1) This study aimed to assess whether brief self-confidence workshops could effectively treat depression across areas with different deprivation levels in London.
2) An open randomized controlled trial assigned participants screening positive for depression to either receive a 1-day workshop immediately or after a 12-week waitlist period.
3) Results showed that those receiving the workshop had significantly greater reductions in depression scores compared to the waitlist group based on assessments 12 weeks later, supporting the workshops' effectiveness in treating depression across different London communities.
This document describes the development and testing of a recovery-focused cognitive behavioral therapy (RfCBT) for early-stage bipolar disorder. RfCBT was designed to explicitly target personal recovery rather than just symptom reduction. A pilot study found that RfCBT showed promise in improving personal recovery outcomes, increasing time to relapse, and enhancing quality of life compared to treatment as usual. The results provide preliminary evidence to support further evaluation of RfCBT in a larger definitive randomized controlled trial.
Self management is a recent concept in pulmonary rehabilitation. this concept uses patient's ability to manage their self with no direct interaction with their healthcare provider.
EVIDENCE-BASED PSYCHIATRIC NURSING PRACTICE, Components of EPBBASES FOR NURSING PRACTICE, DEVELOPING EVIDENCE-BASED CARE, HIERARCHY OF RESEARCH EVIDENCE, TAXONOMY FOR INFORMED DECISION-MAKING, CHARACTERISTICS OF GOOD BEHAVIORAL HEALTH PRACTICE GUIDELINES, CLINICAL ALGORITHMS
The BYAP project aims to identify self-management strategies used by youth with bipolar disorder to stay well and increase youth engagement in mental health research. The project team conducted focus groups with 21 youth on Vancouver Island who have bipolar disorder. Thematic analysis identified key self-management strategies around healthy lifestyle, social support networks, and in-the-moment coping techniques. Preliminary results show youth with bipolar disorder have valuable knowledge to share and prefer different knowledge translation methods than adults. The project is learning effective youth engagement requires significant effort but yields worthwhile results.
The need for empirically supported psychology training standards (psychothera...Scott Miller
This article discusses the lack of empirical evidence supporting current psychology training standards. It reviews research on the effects of clinical experience, supervision, coursework and research completion requirements. The research provides little evidence that these standards improve psychotherapy outcomes for future clients of psychology students. The article calls for psychology accreditation agencies to apply scientific principles and require empirical evidence that training standards benefit clients before mandating costly requirements. It proposes randomized studies comparing outcomes for students receiving different aspects of training could provide needed evidence about the efficacy of current standards.
This document introduces CREST.BD's Bipolar Wellness Centre, which provides online interventions and knowledge translation strategies to engage patients with bipolar disorder. It shares results from a mixed methods analysis evaluating the impact of engagement strategies. The strategies included webinars, videos, workshops, and individual sessions. Quantitative results found improvements in quality of life and recovery scores. Qualitative interviews identified themes around implementing strategies learned and preferences for different engagement approaches. The take home message is that diverse knowledge translation strategies can impact outcomes and engagement when developed with attention to online engagement mechanisms.
The Carlat Psychiatry Report (Interview with Scott Miller, April 2015)Scott Miller
The April 2015 issue of the Carlat Psychiatry Report, an unbiased report/review of "all things psychiatric." The issue contains a lengthy interview with Dr. Scott Miller on the subject of top performing clinicians.
This study examined whether psychotherapists' outcomes improve over time and with increased experience. The researchers analyzed data from over 6,500 patients seen by 170 psychotherapists over an average of 4.73 years. Using multilevel modeling, they found that while therapists' outcomes were generally comparable to clinical trials, there was a very small but statistically significant tendency for patient outcomes to diminish as therapists gained more experience in terms of both time and number of patients seen. However, therapists showed lower rates of early termination as their experience increased. The results suggest that while experience may not necessarily lead to better patient outcomes, it can reduce dropout rates.
This document describes the development and testing of a recovery-focused cognitive behavioral therapy (RfCBT) for early-stage bipolar disorder. RfCBT was designed to explicitly target personal recovery rather than just symptom reduction. A pilot study found that RfCBT showed promise in improving personal recovery outcomes, increasing time to relapse, and enhancing quality of life compared to treatment as usual. The results provide preliminary evidence to support further evaluation of RfCBT in a larger definitive randomized controlled trial.
Self management is a recent concept in pulmonary rehabilitation. this concept uses patient's ability to manage their self with no direct interaction with their healthcare provider.
EVIDENCE-BASED PSYCHIATRIC NURSING PRACTICE, Components of EPBBASES FOR NURSING PRACTICE, DEVELOPING EVIDENCE-BASED CARE, HIERARCHY OF RESEARCH EVIDENCE, TAXONOMY FOR INFORMED DECISION-MAKING, CHARACTERISTICS OF GOOD BEHAVIORAL HEALTH PRACTICE GUIDELINES, CLINICAL ALGORITHMS
The BYAP project aims to identify self-management strategies used by youth with bipolar disorder to stay well and increase youth engagement in mental health research. The project team conducted focus groups with 21 youth on Vancouver Island who have bipolar disorder. Thematic analysis identified key self-management strategies around healthy lifestyle, social support networks, and in-the-moment coping techniques. Preliminary results show youth with bipolar disorder have valuable knowledge to share and prefer different knowledge translation methods than adults. The project is learning effective youth engagement requires significant effort but yields worthwhile results.
The need for empirically supported psychology training standards (psychothera...Scott Miller
This article discusses the lack of empirical evidence supporting current psychology training standards. It reviews research on the effects of clinical experience, supervision, coursework and research completion requirements. The research provides little evidence that these standards improve psychotherapy outcomes for future clients of psychology students. The article calls for psychology accreditation agencies to apply scientific principles and require empirical evidence that training standards benefit clients before mandating costly requirements. It proposes randomized studies comparing outcomes for students receiving different aspects of training could provide needed evidence about the efficacy of current standards.
This document introduces CREST.BD's Bipolar Wellness Centre, which provides online interventions and knowledge translation strategies to engage patients with bipolar disorder. It shares results from a mixed methods analysis evaluating the impact of engagement strategies. The strategies included webinars, videos, workshops, and individual sessions. Quantitative results found improvements in quality of life and recovery scores. Qualitative interviews identified themes around implementing strategies learned and preferences for different engagement approaches. The take home message is that diverse knowledge translation strategies can impact outcomes and engagement when developed with attention to online engagement mechanisms.
The Carlat Psychiatry Report (Interview with Scott Miller, April 2015)Scott Miller
The April 2015 issue of the Carlat Psychiatry Report, an unbiased report/review of "all things psychiatric." The issue contains a lengthy interview with Dr. Scott Miller on the subject of top performing clinicians.
This study examined whether psychotherapists' outcomes improve over time and with increased experience. The researchers analyzed data from over 6,500 patients seen by 170 psychotherapists over an average of 4.73 years. Using multilevel modeling, they found that while therapists' outcomes were generally comparable to clinical trials, there was a very small but statistically significant tendency for patient outcomes to diminish as therapists gained more experience in terms of both time and number of patients seen. However, therapists showed lower rates of early termination as their experience increased. The results suggest that while experience may not necessarily lead to better patient outcomes, it can reduce dropout rates.
This document summarizes a research poster presentation on a therapeutic recreation program for inpatients in an acute psychiatric care unit. The program aimed to address challenges like isolation, depression, and lack of motivation through weekly group interventions including yoga, pet therapy, music therapy, and expressive arts. Participants completed pre- and post-surveys to evaluate changes in mood and depression symptoms. Results found statistically significant improvements in mood and high patient satisfaction rates, showing that the multi-modal recreation therapy program was effective in improving outcomes for psychiatric inpatients.
Deterioration in Psychotherapy: A Summary of Research by Jorgen FlorScott Miller
This study explored how 10 Norwegian psychologists think about patient deterioration in psychotherapy. The psychologists showed a lack of common terminology around deterioration and underestimated its occurrence. They received little education on deterioration and felt uncomfortable discussing it. The study highlights the lack of awareness around negative outcomes in education and practice. It aims to provide a better basis for quantitative research on how deterioration is interpreted.
The Life Science Addiction Treatment Center is a private residential facility that offers short, moderate, and long-term inpatient treatment for adults struggling with alcohol and/or drug addiction. Its mission is to provide evidence-based treatment in a professional and affordable manner using a personalized approach. The treatment program utilizes principles from cognitive behavioral therapy and other therapeutic models. It offers a variety of group and individual therapy sessions, educational workshops, recreational activities, and medical and psychiatric support to help clients develop coping skills and achieve rehabilitation and wellness goals. The facility is located in a serene natural setting near Montreal, Quebec and employs a multidisciplinary clinical team.
Article in Division 29's journal, psychotherapy that reviews the research on routine outcome monitoring, arguing that current efforts are at risk for repeating the history of failed efforts to improve the outcome of psychotherapy.
Acceptance and Commitment Therapy (ACT) is a form of cognitive behavioral therapy that uses mindfulness and behavioral activation to increase psychological flexibility. ACT has been shown to effectively treat a broad range of mental health issues by focusing on six core processes: acceptance, defusion, presence, self-awareness, values identification, and committed action. ACT reduces dysfunctional thoughts and behaviors while increasing effective action and alleviating distress. Studies have found ACT reduces OCD and depression symptoms, prevents psychosis rehospitalization, and improves general mental health and workplace stress coping. ACT is delivered flexibly in individual sessions, groups, or self-help formats.
Excellence in therapy: An Interview with Scott D. Miller, Ph.D.Scott Miller
1) The interviewee, Scott Miller, became involved in psychotherapy through a series of fortunate events and encounters with inspiring professors during his university studies.
2) Miller believes that diagnostic codes are not very useful or informative. He finds it more useful to understand each client's unique characteristics to tailor therapy to the individual.
3) Most therapists do good work, but therapists vastly overestimate their own effectiveness by around 65% on average. Outcomes have remained fairly stable over time despite efforts to improve. Feedback from clients is important for improving practice.
CET is an evidence-based cognitive rehabilitation program for patients with schizophrenia. Several randomized controlled trials have found CET to be effective at improving cognitive functioning, social adjustment, and real-world outcomes for patients with chronic and early-course schizophrenia. Benefits were found to persist for up to 3 years after treatment. Specifically, CET was shown to significantly improve processing speed, social cognition, cognitive style and social adjustment for chronic patients, and cognitive style, social cognition, social adjustment and symptoms for early-course patients. CET participants also demonstrated better vocational and social engagement outcomes long-term compared to controls. The studies provide support for CET as an effective rehabilitation approach for improving cognitive and functional abilities in schizophrenia.
Exercise programs for people with dementia: What's the evidence?Health Evidence™
Health Evidence hosted a 90 minute webinar examining the effectiveness of exercise programs for people with dementia. Click here for access to the audio recording: https://youtu.be/jC8HhC2XFrE
Dorothy Forbes, Professor, Faculty of Nursing, University of Alberta, Edmonton led the session and presented findings from her latest Cochrane review:
Forbes, D., Forbes, S. C., Blake, C. M., Thiessen, E. J., & Forbes, S. (2015). Exercise programs for people with dementia. Cochrane Database of Systematic Reviews, 2015(4), CD006489.
As the population ages, the number of people suffering with dementia will also rise. Not only will this affect quality of life of people with dementia but will also increase the burden of family caregivers, community care, and residential care services. Exercise interventions have been identified as a potential way of reducing or delaying the progression of dementia and its symptoms. This review examines two questions: do exercise programs for older people with dementia improve cognition, activities of daily living (ADLs), challenging behaviour, depression, and mortality in older people with dementia? and; do exercise programs for older people with dementia have an indirect impact on family caregivers' burden, quality of life, and mortality?
At WriteSteps Occupational Therapy, Danielle comprehensive evaluation is offered in numerous areas, including visual motor skills, visual perceptual skills, handwriting, self-care, and sensory integration. Danielle has extensive experience performing evaluations and tailors her evaluation to fit the needs of each child she works with.
A feasibility study to examine the adoption of CBT techniques and their impact on clinical practice in the community pharmacy environment
Led by the AHSN Network
Day One, Pop-up University 8, 11.00
The document discusses recovery from mental illness, specifically schizophrenia. It provides statistics on the prevalence and outcomes of schizophrenia. Despite advances in treatment, outcomes have not significantly improved, with only 13.5% meeting recovery criteria. The recovery program described aims to facilitate personal growth and transformation beyond acute symptoms through a collaborative, strengths-based approach focused on self-directed goal setting. It emphasizes hope, well-being, social inclusion and meaning rather than just treating illness. One patient's story of improving life through the program is shared.
PRIME Centre Wales
Long Term Conditions Consensus Meeting
Tuesday 10th November 2015, St Mary's Priory, Abergavenny, NP7 5ND
http://www.primecentre.wales/ltc-consensus-meeting.php
The end of mental illness thinking? - ¿El fin de pensar en enfermedad mental?Richard Pemberton
The document summarizes key points from a discussion on rethinking the classification of mental disorders:
1) The Division of Clinical Psychology argues that current psychiatric classification systems based on disease models have significant limitations and a paradigm shift is needed towards more psychosocial models.
2) Classification systems can negatively impact those diagnosed by promoting stigma, restricting identity, and disempowering service users.
3) The statement recommends moving to multi-factorial, contextual approaches developed with service users that incorporate social and psychological factors rather than relying solely on biological models.
4) Alternatives to psychiatric diagnosis proposed include focusing on people's problems and formulating comprehensive understandings of issues rather than rigid categories.
The IAPT (Increasing Access to Psychological Therapies) programme aims to implement NICE-recommended psychological therapies for anxiety and depression on a national scale in England. It uses a stepped care model to provide the least intrusive but most effective treatment first. Services offer a range of evidence-based interventions including CBT, guided self-help, groups, computer-assisted therapy, and more intensive treatments. Challenges for the future include further integration with primary care, links to long-term conditions and employment support, and ensuring coherent services across commissioning bodies in the changing NHS landscape.
Developing a Postdoctoral Psychology Residency Program in Your Community Heal...CHC Connecticut
Two years later, we continue to witness the pandemic’s toll on mental health – and a sustained increased demand for mental health services. Behavioral health care providers who are experienced in integrated care settings are needed now more than ever.
Join this webinar to learn how your health center can establish its own postdoctoral clinical psychology residency program.
This webinar will address considerations such as program structure, design, curriculum, the supervisor’s role, required resources, and the benefits of sponsoring an in-house formal postdoctoral clinical psychology residency training program.
Panelists:
• Dr. Tim Kearney, Chief Behavioral Health Officer, Community Health Center, Inc.
• Dr. Chelsea McIntosh, Training Director, CHC Postdoctoral Residency Program, Community Health Center Inc.
Principle and standards (b.sc nursing 3rd year)chetnamarkam
The document outlines principles of mental health nursing and standards of practice. It discusses 12 general principles of mental health nursing including accepting patients as they are, using self-understanding as a therapeutic tool, avoiding increasing a patient's anxiety, and focusing care on the patient as a person rather than just symptoms. It also describes 11 standards of mental health nursing practice organized into professional practice standards and professional performance standards related to areas like assessment, planning, intervention and evaluation of care.
Slides from a lunch and learn webinar hosted by NHS England's Long Term Conditions Team, on the topic of health coaching by lay professionals.
The speakers and Anya de Longh and Jim Phillips.
This document summarizes a research poster presentation on a therapeutic recreation program for inpatients in an acute psychiatric care unit. The program aimed to address challenges like isolation, depression, and lack of motivation through weekly group interventions including yoga, pet therapy, music therapy, and expressive arts. Participants completed pre- and post-surveys to evaluate changes in mood and depression symptoms. Results found statistically significant improvements in mood and high patient satisfaction rates, showing that the multi-modal recreation therapy program was effective in improving outcomes for psychiatric inpatients.
Deterioration in Psychotherapy: A Summary of Research by Jorgen FlorScott Miller
This study explored how 10 Norwegian psychologists think about patient deterioration in psychotherapy. The psychologists showed a lack of common terminology around deterioration and underestimated its occurrence. They received little education on deterioration and felt uncomfortable discussing it. The study highlights the lack of awareness around negative outcomes in education and practice. It aims to provide a better basis for quantitative research on how deterioration is interpreted.
The Life Science Addiction Treatment Center is a private residential facility that offers short, moderate, and long-term inpatient treatment for adults struggling with alcohol and/or drug addiction. Its mission is to provide evidence-based treatment in a professional and affordable manner using a personalized approach. The treatment program utilizes principles from cognitive behavioral therapy and other therapeutic models. It offers a variety of group and individual therapy sessions, educational workshops, recreational activities, and medical and psychiatric support to help clients develop coping skills and achieve rehabilitation and wellness goals. The facility is located in a serene natural setting near Montreal, Quebec and employs a multidisciplinary clinical team.
Article in Division 29's journal, psychotherapy that reviews the research on routine outcome monitoring, arguing that current efforts are at risk for repeating the history of failed efforts to improve the outcome of psychotherapy.
Acceptance and Commitment Therapy (ACT) is a form of cognitive behavioral therapy that uses mindfulness and behavioral activation to increase psychological flexibility. ACT has been shown to effectively treat a broad range of mental health issues by focusing on six core processes: acceptance, defusion, presence, self-awareness, values identification, and committed action. ACT reduces dysfunctional thoughts and behaviors while increasing effective action and alleviating distress. Studies have found ACT reduces OCD and depression symptoms, prevents psychosis rehospitalization, and improves general mental health and workplace stress coping. ACT is delivered flexibly in individual sessions, groups, or self-help formats.
Excellence in therapy: An Interview with Scott D. Miller, Ph.D.Scott Miller
1) The interviewee, Scott Miller, became involved in psychotherapy through a series of fortunate events and encounters with inspiring professors during his university studies.
2) Miller believes that diagnostic codes are not very useful or informative. He finds it more useful to understand each client's unique characteristics to tailor therapy to the individual.
3) Most therapists do good work, but therapists vastly overestimate their own effectiveness by around 65% on average. Outcomes have remained fairly stable over time despite efforts to improve. Feedback from clients is important for improving practice.
CET is an evidence-based cognitive rehabilitation program for patients with schizophrenia. Several randomized controlled trials have found CET to be effective at improving cognitive functioning, social adjustment, and real-world outcomes for patients with chronic and early-course schizophrenia. Benefits were found to persist for up to 3 years after treatment. Specifically, CET was shown to significantly improve processing speed, social cognition, cognitive style and social adjustment for chronic patients, and cognitive style, social cognition, social adjustment and symptoms for early-course patients. CET participants also demonstrated better vocational and social engagement outcomes long-term compared to controls. The studies provide support for CET as an effective rehabilitation approach for improving cognitive and functional abilities in schizophrenia.
Exercise programs for people with dementia: What's the evidence?Health Evidence™
Health Evidence hosted a 90 minute webinar examining the effectiveness of exercise programs for people with dementia. Click here for access to the audio recording: https://youtu.be/jC8HhC2XFrE
Dorothy Forbes, Professor, Faculty of Nursing, University of Alberta, Edmonton led the session and presented findings from her latest Cochrane review:
Forbes, D., Forbes, S. C., Blake, C. M., Thiessen, E. J., & Forbes, S. (2015). Exercise programs for people with dementia. Cochrane Database of Systematic Reviews, 2015(4), CD006489.
As the population ages, the number of people suffering with dementia will also rise. Not only will this affect quality of life of people with dementia but will also increase the burden of family caregivers, community care, and residential care services. Exercise interventions have been identified as a potential way of reducing or delaying the progression of dementia and its symptoms. This review examines two questions: do exercise programs for older people with dementia improve cognition, activities of daily living (ADLs), challenging behaviour, depression, and mortality in older people with dementia? and; do exercise programs for older people with dementia have an indirect impact on family caregivers' burden, quality of life, and mortality?
At WriteSteps Occupational Therapy, Danielle comprehensive evaluation is offered in numerous areas, including visual motor skills, visual perceptual skills, handwriting, self-care, and sensory integration. Danielle has extensive experience performing evaluations and tailors her evaluation to fit the needs of each child she works with.
A feasibility study to examine the adoption of CBT techniques and their impact on clinical practice in the community pharmacy environment
Led by the AHSN Network
Day One, Pop-up University 8, 11.00
The document discusses recovery from mental illness, specifically schizophrenia. It provides statistics on the prevalence and outcomes of schizophrenia. Despite advances in treatment, outcomes have not significantly improved, with only 13.5% meeting recovery criteria. The recovery program described aims to facilitate personal growth and transformation beyond acute symptoms through a collaborative, strengths-based approach focused on self-directed goal setting. It emphasizes hope, well-being, social inclusion and meaning rather than just treating illness. One patient's story of improving life through the program is shared.
PRIME Centre Wales
Long Term Conditions Consensus Meeting
Tuesday 10th November 2015, St Mary's Priory, Abergavenny, NP7 5ND
http://www.primecentre.wales/ltc-consensus-meeting.php
The end of mental illness thinking? - ¿El fin de pensar en enfermedad mental?Richard Pemberton
The document summarizes key points from a discussion on rethinking the classification of mental disorders:
1) The Division of Clinical Psychology argues that current psychiatric classification systems based on disease models have significant limitations and a paradigm shift is needed towards more psychosocial models.
2) Classification systems can negatively impact those diagnosed by promoting stigma, restricting identity, and disempowering service users.
3) The statement recommends moving to multi-factorial, contextual approaches developed with service users that incorporate social and psychological factors rather than relying solely on biological models.
4) Alternatives to psychiatric diagnosis proposed include focusing on people's problems and formulating comprehensive understandings of issues rather than rigid categories.
The IAPT (Increasing Access to Psychological Therapies) programme aims to implement NICE-recommended psychological therapies for anxiety and depression on a national scale in England. It uses a stepped care model to provide the least intrusive but most effective treatment first. Services offer a range of evidence-based interventions including CBT, guided self-help, groups, computer-assisted therapy, and more intensive treatments. Challenges for the future include further integration with primary care, links to long-term conditions and employment support, and ensuring coherent services across commissioning bodies in the changing NHS landscape.
Developing a Postdoctoral Psychology Residency Program in Your Community Heal...CHC Connecticut
Two years later, we continue to witness the pandemic’s toll on mental health – and a sustained increased demand for mental health services. Behavioral health care providers who are experienced in integrated care settings are needed now more than ever.
Join this webinar to learn how your health center can establish its own postdoctoral clinical psychology residency program.
This webinar will address considerations such as program structure, design, curriculum, the supervisor’s role, required resources, and the benefits of sponsoring an in-house formal postdoctoral clinical psychology residency training program.
Panelists:
• Dr. Tim Kearney, Chief Behavioral Health Officer, Community Health Center, Inc.
• Dr. Chelsea McIntosh, Training Director, CHC Postdoctoral Residency Program, Community Health Center Inc.
Principle and standards (b.sc nursing 3rd year)chetnamarkam
The document outlines principles of mental health nursing and standards of practice. It discusses 12 general principles of mental health nursing including accepting patients as they are, using self-understanding as a therapeutic tool, avoiding increasing a patient's anxiety, and focusing care on the patient as a person rather than just symptoms. It also describes 11 standards of mental health nursing practice organized into professional practice standards and professional performance standards related to areas like assessment, planning, intervention and evaluation of care.
Slides from a lunch and learn webinar hosted by NHS England's Long Term Conditions Team, on the topic of health coaching by lay professionals.
The speakers and Anya de Longh and Jim Phillips.
The document discusses the Take Charge intervention for stroke rehabilitation. It provides the following key points in 3 sentences:
The Take Charge intervention aims to improve intrinsic motivation in people who have had a stroke by focusing on personal factors like autonomy, mastery, purpose and connectedness. Research shows Take Charge can improve independence, quality of life, and participation when delivered in 1-2 sessions in the community months after a stroke. Take Charge puts the person with stroke in control of their rehabilitation by focusing the session on their personal goals and dreams rather than a clinician-led plan.
Taking Charge after Stroke (TaCAS) is an effective intervention for improving outcomes for people living in the community after a stroke. It aims to spark intrinsic motivation by putting the person with stroke "in the driving seat" and focusing on their dreams and goals beyond just the stroke. The TaCAS trial found Take Charge improved quality of life, independence, and participation at 6 and 12 months follow-up compared to usual care. It was effective with as few as one session and showed better results with two sessions. Take Charge is a low-cost, easy to deliver intervention that can change clinical practice by supporting better long-term stroke recovery outcomes through enhancing intrinsic motivation.
This document summarizes a pilot randomized controlled study that tested a community-based, 8-week life skills class for individuals with low mood and depression. Fifty-three individuals were recruited from the community and randomized into either an immediate access group that received the classes, or a delayed access control group. The classes aimed to provide cognitive behavioral therapy content through guided self-help materials. Results showed good recruitment, attendance, and satisfaction. Preliminary results suggest the intervention may improve anxiety and depression, especially for those taking antidepressants. The study provides estimates for an adequately powered future trial of this low-intensity, group-based intervention for managing depression and anxiety.
DBT is a type of cognitive behavioral therapy developed in 1993 to treat borderline personality disorder and reduce suicidal behaviors. It combines standard CBT techniques with acceptance-based strategies. DBT aims to help patients regulate emotions, improve interpersonal skills, and tolerate distress through weekly individual therapy, group skills training, therapist contact between sessions, and a consultation team for the therapists. Key aspects of DBT include balancing acceptance of oneself and the need for change, as well as balancing validation of experiences and problem-solving. Studies have found DBT can significantly reduce depression, hopelessness, and self-harm behaviors among adolescents.
Bronwen Bonfield, acceptance & commitment therapyMS Trust
This document describes an 8-week Acceptance and Commitment Therapy group for individuals with neurological conditions. The group aims to help participants adjust to living with their health condition by learning skills like mindfulness, values identification, and committed action. Sessions include interactive discussions, exercises, and homework. Evaluation found the group helped with psychological flexibility and quality of life, though some saw increased anxiety. Feedback from participants was positive and they found it helpful for managing their condition in daily life.
This document provides an overview of community psychiatry and the roles of nurses in community mental health services in Zambia. It defines key terms in community psychiatry like institutionalism, deinstitutionalization, and levels of prevention. It describes the introduction of community mental health services in Zambia in the 1970s with the roles of community health workers. It outlines the current community services provided and the levels of intervention as mental health promotion, primary prevention through education, secondary prevention through treatment, and tertiary prevention through rehabilitation. Finally, it lists the various roles of nurses in delivering community mental health services.
This document provides an overview of community mental health programs in India. It discusses the aims of community mental health programs, which include promoting mental health, early diagnosis and treatment of mental illnesses, and rehabilitation. It outlines the roles of community mental health nurses in providing primary, secondary, and tertiary prevention. This includes activities like mental health education, screening, crisis intervention, and helping patients regain functioning. The document also discusses the factors that led to the development of community-based mental healthcare in India to make services more accessible and reduce costs.
Community diagnosis involves identifying and quantifying health problems in a community through data collection and analysis. It aims to understand factors influencing community health, highlight available resources, and identify local health priorities to improve health status. The process involves initiating a project, collecting both quantitative and qualitative data, diagnosing the community's health status and determinants, and disseminating findings to stakeholders and the public. Challenges can include communities prioritizing other issues over real health problems and rushing conclusions without proper understanding. Regular assessment allows health programs to continuously adapt to community needs.
Similar to One Day Cognitive Behaviour Therapy (20)
Addiction, Opioids, Cannabis, Cocaine, Alcohol, Stimulants.pptAziz Mohammad
This document discusses drug addiction and focuses on opioid and alcohol addiction. It defines drug addiction as a chronic relapsing disorder characterized by compulsive drug use despite negative consequences. The document outlines various substances of abuse including opioids, alcohol, benzodiazepines, and stimulants. It describes the clinical presentations of addiction from experimental use to dependence and withdrawal. Significant details are provided on the neurobiology and pharmacology of opioids and alcohol and how they impact the brain's reward system and lead to tolerance and withdrawal. Health risks of addiction like infectious diseases and physical complications are summarized. The document concludes with discussing harm reduction approaches like methadone maintenance and needle exchange programs.
The document provides an overview of headaches and headache disorders. It begins by classifying headaches into primary and secondary types according to the International Classification of Headache Disorders. Tension-type headache is discussed in more detail, including its clinical features, diagnostic criteria, prevalence, pathophysiology, treatment options including pharmacological and non-pharmacological approaches, and its high rates of comorbidity with mental health conditions like depression and anxiety. The document emphasizes screening headache patients for psychiatric symptoms.
The document discusses mood disorders including bipolar affective disorder, its symptoms such as mania and depression, course and prognosis, etiology involving genetic and biological factors, and treatments including mood stabilizers, antipsychotics, and electroconvulsive therapy. It also covers distinguishing bipolar depression from unipolar depression, assessing suicide risk, and the importance of stopping antidepressants if a patient is already taking them due to risk of inducing mania or a mixed episode.
This document discusses the psychological impact of the COVID-19 pandemic. It notes that the pandemic has caused stress, anxiety, depression, and other mental health issues in the general population and healthcare workers. Risk factors for worse mental health outcomes include being female, younger age, excessive social media use, pre-existing psychiatric conditions, and quarantine. The document also outlines neurological effects that have been observed in some severe COVID-19 cases, as well as strategies to help minimize the psychological impact, such as self-care, correct information dissemination, support for healthcare workers, and successful vaccination programs.
This document discusses extrapyramidal symptoms, which are movement disorders that result from disruption of the basal ganglia network in the brain. It provides an overview of the anatomy of the basal ganglia and their role in motor control. It then presents a case scenario of a 16-year-old boy who developed acute dystonia after taking an unspecified nausea medication, likely causing the extrapyramidal symptom. The document outlines different extrapyramidal symptoms like parkinsonism, acute dystonia, neuroleptic malignant syndrome, and tardive dyskinesia. It provides recommendations for treating each condition, such as using procyclidine or benztropine for acute dystonia.
This document presents a long case presentation of a 13-year-old female patient from Charsadda. She has a history of excessive weeping, not eating, repetitive behaviors such as touching people's faces and picking things, and intellectual impairment. Her symptoms have been present since early childhood. A psychiatric evaluation found mood and speech abnormalities, intellectual impairment, and obsessive-compulsive-like behaviors. Differential diagnoses include autism spectrum disorder, obsessive-compulsive disorder with intellectual impairment, or schizophrenia. She is being treated with fluoxetine and olanzapine, along with behavioral management, educational support, and family counseling.
Mr. AR, a 50-year-old Afghani farmer, was admitted to the hospital due to a 2-year history of delusional beliefs that centipedes were crawling in his brain. He had received prior treatment from multiple doctors and faith healers without improvement. Upon examination, he was found to have a delusional disorder with comorbid depression. He was started on risperidone, fluoxetine, and ECT, which led to an improvement in his symptoms. His long term prognosis was considered guarded due to potential noncompliance and the entrenched nature of his delusional beliefs.
1. Said Mohammad, an 18-year-old male from Peshawar, presented with suspiciousness, aggression, insomnia, lack of appetite, and social withdrawal over the past month.
2. His symptoms began one month ago when he started socially withdrawing and expressing beliefs that his family was plotting to kill him. Over the past three days, he became aggressive, refused to eat or sleep, and believed his family would poison him.
3. He was brought to the hospital by his family after attempts to treat him with spiritual healers were unsuccessful. His symptoms appeared to develop after recently relocating with his family due to security concerns.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
3. Introduction
By 2030, depression is forecast to be the
leading cause of disease burden worldwide
World Health Organization. The Global Burden of Disease: 2004
Update WHO, 2008.
4. Introduction (cont..)
• Despite its high prevalence rates, numerous barriers
prevent seeking and accessing help so that depression
remains vastly undertreated.
• In the UK, 54% of people experiencing a depressive
episode did not contact their general practitioner (GP).
• Bebbington PE, Meltzer H, Brugha TSA, Farrell M,
Jenkins R, Ceresa C, et al.
Unequal access and unmet need: neurotic disorders and the use
of primary care services. Psychol Med 2000; 30: 1359–67
5. Introduction (cont..)
• In addition, although the public prefer
psychological treatment over medication for
depression, psychological services have been
very limited.
• Cognitive–behavioural therapy (CBT) is as
effective as medication in individuals with
moderate to severe depression, and has long-
term benefits.
6. Introduction (cont..)
• Psychoeducational interventions advertised as
‘depression’ workshops had a lower uptake, attracting
mostly people who had already used specialist services.
• Riedel-Heller SG, Matschinger H, Angermeyer MC. Mental
disorders – who and what might help? Soc Psychiatry Psychiatr
Epidemiol 2005; 40: 167–74.
• Layard R. The case for psychological treatment centres. BMJ
2006; 332: 1030–2
7. Introduction (cont..)
• Changing the name of the workshops to a non-diagnostic label of
‘self-confidence’ workshop led to a much higher uptake, with 39%
of self-referrers never having previously consulted their GP for
depression.
• A small randomised controlled trial (RCT) of 1-day self-confidence
workshops v. a waiting list control found the intervention to be
effective in reducing depression and improving self-esteem after
12 weeks.
• Clark DM, Layard R, Smithies R, Richards DA, Suckling R, Wright B. Improving
access to psychological therapy: Initial evaluation of two UK demonstration sites.
Behav Res Ther 2009; 47: 910–20
8. Introduction (cont..)
• So far, the effectiveness of these brief workshops has
only been demonstrated with a group of people
varying in depression symptoms in one relatively
deprived part of London, and no full economic
evaluation has been undertaken.
9. Introduction (cont..)
• This study aims to assess whether the self-
confidence workshops can be effective and cost-
effective in areas with different deprivation
levels, focusing just on people with depression.
• If shown to be successful, this could provide an
alternative effective and cost-effective
psychological intervention for people with
depression in the community, given the low take-
up rates for treatment for depression and
preferences for psychological treatment.
10. Method
Design:
A multicentre open RCT design was used, with
self-confidence workshops run across eight
boroughs in south London, with experimental and
waiting list control arm participants followed up
after 12 weeks.
Workshops were run between April 2010 and
July 2011. Ethical approval was obtained from the
King’s College Ethical Committee
11. The aims of the study were:
• (a) to assess whether the self-confidence workshops affected
depression, the primary clinical outcome;
• (b) to assess the effect of the workshops on the secondary
clinical outcomes of anxiety and self-esteem;
• (c) to investigate prognostic indicators of those who benefit most
from the workshops;
• (d) to assess the proportion of participants from difficult-
toengage groups that accessed the intervention, specifically GP
non-consulters and BME groups, in relation to local population
distributions;
• (e) to assess whether the workshops were cost-effective
compared with treatment as usual.
12. Study setting
• The study was run in eight London boroughs. Using rank
scores (range 1–326, where 1 indicates most deprived)
derived from the Index of Multiple Deprivation 2010, in
order of decreasing deprivation, the boroughs were:
• Greenwich (28),
• Lambeth (29),
• Lewisham (31),
• Croydon (107),
• Wandsworth (121),
• Bexley (174),
• Merton/Sutton (208), and
• Kingston upon Thames (255)
13. Study setting (cont..)
• Because workshops were designed to be
accessible to the community, a self-referral
process was used to recruit participants.
• Publicity was distributed for workshops 2–3
months before each introductory talk, which is
where participants were recruited.
14. Study setting (cont..)
• A5 flyers advertising free 1-day workshops entitled
‘How to improve your self-confidence’ were posted to
libraries, GP practices, community centres, leisure
centres and pharmacies.
• The same advertisement was displayed in local
magazines a few weeks before the introductory talk.
• Interested individuals were asked to email or
telephone for further information and to register for
the introductory talk.
• To maximise access, all workshops were held on
Saturdays in non-mental health settings such as
libraries, community centres or leisure centres.
15. Participants
Study participants had to be at least 18 years of age and have
depression, as indicated by a Beck depression Inventory score of 14
or above.
Other exclusion criteria were
• Unavailability for the workshop dates and people attending the
workshop together (because of the possibility of ‘contamination’
if they were randomised to different groups).
• Those who were unable to complete the baseline self-
assessment questionnaires as well as, under ‘other’, those
participants who had attention and concentration difficulties
during the introductory talk.
• Research assistants and/or workshop leaders assessed
participants against these criteria when registering or at the
introductory talks.
• No exclusion criteria were specified in relation to
antidepressants or concurrent psychological therapy
16.
17. Intervention
• Up to 30 people could attend each workshop.
• The day’s programme ran from 09.30 h to 16.30 h and was
structured into four sessions.
• First, information was given about the development of low
self-confidence and its emotional components, including
depression.
• The second session consisted of cognitive components of
low self-confidence, particularly identifying and
challenging negative thoughts.
• Behavioural methods for improving low self-confidence,
including problemsolving and assertiveness, were taught in
the third session.
• The final session was devoted to action planning, with
participants setting their own homework targets to start
improving their confidence.
18. Intervention (cont..)
• Workshops were run by two teams, each
comprising two clinical or counselling
psychologists, with two reserve psychologists
providing cover in case of unavailability.
Workshop leaders had an average of 3.5 years’
(range 2–7) post-qualification experience in
delivering CBT. Workshop leaders received
training in delivering the programme by
undergoing a 2-day training programme, in which
they observed a workshop and then ran a
workshop themselves under observation on a
single day.
19. Measures
• Self-report questionnaires were administered at the
introductory talk and 12 weeks after randomisation
and comprised the following measures.
• Primary outcome measures:
• Beck Depression Inventory-Second Edition (BDI-II,
referred to here as BDI): to measure severity of
depression. Scores are normally categorised into non-
depressed (<10), mildly depressed (10–19), moderately
depressed (20–28) and severely depressed (>29).
• An eligibility criterion used for this study was a BDI
score of 14 and above
20. Measures (Cont..)
• Secondary outcome measures
• Generalised Anxiety Disorder-7 (GAD-7). A
seven-item, fourpoint scale to assess anxiety
• Rosenberg Self-Esteem Scale (RSES). A ten-
item, four-point scale to measure changes in
self-esteem
21. Measures (Cont..)
• EQ-5D.
• A measure of health-related quality of life.
Health status is measured on five dimensions on
three-point scales. The associated tariffs for
England24 are then applied to calculate quality-
adjusted life-years (QALYs). The instrument also
includes a visual analogue scale, allowing
individuals to rate their current health status on a
scale from 0 (worst) to 100 (best).
22. Procedure
• Eligible participants were randomly allocated either to receive
the workshop after 3 weeks (experimental arm) or to wait for
12 weeks for the workshop (control arm).
• One month after the experimental arm workshop, participants
were invited to a non-therapeutic 2 h booster group session run
by the same workshop leaders to help consolidate learning.
• At follow-up, a 2 h group meeting was held for experimental
arm participants when outcome measures were completed at
the beginning of the session, followed by a group discussion
and signposting to other services as appropriate.
• Participants in the control arm were advised to see their GP as
usual during the 12-week waiting period.
• At 12-week follow-up, outcome measures for the control arm
were collected immediately before they attended the
workshop.
23. Randomisation & Masking
• Randomisation was performed using an online
randomisation system provided by the King’s Clinical
Trials Unit at the Institute of Psychiatry, King’s College
London. Randomisation was stratified by gender, self-
reported ethnicity (White/Other), depression (BDI
mild, moderate and severe categories) and borough.
• An open design was used as masking of arm allocation
for research assistants and participants was not
possible. However, the trial statistician’s masking was
maintained until the primary analysis
24.
25. Clinical outcomes
• Overall, 66% of experimental arm and 98% of
control armmparticipants completed
treatment.
• The proportion of participants lost to follow-
up was 8% greater in the experimental arm
compared with the control arm (95% CI, P=
0.018), but there was no significant difference
between the arms in the proportion actively
withdrawing from the trial (P= 0.29).
26. Clinical outcomes
• The BDI scores of the experimental arm were 5.3
points lower compared with the control arm. This
corresponds to an adjusted effect size of 0.55.
• Scores on GAD-7 were lower by 1.6 points and
RSES higher by 1.8 points in the experimental
arm.
• In the per protocol analysis, BDI scores were 7.7
points lower in the experimental arm (95%).
29. Satisfaction with workshop
• Overall satisfaction with the workshops was very high,
with 96% being mostly or very satisfied, and 96%
mostly or very satisfied with the amount of help
received.
• Most (95%) said they generally or definitely received
the help they wanted;
• 78% said most or almost all of their needs had been
met, and
• 98% would recommend the programme to a friend.
• The service helped 94% deal more effectively with their
problems and 93% would return to the service
30. Prognostic Factors
• In terms of prognostic factors, a higher
baseline BDI was found to predict a higher
outcome score.
• Being categorised in an employment group
other than paid employment was predictive of
a worse outcome, but the only statistically
significant difference was between
housewife/husband and paid employment.
• Ethnicity did not predict outcome.
31. Economic Analysis
• The average total intervention cost per person
in the experimental arm was £161 (s.d.= £76)
in the base case.
• In the best case scenario, it was £95 (s.d.=
£27) and in the worst case, it was £192 (s.d.=
£110)
32. Discussion
This RCT shows that at 12 weeks, 1-day psychoeducational
selfconfidence workshops are clinically effective at
improving depression in a community sample recruited
from areas of differing deprivation.
Additionally, the workshops were effective at reducing
levels of anxiety and increasing self-esteem.
There was a differential effect of gender on depression
outcome, whereby women benefited more from the
workshops than men. The workshops attracted difficult to
engage groups.
A quarter of the participants had not previously consulted
their GP for depression.
33. Discussion(cont..)
A higher proportion of individuals from BME groups
also participated than would be expected from the
local population distribution.
The economic analysis found no significant
differences in baseline total support costs between
the experimental and control arms.
Based on depressive symptoms (BDI) and the related
measure of depression-free days, the intervention
has a high probability of being cost-effective, given a
significant improvement in BDI in the experimental
arm over and above the improvement seen in the
control arm.
34. Strength and Weaknesses
• An effect size of 0.55 on the BDI compares favourably
with the mean effect size of 0.31 that has been found
in a meta-analysis of RCTs of psychological treatments
for depression in primary care.
• The study had a large sample size and was multicentre,
with the workshops covering some of the most
deprived (e.g. Greenwich, Lambeth) and least deprived
(e.g. Kingston upon Thames, Merton/Sutton) boroughs
in England.
• The results are therefore likely to be generalisable to
populations with varying levels of deprivation.
35. Strengths
• A major strength was its accessibility.
• Using a self-referral system to attract
members of the public with depression to the
workshops was very successful.
• Importantly, 25% of the participants had never
consulted their GP about their psychological
problems, presumably either not seeing their
GP about their depression or not raising their
depression if they did consult.
36. Strengths(cont..)
• This supports previous studies showing that providing
an accessible alternative route can help improve help-
seeking for depression by the public.
• Notably, there was a higher proportion (32%) of
participants from BME groups than expected.
• Participants represented 1.5 times the BME population
in five boroughs and twice the Asian population in
three boroughs.
• This is remarkable given the reluctance of BME
communities to consult their GPs for Psychiatric
problems
37. Comparison with other studies
The effect size of these self-confidence workshops
plus booster compared favourably with other
primary care interventions. It is higher than that of
a traditional 12-session ‘Coping with Depression’
course, which a meta-analysis found to have a
mean effect size of only 0.28.
It also compares well with computerised CBT for
depressive symptoms where a meta-analysis found
an effect size of 0.32.
38. Limitations
• Some limitations were that only self-report
measures were used rather than a clinical
interview.
• However, clinical diagnostic interviews for
depression were not feasible given the large
community samples.
• The workshops also attracted quite a high
proportion of graduates (44%), possibly biasing
the results.
• Follow-up data were only collected after 3
months.
39. Service implications
The self-confidence workshops approach could well
help the undertreatment of depression. It could
provide a viable and effective alternative way for
the public to directly access a brief and acceptable
psychological intervention for depression, by
offering early intervention to those who are
reluctant to seek help from their GPs, such as those
from BME communities, in areas of varying social
deprivation. It could also help circumvent the
common problem of underdetection of depression
in primary care.
40. Service implications
Given the dearth of evidence on the cost-
effectiveness of interventions for depression,
this study is a valuable contribution to the
evidence base. The intervention is relatively
cheap to provide, at around £161 per
participant, and there is no associated increase
in other support costs. It should therefore be
considered a cost-effective way of engaging
people who receive little in terms of other
support, despite high levels of distress.
41. • Funding
• This paper presents independent research
funded by the National Institute for Health
Research (NIHR) under its Research for Patient
Benefit (RfPB) Programme