scholarly journals A systematic scoping review of psychological therapies for psychosis within acute psychiatric in-patient settings

2018 ◽  
Vol 213 (2) ◽  
pp. 490-497 ◽  
Author(s):  
Pamela Jacobsen ◽  
Kathleen Hodkinson ◽  
Emmanuelle Peters ◽  
Paul Chadwick
Keyword(s):  
Outcome Measures ◽  
Scoping Review ◽  
Psychotic Disorders ◽  
Evidence Base ◽  
Allocation Concealment ◽  
Current Evidence ◽  
Psychological Therapies ◽  
Affective Symptoms ◽  
Wide Range ◽  
Current Evidence Base

BackgroundPeople with psychotic disorders account for most acute admissions to psychiatric wards. Psychological therapies are a treatment adjunct to standard medication and nursing care, but the evidence base for such therapies within in-patient settings is unclear.AimsTo conduct a systematic scoping review of the current evidence base for psychological therapies for psychosis delivered within acute in-patient settings (PROSPERO: CRD42015025623).MethodAll study designs, and therapy models, were eligible for inclusion in the review. We searched PubMed, PsycINFO, EThOS, ProQuest, conference abstracts and trial registries.ResultsWe found 65 studies that met criteria for inclusion in the review, 21 of which were randomised controlled trials (RCTs). The majority of studies evaluated cognitive–behavioural interventions. Quality was variable across all study types. The RCTs were mostly small (n<25 in the treatment arm), and many had methodological limitations including poorly described randomisation methods, inadequate allocation concealment and non-masked outcome assessments. We found studies used a wide range of different outcome measures, and relatively few studies reported affective symptoms or recovery-based outcomes. Many studies described adaptations to treatment delivery within in-patient settings, including increased frequency of sessions, briefer interventions and use of single-session formats.ConclusionsBased on these findings, there is a clear need to improve methodological rigour within in-patient research. Interpretation of the current evidence base is challenging given the wide range of different therapies, outcome measures and models of delivery described in the literature.Declaration of interestNone.

scholarly journals Characterising the evidence base for advanced clinical practice in the UK: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036192 ◽  
Author(s):  
Catrin Evans ◽  
Brenda Poku ◽  
Ruth Pearce ◽  
Jeanette Eldridge ◽  
Paul Hendrick ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Scoping Review ◽  
Health Workforce ◽  
Grey Literature ◽  
Evidence Base ◽  
Current Evidence ◽  
Multiprofessional Team ◽  
Wide Range ◽  
Current Evidence Base ◽  
The Uk

IntroductionA global health workforce crisis, coupled with ageing populations, wars and the rise of non-communicable diseases is prompting all countries to consider the optimal skill mix within their health workforce. The development of advanced clinical practice (ACP) roles for existing non-medical cadres is one potential strategy that is being pursued. In the UK, National Health Service (NHS) workforce transformation programmes are actively promoting the development of ACP roles across a wide range of non-medical professions. These efforts are currently hampered by a high level of variation in ACP role development, deployment, nomenclature, definition, governance and educational preparation across the professions and across different settings. This scoping review aims to support a more consistent approach to workforce development in the UK, by identifying and mapping the current evidence base underpinning multiprofessional advanced level practice in the UK from a workforce, clinical, service and patient perspective.Methods and analysisThis scoping review is registered with the Open Science Framework (https://osf.io/tzpe5). The review will follow Joanna Briggs Institute guidance and involves a multidisciplinary and multiprofessional team, including a public representative. A wide range of electronic databases and grey literature sources will be searched from 2005 to the present. The review will include primary data from any relevant research, audit or evaluation studies. All review steps will involve two or more reviewers. Data extraction, charting and summary will be guided by a template derived from an established framework used internationally to evaluate ACP (the Participatory Evidence-Informed Patient-Centred Process-Plus framework).DisseminationThe review will produce important new information on existing activity, outcomes, implementation challenges and key areas for future research around ACP in the UK, which, in the context of global workforce transformations, will be of international, as well as local, significance. The findings will be disseminated through professional and NHS bodies, employer organisations, conferences and research papers.

Theraplay

2017 ◽  
pp. 42-59 ◽  
Author(s):  
Catherine Tucker ◽  
Sondra Smith-Adcock
Keyword(s):  
Behavioral Problems ◽  
Evidence Base ◽  
Emotional And Behavioral Problems ◽  
Current Evidence ◽  
Clinical Settings ◽  
Neuroscience Research ◽  
Wide Range ◽  
Current Evidence Base ◽  
Childhood Problems ◽  
Families With Children

Theraplay® is a brief, attachment-based parent-child psychotherapy approach that uses interactional play to establish ‘affectional' bonds between caregiver and child. Recent research related to Theraplay suggests it is an evidence-based practice for use in schools and clinical settings for a wide range of childhood problems, including those that are trauma-based. Of particular importance, Theraplay is emerging as an approach that is consistent with current neuroscience research on children's brain development and new understandings of attachment and disruption advanced by researchers. Young clients with some form of trauma-related symptoms comprise a large percentage of clinical cases, and present with complicated emotional and behavioral problems In this chapter, we will explore the basic theoretical underpinnings of Theraplay, the relevant mechanisms of change, and current evidence base. Although Theraplay can be used with a wide range of clients and problems, in this chapter, the focus will be on the applicatio with families with children who have experienced trauma.

scholarly journals Designing and using incentives to support recruitment and retention in clinical trials: a scoping review and a checklist for design

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Beth Parkinson ◽  
Rachel Meacock ◽  
Matt Sutton ◽  
Eleonora Fichera ◽  
Nicola Mills ◽  
...  
Keyword(s):  
Scoping Review ◽  
Pay For Performance ◽  
Evidence Base ◽  
Unintended Consequences ◽  
Current Evidence ◽  
Incentive System ◽  
Design Issues ◽  
Recruitment And Retention ◽  
Design Choice ◽  
Current Evidence Base

Abstract Background Recruitment and retention of participants are both critical for the success of trials, yet both remain significant problems. The use of incentives to target participants and trial staff has been proposed as one solution. The effects of incentives are complex and depend upon how they are designed, but these complexities are often overlooked. In this paper, we used a scoping review to ‘map’ the literature, with two aims: to develop a checklist on the design and use of incentives to support recruitment and retention in trials; and to identify key research topics for the future. Methods The scoping review drew on the existing economic theory of incentives and a structured review of the literature on the use of incentives in three healthcare settings: trials, pay for performance, and health behaviour change. We identified the design issues that need to be considered when introducing an incentive scheme to improve recruitment and retention in trials. We then reviewed both the theoretical and empirical evidence relating to each of these design issues. We synthesised the findings into a checklist to guide the design of interventions using incentives. Results The issues to consider when designing an incentive system were summarised into an eight-question checklist. The checklist covers: the current incentives and barriers operating in the system; who the incentive should be directed towards; what the incentive should be linked to; the form of incentive; the incentive size; the structure of the incentive system; the timing and frequency of incentive payouts; and the potential unintended consequences. We concluded the section on each design aspect by highlighting the gaps in the current evidence base. Conclusions Our findings highlight how complex the design of incentive systems can be, and how crucial each design choice is to overall effectiveness. The most appropriate design choice will differ according to context, and we have aimed to provide context-specific advice. Whilst all design issues warrant further research, evidence is most needed on incentives directed at recruiters, optimal incentive size, and testing of different incentive structures, particularly exploring repeat arrangements with recruiters.

scholarly journals Cognitive analytic therapy at 30

2014 ◽  
Vol 20 (4) ◽  
pp. 258-268 ◽  
Author(s):  
Anthony Ryle ◽  
Stephen Kellett ◽  
Jason Hepple ◽  
Rachel Calvert
Keyword(s):  
Public Mental Health ◽  
Evidence Base ◽  
Current Evidence ◽  
Personal Construct ◽  
List Type ◽  
National Guidelines ◽  
Wide Range ◽  
Current Evidence Base ◽  
Analytic Therapy ◽  
Cognitive Analytic Therapy

SummaryCognitive analytic therapy (CAT) was formalised in 1984 by Anthony Ryle. It facilitated the clinical integration of psychodynamic therapy and personal construct/cognitive psychology. It is a brief, user-friendly relational therapy, applicable to the wide range of psychological problems typically seen in public mental health settings. It has recently been included in national guidelines for the treatment of personality disorder in the National Health Service. CAT provides a coherent model of development and psychopathology, which centrally views the self as both socially formed and embedded. Owing to its core relational grounding, CAT is being increasingly applied to team contexts/systems, enabling a ‘common language’ for team formulation/practice. It is also being successfully delivered as a group therapy. This article describes the development and unique features of the CAT model, analyses the current evidence base and identifies potential future directions for the model.LEARNING OBJECTIVESBe able to describe the core principles of the CAT approach.Appreciate the evidence base for CAT.Understand CAT's place today among talking therapies.

scholarly journals IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings

2020 ◽  
Vol 13 ◽  
Author(s):  
Graham R. Thew
Keyword(s):  
Evidence Base ◽  
Routine Care ◽  
Current Evidence ◽  
List Type ◽  
Face To Face ◽  
Internet Interventions ◽  
Psychological Therapies ◽  
Current Evidence Base ◽  
Online Format ◽  
The Right

Abstract Compared with the traditional face-to-face format, therapist-guided internet interventions offer a different approach to supporting clients in learning skills to manage and overcome mental health difficulties. Such interventions are already in use within IAPT (Improving Access to Psychological Therapies) and other routine care settings, but given their potential to deliver treatment more efficiently and therefore increase availability and access to evidence-based interventions, their use is likely to increase significantly over the coming years. This article outlines what is meant by therapist-guided internet interventions and why an online format is thought to be advantageous for clients, therapists, services, and communities more broadly. It reviews the current evidence in the context of common therapist beliefs about internet-based treatment. It aims to identify gaps where further research is required, particularly in relation to the broader implementation of these treatments in IAPT and other routine clinical services. Specifically, it emphasises the importance of choosing the right programmes, providing adequate therapist training in their use, and considering practical and organisational issues, all of which are likely to determine the success of implementation efforts. Key learning aims (1) To understand what therapist-guided internet interventions are and their potential advantages. (2) To understand the current evidence base for these interventions. (3) To learn where further research is needed with regard to both the interventions themselves, and to their broader implementation in IAPT.

scholarly journals Mindfulness-based interventions in secure settings: challenges and opportunities

2013 ◽  
Vol 19 (3) ◽  
pp. 191-200 ◽  
Author(s):  
Dumindu Witharana ◽  
Gwen Adshead
Keyword(s):  
Mental Healthcare ◽  
Evidence Base ◽  
Mechanisms Of Action ◽  
Current Evidence ◽  
Psychological Treatments ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Current Evidence Base ◽  
Challenges And Opportunities ◽  
Recent Developments

SummaryPsychological treatments in secure settings have traditionally been based on psychodynamic and cognitive–behavioural approaches. Recent developments, supported by an emerging evidence base, have generated a significant amount of interest in mindfulness-based psychological therapies and their utility in diverse areas of mental healthcare. In this article we analyse the current evidence base and describe possible mechanisms of action of mindfulness-based psychological approaches. On the basis of the evidence, we advocate a cautious but positive approach to using mindfulness-based interventions in secure services.

scholarly journals The current evidence base surrounding Bobath Concept (NDT) in adult neurorehabilitation: a scoping review update

2021 ◽  
Author(s):  
Sofia Marques ◽  
◽  
Julie Vaughan-Graham ◽  
Daniela Figueiredo ◽  
Rui Costa
Keyword(s):  
Scoping Review ◽  
Adult Population ◽  
Evidence Base ◽  
Current Evidence ◽  
Clear Understanding ◽  
Neurological Rehabilitation ◽  
Current Evidence Base ◽  
Rehabilitation Science ◽  
Different Types ◽  
Review Question

Review question / Objective: This scoping review aimed to gain a clear understanding of the current evidence base surrounding neurological rehabilitation based on the Bobath Concept (NDT) in adult population, by analyzing the different types of evidence that address and inform practice in this field and the way the research has been conducted. The specific questions, in regards to the available international published and unpublished literature, are: • What types of research are being conducted about the Bobath concept in adult neurorehabilitation? • How Bobath concept in adult neurorehabilitation is being studied, defined, conceptualized and operationalized? • What are the main knowledge gaps about the research involving the Bobath concept in adult neurorehabilitation and the implications for rehabilitation science? Condition being studied: The Bobath Concept approach in adult neuroreabilitation.

scholarly journals Employment Supports for Adults With Disabilities in Low- and Middle-Income Countries: A Campbell Systematic Review

2017 ◽  
Vol 29 (3) ◽  
pp. 243-255 ◽  
Author(s):  
Janice Tripney ◽  
Nina Hogrebe ◽  
Elena Schmidt ◽  
Carol Vigurs ◽  
Ruth Stewart
Keyword(s):  
Systematic Review ◽  
Research Evidence ◽  
Evidence Base ◽  
Current Evidence ◽  
Market Outcomes ◽  
High Quality Research ◽  
Middle Income ◽  
Employment Supports ◽  
Wide Range ◽  
Current Evidence Base

Objective: To identify, appraise, and synthesize studies of interventions to improve labor market outcomes of adults in developing countries with physical and/or sensory disabilities. Method: Systematic review methods, following Campbell Collaboration guidelines, were utilized. A comprehensive search was used to identify relevant studies published between 1990 and 2013, which were graded for study quality and a narrative approach used to synthesize the research evidence. Results: Fourteen studies covering a wide range of interventions met the inclusion criteria. Although individual studies reported improvements in outcomes, heterogeneity was high and studies were generally of poor methodological quality. Conclusions: There is a lack of high-quality research evidence to inform decision-making in this area. Stakeholders should be cautious when interpreting the results of the current evidence base.

scholarly journals Use and Evaluation of Computerized Clinical Decision Support Systems for Early Detection of Sepsis in Hospitals: Protocol for a Scoping Review (Preprint)

2020 ◽  
Author(s):  
Ling Li ◽  
Khalia Ackermann ◽  
Jannah Baker ◽  
Johanna Westbrook
Keyword(s):  
Health Care ◽  
Decision Support ◽  
Early Detection ◽  
Clinical Decision Support ◽  
Scoping Review ◽  
Clinical Decision ◽  
Evidence Base ◽  
Current Evidence ◽  
Scoping Reviews ◽  
Current Evidence Base

BACKGROUND Sepsis is a leading cause of death in hospitals, with high associated costs for both patients and health care systems worldwide. Early detection followed by timely intervention is critical for successful sepsis management and, hence, can save lives. Health care institutions are increasingly leveraging clinical data captured in electronic health records for the development of <i>computerized clinical decision support</i> (CCDS) systems aimed at enhancing the early detection of sepsis. However, a comprehensive evidence base regarding sepsis CCDS systems to inform clinical practice, research, and policy is currently lacking. OBJECTIVE This scoping review aims to systematically describe studies reporting on the use and evaluation of CCDS systems for early detection of sepsis in hospitals. METHODS The methodology for conducting scoping reviews presented by the Joanna Briggs Institute Reviewer’s Manual and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) will be used and adapted as guides. A comprehensive literature search of 10 electronic databases will be conducted to identify all empirical quantitative and qualitative studies that investigate the use of CCDS systems for early detection of sepsis in hospitals. Detailed inclusion and exclusion criteria have been developed. Two reviewers will independently screen all articles based on these criteria. Any discrepancies will be resolved through discussion and further review by a third researcher if required. RESULTS Electronic database searches have retrieved 12,139 references after removing 10,051 duplicates. As of the submission date of this protocol, we have completed the title and abstract screening. A total of 372 references will be included for full-text screening. Only 15.9% (59/372) of these studies were focused on children: 11.0% (41/372) for pediatric and 4.8% (18/372) for neonatal patients. The scoping review and the manuscript will be completed by December 2020. CONCLUSIONS Results of this review will guide researchers in determining gaps and shortcomings in the current evidence base for CCDS system use and evaluation in the early detection of sepsis. The findings will be shared with key stakeholders in clinical care, research, policy, and patient advocacy. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/24899

Viel Leiden mit der Haut, aber keine Ursache - ein Blick in die neue Leitlinie hilft

2018 ◽  
Vol 6 (4) ◽  
pp. 214-216
Author(s):  
Uwe Gieler
Keyword(s):  
Clinical Problem ◽  
Evidence Base ◽  
Stepped Care ◽  
Current Evidence ◽  
Therapeutic Approaches ◽  
Medical Specialties ◽  
Levels Of Care ◽  
Wide Range ◽  
Current Evidence Base ◽  
Irritable Bowel

Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease. This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years. We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

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