scholarly journals Radically open dialectical behaviour therapy adapted for adolescents: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Baudinet ◽  
Catherine Stewart ◽  
Eleanor Bennett ◽  
Anna Konstantellou ◽  
Rhian Parham ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Case Series ◽  
Small Sample ◽  
Behaviour Therapy ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Dialectical Behaviour Therapy ◽  
Symptoms Of Depression ◽  
Self Harm

Abstract Background Overcontrol is a transdiagnostic cluster of traits associated with excessive psychological, behavioural and social inhibitory control. It is associated with psychiatric diagnoses of depression, restrictive eating disorders and/or obsessive-compulsive personality disorder. Radically Open Dialectical Behaviour Therapy is a transdiagnostic treatment for maladaptive overcontrol. This case series evaluates an adolescent adaption (RO-A) for a transdiagnostic group of adolescents identified as overcontrolled. Methods Twenty-eight adolescents were consecutively referred for RO-A from two different National and Specialist Child and Adolescent Mental Health Services between June 2017 and February 2020. Baseline self-report measures assessed overcontrol characteristics, relationship and attachment quality and mental health symptoms of depression and eating disorders, which were repeated at discharge. Results Adolescents in this case series reported high rates of depression (78.6%), self-harm (64.3%) and eating disorders (78.6%). Most (85.7%) had two or more mental health diagnoses and all had previous mental health treatments before starting RO-A. The mean number of RO-A sessions attended was 18 group-based skills classes and 21 individual sessions over a mean period of 34 weeks. Significant improvements with medium and large effect sizes were reported in cognitive flexibility (d = 1.63), risk aversion (d = 1.17), increased reward processing (d = .79) and reduced suppression of emotional expression (d = .72). Adolescents also reported feeling less socially withdrawn (d = .97), more connected to others (d = 1.03), as well as more confident (d = 1.10) and comfortable (d = .85) in attachment relationships. Symptoms of depression (d = .71), eating disorders (d = 1.06) and rates of self-harm (V = .39) also significantly improved. Exploratory correlation analyses suggest improvements in overcontrol are moderately to strongly correlated with improvements in symptoms of depression and eating disorders. Conclusions This case series provides preliminary data that RO-A may be an effective new treatment for adolescents with overcontrol and moderate to severe mental health disorders like depression and eating disorders. RO-A led to improved management of overcontrol, improved relationship quality and reduced mental health symptoms. Further evaluation is indicated by this case series, particularly for underweight young people with eating disorders. More rigorous testing of the model is required as conclusions are only tentative due to the small sample size and methodological limitations.

Dialectical behaviour therapy for younger adults: evaluation of 22 weeks of community delivered dialectical behaviour therapy for females 18–25 years

2015 ◽  
Vol 32 (4) ◽  
pp. 299-305 ◽  
Author(s):  
J. L. Lyng ◽  
M. A. Swales ◽  
R. P. Hastings
Keyword(s):  
Mental Health ◽  
Health Centre ◽  
Drop Out ◽  
Self Report ◽  
Future Research ◽  
Behaviour Therapy ◽  
Mental Health Symptoms ◽  
Younger Adults ◽  
Health Symptoms ◽  
Dialectical Behaviour Therapy

BackgroundDialectical behaviour therapy (DBT) is a multi-modal psychological therapy with established efficacy in treating borderline personality disorder (BPD). Younger adults represent a group more likely to drop out of treatment than their older counterparts and treatments specifically targeted at this younger cohort may be advantageous.The current studyWe describe an evaluation of a DBT programme in a mental health centre for younger adults 18–25 years who met criteria for BPD (n=11).MethodologyWe used a simple pre/post-test design, measuring BPD symptoms, general mental health symptoms, and coping skills using self-report questionnaires at the beginning of DBT and again following the delivery of 22 weeks of DBT.FindingsStatistically significant reductions were found in BPD symptoms and several mental health symptoms alongside an increase in DBT skills use. Dropout was 31% at 22 weeks of treatment. Methodological weaknesses and avenues for future research are discussed.

scholarly journals Preventing mental health symptoms in adolescents using dialectical behaviour therapy skills group: a feasibility study

2017 ◽  
Vol 23 (1) ◽  
pp. 70-85 ◽  
Author(s):  
Rowan Burckhardt ◽  
Vijaya Manicavasagar ◽  
Frances Shaw ◽  
Andrea Fogarty ◽  
Philip J. Batterham ◽  
...  
Keyword(s):  
Mental Health ◽  
Feasibility Study ◽  
Behaviour Therapy ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Dialectical Behaviour Therapy ◽  
Skills Group ◽  
Group A

Manual-assisted cognitive-behaviour therapy (MACT): a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self-harm

1999 ◽  
Vol 29 (1) ◽  
pp. 19-25 ◽  
Author(s):  
K. EVANS ◽  
P. TYRER ◽  
J. CATALAN ◽  
U. SCHMIDT ◽  
K. DAVIDSON ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Small Sample ◽  
Cost Of Care ◽  
Behaviour Therapy ◽  
Deliberate Self Harm ◽  
Dialectical Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Self Harm

Background. The treatment of deliberate self-harm (parasuicide) remains limited in efficacy. Despite a range of psychosocial, educational and pharmacological interventions only one approach, dialectical behaviour therapy, a form of cognitive-behaviour therapy (CBT), has been shown to reduce repeat episodes, but this is lengthy and intensive and difficult to extrapolate to busy clinical practice. We investigated the effectiveness of a new manual-based treatment varying from bibliotherapy (six self-help booklets) alone to six sessions of cognitive therapy linked to the booklets, which contained elements of dialectical behaviour therapy.Methods. Thirty-four patients, aged between 16 and 50, seen after an episode of deliberate self-harm, with personality disturbance within the flamboyant cluster and a previous parasuicide episode within the past 12 months, were randomly assigned to treatment with manual-assisted cognitive-behaviour therapy (MACT N=18) or treatment as usual (TAU N=16). Assessment of clinical symptoms and social function were made at baseline and repeated by an independent assessor masked to treatment allocation at 6 months. The number and rate of all parasuicide attempts, time to next episode and costs of care were also determined.Results. Thirty-two patients (18 MACT; 14 TAU) were seen at follow-up and 10 patients in each group (56% MACT and 71% TAU) had a suicidal act during the 6 months. The rate of suicidal acts per month was lower with MACT (median 0·17/month MACT; 0·37/month TAU; P=0·11) and self-rated depressive symptoms also improved (P=0·03). The treatment involved a mean of 2·7 sessions and the observed average cost of care was 46% less with MACT (P=0·22).Conclusions. Although limited by the small sample, the results of this pilot study suggest that this new form of cognitive-behaviour therapy is promising in its efficacy and feasible in clinical practice.

scholarly journals A pilot study of the impact of an integrated individual- and family therapy model for self-harming adolescents on overall healthcare consumption

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Moa Bråthén Wijana ◽  
Inna Feldman ◽  
Richard Ssegonja ◽  
Pia Enebrink ◽  
Ata Ghaderi
Keyword(s):  
Mental Health ◽  
Family Therapy ◽  
Clinical Outcomes ◽  
Small Sample ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Healthcare Consumption ◽  
General Mental Health ◽  
The Cost ◽  
The Impact

Abstract Background Self-harming behaviors in adolescents cause great suffering and can lead to considerable costs to the healthcare system. The aim of the current study was to investigate the cost of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) and to compare the adolescent’s healthcare consumption 1 year before and 1 year after treatment. Method The study had a within group design with repeated measures. The clinical outcomes and the cost of ICT treatment are based on a sample of 49 participants who were previously enrolled in an intervention trial. Participants with significantly improved clinical outcomes (self-harm behavior, or general mental health symptoms) were defined as treatment responders. Calculation of changes in healthcare consumption is based on 25 participants who gave their consent to participate in a retrospective collection of healthcare data from medical records, including inpatient and outpatient care, and prescribed medication. Results The average estimated cost of ICT per person was €5293. There were no significant differences between the cost of healthcare consumption 1 year before and after ICT, but the results suggested that the adolescents consumed less inpatient and specialized care after treatment. There was a significantly higher cost of psychotropic medication after treatment explained by a higher consumption of central stimulants. Treatment responders (general mental health problems) reduced their consumption of healthcare resources significantly more than non-responders, especially regarding hospital visits and total health care costs. Conclusions Good response to the ICT in terms of improved general mental health symptoms seems to be associated with reduced healthcare consumption during the post-treatment period. However, controlled studies with larger sample sizes are needed to draw causal conclusions. The results of this study should be interpreted with caution as it is based on a small sample and attrition rate was high. Trial registration This study has been registered with the ISRCTN: 15885573.

scholarly journals Targeting maladaptive overcontrol with radically open dialectical behaviour therapy in a day programme for adolescents with restrictive eating disorders: an uncontrolled case series

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Julian Baudinet ◽  
Mima Simic ◽  
Helena Griffiths ◽  
Cecily Donnelly ◽  
Catherine Stewart ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Social Connectedness ◽  
Case Series ◽  
Self Report ◽  
Behaviour Therapy ◽  
Treatment Needs ◽  
Dialectical Behaviour Therapy ◽  
Restrictive Eating ◽  
Eating Disorder Symptoms

Abstract Background Radically Open Dialectical Behaviour Therapy (RO-DBT) was developed to target maladaptive overcontrol, a proposed core difficulty of restrictive eating disorders. RO-DBT is now the main group treatment model at the Intensive day Treatment Programme (ITP), Maudsley Hospital. This ITP case series aimed to investigate whether overcontrol is associated with restrictive eating disorder symptoms in adolescents and to evaluate ITP outcomes since RO-DBT skills classes were introduced. Method Self-report measures of eating disorder symptoms and temperament, personality and social characteristics linked to overcontrol were collected at assessment and discharge from ITP for all consecutive adolescents who attended between February 2015 and January 2019 (N = 131). Weight change, global outcomes and treatment needs post-ITP were also recorded. Results Eating disorder symptoms at assessment were significantly correlated with overcontrol factors, including social connectedness (r = −.67), reward responsivity (r = −.54), and cognitive inflexibility (r = .52). Adolescents stayed in ITP on average 13.40 weeks. 70.8% had a Good-Intermediate outcome on Morgan-Russell scale. 4.6% did not respond and were referred to inpatient treatment from ITP. Significant improvements in drive for thinness (d = .33), depressive mood (d = .41), social connectedness (d = .48), and emotional expressiveness (d = .97) were reported at discharge. No changes were observed in perfectionism or negative temperament. Conclusions This study offers preliminary evidence that eating disorder symptoms are associated with overcontrol factors in adolescence and that they can improve with RO-DBT informed day programme treatment. RO-DBT is a promising treatment that offers a new way of conceptualising treatment targets and recovery for adolescent restrictive eating disorders.

Dating Violence: Mental Health Consequences Based on Type of Abuse

2012 ◽  
Vol 27 (2) ◽  
pp. 215-228 ◽  
Author(s):  
Lee Eshelman ◽  
Alytia A. Levendosky
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Physical Abuse ◽  
Female College Students ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Symptoms Of Depression ◽  
Physical Injuries ◽  
Type Of Abuse ◽  
Physical And Sexual Abuse

This study aims to determine the relationship between psychological, physical, and sexual abuse, and mental health symptoms. Female college students (N = 499) completed anonymous online surveys to report experiences of abuse, as well as symptoms of depression, posttraumatic stress disorder (PTSD), and physical injuries. Five groups of participants were found: no abuse; psychological abuse; physical abuse; psychological and physical abuse; and psychological, physical, and sexual abuse. The multiple abuse groups showed the highest rate of mental health symptoms. In addition, increased frequency of abuse was related to more mental health symptoms and more physical injuries.

scholarly journals Representation of #CAMHS on social media platform TikTok

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S241-S242
Author(s):  
Preetisha Chadee ◽  
Sacha Evans
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Service Users ◽  
Mental Health Symptoms ◽  
Negative Perception ◽  
Health Symptoms ◽  
Raising Awareness ◽  
Media Platform ◽  
Self Harm ◽  
Insight Into

AimsThe video-based free social media app, TikTok, has grown in popularity during the COVID-19 pandemic, with half of British children using Tik Tok regularly. With more than 2 billion downloads, it was the most downloaded app of 2020. Child and Adolescent Mental Health Services (CAMHS) is currently found on TikTok via the hashtag #CAMHS. The aim of this study was to explore how CAMHS is represented on TikTok through reviewing the hashtags associated with CAMHS and exploring the themes of videos with the #CAMHS hashtag.MethodThe Tik Tok app was downloaded and a search for the hashtags which featured the word #CAMHS was undertaken. A thematic analysis of the top 100 most popular uploaded videos featuring the #CAMHS was conducted. The number of likes, views and shares of the videos featuring each theme was recorded.ResultVideos with the hashtag #CAMHS had 203.9 million views, followed by: #camhsmeme(s) totalling 43.1 million views, #camhsjokes with 21.4 million views and #camhskids, 12.5 million views. The top 100 most popular videos represented 24% of total viewed videos with the hashtag #CAMHS.The most popular recurrent themes associated with the hashtag #CAMHS in our sample were: raising awareness of mental health symptoms and management (40% of videos), reference to self-harm (27% of videos) and negative perception of CAMHS (27% of videos).Raising awareness of mental health symptoms and management had the most likes (3,694,700) and views (17,435,900). This was followed by videos with themes of reference to self-harm (3,006,300 likes and 14,382,700 views). The most shared themes were: reference to suicide (shared 56,763 times) and videos which portrayed a theme of negative perception of CAMHS (40,628 shares). Videos with themes of a negative perception of CAMHS also garnered 1,762,500 likes and 8,666,900 views.ConclusionCAMHS is actively represented on TikTok through freely accessible unregulated videos. Videos with themes of raising awareness of mental health symptoms and management can potentially allow young people to share their experiences. Nonetheless, popular hashtags such as #CAMHSmemes and #CAMHSjokes, as well as videos featuring themes of negative perception of CAMHS, could potentially undermine the reputation of CAMHS to existing and future service users. The content of these videos should be taken seriously by CAMHS clinicians as it can potentially provide an insight into service users’ experiences of CAMHS on a scale that has not been observed before. Presently these videos are not screened or modulated by the NHS CAMHS service.

A national survey of self-reported mental health of Veterans pursuing post-secondary education in Canada

2021 ◽  
pp. e20200047
Author(s):  
John S. Ogrodniczuka ◽  
Tim Laidler ◽  
John L. Oliffecc
Keyword(s):  
Mental Health ◽  
Secondary Education ◽  
Psychological Symptoms ◽  
Post Secondary Education ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Post Secondary ◽  
The Past ◽  
High Prevalence ◽  
Self Harm

Lay Summary This article details self-reported mental health symptoms among Canadian Veterans pursing post-secondary education in Canada. Participants reported high prevalence of psychological symptoms, most notably feeling exhausted (80.5%) and overwhelmed (78.9%). More than 1 in 10 respondents reported seriously considering suicide (13.4%), and 5.9% had attempted suicide in the past 12 months. Furthermore, 8.7% of respondents had indicated intentional self-harm (cut, burned, bruised, or otherwise injured themselves) within the past 12 months. The findings reflect significant mental health symptoms for Veterans attending Canadian colleges and universities, underscoring the need to provide tailored services to safely integrate Veterans to campus life.

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