scholarly journals Pathways to Recovery: development and evaluation of a cognitive–behavioural therapy in-patient treatment programme for adults with anorexia nervosa

2018 ◽  
Vol 42 (3) ◽  
pp. 95-101
Author(s):  
Andrea Brown ◽  
Richard Jenkinson ◽  
Julia Coakes ◽  
Annette Cockfield ◽  
Tish O'Brien ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Cognitive Behavioural Therapy ◽  
Previous Treatment ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Clinical Implications ◽  
Treatment Model ◽  
Treatment Programme ◽  
Cognitive Behavioural

Aims and methodA cognitive–behavioural therapy in-patient treatment model for adults with severe anorexia nervosa was developed and evaluated, and outcomes were compared with the previous treatment model and other published outcomes from similar settings.ResultsThis study showed the Pathways to Recovery outcomes were positive in terms of improvements in body mass index and psychopathology.Clinical implicationsAdults with anorexia nervosa can achieve good outcomes despite longer illness duration and comorbidities.Declaration of interestA.B., A.C. and L.H. work at The Retreat where the Pathways to Recovery were developed.

scholarly journals Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive–behavioural therapy in out-patients with anorexia nervosa

2016 ◽  
Vol 46 (16) ◽  
pp. 3291-3301 ◽  
Author(s):  
N. Egger ◽  
B. Wild ◽  
S. Zipfel ◽  
F. Junne ◽  
A. Konnopka ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Base Case ◽  
Adult Women ◽  
Net Benefit ◽  
Cognitive Behavioural

BackgroundAnorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive–behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN.MethodThe analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost–utility and assumptions underlying the base case were investigated in exploratory analyses.ResultsCosts of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends.ConclusionsDepending on the WTP, FPT proved cost-effective in the treatment of adult AN.

scholarly journals Use of cognitive–behavioural therapy skills among trained psychiatrists

2006 ◽  
Vol 30 (2) ◽  
pp. 58-60 ◽  
Author(s):  
Graeme Whitfield ◽  
Moira Connolly ◽  
Alan Davidson ◽  
Chris Williams
Keyword(s):  
Professional Development ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Postal Survey ◽  
Clinical Implications ◽  
Therapeutic Activity ◽  
Protected Time ◽  
Training And Supervision ◽  
Cognitive Behavioural ◽  
The Cost

Aims and MethodPrevious studies have suggested that despite the cost of attendance at postgraduate cognitive–behavioural therapy (CBT) courses, psychiatrists are unable to engage in CBT after qualification. A postal survey of psychiatrists with postgraduate CBT training currently practising in Scotland was performed to assess the levels of training and supervision that they provide, therapeutic CBT activity, and supervision and continued professional development that they receive.ResultsOf the 58 psychiatrists, 51 replied to the survey (88%). Less than half of the respondents supervised other staff. Although 43 (84%) engaged in some therapeutic CBT activity, only 25 (49%) received supervision for their own practice. The main reasons given for not engaging in CBT therapeutic activity were that there was inadequate ‘protected time’ and that CBT had not been included in ‘job plans'.Clinical ImplicationsPsychiatrists can help to disseminate CBT skills. To do this, they require personal supervision, and time for the development and maintenance of therapeutic skills as well as for the training and supervision of others. This survey builds on the results of others and indicates that these requirements are currently being inadequately met.

scholarly journals Temperament, character and personality disorders as predictors of response to interpersonal psychotherapy and cognitive-behavioural therapy for depression

2007 ◽  
Vol 190 (6) ◽  
pp. 503-508 ◽  
Author(s):  
Peter R. Joyce ◽  
Janice M. McKenzie ◽  
Janet D. Carter ◽  
Alma M. Rae ◽  
Suzanne E. Luty ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Treatment Response ◽  
Cognitive Behavioural Therapy ◽  
Randomised Trial ◽  
Interpersonal Psychotherapy ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Comparable Efficacy ◽  
Cognitive Behavioural

BackgroundInterpersonal psychotherapy and cognitive–behavioural therapy are widely accepted as effective treatments for major depression. There is little evidence on how personality disorder or personality traits affect treatment response.AimsTo determine whether personality disorder or traits have an adverse impact on treatment response to interpersonal psychotherapy or cognitive–behavioural therapy in people receiving out-patient treatment for depression.MethodThe study was a randomised trial in a university-based clinical research unit for out-patients with depression.ResultsPersonality disorder did not adversely affect treatment response for patients with depression randomised to cognitive–behavioural therapy Conversely, personality disorder did adversely affect treatment response for patients randomised to interpersonal psychotherapy.ConclusionsDespite the two therapies having comparable efficacy in patients with depression, response to interpersonal psychotherapy (but not cognitive–behavioural therapy) is affected by personality traits. This could suggest the two therapies are indicated for different patients or that they work by different mechanisms.

scholarly journals Cognitive-behavioural intervention for self-harm: randomised controlled trial

2008 ◽  
Vol 192 (3) ◽  
pp. 202-211 ◽  
Author(s):  
Nadja Slee ◽  
Nadia Garnefski ◽  
Rien van der Leeden ◽  
Ella Arensman ◽  
Philip Spinhoven
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Control Group ◽  
Behavioural Intervention ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention ◽  
Self Harm

BackgroundSelf-harm by young people is occurring with increasing frequency. Conventional in-patient and out-patient treatment has yet to be proved efficacious.AimsTo investigate the efficacy of a short cognitive-behavioural therapy intervention with 90 adolescents and adults who had recently engaged in self-harm.MethodParticipants (aged 15–35 years) were randomly assigned to treatment as usual plus the intervention, or treatment as usual only. Assessments were completed at baseline and at 3 months, 6 months and 9 months follow-up.ResultsPatients who received cognitive-behavioural therapy in addition to treatment as usual were found to have significantly greater reductions in self-harm, suicidal cognitions and symptoms of depression and anxiety, and significantly greater improvements in self-esteem and problem-solving ability, compared with the control group.ConclusionsThese findings extend the evidence that a time-limited cognitive-behavioural intervention is effective for patients with recurrent and chronic self-harm.

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