329 therapists responded (65.8%). A surprisingly small number of CBT therapists were using CSH (12 or 2.4%) and only 5 or 1% were using it as an alternative to patient-therapist contact. Despite this, over 90% of the responding therapists had not ruled out using CSH in the future, but the majority of these would use it to supplement rather than as an alternative to individual face-to-face therapy. The need to know more about computerized self-help and the need for training in therapy using this modality were seen as the main factors that would have to change to allow the therapists to use CSH. Knowledge of and ability to use computers did not appear to be an important factor as most therapists in this sample used computers on a regular basis. Most therapists were not aware of evidence of the effectiveness of CSH but the minority who did feel able to express views stated that CSH would be less effective than individual face-to-face therapy and result in less client satisfaction.

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