scholarly journals Psychodynamic psychotherapy: developing the evidence base

2014 ◽  
Vol 20 (4) ◽  
pp. 269-279 ◽  
Author(s):  
Jessica Yakeley
Keyword(s):  
Outcome Research ◽  
Psychodynamic Psychotherapy ◽  
Psychological Treatment ◽  
Psychotherapy Research ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Treatment Modalities ◽  
List Type ◽  
Therapeutic Modalities ◽  
Cognitive Behavioural

SummaryPsychodynamic psychotherapy has been criticised as being based on outdated principles of psychoanalysis and lacking an adequate evidence base to convincingly demonstrate its efficacy. This article summarises the recent evidence from high-quality outcome studies to show that psychodynamic psychotherapy is as effective in the treatment of a range of mental disorders as other psychological treatment modalities such as cognitive-behavioural therapy, as well as reviewing process-outcome research aiming to elucidate mechanisms of therapeutic change. A paradigm for psychodynamic psychotherapy research based on attachment theory is introduced, which may inform the development of psychodynamic therapeutic modalities tailored for specific conditions.LEARNING OBJECTIVESUnderstand the basic principles and techniques of psychodynamic psychotherapy.Be able to summarise the recent evidence base for the efficacy of psychodynamic psychotherapy.Appreciate process-outcome research that elucidates therapeutic mechanisms underpinning psychodynamic psychotherapy.

scholarly journals The evidence for cognitive behavioural therapy in any condition, population or context: a meta-review of systematic reviews and panoramic meta-analysis

2021 ◽  
Vol 51 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Beth Fordham ◽  
Thavapriya Sugavanam ◽  
Katherine Edwards ◽  
Paul Stallard ◽  
Robert Howard ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Prediction Interval ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Random Effect ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
World Health ◽  
Cognitive Behavioural ◽  
Treatment Research

AbstractThe majority of psychological treatment research is dedicated to investigating the effectiveness of cognitive behavioural therapy (CBT) across different conditions, population and contexts. We aimed to summarise the current systematic review evidence and evaluate the consistency of CBT's effect across different conditions. We included reviews of CBT randomised controlled trials in any: population, condition, format, context, with any type of comparator and published in English. We searched DARE, Cochrane, MEDLINE, EMBASE, PsycINFO, CINAHL, CDAS, and OpenGrey between 1992 and January 2019. Reviews were quality assessed, their data extracted and summarised. The effects upon health-related quality of life (HRQoL) were pooled, within-condition groups. If the across-condition heterogeneity was I2 < 75%, we pooled effects using a random-effect panoramic meta-analysis. We summarised 494 reviews (221 128 participants), representing 14/20 physical and 13/20 mental conditions (World Health Organisation's International Classification of Diseases). Most reviews were lower-quality (351/494), investigated face-to-face CBT (397/494), and in adults (378/494). Few reviews included trials conducted in Asia, South America or Africa (45/494). CBT produced a modest benefit across-conditions on HRQoL (standardised mean difference 0.23; 95% confidence intervals 0.14–0.33, I2 = 32%). The effect's associated prediction interval −0.05 to 0.50 suggested CBT will remain effective in conditions for which we do not currently have available evidence. While there remain some gaps in the completeness of the evidence base, we need to recognise the consistent evidence for the general benefit which CBT offers.

scholarly journals Internet-assisted cognitive behavioural therapy for non-cardiac chest pain: a pilot and feasibility study

2021 ◽  
Vol 14 ◽  
Author(s):  
Terje Thesen ◽  
Egil Jonsbu ◽  
Egil W. Martinsen ◽  
Joseph A. Himle ◽  
Frode Thorup ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Retention Rate ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
List Type ◽  
Structured Interviews ◽  
Cognitive Behavioural

Abstract Nearly half of patients with non-cardiac chest pain (NCCP) experience significant complaints after a negative cardiac evaluation, at considerable costs for society. Due to the lack of treatment capacity and low interest for psychological treatment among patients with somatic complaints, only a minority receive effective treatment. The aim of this study was to assess the feasibility and usefulness of internet-assisted cognitive behavioural therapy (I-CBT), including encouragement of physical activity for this condition. Ten patients with NCCP received a six-session I-CBT intervention with minimal support from a therapist. Questionnaires assessing cardiac anxiety, fear of bodily sensations, depression, interpretation of symptoms, frequency of chest pain and impact of chest pain symptoms were collected at baseline, post-treatment and at 3-month follow-up. Semi-structured interviews employing a phenomenological hermeneutic approach assessed the participants’ experience of the intervention. Quantitative results showed clear improvements in several measures both at end of treatment and at 3-month follow-up. The retention rate was 100% and client satisfaction was high. The intervention was feasible to implement in a cardiac setting. This setting made it easier for patients to accept a psychological approach. Qualitative interviews revealed that the participants felt respected and taken care of, and they obtained a better understanding of their chest pain and how to cope with it. This pilot study yielded promising results regarding feasibility, clinical effect and patient satisfaction from a brief I-CBT intervention for NCCP in a cardiac setting. These results indicate that a randomized controlled trial with a larger sample size is warranted. Key learning aims (1) Feasibility of internet-assisted cognitive behavioural therapy (I-CBT) for non-cardiac chest pain (NCCP). (2) How NCCP patients experience I-CBT. (3) Possible effects of I-CBT. (4) How I-CBT can be delivered at the Cardiac Department.

Interventions for specific conditions

2019 ◽  
pp. 253-260
Author(s):  
Ian Barkataki ◽  
Louise Ross
Keyword(s):  
Psychotic Disorders ◽  
Psychological Treatment ◽  
Bipolar Affective Disorder ◽  
Psychological Theory ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Supporting Evidence ◽  
Staff Support ◽  
Cognitive Behavioural

This chapter focuses on specific psychological interventions for disorders and conditions that commonly present within an inpatient environment. Three main psychological orientations (cognitive behavioural therapy, psychodynamic psychotherapy, and systemic therapy) are defined, along with their strengths and applicability for inpatient work. The importance of adapting psychological approaches in this setting is considered. Psychological theory, supporting evidence base, and specific techniques for mood disorders (including depression, bipolar affective disorder, and anxiety); psychotic disorders; and personality disorders are outlined in greater detail. The practical considerations of short-term and acute working, including the importance of staff support, in the delivery of effective psychological treatment on the ward are discussed.

Using the evidence base for social anxiety to understand and treat paranoia: a single case experimental design

2019 ◽  
Vol 12 ◽  
Author(s):  
Stephanie Hicks
Keyword(s):  
Experimental Design ◽  
Social Anxiety ◽  
Cognitive Biases ◽  
Single Case ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
List Type ◽  
Clinical Model ◽  
Intervention Method ◽  
Cognitive Behavioural

AbstractResearch suggests that paranoia and social anxiety can be understood as part of the same continuum, having shared processes such as the anticipation of threat, cognitive biases, poor self-concept, worry and safety-seeking behaviours. There is limited research on whether evidence-based interventions for social anxiety could be used with individuals who experience paranoia; however, an existing brief intervention study using techniques taken from cognitive behavioural therapy (CBT) for social anxiety has had promising results.This paper uses a single-case experimental design to explore whether using a clinical model of the maintenance of paranoia followed by CBT for social anxiety can be an effective formulation and intervention method in cases where social anxiety processes appear to be maintaining paranoid thoughts. This may be an effective formulation and intervention method, resulting in a reduction in anxiety and a reduction in the distress associated with paranoid thoughts. The clinical implications are discussed along with limitations and recommendations for further research.Key learning aims(1)To describe shared processes in social anxiety and paranoia.(2)To identify the benefits and limitations of using a clinical model of paranoia and CBT for social anxiety for formulation and intervention with individuals experiencing paranoia.(3)To identify areas where further research is warranted in treatment for individuals experiencing paranoia.

scholarly journals Group cognitive–behavioural therapy for anxiety and depression

2010 ◽  
Vol 16 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Graeme Whitfield
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Current Evidence ◽  
Anxiety And Depression ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Current Evidence Base ◽  
Group Cbt

SummaryCognitive–behavioural therapy (CBT) is a psychological treatment approach that can be delivered not only on a one-to-one basis but also to groups and in self-help formats. However, the evidence base supporting individual CBT is more extensive than the research regarding group CBT. This is likely to influence the choice of services that develop in the Improving Access to Psychological Therapies (IAPT) programme for the treatment of depression and anxiety disorders in primary care in England. This article outlines the different forms that group CBT takes, the way in which it may benefit people and the current evidence base supporting its use for anxiety and depression. It also outlines the advantages of group or individual CBT and describes those patients who appear to be best suited to a specific delivery.

scholarly journals Supportive psychodynamic psychotherapy for psychosis

2013 ◽  
Vol 19 (4) ◽  
pp. 310-318 ◽  
Author(s):  
Bent Rosenbaum ◽  
Brian Martindale ◽  
Alison Summers
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Treatment Option ◽  
Psychodynamic Psychotherapy ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Psychoanalytic Therapy ◽  
Advantages And Disadvantages ◽  
Cognitive Behavioural ◽  
The Uk

SummaryThe UK National Institute for Health and Care Excellence guidance suggests that psychodynamic principles may be used to understand the experiences of people with psychosis. In this article we consider the application of psychodynamic principles in psychotherapy for psychosis, focusing on one particular model: supportive psychodynamic psychotherapy (SPP). We describe this approach with a detailed fictitious case example and discuss how SPP has developed through significant modifications of classical psychoanalytic therapy and the evidence base for it. We consider its overlap with cognitive–behavioural therapy, its advantages and disadvantages, and the arguments for making SPP available as a treatment option in services for psychosis.

Increasing access to brief Coping Strategy Enhancement for distressing voices: a service valuation exploring a possible role for briefly-trained therapists

2021 ◽  
Vol 14 ◽  
Author(s):  
Phil Clarke ◽  
Anna-Marie Jones ◽  
Mark Hayward
Keyword(s):  
Coping Strategy ◽  
Primary Outcome ◽  
Negative Impact ◽  
Psychological Treatment ◽  
Service Evaluation ◽  
Behavioural Therapy ◽  
List Type ◽  
Hearing Voices ◽  
Cognitive Behavioural ◽  
Impact Scale

Abstract Hearing voices is a distressing and trans-diagnostic experience. Cognitive behavioural therapy (CBT) is an effective psychological treatment for distressing voices, but is offered to only a minority of patients. Limited resources are a barrier to accessing CBT. Evaluations of brief forms of CBT for voices have offered encouraging findings, but the ability of briefly-trained therapists to deliver these brief therapies has yet to be explored. We evaluated the outcomes of a brief form of CBT (Coping Strategy Enhancement, CSE) for voices when delivered by highly-trained and briefly-trained therapists. This was a service evaluation comparing pre–post outcomes in patients who had completed brief CSE over four sessions, within NHS Mental Health Services, delivered by highly-trained and briefly-trained therapists. The primary outcome was the negative impact scale of the Hamilton Program for Schizophrenia Voices Questionnaire. Data were available from 92 patients who completed a course of brief CSE – nearly half of whom received therapy from a briefly-trained therapist. Modest benefits across the sample were consistent with previous evaluations and did not seem to be influenced by the training of the therapist. This service evaluation offers further evidence that brief CSE can begin a therapeutic conversation about distressing voices within routine clinical practice. The usefulness of this initial conversation does not seem to be reliant upon the extent of therapist training, suggesting that briefly-trained therapists may play a role in increasing access to these conversations for patients distressed by hearing voices. Key learning aims (1) How can access to CBT be increased for patients distressed by hearing voices? (2) Can a wider workforce of briefly-trained therapists start a CBT-informed conversation about distressing voices? (3) How do the outcomes of these conversations compare with the same conversations facilitated by highly trained therapists?

Critical issues in cognitive behavioural therapy (CBT) with gender and sexual minorities (GSMs)

2022 ◽  
Vol 15 ◽  
Author(s):  
Sérgio A. Carvalho ◽  
Paula Castilho ◽  
Daniel Seabra ◽  
Céu Salvador ◽  
Daniel Rijo ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioural Therapy ◽  
Minority Stress ◽  
Sexual Minorities ◽  
Clinical Work ◽  
Behavioural Therapy ◽  
List Type ◽  
Cognitive Behavioural ◽  
Critical Issues ◽  
Societal Structure

Abstract In a cisheteronormative culture, gender and sexual minorities (GSMs) may experience additional challenges that get in the way of a meaningful life. It is crucial that clinicians are mindful of these challenges and cognizant about the specificities of clinical work with GSMs. This article points out how societal structure interferes with mental health, and clarifies what clinicians must take into account when using affirmative cognitive behavioural therapy (CBT) interventions. Knowledge of up-to-date terminology and use of affirmative language are the first steps that contribute to clients’ experience of respect, which is paramount for the development of a good therapeutic relationship. Considering a conceptual framework of minority stress to understand vulnerability in GSM, specificities in formulation and key psychological processes are discussed. Moreover, guidelines and practical tools for intervention are presented within a CBT approach. Some reflections on therapists’ own personal biases are encouraged, in order to increase the efficacy of interventions. Key learning aims After reading this article you will be able to: (1) Recognize the uniqueness of gender and sexual minorities (GSM) stressors in broad and specific contexts, and their impact on mental health. (2) Identify the underlying key processes and specificities in therapeutic work with GSMs, from a CBT perspective. (3) Recognize the importance of a culturally sensitive approach in affirmative CBT interventions.

Cost-effectiveness and cost-utility evaluation of the individual vs. group transdiagnostic psychological treatment for emotional disorders in Primary Care (PsicAP-Costs) v2

2021 ◽  
Author(s):  
Angel Aguilera-Martin ◽  
Mario Gálvez-Lara ◽  
Fátima Cuadrado ◽  
Eliana Moreno ◽  
Francisco García-Torres ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Emotional Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Cognitive Behavioural ◽  
Utility Evaluation ◽  
The Individual

The aim of this study is to compare, in cost-effectiveness and cost-utility terms, a brief transdiagnostic cognitive-behavioural therapy in two different modes, individual and group, with the treatment usually administered in primary care (TAU). Participants between 18 and 65 years old and with, according to the pretreatment evaluation, mild to moderate emotional disorders will be randomly allocated to the three clusters. They will be assessed again immediately after treatment and 6 and 12 months later. ClinicalTrials.gov: NCT04847310

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