Cognitive Behaviour Therapist最新文献

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Under the hood: lay counsellor element use in a modular multi-problem transdiagnostic intervention in lower resource countries. 在底层:外行顾问元素在低资源国家模块化多问题跨诊断干预中的使用。

IF 3.5

Cognitive Behaviour Therapist Pub Date : 2019-01-01 Epub Date: 2019-01-10 DOI: 10.1017/S1754470X18000144

Laura K Murray, Emily E Haroz, Michael D Pullmann, Shannon Dorsey, Jeremy Kane, Jura Augustinavicius, Catherine Lee, Paul Bolton

{"title":"Under the hood: lay counsellor element use in a modular multi-problem transdiagnostic intervention in lower resource countries.","authors":"Laura K Murray, Emily E Haroz, Michael D Pullmann, Shannon Dorsey, Jeremy Kane, Jura Augustinavicius, Catherine Lee, Paul Bolton","doi":"10.1017/S1754470X18000144","DOIUrl":"https://doi.org/10.1017/S1754470X18000144","url":null,"abstract":"The use of transdiagnostic mental health treatments in low resource settings has been proposed as a possible aid in scaling up mental health services. Modular, multi-problem transdiagnostic treatments can be used to treat a range of mental health problems and are designed to handle comorbidity. Two randomized controlled trials have been completed on one treatment - the Common Elements Treatment Approach, or CETA - delivered by lay counsellors in Iraq and Thailand. This paper utilizes data from two clinical trials to explore the delivery of CETA by lay providers, examining fidelity and flexibility of element use. Data were collected at every therapy session. Clients completed a short symptom assessment and providers described the clinical elements delivered during sessions. Analyses included descriptive statistics of delivery including selection and sequencing of treatment elements, and the variance in element dose, clustering at the counsellor level, using multi-level models. Results indicate that lay providers in low resource settings (with supervision) demonstrated fidelity to the recommended CETA elements, order and dose, and occasionally added in elements and flexed dosage based on client presentation (i.e. flexibility). This modular approach did not result in significantly longer treatment duration. Our analysis suggests that lay providers were able to learn decision-making processes of CETA based on client presentation and adjust treatment as needed with supervision. As modular multi-problem transdiagnostic treatments continue to be explored in low resource settings, research should continue to focus on 'unpacking' lay counsellor delivery of these interventions, decision-making processes, and the level of supervision required.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S1754470X18000144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37061057","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}

引用次数: 8

An adapted imaginal exposure approach to traditional methods used within trauma-focused cognitive behavioural therapy, trialled with a veteran population. 在创伤认知行为治疗中使用的传统方法的一种适应的图像暴露方法，在退伍军人人群中进行试验。

IF 3.5

Cognitive Behaviour Therapist Pub Date : 2016-01-01 Epub Date: 2016-06-01 DOI: 10.1017/S1754470X16000052

Manveer Kaur, Dominic Murphy, Kirsten V Smith

{"title":"An adapted imaginal exposure approach to traditional methods used within trauma-focused cognitive behavioural therapy, trialled with a veteran population.","authors":"Manveer Kaur, Dominic Murphy, Kirsten V Smith","doi":"10.1017/S1754470X16000052","DOIUrl":"https://doi.org/10.1017/S1754470X16000052","url":null,"abstract":"Trauma-focused cognitive behavioural therapy (TF-CBT) is beneficial for individuals with post-traumatic stress disorder (PTSD); however, a subset of clients struggle to engage with traditional methods, due to high levels of avoidance and dissociation. This paper aims to describe an adapted approach to imaginal reliving and prolonged exposure, to facilitate subsequent cognitive updating. The paper demonstrates the technique with veterans, who are a client group that may struggle with some aspects of traditionally implemented TF-CBT. Two case studies are described, both with PTSD symptoms stemming from traumatic military experiences. An adapted exposure technique is utilized to address the barriers of high dissociation, poor access to trauma-related cognitions and fixed intrusive imagery. The approach involved three stages: (1) reliving the trauma outdoors, (2) manipulating the perspectives of the imagery, and (3) restructuring the narrative with new perspectives. Both clients showed decreased dissociation and improved toleration of their traumatic imagery. Improvement of PTSD symptoms and quality-of-life functioning was observed for both clients on objective measures. Adapting TF-CBT to have a stronger emphasis on grounding and allocentric processing may be helpful for a subset of patients with PTSD that present with high levels of dissociation and avoidance. Further research and investigation into alternative populations is needed.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S1754470X16000052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36485220","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}

引用次数: 22

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