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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.

Cognitive behaviour therapy (CBT) is currently one of the recommended treatments for depression for the general population and guidance recommends that people with a learning disability should have access to the same treatments as people without a learning disability. The purpose of this paper is to identify, outline and evaluate current research on the effectiveness of CBT for depression for people with a learning disability. The clinical, service and research implications are considered.

A systematic search was conducted and five relevant articles were identified for critical review.

There is a limited but promising evidence base for the use of CBT for depression with people with learning disabilities.

The current review identified a number of methodological issues and future research should attempt to overcome these (e.g. small sample sizes and lack of controls). In particular, research should focus on determining the relative contribution of cognitive and behavioural techniques in producing a change in depressive symptoms.

Services (including those provided as part of Improving Access to Psychological Therapies) should be offering CBT-based interventions for people with learning disabilities who are experiencing depression.

This paper provides a comprehensive and up to date review of the current literature regarding the use of CBT for depression for people with a learning disability. This will be of value to clinicians working with people with a learning disability as well as those commissioning services.

Individuals who have autism spectrum disorders (ASD) commonly experience anxiety about social interaction and social situations. Cognitive behaviour therapy (CBT) is a recommended treatment for social anxiety (SA) in the non-ASD population. Therapy typically comprises cognitive interventions, imagery-based work and for some individuals, behavioural interventions. Whether these are useful for the ASD population is unclear. Therefore, the purpose of this paper is to undertake a systematic review to summarise research about CBT for SA in ASD.

Using a priori criteria, the authors searched for English-language peer-reviewed empirical studies in five databases. The search yielded 1,364 results. Titles, abstracts, and relevant publications were independently screened by two reviewers.

Four single case studies met the review inclusion criteria; data were synthesised narratively. Participants (three adults and one child) were diagnosed with ASD and SA. There were commonalities in interventions and techniques used: participants were encouraged to identify and challenge negative thoughts, enter anxiety-provoking social situations, and develop new ways of coping. Unlike CBT for SA in non-ASD individuals, treatment also included social skills interventions. Outcomes were assessed using self- or informant-reports. Improvements in SA, depressive symptoms, social skills, and activity levels were noted. Generalisability of results is hampered, however, by the small number of studies and participants and lack of randomised controlled trial conditions employed.

Future studies should investigate how beliefs and behaviours indicative of SA can be ameliorated in individuals with ASD.

This is the first review to synthesise empirical data about CBT for SA in ASD.

Rewind is a trauma-focussed exposure technique that is part of Human Givens (HG) therapy. However, there have been no controlled studies examining the effectiveness or acceptability of Rewind, and a previous study comparing HG therapy outcomes with cognitive behaviour therapy (CBT) benchmarks has yet to be replicated. The paper aims to address these issues.

This preliminary investigation used an observational, quasi-experimental design. Using both between-subject and within-subject designs, the outcome measures of those who had Rewind in the second session and participants who had treatment-as-usual (TAU) in the second session followed by Rewind in the third session were compared. Pre–post treatment scores were used to evaluate the overall HG therapy and to compare with benchmarks.

Rewind was more effective than control treatment sessions, with 40 per cent recovered and 57 per cent having reliably improved or recovered after the Rewind treatment session. Rewind sessions were rated as acceptable as other treatment sessions. The effect size of HG therapy was above the CBT Clinical Outcomes in Routine Evaluation Outcome-10 (CORE-10) benchmark of 1.22. The recovery rate for treatment completers was 63 per cent, with 91 per cent recovered or reliably improved and was equivalent to the top quartile of services.

Rewind is a promising alternative trauma treatment, as people need not discuss details of the trauma, multiple traumas can be treated in one session and fewer treatment sessions may be needed.

There are few HG studies reported in the peer-reviewed literature. This preliminary study is the first controlled study of Rewind. The findings are also in line with previous research on HG therapy.

People with learning disabilities have traditionally been denied access to a range of psychological therapies. Similarly, offenders with learning disabilities, particularly in prison settings, have largely been unable to access treatment strategies that are provided for offenders who do not have such disabilities. As a consequence these individuals are denied the opportunity to address their criminogenic needs and/or attend to their psychological welfare. This paper provides a brief exploration of the reasons and evidence for such practice, alongside the evidence that people with learning disabilities can successfully engage in psychotherapy. It is concluded that there is no evidence that would support the exclusion of people with disabilities from treatment options.

The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as defined in DSM 5 with reference to common mental health disorders. It also examines differences in the numbers of appropriately trained cognitive behaviour therapy (CBT) therapists and highlights the lack of provision of CBT reflected in the much smaller number of accredited therapists in Wales compared to other parts of the UK.

This population was identified by way of an audit of data collected via the out-patient clinics conducted by the author.

The paper identifies a high proportion of patients who attended SMSs as having complex psychological need as a consequence of co-morbidity.

The results of the audit may have limitations but the implications from the findings suggest potential value in looking more at clinical outcomes following evidence-based psychological interventions.

A conclusion from the findings is suggested value in a more structured approach to looking at clinical outcomes.

This audit was undertaken in North Wales. There is no IAPT or matrix-structured Level II CBT training programmes available in Wales. The audit identifies the need for more evidence-based psychological interventions such as CBT linked to the development of such services. The apparent lack of political will to change the status quo is also highlighted as a problem.

The Improving Access to Psychological Therapies (IAPT) programme was established to treat people with mild to moderate depression and anxiety and bring them to recovery. Although the Positive Practice Guide for people with intellectual disabilities was published in 2009, no geographical areas are listed as having a special interest in specifically rolling out IAPT to people with intellectual disabilities. Issues related to whether current IAPT services can meet the needs of people with intellectual disabilities are considered, along with adaptations that would be needed to ensure the service is accessible and meets the needs of people with intellectual disabilities.

Dialectical behaviour therapy (DBT) has been widely used in a number of different settings with published outcomes and literature supporting its validity and efficacy. What is less understood is DBT’s application to forensic populations. The purpose of this paper is to qualitatively explore the experiences of high risk and adult male forensic clients (diagnosed with borderline personality disorder (BPD) and antisocial personality disorder (ASPD)) in a forensic adapted version of DBT.

Six clients who had completed four modules of DBT and individual therapy engaged in semi-structured interviews which were transcribed and analysed using thematic analysis.

The findings identified emerging themes relating to group processes and treatment outcomes. Specifically, the importance of motivation, shared learning, professionalism, reinforcement and reflection in creating a positive experience of DBT were identified. In addition clients identified feeling supported, a sense of belonging, personal achievement, increased knowledge and skills application as being part of their experience of DBT.

Whilst efforts were made to manage limitations, potential confounders include the impact of the researcher’s direct involvement in the facilitation of DBT and the small sample size.

This study provides support for the use of DBT with forensic males diagnosed with ASPD and BPD and the importance of the group component to the treatment modality. It emphasises the importance of group cohesion and the development of interpersonal factors including feeling supported, sense of belonging and a sense of achievement.

This paper provides a unique contribution to the understanding of the application of DBT with forensic male clients with personality disorder. It is the first known study to use qualitative methods to explore forensic male clients’ experiences of group and individual DBT. This paper provides insight into the key themes of clients’ experiences of DBT. These identified themes lend support to the importance of motivation of clients and the experience of shared learning, reinforcement and reflection. Furthermore, feeling supported, having a sense of belonging and a sense of personal achievement were identified as key to the positive experience of clients.

Traditional clinical psychological practices have often been adapted for the context of executive coaching. Cognitive behavioral therapy (CBT) in particular is the most scientifically supported psychological modality. CBT like other practices has been used in coaching as cognitive behavioral coaching but rarely discussed more explicitly for the executive population. Here, we offer a specific adaptation – cognitive behavioral executive coaching (CBEC) – and suggest that it presents a flexible structure that can meet the multiple agendas that are framed for executive coaching. Additionally, the core features of CBT and CBEC in particular satisfy the major needs of executives in coaching arrangements. We conclude by demonstrating a CBEC process model for coaching the high-performing executive.