Search results

21 – 30 of over 1000
Article
Publication date: 9 September 2013

Lois Dugmore

The main aim of this paper is to highlight innovative partnership working between voluntary sector General Practitioner's and primary and secondary mental health services to…

311

Abstract

Purpose

The main aim of this paper is to highlight innovative partnership working between voluntary sector General Practitioner's and primary and secondary mental health services to improve access to services. Many clients are turned away from services when they disclose substance use, this paper discusses why clients are excluded and how psychological therapies can engage clients in treatment using an alternative approach to health centres. It identifies the need for agencies to have multiple skills in working with both mental health and substance use to provide access to services.

Design/methodology/approach

The improving access to psychological therapies (IAPT) group was developed to work with clients using psychological interventions to create, a more flexible approach to services for substance users with psychological difficulties and so the IAPT group was developed. To ensure group's stability it was thought that consistent staff from both organisations should remain in the programme for its duration. To ensure adequate staffing, two staff from the drug agency and three staff from the IAPT team were identified and had shown a firm commitment to work on the programme, and it was agreed that two staff were present at each meeting. The voluntary sector agency premises were chosen as the venue, due to their proximity to bus routes and the anonymity of the service location. The group convened for a period of six weeks and would be a closed group (start with the same group members and have no changes during the groups duration). This would allow clients to engage, work together and to gain confidence in supporting each other. It also allowed clients to work with existing group dynamics and to set boundaries. Establishing the group it was important that it met in the afternoon to allow clients to arrive. The group started at 1 p.m., and worked through until 4 p.m., starting with coffee and having a break within the afternoon. Time was also allocated at the end to talk to staff or other group members about any concerns. The programme included workbooks and hand outs to help clients continue the process at home. Information packs were given including helpline numbers and service information. The group was based using cognitive behavioural therapy techniques, mindfulness and dialectical behavioural therapy. Some motivational interviewing techniques and harm reduction messages as well as relapse prevention were included.

Findings

Half the group reported that they had reduced their drug use, two went on to join group programmes. In total, 100 per cent agreed to continue to meet and support each other in a less formal setting. The group felt strongly that it should remain only about cannabis and not to introduce other drugs into the group. All clients felt the group should be a 12-week programme the staff running the group concurred with this. All participants felt the group was helpful but could have been 12 weeks, that it reduced their symptoms and enabled them to interact with others who understood their needs. Peer support was highlighted as the most useful. Two participants entered other drug programmes after the group. All participants associated their substance use with their mood.

Originality/value

There are no other projects that have worked outside the IAPT model that integrate substance users and voluntary sector agencies. Provides a unique view of multi agency approach using IAPT in a non–General Practitioner setting with clients normally excluded from IAPT services due to drug use. Is about inclusion of a normally excluded group.

Details

Drugs and Alcohol Today, vol. 13 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 20 July 2009

Graham Turpin, Jeremy Clarke, Ruth Duffy and Roslyn Hope

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…

Abstract

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.

Article
Publication date: 1 July 2007

Fiona Mackay and Claire Wilson

Janette1 is a young woman with both a mild intellectual disability and moderate physical disabilities who experienced a major depressive disorder at a stage in her life when many…

Abstract

Janette1 is a young woman with both a mild intellectual disability and moderate physical disabilities who experienced a major depressive disorder at a stage in her life when many young adults leave home. This case study exemplifies the success of a multi‐disciplinary, multi‐agency and multi‐element intervention for severe depression in relation to the tasks of adolescence. The impact of a combination of treatments (including attendance at an assessment day unit, electro‐convulsive therapy (ECT) and cognitive behavioural therapy (CBT)) on Janette's mood has been assessed regularly using the Glasgow Depression Inventory ‐ Learning Disability (GDS‐LD) scale (Cuthill, 2003). There is currently very little literature on either using ECT with people with learning disabilities or assessing depression in this population. The multiple inputs, in Janette's case, have had the desired effect of greatly improving her mood, which has been sustained via outpatient follow‐up and tailoring of day and respite services.

Details

Tizard Learning Disability Review, vol. 12 no. 3
Type: Research Article
ISSN: 1359-5474

Article
Publication date: 23 November 2021

Celal Perihan, Mack D. Burke, Lisa Bowman-Perrott and Joel Bocanegra

The purpose of this study was to investigate the quality of current studies that assess and treat anxiety symptoms in children with autism spectrum disorder (ASD). More…

Abstract

Purpose

The purpose of this study was to investigate the quality of current studies that assess and treat anxiety symptoms in children with autism spectrum disorder (ASD). More specifically the study aimed to answer the following questions: What are the qualities of the current studies using cognitive behavioral therapies (CBTs) to treat anxiety symptoms in children with ASD? Did studies make necessary modifications and adaptations to CBTs according to the evidence-based strategies and implement these versions of CBTs with precise fidelity? Were the selected measurements appropriate for assessing the anxiety symptoms in children with ASD?

Design/methodology/approach

A systematic review protocol was developed from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Moher et al., 2009). A rubric was adapted based on the CEC (Council for Exceptional Children; Cook, 2014) group comparison studies standards and the Evaluative Method for Determining EBP in Autism (Reichow et al., 2007). The 3-point Likert Scale (Chard et al., 2009) was adapted to score each study based on the rubric.

Findings

CBT is a first-line treatment with significant mixed results. Current studies use adapted versions of existing CBTs for children with ASD without reporting empirical evidence to these adaptations and changes. Reporting of the implementation fidelity is still an issue in the treatment of anxiety. Anxiety measurements that were designed for typically developing children failure to detect unusual anxiety symptoms in children with ASD.

Research limitations/implications

The first limitation of this study was including a variety of studies across CBT programs and types of anxiety symptoms. Types of anxiety and CBT treatments may require separate analyses with specific indicators. Due to the limited studies, reviews could not be analyzed across types of CBT programs. The second limitation was the types of studies. Most of the studies were pilot studies. Pilot studies might use various instruments and CBTs components for making selections to produce the best effects and results. The final limitation was the lack of examination of the data analysis process.

Originality/value

These findings are important because due to the variety of changes or adaptation to CBTs, inappropriate implementations and failure to detect unusual anxiety symptoms of children with ASD may cause significant differences in treatment responses and outcomes. The study demonstrated that the majority of the studies used adapted versions of existing CBTs without reporting empirical evidence for these adaptations and changes. The findings have shown that reporting of the implementation fidelity is still an issue. Moreover, the majority of studies had used anxiety measurements that were designed for typically developing children, not for children with ASD.

Open Access
Article
Publication date: 26 July 2012

Monica Blanaru, Boaz Bloch, Limor Vadas, Zahi Arnon, Naomi Ziv, Ilana Kremer and Iris Haimov

Posttraumatic stress disorder (PTSD), an anxiety disorder with lifetime prevalence of 7.8%, is characterized by symptoms that develop following exposure to traumatic life events…

5628

Abstract

Posttraumatic stress disorder (PTSD), an anxiety disorder with lifetime prevalence of 7.8%, is characterized by symptoms that develop following exposure to traumatic life events and that cause an immediate experience of intense fear, helplessness or horror. PTSD is marked by recurrent nightmares typified by the recall of intrusive experiences and by extended disturbance throughout sleep. Individuals with PTSD respond poorly to drug treatments for insomnia. The disadvantages of drug treatment for insomnia underline the importance of non-pharmacological alternatives. Thus, the present study had three aims: first, to compare the efficiency of two relaxation techniques (muscular relaxation and progressive music relaxation) in alleviating insomnia among individuals with PTSD using both objective and subjective measures of sleep quality; second, to examine whether these two techniques have different effects on psychological indicators of PTSD, such as depression and anxiety; and finally, to examine how initial PTSD symptom severity and baseline emotional measures are related to the efficiency of these two relaxation methods. Thirteen PTSD patients with no other major psychiatric or neurological disorders participated in the study. The study comprised one seven-day running-in, no-treatment period, followed by two seven-day experimental periods. The treatments constituted either music relaxation or muscle relaxation techniques at desired bedtime. These treatments were randomly assigned. During each of these three experimental periods, subjects' sleep was continuously monitored with a wrist actigraph (Ambulatory Monitoring, Inc.), and subjects were asked to fill out several questionnaires concerned with a wide spectrum of issues, such as sleep, depression, and anxiety. Analyses revealed a significant increase in objective and subjective sleep efficiency and a significant reduction in depression level following music relaxation. Moreover, following music relaxation, a highly significant negative correlation was found between improvement in objective sleep efficiency and reduction in depression scale. The study‘s findings provide evidence that music relaxation at bedtime can be used as treatment for insomnia among individuals with PTSD.

Details

Mental Illness, vol. 4 no. 2
Type: Research Article
ISSN: 2036-7465

Keywords

Article
Publication date: 14 September 2015

Kerry Lynn Sheldon, Simon P. Clarke and Nima Moghaddam

Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present individual-level…

Abstract

Purpose

Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present individual-level analysis of changes in a group of patients discharged from psychological therapy within an outpatient pain service. The service had recently shifted from a traditional cognitive-behavioural approach to one underpinned by Acceptance and Commitment Therapy.

Design/methodology/approach

Reliable and clinically significant change methodology was applied to CORE-10 outcomes for 27 patients discharged during 2013-2014. Outcomes were compared to 2012-2013. A patient satisfaction questionnaire was administered and functional outcomes were collated.

Findings

Outcomes were not adversely affected by the shift in service focus as clients demonstrating reliable improvement increased from 2012-2013; 81 per cent reliably improved, 44 per cent made a clinically significant improvement. Increases in returning to work/unpaid activities at post-treatment were noted. The service met a number of NICE quality standards concerning the “relational” aspects of care.

Research limitations/implications

Clinical effectiveness is evaluated through one outcome measure thereby limiting conclusions. The longer term effectiveness of the service remains unclear. Narrow demographic information limits an assessment of any systematic biases in findings. Little is known about treatment drop-outs.

Practical implications

A number of recommendations concerning data collection and future service evaluations are made.

Social implications

Returning to paid or unpaid activities has a high public health impact.

Originality/value

This paper contributes towards the evidence base for using psychological therapies with clients experiencing chronic pain and related distress. Importantly, the paper complements evidence for general efficacy (from large-scale controlled studies) through an evaluation of real-world effectiveness (i.e. practice-based evidence).

Details

Mental Health Review Journal, vol. 20 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 3 January 2017

Nigel Beail

Over a decade ago “Psychotherapy and learning disabilities” was published by the UK Royal College of Psychiatrists. It was decided by the Royal College and British Psychological…

627

Abstract

Purpose

Over a decade ago “Psychotherapy and learning disabilities” was published by the UK Royal College of Psychiatrists. It was decided by the Royal College and British Psychological Society’s faculties for people who have ID to revise and update this report. The paper aims to discuss these issues.

Design/methodology/approach

Experts in the field were invited to make a contribution on their approach covering method, adaptations, service user views and outcomes.

Findings

A great deal has changed in the last decade in terms of service development and research resulting in a much wider range of therapies being made available and there being a growing evidence base.

Research limitations/implications

Further work needs to be carried out to make such information accessible to carers and service users.

Practical implications

The report is a useful resource for professionals involved in the support of the mental health and emotional needs of people who have ID.

Social implications

The report should help expand the range of therapies available to people who have ID who need then so they can live more fulfilling lives.

Originality/value

The report provide extensive coverage of the range of psychological therapies available to people who have ID along with their evidence base.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 11 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 1 November 2006

Jane Barlow, Doug Simkiss and Sarah Stewart‐Brown

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and…

Abstract

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.

Details

Journal of Children's Services, vol. 1 no. 3
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 16 September 2011

H. Thompson Prout and Brooke K. Browning

The purpose of this paper is to provide an update on the effectiveness of psychotherapy with persons with intellectual disabilities.

978

Abstract

Purpose

The purpose of this paper is to provide an update on the effectiveness of psychotherapy with persons with intellectual disabilities.

Design/methodology/approach

This paper focused on summarizing the conclusions of other reviews published in the last ten years, including a recent review by the authors.

Findings

The paper concludes that there is evidence that psychotherapy with persons with intellectual disabilities is at least moderately effective. Further, there is evidence of effectiveness of psychotherapy for both child and adolescent, and adult populations. There is also evidence that a range of therapeutic interventions are effective and that a spectrum of problems can be addressed via psychotherapy.

Research limitations/implications

This area has received relatively little attention in the research literature and the area lacks a large base of methodologically sound and rigorous studies. There is a need for well‐designed studies, particularly randomized controlled trials (RCTs), and a need for better specification of treatments (e.g. manualized), better outcome measures, and clearer specification of diagnostic categories within the intellectual disability population.

Practical implications

This review provides continued support for the use of psychotherapy with persons with intellectual disabilities.

Originality/value

This review appears to represent the most current overview of research in this area.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 5 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

Book part
Publication date: 5 September 2018

Matthew R. Leon, Holly K. Osburn and Thomas Bellairs

Post-traumatic stress disorder (PTSD) affects both civilian and military populations following wartime experiences. However, despite an abundance of research investigating…

Abstract

Post-traumatic stress disorder (PTSD) affects both civilian and military populations following wartime experiences. However, despite an abundance of research investigating civilian and military populations separately, much less focus has been given to synthesizing and integrating findings to describe how civilian and military war survivors are comparatively affected by PTSD. This review is broken down into three sections covering (1) risk factors associated with PTSD, (2) relationships between PTSD and mental health outcomes, and (3) protective factors that can attenuate PTSD and its effects. Each section covers findings for civilians and military personnel and highlights similarities and differences between groups.

Details

Occupational Stress and Well-Being in Military Contexts
Type: Book
ISBN: 978-1-78756-184-7

Keywords

21 – 30 of over 1000