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Cognitive behavioural therapy and the impact of internalised societal discourses in people with intellectual disabilities: a case example
- Authors:
- GERRY Louise, CRABTREE Jason
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(1), 2013, pp.59-65.
- Publisher:
- Emerald
Cognitive behaviour therapies (CBT) are being seen as the treatment of choice for people with intellectual disabilities. And, the authors suggest, as the focus of national services change, more people with learning disabilities are likely to access mainstream health services such as Improving Access to Psychological Therapies in which CBT is often the primary mode of therapy. With this in mind they describe a cautionary case that demonstrates some of the potential dilemmas and challenges that can be experienced when working with clients with intellectual disabilities. The challenges stem from using an approach that locates problems within people rather than as being generated and maintained through social relations and social discourses. The case describes work with Mark, a young man with intellectual disabilities who accessed services for support with his low mood. It appears from this case example that there is the potential for therapeutic techniques used in CBT to promote questions that invite, generate and reinforce feelings of incompetence and inability in people with intellectual disabilities. The authors discuss the use of narrative techniques as a means of avoiding locating the problem as being within clients with intellectual disabilities; the implications that this has for the use of CBT with this client group are considered.
Enhancing the mental well-being of people with multiple sclerosis
- Authors:
- ASKEY-JONES Sally, et al
- Journal article citation:
- Nursing Times, 24.2.09, 2009, p.22.
- Publisher:
- Nursing Times
Briefly reports on a services that aims to enhance the mental and emotional wellbeing of people who have multiple sclerosis. The service provides assessment and treatment using medication, cognitive behavioural therapy (CBT) and psychosocial interventions. Patients also receive education that helps them empower them to take control over their lives.
An exploration into the effectiveness of self-help CBT for mothers with mild to moderate depression and/or anxiety in the London Borough of Bexley
- Authors:
- PALMER David, et al
- Journal article citation:
- Journal of Children's Services, 7(3), 2012, pp.178-190.
- Publisher:
- Emerald
This study evaluated the impact of guided self-help cognitive behavioural therapy (CBT) for mothers with depression/anxiety undertaken in two Sure Start children's centres in the London Borough of Bexley. Twenty three participants who attended an initial appointment with a Psychological Well-being Practitioner were assessed and allocated to a guided self-help CBT intervention. Findings indicated that guided self-help CBT produced a significant clinical benefit for participants with mild to moderate depression/anxiety. Narratives with participants also highlighted improved confidence and self-esteem, positive thinking and better coping strategies, which may have a positive impact on their children and families. The authors concluded that the findings demonstrate the need to recognise and support the therapeutic social milieu, particularly in settings that are familiar and accessible.
Cognitive behavioural therapy with older people: interventions for those with and without dementia
- Author:
- JAMES Ian Andrew
- Publisher:
- Jessica Kingsley
- Publication year:
- 2010
- Pagination:
- 256p., bibliog.
- Place of publication:
- London
The use of Cognitive Behavioural Therapy (CBT) with older people both with and without cognitive difficulties is discussed. The book is divided into three main parts. The first orientates the reader, examines potential adaptations and discusses CBT from a practical and conceptual perspective. The second section reviews older people’s therapy in terms of assessment, formulation and interventions. The final part offers practical advice, using case examples in both dementia and depression. The text is aimed at trainees and experienced therapists alike and is expected to be of value to anybody using CBT in their work with older people, regardless of their clients' levels of cognitive ability.
Psycho-educational CBT insomnia workshops for the general public: an audit of access and clinical outcomes
- Authors:
- PRYTYS Marta, et al
- Journal article citation:
- Journal of Public Mental Health, 9(1), March 2010, pp.8-15.
- Publisher:
- Emerald
Help-seeking for insomnia remains low despite its high prevalence and its potentially severe consequences. Cognitive behavioural therapy for insomnia (CBT-I) is an evidence-based treatment, which targets factors that perpetuate insomnia over time. Using a format developed by Brown and colleagues offering self-referral psycho-educational workshops for the community, intensive, one-day CBT-I workshops were led by two clinical/counselling psychologists for the general public on a routine basis in Southwark, London throughout 2007. A total of 121 people enquired about the programme, 60 completed the introductory stage and 32 continued through to the follow up stage. Participants completed a battery of measures at the introductory and follow up phases of the workshop programme including measures of insomnia, anxiety and depression. Of the 60 people entering the programme, the large majority were women, 58% had clinical insomnia as indicated by the Insomnia Severity Index (ISI) and 75% had clinical levels of depression as measured by the Beck Depression Inventory (BDI; scores over 10). At the follow-up stage, there were significant improvements on all measures, and there was a high degree of participant satisfaction with the workshops. The authors suggest that such large-scale interventions offer an important, potentially cost-effective means of disseminating evidence-based psychological interventions to large numbers of people.
High tech therapy
- Author:
- SHIPLEY Diane
- Journal article citation:
- Mental Health Today, December 2009, pp.16-18.
- Publisher:
- Pavilion
- Place of publication:
- Hove
National Institute for Health and Clinical Excellence (NICE) guidelines state that therapy, especially cognitive behavioural therapy (CBT), should be the first choice of treatment for people with mild-to-moderate depression and anxiety. The Improving Access to Psychological Therapies Programme, designed to put into practice the NICE recommendations, will fund an additional 3,700 therapists with the aim of providing psychological help to an extra 900,000 people, but it will be some time before these therapists are qualified. In the meantime, some additional treatment is being offered through computerised CBT (CCBT), which is administered via CD-ROM with service users also attending weekly sessions at a GP surgery or local mental health charity. NICE has recommended 2 specific CCBT programmes – FearFighter for anxiety and Beating the Blues for depression. According to NICE guidelines, these can be as effective as medication. This article looks at computerised and therapist-led CBT, including assessing the pros and cons of each.
Inequalities and the mental health of young people: a systematic review of secondary school-based cognitive behavioural interventions
- Authors:
- KAVANAGH J, et al
- Publisher:
- University College London. Institute of Education. EPPI-Centre
- Publication year:
- 2009
- Pagination:
- 114p.
- Place of publication:
- London
This review aimed to increase what is known about promoting good mental health and mental health inequalities. It focused on the role of interventions based on the techniques of cognitive behavioural therapy (CBT) for preventing and reducing suicidality, depression and anxiety in young people. A further aim of the study was to use the systematic review as a case study to applying an ‘equity lens’ to a review topic, by building on work completed in an earlier systematic map and methodological review. Results of the review found that CBT delivered to young people in secondary schools can reduce the symptoms of depression and anxiety. No evidence was found to assess the impact of CBT on suicidal thinking or behaviour. Few studies provided any useful data that might be used to examine the impact of CBT-based interventions on inequalities in mental health. No studies presented data relevant to evaluating the differential impact of interventions according to differences in the participants’ gender, age, religion, education or social capital. Although conclusions about impact of CBT on inequalities are therefore tentative, there are suggestions that it might be less effective for people who are more socio-economically disadvantaged.
On the cyber couch
- Author:
- ILLMAN John
- Journal article citation:
- Health Service Journal, 09.12.04, 2004, pp.14-15.
- Publisher:
- Emap Healthcare
Many psychiatric patients prefer to face their problems without having to face another human being. Examines the financial cost - and human implications - of computerised cognitive behaviour therapy. Briefly mentions a range of applications include, COPE, FearFighter and Overcoming Depression, the latter being part of the CALIPSO range of self help and training products.
Help-seeking and receipt of treatment among UK service personnel
- Authors:
- IVERSEN Amy C., et al
- Journal article citation:
- British Journal of Psychiatry, 197(2), August 2010, pp.149-155.
- Publisher:
- Cambridge University Press
It is inevitable that some armed forces personnel will develop post-conflict mental disorders, and therefore data on help-seeking behaviour and receipt of treatment for mental disorders are important for both research and policy. This study examines mental healthcare service use and receipt of treatment in a sample of the UK military. The participants were drawn from an existing UK military health cohort. The sample was stratified by reserve status and by participation in the main war-fighting period of the Iraq War. A total of 821 participants completed a telephone-based structured diagnostic interview comprising the Patient Health Questionnaire and Primary Care Post-Traumatic Stress Disorder Screen (PC–PTSD), and a series of questions about service utilisation and treatment receipt. The results showed that only 23% of those with common mental disorders and still serving in the military were receiving any form of medical professional help. Non-medical sources of help such as chaplains were more widely used. Among regular personnel in receipt of professional help, most were seen in primary care (79%) and the most common treatment was medication or counselling/psychotherapy. Few regular personnel were receiving cognitive-behavioural therapy (CBT). These findings are comparable with those reported for the general population.
Systematic review and meta-analysis of interventions relevant for young offenders with mood disorders, anxiety disorders, or self-harm
- Authors:
- TOWNSEND Ellen, et al
- Journal article citation:
- Journal of Adolescence, 33(1), February 2010, pp.9-20.
- Publisher:
- Academic Press
In the context that mood and anxiety disorders and problems with self-harm are significant and serious issues that are common in young people in the criminal justice system, this study aimed to examine whether interventions relevant to young offenders with such disorders or problems are effective. In order to identify which interventions should be recommended for young offenders a systematic review of trials of interventions was undertaken, with searches of electronic databases and a check of references of key papers identified, and searches of a range of sources for unpublished studies, including contacting experts in the field. 10 studies were identified as suitable for inclusion in the review. Individual trials reported varying degrees of success in terms of the effectiveness of experimental interventions decreasing depression, anxiety or self harm, however meta-analysis of data from 3 studies showed that group-based cognitive behaviour therapy may help to reduce symptoms of depression in young offenders. The authors conclude that the trials included in the review demonstrate that it is possible to carry out randomised controlled trials for mental health problems with young offenders in both incarcerated and non-incarcerated settings, and that future studies should adopt adequate randomisation procedures, compare experimental treatments to usual care, and evaluate outcomes over a 12 month follow-up period, and that this evidence is crucial given the high unmet needs in relation to these problems in young offenders.