The review showed that robust evidence for the effectiveness of iCBT as an add-on to TAU is still limited, with results not necessarily generalisable to people from different backgrounds based on age, gender, education, and mental healthcare settings. Clearly more research is needed, as remotely delivered, self-guided iCBT has the promise to increase accessibility and be more cost-effective.
Guided self-help (GSH) for anxiety is widely implemented in primary care services because of service efficiency gains, but there is also evidence of poor acceptability, low effectiveness and relapse. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The integration of smoking cessation treatment in NHS Talking Therapies would help people with mental health conditions who smoke receive evidence-based support for both at the same time and location. However, more funding and staffing of these talking therapies would be necessary if the intervention was implemented. There are already long-wait times of twenty-three weeks (162 days) for an initial consultation for NHS Talking Therapies (NHS, n.d.). Making another population eligible for these services would potentially overwhelm these services and increase wait times. With the evidence in mind, it would be useful for clinicians to gather information on smoking and substance use during the initial mental health assessment and inform their practice.
The association between loneliness, negative cognitions, and emotions indicate that cognitive behavioural therapy techniques focused on the ‘here and now’, such as cognitive restructuring and exposure, may be helpful to enhance satisfaction from in-person social interactions. This may be particularly helpful for people with psychosis to navigate fears of rejection and facilitate a connection with individuals outside their close social circles. It would be interesting to explore how these techniques might alter neural sensitivity to social reward and increase social motivation.
Bouldering psychotherapy (BPT) for depression has proven effective, but nothing is known about its potential predictors of response. This study should identify predictors of response to BPT, cognitive behavioural therapy (CBT) and an active control (home-based exercise programme; EP) using a literature-based model.
Lesbian, gay, bisexual, transgender, queer/questioning and other sexual and gender diverse (LGBTQ+) persons frequently lack access to mental health service organizations (MHOs) and therapists who are competent with LGBTQ+ clients. Existing continuing education programmes to better equip therapists to work with LGBTQ+ clients are often not widely accessible or skills focused, evaluated for effectiveness and inclusive of MHO administrators who can address the organizational climate needed for therapist effectiveness. A virtual, face-to-face, multi-level (administrators and therapists) and multi-strategy (technical assistance, workshop and clinical consultations) LGBTQ+ cultural competence training—the Sexual and Gender Diversity Learning Community (SGDLC)—was tested in a pilot randomized controlled trial.
The aim of this systematic review was to synthesise qualitative evidence on young people's conceptualisation, utilisation and experiences of the therapeutic alliance in individual psychotherapy or counselling and its role in bringing about change.
Although this study suggested that long-term psychoanalytic psychotherapy in combination with treatment as usual was not cost-effective compared with TAU, there may be more explanations to this. Given the sustained long-term effects over the follow-up period and the trajectory of treatment benefits in the LTPP+TAU group, it seems plausible that the timescale of this study was too short to accurately portray the long-term benefits of LTPP.
The usefulness of therapists' self-disclosure (TSD) in psychotherapy remains controversial, and little is known regarding the potential risks and benefits of TSD in times of global crisis such as the COVID-19 pandemic and in teletherapy. We examined two independent samples of therapists (N = 1705; Study 1) and patients (N = 772; Study 2) on their perceptions of increases in TSD during the transition to teletherapy early in the COVID-19 pandemic (spring 2020).
Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia.
Low self-esteem can impair daily functioning and is a risk or maintenance factor for several mental health problems. Sexual minority young adults, for example, those identifying as lesbian, gay or bisexual, on average have lower self-esteem than their heterosexual peers. Compassion-based interventions for low self-esteem might be especially beneficial for sexual minority young adults, whose higher levels of shame and self-criticism are likely to be contributing to maintenance of their low self-esteem.
Healthcare providers are at high risk of occupational burnout, which has negative implications on the individual, their profession, the organisation and their patients. Psychologists are particularly susceptible to the repercussions of burnout due to the emotionally draining nature and content of their work. However, research has failed to outline and evaluate effective interventions for burnout within the profession. This study aimed to investigate the treatment effectiveness of burnout through a systematic literature review. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Psychotherapy for self-harm - Hannah Wallace summarises a systematic review exploring people's experiences of psychotherapy for self-harming behaviours.
A strong cooperative bond between the patient and provider (“therapeutic alliance”) is robustly associated with better alcohol use disorder (AUD) treatment outcomes. Although digital treatments for AUD have significant potential, the function of the alliance during digital programs is unclear. We compared the validity of patient-reported measures of the alliance with a digital treatment (“digital alliance”) for AUD and the alliance with their clinician (“clinician alliance”). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
There is a need to improve the training and supervision of specialist and non-specialist professionals working with trafficking survivors. Further training for non-specialist stakeholders and professionals who are in frequent and close contact with survivors, for example in camps or government accommodations, is also required. Survivors of trafficking are in contact with many organisations and sectors, and they may not disclose their experiences outright; therefore providing training which improves understanding of modern slavery should be a priority for all major psychological, housing, employment, welfare, and immigration support networks and organisations (among others).
The study findings imply dedicated interventions for specific needs at each stage of recovery are required.
Patients showed a stronger preference for CAT-GSH, compared to CBT-GSH, and CAT-GSH participants were found to be more likely to complete full treatment. However, findings seem to indicate that preference accommodation did not have an impact on clinical outcomes, and the two GSH versions evaluated were found to be equally effective treatment options for the treatment of anxiety. Hence, CAT-GSH may represent an effective and well-tolerated option that could be offered to anxious patients in primary care settings.
"Overall, this study has important implications for practice, as it is a novel anti-stigma intervention that has been tested on members of the public in a real workplace setting, with initial results showing potential benefits for both companies and their employees. In comparison to existing workplace interventions, which often target individuals already struggling with mental illness, this intervention was developed with universal implementation in mind."
The cornerstone of this study is it’s contribution to our learning about what works for whom – and when it works best. Having personally discussed with many clients and ex-clients the changes to service provision that COVID-19 brought, the recurring main theme is the importance of patient choice and the concern that services who are still working predominantly or exclusively remotely are not offering this. We have gained a lot from digital developments during this period, which has increased access to therapy for many people; but we must not let this overshadow the preferences of others who may need other adaptations to ensure they can access services in a timely and appropriate way.