scholarly journals Addressing concerns about smoking cessation and mental health: theoretical review and practical guide for healthcare professionals

2020 ◽  
pp. 1-11
Author(s):  
Gemma M. J. Taylor ◽  
Amanda L. Baker ◽  
Nadine Fox ◽  
David S. Kessler ◽  
Paul Aveyard ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Evidence Based ◽  
Depression And Anxiety ◽  
Stop Smoking ◽  
Cognitive Behavioural

SUMMARY Smoking rates in people with depression and anxiety are twice as high as in the general population, even though people with depression and anxiety are motivated to stop smoking. Most healthcare professionals are aware that stopping smoking is one of the greatest changes that people can make to improve their health. However, smoking cessation can be a difficult topic to raise. Evidence suggests that smoking may cause some mental health problems, and that the tobacco withdrawal cycle partly contributes to worse mental health. By stopping smoking, a person's mental health may improve, and the size of this improvement might be equal to taking antidepressants. In this article we outline ways in which healthcare professionals can compassionately and respectfully raise the topic of smoking to encourage smoking cessation. We draw on evidence-based methods such as cognitive–behavioural therapy (CBT) and outline approaches that healthcare professionals can use to integrate these methods into routine care to help their patients stop smoking.

Psychiatry

2018 ◽  
Author(s):  
Isabel McMullen
Keyword(s):  
Mental Health ◽  
Psychiatric Illness ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Behavioural Therapy ◽  
Outpatient Clinics ◽  
Personal Stories ◽  
Cognitive Behavioural ◽  
The Uk ◽  
State Examination

Mental health problems are estimated to affect one in four people each year in the UK, making mental illness one of the commonest presentations to GP surgeries, outpatient clinics, and Emergency Departments. Yet many doctors and medical students feel uncertain about how to approach patients with a psychiatric disorder. The key to becoming a good psychiatrist lies in the clinical interview. There are few physical signs or investigations that allow doctors to diagnose psychiatric illness, so a detailed history and mental state examination are important. As a psychiatrist, you are in the privileged position of having patients tell you their personal stories, and the skill is in listening attentively and asking relevant questions to help to clarify parts of the story. The best way to practise these techniques is to watch experienced clinicians at work and to interview patients yourself. Obviously diagnosis is important, so you need to be aware of the types of symptoms that fit with each type of disorder, as well as the medical conditions that may mimic psychiatric illness. Investigations may be necessary to rule out other diseases, and you need to be able to request these appropriately. Psychiatrists have access to a range of treatments—medical (e.g. antidepressants), psychological (e.g. cognitive behavioural therapy), and physical (e.g. electroconvulsive therapy)—and you need to know which ones to recommend. Most of these treatments are delivered in conjunction with the multidisciplinary team, so you should be clear about the roles of each team member. Finally, there is overlap between psychiatry and the law, which can raise interesting ethical issues. It is sometimes necessary to treat a person against their will, for the safety of that person or others, so you need to know about mental health law. Psychiatrists are also often requested to provide a second opinion in difficult capacity assessments.

In Conversation… Reducing mental health problems in schools

2018 ◽  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioural Therapy ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Health Problems ◽  
Clinical Psychologist ◽  
Therapy Approach ◽  
Whole School ◽  
Cognitive Behavioural

Dr Sophie Browning is a Consultant Clinical Psychologist working on whole school approaches to mental health. In this podcast with psychology journalist Jo Carlowe, she discusses an innovative cognitive behavioural therapy approach for reducing anxiety and mental health problems in schools. You can listen to this podcast on SoundCloud or iTunes.

Organisational Readiness for Implementing an Internet-Based Cognitive Behavioural Therapy Intervention for Depression across Community Mental Health Services in Albania and Kosovo: A Directed Content Qualitative Study. (Preprint)

2021 ◽  
Author(s):  
Asmae Doukani ◽  
Arlinda Cerga Pashoja ◽  
Naim Fanaj ◽  
Gentiana Qirjako ◽  
Andia Meksi ◽  
...  
Keyword(s):  
Mental Health ◽  
Content Analysis ◽  
Cognitive Behavioural Therapy ◽  
Clinical Supervision ◽  
Clinical Training ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Change Commitment

BACKGROUND The use of digital mental health (MH) programs such as internet-based cognitive behavioural therapy (iCBT) hold promise in increasing the quality and access of MH services. However very little research has been conducted in understanding the feasibility of implementing iCBT in Eastern Europe. OBJECTIVE To qualitatively examine organisational readiness for implementing iCBT for depression within community MH centres (CMHCs) across Albania and Kosovo. METHODS Qualitative semi-structured focus group discussions (FGDs) guided by Bryan Weiner’s model of organisational readiness for implementing change were conducted. The questions broadly explored shared determination to implement change, (change commitment), and shared belief in their collective capability to do so (change efficacy). Data were collected between November and December 2017. A range of healthcare professionals working in and in association with the CMHCs were recruited from three CMHCs in Albania, and four CMHCs in Kosovo, which are participating in a large multinational trial on the implementation of iCBT across nine countries (Horizon 2020 ImpleMentAll project). Data were analysed using a directed approach to qualitative content analysis, which used a combination of both inductive and deductive approaches. RESULTS Six FGDs involving 69 MH care professionals were conducted. Participants from Kosovo (n=36) and Albania (n=33) were mostly female (n=48, 69.9%) and nurses (n=26, 37.7%), with an average age of 41.3 years. A qualitative directed content analysis revealed several barriers and facilitators potentially affecting the implementation of digital CBT interventions for depression in community MH settings. While commitment for change was high, change efficacy was limited due to a range of situational factors. Barriers impacting ‘change efficacy’ included lack of clinical fit for iCBT, high stigma affecting help-seeking behaviours, lack of human resources, poor technological infrastructure, and high caseload. Facilitators included having a high interest and capability in receiving training for iCBT. For ‘change commitment’, participants largely expressed welcoming innovation and that iCBT could increase access to treatments for geographically isolated people, and reduce the stigma associated with MH care. CONCLUSIONS In all, participants perceived iCBT positively in relation to promoting innovation in MH care, increasing access to services and reducing stigma. On the other hand, a range of barriers were also highlighted in relation to accessing the target treatment population, a culture of MH stigma, underdeveloped ICT infrastructure and limited appropriately trained healthcare workforce. Such barriers may be addressed through, (a) a public facing campaign that addresses MH stigma, (b) service-level adjustments that permit staff with the time, resources and clinical supervision to deliver iCBT, and (c) establishment of suitable clinical training curriculum for healthcare professionals. CLINICALTRIAL ClinicalTrials.gov NCT03652883. 29 August 2018

scholarly journals Engagement and outcomes for a computerised cognitive-behavioural therapy intervention for anxiety and depression in African Americans

BJPsych Open ◽  
2017 ◽  
Vol 3 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Charles R. Jonassaint ◽  
Patrice Gibbs ◽  
Bea Herbeck Belnap ◽  
Jordan F. Karp ◽  
Kaleab Z. Abebe ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
African Americans ◽  
Cognitive Behavioural Therapy ◽  
Randomised Clinical Trial ◽  
Behavioural Therapy ◽  
Anxiety Symptoms ◽  
Primary Care Doctor ◽  
Depression And Anxiety ◽  
Cognitive Behavioural

BackgroundComputerised cognitive-behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans.AimsWe studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18–75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for depression and anxiety.MethodPatients with moderate levels of mood and/or anxiety symptoms (PHQ-9 or GAD-7≥10) were randomised to receive either care-manager-guided access to the proven-effective Beating the Blues® CCBT programme or usual care from their primary care doctor.ResultsCompared with White participants, African Americans were less likely to start the CCBT programme (P=0.01), and those who did completed fewer sessions and were less likely to complete the full programme (P=0.03). Despite lower engagement, however, African Americans who started the CCBT programme experienced a greater decrease in self-reported depressive symptoms (estimated 8-session change: −6.6 v. −5.5; P=0.06) and similar decrease in anxiety symptoms (−5.3 v. −5.6; P=0.80) compared with White participants.ConclusionsCCBT may be an efficient and scalable first-step to improving minority mental health and reducing disparities in access to evidence-based healthcare.

Befriending versus CBT for Schizophrenia: A Convergent and Divergent Fidelity Check

2005 ◽  
Vol 34 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Derek Milne ◽  
Sarah Wharton ◽  
Ian James ◽  
Doug Turkington
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Symptom Improvement ◽  
Initial Symptom ◽  
Archival Data ◽  
Effective Interventions ◽  
Cognitive Behavioural ◽  
Speech Content

Befriending (BF) has received attention as a beneficial part of mental health care. For example, when compared with cognitive-behavioural therapy (CBT) for schizophrenia, BF was found to be as effective as CBT in terms of initial symptom improvement (Sensky et al., 2000). Why was the BF apparently so effective? Was the BF really a discrete and powerful intervention? Or was it simply an unrecognized aspect of regular CBT? We addressed these questions by first observing BF's convergence with “social support” (a plausibly discrete treatment) and, second, by examining its divergence from CBT, drawing on archival data. For the convergence prediction we correlated the speech content of therapists' in 10 BF sessions from the Sensky et al. study with previously published social support data from stylists working with people with severe mental health problems in a psychiatric hospital (Milne and Netherwood, 1997). For the second prediction the same 10 BF sessions were compared with a sample of 10 CBT sessions, also from the Sensky et al. study. The results indicated that BF was indeed significantly correlated (converged) with social support (r=0.7; p<.05), and also that it did differ (diverged) significantly from CBT (p<.05). As a treatment fidelity check, therefore, these findings indicate tentatively that the two treatments in the Sensky et al. (2000) study were appropriately implemented. As an analysis of effective interventions for schizophrenia, it cautiously suggests that “social support” merits serious attention, and is perhaps no mere placebo.

Are Depressed Adolescents Routinely Offered CBT? A Brief Review of Current Practice

2007 ◽  
Vol 36 (1) ◽  
pp. 113-117 ◽  
Author(s):  
Gill Ross ◽  
Chris Brannigan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Depression ◽  
Behavioural Therapy ◽  
Postal Questionnaire ◽  
Evidence Based ◽  
Empirically Supported ◽  
Cognitive Behavioural ◽  
Research Findings

AbstractAn increasing body of research in support of cognitive-behavioural therapy (CBT) for adolescent depression has emerged during the last two decades. However, it has been suggested that empirically supported treatments are seldom carried out in clinical practice. Although the reasons for this are likely to be diverse, it is argued that mental health services have an ethical responsibility to offer evidence-based interventions. Whether empirically supported interventions, such as CBT, are consistently offered to depressed adolescents attending Child and Adolescent Mental Health Services (CAMHS) is currently unknown. A primary aim of this study was to survey the use of CBT for depression in a number of United Kingdom (UK) CAMHS settings. A postal questionnaire was sent to 117 members of the BABCP Children, Adolescents and Families Special Interest Branch, of which 44 completed questionnaires were returned. Descriptive statistics indicate that just over half of the organizations represented routinely offered CBT to depressed adolescents. CBT practice and the transportation of evidence-based research findings to CAMHS settings are discussed.

scholarly journals Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review

2020 ◽  
Author(s):  
Suzannah Stuijfzand ◽  
Camille Deforges ◽  
Vania Sandoz ◽  
Consuela-Thais Consuela-Thais Sajin ◽  
Cécile Jaques ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Care ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Psychological Impact ◽  
Health Problems ◽  
Drug Misuse ◽  
Mental Wellbeing ◽  
Rapid Review ◽  
Evidence Based

Abstract Background: Epidemics or pandemics, such as the current Coronavirus Disease 2019 (COVID-19) crisis, pose unique challenges to healthcare professionals (HCPs). Caring for patients during an epidemic/pandemic may impact negatively on the mental health of HCPs. There is a lack of evidence-based advice on what would be effective in mitigating this impact. Objectives: This rapid review synthesizes the evidence on the psychological impact of pandemics/epidemics on the mental health of HCPs, what factors predict this impact, and the evidence of prevention/intervention strategies to reduce this impact. Method: According to rapid review guidelines, systematic searches were carried out in Embase.com, PubMed, APA PsycINFO-Ovid SP, and Web of Science (core collection). Searches were restricted to the years 2003 or later to ensure inclusion of the most recent epidemic/pandemics, such as Severe Acute Respiratory Syndrome (SARS). Papers written in French or English, published in peer-reviewed journals, and of quantitative design using validated measures of mental health outcomes were included. Of 1308 papers found, 50 were included. The full protocol for this rapid review was registered with Prospero ( reg.no. CRD42020175985). Results: Results show that exposed HCPs working with patients during an epidemic/pandemic are at heightened risk of mental health problems in the short and longer term, particularly: psychological distress, insomnia, alcohol/drug misuse, and symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, burnout, anger, and higher perceived stress. These mental health problems are predicted by organizational, social, personal, and psychological factors and may interfere with the quality of patient care. Few evidence-based early interventions exist so far. Discussion: HCPs need to be provided with psychosocial support to protect their mental wellbeing if they are to continue to provide high quality patient care. Several recommendations relevant during and after an epidemic/pandemic, such as COVID-19, and in preparation for a future outbreak, are proposed.

scholarly journals Developing and implementing an online psychotherapy program to address mental health challenges in oncology and palliative care patients: Protocol (Preprint)

2021 ◽  
Author(s):  
Nazanin Alavi ◽  
Callum Stephenson ◽  
Shadé Miller ◽  
Payam Khalafi ◽  
Israa Sinan ◽  
...  
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
Behavioural Therapy ◽  
Depression And Anxiety ◽  
Treatment As Usual ◽  
Online Delivery ◽  
Online Psychotherapy ◽  
Cognitive Behavioural ◽  
Mental Health Challenges ◽  
Psychotherapy Program

BACKGROUND The demand for mental health care, particularly for depression and anxiety, is three times greater in oncology and palliative care patients compared to the general population. This population faces unique barriers making them more susceptible to mental health challenges. Various forms of psychotherapy have been deemed effective in addressing mental health challenges in this population including supportive psychotherapy, cognitive behavioural therapy, problem-based therapy, and mindfulness. However, oncology and palliative care patient's access to traditional face-to-face psychotherapy resources is limited due to compromised immune systems making frequent visits to hospitals dangerous. Additionally, patients can face hospital fatigue from numerous appointments and investigations or may live in remote areas making commutes both physically and financially taxing. The online delivery of psychotherapy is a promising solution to address these accessibility barriers. Moreover, the online delivery of psychotherapy has been proven effective in addressing depression and anxiety in other populations and may be able to be transferred to oncology and palliative care patients. OBJECTIVE The study will investigate the feasibility and effectiveness of online delivery of psychotherapy for oncology and palliative care patients with comorbid depression or anxiety. It is hypothesized that this program will be a viable and efficacious treatment modality compared to treatment as usual in addressing depression and anxiety symptoms in this population. METHODS Participants (n = 60) with depression or anxiety will be recruited from oncology and palliative care settings in Kingston, Ontario, Canada. Participants will be randomly allocated to either receive 8 weeks of online psychotherapy plus treatment as usual (treatment arm), or treatment as usual exclusively (control arm). The online psychotherapy program will incorporate cognitive behavioural therapy, mindfulness, and problem-solving skills as well as homework assignments with personalized feedback from a therapist. All online programs will be delivered through a secure online platform specifically designed for the online delivery of psychotherapy. To evaluate treatment efficacy, all participants will complete standardized symptomology questionnaires at baseline, mid-point (week 4), and post-treatment. RESULTS The study received ethics approval in February 2021 and began recruitment in April 2021. Participant recruitment has been conducted through social media advertisements, physical advertisements, and physician referrals. To date, there have been 11 (treatment n = 5; control n = 4; drop-out n = 2) participants recruited. Data collection is expected to conclude by December 2021, and data analysis is expected to be completed by January 2022. Linear regression (for continuous outcomes) will be conducted with interpretive qualitative methods. CONCLUSIONS Findings from this study can be incorporated into clinical policy and help develop more accessible mental health treatment options for oncology and palliative care patients. The asynchronous and online delivery of psychotherapy is a more accessible, scalable, and financially feasible treatment that could have major implications on the health care system. CLINICALTRIAL ClinicalTrials.gov NCT04664270; clinicaltrials.gov/ct2/show/NCT04664270

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