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No current psychotherapeutic intervention is designed to enhance job retention in employees with moderate–severe recurrent depression. The aim of this study is to test the feasibility of a new, interdisciplinary work-focused relational group cognitive behavioural therapy (CBT) treatment programme for moderate–severe depression.

The programme was based on a theoretical integration of occupational stress, psychological, social/interpersonal and bio-medical theories. It consisted of up to four 1:1 psychotherapy sessions; 12 work-focused, full-day, weekly CBT sessions facilitated by a cognitive behavioural therapist and occupational therapist; and up to four optional 1:1 sessions with an occupational therapist. Depression severity (primary outcome) and a range of secondary outcomes were assessed before (first CBT session) and after (twelfth CBT session) therapy using validated instruments.

Eight women (26–49 years) with moderate–severe depression participated. Five were on antidepressant medication. While there was no statistically significant change in Hamilton Depression Rating Scale depression scores after therapy (n = 5; p = 0.313), Beck Depression Inventory-II depression scores significantly decreased after therapy (n = 8; –20.0 median change, p = 0.016; 6/8 responses, 7/8 minimal clinically important differences, two remissions). There were significant improvements in the secondary outcomes of overall psychological distress, coping self-efficacy, health-related quality of life and interpersonal difficulties after therapy. All clients in work at the start of therapy remained in work at the end of therapy. The intervention was safe and had 100% retention.

A major limitation was recruitment shortfall, resulting in a small sample of middle-aged women, which reduces representativeness and increases the possibility of methodological weaknesses in terms of the statistical analysis. A definitive trial would need much larger samples to improve statistical power and increase confidence in the findings. Another major limitation was that two of the authors were involved in delivering the intervention such that its generalisability is uncertain.

This novel programme was evaluated and implemented in the real world of clinical practice. It showed promising immediate positive outcomes in terms of depressive symptoms, interpersonal difficulties and job retention that warrant further exploration in a longer-term definitive study.

Empirical studies focused on enhancing job retention in employees with moderate–severe recurrent depression are lacking, so this study was highly relevant to a potentially marginalised community.

While limited by a recruitment shortfall, missing data and client heterogeneity, this study showed promising immediate positive outcomes for the new programme in terms of depressive symptoms, interpersonal difficulties and job retention that warrant exploration in a definitive study.

The purpose of this paper is to critique the current manner in which cognitive behavioural therapy (CBT) is delivered, with a focus on the impact of evidence-based practice.

This paper is based upon the experiences, ideas and clinical practice of the authors.

The reductionist approach based on psychiatric diagnosis is put forward as the mechanism by which CBT has gradually lost its status as a form of psychotherapy.

An alternative framework based on revitalising CBT as a client centred, problem-based and formulation driven form of therapy is put forward.

The past decade has seen an expansion of psychological treatments available to patients in the NHS. Research into the effectiveness of psychological treatments is also increasing, but this evidence is often not known or used by practitioners. This paper describes the development of a local clinical practice guideline from the research evidence to assist local GPs and psychological practitioners in selecting the most appropriate of three commonly available psychological treatments for adult patients — brief counselling, cognitive behaviour therapy, and psychodynamic psychotherapy. The steps of the guideline development process and difficulties encountered are outlined, and the local dissemination and implementation process described. A survey of GPs and practice counsellors conducted a month following distribution of the guideline found that most recipients reported it useful with many also reporting having used it already in clinical practice. The limitations as well as strengths of this local guideline development process are discussed.

It has been suggested that the emotional needs of people with intellectual disabilities have been neglected (Kroese, 1998). More recently there has been evidence of increased clinical and research activity in this area (Beail, 2003; Bouras & Holt, 2007; Foundation for People with Learning Disabilities, 2004). Currently much of the focus in this area is on mental ill‐health. This article will consider briefly the literature on mental ill‐health, with particular emphasis on the development of individual treatment approaches. From this discussion it will be evident that much of the research and theory in this area focuses on deficits and disadvantage. I will go on to suggest that a clinical and research focus that explores strengths and resilience will offer a more positive agenda for developing understanding of emotional well‐being and mental ill‐health in people with intellectual disabilities.

The randomised control trial is regarded as the gold standard among the methods used in treatment outcome studies, whatever the treatment. This method imposes the highest level of control over other factors that may influence outcome so that the true effects of the treatment can be tested. In this paper the key features of an RCT are examined, along with potential challenges that emerge when applied to evaluations of psychotherapeutic interventions with people who have learning disabilities.

This paper reviews the literature on therapeutic process specific to sexual offender treatment. The general clinical literature emphasises the importance of therapist style, the client's perceptions, the therapeutic alliance and cohesiveness. We highlight the importance of therapist characteristics, group cohesion and emotion in effective treatment of sexual offenders. Implications for programming and research are emphasised.

Behavioural activation is a contemporary behavioural treatment for depression that has the potential advantages of being more readily adopted in psychiatric inpatient environments than more complex psychological treatment approaches and requiring less intensive training than these approaches. In this article the theoretical and empirical foundations of behavioural activation are described along with an outline of the therapeutic process and key interventions used. Consideration is then given to factors influencing the implementation of BA in psychiatric inpatient environments.

The purpose of study was to assess the impact of an online training program for a brief cognitive-behavioral therapy (CBT) that integrated physical health management designed for use by mental health providers in the primary care setting.

In total, 19 providers from two Veterans Health Administration (VHA) medical centers completed online training as part of a larger trial. Statistical analyses compared provider self-reported CBT knowledge and abilities at pretraining, posttraining, and long-term follow-up. Additionally, data were collected on providers’ experiences of the training.

Providers’ baseline to post-training scores improved on general CBT knowledge and ability, as well as across 11 CBT principles and techniques. Post-training scores were maintained over time.

A small sample size, sole focus on VHA data, and reliance on self-report measures are limitations of the study.

Qualitative data suggested training was feasible, acceptable, and potentially scalable; however, a one-size-fits-all approach may not be ideal.

Online training has potential for providing wider access to providers with limited access to traditional face-to-face training.

This paper describes an innovative, multi‐modular group therapy programme based on cognitive‐behavioural principles and psycho‐education. It introduces participants to strategies and skills to assist with deficits such as poor social skills, low self‐esteem, poor emotional regulation and problematic inter‐personal relationships. The manual‐based format of this programme enables members to be introduced to working in a group, and enables facilitators to obtain qualitative information about group members to promote existing skills in future treatment programmes. The core deficit areas targeted by the programme are not by any means exclusive to individuals in in‐patient forensic learning disability settings, so the programme can be useful for clients with learning disability and offending behaviours who are resident in the community.