scholarly journals Patients’ perspectives on GP interactions after cognitive behavioural therapy for refractory IBS: a qualitative study in UK primary and secondary care

2018 ◽  
Vol 68 (674) ◽  
pp. e654-e662 ◽  
Author(s):  
Alice Sibelli ◽  
Rona Moss-Morris ◽  
Trudie Chalder ◽  
Felicity L Bishop ◽  
Sula Windgassen ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cognitive Behavioural Therapy ◽  
Symptom Management ◽  
Secondary Care ◽  
Behavioural Therapy ◽  
Shared Responsibility ◽  
Structured Interviews ◽  
National Guidelines ◽  
Health Seeking ◽  
Cognitive Behavioural

BackgroundPrevious studies have identified issues with the doctor–patient relationship in irritable bowel syndrome (IBS) that negatively impact symptom management. Despite this, little research has explored interactions between GPs and patients with refractory IBS. National guidelines suggest cognitive behavioural therapy (CBT) as a treatment option for refractory symptoms.AimTo explore perceptions of interactions with GPs in individuals with refractory IBS after receiving CBT for IBS or treatment as usual (TAU).Design and settingThis qualitative study was embedded within a trial assessing CBT in refractory IBS. Fifty-two participants took part in semi-structured interviews post-treatment in UK primary and secondary care.MethodInductive and/or data-driven thematic analysis was conducted to identify themes in the interview data.ResultsTwo key themes were identified: perceived paucity of GPs’ IBS knowledge and lack of empathy from GPs, but with acknowledgement that this has improved in recent years. These perceptions were described through three main stages of care: reaching a ‘last-resort diagnosis’; searching for the right treatment through a trial-and-error process, which lacked patient involvement; and unsatisfactory long-term management. Only CBT participants reported a shared responsibility with their doctors concerning symptom management and an intention to reduce health-seeking behaviour.ConclusionIn this refractory IBS group, specific doctor–patient communication issues were identified. Increased explanation of the process of reaching a positive diagnosis, more involvement of patients in treatment options (including a realistic appraisal of potential benefit), and further validation of symptoms could help. This study supports a role for CBT-based IBS self-management programmes to help address these areas and a suggestion that earlier access to these programmes may be beneficial.

scholarly journals Ethnicity and impact on the receipt of cognitive–behavioural therapy in people with psychosis or bipolar disorder: an English cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e034913
Author(s):  
Rohan Michael Morris ◽  
William Sellwood ◽  
Dawn Edge ◽  
Craig Colling ◽  
Robert Stewart ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Cognitive Behavioural Therapy ◽  
Secondary Care ◽  
Behavioural Therapy ◽  
Single Session ◽  
Black African ◽  
Cognitive Behavioural ◽  
Black Caribbean ◽  
To Receive

Objectives(1) To explore the role of ethnicity in receiving cognitive–behavioural therapy (CBT) for people with psychosis or bipolar disorder while adjusting for differences in risk profiles and symptom severity. (2) To assess whether context of treatment (inpatient vs community) impacts on the relationship between ethnicity and access to CBT.DesignCohort study of case register data from one catchment area (January 2007–July 2017).SettingA large secondary care provider serving an ethnically diverse population in London.ParticipantsData extracted for 30 497 records of people who had diagnoses of bipolar disorder (International Classification of Diseases (ICD) code F30-1) or psychosis (F20–F29 excluding F21). Exclusion criteria were: <15 years old, missing data and not self-defining as belonging to one of the larger ethnic groups. The sample (n=20 010) comprised the following ethnic groups: white British: n=10 393; Black Caribbean: n=5481; Black African: n=2817; Irish: n=570; and ‘South Asian’ people (consisting of Indian, Pakistani and Bangladeshi people): n=749.Outcome assessmentsORs for receipt of CBT (single session or full course) as determined via multivariable logistic regression analyses.ResultsIn models adjusted for risk and severity variables, in comparison with White British people; Black African people were less likely to receive a single session of CBT (OR 0.73, 95% CI 0.66 to 0.82, p<0.001); Black Caribbean people were less likely to receive a minimum of 16-sessions of CBT (OR 0.83, 95% CI 0.71 to 0.98, p=0.03); Black African and Black Caribbean people were significantly less likely to receive CBT while inpatients (respectively, OR 0.76, 95% CI 0.65 to 0.89, p=0.001; OR 0.83, 95% CI 0.73 to 0.94, p=0.003).ConclusionsThis study highlights disparity in receipt of CBT from a large provider of secondary care in London for Black African and Caribbean people and that the context of therapy (inpatient vs community settings) has a relationship with disparity in access to treatment.

Individual Face-to-Face Cognitive Behavioural Therapy in Multiple Sclerosis: A Qualitative Study

2016 ◽  
Vol 72 (7) ◽  
pp. 651-662 ◽  
Author(s):  
K. Gottberg ◽  
C. Chruzander ◽  
G. Backenroth ◽  
S. Johansson ◽  
G. Ahlström ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Qualitative Study ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Face To Face ◽  
Cognitive Behavioural

scholarly journals Individuals’ Long Term Use of Cognitive Behavioural Skills to Manage their Depression: A Qualitative Study

2016 ◽  
Vol 45 (1) ◽  
pp. 46-57 ◽  
Author(s):  
Lydia R. M. French ◽  
Laura Thomas ◽  
John Campbell ◽  
Willem Kuyken ◽  
Glyn Lewis ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Learning Process ◽  
Behavioural Therapy ◽  
Educational Model ◽  
Structured Interviews ◽  
Cognitive Behavioural ◽  
Continued Use ◽  
People Skills ◽  
Trial Evidence

Background: Cognitive Behavioural Therapy (CBT) aims to teach people skills to help them self-manage their depression. Trial evidence shows that CBT is an effective treatment for depression and individuals may experience benefits long-term. However, there is little research about individuals’ continued use of CBT skills once treatment has finished. Aims: To explore whether individuals who had attended at least 12 sessions of CBT continued to use and value the CBT skills they had learnt during therapy. Method: Semi-structured interviews were held with participants from the CoBalT trial who had received CBT, approximately 4 years earlier. Interviews were audio-recorded, transcribed and analysed thematically. Results: 20 participants were interviewed. Analysis of the interviews suggested that individuals who viewed CBT as a learning process, at the time of treatment, recalled and used specific skills to manage their depression once treatment had finished. In contrast, individuals who viewed CBT only as an opportunity to talk about their problems did not appear to utilize any of the CBT skills they had been taught and reported struggling to manage their depression once treatment had ended. Conclusions: Our findings suggest individuals may value and use CBT skills if they engage with CBT as a learning opportunity at the time of treatment. Our findings underline the importance of the educational model in CBT and the need to emphasize this to individuals receiving treatment.

scholarly journals A qualitative study of cognitive behavioural therapy in multiple sclerosis: experiences of psychotherapists

2017 ◽  
Vol 12 (1) ◽  
pp. 1325673
Author(s):  
Charlotte Ytterberg ◽  
Charlotte Chruzander ◽  
Gunnel Backenroth ◽  
Marie Kierkegaard ◽  
Gerd Ahlström ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Qualitative Study ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cognitive Behavioural
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