scholarly journals Use of cognitive–behavioural therapy skills among trained psychiatrists

2006 ◽  
Vol 30 (2) ◽  
pp. 58-60 ◽  
Author(s):  
Graeme Whitfield ◽  
Moira Connolly ◽  
Alan Davidson ◽  
Chris Williams
Keyword(s):  
Professional Development ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Postal Survey ◽  
Clinical Implications ◽  
Therapeutic Activity ◽  
Protected Time ◽  
Training And Supervision ◽  
Cognitive Behavioural ◽  
The Cost

Aims and MethodPrevious studies have suggested that despite the cost of attendance at postgraduate cognitive–behavioural therapy (CBT) courses, psychiatrists are unable to engage in CBT after qualification. A postal survey of psychiatrists with postgraduate CBT training currently practising in Scotland was performed to assess the levels of training and supervision that they provide, therapeutic CBT activity, and supervision and continued professional development that they receive.ResultsOf the 58 psychiatrists, 51 replied to the survey (88%). Less than half of the respondents supervised other staff. Although 43 (84%) engaged in some therapeutic CBT activity, only 25 (49%) received supervision for their own practice. The main reasons given for not engaging in CBT therapeutic activity were that there was inadequate ‘protected time’ and that CBT had not been included in ‘job plans'.Clinical ImplicationsPsychiatrists can help to disseminate CBT skills. To do this, they require personal supervision, and time for the development and maintenance of therapeutic skills as well as for the training and supervision of others. This survey builds on the results of others and indicates that these requirements are currently being inadequately met.

scholarly journals Cognitive–behavioural therapy: a survey of the training, practice and views of Scottish consultant psychiatrists

2001 ◽  
Vol 25 (11) ◽  
pp. 425-428 ◽  
Author(s):  
Peter David Le Fevre ◽  
Rainer Goldbeck
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Current Practice ◽  
Behavioural Therapy ◽  
Postal Survey ◽  
Formal Training ◽  
Exact Form ◽  
Cognitive Behavioural ◽  
Training Opportunities ◽  
And Training ◽  
Training Practice

Aims and MethodA postal survey of all consultant psychiatrists employed by the NHS in Scotland was performed with the aim of determining the numbers and characteristics of consultant psychiatrists who have received training in cognitive–behavioural therapy (CBT). Additional aims were to ascertain the current practice of CBT, along with general attitudes towards practice and training issues.ResultsNine per cent of consultant psychiatrists had received formal training in CBT. An additional 20% had received informal tuition with supervision of cases. For consultants appointed within the previous five years, 48% had received the recommended amount of supervised experience. In practice, consultants were unable to devote significant amounts of time to formal CBT but were actively using CBT techniques and supported the availability of training opportunities.Clinical ImplicationsThe survey suggests that the current Royal College of Psychiatrists' guidelines do not appear to have been fully implemented for the area surveyed. Further debate is needed to ascertain the exact form that training in CBT should take.

scholarly journals Cost-effectiveness of computerized cognitive–behavioural therapy for the treatment of depression in primary care: findings from the Randomised Evaluation of the Effectiveness and Acceptability of Computerised Therapy (REEACT) trial

2017 ◽  
Vol 47 (10) ◽  
pp. 1825-1835 ◽  
Author(s):  
A. Duarte ◽  
S. Walker ◽  
E. Littlewood ◽  
S. Brabyn ◽  
C. Hewitt ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Scenario Analyses ◽  
Cognitive Behavioural ◽  
Life Years ◽  
Gp Care ◽  
The Cost

BackgroundComputerized cognitive–behavioural therapy (cCBT) forms a core component of stepped psychological care for depression. Existing evidence for cCBT has been informed by developer-led trials. This is the first study based on a large independent pragmatic trial to assess the cost-effectiveness of cCBT as an adjunct to usual general practitioner (GP) care compared with usual GP care alone and to establish the differential cost-effectiveness of a free-to-use cCBT programme (MoodGYM) in comparison with a commercial programme (Beating the Blues) in primary care.MethodCosts were estimated from a healthcare perspective and outcomes measured using quality-adjusted life years (QALYs) over 2 years. The incremental cost-effectiveness of each cCBT programme was compared with usual GP care. Uncertainty was estimated using probabilistic sensitivity analysis and scenario analyses were performed to assess the robustness of results.ResultsNeither cCBT programme was found to be cost-effective compared with usual GP care alone. At a £20 000 per QALY threshold, usual GP care alone had the highest probability of being cost-effective (0.55) followed by MoodGYM (0.42) and Beating the Blues (0.04). Usual GP care alone was also the cost-effective intervention in the majority of scenario analyses. However, the magnitude of the differences in costs and QALYs between all groups appeared minor (and non-significant).ConclusionsTechnically supported cCBT programmes do not appear any more cost-effective than usual GP care alone. No cost-effective advantage of the commercially developed cCBT programme was evident compared with the free-to-use cCBT programme. Current UK practice recommendations for cCBT may need to be reconsidered in the light of the results.

scholarly journals Economic evaluation of online computerised cognitive–behavioural therapy without support for depression in primary care: randomised trial

2010 ◽  
Vol 196 (4) ◽  
pp. 310-318 ◽  
Author(s):  
S. A. H. Gerhards ◽  
L. E. de Graaf ◽  
L. E. Jacobs ◽  
J. L. Severens ◽  
M. J. H. Huibers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Significant Group ◽  
Efficient Treatment ◽  
Cognitive Behavioural ◽  
The Cost

BackgroundEvidence about the cost-effectiveness and cost utility of computerised cognitive–behavioural therapy (CCBT) is still limited. Recently, we compared the clinical effectiveness of unsupported, online CCBT with treatment as usual (TAU) and a combination of CCBT and TAU (CCBT plus TAU) for depression. The study is registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (ISRCTN47481236).AimsTo assess the cost-effectiveness of CCBT compared with TAU and CCBT plus TAU.MethodCosts, depression severity and quality of life were measured for 12 months. Cost-effectiveness and cost-utility analyses were performed from a societal perspective. Uncertainty was dealt with by bootstrap replications and sensitivity analyses.ResultsCosts were lowest for the CCBT group. There are no significant group differences in effectiveness or quality of life. Cost-utility and cost-effectiveness analyses tend to be in favour of CCBT.ConclusionsOn balance, CCBT constitutes the most efficient treatment strategy, although all treatments showed low adherence rates and modest improvements in depression and quality of life.

scholarly journals Cognitive-behavioural therapy for schizophrenia: Filling the therapeutic vacuum

2003 ◽  
Vol 183 (2) ◽  
pp. 98-99 ◽  
Author(s):  
Douglas Turkington ◽  
David Kingdon ◽  
Paul Chadwick
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Convincing Evidence ◽  
Family Work ◽  
Standard Clinical Practice ◽  
Cognitive Behavioural ◽  
Accepted Part ◽  
The Cost

When does a therapeutic intervention become an accepted part of standard clinical practice? Is it when there is sufficient research evidence? But what constitutes ‘sufficient’? What about available resources and acceptability to patients? Do we have to wait until the National Institute for Clinical Excellence pronounces? A convincing evidence base for family work in schizophrenia (Kuipers, 2000) has existed for many years but has been poorly implemented (Anderson & Adams, 1996). Will cognitive-behavioural therapy (CBT) for psychosis suffer the same fate? Which professional group will champion such an implementation? The evidence for other psychological treatments is less robust. Psychoeducation may prolong time to relapse and improve insight but at the cost of increasing suicidal ideation (Carroll et al, 1998). Personal therapy (Hogarty et al, 1997) may be of value but is contra-indicated for patients who are living alone in the community. Psychodynamic approaches are advocated (Mace & Margison, 1997) but most psychiatrists do not support their use in practice, owing to lack of evidence of efficacy.

scholarly journals If formulation is the heart of cognitive behavioural therapy, does this heart rule the head of CBT therapists?

2013 ◽  
Vol 6 ◽  
Author(s):  
Michael Zivor ◽  
Paul M. Salkovskis ◽  
Victoria B. Oldfield
Keyword(s):  
Clinical Practice ◽  
Cognitive Behavioural Therapy ◽  
Reference Group ◽  
Behavioural Therapy ◽  
Routine Clinical Practice ◽  
Training And Supervision ◽  
Cognitive Behavioural ◽  
Empirical Level ◽  
Group A ◽  
Level Of Training

AbstractCognitive behavioural therapy (CBT) is an empirically grounded approach which typically relies on formulation to guide the shape and course of therapy. Cognitive formulation is widely advocated but poorly understood at an empirical level. This study aimed to characterize how clinicians understand the structure and uses of formulation and how they report on using it in their clinical practice relative to an expert reference group. A total of 124 clinicians in routine clinical practice completed a questionnaire, which assessed their clinical use and understanding of formulation. For some aspects of the questionnaire a comparison with a reference group, 15 highly specialist CBT therapists, was used. High levels of self-rated expertise were noted and at levels comparable to that of the highly specialist group. Participants rated themselves as less capable in terms of their formulation skills relative to their self-rating in CBT overall. Formulation is typically rated as important by those with some professional commitment to CBT. There may be some gaps in the way formulation is applied in clinical practice that should be addressed at the level of training and supervision.

scholarly journals Does a therapist's reflective ability predict the accuracy of their self-evaluation of competence in cognitive behavioural therapy?

2016 ◽  
Vol 9 ◽  
Author(s):  
Maria E. Loades ◽  
Pamela J. Myles
Keyword(s):  
Cognitive Therapy ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Self Evaluation ◽  
Training And Supervision ◽  
Cognitive Behavioural ◽  
Research Findings ◽  
The Relationship ◽  
Therapy Sessions ◽  
Level Of Agreement

AbstractAccurately evaluating how competently one is performing can be a precursor to seeking training and supervision, therefore contributing to safe, effective practice. Little is known about what predicts accurate self-evaluation. Prior research findings are inconsistent, with overestimation of self-rated competence in some studies and underestimation in others. We aimed to explore the relationship between therapists' reflective ability and the level of agreement between self-rated competence and competence rated by an experienced CBT assessor. Thirteen trainees undertaking a postgraduate CBT diploma submitted a series of recordings accompanied by self-ratings using the Cognitive Therapy Scale – Revised (CTS-R) and related written reflective analyses. Independent assessors marked the written analyses using a standardized marking scheme and rated the therapy sessions using the CTS-R. Trainees tended to overestimate or underestimate their competence in comparison to the independent assessors. The level of agreement between the assessors' ratings and self-evaluation of competence tended to improve during training, while reflective ability did not. Reflective ability was significantly related to level of agreement between self-rated and assessor-rated competence. Trainees do not consistently demonstrate the bias for overestimating their competence previously found in qualified therapists. During training, the tendency of an individual to over- or underestimate their competence may not remain stable, but tends to become more consistent with ratings undertaken by an experienced CBT assessor. Trainees who were rated as more reflective, tended to agree more closely with independent assessors on evaluation of competence. Therefore, enhancing reflective ability may help therapists to more accurately self-evaluate their competence.

scholarly journals Cognitive–behavioural therapy by psychiatric trainees: can a little knowledge be a good thing?

2015 ◽  
Vol 39 (1) ◽  
pp. 39-44
Author(s):  
Eric Kelleher ◽  
Melissa Hayde ◽  
Yvonne Tone ◽  
Iulia Dud ◽  
Colette Kearns ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Psychiatric Hospital ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Good Thing ◽  
Clinical Implications ◽  
Clinical Interventions ◽  
Cognitive Behavioural ◽  
The Mean

Aims and methodTo establish the competency of psychiatric trainees in delivering cognitive–behavioural therapy (CBT) to selected cases, following introductory lectures and supervision. Supervisor reports of trainees rotating through a national psychiatric hospital over 8.5 years were reviewed along with revised Cognitive Therapy Scale (CTS-R) ratings where available. Independent t-test was used to compare variables.ResultsStructured supervision reports were available for 52 of 55 (95%) trainees. The mean result (4.6, s.d. = 0.9) was at or above the accepted level for competency (≥3) for participating trainees. Available CTS-R ratings (n = 22) supported the supervisor report findings for those particular trainees.Clinical implicationsThis study indicates that trainees under supervision can provide meaningful clinical interventions when delivering CBT to selected cases. The costs of supervision need to be judged against these clinical gains.

Exploring Service Users’ Perceptions of Cognitive Behavioural Therapy for Psychosis: A User Led Study

2012 ◽  
Vol 41 (1) ◽  
pp. 89-102 ◽  
Author(s):  
Martina Kilbride ◽  
Rory Byrne ◽  
Jason Price ◽  
Lisa Wood ◽  
Sarah Barratt ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Structured Learning ◽  
Clinical Implications ◽  
Service Users ◽  
Subjective Experiences ◽  
Structured Interviews ◽  
Potential Barriers ◽  
Cognitive Behavioural ◽  
Personal Understanding

Background and aims: This study explored individuals’ subjective experiences of Cognitive Behavioural Therapy for psychosis (CBTp) with the aim of identifying coherent themes consistent across individual accounts and any potential barriers to CBTp effectiveness. Method: Semi-structured interviews were conducted with nine individuals with experience of CBTp. A qualitative Interpretive Phenomenological Analysis was used to analyze the data collected to identify common themes. Results: Five super-ordinate themes emerged from our analyses: CBT as a process of person-centred engagement; CBT as an active process of structured learning; CBT helping to improve personal understanding; CBT is hard work; Recovery and outcomes of CBT for psychosis. Conclusions: The theoretical and clinical implications are discussed.

scholarly journals Pathways to Recovery: development and evaluation of a cognitive–behavioural therapy in-patient treatment programme for adults with anorexia nervosa

2018 ◽  
Vol 42 (3) ◽  
pp. 95-101
Author(s):  
Andrea Brown ◽  
Richard Jenkinson ◽  
Julia Coakes ◽  
Annette Cockfield ◽  
Tish O'Brien ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Cognitive Behavioural Therapy ◽  
Previous Treatment ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Clinical Implications ◽  
Treatment Model ◽  
Treatment Programme ◽  
Cognitive Behavioural

Aims and methodA cognitive–behavioural therapy in-patient treatment model for adults with severe anorexia nervosa was developed and evaluated, and outcomes were compared with the previous treatment model and other published outcomes from similar settings.ResultsThis study showed the Pathways to Recovery outcomes were positive in terms of improvements in body mass index and psychopathology.Clinical implicationsAdults with anorexia nervosa can achieve good outcomes despite longer illness duration and comorbidities.Declaration of interestA.B., A.C. and L.H. work at The Retreat where the Pathways to Recovery were developed.

scholarly journals Psychiatry trainees' experiences of cognitive-behavioural therapy training in a UK deanery: A qualitative analysis

2017 ◽  
Vol 41 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Amy Alice Carson ◽  
Sarah Emily Clark
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Interpretative Phenomenological Analysis ◽  
Behavioural Therapy ◽  
Phenomenological Analysis ◽  
Clinical Implications ◽  
Structured Interviews ◽  
Training Experience ◽  
Personal Influence ◽  
Therapy Training ◽  
Cognitive Behavioural

Aims and methodTo explore core psychiatry trainees' experiences of cognitive-behavioural therapy (CBT) training by using interpretative phenomenological analysis of semi-structured interviews conducted with seven core trainee psychiatrists in Yorkshire and the Humber Deanery.ResultsFour key themes emerged: (1) barriers to training; (2) guidance, with emphasis on the importance of supervision groups; (3) acquisition of new skills and confidence; (4) personal influence on the training experience.Clinical implicationsMany trainees in Yorkshire have a positive experience of CBT training; however, some also experience barriers to acquiring the relevant skills. Further research should build on the positive factors and barriers identified here, with a view to guiding improvements in training nationwide.

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