Search results

The aim of this paper is to explore how the role of low intensity cognitive behavioural therapy (CBT) could be incorporated as a treatment option for individuals who engage in non‐suicidal self‐injury. Primary Care Mental Health Workers (PCMHWs) and Psychological Wellbeing Practitioners (PWPs) are employed to assist patients experiencing common mental health problems through CBT‐based self‐help materials; this is commonly referred to as low intensity CBT.

This article reviews the literature in order to investigate how these workers could incorporate their skills to offer support to those who self‐harm as means of coping with psychological distress.

The findings from this review identify a call for research into the efficacy of low intensity CBT, to enable the dissemination of clear guidance into the treatment of non‐suicidal self‐injury, considering the role of PWPs and PCMHWs.

At present, there is a lack of guidance into the treatment options for people who participate in non‐suicidal self‐injury. There is ambiguity into how PWPs and PCMHWs should manage this client base and training courses designed for these workers do not address the issues of self‐harm. It is hoped that this article may promote the development of such protocols.

Around the UK, a number of strategies are being employed to expand the availability and increase the accessibility of psychological treatments for anxiety and depression. Recommended interventions include supported self‐help programs based on CBT principles such as computerised cognitive behavioural therapies (CCBT) for mild‐to‐moderate depression, phobia, and panic. This paper seeks to describe innovative third sector, service‐user led CCBT clinics commissioned within Greater Manchester.

The paper describes how the project was initially set up, how the services are managed, how they work, and the impact of these services on the population they serve.

The CCBT clinic achieves a high throughput of service‐users, including more than one‐third accessing the service through self‐referral. Intake and outcome measures suggest that CCBT service users are representative of both the local population and those accessing increasing access to psychological therapies (IAPT) services for common mental health problems. For those engaging with the CCBT service, outcomes are equivalent to those reported in NHS‐based demonstration IAPT services. Service users highly value the service offered including the computer‐based programs and the support offered by paid and voluntary staff.

Roll out of this effective service model is recommended.

This paper has described a successful third‐sector, user‐led, CCBT self‐help clinic offering a Tier‐2 service for anxiety and depression that meets local needs. This will be of interest to service users, providers, and commissioners who want to develop similar services.

The principle of equivalence states that the provision of healthcare in the community should be extended into prisons. Stress control is a psychoeducational intervention that has had success in the community and has been adapted for use in different settings. The purpose of this paper is to establish whether stress control can be beneficial in a custodial setting.

Stress control was evaluated by looking at clinical effectiveness, satisfaction, attrition rate, cost effectiveness and suitability of the materials for use in a custodial environment. In total, 14 prisoners completed six sessions of stress control. Data were obtained using two clinical scales and an evaluation questionnaire.

Participants' anxiety significantly decreased and their wellbeing increased after completing Stress Control. Prisoners were satisfied with the intervention and there was a small attrition rate.

The audit had a small sample size, there were no control conditions and measures were self report. There was a selection bias arising from the exclusion criteria. A large‐scale randomised controlled trial should be conducted to further test effectiveness.

The adapted materials are effective and appropriate for use in a custodial setting. There can be improved access for psychological therapy for a prison population, a cost effective intervention, acceptable to a prison population and evidence based. Further recommendations for future developments are discussed.

The applicability of an established programme for mood management to custodial settings is an area of significance to forensic practice.

This study aims to explore whether the cultural competency training in Improving Access to Psychological Therapies (IAPT) services is sufficient to equip Psychological Wellbeing Practitioners (PWP) to support Black, Asian and Minority Ethnic (BAME) service users.

A qualitative design was adopted using semi-structured interviews with six PWP participants. Reflexive thematic analysis using Braun and Clarke’s (2006) six-step process was used in data analysis.

Three themes revealed evaluations of PWP training, factors supporting PWPs’ cultural competency and points of improvement for PWP training. The training briefly and superficially covered cultural competency content; however, it encouraged PWPs to explore potential personal and cultural biases in therapy. PWP training can also be improved by providing more culturally relevant resources and involving BAME service users.

A small sample size (N = 6) was used, impacting the findings’ generalizability.

PWP training does not sufficiently equip PWPs to support BAME service users. PWPs’ reflection of their own ethnic identity and personal experiences, when combined with training, can improve cultural competency. IAPT training should focus on cultural awareness, knowledge and skills to enhance therapeutic experience. Moreover, PWPs should reflect on their identity, personal biases and experiences when working with diverse communities.

This is one of the few qualitative studies evaluating the cultural competencies of PWPs in IAPT.

The purpose of this paper is to explore how the use of self‐help bibliotherapy developed from a local pilot scheme to become national policy in Wales. Analysis aims to focus on the use of evidence‐based practice (EBP) as a justification in the process of policy creation.

A mixed methodological approach was used to gather data, incorporating semi‐structured interviews, documents, and descriptive statistics. Actor‐network theory (ANT) was used as a critical lens to frame analysis.

The study finds that the translation from local pilot to national initiative was achieved using legitimising discourses including EBP. These discourses were used selectively, and in response to the needs of the focal actors in the network. The complex relationship between EBP and self‐help bibliotherapy is explored in connection with healthcare policy, concluding that the use of EBP legitimises a lack of patient‐centred evaluation.

Limitations of the research include a lack of engagement with patients using the scheme, and future research should aim to present a more patient‐centred account to complement this policy‐focused work.

Little in‐depth work has been conducted on the strategy behind the introduction of bibliotherapy schemes in the UK or elsewhere, and this paper presents an in‐depth theoretical analysis of the first nationwide bibliotherapy scheme in the world.

There is an urgent need to upscale accessible mental health (MH) interventions that address barriers to care among Syrian refugee adolescents. The Happy Helping Hand (HH) is an innovative, cognitive behavioral digital game designed to improve MH for adolescents across digital divides. This study aims to examine the impact of HH implemented among Syrian refugees who varied according to group size and face-to-face (F2F) versus digital contact.

This mixed-methods study took place in Central Beqaa, Lebanon, from September 2020 to February 2021. Nine groups of Syrian displaced adolescents (n = 125) aged 13–17 years (M_age = 13.6 years) were recruited from an education center, two orphanages and one informal settlement to participate in the ten-session HH program. The WHO-Five-Well-being Index (WHO5) is a validated measure used to evaluate HH impact on MH at baseline and directly postintervention.

Significant improvements were seen in WHO5 scores in F2F and digital settings from baseline to follow-up. At baseline, 28% reported normal well-being, which increased to 99% after HH participation. WHO5 scores changed from M = 59.4 at baseline, indicating depression, to M = 77.3 at follow-up, indicating normal well-being. Smaller groups with more F2F contact reported greater improvements in mean WHO5 than larger groups with less F2F contact. The greatest aggregate change in well-being was achieved when HH was implemented digitally in bigger groups.

Study results indicate that the HH game can improve well-being and MH for Syrian refugees. Importantly, results build on the base of evidence on digital MH interventions as promising tools on the way to ensure healthy lives and well-being for all.

Two years ago, we published within this journal a scoping article (Turpin et al, 2006) concerning the urgent need to review and enhance the workforce responsible for delivering psychological therapies to people seeking help for common mental health problems in primary care (London School of Economics, 2006). We estimated that the demand for such interventions, the service models that might deliver increased capacity for psychological treatments, the implications for workforce numbers and the impact that this would have on education and training. Much of the thinking that was adopted within the review was based on current development work around the mental health workforce led by the National Workforce Programme sponsored by the National Institute for Mental Health England (NIMHE) on New Ways of Working (NWW).The current paper reflects on the process and the added value that NWW has contributed to what is a radical new venture, which has been described by the lead evaluator of the pilot Improving Access for Psychological Therapies (IAPT) phase, Professor Glenys Parry, as 'the industrialisation of psychological therapies'. More specifically, it reviews the implementation of a national programme designated as IAPT, which was commissioned on the basis of the NWW work, and the evidence accrued from the IAPT national demonstration sites at Doncaster and Newham, together with the efforts of Lord Layard and the New Savoy Partnership.The first year implementation of IAPT is described, together with the lessons learned from the roll out. As the programme has developed, it has become important to ensure that clients also have a choice of evidence‐based interventions. NWW has provided a means to help practitioners come together from a range of therapeutic orientations and professions to contribute to this more diverse workforce. Finally, it is argued that NWW has been instrumental in helping managers and professions alike think more flexibly about service models and provision, and how to develop a new workforce competent to deliver such an innovative service.

The purpose of this paper is to discuss the implementation and evaluation of a cognitive behavioral therapy (CBT) training course for clinicians in Chiba, the sixth-largest province in Japan.

Individual CBT for obsessive-compulsive disorder, bulimia nervosa, or social anxiety disorder was delivered by trainees of the Chiba CBT training course in a single study design.

The results demonstrated that individual CBT delivered by trainees led to statistically significant reductions in symptom severity for all three disorders. Feedback from the trainees indicated that the training course achieved its aims.

Barriers to the dissemination of CBT in Japan such as opportunities for training and possible solutions are discussed.

This paper evaluates the Chiba CBT training course, which is a Japanese adaptation of the UK Improving Access to Psychological Therapies Project and the first post-qualification CBT training course in Japan.

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.