Cognitive Behaviour Therapist最新文献

{"title":"Addressing equality, diversity and inclusion as part of CBT training: a course evaluation study","authors":"Vickie L. Presley","doi":"10.1017/s1754470x23000235","DOIUrl":"https://doi.org/10.1017/s1754470x23000235","url":null,"abstract":"Abstract It is widely documented that Black, Asian and Minority Ethnic (BAME) communities experience poorer mental health, and have a poorer experience of mental health services. Therapists delivering cognitive behavioural therapy (CBT) in services such as NHS Talking Therapies Services for Anxiety and Depression, are working with increasingly diverse client groups, but treatment access and recovery rates remain below what they should be compared with the White British population. Previous research indicates that CBT therapists may not receive appropriate training that allows them to develop the skills required to work effectively transculturally. The present study therefore aimed to evaluate a CBT training programme within this context, from the perspective of previous course graduates. Thirty participants took part in an online survey with questions requiring both Likert-scaled answers and free-text responses. Descriptive statistics, inferential statistics and template analysis were used to analyse the data. The results of the survey were favourable overall for both White British and BAME respondents. Positive areas of practice highlighted included peer learning within a diverse cohort, building awareness of own biases, and reflective learning spaces. Areas of development included increased integration of teaching focused on adapting CBT models for minority groups, diversification of teaching staff, and reducing fear and avoidance of exploring issues related to equality, diversity and inclusion. Tentative implications for improving CBT training course delivery in this context have been offered. Key learning aims (1) To acknowledge the challenges faced by service users from BAME communities in accessing equitable mental health treatment, including cognitive behavioural psychotherapy. (2) To consider explanations for why CBT therapists working in NHS services might find it difficult to work effectively transculturally. (3) To establish ways in which CBT training programmes might help therapists to embark more successfully on the journey of developing cultural competence, during training and beyond.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135505195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing dialectical behaviour therapy in routine practice: an evaluation of a national CAMHS DBT service for adolescents","authors":"J. Camp, K. Hunt, L.M. Smith","doi":"10.1017/s1754470x23000211","DOIUrl":"https://doi.org/10.1017/s1754470x23000211","url":null,"abstract":"Abstract Self-harming behaviours are reported to be increasing amongst young people and are associated with increased risk of suicide. The recently published UK clinical guidelines highlight that cross-sector awareness and early psychosocial assessment of self-harming is necessary, alongside careful triaging as to the level of support required. Dialectical behaviour therapy for adolescents (DBT-A) is a recommended intervention for young people with more severe difficulties. The current study aims to contribute to the data available to inform ongoing clinical decisions about the feasibility and implementation of DBT-A by reporting the intervention method, participant characteristics, and clinical outcomes of a national (UK) DBT service for young people with high levels of need and risk. Young people who commenced treatment between 2015 and 2021 were included. Completion rates, reasons for non-completion, and discharge pathways are reported. Measurement and changes in outcomes, including self-harm, in-patient bed days, accident and emergency department attendances and education/work status, are reported, as well as for routine outcome measures assessing emotion dysregulation and symptoms of emerging borderline personality disorder, depression and anxiety. The clinical significance of these outcomes are considered. Ideas for service evaluation, which are feasible and replicable in busy clinical settings are proposed, as well as a discussion of potential adaptations to standardised protocols needed in this context to fit with National Health Service (NHS) resources and the needs of the target population. Key learning aims (1) To learn about the implementation of dialectical behaviour therapy (DBT) and concurrent outcome monitoring in a UK National Health Service CAMHS out-patient setting. (2) To understand the clinical profile and response to treatment of young people with high levels of suicidal and non-suicidal self-harming behaviours. (3) To present a potential method for outcome monitoring and collection for CAMHS DBT services.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135059562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in digital CBT: where are we now, and where next?","authors":"Graham R Thew,&nbsp;Alexander Rozental,&nbsp;Heather D Hadjistavropoulos","doi":"10.1017/S1754470X22000423","DOIUrl":"https://doi.org/10.1017/S1754470X22000423","url":null,"abstract":"<p><p>Digital CBT refers to the use of digital tools, platforms or devices to deliver or enhance cognitive behavioural therapy assessment, formulation, treatment, training and supervision. The 'Advances in Digital CBT' special issue aimed to document examples of innovative digital CBT practice in this rapidly developing field. In this paper, we have briefly summarised and synthesised the advances demonstrated in this group of articles. These include developments in our understanding of mental health apps, the use of digital tools as an adjunct to therapy, the effectiveness of remotely delivered CBT in routine clinical practice, our understanding of user experiences and involvement, and in digital CBT research methods. We consider the extent of current knowledge in these areas and identify where gaps in evidence lie and how the field could be taken forward to address these. Lastly, we reflect on the broader digital CBT picture and offer our suggestions of six key directions for future research: using robust study designs to evaluate and optimise digital tools; translating and culturally adapting digital tools and practices; understanding and addressing digital exclusion; exploring, reporting and addressing possible negative effects; improving user involvement in design and evaluation; and addressing the implementation gap for digital tools. We suggest that further advances in these areas would be of particular benefit to the digital CBT field.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10364163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do others think? The why, when and how of using surveys in CBT.","authors":"Hannah Murray, Alice Kerr, Emma Warnock-Parkes, Jennifer Wild, Nick Grey, David M Clark, Anke Ehlers","doi":"10.1017/S1754470X22000393","DOIUrl":"10.1017/S1754470X22000393","url":null,"abstract":"<p><p>Surveys are a powerful technique in cognitive behavioural therapy (CBT). A form of behavioural experiment, surveys can be used to test beliefs, normalise symptoms and experiences, and generate compassionate perspectives. In this article, we discuss why and when to use surveys in CBT interventions for a range of psychological disorders. We also present a step-by-step guide to collaboratively designing surveys with patients, selecting the appropriate recipients, sending out surveys, discussing responses and using key learning as a part of therapy. In doing so, we hope to demonstrate that surveys are a flexible, impactful, time-efficient, individualised technique which can be readily and effectively integrated into CBT interventions.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10797873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten misconceptions about trauma-focused CBT for PTSD.","authors":"Hannah Murray, Nick Grey, Emma Warnock-Parkes, Alice Kerr, Jennifer Wild, David M Clark, Anke Ehlers","doi":"10.1017/S1754470X22000307","DOIUrl":"10.1017/S1754470X22000307","url":null,"abstract":"<p><p>Therapist cognitions about trauma-focused psychological therapies can affect our implementation of evidence-based therapies for posttraumatic stress disorder (PTSD), potentially reducing their effectiveness. Based on observations gleaned from teaching and supervising one of these treatments, cognitive therapy for PTSD (CT-PTSD), ten common 'misconceptions' were identified. These included misconceptions about the suitability of the treatment for some types of trauma and/or emotions, the need for stabilisation prior to memory work, the danger of 'retraumatising' patients with memory-focused work, the risks of using memory-focused techniques with patients who dissociate, the remote use of trauma-focused techniques, and the perception of trauma-focused CBT as inflexible. In this article, these misconceptions are analysed in light of existing evidence and guidance is provided on using trauma-focused CT-PTSD with a broad range of presentations.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9218800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'I'm unlikeable, boring, weird, foolish, inferior, inadequate': how to address the persistent negative self-evaluations that are central to social anxiety disorder with cognitive therapy.","authors":"Emma Warnock-Parkes,&nbsp;Jennifer Wild,&nbsp;Graham Thew,&nbsp;Alice Kerr,&nbsp;Nick Grey,&nbsp;David M Clark","doi":"10.1017/S1754470X22000496","DOIUrl":"https://doi.org/10.1017/S1754470X22000496","url":null,"abstract":"<p><p>Patients with social anxiety disorder (SAD) have a range of negative thoughts and beliefs about how they think they come across to others. These include specific fears about doing or saying something that will be judged negatively (e.g. 'I'll babble', 'I'll have nothing to say', 'I'll blush', 'I'll sweat', 'I'll shake', etc.) and more persistent negative self-evaluative beliefs such as 'I am unlikeable', 'I am foolish', 'I am inadequate', 'I am inferior', 'I am weird/different' and 'I am boring'. Some therapists may take the presence of such persistent negative self-evaluations as being a separate problem of 'low self-esteem', rather than seeing them as a core feature of SAD. This may lead to a delay in addressing the persistent negative self-evaluations until the last stages of treatment, as might be typically done in cognitive therapy for depression. It might also prompt therapist drift from the core interventions of NICE recommended cognitive therapy for social anxiety disorder (CT-SAD). Therapists may be tempted to devote considerable time to interventions for 'low self-esteem'. Our experience from almost 30 years of treating SAD within the framework of the Clark and Wells (1995) model is that when these digressions are at the cost of core CT-SAD techniques, they have limited value. This article clarifies the role of persistent negative self-evaluations in SAD and shows how these beliefs can be more helpfully addressed from the start, and throughout the course of CT-SAD, using a range of experiential techniques.</p><p><strong>Key learning aims: </strong>To recognise persistent negative self-evaluations as a key feature of SAD.To understand that persistent negative self-evaluations are central in the Clark and Wells (1995) cognitive model and how to formulate these as part of SAD.To be able to use all the experiential interventions in cognitive therapy for SAD to address these beliefs.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9884534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10871196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survivor Guilt: A Cognitive Approach.","authors":"Hannah Murray, Yasmin Pethania, Evelina Medin","doi":"10.1017/S1754470X21000246","DOIUrl":"10.1017/S1754470X21000246","url":null,"abstract":"<p><p>Survivor guilt is a common experience following traumatic events in which others have died. However, little research has addressed the phenomenology of survivor guilt, nor has the issue been conceptualised using contemporary psychological models which would help guide clinicians in effective treatment approaches for this distressing problem. This paper summarises the current survivor guilt research literature and psychological models from related areas, such as posttraumatic stress disorder, moral injury and traumatic bereavement. Based on this literature, a preliminary cognitive approach to survivor guilt is proposed. A cognitive conceptualisation is described, and used as a basis to suggest potential treatment interventions for survivor guilt. Both the model and treatment strategies require further detailed study and empirical validation, but provide testable hypotheses to stimulate further research in this area.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7611691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39466322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive therapy for moral injury in post-traumatic stress disorder.","authors":"Hannah Murray, Anke Ehlers","doi":"10.1017/S1754470X21000040","DOIUrl":"10.1017/S1754470X21000040","url":null,"abstract":"<p><p>Moral injury is the profound psychological distress that can arise following participating in, or witnessing, events that transgress an individual's morals and include harming, betraying, or failure to help others, or being subjected to such events, e.g. being betrayed by leaders. It has been primarily researched in the military, but it also found in other professionals such as healthcare workers coping with the COVID-19 pandemic and civilians following a wide range of traumas. In this article, we describe how to use cognitive therapy for post-traumatic stress disorder (CT-PTSD) to treat patients presenting with moral injury-related PTSD. We outline the key techniques involved in CT-PTSD and describe their application to treating patients with moral injury-related PTSD. A case study of a healthcare worker is presented to illustrate the treatment interventions.</p><p><strong>Key learning aims: </strong>(1)To recognise moral injury where it arises alongside PTSD.(2)To understand how Ehlers and Clark's cognitive model of PTSD can be applied to moral injury.(3)To be able to apply cognitive therapy for PTSD to patients with moral injury-related PTSD.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39124796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cognitive Behavioral Therapy Competence Scale (CCS): initial development and validation.","authors":"Natalie Rodriguez-Quintana,&nbsp;Seo Youn Choi,&nbsp;Emily Bilek,&nbsp;Elizabeth Koschmann,&nbsp;Jeffrey Albrecht,&nbsp;Michael Prisbe,&nbsp;Shawna Smith","doi":"10.1017/s1754470x21000362","DOIUrl":"https://doi.org/10.1017/s1754470x21000362","url":null,"abstract":"<p><strong>Background: </strong>Nearly one-third of youth are affected by a mental health disorder, and the majority do not receive adequate care. To improve clinical outcomes among youth, efforts have been made to train providers in evidence-based mental health practices, such as cognitive behavioral therapy (CBT). Such efforts call for valid assessment measures that can inform and evaluate training activities.</p><p><strong>Aims: </strong>This study presents the development and validation of the CBT Competence Scale (CCS), a brief self-report measure to assess provider competence for CBT delivery.</p><p><strong>Method: </strong>Participants were 387 school mental health professionals (SMHPs) working with students in Michigan, USA. Initial items (<i>n</i>=59) were developed to evaluate competence in delivering common elements of CBT, with competence conceptualized as covering domains of knowledge, perception, and use of CBT techniques. CCS validation proceeded in three steps: using item response theory to select the most important items for assessing knowledge, evaluating the factor structure using exploratory and then confirmatory factor analyses, and examining reliability and validity of the resultant measure.</p><p><strong>Results: </strong>The validated CCS measure consists of four dimensions of CBT competence across 33 items: Non-behavioral skills, Behavioral skills, Perceptions, and Knowledge. The CCS demonstrated excellent internal consistency and good construct-based validity.</p><p><strong>Conclusions: </strong>The CCS holds promise as a valid, informative measure of CBT competence appropriate for the school setting, with potential for application in other environments such as mental health clinics.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40549820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the COVID-19 pandemic: 'Learning the hard way' - adapting long-term IAPT service provision using lessons from past outbreaks.","authors":"Lilian Skilbeck, Christopher Spanton, Ian Roylance","doi":"10.1017/S1754470X20000379","DOIUrl":"10.1017/S1754470X20000379","url":null,"abstract":"<p><p>Infectious disease outbreaks have occurred sporadically over the centuries. The most significant ones of this century, as reported by the World Health Organization, include the EVD epidemic, SARS pandemic, Swine Flu pandemic and MERS pandemic. The long-term mental health consequences of outbreaks are as profound as physical ones and can last for years post-outbreak. This highlights the need for enhancing the preparedness of pragmatic mental health service provision. Due to its magnitude, the novel COVID-19 pandemic has proven to be the most impactful. Compared with previous outbreaks, COVID-19 has also occurred at higher rates in frontline staff in addition to patients. As COVID-19 is more contagious than earlier outbreaks, there is a need to identify infected people quickly and isolate them and their contacts. This is the current context in which mental health services including IAPT have had to operate. Evidently, Improving Access to Psychological Therapies (IAPT) services are a major mental health service provider in the UK that have demonstrated variability in their response to COVID-19. While some IAPT services quickly adapted their existing strengths and resources (e.g. remote working), other services were less prepared. To date, there are no clear unitary guidelines on how IAPT services can use their pre-existing resources to respond to the long-term effects of outbreaks. In light of this, the current paper aims to reflect on the lessons learned from past outbreaks in order to consider how an enhanced remit of IAPT might integrate with other services to meet the long-term needs of patients and staff affected by COVID-19.</p><p><strong>Key learning aims: </strong>(1)To understand the development of IAPT within the NHS mental health services.(2)To understand the nature of past outbreaks and COVID-19.(3)To reflect on lessons from past outbreaks in order to understand how IAPT can respond to the long-term effects of COVID-19.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39124794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}