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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.

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

To determine the extent to which psychiatrists of different grades complied with published recommendations regarding referral for psychological treatment of patients suffering from depression.

Clinic letters regarding patients with depression were audited to see whether patients were referred for psychological treatment and, if not, whether a reason was recorded. The results were presented and the audit repeated.

There was little difference in the results of the two audits. Overall, 51 per cent of depressed patients were referred for psychological treatment and 26 per cent were not referred without a reason being given. SHOs were significantly (p=0.008) more likely than other grades not to refer without giving a reason.

SHOs should be encouraged to consider psychological treatment for depression and to record their reasons when not making a referral for this.

This audit has identified a probable reluctance of SHOs to consider referral for psychological treatment and hence suggests that this issue should be specifically addressed as a supervision and training issue.

Mental health problems are increasing in society. To deal with these problems effectively, it is imperative that appropriate treatments are delivered. Some evidence suggests that patients often do not complete the full course of many psychotherapy treatments. The aim of this study was to estimate the average length of treatment for patients referred to the adult specialty of a large clinical psychology department. A stratified sampling strategy was chosen to obtain an unbiased and precise estimator of the average treatment length for the population of patients whose files had been closed in one calendar year (n = 3021). The stratified sampling mean estimator for the population mean was 3.9 appointments; standard psychotherapy treatments are often planned to be more than ten appointments. These results suggest that many patients are failing to receive the full treatment planned by mental health professionals. Perhaps more psychotherapy treatments need to be delivered in a smaller number of appointments. Stratified sampling could be used to estimate treatment duration in particular contexts, thereby allowing treatments to be designed to meet local needs.

The purpose of this paper is to evaluate the effectiveness of psychological treatments and identify required adaptations to increase acceptability and improve outcomes for people with dementia or mild cognitive impairment who experience psychological distress.

The Cochrane Dementia and Cognitive Improvement Group Specialised Register and other databases were searched for eligible studies. Inclusion criteria identified nine randomised controlled trials comparing a psychological intervention (cognitive behavioural therapy, relaxation training therapies, multimodal therapies, psychodynamic therapy, counselling and cognitive rehabilitation) with usual care, with measures of depression and/or anxiety as an outcome. The appraisal of papers was conducted using the Mixed Methods Appraisal Tool. Data was analysed using meta-analysis.

A small, significant effect size before to after intervention was revealed, suggesting that psychological treatments may be effective in reducing psychological distress in people with dementia, with several therapy adaptations identified.

Because of methodological limitations and a small number of studies evaluated, the quality of evidence was low for outcomes for depression, and there were no significant outcomes in anxiety.

The current review offers a unique contribution in identifying specific adaptations deemed helpful in improving the accessibility and acceptability of therapy for people with dementia, suggesting therapy can be adjusted enough to support this client-group. Future studies should use high-quality trials using standardised psychological interventions, of sufficient length, with long-term follow-up and offer of specific adaptations to increase accessibility and outcomes.

This study examines the relationship of personality characteristics to drug treatment effectiveness for prison releasees. Prison releasees from two drug treatment programs (an out‐patient setting and a therapeutic community setting) are compared with each other and to releasees from a comparison group. Treatment success is measured 6 months after release from prison in terms of 1) abstinence of illicit drug use and 2) lack of recidivism. The data are analyzed using logistic regression with demographic, criminal history, past drug use, psychological, and treatment measures included in the equations. Findings suggest that several personality dimensions are related to treatment effectiveness, sometimes in unexpected ways. The findings also reveal that different personality characteristics are associated with each of the two measures of treatment success. The results are discussed in terms of policy implications for treatment programs.

Manipulation checks are a recommended for experimental accounting research. Usage of information gained by manipulation checks varies. In some studies, participants who failed the manipulation check are removed from the sample. Other studies report the results of the manipulation checks but still use the full sample. Some authors recommend removing participants who failed the manipulation check as a means to increase the power of the statistical analysis. Others warn that removing these participants endangers the randomization as a crucial precondition for gaining valid insights from experimental research. Until now, there is little research on how sensitive results react to exclusion of participants. The purpose of this paper is to study the effects of removing participants failing the manipulation checks on the evaluation of a hypothesis and the development of alternative usages of the information gained from manipulation checks.

Based on an analytical model and a simulation, the authors show how removing participants who fail the manipulation check affects experimental findings.

Simulations show that statistical results and conclusions drawn from an experiment differ substantially, depending on whether participants who failed the manipulation check are removed from the sample. As the participants who are removed are no random sub-sample, but share a certain property, the experimental results react strongly, typically showing significant results, where there are actually none.

This paper is, to the best of the authors’ knowledge, the first to address the sensitivity of experimental results to removing participants who fail the manipulation check from the sample and the implications for the validity of conclusions drawn from experimental accounting research. This paper’s contribution is a better way of using information gained in the manipulation check in the statistical analysis of the experimental data.

A repeated measures cohort study was conducted to investigate the impact of attending a day treatment programme on physical and psychological state, and to assess which baseline factors predicted level of recovery. Physical and psychological outcomes of treatment were analysed for 116 patients admitted to the treatment programme between 1996 and 2006 and were found to be in line with previous day care evaluations, with the majority of patients showing improvements on all measures. A multiple regression analysis revealed several factors to be predictive of treatment outcomes including patient demographics, comorbidities and traumatic life events. In particular, those patients who benefited most from the treatment had a lower body mass index at admission, stayed longer at the unit, were older, less likely to have other physical and psychiatric comorbidities, particularly obsessive compulsive disorder or a history of sexual abuse, and whose most predominant eating disorder problem was characterised by low weight.

The purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the presence or absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping the overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. The authors examined the relationship between an individual’s level of intellectual disability and the presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.

A cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.

There was a high prevalence of mental health comorbidity, even higher for autistic adults. However, a relatively small percentage of the study population was receiving psychological interventions. The most frequent non-pharmacological intervention was a positive behaviour support plan, irrespective of comorbid mental illnesses.

Not having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions, particularly for those with moderate to severe intellectual disability and for those with associated autism.

This large sample study examined the relationship between intellectual disability level and the presence of autism with accessing psychological interventions.

Individuals being treated in medium secure hospitals have typically engaged in some form of offending in other service settings or while in the community. Although psychological treatment for addressing such behaviour in medium secure hospitals is beginning to be developed, at present there is a lack of evidence of ‘what works’. This paper reports a review of the type and level of offending behaviour engaged in by those in a single medium secure service, including the conviction histories for such behaviours and the psychological approaches to risk reduction and offending behaviour taken in medium secure hospitals in England and Wales. The need to develop an evidence base for psychological treatment in medium secure services including at the individual level is clearly indicated.