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Working with people who are experiencing mental health difficulties brings many challenges about how best to progress towards shared goals. The cognitive–behavioural therapy (CBT) approach can provide a structure and framework for effective treatment. It aims to help people identify goals and work towards them. We describe a practical approach that provides a structure for step-by-step planning, engaging the patient and promoting planned change. debbie.moores@sssft.nhs.uk
Mental Elf Blog post. It is now an increasingly well accepted truism that the origins of mental illness often lie in childhood and adolescence. Most psychological and psychiatric problems present for the first time before the age of 18 years, and even for the remainder there is often a link to important early life risk factors, such as child maltreatment and other psychological or economic adversities.
However, acknowledging that, and doing something useful about it to prevent future mental health problems are different things. To be able to successfully intervene early we need to be able to offer interventions that are effective, acceptable to patients/service users and cost-effective. We also need to work out who these interventions should be offered to.
American Psychologist70.9 (Dec 2015): 832-864. In 2015, the American Psychological Association adopted Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients in order to describe affirmative psychological practice with transgender and gender nonconforming (TGNC) clients. There are 16 guidelines in this document that guide TGNC-affirmative psychological practice across the lifespan, from TGNC children to older adults. To read the full article, log in using your NHS OpenAthens details
Implementation of new effective treatments involves training, supervision and quality control of therapists, who are used to utilize other methods. Not much is known about therapists' views on how new psychotherapy methods should be taught. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Depression is a highly prevalent disorder, causing a large burden of disease and substantial economic costs. Web-based self-help interventions seem promising in promoting mental health. Library Services do not currently have access to this journal through this site, but you can request a copy of the article online and we will get a copy to you: http://bit.ly/1Xyazai
Follow-up data from the CoBalT trial poses an interesting clinical question (Wiles et al, 2016). If an individual has apparently treatment-resistant depression and antidepressant ‘usual care’ appears the only option available, is there any possible benefit to providing a moderate length course of CBT alongside the medication, and if so, what are the benefits and how long do they last for? Could benefits be detected not just months, but years after the end of therapy?
Open access. The aims of the study were to develop a scale sensitive enough to measure the interpersonal processes within a therapeutic environment, and to explore whether the new scale was sensitive enough to detect differences between settings, including a community based on compassionate mind and contextual behaviourism. The Therapeutic Environment Scales (TESS) were validated with 81 participants in three different settings: a specialist service for anxiety disorders, a specialist in-patient ward and a psychodynamic therapeutic community.
In a recent Cochrane review, it was concluded that CST is indeed very effective, but that there is a gap in the evidence base on the delivery of CST and how this may affect the outcome (Woods et al., 2012). Therefore, Orgeta and colleagues (2015) conducted a multicentre randomised controlled trial (RCT) to evaluate the effects (and cost-effectiveness) of a carer-led home-based CST. It’s this recent study that I am discussing in this blog.
Mindfulness is increasingly being recommended to help patients with recurrent depression and anxiety stay well. However, current treatment recommendations ask a lot in terms of commitment, with around 100 hours of practice and learning over a 2-month period. There is therefore increased interest in approaches that deliver key mindfulness skills in a shorter time frame. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Cognitive therapies could be an effective alternative to medication in the treatment of depression, according to NIHR research featured in a new Highlight from the NIHR Dissemination Centre.
The Highlight brings together four studies funded by the NIHR that shed light on when, how and for whom, cognitive therapies might be effective. These are accompanied by blogs and interviews with charities, clinicians, researchers and patients.
Open access. Telephone-administered cognitive behavioural therapy (T-CBT) has attracted international recognition as a potential means of providing effective psychological treatment whilst simultaneously lowering costs, maximizing service efficiency and improving patient access to care. A lack of rigorous exploration of therapist perspectives means that little is known about professional readiness to adopt such delivery models, or the work that may be involved in ensuring successful implementation.
Blog post. We hear a lot about the unwelcome side-effects of psychiatric drugs, but not so much about the fact that therapy can also leave people feeling worse than they did already. Data is thin on the ground, but best estimates suggest that between 5 to 10 per cent of therapy clients experience a worsening of their symptoms. Now a study in The British Journal of Psychiatry has provided further evidence, from the clients' perspective, about the prevalence of harmful therapy outcomes, with around 1 in 20 of thousands of participants saying that they had experienced "lasting bad effects" from therapy.
Journal of Counseling Psychology 63.2 (Mar 2016): 173-182.
Although integrating progress monitoring (PM) measures into psychotherapy practice can provide numerous benefits, including improved client outcomes, relatively few clinicians use these measures (e.g., Ionita & Fitzpatrick, 2014). To better understand the reasons for clinicians’ reluctance, consensual qualitative research methodology was used to examine the challenges faced by clinicians currently using PM measures. To read the full article, log in using your NHS OpenAthens details