scholarly journals Treatment outcomes in depression: reducing drop-out rates in cognitive therapy

2018 ◽  
Vol 24 (2) ◽  
pp. 101-109
Author(s):  
Alexandra D. Pentaraki
Keyword(s):  
Cognitive Therapy ◽  
Behavioural Therapy ◽  
Learning Objectives ◽  
Drop Out ◽  
List Type ◽  
Related Factors ◽  
Factors Associated ◽  
Cognitive Behavioural ◽  
Promising Treatment ◽  
Drop Out Rates

SUMMARYAlthough cognitive therapy is a promising treatment for depression, high drop-out rates and, conversely, the specific elements that make the intervention effective continue to puzzle practising clinicians. This article discusses both therapist-related factors (including competence and competencies) and patient-related factors (such as engagement in therapy and external logistical problems with attendance) that are related to drop-out and suggests practical ways to address them and improve outcomes. It examines cognitive and behavioural elements of manualised cognitive therapy and discusses findings relating to cognitive–behavioural therapy (CBT) in particular.LEARNING OBJECTIVES•Understand factors associated with high drop-out rates in the cognitive therapy of depression and ways to reduce them•Learn about treatment integrity in cognitive therapy of depression and its relationship to the clinical outcome•Identify specific cognitive therapy techniques associated with patients' improvement in depressionDECLARATION OF INTERESTNone.

scholarly journals Health anxiety: detection and treatment

2018 ◽  
Vol 24 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Peter Tyrer ◽  
Helen Tyrer
Keyword(s):  
Health Anxiety ◽  
Behavioural Therapy ◽  
Learning Objectives ◽  
List Type ◽  
Psychological Treatments ◽  
Cognitive Behavioural ◽  
New Diagnosis ◽  
Changing Attitudes ◽  
Term Benefit

SUMMARYHealth anxiety is an important new diagnosis that is increasing in frequency because of changing attitudes towards health, particularly excessive use of health information on the internet (cyberchondria). People with abnormal health anxiety become over-diligent monitors of their health, misinterpret most somatic sensations as evidence of disease, consult medical professionals unnecessarily and frequently, and are often over-investigated. Relatively few patients with health anxiety present to psychiatrists; most are seen in primary and secondary medical care. This paper reviews the diagnosis and presenting features of health anxiety, its identification in practice and its treatment. A range of simple psychological treatments have been shown to have long-lasting benefit for the disorder but are greatly under-used.LEARNING OBJECTIVES•To be able to identify abnormal health anxiety with the aid of probe questions•To respond to people whom you have identified with excessive health anxiety in a way that facilitates its treatment•To learn a few simple techniques derived from cognitive–behavioural therapy that can lead to long-term benefitDECLARATION OF INTERESTNone.

scholarly journals What we know, what we do not know, and where are we heading? Efficacy and acceptability of psychological interventions for depression

2015 ◽  
Vol 25 (4) ◽  
pp. 301-308 ◽  
Author(s):  
N. Solomonov ◽  
J. P. Barber
Keyword(s):  
Randomized Clinical Trials ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Interpersonal Therapy ◽  
Problem Solving Therapy ◽  
Cognitive Behavioural ◽  
Treatment Of Depression ◽  
Personalised Treatment ◽  
Meta Analyses ◽  
And Control

In the past several decades, increasing evidence supports the efficacy of psychotherapies for depression. The vast majority of findings from meta-analyses, randomized clinical trials (RCTs) and naturalistic studies have demonstrated that well-established psychotherapies (behavioural activation, problem-solving therapy, psychodynamic therapy, cognitive-behavioural therapy, interpersonal therapy and emotion-focused therapy) are superior to no-treatment and control conditions, and are in most cases equally effective in treating depression. However, despite this abundant support for psychotherapies, studies have also consistently shown high drop-out rates, high percentages of non-respondent patients who experience treatment failures, and mixed findings regarding the enduring effects of psychotherapy. Thus, there is a need to develop more personalised treatment models tailored to patients’ needs. A new integrative sequential stepwise approach to the treatment of depression is suggested.

Factors associated with differential response to online cognitive behavioural therapy

2011 ◽  
Vol 47 (5) ◽  
pp. 827-833 ◽  
Author(s):  
Katherine S. Button ◽  
Nicola J. Wiles ◽  
Glyn Lewis ◽  
Tim J. Peters ◽  
David Kessler
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Differential Response ◽  
Factors Associated ◽  
Cognitive Behavioural

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.

scholarly journals ‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Katherine Newman-Taylor
Keyword(s):  
Behavioural Therapy ◽  
Illustrative Case ◽  
Imagery Task ◽  
List Type ◽  
Short Term ◽  
Cognitive Behavioural ◽  
Imagery Rescripting ◽  
Illustrative Case Study ◽  
The Impact

Abstract People with psychosis do not have routine access to trauma-focused cognitive behavioural therapy (CBT) interventions such as imagery rescripting (IR), partly due to clinical caution. This case study describes the use of a simple imagery task designed to engender ‘felt security’, as a means of facilitating IR with a woman struggling with distressing memory intrusions, linked to her voices and paranoia. We assessed the impact of the felt security task, which was used before IR to enable Kip to engage in reprocessing of her trauma memories, and again after IR so that she would leave sessions feeling safe. The brief imagery task was effective in improving felt security before IR sessions. Felt security then reduced during IR, when distressing material was recalled and reprocessed, and increased again when the task was repeated. It is not yet clear whether trauma-focused interventions such as IR need to be routinely adapted for people with psychosis. In the event that individuals express concerns about IR, if the person’s formulation indicates that high levels of arousal may trigger an exacerbation of voices, paranoia or risk, or where clinicians are otherwise concerned about interventions likely to increase emotional arousal in the short term, the felt security task may facilitate safe and effective reprocessing of trauma memories. This in turn may increase access to trauma-focused CBT for people with psychosis. Key learning aims (1) To understand that people with psychosis need access to trauma-focused CBT. (2) To be familiar with a simple attachment-based imagery task designed to foster ‘felt security’. (3) To learn that this task may facilitate imagery rescripting in people with psychosis.

The practice and research of cognitive behavioural therapy in Egypt: a review of the current status

2020 ◽  
Vol 13 ◽  
Author(s):  
Reham Aly ◽  
Hisham Ramy ◽  
Shanaya Rathod
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Arab World ◽  
Behavioural Therapy ◽  
Current Status ◽  
Evidence Based ◽  
List Type ◽  
Cultural Variations ◽  
Western Countries ◽  
Mixed Response ◽  
Cognitive Behavioural

Abstract Cognitive behavioural therapy (CBT) is generally defined as a short-term, problem-oriented psychotherapy that focuses on modifying dysfunctional emotions, thoughts and actions. In clinical practice, CBT consists of a number of cognitive and behavioural techniques that aim to help patients suffering from psychological disorders. The practice of CBT is well established in Western countries. In non-Western countries, CBT is still in the process of being established as the evidence-based psychotherapy. Despite being the heart of the Arab world, the development and practice of psychotherapy in Egypt in general, and CBT specifically, is still emerging. The training and practice of CBT has received a mixed response in Egypt. In practical settings, evidence-based CBT is subject to individual and cultural variations and adaptations. Many local studies examining the efficacy of CBT in psychiatric disorders among different population groups in Egypt have been conducted. Unfortunately, many of these studies have not been published and therefore have missed the opportunity for international recognition. The current review aims to explore the practice of CBT with a specific focus on national research of efficacy and adaptability of CBT for different populations in Egypt. Key learning aims (1) Current status of the practice and education of CBT in Egypt. (2) Body of research conducted on CBT in Egypt. (3) Needs and recommendations for further development of CBT provision in Egypt.

Client-led culturally responsive CBT – integrating familism in the treatment of chronic depression: a case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Lilian Skilbeck ◽  
Christopher Spanton ◽  
Ian Roylance
Keyword(s):  
Cultural Adaptation ◽  
Treatment Plan ◽  
Behavioural Therapy ◽  
Cultural Responsiveness ◽  
Chronic Depression ◽  
List Type ◽  
Her Family ◽  
Psychological Therapies ◽  
Cognitive Behavioural

Abstract Britain has increasingly become a multi-cultural society. In order to improve access to primary care psychological therapy including cognitive behavioural therapy (CBT), there has been an increase in focus on cultural adaptation and cultural responsiveness. To date, these adaptations have focused on domains such as language, beliefs and values. In this case, familism was the focus for adaptation. The client was a 22-year-old female from a black African-British background. She presented with severe symptoms of chronic depression as measured on routine standard questionnaires and the interview. She had minimal success from previous interventions and was struggling to make progress. Therapy was guided by the client’s views on what issues had a bearing on her difficulties. The client hypothesised that familism factors with themes around ‘my parents’ culture’ and ‘family comes first’ were interacting with her cognitive behavioural factors to maintain her problem. She requested the involvement of her family in her treatment plan. In line with the Improving Access to Psychological Therapies–Black, Asian and Minority Ethnic service user Positive Practice Guide, this was integrated as part of her formulation. Upon involvement of her father in a single session, the client attained reliable improvement. She attributed her improvement to this involvement. By the end of therapy, she reached recovery, which was maintained at 3-month follow-up. This study was responsive to the client’s own perceived cultural needs through the integration of familism into her CBT formulation. It illustrates a client-led cultural adaptation of CBT to treat chronic depression. Key learning aims It is hoped that the reader will increase their understanding of the following from reading this case study: (1) Creating an environment where clients can freely discuss their perceived cultural factors from the outset. (2) Client-led cultural responsiveness to their expressed cultural needs. (3) Familism as a domain for adapting CBT.

scholarly journals Computerised cognitive-behavioural therapy for depression: systematic review

2008 ◽  
Vol 193 (3) ◽  
pp. 181-184 ◽  
Author(s):  
Eva Kaltenthaler ◽  
Glenys Parry ◽  
Catherine Beverley ◽  
Michael Ferriter
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Treatment Options ◽  
Computer Software ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Potential Range ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Depression Education

BackgroundComputerised cognitive–behavioural therapy (CCBT) is used for treating depression and provides a potentially useful alternative to therapist cognitive–behavioural therapy (CBT).AimsTo systematically review the evidence for the effectiveness of CCBT for the treatment of mild to moderate depression.MethodElectronic databases were searched to identify randomised controlled trials. Selected studies were quality assessed and data extracted by two reviewers.ResultsFour studies of three computer software packages met the inclusion criteria. Comparators were treatment as usual, using a depression education website and an attention placebo.ConclusionsThere is some evidence to support the effectiveness of CCBT for the treatment of depression. However, all studies were associated with considerable drop-out rates and little evidence was presented regarding participants' preferences and the acceptability of the therapy. More research is needed to determine the place of CCBT in the potential range of treatment options offered to individuals with depression.

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