This document outlines a workshop on group CBT for OCD led by Professor Karina Lovell. The workshop aims to: identify recommended OCD treatments in NICE guidelines; examine how group CBT fits in guidelines and evidence base; examine advantages and disadvantages of group CBT; and examine how group CBT works in practice. Group CBT is an effective treatment for OCD as shown in randomized controlled trials and meta-analyses, though more research is needed comparing it to individual CBT. The workshop covered OCD prevalence and impacts, NICE guideline recommendations including CBT with exposure and response prevention, and how group CBT is structured and implemented in a closed group format over 7-12 weekly sessions.
How to Improve Quality of Services by Integrating Common Factors into Treatme...Scott Miller
Presentation by Dr. Bruce Wampold about how the outcome and quality of psychotherapy can be improved by adding common factors to the treatment. Wampold documents the lack of difference in outcome between competing treatment methods AND the relatively large contribution made by common factors to outcome.
How to Improve Quality of Services by Integrating Common Factors into Treatme...Scott Miller
Presentation by Dr. Bruce Wampold about how the outcome and quality of psychotherapy can be improved by adding common factors to the treatment. Wampold documents the lack of difference in outcome between competing treatment methods AND the relatively large contribution made by common factors to outcome.
Research on Psychotherapy: A Presentation at the 2013 Evolution of Psychother...Scott Miller
A summary of the findings from research on psychotherapy presented on a panel discussion with David Barlow and Steven Hayes at the 2013 Evolution of Psychotherapy conference in Anaheim, California
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.
Regular practice of yoga promotes strength, endurance, flexibility and facilitates characteristics of friendliness, compassion & self-control. So this study was conducted to find out the effect of yoga on anxiety. This study was conducted on 200 anxiety cases having age range of 18 to 55 years. Hamilton anxiety scale was used to measure the anxiety. These cases were divide into two group randomly i.e. study group and control group. Study group was given certain set of yogic exercise. Both the groups were followed and results were compared where independent variables yoga and dependent variable Anxiety was used. Chi-square, independent t test, was used for data analysis. It was observed that Anxiety was significantly decreased after the yogic intervention (P=0.042S). So it can be concluded that yoga can reduce perceived stress improve well-being even more significantly so its recommend to do yoga regularly.
Summary of current research on routine outcome measurement, feedback, the validity, reliability, and effectiveness of the ORS and SRS (or PCOMS Outcome Management System)
Intervento di Peter Sturmey - The Graduate Center and Queens College, City University of New York - "Il trattamento dei disturbi del comportamento e autolesionismo nelle persone con spettro autistico" al preconvegno del "5 Convegno Autismi" organizzato dal Centro Studi Erickson il 14 e 15 ottobre a Rimini.
LRI05 - Self Help for Distress in Cancer - Is It Time For An RCT [Oct 2005]Alex J Mitchell
This is an academic presentation from 2005 outlining the case for a randomized controlled trial of a self-help programme to help people deal with distress and depression following the diagnosis of cancer
Research on Psychotherapy: A Presentation at the 2013 Evolution of Psychother...Scott Miller
A summary of the findings from research on psychotherapy presented on a panel discussion with David Barlow and Steven Hayes at the 2013 Evolution of Psychotherapy conference in Anaheim, California
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.
Regular practice of yoga promotes strength, endurance, flexibility and facilitates characteristics of friendliness, compassion & self-control. So this study was conducted to find out the effect of yoga on anxiety. This study was conducted on 200 anxiety cases having age range of 18 to 55 years. Hamilton anxiety scale was used to measure the anxiety. These cases were divide into two group randomly i.e. study group and control group. Study group was given certain set of yogic exercise. Both the groups were followed and results were compared where independent variables yoga and dependent variable Anxiety was used. Chi-square, independent t test, was used for data analysis. It was observed that Anxiety was significantly decreased after the yogic intervention (P=0.042S). So it can be concluded that yoga can reduce perceived stress improve well-being even more significantly so its recommend to do yoga regularly.
Summary of current research on routine outcome measurement, feedback, the validity, reliability, and effectiveness of the ORS and SRS (or PCOMS Outcome Management System)
Intervento di Peter Sturmey - The Graduate Center and Queens College, City University of New York - "Il trattamento dei disturbi del comportamento e autolesionismo nelle persone con spettro autistico" al preconvegno del "5 Convegno Autismi" organizzato dal Centro Studi Erickson il 14 e 15 ottobre a Rimini.
LRI05 - Self Help for Distress in Cancer - Is It Time For An RCT [Oct 2005]Alex J Mitchell
This is an academic presentation from 2005 outlining the case for a randomized controlled trial of a self-help programme to help people deal with distress and depression following the diagnosis of cancer
Acceptance and Commitment Therapy as a Web-based Intervention for Depressive ...Tejas Shah
To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control
condition.
What are the key components of effective OCD treatment offered in Chennai's p...tharahiniindhu
This presentation explores best practices in treating OCD at psychiatric clinics in Chennai.
We will discuss evidence-based approaches and the latest advancements in OCD treatment in Chennai.
Visit: https://www.chennaiminds.com/anxiety-ocd/
Answer each topic in at least two paragraphs.Topic 1 List.docxjustine1simpson78276
Answer each topic in at least two paragraphs.
Topic 1: List and briefly discuss various operating system services.
Topic 2: Briefly discuss the user interfaces of operating systems
Topic 3: Discuss how the round robin scheduling algorithm works.
Topic 4: Discuss the strength and weakness of each of the CPU scheduling algorithm.
Topic 5: Briefly discuss the needs for virtual memory.
Topic 6: Briefly discuss how virtual memory works.
Topic 7: What Ubuntu features do you like the best? Why?
Topic 8: What Ubuntu features do you like the least? Why?
Week 6: Foundations of Group Work and Types of Groups
And as participants improve, the group as a whole benefits. Members can be agents of change for each other. Seeing others' progress can help group members realize they, too, can cope and feel better.
—Dr. Nina W. Brown, “Power in Numbers”
Group therapy can be very beneficial for clients. In fact, research has shown that for many clients, group therapy is as effective as individual therapy. Members of groups are not only able to influence change within each other, but they are often able to more easily relate to the guidance of peers than that of a therapist. With the increasing popularity of this therapeutic approach, it is essential for you to have a strong foundation in psychotherapeutic techniques for groups.
This week, as you explore group therapy, you consider how you might apply current literature to your own clinical practice. You also examine your own practicum experiences involving group therapy sessions.
Photo Credit: [Tom Merton]/[Caiaimage]/Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
· Chapter 11, “Group Therapy” (Review pp. 407–428.)
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
· Chapter 1, “The Therapeutic Factors” (pp. 1–18)
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
· Chapter 2, “Interpersonal Learning” (pp. 19–52)
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
· Chapter 3, “Group Cohesiveness” (pp. 53–76)
Leszcz, M., & Kobos, J. C. (2008). Evidence-based group psychotherapy: Using AGPA's practice guidelines to enhance clinical effectiveness. Journal of Clinical Psychology, 64(11), 1238–1260. doi:10.1002/jclp.20531
Note: Retrieved from Walden Library databases.
Marmarosh, C. L. (2014). Empirical research on attachment in group psychotherapy: Moving the field forward. Psychotherapy, 51(1), 88–92. doi:10.1037/a0032523
Note: Retrieved from Walden Library databases.
Microsoft. (2017)..
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. Aims of the workshop
Identify the recommended treatments for OCD
(NICE guidelines)
Identify how and where group treatment for OCD
is incorporated into the NICE guideline
Examine the evidence base for group CBT for
OCD
Examine the advantages and disadvantages for
group CBT for OCD
Examine how group therapy for OCD works in
practice
3. The prevalence of OCD is estimated at:
A
1-3%
B
4-7%
C
8-11%
D
12-15%
4. NICE Guidelines do not recommend
which treatment for OCD?
A
B
CBT (with exposure and SSRI’s
response prevention)
C
D
Psychodynamic
psychotherapy
Group CBT
5. Which of the following modes of delivery have been
tested with OCD:
1) Bibliotherapy
2) cCBT
3) Group CBT
4) Telephone
A
1,2,3 & 4
B
1,3 & 4
C
1& 4
D
2,3 & 4
6. Which of the following low intensity interventions do NICE
recommend:
1) cCBT
2) Brief individual CBT
3) Group CBT
4) CBT delivered by telephone
A
1, 2, 3 & 4
B
1&2
C
2, 3 & 4
D
2&4
7. Nice guidelines determine low intensity
treatments as less than how many
therapist hours?
A
B
5
10
C
D
15
20
8. The most common outcome measure used in
treatment studies is the ?
A
B
BDI
OCC
C
CORE-OM
D
YBOC’s
9. In 1996 OCD was ranked as the ?th leading
cause of disability
A
8th
B
9th
C
10th
D
11th
10. Obsessive compulsive disorder
OCD is a major disorder is and under
recognized public health problem.
10th leading cause of disability by
WHO
Lifetime prevalence (1.9-3.0%)
There is evidence that without
adequate treatment the disorder
tends to have a chronic fluctuating
course
11. Obsessions
Obsessions are repetitive, recurring thoughts,
ideas, images or impulses that are experienced
as intrusive and are usually distressing or
anxiety provoking. Such thoughts are often
centered on dirt and contamination, accidental
harm, illness, aggression, sex, orderliness and
perfection.
12. Compulsions
Compulsions (rituals) are repetitive and
intentional acts and serve to reduce anxiety the
thoughts provoke. The person recognizes that
their behavior is excessive or unreasonable.
13. NICE Guidelines
Obsessive compulsive disorder:
core
interventions in the treatment of obsessive compulsive
disorder and body dysmorphic disorder
Published 2005
14. What is NICE?
National Institute for Health and Clinical
Excellence
Part of the NHS
Established 1999
Produces Clinical Guidelines for the
“appropriate treatment and care of people
with specific diseases and conditions
within the NHS in England and Wales”
15. What does the NICE OCD/BDD
guideline cover
Children, young people and adults with OCD/BDD –
mild, moderate and severe functional impairment
A stepped-care approach to recognition, assessment,
treatment interventions, intensive treatment and inpatient
services, discharge and re-referral
Who is it aimed at?
Healthcare professionals who share in the treatment and
care of people with OCD/BDD
Commissioners of services
Service users, families/carers
16. NICE recommendations
identified as key priorities
All people with OCD should have
access to evidence-based treatments:
CBT including exposure and
response prevention (ERP) and/or
pharmacology
CBT (including ERP) should be
offered in a variety of formats
17. Treatment options for adults with OCD
Mild functional
impairment
Brief CBT (+ERP)
< 10 therapist hours
(individual
or group
formats)
Moderate functional
impairment
Offer choice of:
more intensive CBT
(+ERP)
>10 therapist hours
or
course of an SSRI
Patient cannot engage in/CBT
(+ERP) is inadequate
Severe functional
impairment
Inadequate
response at 12
weeks
Multidisciplinary
review
Offer combined
treatment of
CBT (+ERP)
and an SSRI
19. Low intensity interventions
Brief individual CBT (including ERP)
using structured self help
Brief individual CBT (including ERP) by
telephone
Group CBT (including ERP)
20. Exposure and response
prevention
Exposure is the therapeutic confrontation to a
feared stimulus in imagination or in vivo until
fear subsides (process known as habituation).
Response prevention is resisting carrying out
the ritual.
21. Small group work
In small groups discuss for 10 minutes the
advantages and disadvantages of group
treatment for people with OCD
Identify a scribe to feedback to the large
group
22. Advantages of group treatment
Cost effective
‘sharing’ of experiences between
participants
Possibly more motivating for participants
23. Disadvantages of group
treatment
Some people don’t like group treatment
Difficult to organise at a convenient time
for all group members
It may be more difficult to involve
families/relatives
24. Group CBT – The evidence base
Cordioli et al (2003) RCT: compared efficacy of group CBT with
waiting list control
McLean et al (2001) RCT: compared efficacy of two group
treatment types (CBT or ERP) by two time frames (immediate or
delayed start)
Jones & Menzies (1998) RCT compared efficacy of DIRT with a
waiting list control
Fals-Stewart et al (1993) RCT compared effectiveness of group
behaviour therapy with individual behaviour therapy
Emmelkamp et al (1988) RCT compared group cognitive therapy
(RET) with group behaviour therapy (exposure in vivo)
25. Systematic review
Reviewed 13 trials of group CBT treatment. Overall
pre–post-ES of these trials of 1.18 and a between-group
ES of 1.12 compared with waiting list control in three
randomized controlled studies indicate that group
CBT/ERP is an effective treatment for OCD. Group CBT
achieved better results than pharmacological treatment
in two studies. One study found no significant differences
between individual and group CBT.
Jónsson & Hougaard Group cognitive behavioural therapy for obsessive–
compulsive disorder: a systematic review and meta-analysis (2009). Acta
Psychiatrica Scandinavica, Volume 119, Pages: 98-106
26. What does this evidence mean
Post treatment, group CBT was found to be
more effective than either no therapy or
sertraline, but no different than ERP
There are no RCTs in adults with OCD
comparing the effectiveness of group CBT with
individual CBT.
Group CBT for OCD is effective
Further research is needed to evaluate individual
versus group CBT for OCD.
27. Group CBT - Application
Pre attendance
Detailed individual assessment of problem
Explanation of group process,
expectations and treatment model to
enable the individual to make an informed
decision
Willingness and commitment to participate
in group CBT
28. Group CBT - Application
Closed group format
5 – 12 participants
1 or 2 therapists
Weekly or twice weekly sessions
1 – 2.5 hours duration
7 -12 sessions plus follow up
Pre, post and follow-up measures
29. Group CBT - Application
Education regarding OCD and
treatment model
CBT including ERP
Relapse prevention
Between session tasks tasks
Monitoring progress
Telephone contact between sessions if
required
31. Evaluation
Was the workshop at the right level
Did it cover what you wanted
What did you like
What would you want to change if we were to do
the workshop again
32. Thank you for listening
Karina.Lovell@manchester.ac.uk
Editor's Notes
1960’s
3-13%
1,2,3 &4
1,2,3 &4
1995
Problem solving
Problem solving
NOTES FOR PRESENTER
Please refer to the NICE guideline and QRG (pages 10 and 11) for the full overview of treatment pathway
Mild functional impairment: if the patient cannot engage in CBT (with ERP) or CBT (with ERP) is inadequate, consider:
Moderate functional impairment:if inadequate response at 12 weeks, multidisciplinary review and consider:
Severe functional impairment:if inadequate response at 12 weeks, or no response to SSRI or patient has not engaged in CBT, consider: (refer to MDT expertise in OCD for assessment and further planning next slide 15)
Refer to QRG (page 10) and NICE guideline –
Section 1.5.1 to 1.5.1.7
The intensity of psychological treatment has been defined as the hours of therapist input per patient. By this definition, most group treatments are defined as low intensity treatment (less than 10 hours of therapist input per patient), although each patient may receive a much greater number of hours of therapy.
CBT and ERP can be delivered in a variety of ways e.g. individual / group therapy, telephone, books and self-help.
Krone et al (1991) 36 patients in group programme
DIRT 1 therapist