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Hannah Murray
BACKGROUND: Therapists in Improving Access to Psychological Therapies (IAPT) services are often expected to treat complex presentations of post-traumatic stress disorder (PTSD), such as individuals with multiple, prolonged or early life trauma histories and significant co-morbidity, for which they have received minimal training. Although high recovery rates for PTSD have been demonstrated in randomized controlled trials, these are not always replicated in routine practice, suggesting that training interventions are required to fill the research-practice gap...
March 28, 2017: Behavioural and Cognitive Psychotherapy
Jo Meadows, Stephen Kellett
BACKGROUND: There is a lack of treatment plurality at step 2 of Improving Access to Psychological Therapies (IAPT) services. This project therefore sought to develop and pilot a cognitive analytic informed guided self-help treatment for mild-to-moderate anxiety for delivery by Psychological Wellbeing Practitioners (PWPs). METHOD: Medical Research Council treatment development guidelines were used. Phase I included development of the six-session treatment manual using practice guidelines, small-scale modelling (n = 3) and indicated manual iterations...
March 22, 2017: Behavioural and Cognitive Psychotherapy
Stephen Kellett, Mel Simmonds-Buckley, Paul Bliss, Glenn Waller
BACKGROUND: The evidence base for behavioural activation (BA) is mainly grounded in the individual delivery method, with much less known about the impact of group delivery. AIMS: To conduct a pilot study of behavioural activation in groups (BAG) for depression delivered in a routine service setting, in order to explore acceptability, effectiveness and predictors of outcome. METHODS: The manualized group treatment format was delivered in a Primary Care mental health setting, at step three of an Improving Access to Psychological Therapies (IAPT) service...
March 13, 2017: Behavioural and Cognitive Psychotherapy
David Saxon, Kate Ashley, Lindsey Bishop-Edwards, Janice Connell, Phillippa Harrison, Sally Ohlsen, Gillian E Hardy, Stephen Kellett, Clara Mukuria, Toni Mank, Peter Bower, Mike Bradburn, John Brazier, Robert Elliott, Lynne Gabriel, Michael King, Stephen Pilling, Sue Shaw, Glenn Waller, Michael Barkham
BACKGROUND: NICE guidelines state cognitive behavioural therapy (CBT) is a front-line psychological treatment for people presenting with depression in primary care. Counselling for Depression (CfD), a form of Person-Centred Experiential therapy, is also offered within Improving Access to Psychological Therapies (IAPT) services for moderate depression but its effectiveness for severe depression has not been investigated. A full-scale randomised controlled trial to determine the efficacy and cost-effectiveness of CfD is required...
March 1, 2017: Trials
Judith Gellatly, Rebecca Pedley, Christine Molloy, Jennifer Butler, Karina Lovell, Penny Bee
BACKGROUND: Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can substantially impact upon quality of life and everyday functioning. Guidelines recommend pharmacological and psychological treatments, using a cognitive behaviour therapy approach (CBT) including exposure and response prevention, but access has generally been poor. Low intensity psychological interventions have been advocated. The evidence base for these interventions is emerging but there is a paucity of information regarding practitioners' perceptions and experiences of supporting individuals with OCD using this approach...
February 22, 2017: BMC Psychiatry
Hayley Marwood, Deborah Chinn, Kenneth Gannon, Katrina Scior
BACKGROUND: People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. METHOD: Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT...
January 24, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
Catharina Gustavsson, Lena von Koch
BACKGROUND AND OBJECTIVE: In previous short-term and 2-year follow-ups, a pain and stress self-management group intervention (PASS) had better effect on pain-related disability, self-efficacy, catastrophizing, and perceived pain control than individually administered physiotherapy (IAPT) for patients with persistent tension-type neck pain. Studies that have evaluated long-term effects of self-management approaches toward persistent neck pain are sparse. The objective of this study was to compare pain-related disability, self-efficacy for activities of daily living (ADL), catastrophizing, pain, pain control, use of analgesics, and health care utilization in people with persistent tension-type neck pain 9 years after they received the PASS or IAPT...
2017: Journal of Pain Research
M R Bennion, G Hardy, R K Moore, A Millings
OBJECTIVE: To document the range of web and smartphone apps used and recommended for stress, anxiety or depression by the National Health Service (NHS) in England. DESIGN: The study was conducted using Freedom of Information (FOI) requests and systematic website searches. DATA SOURCES: Data were collected via FOI requests to NHS services between 13 February 2015 and 31 March 2015, and searches conducted on NHS apps library websites between 26 March 2015 and 2 November 2015...
January 23, 2017: BMJ Open
S Rachman
Important developments took place during the past decade. Two major nationwide treatment/training programmes were initiated: IAPT and the US Army Resiliency Program. Work on the psychological immune system presages a major advance in scientific knowledge. The reformulation of human actions, moving the emphasis from retrospection to prospection has wide implications. The concept of wellbeing has had a major impact on health psychology. The topics covered include the U.K. scheme for improving access to psychological therapies, resilience training in the military, wellbeing, the psychological immune system, the concept of prospection, some recent trends in psychopathology, mental contamination...
January 2017: Behaviour Research and Therapy
Rachel A Belk, Mark Pilling, Katherine D Rogers, Karina Lovell, Alys Young
BACKGROUND: The PHQ-9 and the GAD-7 assess depression and anxiety respectively. There are standardised, reliability-tested versions in BSL (British Sign Language) that are used with Deaf users of the IAPT service. The aim of this study is to determine their appropriate clinical cut-offs when used with Deaf people who sign and to examine the operating characteristics for PHQ-9 BSL and GAD-7 BSL with a clinical Deaf population. METHODS: Two datasets were compared: (i) dataset (n = 502) from a specialist IAPT service for Deaf people; and (ii) dataset (n = 85) from our existing study of Deaf people who self-reported having no mental health difficulties...
November 3, 2016: BMC Psychiatry
Paul Clarkson, Clarissa M Giebel, David Challis, Paul Duthie, Alan Barrett, Helen Lambert
AIM: To evaluate the outcomes of participants attending a psychological therapies service for military veterans. BACKGROUND: The UK Military Veterans' Improving Access to Psychological Therapies Service (North West) (MV IAPT) provided a clinical psychological therapies service for military veterans. Outcomes of depression, anxiety and social adjustment were assessed after treatment in the service's pilot phase. DESIGN: An observational, prospective cohort study examined changes in depression, anxiety and social adjustment during receipt of the service...
October 2016: Nursing Open
Sarah Gowling, Jennie Persson, Genevieve Holt, Sue Ashbourne, James Bloomfield, Hannah Shortland, Clare Bate
IAPT (Improving Access to Psychological Therapies) is a national programme aimed at increasing availability of evidence based psychological therapies in the NHS. IAPT is primarily for people who have mild to moderate, common mental health difficulties such as depression, anxiety, phobias and post traumatic stress disorder (PTSD). The programme seeks to use the least intrusive method of care possible to treat people at the time when it will be of most help to them. Individuals are able to self-refer into most IAPT services or alternatively can request to be referred by their GP or other services in the community...
2016: BMJ Quality Improvement Reports
Sheena Liness, Susan Lea, Steffen Nestler, Hannah Parker, David M Clark
BACKGROUND: The UK Department of Health Improving Access to Psychological Therapies (IAPT) initiative set out to train a large number of therapists in cognitive behaviour therapies (CBT) for depression and anxiety disorders. Little is currently known about the retention of IAPT CBT trainees, or the use of CBT skills acquired on the course in the workplace after training has finished. AIMS: This study set out to conduct a follow-up survey of past CBT trainees on the IAPT High Intensity CBT Course at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), one of the largest IAPT High Intensity courses in the UK...
January 2017: Behavioural and Cognitive Psychotherapy
Annemarie I Luik, Sophie Bostock, Leanne Chisnall, Simon D Kyle, Nicky Lidbetter, Nick Baldwin, Colin A Espie
BACKGROUND: Evidence suggests that insomnia may be an important therapeutic target to improve mental health. AIMS: Evaluating changes in symptoms of depression and anxiety after supported digital cognitive behavioural therapy (dCBT) for insomnia delivered via a community-based provider (Self Help Manchester) of the Improving Access to Psychological Therapies (IAPT) service. METHOD: Supported dCBT for insomnia was delivered to 98 clients (mean age 44...
January 2017: Behavioural and Cognitive Psychotherapy
Elizabeth Newton, Nicola Shepherd, Jim Orford, Alex Copello
BACKGROUND: The psychological difficulties and emotional impacts resulting from the substance use of close relatives constitute a large, underestimated and frequently unidentified health burden. The development of primary care mental health services in response to the Improving Access to Psychological Therapies initiative provides an opportunity to investigate this in more depth. AIMS: A preliminary exploration of prevalence of IAPT service-users being treated for moderate-severe depression and/or anxiety who report that they have relatives with alcohol and/or drug problems...
November 2016: Behavioural and Cognitive Psychotherapy
Stephen Kellett, Kimberley Webb, Nic Wilkinson, Paul Bliss, Tom Ayers, Gillian Hardy
BACKGROUND: There are national policy drivers for mental health services to demonstrate that they are effectively meeting the psychological needs of people with long-term health conditions/medically unexplained symptoms (LTC/MUS). AIMS: To evaluate the implementation of a stepped-care service delivery model within an Improving Access to Psychological Therapies (IAPT) service for patients with depression or anxiety in the context of their LTC/MUS. METHOD: A stepped-care model was designed and implemented...
September 2016: Behavioural and Cognitive Psychotherapy
D Chinn, E Abraham
BACKGROUND: The Improving Access to Psychological Therapies (IAPT) service was established to address common mental health problems among the English population in a timely manner in order to counter the social and economic disadvantage accompanying such difficulties. Using the concept of candidacy, we examined how the legitimacy of claims by people with intellectual disabilities to use this service is facilitated or impeded. METHOD: We used a sequential mixed methods design...
June 2016: Journal of Intellectual Disability Research: JIDR
Paul Cromarty, Aaron Drummond, Tamara Francis, Julianne Watson, Malcolm Battersby
OBJECTIVE: NewAccess is a Low Intensity Cognitive Behaviour Therapy (LiCBT) early intervention pilot, for mild to moderate depression and anxiety. In November 2015 the Australian Government Review of Mental Health Programmes and Services specifically highlighted the program, stating, "Primary Health Networks will.…be encouraged and supported to work towards better utilisation of low intensity 'coaching' services for people with lesser needs, building on evaluations of programmes such as the NewAccess model of care, and the Improving Access to Psychological Therapies model of stepped care implemented in the United Kingdom...
October 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Marc Serfaty, Michael King, Irwin Nazareth, Adrian Tookman, John Wood, Anna Gola, Trefor Aspden, Kathryn Mannix, Sarah Davis, Stirling Moorey, Louise Jones
BACKGROUND: The prevalence of depressive disorder in adults with advanced cancer is around 20 %. Although cognitive behavioural therapy (CBT) is recommended for depression and may be beneficial in depressed people with cancer, its use for depression in those with advanced disease for whom cure is not likely has not been explored. METHODS: People aged 18 years and above with advanced cancer attending General Practitioner (GP), oncology or hospice outpatients from centres across England will be screened to establish a DSM-IV diagnosis of depression...
February 29, 2016: Trials
Nilay Hepgul, Sinead King, Myanthi Amarasinghe, Gerome Breen, Nina Grant, Nick Grey, Matthew Hotopf, Paul Moran, Carmine M Pariante, André Tylee, Janet Wingrove, Allan H Young, Anthony J Cleare
BACKGROUND: A substantial number of patients do not benefit from first line psychological therapies for the treatment of depression and anxiety. Currently, there are no clear predictors of treatment outcomes for these patients. The PROMPT project aims to establish an infrastructure platform for the identification of factors that predict outcomes following psychological treatment for depression and anxiety. Here we report on the first year of recruitment and describe the characteristics of our sample to date...
February 27, 2016: BMC Psychiatry
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