{"title":"What if we have too many models of worry and GAD?","authors":"Mark H Freeston","doi":"10.1017/S1352465822000649","DOIUrl":"10.1017/S1352465822000649","url":null,"abstract":"","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9464169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Living with loss: a cognitive approach to prolonged grief disorder - incorporating complicated, enduring and traumatic grief - ADDENDUM.","authors":"Michael Duffy, Jennifer Wild","doi":"10.1017/S1352465823000279","DOIUrl":"10.1017/S1352465823000279","url":null,"abstract":"<p><p>The subject of prolonged, complicated and traumatic grief has become more topical as a consequence of the Covid-19 pandemic. CBT practitioners have been asked to provide effective therapeutic responses for clients with enduring distressing grief reactions. These enduring grief conditions have now been categorised as Prolonged Grief Disorder in the two main mental health classification systems: in the ICD -11 in November 2020 and as a revision to the DSM-5 in 2021. In this paper we draw on our research and clinical experience in applying cognitive therapy for PTSD (CT-PTSD) to traumatic bereavement to derive lessons for the treatment of prolonged grief. During the pandemic the authors of this paper delivered several workshops on prolonged grief disorder (PGD) during which clinicians raised several thought-provoking questions; how do we differentiate between normal and abnormal or pathological grief; how do we categorise pathological grief; how effective are existing therapies and is there a role for CBT; and how do our experiences with Cognitive Therapy for PTSD help with conceptualisation and treatment of PGD. The purpose of this paper is to answer these important questions and in so doing, consider the historical and theoretical concepts relating to complex and traumatic grief, factors that differentiate normal grief from abnormal grief, maintenance factors for PGD and implications for CBT treatments.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9625175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What if we have too many models of worry and GAD? - ADDENDUM.","authors":"Mark H Freeston","doi":"10.1017/S1352465823000267","DOIUrl":"10.1017/S1352465823000267","url":null,"abstract":"<p><strong>Background and aims: </strong>It is almost 40 years since Borkovec <i>et al.</i> (1983) provided the definition of worry that has guided theory, research and treatment of Generalized Anxiety Disorder (GAD). This review first considers the relative paucity of research but the proliferation of models. It then considers nine models from 1994 to 2021 with the aim of understanding why so many models have been developed.</p><p><strong>Methods and results: </strong>By extracting and coding the components of the models, it is possible to identify similarities and differences between them. While there are a number of unique features, the results indicate a high degree of similarity or overlap between models. The question of why we have so many models is considered in relation to the nature of GAD. Next, the treatment outcome literature is considered based on recent meta-analyses. This leads to the conclusion that while efficacy is established, the outcomes for the field as a whole leave room for improvement. While there may be scope to improve outcomes with existing treatments, it is argued that rather than continue in the same direction, an alternative is to simplify models and so simplify treatments.</p><p><strong>Discussion: </strong>Several approaches are considered that could lead to simplification of models resulting in simpler or single-strand treatments targeting specific processes. A requirement for these approaches is the development of brief assessments of key processes from different models. Finally, it is suggested that better outcomes at the group level may eventually be achieved by narrower treatments that target specific processes relevant to the individual.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9693503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CBT 50 years on: a celebration of empirically grounded and evidence-based psychological therapy.","authors":"Paul Salkovskis, Richard Thwaites","doi":"10.1017/S1352465824000080","DOIUrl":"10.1017/S1352465824000080","url":null,"abstract":"","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What's in the mind's eye of individuals with bipolar disorders: an exploration of the content and characteristics of mental images in different thymic phases.","authors":"K M'Bailara, F Echegaray, M Di Simplicio","doi":"10.1017/S1352465823000401","DOIUrl":"https://doi.org/10.1017/S1352465823000401","url":null,"abstract":"<p><strong>Background: </strong>Mental imagery, or 'seeing with the mind's eye' (Kosslyn <i>et al</i>. ), provokes strong emotional responses (Ji <i>et al</i>., ). To date, there is a lack of data on the content and clinical characteristics (e.g. vividness, likelihood, emotional effects) of spontaneous mental images (MI) in people with bipolar disorder (BD) according to their thymic states.</p><p><strong>Aim: </strong>The current study sought to assess the characteristics associated with the contents of MI in people with BD.</p><p><strong>Method: </strong>Forty-two euthymic individuals diagnosed with BD (American Psychiatric Association, ) were asked to self-report their MI during depression, (hypo)mania and euthymia. Participants also rated levels of vividness, likelihood and emotional activation related to MI (i.e. valence, arousal, type of emotion).</p><p><strong>Results: </strong>The contents of the MI revealed phenomenological aspects of BD. Different themes were associated with each thymic phase. In (hypo)mania and in euthymia, the mental images were assessed as being as vivid as probable (<i>p</i>>.05). (Hypo)manic and euthymic-related MI activated more pleasure than displeasure (<i>p</i><.001) and were mainly associated with joy. In depression, MI were assessed as more vivid than likely (<i>p</i><.05). In depression, MI activated more displeasure than pleasure (<i>p</i><.0001) and induced mainly sadness.</p><p><strong>Discussion: </strong>Overall, a congruence between the contents of images and the three thymic phases was found. The content of the MI was related to self-reported emotional effects that were congruent with the thymic phases concerned. The results add new clinical information for the use of imagery-based cognitive therapy in individuals with BD.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Decoupling: adaptation of a treatment for body-focused repetitive behaviour to Tourette syndrome. A case report.","authors":"Steffen Moritz, Danielle Penney, Stella Schmotz","doi":"10.1017/S1352465823000152","DOIUrl":"https://doi.org/10.1017/S1352465823000152","url":null,"abstract":"<p><strong>Aims: </strong>Tourette syndrome (TS) is a neurological condition; its etiology is not yet fully understood. Cognitive behavioural therapy with habit reversal training is the recommended first-line treatment, but is not effective in all patients. This is the first report examining the usefulness of decoupling, a behavioural self-help treatment originally developed for patients with body-focused repetitive behaviours, in a patient with TS.</p><p><strong>Method: </strong>Patient P.Z. showed 10 motor and three vocal tics on the Adult Tic Questionnaire (ATQ) before treatment. He was taught decoupling by the first author.</p><p><strong>Results: </strong>The application of decoupling led to a reduction of P.Z.'s eye tics, which was one of his first and most enduring and severe tics. It was not effective for other areas. Quality of life and depression improved, which P.Z. attributed to the improvement of his tics.</p><p><strong>Conclusion: </strong>Decoupling may be adopted as an alternative, when habit reversal training is not feasible. Future research, preferably using a controlled design with a large sample, may elucidate whether decoupling is only effective for tics relating to the eyes, the most common symptom in tic disorder/TS, or whether its effects extend to other symptoms.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10329164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Connor Heapy, Paul Norman, Sarah Cockayne, Andrew R Thompson
{"title":"The effectiveness of mindfulness-based cognitive therapy for social anxiety symptoms in people living with alopecia areata: a single-group case-series design.","authors":"Connor Heapy, Paul Norman, Sarah Cockayne, Andrew R Thompson","doi":"10.1017/S1352465823000292","DOIUrl":"https://doi.org/10.1017/S1352465823000292","url":null,"abstract":"<p><strong>Background: </strong>Alopecia areata (AA) is an immunological disorder characterised by hair loss. Individuals with AA report high levels of social anxiety. One intervention that holds potential for reducing social anxiety in individuals with AA is mindfulness-based cognitive therapy (MBCT).</p><p><strong>Aims: </strong>Our key aim was to investigate whether MBCT reduces social anxiety in individuals with AA. The study also investigated whether MBCT reduces depression, general anxiety, and increases quality of life and increases trait mindfulness in individuals with AA.</p><p><strong>Method: </strong>Five participants with AA took part in an 8-session in-person MBCT intervention. A multiple-baseline single-group case series design was adopted. Idiographic measures of social anxiety were measured each day from baseline, through intervention, to follow-up. Standardised questionnaires of trait mindfulness, social anxiety, depression, anxiety, and quality of life were completed at baseline, post-intervention, and at 4-week follow-up.</p><p><strong>Results: </strong>All participants completed the MBCT course, but one participant was excluded from the idiographic analysis due to a high amount of missing data. The remaining four participants demonstrated reductions in idiographic measures of social anxiety from baseline to follow-up. These effects were larger between baseline and follow-up, than between baseline and post-intervention. Two participants demonstrated significant improvement in standardised measures of wellbeing from baseline to follow-up - they also practised mindfulness most regularly at home between sessions.</p><p><strong>Conclusion: </strong>MBCT may be effective in reducing social anxiety and improving wellbeing in individuals with AA, although this might be dependent on the extent to which participants regularly practise mindfulness exercises.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Implementation of a case formulation to reduce restrictive interventions on a psychiatric intensive care unit: quasi-experimental single case evaluation - CORRIGENDUM.","authors":"Faye Cox, Stephen Kellett","doi":"10.1017/S1352465823000383","DOIUrl":"10.1017/S1352465823000383","url":null,"abstract":"","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tom Cawthorne, Anton Käll, Sophie Bennett, Elena Baker, Gerhard Andersson, Roz Shafran
{"title":"The development and preliminary evaluation of Cognitive Behavioural Therapy (CBT) for Chronic Loneliness in Young People.","authors":"Tom Cawthorne, Anton Käll, Sophie Bennett, Elena Baker, Gerhard Andersson, Roz Shafran","doi":"10.1017/S1352465823000231","DOIUrl":"https://doi.org/10.1017/S1352465823000231","url":null,"abstract":"Abstract Background: Approximately 10% of young people ‘often’ feel lonely, with loneliness being predictive of multiple physical and mental health problems. Research has found CBT to be effective for reducing loneliness in adults, but interventions for young people who report loneliness as their primary difficulty are lacking. Method: CBT for Chronic Loneliness in Young People was developed as a modular intervention. This was evaluated in a single-case experimental design (SCED) with seven participants aged 11–18 years. The primary outcome was self-reported loneliness on the Three-Item Loneliness Scale. Secondary outcomes were self-reported loneliness on the UCLA-LS-3, and self- and parent-reported RCADS and SDQ impact scores. Feasibility and participant satisfaction were also assessed. Results: At post-intervention, there was a 66.41% reduction in loneliness, with all seven participants reporting a significant reduction on the primary outcome measure (p < .001). There was also a reduction on the UCLA-LS-3 of a large effect (d = 1.53). Reductions of a large effect size were also found for parent-reported total RCADS (d = 2.19) and SDQ impact scores (d = 2.15) and self-reported total RCADS scores (d = 1.81), with a small reduction in self-reported SDQ impact scores (d = 0.41). Participants reported high levels of satisfaction, with the protocol being feasible and acceptable. Conclusions: We conclude that CBT for Chronic Loneliness in Young People may be an effective intervention for reducing loneliness and co-occurring mental health difficulties in young people. The intervention should now be evaluated further through a randomised controlled trial (RCT).","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maisha Murshed, Rebecca Doherty, Sepideh Mhojatoleslami, Said Aris Tarabi, Anupama Rammohan
{"title":"Increasing ethnicity reporting to better understand cultural needs accessing a primary care talking therapy service.","authors":"Maisha Murshed, Rebecca Doherty, Sepideh Mhojatoleslami, Said Aris Tarabi, Anupama Rammohan","doi":"10.1017/S1352465823000176","DOIUrl":"https://doi.org/10.1017/S1352465823000176","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic highlighted the under-utilisation of statutory mental health care services by minority ethnic groups in the United Kingdom (UK).</p><p><strong>Aim: </strong>To improve ethnicity reporting to better understand the needs of patients accessing a primary care talking therapies service.</p><p><strong>Method: </strong>We conducted a clinical audit to observe outcomes from pre-COVID (2019), first wave of COVID-19 (2020) and 2021 for three broad ethnic categories: black African/Caribbean, Asian and white British. Intervention was conducted on staff to improve data recording of ethnicity. A patient survey was sent to those identified as dropped out from treatment from May 2020 to April 2021. A total of 229 patients responded to the survey. The survey asked for reasons that impacted on not continuing with sessions.</p><p><strong>Results: </strong>Quantitative analysis showed a statistically significant difference on discharge outcome between white British and black African/Caribbean (<i>p</i>=<0.0001), with black African/Caribbean patients most likely to drop out of treatment, and in 2020 the Asian population was below the recovery target of 50%. Qualitative analysis revealed therapist factors included lack of confidence in therapist and not being listened to, patient factors included neurodiversity, being unsure whether it would be helpful and confidentiality concerns, and service factors included being notified of discharge from the service, remote delivery of therapy, treatment options, and treatment materials.</p><p><strong>Discussions: </strong>Services must work towards improving service provision by capturing hidden disparities and socialising treatment to meet the needs of minority ethnic groups in the UK. The present study recommends culturally adapted treatment and co-producing therapy materials.</p>","PeriodicalId":47936,"journal":{"name":"Behavioural and Cognitive Psychotherapy","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10329167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}