BibliothEP: A Study Evaluating the Effectiveness of Bibliotherapy for Premature Ejaculation (PE)

Objective: The BibliothEP study aimed to assess the efficacy of a bibliotherapy for premature ejaculation (PE) Design and Method: The study was conducted in two phases. First, a sample of 120 participants suffering from PE read a concise cognitive behavioural self-help manual for PE (51 A5 pages including illustrations) and were compared after treatment to 66 waiting list controls. Second, 36 subjects received and read the self-help manual and were compared after treatment to 32 subjects having received the same manual plus a complementary brief guidance (45-90 minutes) from a coach not specialized in sex therapy, but who had been specifically trained to support the bibliotherapy intervention (by attending a 5-hour training module). The main outcome measures were self-determined latency time to ejaculation, feelings of control, sexual satisfaction, PE-related distress and subjective impression of improvement. Results: At 6-month posttreatment, all participants showed significant improvements as compared to waiting list condition. The improvements were maintained at 12 month. They were slightly greater in the case of complementary therapist support. Improvements were demonstrated for all forms of PE, but the intervention appeared to be slightly more effective when the problem was of moderate severity. In all cases, improvements in sexual functioning were accompanied by improvements in sexual cognitions. Conclusions: The cost-effectiveness of the self-help manual makes it a valuable first-line treatment for any form of PE. Moreover, the outcome of the bibliotherapy process might be increased by coaching from a health worker specifically trained to this aim.

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ASSESSING THE TAKE UP AND ACCEPTABILITY OF A SELF-HELP ROOM USED BY PATIENTS AWAITING THEIR INITIAL OUTPATIENT APPOINTMENT

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246580100306x ◽

2001 ◽

Vol 29 (3) ◽

pp. 333-343 ◽

Cited By ~ 15

Author(s):

Graeme E. Whitfield ◽

Chris J. Williams ◽

David A. Shapiro

Keyword(s):

Psychological Health ◽

General Health Questionnaire ◽

The Self ◽

Waiting List ◽

Dysfunctional Attitudes ◽

Control Group ◽

Low Mood ◽

Self Help ◽

Group Data ◽

Scale Scores

This open study measured the proportion of routine referrals from primary care to a psychiatric sector team with symptoms of anxiety and/or low mood who chose to take up the option of attending a self-help room to use the CBT self-help manual Mind over mood during a 6-week waiting list period. It assessed changes in psychological health, dysfunctional attitudes and degree of hopelessness during the period of use of the self-help manual, as well as patient satisfaction with it. Twenty-two of 42 consecutive referrals attended the room (mean 3.55 sessions – SD 1.71). The Beck Hopelessness Scale (BHS), the General Health Questionnaire (GHQ), and Dysfunctional Attitudes Scale (DAS), as well as measures of patient participation and satisfaction, were completed at the beginning and end of the 6-week period for those patients who attended the room. All three scale scores fell significantly over the study period, and the DAS and BHS scores at 6 weeks were negatively correlated with the number of sessions attended. The patients generally judged that the self-help intervention was acceptable and effective, and that their knowledge in a number of key areas had been improved. Conclusions regarding effectiveness are limited by the absence of control group data; nonetheless, this study does suggest that the provision of a self-help room containing Mind over mood is useful for patients with anxiety and low mood on a waiting list for a psychiatric outpatient assessment.

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THE POSSIBILITY OF REDUCING THERAPIST CONTACT AND TOTAL LENGTH OF THERAPY IN THE TREATMENT OF PANIC DISORDER

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465899273055 ◽

1999 ◽

Vol 27 (3) ◽

pp. 231-247 ◽

Cited By ~ 16

Author(s):

Cristina Botella ◽

Azucena García-Palacios

Keyword(s):

Panic Disorder ◽

Public Mental Health ◽

Cost Benefit ◽

Treatment Programs ◽

Behavioural Treatment ◽

Self Help ◽

Cognitive Behavioural ◽

Post Test ◽

The Cost

This study compares the effectiveness of a standard cognitive-behavioural treatment for panic disorder with a reduced therapist contact program supported by self-help materials. This program shortens the total therapy length (from 10 to 5 weeks) and the contact time with the therapist (from 10 to 5 sessions). The sample was mostly referred from a public mental health unit, and it had a low level of education (average of 9.7 years). The subjects were assessed according to several variables related with panic disorder at pre- and post-test, and at 12-month follow-up. The results demonstrated that both programs produced significant improvements for all variables at post-test, the benefits were maintained at follow-up assessment, and even heightened for some of the measures. Also, both treatment programs obtained comparable improvements for most measures. These results suggest that the programs that reduce the contact with the therapist, supported by self-help materials, and shorten the time that the patient suffers from this problem (Margraf, Barlow, Clark, & Telch, 1993) may be a good intervention for the treatment of panic disorder. These programs can help to overcome some of the cost-benefit therapeutic limitations of standard cognitive-behavioural programs.

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Implementing a hybrid cognitive-behavioural therapy for pain-related insomnia in primary care: lessons learnt from a mixed-methods feasibility study

BMJ Open ◽

10.1136/bmjopen-2019-034764 ◽

2020 ◽

Vol 10 (3) ◽

pp. e034764 ◽

Cited By ~ 1

Author(s):

Nicole K Y Tang ◽

Corran Moore ◽

Helen Parsons ◽

Harbinder Kaur Sandhu ◽

Shilpa Patel ◽

...

Keyword(s):

Primary Care ◽

Mixed Methods ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

The Self ◽

Control Treatment ◽

Outcomes Measures ◽

Self Help ◽

Cognitive Behavioural ◽

To Receive

ObjectivesTo test the feasibility of implementing a brief but intensive hybrid cognitive behavioural therapy (Hybrid CBT) for pain-related insomnia.DesignMixed-methods, with qualitative process evaluation on a two-arm randomised controlled feasibility trial.SettingPrimary care.ParticipantsTwenty-five adult patients with chronic pain and insomnia.InterventionHybrid CBT or self-help control intervention.Primary and secondary outcome measuresPrimary outcomes measures were the Insomnia Severity Index and interference scale of the Brief Pain Inventory (BPI). Secondary outcomes measures were the present pain intensity rating from the BPI, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale and EQ-5D-5L.ResultsFourteen participants were randomised to receive Hybrid CBT, 11 to receive the self-help control treatment. Of the 14 in the Hybrid CBT group, 9 (64%) completed all four treatment sessions (4 discontinued due to poor health; 1 due to time constraints). Adherence to the self-help control treatment was not monitored. The total number of participants completing the 12-week and 24-week follow-ups were 12 (6 in each group; Hybrid CBT: 43%; self-help: 55%) and 10 (5 in each group; Hybrid CBT: 36%; self-help: 45%). Based on the data available, candidate outcome measures appeared to be sensitive to changes associated with interventions. Thematic analysis of pre-postintervention interview data revealed satisfaction with treatment content among those who completed the Hybrid CBT, whereas those in the self-help control treatment wanted more contact hours and therapist guidance. Other practical suggestions for improvement included shortening the duration of each treatment session, reducing the amount of assessment paperwork, and minimising the burden of sleep and pain monitoring.ConclusionImportant lessons were learnt with regard to the infrastructure required to achieve better patient adherence and retention. Based on the qualitative feedback provided by a subset of treatment completers, future trials should also consider lowering the intensity of treatment and streamlining the data collection procedure.Trial registration numberISRCTN17294365.

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The Impact of a Novel Computerized CBT CD Rom (Overcoming Depression) Offered to Patients Referred to Clinical Psychology

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246580500250x ◽

2005 ◽

Vol 34 (1) ◽

pp. 1-11 ◽

Cited By ~ 22

Author(s):

Graeme Whitfield ◽

Robert Hinshelwood ◽

Adele Pashely ◽

Linda Campsie ◽

Chris Williams

Keyword(s):

Clinical Psychology ◽

Behavioural Therapy ◽

Waiting List ◽

Cd Rom ◽

Intention To Treat ◽

Symptoms Of Depression ◽

Self Help ◽

Cognitive Behavioural ◽

The Impact ◽

Treat Analysis

A new CBT based CD Rom (Williams, Taylor, Aubin, Harkin and Cottrell, 2002) was introduced as a way of offering a clinical psychology waiting-list initiative for patients with depression and depression with anxiety. This study evaluated the impact of this computerized cognitive behavioural therapy (CCBT) on consecutive referrals. Six hourly sessions of the interactive computer programme were offered to clients on the waiting list, to be completed by them with some support from a self-help support nurse. Seventy-eight consecutive referrals were offered an appointment for CCBT; 20 (26%) attended at least one session of CCBT and 14 (70% of starters) completed all six hour-long sessions. Beck Depression Inventory scores (BDI-II) fell from a mean of 28.15 (SD 11.41) to 20.00 (SD 10.41) (p = .000) over the 6-week intervention period using an intention to treat analysis. The discussion asks why only a quarter of patients on this psychology waiting list chose to use a CBT CD-Rom, but also notes that those who did use it had clinically and statistically significant reductions in their reported symptoms of depression.

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Cost-effectiveness of cognitive behavioural therapy, graded exercise and usual care for patients with chronic fatigue in primary care

Psychological Medicine ◽

10.1017/s0033291704001928 ◽

2004 ◽

Vol 34 (6) ◽

pp. 991-999 ◽

Cited By ~ 28

Author(s):

P. McCRONE ◽

L. RIDSDALE ◽

L. DARBISHIRE ◽

P. SEED

Keyword(s):

Primary Care ◽

Cost Effectiveness ◽

Usual Care ◽

Cognitive Behavioural Therapy ◽

Chronic Fatigue ◽

Behavioural Therapy ◽

Self Help ◽

Cognitive Behavioural ◽

Graded Exercise ◽

The Cost

Background. Chronic fatigue is a common condition, frequently presenting in primary care. The aim of this study was to compare the cost-effectiveness of cognitive behavioural therapy (CBT) and graded exercise therapy (GET), and to compare therapy with usual care plus a self-help booklet (BUC).Method. Patients drawn from general practices in South East England were randomized to CBT or GET. The therapy groups were then compared to a group receiving BUC recruited after the randomized phase. The main outcome measure was clinically significant improvements in fatigue. Cost-effectiveness was assessed using the net-benefit approach and cost-effectiveness acceptability curves.Results. Costs were available for 132 patients, and cost-effectiveness results for 130. Costs were dominated by informal care. There were no significant outcome or cost differences between the therapy groups. The combined therapy group had significantly better outcomes than the standard care group, and costs that were on average £149 higher (a non-significant difference). Therapy would have an 81·9% chance of being cost-effective if society were willing to attach a value of around £500 to each four-point improvement in fatigue.Conclusion. The cost-effectiveness of cognitive behavioural therapy and graded exercise were similar unless higher values were placed on outcomes, in which case CBT showed improved cost-effectiveness. The cost of providing therapy is higher than usual GP care plus a self-help booklet, but the outcome is better. The strength of this evidence is limited by the use of a non-randomized comparison. The cost-effectiveness of therapy depends on how much society values reductions in fatigue.

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Problems of Drop-out in the Self-help Treatment of Chronic, Occupational Pain of the Upper Limbs

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465800011644 ◽

1993 ◽

Vol 21 (4) ◽

pp. 311-328 ◽

Cited By ~ 6

Author(s):

Susan H. Spence ◽

Louise Sharpe

Keyword(s):

The Self ◽

Drop Out ◽

Pain Beliefs ◽

Drop Out Rate ◽

Self Help ◽

Cognitive Behavioural ◽

Chronic Pain Patients ◽

Pain Patients ◽

Very High

The present study evaluated the effectiveness of a self-help, cognitive-behavioural programme in the rehabilitation of a sample of chronic pain patients. The results demonstrated significant benefits for subjects who completed the self-help treatment on measures of depression, anxiety, coping strategies, impact on daily living, pain beliefs and self-monitored pain. These benefits were generally maintained at 6 month follow-up and no differences were found in outcome between subjects who completed the self-programme compared to those who completed the same treatment in a traditional clinic-based format. Unfortunately, a very high drop-out rate was found for the self-help condition, indicating the approach to be unsuitable for many clients. Attempts to identify the characteristics of subjects who completed the self-help programme versus those who dropped-out revealed only one predictor, namely pretreatment ratings of the credibility of the programme.

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