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Article
Publication date: 7 September 2012

David Palmer, Sarah Pittaway, Lindsey Cook, Sandra Garner, Sue Holtum, Jackie Sansom and Charu Bassi

The purpose of this paper is to evaluate the impact of guided self‐help cognitive behavioural therapy (CBT) for mothers with depression and/or anxiety undertaken in two Sure Start…

Abstract

Purpose

The purpose of this paper is to evaluate the impact of guided self‐help cognitive behavioural therapy (CBT) for mothers with depression and/or anxiety undertaken in two Sure Start children's centres in the London Borough of Bexley.

Design/methodology/approach

A quantitative study was carried out involving 23 participants who attended an initial appointment with a Psychological Well‐being Practitioner and who were assessed and allocated to a guided self‐help CBT intervention (either workbooks or computer‐based). In addition, in‐depth interviews were undertaken with nine participants who had completed the programme.

Findings

The study finds that guided self‐help CBT produced a significant clinical benefit for participants with mild to moderate depression and/or anxiety. Narratives with participants also highlighted improved confidence and self‐esteem, positive thinking and better coping strategies, which may have a positive impact on their children and families. This research also demonstrated the importance of a partnership approach to providing therapeutic interventions for vulnerable groups such as those in this study.

Originality/value

The findings represent a “snap‐shot” of the positive effects of guided self‐help CBT for those suffering maternal depression. They demonstrate the need to recognise and support the therapeutic social milieu, particularly in settings that are familiar and accessible. In addition, psychological interventions that include facilitative holistic working and inter‐agency working can be particularly effective.

Details

Journal of Children's Services, vol. 7 no. 3
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 9 December 2011

Hayley Williams

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…

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Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

The Journal of Mental Health Training, Education and Practice, vol. 6 no. 4
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 2 March 2012

Liz Brewster, Barbara Sen and Andrew Cox

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…

1840

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Originality/value

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.

Article
Publication date: 9 December 2011

Kate Cavanagh, Nick Seccombe, Nicky Lidbetter and Dawn Bunnell

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Practical implications

Roll out of this effective service model is recommended.

Originality/value

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.

Details

Journal of Public Mental Health, vol. 10 no. 4
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 1 August 2008

Jim White, A Joice, S Petrie, S Johnston, D Gilroy, P Hutton and N Hynes

STEPS is a primary care mental health team that has attempted to develop a very high volume multi‐level, multi‐purpose service for those with mild to moderate problems. The…

Abstract

STEPS is a primary care mental health team that has attempted to develop a very high volume multi‐level, multi‐purpose service for those with mild to moderate problems. The service attempts to overcome many of the limitations of more traditional services. This paper describes the services contained within the six level model.

Details

Journal of Public Mental Health, vol. 7 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 1 October 2006

Kevin Gournay

This article sets out to provide information regarding the evidence base for psychological treatments and to demonstrate that the number of mental health professionals who are…

Abstract

This article sets out to provide information regarding the evidence base for psychological treatments and to demonstrate that the number of mental health professionals who are available and competent to deliver these treatments is very small compared with the numbers of people who might benefit. The article also considers the prevalence of conditions that are amenable to psychological treatment and then explores how ‘stepped care’ may be one solution for providing available treatment resources in a way that is fairest and most effective for the population at large.

Details

The Journal of Mental Health Training, Education and Practice, vol. 1 no. 2
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 1 October 2006

Graham Turpin, Roslyn Hope, Ruth Duffy, Matt Fossey and James Seward

Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to…

Abstract

Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.

Details

The Journal of Mental Health Training, Education and Practice, vol. 1 no. 2
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 12 January 2021

Zoë Meropi Hepburn, Emily Rose Rothwell and Julia Ann Fox-Clinch

To evaluate the effectiveness of an adaptation of Interpersonal Group Psychotherapy (IPT-G), in facilitating short- and longer-term improvements in eating disorder symptomology…

Abstract

Purpose

To evaluate the effectiveness of an adaptation of Interpersonal Group Psychotherapy (IPT-G), in facilitating short- and longer-term improvements in eating disorder symptomology, psychosocial impairment, anxiety, depression and attachment difficulties among adults living with overweight and diagnosed with binge eating disorder (BED).

Design/methodology/approach

In total, 24 participants completed measures at the start of IPT-G, mid-treatment, discharge and six-month follow-up. Quantitative outcomes were analysed utilising one-way repeated measures analysis of variance.

Findings

Treatment retention was 100%. Significant improvements in binge-eating frequency, psychosocial impairment and depression were achieved at mid-treatment and maintained at post-treatment and six-month follow-up, and with large effect sizes. Attachment anxiety had reduced significantly at post-treatment and was maintained at six-month review. Body mass index (BMI) had stabilised by mid-treatment and was maintained at post-treatment and six-month follow-up. All hypotheses were supported, with the exception that attachment avoidance did not improve significantly and following a post-treatment reduction, anxiety symptoms deteriorated slightly by six-month follow-up, such that they were no longer significantly different from pre-treatment levels.

Practical implications

Despite being the most prevalent of the eating disorders (compared to anorexia nervosa and bulimia nervosa), BED is under-recognised and under-treated in clinical settings. Results indicate the sustained effectiveness of IPT-G in improving eating disorder and comorbid symptomology associated with BED.

Originality/value

This is the first UK study to investigate the effectiveness of IPT-G at treating BED. Unlike previous studies in the field, this study did not exclude participants based on age, BMI or psychiatric comorbidity.

Details

Mental Health Review Journal, vol. 26 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 16 March 2012

Gordon Bell

This paper seeks to describe a new service developed by national debt charity Consumer Credit Counselling Service (CCCS) aimed at identifying clients within its online debt…

197

Abstract

Purpose

This paper seeks to describe a new service developed by national debt charity Consumer Credit Counselling Service (CCCS) aimed at identifying clients within its online debt counselling tool who may be suffering from stress and anxiety and then referring them for advice and support, including computer‐based cognitive behavioural therapy (CCBT).

Design/methodology/approach

Since December 2010, clients using CCCS Debt Remedy, the charity's online debt counselling tool, have been asked four trigger questions which indicate whether the user is suffering from depression and/or anxiety. Clients who show these signs, after they receive a recommendation about how to deal with their debt, are offered the opportunity to complete a more comprehensive assessment known as CCCS Wellbeing. The CCCS Wellbeing assessment consists of 16 questions, nine relating to depression and seven to anxiety. The depression questions are based on the medically endorsed depression screener, PHQ‐9, and the anxiety questions are based on the similarly medically endorsed anxiety screener, GAD‐7. These two screeners are also the source of the four original trigger questions.

Findings

Of the 36,618 clients who were counselled by CCCS Debt Remedy between the launch of the new service in December 2010 and the end of May 2011, 65 percent obtained a recommendation to undertake CCCS Wellbeing. The vast majority of clients who obtained a CCCS Wellbeing recommendation through the online debt counselling tool were showing signs of both depression and anxiety (74 percent).

Originality/value

The high propensity for people to be recommended to CCCS Wellbeing demonstrates the need for the service. This will inform future service development by CCCS, which is studying new ways to further identify and refer for help its clients who are struggling with their mental health.

Details

Journal of Public Mental Health, vol. 11 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 2 September 2021

Nicola Walker, Madeleine Vernon-Smith and Michael Townend

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Practical implications

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.

Social implications

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.

Originality/value

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.

Details

Mental Health Review Journal, vol. 26 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

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