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Do empirically supported treatments generalize to private practice? A benchmark study of a cognitive-behavioural group treatment programme for social phobia
- Authors:
- GASTON Jonathan E., et al
- Journal article citation:
- British Journal of Clinical Psychology, 45(1), March 2006, pp.33-48.
- Publisher:
- Wiley
There is much debate as to whether the treatment effects achieved in well-controlled studies such as randomized controlled trials (RCTs) are generalizable to more `naturalistic' clinical populations, such as that seen in private practice. The current study sought to examine this issue in relation to social phobia. A benchmarking strategy was used to compare the effectiveness of a cognitive-behaviour therapy group programme for social phobia that was developed and evaluated in a research unit, to that of a private practice population. Fifty-eight participants from a university research unit and 54 participants from an independent private practice who met the principal diagnostic criteria for social phobia completed the 10-session group programme. Symptom severity was measured at pre-treatment, post-treatment, and 3 months after treatment. No significant treatment differences were found between the research unit and private practice groups. Both groups showed significant treatment effects that were maintained at 3-month follow-up. These findings suggest that treatments developed for RCTs are potentially transportable to private practice settings.
What's funny about phobias?
- Author:
- DAVIDSON Joyce
- Journal article citation:
- Mental Health Today, April 2005, pp.22-24.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Discusses the problem that phobias are a seriously disabling problem for many millions but continue to be treated with mirth or derision. Reports on a study, funded by the NHS, which used in-depth, semi-structured interviews with 40 service users to explore how phobics feel about the condition, about other people's perceptions of phobia, and about the services currently available to them and how
You can ring our bell
- Author:
- -
- Journal article citation:
- Mental Health Today, March 2005, pp.16-17.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Profiles the service 'No Panic', winner of the 2004 NIMHE Positive Practice Award for user involvement and leadership. The service provides a helpline and support programme for people with anxiety disorders. Volunteers are all trained in simple cognitive behaviour therapy techniques to help people manage their anxiety.
Dog gone good: managing dog phobia in a teenage boy with a learning disability
- Authors:
- NEWMAN Craig, ADAMS Katie
- Journal article citation:
- British Journal of Learning Disabilities, 32(1), March 2004, pp.35-38.
- Publisher:
- Wiley
This is a case study of a 17-year-old boy with a moderate learning disability who had a severe phobia of dogs. A systematic desensitization approach with relaxation and modelling was used to manage his phobic response to dogs. A hierarchy of fear was identified, and progress was made by increasing the level of exposure to dogs whilst controlling for anxiety levels. Results showed that after 28 sessions the client was able to manage his both behaviour and anxiety level when in contact with unfamiliar loose dogs. The study highlighted the importance of selecting an appropriate model and brought into light some ethical concerns in working with young people who have fears of possibly dangerous animals such as dogs.
Reducing demands on clinicians by offering computer-aided self-help for phobia/panic
- Authors:
- KENWRIGHT Mark, LINESS Sheena, MARKS Isaac
- Journal article citation:
- British Journal of Psychiatry, 179, November 2001, pp.456-459.
- Publisher:
- Cambridge University Press
Many patients with phobia/panic find it hard to access effective treatment. This study aims to test the feasibility of computer-guided exposure therapy for phobia/panic. Self-referrals were screened for 20 minutes and, if suitable, had six sessions of computer-guided self-help. At pre-treatment, computer-guided cases were slightly less severe than clinician-guided patients. In a post-treatment intent-to-treat analysis, both groups improved comparably but computer-guided patients spent 86% less time with a clinician than did purely clinician-guided patients, who had no access to the computer system. Concludes that computer-guided self-exposure therapy appeared feasible and effective for self-referrals and a controlled study is now needed.
Phobic disorders and fear of crime in the elderly
- Author:
- LINDESAY J.
- Journal article citation:
- Aging and Mental Health, 1(1), February 1997, pp.81-85.
- Publisher:
- Taylor and Francis
Examines the fear of crime reported by a community sample of elderly cases of phobic disorder, compared with age- and sex-matched controls. Also explores the relationships between phobic disorder and other variables thought to influence the evaluation of risk, such as gender, victimization experience and physical health. Findings suggest that phobic disorders in old age are associated with greater perceived personal vulnerability, and that this contributes to a significant proportion of the problematic fear of crime in this age group.
How common are the anxiety disorders in old age?
- Authors:
- MANELA M., KATONA C., LIVINGSTON G.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(1), January 1996, pp.65-70.
- Publisher:
- Wiley
This community study of the anxiety disorders in people aged 65 and over found a relatively high prevalence of anxiety disorders with phobic disorders being the most prevalent subclassification. While generalised anxiety was usually seen with other psychiatric syndromes, phobic disorder was usually observed in the absence of either depression or anxiety. The results suggest that while generalized anxiety should be placed below depression in a diagnostic hierarchy, phobic disorder does not fit with this diagnostic model.
Cognitive behavioural interviewing for adult disorders: a practical handbook
- Authors:
- WILSON Peter H., SPENCE Susan H., KAVANAGH David J.
- Publisher:
- Routledge
- Publication year:
- 1989
- Pagination:
- 247p., bibliog.
- Place of publication:
- London
Provides a guide to the interview assessment of a wide range of adult psychological problems : fear and anxiety problems; depression; obesity; sexual dysfunction; insomnia; headaches and substance abuse.
Association of age and gender with anxiety disorders in older adults: a systematic review and meta‐analysis
- Authors:
- GRENIER Sebastien, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 34(3), 2019, pp.397-407.
- Publisher:
- Wiley
Objectives: To provide an estimate of 12‐month and lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM‐IV) anxiety disorders in older adults based on published studies on this topic and to identify the impact of gender and age. Methods/Design: A systematic review and meta‐analysis was performed. Six databases were searched, and manual searches through reference lists of selected articles and reviews were performed. When the information was available, summary effects were calculated for the prevalence of each anxiety disorder and for every age and gender subgroups. Summary odd ratios (OR) were calculated to compare the prevalence of an anxiety disorder according to age and gender. Results: A total of 6464 studies were identified, and 16 studies were included in the meta‐analyses. Prevalence was significantly higher in women than men for generalized anxiety disorder (12 month OR = 6.10, P = 0.001; lifetime OR = 1.96, P = 0.001), 12‐month social anxiety disorder (OR = 2.07, P = 0.01), and lifetime post‐traumatic stress disorder (OR = 1.93, P = 0.002). The prevalence of specific phobia was significantly lower in both the 75 to 84 and 85 years and above age groups when compared with the 65 to 74 years age group (OR = 0.70, P = 0.004 and OR = 0.63, P = 0.01, respectively). Conclusions: Our results suggest that the tendency for women to experience a greater prevalence of anxiety disorders remains present in older adults. Specific phobia was the only disorder to be less frequent with advancing age. This is likely to change with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) criteria because this new DSM version now indicates that fear of falling is a possible type of specific phobia and fear of falling is generally more frequent in the oldest age groups. (Edited publisher abstract)
Cognitive behavioural therapy for anxiety in a man with autism spectrum disorder, intellectual disability, and social phobia
- Author:
- WRIGHT Kevin Paul
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 7(5), 2013, pp.284-292.
- Publisher:
- Emerald
Purpose: This paper evaluates the effectiveness of cognitive-behavioural therapy (CBT) in the treatment of social anxiety with a 19-year-old man with intellectual disabilities (ID) and autistic spectrum disorders. Design/methodology/approach: The intervention was evaluated using an A-B single case design. An idiosyncratic measure was developed to measure anxiety symptoms on a daily basis. The brief symptom inventory (BSI; Derogatis, 1975) measured symptom patterns across nine psychological dimensions and was administered at initial assessment, pre-intervention and post-intervention. Findings: Visual and statistical analysis of the data showed that anxiety severity dramatically reduced throughout the course of therapy, reaching and maintaining zero and this was statistically significant. Data seemed to show that sudden gains in the reduction of anxiety severity occurred during the relaxation and cognitive phases of intervention. This sudden gain coincided with an increase in daily activities, and exposure to more anxiety provoking events which was also statistically significant. Global anxiety scores, as measured by the BSI, showed a notable reduction at post-treatment. Originality/value: This paper demonstrates that CBT can bring about meaningful improvements in the treatment of anxiety in people with ID and autism and suggests that further exploration with the wider population is needed. (Publisher abstract)